LDN Video Interviews and Presentations

Pharmacist Stephen Dickson, LDN Radio Show 30 Jan 2020 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Stephen Dickson, Pharm shares his Low Dose Naltrexone (LDN) expereince on the LDN Radio Show with Linda Elsegood.

Stephen Dickson has been working with LDN for over a decade in the UK. As well as running the well established private medical department of Dickson Chemist, he also runs 7 NHS pharmacies in Glasgow. 

Dickson’s Pharmacy has compounded LDN since 2006 and is a leading producer and educator of this safe, effective, and inexpensive off-label drug. Now, many thousands of patients are benefiting from LDN, and ever-increasing numbers of doctors are recognizing it’s powers and prescribing it with confidence. 

This is a summary of Stephen Dickson’s interview. Please listen to the rest of Stephen’s story by clicking on the video above.

Pharmacist Tarek El-Ansary, LDN Radio Show 10 July 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: My guest is Tarek El-Ansary. He's the owner of Carmel Valley Pharmacy. He's also a doctor of pharmacy. Thank you for joining us today. Tarik 

Dr Tarek El-Ansary: yes, my pleasure. Thank you for having me. 

Linda Elsegood: Could you give us your background, please? 

Dr Tarek: Yes, certainly. I've been a pharmacist for almost 21 years. I graduated in 1998 from the University of Pacific School of Pharmacy with a doctorate in pharmacy. I worked in different chain pharmacies for the first eight years. And then I went on to purchase my first pharmacy, an independent pharmacy, and it was retail on need. We barely did any compounding.  I went on to buy a few more pharmacies. And we had a lot of success with that. And then about five years ago in 2013, I started Carmel Valley pharmacy and I wanted to do something different, and, start with compounding and learn all about integrative and functional medicine that goes along with compounding. And that has really opened me up to many, many more opportunities and tools in the treatment options that are available, and it's just been, it's just been an amazing ride and process.  

Linda Elsegood: wow. How would you describe your pharmacy now? 

Dr Tarek: So my pharmacy now is really just focused on customer service and patient care. We do, we're a hybrid pharmacy, which means we do both compounding, and then we also do the retail commercially available pharmaceutical products that are made by the pharmaceutical company. So we do both. And it's a walk-in. People can come in, and we do also offer delivery and mailing, and a lot of consultations. We spend a lot of time, between myself, the pharmacist and the patient, and also interacting with the doctor, getting them involved. And we really do practice the triad of medicine, which is the relationship between the doctor, the pharmacist, and the patient.  

Linda Elsegood: We are moving towards a pharmacist in the UK playing a role. Normally if you wanted any medical advice, you got it from your doctor. You didn't get it from your pharmacist, but it's still not working. How it is working in the States because you there, you just go to the pharmacy and speak to the pharmacist, but the pharmacist doesn't relay that back to the doctor.  So we don't have it working.  It's a bit dysfunctional. Really. It's not as good as what you do so 

Dr Tarek: well, It doesn't work that often unless it's a type of pharmacy like I have when other pharmacies I've been at, which just retail me, it's still, we're still really behind on that also. 

Linda Elsegood: Okay.  

Dr Tarek: Yeah. It's just the type of practice I have now is different, and so now that triad works really well. 

Linda Elsegood: And it's so good that you look into supplements and lifestyle and things that maybe the doctor wouldn't have the chance or time to go through. 

Dr Tarek: Absolutely. You know, with the seminars I attend, I've learned so much about supplements, and unfortunately, the pharmacy schools and the medical schools are just not getting into that and teaching anything about supplements even to this day.

And so with the seminars, I'm learning a lot and doing them on myself, starting them on myself and my family members, and seeing a significant difference in our own health. And so it's giving me the firsthand knowledge to recommend for my patient. And the feedback has been really good and positive, which further reinforces, you know, an ???  to be able to carry on a message to patients who need supplements and specific areas of problems that they have.

Linda Elsegood: When did you first hear about LDN? 

Dr Tarek: Uh, I think it was a seminar I attended. I go to PCCA And a A4M seminars, at least a couple of times a year just to learn the new things and keep up on my knowledge. And, probably about three or four years ago, the first time I heard it brought up at a seminar and in it was, it just sounded, it's really exciting and amazing.

At the same time, a few prescribers in my area started prescribing it and then I was able to spread the word to other prescribers that were open to doing compounds and new things that they hadn't heard about. And so we've seen it really spread since then.  

Linda Elsegood: and you're in California. So I was just thinking about the supplementation.

Do people in California need to take Vitamin D, or do they get enough sunshine? 

Dr Tarek: I would say they still need to take vitamin D. I would say just about everybody. The average level of an American, even including California is 15 and anything below 50 is considered deficient in vitamin D. Actually if you're not above 80, you're not considered optimal. And so you don't get a lot of the preventative effects of vitamin D like preventing cancer and stimulating and really helping to have a healthy immune system. And so by just being at 50, all you're doing is helping to keep your bones healthy, but you're not really helping with the immune system.

From what I've learned, it's for every thousand units you supplement per day, you bring that level up by ten, so if you're at 15 and you take 5,000 units a day, you're going to be at about 65 so you're going to be above the 50 Mark, but you're still not going to be optimal. So that kind of gives an idea of where it is, and we do see people getting tested when they are taking and it kind of, it really does follow along those lines. 

Linda Elsegood: So how long have you been compounding LDN?

Dr Tarek: We've been doing it for probably about four years now. We opened about five years ago, a little over five years ago, and we've been doing compound LDN for the last four years.

Linda Elsegood: What forms do you compound in?

Dr Tarek: Oral,  topical and transdermal. 

Linda Elsegood: Okay. So. When you say oral, is it capsules, tablets? 

Dr Tarek: Yeah, 99% of the time we have done it as a capsule. There are a few that we've done in liquid for small children that can't swallow capsules. And then also if we want systemic absorption, we can do it in transdermal effect, where we put in a light that's on base. So it gets absorbed really well into the systemic circulation. And then topically, we've used it for scars and, and, or itching type skin reactions. We've seen great effects because usually scars and itching and like psoriasis or, or rash, that's part of the immune response. And since we know LDN has a significant effect on our immune system. We’ve been seeing it having a great effect.  

Linda Elsegood: let's 

Dr Tarek: use topically. And then with transdermal always seen it used when we want to insist into the systemic circulation, especially with small children who are on the autistic spectrum. They're getting it absorbed really well and seen great effect. 

Linda Elsegood: So do you have any case studies?

Dr Tarek: Yeah. Yes, I do. I had seen them when they were presented at some seminars. I do not have them handy. I have seen case studies done specifically just as an example, I think it was the glutathione 20% mixed with LDN, 0.5% in a transdermal cream if used with autistic children on the spectrum, and a significant effect that was. That had just by applying that each night by the parents and just rubbing it between the shoulder blades and giving the child a message at nigh with the cream and the parents, the feedback has been really good. And we have about five or six small children who get on a regular basis at our pharmacy and the feedback and the parents had, they tell me that it's made a huge difference in their children's behaviour and their life.

Linda Elsegood: So how old are the children when they starting at the end? What age are they diagnosed normally with, with autism? 

Dr Tarek: It definitely ranges and we've seen as small as four or five years old. I would say probably the most common age is around 10. I think there is a level of confusion and denial on the parents' part of not understanding what is going on with the child's behaviour when they start to present with autistic behaviour around the age of four and five that I think there are a few years where they're just not understanding what's going on and to actually take them to a physician who can make a correct diagnosis.

Linda Elsegood: Yes. I knew a little boy who was autistic. A terrible shock for the parents, I must say. 

Dr Tarek: We have a nephew in our family that is dealing with it and there were a few years of just not understanding what was going on before the diagnosis was made. 

Linda Elsegood: Yeah. I just have to tell you, we, in the first documentary, we did the LDN story, we interviewed a little boy called Jacob, and he's a piano protege. He can just play Beethoven just without looking at music, and he's so talented, but he was all. I would say it was, but of course, he still is, but he doesn't show signs of it anymore. But when he was small, he wasn't responsive to his parents. He didn't want to be hugged. He didn't want to be cuddled. And as he grew older, he just used to fight them the whole time, and regularly he used to smack his mum across the face.

And one day after he'd been on LDN, she was always saying to him, you know, I love you, Jacob. I love you, Jacob. And he just didn't respond, apart from slapping her. But this particular day she said, I love you, Jacob. And he looked at her, and I think he was three or four, and he said, “I love you, mommy.”

And she called her husband, and she said, quick, quick, get the video camera. I want to ask him again, you know, say it again and see if he'll do it, and we will record it because he may never in his life. Say it again. You know, I want to catch it. And he just went from strength to strength—a totally different child. Absolutely. Amazing story.

Dr Tarek: I think there's many like that with LDN.

Linda Elsegood: Yes. Exactly. It gives you hope, but like you were saying, it's the confusion to start with, isn't it? To get that correct diagnosis. So, yeah. Is important. So with your capsules, what filler do you use? 

Dr Tarek: There are two different fillers that we use. Typically we started with avicell, which is just very clean a filler that has no side effects, no inflammatory or reactive effects on, especially specifically to patients who have sensitivities. So we never compound with anything that would contain lactose or gluten or corn starch as a filler. But now there's been a few naturopathic doctors who. They loved the idea of compounding using the filler ginger root, because of its properties, especially with the gut health and just a soothing effect it has on the gut.

So that has been one of our common fillers now with the LDN, and other meds that we compound is using ginger root as a filler. 

Linda Elsegood: Wow. Do you know, I've not heard of that before. How interesting. Sorry, ginger. Tell, make a note of that. Wow. I love ginger. 

Dr Tarek: Yeah. Yeah. It's a great idea to mix it with their LDN.

Linda Elsegood: but of course, being a capsule, you swallow it so you wouldn't notice anyway.

You would use that. It was ginger. 

Dr Tarek: Yeah. You don't get the bad taste. Yeah. 

Linda Elsegood: Oh, bad taste. I love the taste of ginger. 

Dr Tarek: Well, it can, it can have some good tastes, but I think the ginger root powder that we, you know, that we're using its a clean powder, but it does have a little bit of a bitter taste.

Linda Elsegood: does it?

Okay. So what would you say your main patient population is that use LDN? Would you know that? 

Dr Tarek: Yeah. Uh, I would say it's adults over the age of 18 mostly getting it in capsule form. The most common dosing that we see is 2.3 or 4.5 milligram where the, you know, the vast majority is definitely below 4.5 milligram due to the fact that most studies show that the modulating effects of the receptor happen below 4.5 milligrams and we just, I don't think there are enough studies out there to know what happens when we go above 4.5, and I think the consensus is there's not really a need to go above 4.5 for most uses and that we see the effect, the response we want below 4.5 without the side effects. And so that's what we mostly see and the uses, it just ranges significantly between just gut issues, any autoimmune issue, neurological issues and pain. And on and on, it just seems like they keep coming up with a medical diagnosis that they try it on and they see good effects and the side effect profile, even though it's listed as sleep disturbance or vivid dreams. In speaking to my patients, and we have a few hundred different patients getting it each month. The feedback has maybe been one or two has actually told me that they thought they had a, it affected their sleep, but then again, you know, there's a lot of things that could affect our sleep.

So it could have been a coincidence. 

Linda Elsegood: Yes. It seems to be a drug that is well tolerated. I'm must say from my fifteen years of experience of talking to doctors and pharmacists and patients. The people who mainly tend to notice side effects are people that are ultra-sensitive to drugs, and it's usually people who've got fibromyalgia or chronic fatigue syndrome. Those people seem to be so ultra-sensitive that they have to start very, very low and increase very, very slow. People get there if they're patient. But yeah, if you find it is too much for you, it's definitely an idea to have a very low dose and increase slowly. 

Dr Tarek: Yeah, and that's a great point. And the patients who do require the slow titration up, we do the 0.5-milligram capsules, and it's anywhere from every three to seven days. They start to increase from one capsule a night to the second capsule to go to one milligram, and they slowly increase as they can tolerate it, so they get their desired effect, and then we stay at that dose.

Linda Elsegood: I mean, there are some doctors who prescribe up to six milligrams, some even go higher, but there are quite a few that try six. And with the chronic fatigue, there are some doctors who actually use double dosing, night and morning. And it's reported that those patients get more of the boost of energy, which is very helpful in those cases. What about thyroid patients? Do you have many of those on LDN? 

Dr Tarek: We do, specifically when they have autoimmune, when the underlying cause of their thyroid issues is autoimmune, which I think that the large majority of them, and you know, specifically Hashimoto's. When the doctor OD is open and familiar with the uses of LDN, and they do use that on those patients, we're able to see a reduction in dose and their thyroid medication and supplementation, and we're seeing thyroid antibodies reduce just by initiating LDN. 

Linda Elsegood: That's amazing, isn't it? How that happens.

Dr Tarek: about, do you use more often in the ones that said it is helping, 

Linda Elsegood: but I mean, the people are using it for Hashimoto's, hypothyroidism, hyperthyroidism, Graves' disease, Sjogren's syndrome. I mean, they're all thyroid, aren't they? And there was a paper written on Sjogren's syndrome last week, which was interesting.

Yeah. So, yeah. And then you get people who think, how can LDN work for so many different conditions, but it's to do with the autoimmune component. We didn't realize 15 years ago how well LDN worked for pain. It doesn't have to be a condition that is all autoimmune, which causes the pain for the LDN to work. Yeah. And neuropathic pain, especially in diabetics, it works really well for phantom limb pain as well is, another quite new thing that I've learned about, but there is always something happening with LDN. I don't know whether it's common knowledge yet in California, but. pain specialists are using ultra-low-dose naltrexone alongside opioids and weaning patients off the opioids.

That's very exciting. We're actually going to be filming a documentary on LDN and pain because there are so many patients who are addicted to pain medications through no fault of their own. You know, they haven't been buying drugs on a street corner. These are prescription drugs, and it's still the same, isn't it? To try and get off those medications. You still go through the awful withdrawal symptoms, but by using ultra-low-dose naltrexone where you. I'm starting on a microdose and increase that slowly, decrease the opioid and the people that I've spoken to who it worked really well for. It's amazing. Totally amazing.

And quite quickly, because I thought you'd have to do it over a long period of time, but it doesn't seem to be as long as I would think. 

Dr Tarek: Yeah. And those ultra micro low doses, are generally very low. So it's really important for anybody who wants to try it. They really need to be careful and, and understand instead of the dosing we've been talking about thus far, which is 0.5, up to 4.5 milligrams, uh, with, with people who are on opioids, we currently, we want to go start at 0.001 milligrams, so a very ultra-low dose. And because we don't want to throw them into withdrawal and cause them more harm, we want to try to help them.

Linda Elsegood: Exactly. And it's something that you would never, ever try and do on your own. It has to be under medical supervision because you could become stuck.  Definitely. 

Dr Tarek: Yeah. 

Linda Elsegood:  What pain conditions have you your patients been using LDN for?

Dr Tarek:  I've seen it used for some fibromyalgia patients. And some neuropathic pain patients we've asked. We've also included it in our transdermal pain creams, so we are starting to add that into there and seen a lot of, a lot of great results with it. I wish we could use it with, uh—complex regional pain syndrome. The problem is those patients are generally all already on high doses of opioids, so we can't use it on them. But we have seen that it's really effective for those patients. But the patients that we have at our pharmacy, they're already on really high doses of opioids, so they just can't be on it. 

Linda Elsegood: Well, maybe they could try the ultra-low dose. 

Dr Tarek: Yeah, they could. You know, we were just starting to learn about it.

And that’s the exciting thing about LDN is we're constantly in a learning phase with this. And so we're learning more and more uses and more and more types of doses and, and, that's something that we, we want to try to communicate to those physicians that are treating those patients. And. hopefully, we can get an open ear that's open to learning more about it.

Linda Elsegood: Yes. I mean, Dr. Deepak Chopra wrote a paper long while ago now, probably 2015 on complex regional pain syndrome and LDN, not a very interesting paper, but there are more and more pain specialists looking into LDN for pain. And I have spoken to many patients who are not on just morphine or fentanyl patches, but a cocktail of medication and they say that their pain is still on a score of one to 10, 10 being worst, nine on a daily basis.

And it's awful to think that people have to suffer like that, isn't it? 

Dr Tarek: Yeah, I agree.  Yeah, I have a young lady who comes to our pharmacy regularly who has the condition and, when it's acting up, and she comes in, you can, she's just kind of , bent over and walking very slowly, and you can tell that her pain is definitely at a ten on a scale of one to 10 and even though she is currently on high doses of opioids, it's just no stopping it. The pain is at a ten and, and she can't seem to find any relief at that point. Very, very hard to see someone suffer like that.

Linda Elsegood: Unless you've witnessed it and experienced what pain can be like. You think that you know you've got a headache, you take two paracetamol, you feel okay, but there is pain out there that does seem untreatable, doesn't it? Yeah, I can remember. Yes. Dr Samyadev Datta, he's also a pain specialist, and he was telling me how he has a practice, but he also works in the hospital, and he will get a phone call in the middle of the night that there's a patient, you know, screaming out in pain, the pain levels that are a ten and he will go in, and he'll say, okay. This patient is on 14 painkillers on this cocktail. They’re on too many pain medications. It's not going to work. You've got to take them off this, this, this and this, and sorting it all out. But he's very for LDN and ultra-low-dose and there is so much more coming in this in the next year, I am sure because. The PCCA, talking about LDN, more other conferences or talking about LDN? We have an LDN conference not that far from you really, is it? California? Portland in Oregon. 

Dr Tarek: Yeah. Great.

Linda Elsegood: Hopefully, we will be able to get you there. Because meeting all these people and actually being able to put your questions to them. It's an amazing tool. Amazing tool. Well, if you would like to tell our listeners how they can contact you and what your website addresses, that would be good. 

Dr Tarek: Yes. So the name of my pharmacy is Carmel Valley Pharmacy. The website is CarmelValleyPharmacy.com. And the phone number is (858) 481-4990. And lastly, my email, and if you go to the website, you can find my email, but just to mention it, it is, CarmelValleyRX@yahoo.com and I can be reached at any of those ways and I would be happy to receive any more questions or orders for prescriptions or any needs that you have with compounding or regular prescriptions 

Linda Elsegood: Thank you.

Dr Tarek: It was my pleasure. Thank you for the invite.

Linda Elsegood: Carmel Valley Pharmacy is a family-owned independent pharmacy with a mission to provide the best pharmacy experience possible with exceptional customer service, access to knowledgeable pharmacists and cost-friendly prices. Cool. (858) 481-4990.  Call Carmell Valley pharmacy.com the friendly store for their state of the art compounding lab and waiting to help you.

Any questions or comments you may have. Please email me. Linda, contact@ldnresearchtrust.org. I look forward to hearing from you. Thank you for joining us today. We really appreciated your company. Until next time, stay safe and keep well.

Pharmacist Phil Altman, LDN Radio Show (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Phil Altman, Pharm shares his Low Dose Naltrexone (LDN) experience on the LDN Radio Show with Linda Elsegood.

Phil Altman is a member of PCCA and IACP for over a decade and a graduate of Massachusetts College of Pharmacy. Compounding since 1997, he is recognised as one of the leading authorities on women’s health issues in Westchester County and beyond. 

Phil’s integrative philosophy is to treat the whole person, providing the most up to date advice on how to achieve optimum nutrition through proper use of nutritional supplements along with herbal and homeopathic remedies.

This is a summary of Phil Altman’s interview. Please listen to the rest of Phil’s story by clicking on the video above.

Pharmacist Victor Falah, LDN Radio Show (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Pharmacist Victor Falah in the United States shares his Low DoseNaltrexone.

The first time I heard of LDN was in 1994 trough a patient that came to my pharmacy  with a prescription.

Now we have a hundred new patients a week.

And the majority of them are really very happy. Not everybody is using it for the same purpose.

When we started, we get it for people with HIV and then after that, it tends to be good for Multiple Sclerosis patients. And most of our patients right now really have Multiple Sclerosis.

People with MS are very happy with it.

Some patients can have some type of stomach issues and others insomnia but it will pass after a week or two.

I would like to say to people to give it a try for at least 3 months. If you have any kind of side effects give us a call.

Pharmacist Victor Falah's interview. Listen the YouTube video for the full interview.

Pharmacist Terri Weisenbach, LDN Radio Show (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Pharmacist Terri Weisenbach shares her Low Dose Naltrexone (LDN) experience on the LDN Radio Show with Linda Elsegood.

Pharmacist Terri Weisenbach is a partner and vice president of Belmar pharmacy in Colorado, which has been compounding since 1985. They began in hormone replacement therapy yet realised the effectiveness of Low Dose Naltrexone (LDN) a long time ago.

Her abundant knowledge and experience of prescribing LDN has benefited many of her patients in avoiding any potential side-effects of LDN while finding the optimal dose in order to combat the patient’s illness.

Terri Weisenbach’s pharmacy ships to 44 States, covering the majority of the USA. 

This is a summary of Terri Weisenbach’s interview. Please listen to the rest of Terri’s story by clicking on the video above.

Pharmacist Tapio, LDN Radio Show (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Pharmacist Tapio from Norway who takes Low Dose Naltrexone shares his experience.

Since I am taking LDN I have more energy. I sleep better. And another thing has to do with blood circulation. I have hemorrhoids, bleeding sometimes, but since I started with LDN, then the bleeding is it's going away.

It's not easy to get a prescription here in Norway because doctors are not aware of this stuff.

There is a discussion group in Facebook with LDN that is amazing. There's like 8,000 members there.

And a prescription here can be quite expensive so to anybody in Norway I suggest looking for a prescription and buying it at boots Pharmacy.

If you get the doctor who is not interested, so you will have problems getting a prescription. I know we have lots of people getting their prescriptions via England.

Summary from Pharmacist Tapio's interview from Norway. Listen the above YouTube video for the full interview.

Pharmacist Susan Merinstein, LDN Radio Show 2014 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Pharmacist Susan Merinstein shares her Low Dose Naltrexone (LDN) experience on the LDN Radio Show with Linda Elsegood.

Susan Merinstein has been a practicing pharmacist for 33 years and became a compounding pharmacist 13 years ago. She received my Bachelor of Science degree from University of Pittsburgh. She has an active license to practice pharmacy in the state of Pennsylvania.

She have obtained more than 300 hours of continuing education in hormone balancing and compounding, holistic approaches to individual patient problems with focus on the biochemistry and interactions of thyroid, adrenals and sex steroids.

In this interview she explains the success behind Low Dose Naltrexone (LDN), delving into the science.

This is a summary of Susan Merinstein’s interview. Please listen to the rest of Susan Merinstein’s story by clicking on the video above.

Pharmacist Stephen Dickson, LDN Radio Show 2014 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Pharmacist Stephen Dickson from Scotland shares his experience as a LDN compounding pharmacist.

We have got on LDN around 5,000 and that's in the last three to four years.

Basically LDN is compatible with most medications that you're on for a chronic disease. It just means sometimes it needs to be done in a slightly different way or taking a different way or your medication that you are taking altered slightly to enable you to take it.

The obvious exception to that is on the very strong opiate medications. You really have to be very careful not to take the two of those together if you are on a sort of long term, strong opiate painkiller, not because it's going to do any major harm or stop the LDN potentially from working but actually, because the Low Dose Naltrexone stopped the painkiller from working.

Now that doesn't mean that you can't still do that. You just have to be quite clever with your timing and that's where your pharmacist or your doctor can help you with that.

Another one of the questions with interactions, we get very frequently is: "Can I take LDN with Interferon or Tysabri or any of the newer sort of MS drugs?" And certainly there isn't really any logical reason why you can't take the two of them together.

I think what we're finding as time has gone on is that both drugs, Interferon and LDN are modulators of the immune system, but they don't necessarily work in the same subsets of cells or the same receptors and therefore can theoretically compliment each other.

Regarding steroids, there is no direct relationship between steroids and Naltrexone. For example, the main steroids is Prednisone alone and there's no direct interaction between those.

And we certainly tell people that you can continue to take LDN during the whole period of being on a course of steroids, for example, for a chest infection or for a flare up of Emma or for anything.

There's no reason to stop taking it.

People ask what happens if they need to go to the dentist and have a filling or go to hospital for an operation. If you're going into hospital for an operation, we would normally say to people to stop LDN two or three days before you go in. The absolute latest, you would stop with maybe 24 hours before.

And that's not really for any reason other than to make it more simple for your doctors in the hospital. If you were to, for example, taking LDN and you were in a car accident, the amount of opiate painkillers give you in order to relieve your pain if you had a broken leg or something, would still work. They might need to give you slightly more, but it's still complicated. I wouldn't really consider stopping taking LDN before going to the dentist.

The dentists are very limited and the opiates that they can use, generally, if you're having an operation  they'll use a mild sedative and that's via drip, or we'll use an injection, which is a local anesthetic.

LDN has gone from being something that we were very skeptical of initially used in a small number of people with Multiple Sclerosis to something that I'm convinced as a very positive effect in a large number of autoimmune diseases.

One of the most amazing things with LDN is that with people with Fibromyalgia  you would never have thought, I certainly would never have thought would have responded.

I'll never forget the patient who looked at death's door, just absolutely dreadful.

She was exhausted, had been off work for months and months and she just looked terrible. Basically Dr. Tom had given her LDN. Three, four months down the line and the woman was back at work.

It felt great. It looked fabulous. I couldn't believe that something had such a marked effect.

Also the people with Psoriasis, which is like a skin auto immune disease. They tried every cream lotion portion and then eight weeks on LDN and it started to clear up.

These are things that we just don't normally see in a normal practice.

So I'd certainly say LDN for me, it's been very exciting, very interesting.

Now there are over 300 doctors on our database who prescribed LDN in the UK. S couple of years ago, that that was about six, so I think the LDN research trust has been doing an incredible job of promoting awareness of this cause.

And it's something that we hope to continue to be able to support for a long time.

Summary of Pharmacist Stephen Dickson's interview. Listen the above video for the full interview.

Pharmacist Rosella Pirulli Menta, LDN Radio Show 19 June 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: Today I'm joined by a pharmacist and naturopathic doctor, Rosella Pirulli, mentor. Thank you for joining us today. Rosella.

Rosella: Thank you for having me.

Linda Elsegood: Now you said that you got an extraordinary story to tell us:  Your journey. Would you like to explain that to us?

Rosella: Well, I went to St John's University in Queens, and that's where I got my degree in pharmacy and when I started working at a pharmacy in the Bronx of New York I wasn't very happy with just filling prescriptions and checking them and I felt that was not for me. I felt that, if I was going to have a profession and be successful, I wanted to show my children a different way to have a great life and also to be a part of a profession that helps people feeling amazingly well.

So that was my goal and so I only worked in that type of scenery for a few years and then I decided to look into other avenues. I went into homoeopathy where I did get a certificate in homoeopathy and I also looked into supplemental products because I really enjoy the supplements and teaching people how to take the correct supplements, especially if they are on certain medications that require supplements because of the problems that supplements can cause as a side effect. And the first thing I did learn was when patients were taking stands that they need to coQ10 we had a lot of patients that would complain of muscle weakness, fatigue and so I said: " You know what? I need to help patients with  drug issues and side effects." And that was the first step. And then patients would come into the store and I had a lot of patients that would complain about half flashes. And so I said, let me look into that avenue. And so, I started to dwell on how I could start a career in compounding and in that store I really couldn't do it as well but I did get my training to PTCA, and they are an FDA approved facility where I got most of my training from compounding and also in the avenue of bioidentical hormones. And then from there Rye Beach pharmacy took me on because they had a full compounding lab at the time and so they asked me if we did the store for a few years afterwards to be more in compliant, because we're now accredited by the board of PCAB and we also 700 compliance, soon to be 800 compliant by the end of the year.

But in the interim, I had to move to Florida where I worked part-time for Rye Beach pharmacy, and then I worked for a pharmacy in Florida so I had my license there as well. And I was commuting back and forth. I would come here and market to doctors because when I did graduate, I received my bachelor's in pharmacy, but I also, not knowingly, I minored in marketing, so I was I guess then I knew I was going to market, which is great because I enjoy networking.

That's like the passion for me to get doctors together, doctors and pharmacies together. It's my passion to help people get to know each other and there's always room for other avenues. So that's my enjoyment. And right now, I do have my own office where I see patients, I do phone consults as well and I also review blood work with patients. I'm really close to many of the doctors. So that's where I learned more about LDN because I went to PTCA conference and learned about LDN and how important it was for patients in different disease states.

Linda Elsegood: So, you are a supermom. You have five children.

Wow. How does it fit in with a career?

Rosella: Well, it's amazing because my kids understand that we're a team. That's it. We're a team. We work together and we all love each other so much. So my kids are so amazing with each other. They all help each other out.

So the oldest is 22. That's my daughter. My son's 20. My other daughter's 18. And I have a 15-year-old and ten years old. So we are constantly figuring things out and make it work and I think that makes them stronger and closer to the family 

Linda Elsegood: Wow, wonderful! And when did you first really get involved with LDN?

Was it at that PCCA meeting? Had you heard about LDN before then?

Rosella: I heard about it before then because we had a specific doctor that was a Lyme specialist that was working with LDN. So I asked her why was she prescribing LDN and she said it was because she had a lot of patients that were immunocompromised and fatigued, and the LDN is really helpful because it increases immune response. So I said:" That's really interesting. I'd like to learn more about it." So I did some research on it, I spoke with other doctors that were writing for it, why they were writing for it and I had one particular patient that had Crohn's disease. I asked him if he would want to try it and he's been on it ever since. So this is, at least six years that he's been on LDN. He's doing really well and will not stop it. That's for sure. I also took an autoimmune class on LDN. Not only is it great for pain. I actually had another patient that came to see me. She had a severe car accident. She had a lot of neurological issues going on and was on many other pain medications. So I helped wean her off of those pain medications and put her on LDN. Her starting dose was at 1.5 mg. We went up to 4.5 mg and then I said to her: "Let's try 5 milligrams and see if that works for you." That's when she started getting a side effect. She felt very strange. She said in mind a little weird. We went back down to 4.5 mg and she's been on 4.5 mg since about two years now. She's very happy with it. Every once in a while she has to take a Lyrica or something else.

It depends on the stressful situation in our lives, but, I mean, she's off most of her other pain meds because LDN is really working well for her.

Then I have a few other patients that I'm looking into the fertility aspect of it because I do work with a lot of fertility doctors and a lot of them don't know about LDN.

So I did more research on it to see how effective it would be. So right now I'm working with an endocrinologist who's going to start his patients on LDN and see how they do. A lot of people are fascinated by it and they want to try it. They want to help patients this way and I'm happy about that too.

Linda Elsegood: Well, there was a paper released last week by Dr Scott Zashin. He's a rheumatologist in Texas for Sjogren's Syndrome. That was quite good. The more papers and research that people do, it's going to make prescribers more confident in prescribing LDN.

Rosella: I forgot to mention I do have an ALS patient that is using it. This is amazing because he wasn't able to move his fingers and he wasn't speaking. Now it took a little bit of time. He can move his fingers, he can speak a little bit. At one point he didn't have the LDN. His doctor didn't authorize it because I think he was away and he wasn't speaking. So his sister said they need it because this was the only thing that they noticed that he needed. So I called the doctor, and I said:" Just put like PRN refills because this man is doing well with it.

Linda Elsegood: Interesting. So what I was going to say was, how long has the pharmacy been compounding LDN?

Rosella: Let's see. They've been in business for over 50 years and compounding around maybe 15 years.

Linda Elsegood: And what forms do you compound LDN in?

Rosella: Capsules right now for the most part and some creams. I haven't done any sublingual yet, but I think it's worth a try for some patients.

Linda Elsegood: Sublingual is quite a useful tool when people have gut issues that obviously absorb differently and bypasses the stomach so that is hell in some patients, but maybe all your patients can tolerate the capsules quite well. What filler do you use?

Rosella: We use acidophilus. Most patients don't have any issues with that.

Linda Elsegood: Yes. Do you know roughly what patient population you normally treat or is it all autoimmune condition patients?

Rosella: It is hard to say because I'm not in the lab that much. There are a few days that I do work in the lab when they need me but basically working in my own office and I work with a lot of bioidentical patients. So my thought is to really work with thyroid issues and help patients with Hashimoto's.

From what I've read and what I've seen with other patients, LDN really helps to decrease the antibodies in Hashimoto's patients. So that'll also help them with their thyroid. That's going to be my push as well as other autoimmune diseases. And I was looking into other inflammatory diseases like endometriosis, PCOS because I feel that LDN may have a good positive result with those patients as well.

Linda Elsegood: It certainly does. I can speak from experience myself, and with endometriosis worked amazingly.

Rosella: Good to hear. Very good to hear.

Linda Elsegood: I would also like to mention when you treat thyroid patients with LDN, you have to be very careful of the levels of the dose if they're taking thyroid medication because normally they have to start reducing the dose as you increase the LDN.

That is something to look out for. This is why we always say to people who have thyroid conditions to keep in constant contact with the prescriber because you can hit some problems if you are taking too much of your thyroid medication.

Rosella: I agree with you on that. I do work with a lot of patients and I have one endocrinologist that we monitor thyroid and we compound different strengths of thyroid T3,  T4 depending on their blood levels. So we do look at that TSH really carefully and free T3. We also look at FT4, but mainly I look at the TSH and FT3. That to me is very important. I could see a difference in patients if their level changes just a bit. They can start having hair loss or weight gain and fatigue.

That's why  I do tell my patients it's so important that we monitor them, get blood levels done every few weeks to see where they are.

Linda Elsegood: The internet is an amazing tool. It helps people do their own research, but the warning is you can't take notice as gospel truth from just a person on the internet who's not a doctor, not a prescriber, but who is giving advice.

We always say the proper advice is to speak to a pharmacist or a prescriber. You people have had years of training and experience where it's all well and good listening to other people, but when you are talking about your health, you should be talking to a medical professional.

Rosella: Correct. I agree with you on that.

Linda Elsegood: Yes. I mean, it's quite scary. We had an email from a lady who had been given some kind of advice from a friend of a friend of a doctor and their advice was totally wrong. And also you should not buy LDN off the internet. It's illegal. Naltrexone is a prescription-only drug, and therefore you need a prescription to make sure all the safety standards are met.

You said that you were PCAB accredited. So just to explain to people what you have to go through to prove that your pharmacy and your compounding is spot on with the regulations.

Rosella: The regulations are intense and immense. It took us, at least about two years and we're still perfecting it to pass all of the inspection qualifications because if we're ever audited, yes.  PCAB is a credentialing organization. It takes some time for us to make sure we follow every different legality as to having our compounding lab as perfect as possible. Every aspect of it is really important. We have SLPs, and we have meetings every week to make sure that we're following our SLPs. Keeping every temperature in the lab correct, the airflow. We have to make sure that they're wearing their masks, their hats,  jackets and gloves and everything has to be precise and follow to the T. If we ever get inspected, they could definitely find us for anything that they feel that is necessary. We're trying our best to make sure we keep up with it. It's very intense. It really is. That's why we always offer our doctors to come to visit the lab or patients. We have them look through the window because they can't come into the lab and see how we are following protocol per se.

Linda Elsegood: And what are your thoughts on people purchasing LDN off the internet?

Rosella: I just found out that they're selling a prescription item on the internet, and I'm appalled. I don't know how they're doing it. I feel the same way as you. Being that we're a credential lab and we work really hard to keep up with all the laws and the regulations, I don't know where this lab is. It's making the LDN. I have no idea. I would not recommend it at all.

Linda Elsegood: Exactly. The MHRA, which is the medicines regulatory body here in the UK quoted something like 85% of drugs that are shipped into the UK without a prescription is counterfeit. Mostly they're just fillers, they are harmless but some of them are actually lethal.

They're very dangerous. Don't play Russian roulette with your life. Get LDN from a reputable compounding pharmacy.

Rosella: I agree with you. We require to keep it as clean, pure and stable and it's really important to deal with the pharmacy credentials because you never know what you're getting out there. We work hard and we respect it.

Linda Elsegood: And not only that. You have your LDN tested so you have to prove in a 4.5 capsule that there is 4.5 of Naltrexone.

Rosella: Yes, we do.

Linda Elsegood: So if there were no checks, it could be 1 mg, 6 mg, or it could just all be fillers.

Rosella: Exactly. You're right. We do send it out for testing. We send out batches every day of different types of compounds, and then we get our results back within the right range, and we're happy we dispense it. So it's important that we do that.

It can cost up to $200 or more depending on what you're testing.

Linda Elsegood: So pain. Are you using any ultra-low-dose naltrexone yet? It's quite relatively new still. I don't know if that's something that your doctors yet know about.

Rosella: No, I don't think so.

I really haven't heard of that either. So how low is the dose then because I'd like to speak to my doctors about that.

Linda Elsegood: Well it's micro-dosing. It's probably 0.01  kind of thing. But it's really interesting. People who are on high doses of pain medication and have been for years, it's awful how it's not just America, it's all around the world how people are becoming addicted to these pain medications. I know that the whole idea is to try and get patients off the pain medications, but the withdrawals can be quite horrendous. So by using this ultra-low-dose naltrexone in micro-dosing, you can use that alongside with opioids.

They don't have to be off the opioids, but such a small dose makes the opioids far more effective. So it makes them work better, and therefore the patient is able to reduce the amount that they're taking. If you look at it as a sliding scale, you slowly increase the ultra-low dose, and we're still talking microdosing here, and then they can gradually reduce their opioids until they're on the LDN.

Most pain specialists say that they can get their patients off the opioids completely.  Some say that they just take it when they need to. They're not taking it constantly. So I think that is something that's really interesting and something new to many people but how wonderful to get these people off pain medications.  I've spoken to many people who've been on Morphine, Fentanyl, patches, and cocktails of medication and they say that they're still in pain. It doesn't work. So if we can get LDN out there and use to help these people to come off all these pain medications.

how wonderful is that? Tell us what do high doses of painkillers long term do to the body?

Rosella: They can cause a whole host of things, bone loss, blood pressure issues. It depends. I'm looking at patients that not only the opioids but if they take a NSAID what it could cause in the long run. I just believe that most of these medications,  some patients become suicidal too. Depression is another problem, weight gain. So many different things that opioids cause.  I think that if we can help patients come off of them and give them more supplementation and also LDN in a combination that'd be great.

Even Curcumin, Boswellia. There are so many amazing products out there that patients don't know about. They're just scared to come off of their opioids because of the dependency.

Linda Elsegood: Definitely. So how do patients get hold of you for a consultation?

Rosella: On the website. There is the introduction of what I do. I have a video there as well and there's also an evaluation form they can download. So on the website, there is an appointment maker there called shore, so they can make an appointment with me and it makes it really convenient for them.

Most doctors that know what I do, tell the patients to call me or go on the website or email. I have my business cards and I have that for them and that's how they get in touch with me. They used to call here. I have an assistant, her name is Tiffany, and she helps me with setting up appointments, and she's also a technician that helps to fill our scripts.

So that works out really help me.

Linda Elsegood: And do you have a waiting list, or can you see patients quite quickly?

Rosella: It depends on the month because I do marketing two days a week. So that's why it's really convenient for them to make their own schedule. It could range from a week waiting, maybe two weeks at most, then I try to fit them in. So for instance, if they can't see me within the special time frame that I have, which is usually between like eight in the morning and six,  I see them on the weekends if I can. I'll set up that schedule for patients. So I try to make it convenient, try to fit people in as quickly as possible.

Linda Elsegood: And where are you situated?

Rosella: Where am I situated? I'm in the Rye, New York. In Westchester County.

Linda Elsegood: Is it wheelchair friendly for patients too?

Rosella: Well, it is. We are a hybrid store, so downstairs is mainly where we have the retail establishment.

We have home health care and our vitamin line where we have a pharmacist that's full time working in that area. We also have the upstairs where my lab is, and where also is my office and other offices as well. If a patient needs to see me and can't walk up the stairs, there is another office downstairs that I could see them in. That works out for those patients.

Linda Elsegood: Wonderful! And could you just tell us your website?

Rosella: It's www.ryerx.com.

Linda Elsegood: Wonderful. Wow. We need to end of the show.

Rosella: Oh, great. I just wanted to clear something up. I'm not a physician. I'm a naturopath, so I cannot prescribe. I just wanted to clarify that if you don't mind.

Linda Elsegood: No, that's absolutely fine.

 Just explain what a naturopath does.

Rosella: Well, I took some courses in it, and I basically learned more about supplementation. It's a little bit different. I wanted to become a naturopathic physician, but I didn't have the time. I was basically between the kids and working full time.

I didn't go into that avenue. But it's been mainly as like learning about supplementation, helping patients with that as well as a little bit of nutrition. So I would like to go into clinical nutrition as well, but we'll see if I can cross that path when I get a chance to, once all the kids are in college, I guess, I don't know.

I'll figure it out.

Linda Elsegood: Do you test for supplementation to find out what people are low in?

Rosella: We do some blood work for sure. New York is really tough when it comes to other types of testing, so we can only do blood tests and that's how we test and we just saliva testing for the hormones. We are limited to a lot of different types of testing unless a patient lives in Connecticut or New Jersey, then we can test them with the different kits that we have.

Linda Elsegood: What about vitamins? Can you test for vitamin levels or not in New York?

Rosella: It could be tested for sure because we work with a lot of doctors that do a lot of IV therapy and they test all sorts of vitamins.

It depends on the lab that does it. But here are many labs that do testing for vitamins.

Linda Elsegood: Do you find that people in New York are deficient in vitamin D? Do you get enough sunshine there?

Rosella: I would say that everyone is deficient in vitamin D, everyone in America must be, but definitely in New York.

And then, once we rectify that, they feel better. We get them to a certain level, and they could stay on the supplementation for a good long time. Usually, I don't recommend that they come off of it, but if they have levels to go higher than  50, with the doctors ok, we'll bring down the dose a little bit.

Linda Elsegood: How would a patient feel if the vitamin D levels were low?

Rosella: Some patients tell me that they feel achy, others tell me they feel tired or depressed.

Some patients don't have any symptoms at all, so it just depends on the person. I know when I had my levels low, I would feel a little down and when it was a rainy day, I wouldn't feel myself. But now that my levels are normal it doesn't bother me.

So it's really strange how I used to feel.

Linda Elsegood: That's really interesting, isn't it? So anybody out there who would like to come and see you go online, they can find out more about you, play the video and make an appointment, come and see you and the bonuses is they can actually have a look at your compounding lab looking through the window, of course.

But that's also interesting to some people. I'm sure.

Rosella: Yes, absolutely. They love it, especially because we have a clean room as well, and it's separate from the rest of the lab, and that's where we make all the injections of HTG and b12 and they find that very interesting.

Linda Elsegood: Well, thank you very for being our guest today. We learned a lot from you.

Rosella: Thank you very much for having me and have a great day.

Linda Elsegood: Thank you.

Rosella: Thank you. Bye-bye.

Linda Elsegood: Each pharmacy has been family owned since 1946 they are a PCAB accredited compounding pharmacy growing from a corner drugstore to a wellness centre that helps patients to achieve their optimal health covering Connecticut, Florida, Illinois, Massachusetts. New Jersey, New York, Pennsylvania, and Rhode Island.

Visit www.ryerx.com, and I hope for the opportunity to earn trust.

Any questions or comments you may have, please Contact Us.  I look forward to hearing from you. Thank you for joining us today. We really appreciated your company. Until next time, stay safe and keep well.

Pharmacist Rick Upson, LDN Radio Show (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

After years working in other pharmacies, Rick did not hear about low dose naltrexone (LDN) until he bought Palm Beach Compounding Pharmacy in Florida in 2009 – the previous owner had been compounding LDN. The forms they prepare it in are capsules, an oral liquid form dispensed with a syringe to measure it easily, and a topical cream. That has been prescribed a couple of times by Dr. Brian Udell, who is about an hour away, in Davie FL. They haven’t been asked to compound LDN as sublingual drops, which can be helpful for patients whose stomach gets upset from swallowing LDN; but they have compounded troches, a lozenge to dissolve in the mouth so it is absorbed through the lining of the mouth rather than the stomach. Then to the liver, where it will be metabolized.

Conditions he’s aware of being treated with LDN include fibromyalgia, multiple sclerosis, autism, ADD and other behavioral disorders, rheumatoid arthritis, and lupus. Rick’s clients have not reported negative side effects from LDN, however notes that The LDN Book says approximately 8% of people have some sleep disturbance, which is a pretty low incidence. He commented on how it can take three months to get full effect of what LDN can do for you, so impatient people need to be aware.

Linda Elsegood commented on the progressive nature of most autoimmune conditions, and how amazing it is to hold the progression with LDN. She noted that surveys found most people notice something around 4 months on LDN, although some are not stabilized until as long as 18 months on LDN. So patience is needed.

Rick tells of a Facebook page [LDN Got Endorphins?] with many patient stories, that has been informative. He has been selling The LDN Book and finds it valuable, though some content might be too technical for patients. He appreciates how it explains not only LDN, but the related body systems and how they work together, and relevant tests. Linda replied that sales of The LDN Book have done really really well, and it is aimed for both the lay person and prescribers. Rick has focused on getting the book out to those who prescribe compounded medications, as they are the kind who think outside the box.  He knows many who treat things that would benefit from LDN: gastroenterologists who treat Crohn’s disease and inflammatory bowel disease, fibromyalgia, and other similar difficult to treat conditions.

Keywords: fibromyalgia, multiple sclerosis, autism, ADD and other behavioral disorders, rheumatoid arthritis, lupus, Crohn’s disease and inflammatory bowel disease. The LDN Book, compounding, side effects, low dose naltrexone, LDN

Summary from pharmacist Rick Upson, listen to the video for the show.

 Any questions or comments you may have, please contact us. I look forward to hearing from you.