LDN Video Interviews and Presentations

LDN Research Trust on Vimeo.

LDN Research Trust on Vimeo.

Cheri Garvin, Pharmacist - Pain Seminar, VA 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Cheri Garvin is the president of the compounding center located in Leesburg, Virginia. They're an employee owned, PCAB accredited pharmacy. Offering steroidal and non-steroidal compounding medications and a full selection of medical equipment. They call themselves a speciality pharmacy as they manufacture and compound treatments specific to their patients.

This unique approach has attracted many customers across the US, as the need to find drugs that are compatible with their current treatments is removed. They can prescribe Low Dose Naltrexone (LDN) in a variety of forms, including new research into the possibility of using eye-drops.

This is a summary of Cheri Garvin’s presentation. Please listen to the rest of Cheri’s presentation by clicking on the video above.

Pharmacist Brad White - 15th April 2020 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Pharmacist Gene Gresh - 20th May 2020 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Gene Gresh has been a pharmacist for 20 years and works with his son who is also a pharmacist in Vernon, Connecticut.

In this presentation Gene Gresh discusses how when he started 20 years ago Low Dose Naltrexone was compounded but there was little known about it until many years later when scientific studies started to be conducted.  He set out himself to really study LDN beyond the anecdotal evidence he knew to exist through his own customers.      

In his survey of over 600 patients they got a lot of good information and one of the key points that they found was that most of the patients that discontinued LDN did so because they didn't ask questions. They experienced side effects or they didn't see the results they wanted in the time-frame they wanted so they stopped it without any kind of information. With some of these conditions, it's so important for them to get the good information which enables them to persist with it and deal with unwanted effects. 

Pharmacist Steve Hoffart - 5th Feb (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Pharmacist Steve Hoffart shares his Low Dose Naltrexone (LDN) experience on the LDN Radio Show with Linda Elsegood.

Steve Hofart received his Bachelor of Science in Pharmacy with highest honors in 1994 and a Doctorate in Pharmacy from the University of Texas at Austin in 2000. He also holds a board certification and fellowship through the American Academy of Anti-Aging.

In November of 2002, Dr Hoffart saw a need for a more personal pharmacy that could make an impact in the community on a larger scale. Magnolia Pharmacy strives to best work with the "triad". The triad is a strong working relationship between the patient, physician, and pharmacy to solve medication problems and provide real solutions for patients to achieve better health and wellness. 

Cultivating this working relationship has ultimately produced a unique pharmacy experience for each of his patients.

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

Susan - US: Jim's Multiple Sclerosis (MS) 08 Jan 2020 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: I'd like to introduce Susan Garvin from the US, I had the pleasure of meeting Susan and Jim in Nashville at the conference in 2010 this show is dedicated to Susan's late husband, Jim Garvin, who was an LDN user and a huge advocate of LDN. Thank you for joining me today. Susan. 

Susan Garvin: Oh, I'm so pleased. And Jim is watching from above cause he would talk anybody's ear off about LDN and its many uses for ailments that you had. He would talk anybody's ear off. 

Linda Elsegood: Well this is a tribute to Jim, could you tell us about Jim and your life together, how long you were married. 

Susan Garvin: Well, Jim and I were married at age 20 in 1971. We were married to the same people for just shy of 48 years when he passed.

And he was just really dedicated to his family, friends, and his community. Jim was a cable splicer for the phone company he retired from there, after his diagnosis with MS on January 20, 2000, he always said, it's his birthday present. Cause he was born in January, he didn't feel sorry for himself about the diagnosis.

He goes if it's not me. Who else could it be? You know? Jim was diagnosed and actually was told by the doctor that he had Lyme disease, but he got mixed up with another patient. So it was an MS diagnosis. So he retired from the phone company as a cable splicer because of course his many MS symptoms.

And he would find himself ready to pass out, not remember things, walking became a burden for him. We used to call it wall walking where he had to hold on to the walls of the house to get around. At one point he did use a wheelchair because he was unsteady on his feet. 

He, he was taking Betaferon because the doctor wanted him on it. And for a man that was over 250 pounds, just shivering on the bed with flu-like symptoms every other day was pretty hard to watch and see. But he was doing an internet search for other alternative treatments for MS and actually came across some little tidbits of information about low dose naltrexone. So Jim, he decided to call people on the message board that he was searching on. Fin d out that it was really a truly a good treatment for MS and he took a leap of faith and talked the Dr into it, she was not his neurologist who was not really on board but prescribed it anyway, so we got a compounded prescription in the next town over. He came home and tried it and the next day Jim had an improvement in his symptoms of balance. He was able to stand on one foot for balance and so excited as he was, he just called everybody at the doctor's office to just say, thank you.

The doctor was not impressed with that. And after the next consultation, she actually wanted to remove us as patients. So anyway, we had a lot of help and he felt so much better in his symptoms. He was inspired to reach out and tell everybody about it.

So, we have a lot of friends that we met out at the Nashville conference and stayed in touch with them. Jim was known as captain caveman because he would always reach out to people on the internet, and then he called it, go back to his cave. So he was dubbed by Brenda as a captain caveman we had a lot of fun with that.

Jim had, in his own words, he would say he had a turnaround of his symptoms. Have ups and downs and better days and he says he could get out of the bed, make it to the throne room without falling down or having an accident, make it there by himself without a cane or the wheelchair.

And, he did have energy. We had a good life. Jim helped care for a lot of family members. We resumed camping and we pulled a fifth-wheel trailer for camping and visited Arizona. And we just had a very large social world because of that. So again, it gave him an opportunity to teach other people about LDN.

And one of our friends gave him some business cards, printed up with our name, address, and so on. And it said, ask me about LDN. Of course, he passed those out everywhere.

We went to a local viewing of a documentary on low dose naltrexone for Lyme disease. We had a conversation with a man in the lobby afterwards, and he goes on and on. He goes. I had my aunt taking this and, and some crazy man told her about all of this, and LDN and Jim goes, well, you're looking at that crazy man.

We had big chuckles that it comes around and meeting other people that it changed their lives. That really meant a lot to him. We made a lot of good friends that 

Linda Elsegood: I  remember meeting you on the, General Jackson, Mississippi riverboat after the conference in Nashville.

Susan Garvin: Oh, it was so wonderful. Yes. We have a lot of good friends and, Paul and Altha, Brenda was there, Crystal. We have a lot of good memories of those times andwe're just so pleased about how LDN is really changing the world.

We have results that are real now. And when Jim first started it, it was just like, well, maybe it might help you. And you know, we love the testimonies of how it helped people. Jim was on the cutting edge, I would say, of learning and teaching and sharing about LDN as you are.

Linda Elsegood: When did Jim start taking LDN? 

Susan Garvin:  He was started in about January, February, about 2003, I think, 2003 so he was on it about 18 years, without an exacerbation.

And I have to say, Jim saw the neurologist the several days before he passed away, and his neurologist said MRIs taken a few months before, showed there are no changes in your MRIs from the previous and that tickled Jim today because to say that and it was proof that LDN was a life-changer for us. And Jim died of pancreatic cancer, which very few people live through a treatment plan on. But we do feel that it helped his life become meaningful.  

Linda Elsegood: Well, Jim started around the same time as I did then cause I started in, um, December. The 3rd of December in 2003.

Susan Garvin: It's about that. Exactly.

Linda Elsegood: In those days, there were not many people taking LDN. The internet wasn't what it is today either you know. There are more trials and studies being done every month; somebody has done something. There is Facebook now, which there wasn't, or, might've been around, but it wasn't what it is today.

And people sharing information around the world, podcasts and documentaries, conferences, it's all growing momentum over the years. It's a far bigger movement now.

Susan Garvin: Absolutely. I mean, and when Jim researched it, he was in the low thousands on the message board that he was researching on and he sat there and he, he was so funny, had a wicked sense of humour, but he sat there and he said, I felt like somebody slapped me on the back of the head and said. Take a look at this, it can change your life. And again, he did his due diligence and researched that and talked to real people. And again, there is what we, we found that. Testimonies and talking to people made a huge difference. And I think again, Jim talking to other people that we met con a camping trip, after Jim had started this, met up with, people in the Santa Cruz area. And met with them in person and told them, look, I'm a real person. This has changed my life. That person that had MS started, it changed their life also. And you know, you can't take away those things, that life is changed for other people because of you. 

Linda Elsegood: We have 35,000+ people on our main LDN Research Trust Facebook group.

I mean, that is an amazing amount of people, isn't it? I mean, if you put them all in one place at the same time, it would be a huge crowd.

Susan Garvin: Exactly. So, I know that people can take a for so many things, you know? And that that's what's been good for us to know. We share the books, we share testimonies and Facebook.

I mean, having all of those researchers and, and instead of sharing just one on one. We can share it through to the internet and have a larger audience. So we're very proud of the community and how it's grown. 

Linda Elsegood: And patient testimonies are so reassuring and so inspirational for other people who feel, let's say somebody with alopecia who hasn't ever seen anybody with alopecia, let alone know anybody that's taking any kind of treatment. You feel very isolated and on your own, and it really does help to connect with other people who are in the same boat as you, who can talk to you and help. It really does make a big difference.

Susan Garvin: Yeah. that's true. So it's like we are here we're a purpose. And I just think that Jim was definitely one that was blessed. On LDN, he had an almost complete turn around of his symptoms. He still had moments, you know, fatigue and heat intolerance, but being able to take care of yourself and not be a burden on somebody, that was huge to him, that he didn't ever want to "be taken care of" by someone. He was active till the very end. Well that's good to hear, isn't it? That's the time when you think, well, yeah, I've had a good one. Yeah, 

Linda Elsegood: He was amazing. So did you have children, 

Susan Garvin: Yes. We had two,. Our son died about nine years ago. And then we have a daughter that is a teacher and she's taking a two year teaching position in Hong Kong. And we'll be home for her Christmas for a visiting family. So we are totally excited about that. My mother, that's going to be 91, lives with us; we have three dogs at the moment and, mother still goes camping with us. Jim is one that really helps take care of my mother. He gave up three months of our life to go take care of her in Arizona after my father died and invited her to live with us. He always said, if we didn't have her, he wouldn't have me. And he just told me every single day that he loved me. And he did that by showing love to others. 

Linda Elsegood: Do you have any grandchildren?

Susan Garvin: Yes, I have two a 24-year-old beautician, granddaughter, and a 16-year-old, uh, still in high school. So, they'll be in for Christmas probably, and love being a part So, I have the grand dog, so the grand dog is staying with us through my daughter's time in Hong Kong. It's a loving schnauzer and we get to visit and cuddle with her along with our other two dogs. They want to be on your lap and cuddling. So it's like a puppy pile. 

Linda Elsegood: Dogs are such great company and the way they follow you around. 

Susan Garvin: Hmm. They are. And they loved Jim. Jim could teach him anything and they always wanted attention from him. So they were very comforting to him. Cause you know, there were times in the first part of his diagnosis, he'd just be sitting in the recliner, but he'd be laying back and have our little dog laying on his chest. And you know that that was his girlfriend. You know he would have a girlfriend on his chest or a little dog.

And those are cute pictures I keep in my mind. 

Linda Elsegood: So what kinds of dogs do you have. 

Susan Garvin: My oldest is a dachshund and Queensland max. She's got black spots and grey ticking. We have a white Vishaan that's practically toothless cause. she's lost her teeth. And then my daughter's dog, the miniature schnauzer. So a pretty energetic group considering. 

Linda Elsegood: Well, it's been amazing speaking to you, Susan, and thank you so much for sharing Jim's story. You know, it's nice to be remembered for all the hard work that he did and to, you 

Susan Garvin: Well, it's continuing on. I'll be a part of this community forever enough, for I know how life-changing it is for each one of us.

Linda Elsegood: Well, thank you so much for having been our guest today. 

Susan Garvin: Well, thank you, Linda. I look forward to seeing you in person on another future date. 

Linda Elsegood: You can bank on it. Thank you, Susan. 

Susan Garvin: Bye-bye.

Linda Elsegood: [00:21:24] This show is sponsored by our members who made donations. We'd like to give them a very big thank you. We have to cover the monthly costs of the radio station software and with phone lines and phone calls to be able to continue with their idea of the show. And thank you for listening.

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

 

Dawn Ipsen, PharmD - 4th Dec 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: Today I'd like to welcome my guest pharmacist, Dr Dawn Ipsen, who is not only the owner of one compounding pharmacy but two confounding pharmacies in Washington State.  Thank you for joining me today, Dawn.

Dawn Ipsen: [00:01:35] Well, thank you Linda so much for having me. It's an absolute pleasure.

Linda Elsegood: [00:01:39] Great. So tell us, we're all interested. What made you decide you wanted to be a pharmacist?

Dawn Ipsen: [00:01:47] Oh, yes. So I knew at a, pretty early on that I wanted to be in healthcare on some aspect and pharmacy was very intriguing to me and started on that path and lucky for me, I got an opportunity to be a compounding pharmacy intern while I was in pharmacy school in a compounding pharmacy and immediately fell in love.

And so that was my path. I loved how personalized it was, how unique it was, how I was doing things that none of my classmates and colleagues was doing and so that started my journey. This was in the Seattle area. I went to the University of Washington School of pharmacy, and it was almost 20 years ago now and got my doctor and pharmacy degree there, and I've enjoyed it thoroughly.

Linda Elsegood: [00:02:43] So how did you get from pharmacy school to owning to compounding pharmacies?

Dawn Ipsen: [00:02:50] So I've always been an entrepreneur and really loved business sides of things and kind of had this long term goal that someday I was going to own a pharmacy and it definitely happened earlier in my career than I expected.

I had been working for the Kusler's family at Kusler's compounding pharmacy and had always told them: "When you're ready to do something else, keep me in mind." And got that call. Became owner of Kusler's compounding pharmacy. And  Linda, that was almost six years ago now and was just minding my own business, running my pharmacy, helping my community, doing great work.

And a couple of years into that, I received a call from another owner, the owner of Clark's compounding pharmacy in Bellevue, and he was looking for a buyer. He wanted to retire and he'd done his research and determined that he thought I would be a good fit, that I did the kind of pharmacy work that he liked to do, and I help people the way that he felt was the best way.

And so I've owned now Clark's compounding pharmacy in Bellevue, Washington for three years and even the pharmacies are only 25 miles apart. They kind of do similar, but yet different things or both, compounding, online pharmacies, Sterile. Kusler's does contract with some insurance plans, so we do help patients with that.

And Clark's is licensed in nine states, so we work with patients and not only Washington state, but Oregon, Idaho,  Arizona and Nevada. And we have Colorado and a couple of other States as well. So that's been really wonderful, great, fun and challenging. And it's just really neat that I get to use my really strong chemistry and biology background and help people really solve medication problems, for people and pets.

We helped the whole family. So that's intriguing and fun.

Linda Elsegood: [00:04:59] Wow. We never know.  It is been three years. You might get another phone call from another pharmacy.

Dawn Ipsen: [00:05:07] You never know. However, my staff might call crazy people if I do that, but no, I enjoy it, and I love the challenge and I think that it's something that, we're really successful at. We pride ourselves in the quality and in our teamwork and how we take care of patients and that we treat our patients like their family, and how we would want our family to be treated and very personalized with that care.

Linda Elsegood: [00:05:36] So with all your compounding, what forms do you compound LDN into?

Dawn Ipsen: [00:05:44]  So Low Dose Naltrexone is expanding. Actually had been working with Odell style Trek zone for roughly 10 years now, and kind of decided to become a state expert Low Dose Naltrexone about five years ago. And back then it was very primarily capsules only, and that's what we saw and actually five, 10 years ago it was even the doses were very structured at certain doses, not a lot of variability to it.   And we've learned so much, right?  Over the research and over the years. Now we're doing a much wider array of doses. Everything from ultra-low or micro-dosing for maybe patients who

are on pain therapies already and need some extra help with their immune system to even much higher doses, more frequent doses for mood situations or post-traumatic stress or depression.  And along with that, we're also helping patients who maybe there's an autism spectrum situation going on and they don't want to or aren't willing to take capsules in which we're able to make flavoured liquids and we're able to do now LDN in a transdermal.

And a transdermal is very different than just a topical. This is a cream-based that's very special and it's designed to drive the drug into the body,  but it's a great way to go when you have a patient who won't participate or can't participate in taking an oral medicine. And on top of it, we've started doing a lot of topical LDN treatment for skin conditions specifically for  psoriasis, eczema, things of that nature. So those are primarily the most dosage forms we see. So different ways to do oral, different way to do a transdermal, and then we have the topicals as well.

Linda Elsegood: [00:08:03] If I could just ask you, the topical cream or lotion, what do you call it?

Dawn Ispen: [00:08:11] It's usually a topical cream for the skin dermatology conditions.

Linda Elsegood: [00:08:17] So if you've got eczema or allergies or psoriasis and the other skin conditions like backtracked syndrome, Haley Haley's disease, applying that directly to the skin, what do you see? Does it take away the itchy, flaky redness? What do you see when people use it?

Dawn Ispen: [00:08:45] Definitely, so what we were noticing is, in psoriasis patients that were just on oral low dose naltrexone that they would typically get to effect at some point.  But it took a very, very long time. And it was, as you can imagine, hard for patients to be patient, so to speak, and wait for that. Because I mean, we all know how miserable it is to have skin that's irritated. It's red, it itches, it burns, it stings, all those things. It's very difficult to have any sort of quality of life. So we started doing both. We would help doctors with the normal oral therapies that we would be used to seeing, but then we would start making a customized cream for them, naltrexone being one of the ingredients. And we would put it in a cream base that actually had nutraceutical components to it that would help calm the skin already on its own with no drug in it. So yes, they often risked with the naltrexone and that cream base would find relief of redness and inflammation, and we'd start seeing the healing of autoimmune skin disorders much faster than if they were doing the oral alone.

On top of that, we could work more closely meeting their direct needs. So if it was causing pain, we could add an ingredient to help with that. If it was a histamine reaction, we could add another ingredient to help with that. And so it gave us a lot more flexibility to be very, very specific and customized with the treatment they needed on the skin that was bothering them.

Linda Elsegood: [00:10:31] So my question would be, Dawn. If, for example, 3 mg, the highest dose that you could tolerate orally and you're putting a topical lotion or cream on, does it matter how much naltrexone is in that cream? Does it get absorbed into the system? How does it work? Do you see what I'm saying? If three is all you can take and you've got three in the cream, does it matter?

Dawn Ispen: [00:11:03] Well, it depends. So if we are doing the topical cream base, there's a slim chance you could have some added absorption, but then we may want to go back and talk about what does it mean they couldn't tolerate more than three? Was it directly affecting their stomach and they were having nausea or cramps or something like that?

Or was it affecting sleep or why was it three their oral stealing number, right?  So when we go topical or even transdermal, a lot of times we can go higher than one would have thought than they could do orally and still avoid the side effects because they're avoiding that, what we call it in pharmacy, the first-pass effect. When a drug is swallowed it goes to the stomach and then it goes to the liver, and that's sometimes the portion of the system that's causing the side effect. And if we're avoiding that, we can get away with that. The other thing is that, given in these dermatology conditions, if we're doing Naltrexone  and it is just topical, we're not getting the systemic absorption that we would be getting in oral or transdermal delivery.

So in that sense, the amount probably doesn't quite matter, but also the amount of drug that's in that cream, they could put quite a bit on and not be getting a significant dose directly into the bloodstream. 

Linda Elsegood: [00:12:34] okay. And then would it be exactly the same as oral LDN and that if it kicks into the bloodstream, it would be the, and then go quite quickly.

Dawn Ispen: [00:12:44] Righ, so if it did go into the bloodstream or it was a transdermal delivery, what was driven in intentionally, you would expect to get the same effect as if they were on oral. You may avoid side effects of the stomach directly because again, you're not putting that drug directly in their stomach, and that can be helpful for some patients for sure.

Linda Elsegood: [00:13:09] okay. Now, patient feedback. What has been the outcomes of your patients taking LDN?

Dawn Ispen: [00:13:21] The feedback has been very, very positive. It definitely seems to be a drug that Is extremely safely tolerated with very few side effects, if any, and if there are side effects, they're typically dose-related and things that can be managed by proper titrations and proper dosing.

The benefit can be anywhere from subtle improvement to very profound improvement with a huge direct link to a much better quality of life. Even on my more subtle improved patients, they often find that their improvement was way more than they anticipated because they'll sometimes take a vacation or a holiday from LDN and realized symptoms are coming back.

They are not feeling as good,  more fatigued, on and on. And then when they restart low dose naltrexone they can then more clearly see how much benefit it was providing to them.

Linda Elsegood: [00:14:23] And what conditions would you say patients are taking LDN for? Do you know that?

Dawn Ispen: [00:14:30] Yeah. I often do know that. Of course, we have our longterm patients that have been on it for five, even five-plus years at this point that had the Fibromyalgia, Multiple Sclerosis, Crohn's disease, of course. We're seeing even more though conditions that are just in general inflammation-based and in which we're trying to control the body's autoimmune system. So Hashimoto's and Graves', Lyme disease, Rheumatoid Arthritis. We have patients that are using it, as I mentioned, for psoriasis specifically. And then, more recently in the last couple of years, we're seeing patients who do have post-traumatic stress disorder or depression that is been not responding to normal therapies and even cancer conditions that have been very helped by low dose naltrexone.

Linda Elsegood: [00:15:30] So do any of your doctors around your area prescribe LDN for infertility issues?

Dawn Ispen: [00:15:41] We don't have too many in our area that is doing naltrexone for infertility. However. there ts definitely known, it's definitely talked about. There's pretty good literature on its use  and it just might be that I'm not right next to where the infertility clinics are that are working with that.

Linda Elsegood: [00:16:09] What about mental health issues?

Dawn Ispen: [00:16:13] Yes, we definitely have doctors who are using this for mental health issues and are really trying great because they're trying to bring to light the whole topic of mental health and how important it is. And they become so much more open to other ways of thinking, other treatments, other modalities for these patients. So we're seeing things like the use of ketamine for depression. We're seeing the naltrexone being used for depression and PTSD. And I mean, I can honestly say that had patients who had been very concerned about their wellbeing and that once they work with these types of providers, down the road, their quality is just so much better and they're doing great with it.

Linda Elsegood: [00:17:02]  And of course, so many mental health issues with antidepressants, etc can make people feel a bit sluggish, drowsy whether naltrexone actually makes you feel brighter and better, and it's not addictive either.

Dawn Ispen: [00:17:24] Right. You get that endorphin release, which is so important to our wellbeing and how we feel in our motivation and our willingness and desire to interact with others in our community and those are all such important things for being part of this world.

Linda Elsegood: [00:17:45] Do you have any patient case studies you could share with us?

Dawn Ispen: [00:17:49] I'm sure. A couple of my favourites is one, she's a younger patient. Actually, she's only in her 20s, and she comes into the pharmacy and she's been coming in a long time getting naltrexone. At this point, it's usually just a quick pickup: " Hey, how are you?" And out the door, we go. And I was at the counter with her and I literally had to stop and scratch my head and I couldn't.  She looked just so great, so normal, so just young and vibrant. And I honestly couldn't remember why she even has started low dose naltrexone. And so I asked her. I was like, can you remind me why do you take the naltrexone?

What is it doing for you? And, and she's actually multiple sclerosis patients, which we actually have a lot of in Washington state because where we're located in our sunlight exposure and vitamin D levels and all that. And it has hot her completely in remission with her vitamin D and other things she's doing as well.

But she looks just so normal.  Is the only way I can describe it. And how cool is that? They here we have a twenty-something who, who is able to be a vibrant member of the community and have a well-rounded life and do what she wants to do. So she's one of my favourites because thank goodness you're staying on it to help slow any progression of the disease process that might occur later on.

And then I do have one psoriasis patient that I've ever seen psoriasis-like this before. She actually had it even on the back of her calves, which is an unusual location. And started naltrexone. Did that for about a month, just the naltrexone orally itself. And then when we added in the cream.

And when she would come back for refills, I just couldn't get over it, how fast it was healing and we marked it.  I actually took pictures of when she first picked up and then when she came in for refills and then now there's nothing left. So it's been really awesome to see somebody who had been dealing with this for most of her life, who now is doing great, well-controlled.

Her immune system is just functioning properly.

Linda Elsegood: [00:20:05] How long did that take before her skin looked normal again?

Dawn Ispen: [00:20:12] Yeah. So skin is always slow. I mean, that's with patience is a virtue. It's on any skin condition as you have to allow for the full all derm cycle, which usually is right about six weeks on average.

And so, you start in with treatment knew at the beginning or just trying to get the treatments on board and help with any symptom relief they might need. And then usually, like in this particular case, it was really about at the three-month mark that she was coming in happy that the condition was starting to reverse and go back to how the skin was supposed to be.

And then of course for full healing, it's another month or two after that. And then he'd go into maintenance mode at that point.

Linda Elsegood: [00:21:00] Well, that's amazing, isn't it? I mean, psoriasis, if you have it, and I know somebody with psoriasis, how embarrassing it is. People look at you when it's really bad. I'm not comfortable either, is it? So something that can heal and clear that up It's amazing.

Dawn Ispen: [00:21:26] Yeah, it's wonderful because it can be, like you said, not only visibly unappealing and they will often try to hide it if they can with clothing and coverage, but it hurts, it clot cracks, it bleeds, it burns, it itches.

It's just horribly uncomfortable and unrelenting, you know, it doesn't just stop. It continues.

Linda Elsegood: [00:21:50]  Do you have many children as patients?

Dawn Ispen: [00:21:53] We do. We actually work with some doctors who are very in touch with the pediatric population and that's their speciality. And they use naltrexone usually in the kids that they have some sort of a spectrum disorder where they're noncommunicative and they aren't interacting as we hoped they would be able to.

They're a great population to work with and that's where we get to become very creative and work really closely with the family itself on determining how does this child want to receive its medication and is it as simple as custom dosing and maybe they want the capsule a certain colour because it might be more appealing visually to them. Fine, perfectly great with that. Or do they need a liquid and do they want it to be flavoured a certain way or do they need a lozenge? And then for the most difficult of patients, we can do the transdermal cream delivery that I even have a couple of families that they actually apply it to the child's back, back skin area at night when the child is sleeping. So they can receive their dose that way. 

Linda Elsegood: [00:23:25] Wow. So what else do you know about LDN that you haven't shared with us?

Dawn Ispen: [00:23:35] With LDN there are lots of things can augment the therapy of LDN and getting the most out of it. And it's really looking at the patient at a whole and trying to discover what ways can we reduce inflammation load in that patient's body along with optimizing the dosage form and the regimen, the strength and the timing, it should be taken.

 I do work a lot on talking with patients about the importance, especially in Washington,  of vitamin D,  the importance of good gut health and probiotics. We're working more with patients on using full-spectrum C-- to help with pain and anxiety as well,  antioxidants and organic diet and how important all of these things are to get inflammation loads down, to get the best effect out of it.

Linda Elsegood: [00:24:32] Yes. Diet is a big one, isn't it? People do notice a big difference by changing their diet.

Dawn Ispen: [00:24:42] Diet is so huge, and you know, us living in a suburban area, gardening and farming is not simple, right? And our seasons make that challenging too, and just really encouraging our community to buy from the farmer's market get organic as much as you can, grow your food when you can yourself and just eat well, take care of your body, you're worth it. You know? It's like you are worth the extra effort in doing that.

Linda Elsegood: [00:25:14] And sugar is another big thing, isn't it? If you can't cut it out, at least cut it down.

Dawn Ispen: [00:25:21]  Right, and look for good alternatives that are natural and if you do have to have that sweet because, you're right, it's in everything and it's hidden often it's hard to even know it's there.

Linda Elsegood: [00:25:36] It surprises me when you look at a tin food.  Dugar is in pipe beans, it's in..Just trying to think of something else. It's gone. Slipped my mind. But...

Dawn Ispen: [00:25:52] Ketchup, salad dressings.

Linda Elsegood: [00:25:55] Exactly. Sugar, sugar, sugar, sugar. It's not easy, but it's, it's similar if you're buying foods and you read the labels, gluten is in so many things.

Dawn Ispen: [00:26:13] Absolutely.

Linda Elsegood: [00:26:14] I mean, when I first started to be gluten-free, it took me ages to do my shopping because I was looking at everything and trying very hard not to get anything with gluten in it.

But it becomes easier because you know which things you can have and which things you can't have. Once you've gone through reading everything, it does become easier and you do find alternative things. I use honey as a sweetener and I use coconut sugar but it's brown colour so I can still make cakes and waffles occasionally, but there isn't a different colour but if you close your eyes you don't know, you can't see that it's a different colour. You can be creative. It's very expensive to eat organic here, and I should think it's pretty similar in the US isn't it?

Dawn Ispen: [00:27:18] It is. It definitely can be challenging to be able to do that and hard for some families to make that happen. And I always like to refer to the dirty dozen as they call it, of if you really have to pick and choose which product is most important to purchasing, organic versus maybe you could save the finances on something else.  That's at a nice way to integrate or ended up the pathway. Lucky for us in our area, at least, we do have a substantial number of farmer's markets that are all close by and available different days of the week but that can be an option for patients that are really trying to do those things, but maybe not able to get it from the grocery store all the time.

Linda Elsegood: [00:28:16] And the thing is, with organic food, it doesn't last as long as a non-organic without us being sprayed with things to keep it fresh longer.

Dawn Ispen: [00:28:28] And it sometimes doesn't look as pretty, does it either? There are more bruises and changes in how it grows and things like that.

But it's funny how our minds have that used to be the normal, right? That produce always looked like that. And then we've changed to think that that product should look perfect in every instance and that's not necessarily the case. It comes back to what you're saying with the sugar.

Linda Elsegood: [00:28:59] We have a supermarket here that sells half-price vegetables from the supplier, and they're all packaged and they're called wonky vegetables. So the carrots, parsnips, that probably got deformed but they're perfectly fine. There's nothing wrong with them. It's just as they call them wonky,  they're not perfect and I think that's great.

Linda Elsegood: [00:29:34] We've come to the end of the show so we could have carried on talking for ages. We'll have you back again another time and until then, stay well and we will speak to you again soon.

Dawn Ispen: [00:29:48] Wonderful. Thank you. Have a great day.

Linda Elsegood: [00:29:50] Thank you. Bye-bye. This show is sponsored by Kusler's compounding pharmacy and Clark's compounding pharmacy. They are more than a drug store. They are highly trained, compounding pharmacy experts, combining the art and science of preparing personalized medications to meet your specific needs, improving lives by solving medication problems for people and pets, creating solutions to medication challenges.

Visit www.kuslerspharmacy.net

Any questions or comments you may have, please email us at 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 Kim Hansen, LDN Radio Show 30 Oct 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: Today, my guest is pharmacist Kim Hansen. She's from the Town and Country Compounding Pharmacy in New Jersey. Thank you for joining us today, Kim. 

Pharmacist Kim Hansen: Oh, it's my pleasure. Thank you for having me. 

Linda Elsegood: So when did you first decide you wanted to become a pharmacist? Was it something you'd always wanted to do?

Pharmacist Kim Hansen: Absolutely.  I was working in a small independent pharmacy, a traditional retail pharmacy when I was in high school. And on occasion the pharmacist there would say, Hey, Kim, go mix these two creams. Or Hey Kim, go mix these two liquids. I was hooked. I knew that's exactly what I wanted to do. And from that point on I headed for pharmacy school and that was my path. I knew it immediately. That's what I wanted to do.  

Linda Elsegood: So where did you study?

Pharmacist Kim Hansen: Rutgers college of pharmacy in New Jersey. 

Linda Elsegood: So you haven't moved far? 

Pharmacist Kim Hansen: I've travelled far, but I haven't moved far. 

Linda Elsegood: So once you started compounding,  what were the main medications you were doing at that time?

Pharmacist Kim Hansen: Back in the day, it was usually combining a couple of creams together. That was before we had a lot of the manufactured products that we have now. A lot of times compounds start off that way, then they end up being manufactured items later. I used to have to make a topical minoxidil solution. I used to have to make up progesterone capsules way back in the day. Suppositories for progesterone. This was 20 some years ago. So it was before I knew of LDN.  I was doing compounding before that. Mostly progesterone and topical dermatological items that were not commercially available.

Linda Elsegood: How did you hear about LDN?

Pharmacist Kim Hansen: I think it was at a compounding seminar is the first time I'd ever heard of it. It was being discussed for autoimmune issues. I started seeing prescriptions for it about seven or eight years ago. Usually, it was just capsules, usually, it was the three different dose levels that we know differently now. It started gaining traction more for me within the last three years. But I did see it back seven or eight years ago.

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

Pharmacist Kim Hansen: Right now we do capsules and oral suspensions. Most often it's the capsules that patients are happy with. We also do a cream for patients with autism, and occasionally it's added to pain gels as well.

Linda Elsegood: What is the filler of choice for people?

Pharmacist Kim Hansen: Generally speaking, patients are happy with acidophilus. I do have patients that don't want that. And then we usually use micro crystal and cellulose, but if they have a specific filler question or need, we're happy to accommodate that.

Linda Elsegood: And what strengths do you do now in the capsules? 

Pharmacist Kim Hansen: I think our lowest is a hundred microgram capsule because that patient prefers that to be in a capsule form versus the liquid form, anywhere up to 10 milligrams and anything in between. 

Linda Elsegood: And the patient population, what would you say the top conditions that LDN is treated for from your pharmacy? 

Pharmacist Kim Hansen: Hashimoto's, pain and depression. 

Linda Elsegood: So talk us through those three, Kim, the experience that you've seen from those patients. 

Pharmacist Kim Hansen: I'll start with Hashimoto's. We do notice patients are getting to a dose that is appropriate for them and are feeling better. They also require less thyroid hormone.

If someone is on thyroid hormone and start LDN, that should probably be monitored more closely than before you started the LDN, because you'll find that as the inflammation reduces, the thyroid level changes and you may need to change your dose. Usually, it's a reduction in the thyroid dose when it comes to the pain medication using it for that.

I have patients who have had their lives changed. They were in a tremendous amount of pain before, and they were put on other pain pills. Any medications usually were just adding to their pill burden, but not really giving them relief or quality of life that they were looking for. I have patients who weren't able to do any of their activities of daily life and now are doing things that they haven't done in 20 years. To me, that makes things tremendously rewarding to know we can be a part of that success story.  I should also mention when discussing pain with patients, I have patients who have become tolerant to opioids. So we also find that LDN is a way to help reduce the opioid burden and help people get off of those and still maintain their pain relief. I view those two things together like pain and sometimes patients are looking to get off the opioids for relief of their pain. So it actually does both. 

The other I  touched on was depression. I have patients who are using an increasing schedule of LDN and also weaning off usually their SSRI or antidepressant drug. And they're finding if they wean very slowly off the antidepressant and titrate upwards very slowly with the LDN, they're able to get off of the antidepressant and still maintain a non-depressed state. They're happy to be off the medication and be able to use LDN, which we know works in a different way and usually has a better overall effect than the actual medication worked for them. 

Linda Elsegood: Ultra-low-dose naltrexone helps combat the opioid crisis. Could you talk us through how, when people come to your pharmacy, whether it's been addicted to prescription drugs for many years, how LDN plays a part in getting them off the opioids, but still controlling the pain? 

Pharmacist Kim Hansen: I won't get into a specific schedule because it is so dependent on each patient. I will say that we usually start patients on the microdose or the low dose, ultra-low-dose naltrexone, usually in a suspension form, and they'll be on whatever their dose is usually for about a month. And then after they're stabilized with that, the pain management expert will slowly increase the dose of their ultra-low-dose naltrexone and also decrease their opioid dose usually by about 10%. Again I don't want to give schedules and hard limits because every patient is so different in their ability to reduce. It's very varied as far as that goes, but I have many patients who have been on rather strong doses of opioids that have been on that for years, have been able to slowly titrate up on the naltrexone and slowly wean down on the opioid and have had success and be pain-free and opioid-free. That's huge to have that happen. We had one hospice nurse  (certainly hospice nurses are very well versed in pain and pain origins and pain protocols) who herself had her own pain issue. We walked her through this process of slowly starting the ultra-low-dose naltrexone and scaling that up over time and reducing the dose of the opioid over time. Now she’s opioid-free and as pain-free. And it definitely helped her increase her quality of life and also to be able to do the things that she couldn't do before.

So that's a huge story. I mean, someone who is on opioids, to be opioid-free is huge. 

Linda Elsegood: Definitely. For people listening out there who are in a lot of pain, because I'm told nearly daily that there is somebody who is in terrible pain, but they were already on very high doses of an opioid that doesn't seem to be working, you know?  Of course, the problem with opioids is your body gets used to them, and you have to keep increasing the dose to get the effects you were having. So anybody who has chronic pain for whatever reason, or fibromyalgia or having an autoimmune disease that has a pain component to it, how would they go about.

finding a doctor who would prescribe LDN and one that would understand about the ultra-low dose, who would be able to help them transition from the opioids to the ultra-low dose?

Pharmacist Kim Hansen: Two awesome ways to find that out. One is LDN research trust. There are lists of physicians and practitioners on there that are knowledgeable in what we're talking about here. You can also ask your local compounding pharmacist because we are a treasure trove to know who is actually prescribing it in order to be able to send patients.

It works both ways. The prescriber sends the order to us as they know that we'll do a quality compounded product. I can then refer patients back to other practitioners because I know that they're knowledgeable in this and then they've attended our seminars and that we can work together with them in order to get the best outcome for the patients. So it works both ways.  

Linda Elsegood: I was quite surprised when Dr Sam was telling me how quick the process is because I thought it would be a long, slow process. But he was talking just a few weeks, which was, wow. People that had been on opioids for many years, to, find relief like that, it just amazes me that something.so small and so simple seems like tickling the pain with a feather in those ultra-low doses rather than using a really big mallet, which is the opioids, for it to work. It just is mind-blowing, isn't it? And of course, the price, LDN is not expensive, and many people have to pay for it themselves. And it's not a price out of the reach of most people. We still have people who do not have money, they're sick, they're not able to work. And if it's a choice between food or LDN, that's a problem. But we're looking at around $30 a month, depending on where you have it compounded. It's an affordable drug, isn't it? 

Pharmacist Kim Hansen: Absolutely. We try to maintain that because we do understand that patients are in pain and you don't want them to have to choose between therapy and their food or their bills or whatever that is. We want patients to get the relief that they need.

We've kept what we're doing affordable so that we can make sure that it's available to as many patients as possible. Usually, you'll find whatever pharmacy you use, if you're going to be starting a titration and working your way upwards, usually that pharmacy will put together a kit.

So you've got maybe two different doses of a capsule in there so that you can gradually increase to the dose that you are working towards. And then once you arrive at the dose that's working for you, then that pharmacy can make that dose into one pill so that it becomes more economical if that makes sense.

Linda Elsegood: Yeah. I had a lady email me this morning, I think she had Sjogren's syndrome, and she was doing really well. She'd worked up to three milligrams. It did really well. She's now on 4.5 and she's not sleeping,  not feeling as well. And I was trying to explain that with LDN it's not, the higher the dose, the better the benefit. It's what suits you best. And if at three milligrams, she felt really good, why would she need to go to 4.5? It's not working. It's making her feel ill, so she should go back to where she was in a good place. There is so much misinformation out there that people seem to think that this magic 4.5 is the goal that everybody should be on. Have you noticed that with your patients? 

Pharmacist Kim Hansen: Absolutely. I've had patients tell me the same story that you're describing here. Everybody has in their mind that more is better and that the goal is to get to a certain number because that's where the best results are.I am always cautious about making sure I explain to patients, hey, we're dispensing a kit to you. This initial kit is usually good for 49 days or seven weeks, but if at some point halfway through this kit, let one of us know that you're experiencing relief or you're not experiencing anything at all. If you are at a dose where it seems to be optimized, I don't want you to have to continue to go up because the goal isn't to make it more, the goal is to get relief, and if you're getting relief at a lower dose, then stay there because it's very easy to overshoot that and you'll lose the benefit. So, in this case, absolutely more is not better.

Linda Elsegood: Do you have any stories of people who are on a very low dose that have stuck to that's the right dose for them? 

Pharmacist Kim Hansen: Yes, a patient with diabetic neuropathy who was using the kit and they had gotten to a higher dose, and they weren't feeling so good on that. He backed off the dose he had gotten to, I think it was three milligrams. He went up to the next step, said I don't feel as good as I did on the dose before that. Then we know where you should be. And we had him go back to the dose he had come from,  he's much happier there, and he's able to function.

Whereas he was in pain and uncomfortable before. 

Linda Elsegood: What I was getting at there was, I know quite a few people that are on 1.5 or two, which I mean is low for low dose even, isn't it? People tend to think anything under three is no good, but even that is too high for some people. Not everybody gets there. As you were saying with the man with his diabetic neuropathy, you don't have to panic. Or thinking that you know you're not taking the right dose. I know some people think that it's not a therapeutic dose if it's under three, but that is a myth, isn't it? 

Pharmacist Kim Hansen: I would agree with that. Every patient is different and how they respond to it. So even if you have identical twins. A member of your trust that lectured about this, their one set of neighbours. They completely matched as people go, and the same age, same condition, same everything else. If you go down the line and, person A got results more quickly than person B. So person B was discouraged thinking that they weren't going to find the same relief that person A got.  Having to start over with patient B, and go a little bit more slowly, titration was the key for her. So whereas a lot of times you'll see dosage regimens that, every week we're going to increase by whatever the increment is. Sometimes patients will need to go even more slowly than that and maybe increasing every two weeks or maybe every month, whatever that takes. And again, not everyone is the same. So if you get to a dose rate, like, I didn't feel anything the whole way. Sometimes you can, wash it out, start over, and go more slowly and find results there. It's just so dependent on each patient and just because you haven't gotten the answer that you want and you've gone up to 4.5 sometimes the answer isn't going up a higher dose. Maybe it's starting over and going up at a slower pace.  

Linda Elsegood: Some people feel quite discouraged starting again, but by doing it very, very low and moving up very, very slowly the fallout rate isn't as high, and the success rate goes up. You know, 20% of people didn't have the relief they were looking for, but that 20% has reduced, hasn't it? We are getting a better success rate now, understanding there are people who do need to look at LDN differently. 

Pharmacist Kim Hansen: Completely agree. Back in the 80s when we were doing 1.5 and three and 4.5, that was such a rigid structure that you probably lost a lot of patients who didn't have success and or probably had side effects that they weren't pleased with. Changing our thinking with the results we have now, knowing that going more slowly and doing slower increases or lower increases is actually beneficial overall. Yes. Patients who have tried with not finding their success before; it doesn't mean you won't have success trying it in a different fashion.

Linda Elsegood: Exactly. And then there's the other school of thought where you have to take it at night. You know, it's not gonna work for you if you take it in the morning. We now know that's not true. Is that what your experience has been? 

Kim Hansen: I would say that's true.I think yes, at the beginning of the push was, Oh, you have to do it at night because your body does repair at night but you know, here's no reason why you can't do that during the day. And there are also reasons why you would want to do something twice a day and do split dosing. Some disease states and some patients do better when they're split dose.I find that is the case with using it for the antidepressant purposes, sometimes a split dose is better for that patient versus the whole dose at one time of day regardless of morning or evening. Again, individualized treatment, and you have to listen to the patient and listen to what they're saying to you so that you can work on a treatment plan together. 

Linda Elsegood: And you were saying about the topical cream for children with autism. Do you have many children with autism? 

Pharmacist Kim Hansen: We're in New Jersey, unfortunately, we have one of the highest percentages of autism in children. So yes, I do see it, not as often as I once did, but I do see it, and usually, they're not amenable to swallowing pills. So usually the parent is putting on cream at night when they go to sleep, and they don't even know what's being applied.

Even if they take a capsule and they put it into a smoothie or whatnot, kids are wise to that because they're probably on a whole bunch of stuff and they're eyeing up every meal that comes to them, making sure nothing's been hit, so they're pretty wise to it. You'll find that the cream is helpful in those cases and yes, it does work.

Linda Elsegood: And have you come across children with juvenile arthritis or pediatric Crohn’s who are taking LDN? 

Pharmacist Kim Hansen: I have heard of it, but not in my experience here. 

Linda Elsegood: And no children or adults with asthma allergies. 

Pharmacist Kim Hansen:  I had heard of it of course but no experience of that directly here.

Linda Elsegood:  It's amazing, isn't it? Initially, going back,15 and a half years when I started the trust, it was mainly people with MS. Then it went to Crohn's, then fibromyalgia, it was just exploding. But we didn't know too much at that point what it did for chronic pain that wasn't autoimmune. We knew it helped with cancers. We didn't know about all the mental health issues and of course, it's used in fertility clinics as well, and for women's health, for painful periods.  There's a name for that, PCOS, polycystic ovaries. Dr Phil Boyle uses it in his clinic to help women get pregnant. They take it during pregnancy, during breastfeeding, have really happy, contented babies, he says, and they have less chance of needing IV antibiotics for chest infections and things, which is apparently quite common in babies when they're firstborn. And he said, as a rule of thumb those babies are far more content when they come back for checkups,  than babies that haven't been exposed to LDN, which I think is quite interesting, isn't it? 

Pharmacist Kim Hansen: I agree completely with that. When I have a patient that's here, and I'm showing them the list of disease states or conditions that this is helpful for. And of course, their question is always, how could one thing be good for all of these? And I love that question because that means that you're thinking, okay. And you're sceptical, and that's fine, but then when you explain that a lot of these systems are all tied together and how pain and depression are linked by the same pathways as is your immune system, as are a lot of different things, inflammation, all tied together.

When you can explain and have them understand how the different systems in your body interplay, that's when the light bulb goes off because traditionally here in the United States you go to the foot doctor for your foot problem, you go to the GI doctor for your stomach problem, you go to the neurologist for the neurology problem. And really they're not all communicating.  When you look at the thread of symptoms that a patient is dealing with it's like you're missing the overall theme of inflammation or whatever that is. And LDN is helpful for that. So, therefore, it's helpful for all of those conditions. It's not because things are tied together. That's why it's helping you. I hope that made sense.

Linda Elsegood: It does. Now there are other things you can do to help inflammation as well as taking LDN. What do you suggest patients do?

Pharmacist Kim Hansen: For inflammation? Well, it's very important. I always remind patients that their diet is everything. If you look at the glycaemic index, it's scaled anywhere between zero and a hundred and sugar is at the top as being a hundred you would like to keep your dietary choices below a 50 because they are less likely to cause an insulin spike or have a glycaemic effect on your sugar. So if you keep your food items below a 50 more often than above 50 you're reducing the fire in your system. So the whole point of taking naltrexone is to reduce the fire in your body, as explained before.  Everything is connected. You can't expect the pill to do all of the work either. Reducing inflammation that you're adding to the system is also part of it.

You can't walk around eating the standard American diet of high carb and high sugar and poor nutritional value and not have inflammation if you're going to continue to feed the inflammation fire, of course, you're asking the LDN or the naltrexone to help with your symptoms.

Sometimes just reducing a lot of the inflammation that way is helpful and it certainly helps to augment what the LDN is doing. I also find that high-quality C-- products, the full spectrum ones are also helpful at reducing inflammation. Using the LDN in combination with the C--, you get the beneficial additive effects. I have patients who have needed to use that combination, and they've gotten their quality of life back.  

Linda Elsegood: it's funny what you were saying about fruits. My mother was in the hospital, and she was a type two diabetic, but her kidneys were in a very poor state, and she had to have insulin. She had quite a bit of insulin three or four times a day. When she was in the hospital, she asked for a banana. And they bought her a banana. And she said, Oh no, I, I don't like eating bananas a little green and underripe. I like them when the skin is going brown, and it's mottled and inside is all nice and squidgy. And they said, no, you can't have one like that because it's going to affect your insulin because it's very, very high in sugar when it's that ripe. That is correct. The nurse was trying to say very nicely, but it is higher in sugar, and I think my mother was thinking, a banana is a banana. The nurse was trying to say, you can have a banana but you mustn't have it when it's overripe.  Because it's too high in sugar. 

Pharmacist Kim Hansen: When I tried to talk to patients about that, of course, nobody ever wants to hear they have to make changes and give up their banana or wherever it is they're eating. Everybody likes what they eat, but when you explain it and say, Hey, these are inflammatory, what you're doing is adding to your inflammatory burden.  I'm not saying completely avoid the bananas, but if you know that you had had a banana that day cause you had to have it, maybe look at the bottom of the list to make sure that maybe we're balancing that out and making a choice that has less of a glycemic load than maybe the banana or something else. That's not to say that you should never have banana again, but maybe making choices to balance out your day versus choosing everything above 50 if you reduce the amount. Because they are both 50 and take below 50 reducing the amount of inflammation in your system, which is good for all sorts of things, Alzheimer's, heart disease, cancer risk, all of these things driven by inflammation. And why would you not want to reduce those risks? 

Linda Elsegood:  It's altering the way you look at food. Instead of being a diet which people don't stick to. It has to be a lifestyle change, doesn't it?  So it becomes a habit. You know you have good habits instead of bad habits. 

Pharmacist Kim Hansen: Agreed. If you call it a diet, people assume that is a restriction on their lifestyle. If it is health maintenance and it's on a different connotation or inflammation reduction. If you look at it that way, rather than, oh, I'm on a diet. Well, you know what? I'm trying to reduce the inflammation in my body. You'll find that you'll get fewer headaches if you get rid of sugar and carbs, which of course includes bread. There are healthier slices of bread that you can eat, more of the whole grains here.  I was amazed by this too. Everybody's under the misconception that, Oh well I, you know, I'll avoid the white bread cause I know that's not good for me and I'll just eat the wheat bread. It's no better. It really isn't any better. It's like a point or two different on this scale. What you need to do is either do it like a whole grain bread or switch to something that's grain-free, like Ezekiel bread, which has a low-glycemic index. If you're trying to make that effort, there are smarter choices that you can make.

So you don't feel like you're on a diet where you're restricted and being punished. There are ways to explain things.. You just have to be careful about continuing to pile inflammatory product after inflammatory product. It leads to all of the other health problems that I mentioned before.

We're all leading stressful lives, and probably you're not exercising as you should, and not resting as you should, and you're just adding more and more burden to your system to be able to detoxify. Helping your body do its best is certainly a better management tool all around.

Linda Elsegood: Well we've run out of time Kim, can you believe that's 30 minutes gone?

Pharmacist Kim Hansen:  I can't believe you wanted to listen to me. Wow. I'm so happy. 

Linda Elsegood:  Awesome. Thank you so much for having joined us. I really appreciate it. 

Pharmacist Kim Hansen: I'm so grateful to have been asked, and it's my pleasure. If you have any questions, certainly please give me a call and I'm happy to share anything I know. 

Linda Elsegood: Thank you.

At Town and Country Compounding Pharmacy in Ridgewood, New Jersey, owner, pharmacist, John and his team are passionate about low dose naltrexone. They have compounded LDN for over 15 years. And they're committed to compounding high-quality medications and serving as an educational resource for patients and practitioners alike. Visit https://tccompound.com/ or call (201) 447-2020 with any questions or comments you may have. Please email me at ontact@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.

Dr Marie Ekpema PharmD - 16th Oct 2019 on the LDN Radio Show (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Marie Ekpema, PharmD is the clinical director and pharmacy manager at Summerwood Pharmacy and Compounding in Houston Texas in the United States. She undertook additional training in compounding and bioidentical hormone replacement therapy.

Dr. Ekpema’s grandfather was an herbalist, who inspired her to go into pharmacy. Her first 15 years were as a traditional pharmacist, but realized the need to address some of the side effects of medications, such as gut issues and drug-induced nutrient deficiencies. For example, a magnesium deficiency can cause headaches. In the US, most prediabetics are started on Metformin. But working more with doctors and patients regarding supplements and lifestyle choices has resulted in patients on fewer prescriptions, and more targeted medications.

Linda Elsegood related that she had undergone 3 courses of IV steroids in 18 months, which resulted in weight gain, and Type II diabetes. She was put on Metformin, but still was diabetic. She decided to change her diet: removed gluten, removed added sugar, and removed dairy, and at her 6 month check-up was able to stop Metformin, and has held at the pre-diabetic level.

Dr. Ekpema believes in empowering people in decisions about their healthcare. One thing they recommend is gluten, dairy, and sugar restrictions, and ask patients to try it for 60-90 days and give feedback. Medications help manage disease, but infrequently are medications a cure. When you modify diet, especially with autoimmune diseases, results happen. She has seen patients go from using 100 U insulin daily back down to using 10-20 U; and patients being able to reduce medications type and dosage.

Linda Elsegood related she has high cholesterol, likely hereditary, and was told that diet wouldn’t help. Dr. Ekpema verified that is the case in certain types of hypercholesterolemia, but there are other approaches to reduce inflammation in the vessels, such as pomegranate juice daily, garlic, exercise, and reducing inflammatory foods.

For a consultation, patients can contact the pharmacy: https://summerwoodrx.com/ or phone 281-225-4300. Depending on the season, the waiting list could be anywhere from a couple of weeks to a month, particularly during the summer. There is an intake form, and consultations are done in the pharmacy, or over the phone. They communicate with the patient’s physician as well.

The pharmacy compounds LDN capsules, anywhere from 0.5 mg to 6 mg. The also prepare topical LDN.  Most of her patients are middle-aged and older. Prescribers who graduated in the last 15-20 years tend to be more open to LDN. She notes great results with LDN: reduction of symptoms, reduction of pain; and most dramatic, was a patient with psoriasis who had a 70-80% improvement on LDN. It is important to titrate up slowly, however. Also important is gut health for those with autoimmune diseases – if bacteria is not balanced, results won’t be good because it interferes with absorption.

The most frequent side effect patients mention is trouble sleeping, and they advise the physician to titrate up more slowly, or to a lower dose. They have found others have bad dreams, and recommend including some magnesium glycinate for more restful sleep.

An issue Dr. Ekpema relates is buying prescription-only medication through sources that do not require a prescription, because the regulation and testing is not done, and the sites accept no responsibility. At a compounding pharmacy, you can be certain of the quality because it has been tested.

Dr. Ekpema gave appreciation for the LDN Research Trust, the recorded interviews, and the information it provides.

Summary from Marie Ekpema, PharmD’s LDN Radio Show from 16 Oct 2019. Listen to the video for the show.

Keywords: LDN, low dose naltrexone, compounding, bioidentical, hormone, drug-induced nutrient deficiencies, diabetes, hypercholesterolemia, autoimmune, psoriasis, gut health,