LDN Video Interviews and Presentations

Dr Julia Piper - 12th Feb 2020 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: I'd like to introduce my guest today, Dr Julia Piper from Private GP Services in Leicester in the UK. Thanks for joining me today, Julia. 

Julia Piper: Oh, it's a pleasure. Lovely to speak with you Linda and all your listeners. 

Linda Elsegood: Thank you. First of all, let's get to know you, what made you decide to become a doctor. 

Julia Piper: Oh gosh, Linda, that was years ago. I think it was only six years old, and I always wanted to become a doctor.  I remember my cousin was a doctor and I was completely obsessed with how wonderful she was. To do this and want to do it. And eventually, she became a haematologist.

I just never wanted to do anything else. My father said, why didn't you become an engineer? And I could, I just couldn't relate to anything else and that was it really. I mean, people tried to dissuade me over the years for a number of reasons, I guess, you know, to do with the number of hours you're going to have to work, but it didn't quite work, you know, it's like, I'm on my right path, let's put it that way. 

Linda Elsegood: Oh, wow. So where did you study?

Julia Piper: Nottingham University. I chose that because it was very beautiful and green, and I liked being out of doors.  I could have gone to London I guess because we lived in Kent at the time but, I chose Nottingham, and it had quite a different course. You were assessed by continual assessments so that you had exams at the end of every term.

You became a bachelor of Medical Science, so you learned how to be a scientist as well and apart from that it was very similar to other courses, but it was just this, that didn't have to sort of leaving everything to the finals. After two years you really sort of kept on top of things as you went through  

Linda Elsegood: okay. So when you qualified, what path did you take then? 

Julia Piper: Well, I always wanted to be a GP because I loved being out in the community with families and so on. And so I went into vocational training, and I did my own vocational training course, which, in those days, we were able to choose different specialities.

And we did that for two years. And then we had to do a year in general practice. And then I went into a GP practice in Yorkshire where I lived at the time and moved down to Hertfordshire in general practice there and now, and then moved up to Leicestershire, which is where I am at the moment. So I had quite a lot of experience in the NHS, you know, before I, I actually then eventually moved into the private sector.

I mean, it wasn't really planned this move into the private sector only that  I guess I wanted a little bit more time with people and just to have a morning a week where people could just ring me up and say, can I have half an hour? I need more time. Because it was so, you were so stretched for time in the NHS, and so that was meant to be anything else but of, you know, we all know their life changes and evolves, doesn't it?

It changes, and they both send. Eventually, as I say, I went into the private sector and started to see a few patients privately. Interestingly over the years that changed because, I suppose with the regulatory framework changing with the care quality commission, and so on, we had to professionalize our systems and we were the first in the UK to be registered with the care quality commission.

And eventually, I had to make a decision to leave the NHS and some of it, a lot of the locum work I was doing at the time and move totally into the private sector. So I've been doing this now for 25 years, so it's a long time, isn't it? 

Linda Elsegood: Very long time, but it must be very frustrating being a doctor if you have a patient that has a chronic condition, how do you possibly understand all the symptoms and everything they are going through in 10 minutes. 

Julia Piper: Well, absolutely. It's interesting. I think that the way we were trained at medical school and the way doctors, in general, have been trained, up until recently things are beginning to move in different directions.

Now maybe.  but I think we would, we were trained very much to give a label to a disease that that disease has certain evidence-based treatments with drugs or surgery. But what I found as I've moved through life, in particular as we had illnesses in our own family and also with my son's illness of schizophrenia, I have a son who’s has been in incredibly poorly and you know, I, I began to seek other routes to understand what I could do because I felt so frustrated it was like he would give me a prescription on your pad when it became a doctor, and you had to write on it, you know what the medication was or refer to a specialist or to surgery and it seems like we didn't really, we weren’t taught to do anything else. But as I moved into the private sector and I had a bit more time, I think I felt quite guilty that I actually thought I have people coming to see me who are really poorly and there must be more than this. And I think at a very young stage, especially with my sister dying from ovarian cancer, I started to look into alternative routes to heal people and to help to really understand, you know, why both the Chinese chose acupuncture?

I mean. There were clever. They had no science in those days, but they had observed and you had thousands of years of observation and knowledge that, you know, we didn't seem to be taking any notice of. So I trained in acupuncture, I trained in hypnotherapy. And moreover the last few years, I've been training into functional or biological systems medicine.

So that was the root really. It was just frustration. You know that we stopped too soon or we seem to diagnose a disease when it got there, but we didn't seem to do anything to help reduce the risk of developing it. And we didn't seem to do enough when we had made that diagnosis, we didn't have enough tools.

Linda Elsegood: And of course it would seem to me that doctors treat the symptoms rather than the cause, to find the underlying problem, and then the symptoms go away, but you don't actually need to then treat the symptoms. 

Julia Piper: I see. Yes, that's right. I mean, that's really the way we're trained. I think that was my biggest frustration that and I can understand that, you know, once we’ve got a diagnosis, but sometimes medications can be incredibly helpful in the right place but they're not necessarily a panacea, sometimes say, Oh, but you know, we need to have these the tools and understanding this as a body so that we can recognize the causes and the pathway to illness. Because if we don't understand that we a) can’t prevent problems. But b), you know, it's more difficult to turn around some of the symptoms that we see, as you say at the root cause. I agree with you on that one completely.

Linda Elsegood: So how long ago was it when you first heard about LDN? 

Julia Piper: Mmm. Interesting. Low Dose Naltrexone, I mean,  I knew about it for many years actually with those patients that came to see me when I was working in the NHS who were taking Low Dose Naltrexone. So at that time, it wasn't on our list of things that we should be doing.

And so I, probably because I was too busy, you know, seeing so many patients with the NHS, I didn't really look into that further. But I came across it again about five or six years ago. Again, when looking at patients who are chronically ill, studying to a much deeper level with functional medicine and biological systems medicine and not trying to understand what was happening with the immune system because it seemed to me, that it became apparent anyway way to me, but actually much many of our symptoms in our bodies, be it headaches or tummy aches or you know, all the root of chronic illnesses such as MS, Parkinson's disease, where are due to inflammation. And that is so closely tied to the immune system. And that there’s a disruption in our immune system. When I think of the immune system these days, I suppose, I think of it as rather than an army who goes and tries to sort of kill the baddies. I tried to think of it as an intelligence service like MI5? It's very complex, actually working out who is for us and who is against us. Because actually, you know, under different circumstances, you know, that those situations can be, can co-exist right? So I think that's, in terms of, as I began to understand the immune system and look at, say for example, for those people who are au fait with the immune system, the TH1 & the TH2 parts of the immune system and how they become imbalanced, for many reasons and often associated with underlying conditions, depending on how unbalanced they are, you know, it became much easier to understand why a medication such as Low Dose Naltrexone would work and I think, you know, my first foray into that was with people who had autoimmune conditions and whose cellular immunity was not working as well as it might do. And who, probably alongside, developed chronic stealth infection but actually LDN was a very good tool to be able to correct some of the imbalances that had developed.

and as we know there are many, many autoimmune conditions. And as we develop the how-to, how to phrase it, sort of imbalances in the immune system or in the intelligence network that, you know, we need, we need more tools to be able to correct those. But also remembering that as we develop a problem within the immune system, that that really runs alongside some of these chronic stealth infections that then are allowed to develop.

So as I say, what I found with low dose naltrexone, it's a great adjunct. I mean, sometimes it's very good on its own but I find that on its own, the body becomes so complex that no one thing normally is enough to, to get us better. You know, if I've introduced Low Dose Naltrexone, it's on the background of someone that understands the importance of the gut and understands the importance of, you know, having a great diet that is tailor-made to suit them. We all have different idiosyncrasies with our diet, but really we've got to be able to work with our lifestyles and our relationships, our exercise patterns, you know, everything really, as well as having these tools that can help to modulate the immune system and give us that extra bit of support at a much deeper level.

Linda Elsegood: Mmm. Yes. What have patient outcomes been? Could you quote us any case studies? 

Julia Piper: Well, interestingly, I suppose my son was a very good case study in that he had a diagnosis of schizophrenia many years ago. He's 34 now, but he's done incredibly well. I mean, he initially was, had drug-resistant schizophrenia and eventually was switched onto something called Clozapine, and he remains on that for various reasons because we're still working with him. He now on a combination of Clozapine and low dose naltrexone, and he takes a lipotherm glutathione. but along the way, we had, you know, remember when the brain is inflamed, when you have neuroinflammation that our cognitive processes in schizophrenia and in many conditions, but particularly schizophrenia, completely change.

And therefore our perceptions completely change and there are times when the brain becomes fragmented. Schizophrenia is a form of dementia, okay. So that we've managed to turn that around a lot by diet and by diagnosing underlying stealth infections, which were treated. But interestingly, this combination of the medication, which again would be working, eventually, it may be to reduce that, but at the moment, he is stable on the medication. Plus, we initially had IV glutathione and now we're onto the liposomal form, remembering that that enters the cells and can pull out metal such as mercury, which we’ve measured, And we know that that's at the root of his particular problems.  Part of it.  the LDN availability the Low Dose Naltrexone in him has been a great success because with schizophrenia, the microbial activation that happens when you've got cytokines. Cytokines are little messengers produced by the immune system when there's a lot of these around, you know, the immune system of the brain, which is called the microglia, becomes activated and Low Dose Naltrexone, we know, calms that down and it restores the TH1 to TH2 balance. So it means that the tendency towards infection in autoimmune conditions and there are many of them, you know, obviously the inflammatory bowel diseases, Crohn’s disease, rheumatoid arthritis. I mean, there are over 100 different conditions.  And many people may not realize that schizophrenia, for example, it's an autoimmune condition, but they are all helped when we address this TH1 to TH2 balance and increase T regulatory cells. That's a lot happening when we're using this, I've had great success, Linda, in David, my son, but we use it as part of a multidisciplinary approach because we're looking for particular weaknesses, if you like, of, or dials that we can turn in our biological systems that the body will be up to shift with. And when, when we're working on each of those dials simultaneously, at some point, there's a shift and the body is more able to sustain itself in a healthy manner. And I'd like to see more if this biological system of medicine really taught to university, I believe it's becoming more mainstream, I know Bristol university have a scientific department which teaches science underlying functional medicine and I know, a colleague of mine, her daughter's training there. So, you know, things are beginning to shift so that we understand, you know, what it is we're trying to do in modulating and change things at the root level. I think that's good, don’t you?

Linda Elsegood: Yes, definitely. Now, when a patient comes to see you and you've got more than 10 minutes, who obviously has some chronic disease, but they don't know what's wrong with them. How do you go about helping that person when they've walked in, and you know nothing about them? How do you set about treating them? What's the road map? 

Julia Piper: That's a good question. I have a detailed questionnaire, because I really need them to fill out because I like to gain as much information on paper before somebody walked through the door, so it includes the multiple systems questionnaire, for example, I can see quite quickly if somebody is scored like two on the multiple systems questionnaire, then those two symptoms might be incredibly distressing

but I suppose somebody who's scored 165 and like you sort of just gets this. I think I know the questionnaire, I  know what I'm looking for. You know, and we’re asking quite deep questions sometimes to get people to try and think down to the root. You know, what may be their pathway to illness and with functional medicine, we're looking at the detailed question, detailed history. And a road map. They're doing a flow chart as often as someone's life, just to see where these pivotal points are. And when you do that, it becomes much more obvious at what point and what are the triggers and the mediators and you know, the, um, the pathway to wellness, the antecedents, if you like.

So, for example, I mean, I suppose tick bites and the Lyme disease, or even what may turn out to be a chronic infection, for example. We refer to Lyme disease as something which is a chronic and difficult, in fact, the wording and the nomenklatura the naming of these long term conditions now and not so much Lyme as something called M-S. I. D. S. multiple systemic inflammatory disease and infectious disease. So disease syndrome of multiple systemic infectious disease syndrome. And these conditions can become chronic. But if you look at this questionnaire, and you look at the flowchart as someone comes in, you can see how they had, what are the triggers, you know, if there's something recent that suddenly made them present and pick up where your pivotal points are.

And if say for example, in the case of M-SIDS or Lyme, we can, if we can pick up someone lives in a forest or lives in an endemic area of the new forest in the UK, for example, and has had tick bites. Okay. That's not the only thing that's made them ill, but that's a pretty important point that we need to not to miss.

And we asked a lot about toxicology. We ask about—exposures about sensitivities. You know, people have multiple chemical sensitivities. At the root of functional medicine, in the end, two things. One infection and two, toxic insult to the body.

And we want to know what is burdening this person's body that they are suffering from so many symptoms. Almost list numerous systems, too many to this, or you can look at the systems that are going that had been affected that may be producing these symptoms.

So my map, if you like, to gain as much information, particularly about, it's about everything, but it's particularly at the root cause and particularly in a section of the body burden. Does that make sense? 

Linda Elsegood: And how long does it take on the first consultation with a patient to go through.

Julia Piper: Well, I would say we normally try to allow an hour because by the time they've come to see me,  people's often seen in quite a few different doctors. Physical a few little tests. They've been with them and then they've completed this questionnaire, which I find enormously helpful because I can get, I can, I get a really good feel quite quickly.

 With what is going on because there's, you know, once you've understood and you've worked for systems biology for a long time and studied hard, you can start to see where the pivotal points are even sometimes before you've tested. There's that first time.  Well, I'll do a flow chart to see exactly what's been happening over their lifetime, and I can pull it, pull into any tests that may be completely personal to just, you know, pinpoint and a little bit more exactly which dials we need to turn to get somebody better.

So we normally. Sometimes you can get a few little tests done on the day, but I don't normally like to do tests the first time I see someone, because I like to email everybody with potentially a few tests they may need and then you can have a little think about them. And then we can have another little chat often by phone.

because people would sometimes come from quite a distance so I don't want to drag them back. We usually do a little examination at the end of the first hour, and then I'll send them a list of things that I think would be sensible. And then you know, the sort of little few little thoughts about, how, I think the road map is and why we need these tests if any.

The test can be quite expensive, unfortunately. See, we don't always test, but sometimes it can just target you a bit easier. It's quite in order for patients to go back and get the simple tests and that GP of course, and we can sometimes, well since example, I do less just to give an example, less a food sensitivity test now I tend to do the elimination diet and take out things that we know can cause problems. And so it's possible to do things more pragmatically as well. So but that's, that's what I did today. So I'm kind of, I've got to go back and do a couple of emails to patients and, you know think about exactly which tests that we do.

Then when we get the results, we can start with low hanging fruit and then move forward. I'm actually in a situation to see a lot of people, people who are seeing different doctors. So I'm usually, they've had most of the tests done by the way. So my job is seeing where the gaps are and how else we can support, you know, in ways that haven't been considered at that point.

Linda Elsegood: And of course, a lot of people are still unaware that if they've had tests done by their own GP that you are allowed to ask for a copy. You can be charged, but everything you are allowed to have access to everything. 

Julia Piper: And very important people know that they can have a test by the GP  and go back and get them. I can write them down what you need, and you then go and ask them. And it's difficult because some people don't like to go and ask their GP for tests because you know, they, they feel that they might get upset or something. So that they'll only know if you could, I can write them down for you and then I can always write to GP’s if that’s necessary.

I think this is a shame really because a lot of doctors, understandably, I mean, I would have been in the same position if I'd been in the NHS. You know you haven't got time and having the study date, it takes years of study and understanding. When you look through a lens of root cause medicine, it's really hard, you know, because we were trained in such a different way.

But to me, the two can live together well. And the new young doctor at the DePaul side plan, bring out the functional medicine because there's a frustration in the way that they and I do some work at the investor heavy recently in Leicester. And we had a few students, one by one coming in, one sitting with me, and then we had a meeting with them at the end. And I just sat down with them for a day, and I just tell them my son's story, you know? And I said, how much nutrition training have you had? And it's actually zero. Yeah. And it was a shame and I feel so sad and I think to myself, you know, really when I trained, I didn’t know anything about it either, you know, and I say, I think life has changed.

It's for the better. I know we, so, gosh, there were on the internet and wifi, and EMF obviously, we have to limit our exposure, but I feel like there's a lot that's getting better because people understand so much more now. But having said that. I'm thinking it must be very frustrating if you're on an HSG PA traditionally trained these days because a lot of patients that got anything about being ill will know more about it than you do as they come through the door, because they've looked at some of the root causes, and I think it must be very frustrating to be

A doctor in this day and age with such knowledgeable patients because I'm contrary to what a lot of people, and I think Google is amazing. I think the knowledge has got on there, you know? 

Linda Elsegood: Well, we're nearly at the end of the show Julia, but just wanted to ask if a patient goes to the doctor and explains that they've been to see you, would you be happy to work with the GP as well?

Julia Piper: Oh, gosh, yes, very much so. I mean I think a lot of GP’s are very, very busy and you know, again, some people probably feel a bit upset because they feel a bit threatened and that's a shame. You know, it's difficult I think in some cases we have quite a few patients who, especially when their children are involved, you know we have to look after the family and communicate to all agencies because a lot, there's a lot of misunderstanding around children with multiple symptoms and where traditional diagnosis could not be found. Sometimes there’s a lot of pressure put on the families that maybe they're making them up or making the child ill or whatever. So, you know, I do a lot of work with working on explaining carefully what we're doing and actually that is some problem going on and here with the test results. And so we do do that. And sometimes it can be very difficult, you know because people do feel a bit threatened, especially when they don't understand something. Obviously you were working with weird situations and with thought processes,..... mass guidelines.

And so I haven't set up, I mean, B12 injection, somehow we use B12 is something that's actually within the nice guidelines and sometimes you end up, you know, just explaining, well actually you can give this because this person has their neurological condition. And that's what it says in the novice guidelines that sometimes you have got that backing.

But I think the answer is yes, we will work with the NHS under the doctors, and we should be working as a team, and we should be trying to separate things out that sometimes, in reality, we have to, but that's, that's the decision. If the patient, when it comes to a child that has no choice because it's not that time particularly.

Well, you know. Cause of child children in need or child safeguarding. We all compelled to communicate, and we have to communicate. So am I making that up? Yes, I am. I'm just kidding. Basically, yes. And sometimes that's a choice in it, and sometimes there isn't. 

Linda Elsegood: Okay. Now if people want to come to see you, do you have a waiting list?

Julia Piper: Not at the moment no, we don't. We have, I don't, you know, I think at the moment, I don't work all day, every day seeing patients because I tried to keep a balance but we have other doctors here who I work with and we have a lovely coach, health coach and a nutrition coach and a nutritionist who came in and went with us as well.

So, that's the way we do it. So sometimes if you know, I didn't need to do everything, then I can ask them, and I'll tell them certain things. And I find that you know, you can sort of work out what you might need to do in life and then you need that little bit of extra sort of access from a motivational perspective.

She may not change, cause sometimes that isn't so easy, you know, so it's not just me we've got other people that we know that can help as well. Wonderful. 

Linda Elsegood: So could you give us your website address, please do. There. 

Julia Piper: Yes it's https://www.privategp.com/. We rebranded this year before we were very much more like a traditional practice, but I think my daughter said to me, mum, you need to make your website who you are. And so she helped me to, to do that and it was difficult—the time. I remember my father was very poorly. I mean, we lost him in the end.

I found it somehow we've managed to do it despite everything and which we did it. We launched it in May this year. And I hope you like it. So, any feedback would be gratefully received. 

Linda Elsegood: Well, all I can say is thank you very much for sharing your experience with us today. It's been really interesting.

This show is sponsored by Dixon's Chemist who are the experts in LDN at associated treatments in the UK. Dixon's Chemist is the most cost-effective for LDN in all forms within the UK and Europe, maintaining safety standards in excess of what is required. Why would you choose to get your LDN from anywhere else?

Call 01414 046545 today to speak to the LDN experts.

 

New for 2020 LDN radio shows will be available on Spotify and iTunes. They will also be transcribed and added to our website, https://www.ldnresearchtrust.org/

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 appreciate your company. Until next time, stay safe and keep.

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.

Michelle Resendez FNP-C - 15th Jan 2020 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Michelle  Resendez is a certified family nurse practitioner. She combines her love for alternative and natural medicine alongside traditional medicine.

She has successfully treated patients with a diverse range of health conditions that have not responded well to conventional medical treatments.

She said" I first learned about LDN about 10 to 12 years ago, first learned about it from a naturopathic medical. The first patients I treated had thyroid conditions, Hashimoto's, Graves thyroiditis. And so I was really using it to try to the modulator assist the thyroid in functioning better. And from that point, it really expanded and opened the horizons, treating other things.

So we found that people with thyroid conditions, if they're taking thyroid medication, usually have to reduce the amount of thyroid medication.

When I start someone on Low Dose Naltrexone (LDN), easily around 0.5 to one milligram at night, and I will either reduce their thyroid medication in half, or I will just reduce, if they're on a T three medication, I'll reduce that down.

 A lot of times, their autoantibodies will start going down, and that will help the thyroid function better.

Sometimes you'll get some adverse side effects like tremors or palpitations, or just feel a little bit more excitable than her used to feel.

I have a lot of patients start noticing the effect almost immediately within a couple of days. Depends on what condition I'm treating.

A osteoarthritis type pain or structural type pain people usually notice the effects within a week of taking that.

Once they move out to one or two milligrams, they start feeling some relief.

Antibodies are a little bit more resistant, and it might take, two to three months to see antibodies go down with LDN. And that's because of the treatment approach for that is really multifactorial.

And the LDN is just an adjunct to that. And usually, we do lifestyle modifications and diet and, and other interventions to help those antibodies come down as well.

Anyone starting Low Dose Naltrexone (LDN) can experience negative side effects. The most common would be that when they get a rebound effect it at night with those endorphins kicking up, they can get some anxiety. They can get some insomnia.

Patients that we treat for viral conditions or reactivation syndromes like Chronic Fatigue Syndrome, they can actually get more severe adverse side effects such as sweating, fevers, flu like symptoms, feeling sore throat, things like that.

All of that is expected and typical. I don't like to stop treatment if they're experiencing those side effects because that's telling you that it's working. We're getting the endorphin release that we're looking for, and we're getting the immune system enhancements that we're looking for.

Those side effects are what I would consider good responses.

I haven't had anyone had any side effects that  I would consider to be adverse like hives—rashes, vomiting, anything so severe that I'd have to stop them on it.

I treat GI conditions as well. I've had probably the most success with gut issues. It's one of my top responders. Some of my earlier patients were Crohn's patients.

LDN seems to work pretty well for the exhaustion, the fatigue and the pain.

The conditions that I treat teenagers for could be anything from Attention Deficit Disorder, Depression, pain conditions, allergies, sleep issues.

Some of my kids are on the autism spectrum, so I do treat that as well.

I do have quite a few teens and young children on LDN. And I'll actually have them on liquid if they're too young to swallow a pill or won't tolerate a gummy or a sublingual lozenge.

I do have a traditional medical doctor referring to me, Neurology, Cardiology, Rheumatology. Dermatology because there's a lot of dermatologic conditions that can be treated very successfully with both topical LDN called Xeno top and then oral LDN.

The skin conditions I am treating it for it would be the Legos, Psoriasis, Rosacea, Eczema. Those are probably the top of all the skin conditions that respond really well to it. It takes normally 3 months to see results.

There's trials to find if there are some food triggers associated with that.

A lot of it is when they're having fires and because it's triggered by something and I want to find out what that trigger is.

And then the LDN just helps the body heal itself. So it's keeps them in a remission state.

When I first see a patient I typically wll do labs tests first that looks at allergies, hormones, thyroid, inflammatory markers, genetics, things like that. I try to find triggers if I can identify any and remove those before then starting on LDN. I like to see how they respond first to that.

I like to do things in stages so we can really see how impactful each thing is at each stage. So I'll take away the food triggers first if I can identify them and then add LDN onto that at some point.

Right now we've just moved into our new office. So my business partner and I have been here for three months. I'm at a two-month waiting list right now. Once we hire some more back-office staff, I'll be able to stack more appointments and that will trim down for maybe a month or two and then we'll probably get booked up again. I do keep appointments open early morning and sometimes I'll see patients after my last appointment for the day. If there's something urgent or somebody's not responding favourably to meditation or something.

I leave those time slots available for that so I can get people in if I really need.

I would say on average, patients see me every three months. That would be somebody who is stable, doing well on their regimen and not needing any further testing or imaging or interventions done.

So some patients I will see on a monthly basis if they have a lot more chronic illnesses and conditions because I like to do those steps, plan out, maybe CBO treatment, diet.

Also with hormones, thyroid continue to add things to optimize how they're doing and their quality of life.

I have some come in annually. They're probably not my patients on LDN. They're probably more. They're doing our mono treatments, pellets, injections. Yhey're doing other treatments other than just LDN.

Summary from Dr Michelle  Resendez YouTube interview. LDN Radio Show Listen to the video for the full interview.

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.

 

Misty Rushing, CRNA - 25th Dec 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Sherry - 1st Jan 2020 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: Today. I'm joined by Sherry who uses LDN. Thank you for joining me today, Sherry. 

Sherry [00:01:07] Thank you for inviting me. 

Linda Elsegood: [00:01:10] Could you tell our listeners what is it you take LDN for?

Sherry [00:01:16] I have the autoimmune disease, lupus. I have degenerative arthritis and fibromyalgia. These are three of the main concerns in my health, which has caused chronic pain. And it's really brought me to a place of disability, not being able to work and to enjoy life. And my health just kept deteriorating. And so a few months ago I was introduced to the alternative medication of low dose naltrexone. 

Linda Elsegood: [00:02:08] Can we just stop there for a minute? Let's find out first of all, before you found LDN, what was it like, and how long did you have all these conditions? I mean, have you had them all your life? Have they only been the last few years? Start at the beginning of your journey. 

Sherry [00:02:28] probably about 25-30 years ago I started having issues of where I would get a rash all over my body and then begin just feeling really bad and tired, and everything on my body hurt. It would happen maybe two or three times a year, or if I had gotten a virus or a urinary tract infection, I would get these symptoms. And it took several years for it to progress to where I was having these symptoms every month, every two weeks. And it took quite a while for doctors to diagnose the condition as lupus. And it is a progressive type of illness, not like it happens once and then you get better.

It just continued to get worse as I aged, and I developed more degenerative arthritis in my spine and my hands, which also inhibited me from being able to do a lot of physical activity. I was a nurse and you use your hands quite a bit. And that became very difficult to do. And then I started with the chronic muscle pain and fatigue of fibromyalgia that impacted more of my lifestyle. As time went on, I ended up taking early retirement from a job so that I could rest for a little while, and maybe reduce the stress level in my life to see if that would help. I found a job that I could do sitting down and using my computer, but still having to deal with the symptoms of chronic pain, fatigue and then flare-ups from any types of stress or viral illnesses or bacterial illnesses. So it really inhibited my life quite a bit. In 2018, I was awarded a disability determination, and that same year I couldn't do my job anymore even though it was a sit-down job. I just got to where I couldn't do full-time work. It just affected every part of my life, even my extracurricular activities within the community or with church or friends. 

I went to see a rheumatologist, and a couple of years ago and a new drug called Benlysta came out that was the first, uh, treatment for lupus; and I've been getting infusions every month and that has helped tremendously. It's cut back on the number of flare-ups I have with lupus. But degenerative arthritis and the fibromyalgia still had a great impact. And it was to the point where I could not even walk a mile. Or if I had to go to the grocery store and I had to walk around the big shopping centre, I'd make sure to hold onto the cart if I had pain in my back and my legs, and it would just make me have to sit down or, at times lie down. If I had family meals, a holiday celebration where I would do a lot of food preparation, after a short period of time, I just had to go lay down. The pain was just so tremendous in my body because of arthritis.  

Linda Elsegood: [00:07:53] can I just ask you, Sherry, how difficult was it to be diagnosed with fibromyalgia because it hasn't been recognized as a condition for that many years?

Sherry [00:08:03] That's very true. It is difficult, because as far as being recognized, and even lupus, it is the great disguise there. It was hard for them to finally put a diagnosis on me. And you find in your mind that you question whether you are going crazy or something, and what's going on with me? I know I have these feelings. So you finally find other people who are experiencing the same thing you are, and you realize you aren’t the only one that felt that way. And so yeah, it is a very difficult thing going through a disease process that is not truly recognized. 

Linda Elsegood: [00:09:28] And then you, of course, we're told about LDN. I mean, how easy was that to get a prescription and have it filled.

Sherry[00:09:38] That was another story. I had been referred to pain management because the doctor said, well, there's nothing else we can do for you. Go to pain management. And that was getting injections and getting on opioids. For some reason, it did not work on me. I guess maybe I'm just different. But the steroid injections didn't work. And as part of pain management, you also are sent to a psychiatrist to be able to find better ways to deal with chronic pain. And it was through that - that psychiatrist had dealt with other patients whose opioids and injections and all did nothing for the pain. And she said, they were put on a drug, it's off label use, but maybe this will help you. And so I started to do some research on it and talked with my pain management doctor asking if she knew about this use of naltrexone. She had never heard of it before. Then I talked with my rheumatologist and he said he had heard of it, but he's never used it for any of his patients, but he was willing to try it on me. And luckily there was the LDN Research Trust website and all the information that's for providers and patients.  He was able to be directed to that, and as he's educating himself with the use of this drug, he sent my first prescription to my pharmacy. I had no idea that it had become compounded, and my pharmacy didn't know either. So they actually made a mistake and gave me 50 milligrams of naltrexone. I'm thinking it was because I was on opioids at one point. So that was a farce. And then I finally found a pharmacy that did compounding for naltrexone, and that pharmacist was extremely helpful. He directed me to some more LDN research, information so I could educate myself and become part of the lupus support group of those who use LDN. He was an immense source of education and comfort, so I finally was able to get the medication through a compounding pharmacy in our area. 

I even talked with my primary care physician, telling her about the experience that I've been having with low dose naltrexone, and she says, this is what we need to hear. We need to hear about treatments like this, and they're not hearing it. And so anyway, my little part, I'm sharing the website information.

Linda Elsegood: [00:13:30] at what dose did you start on when you started, Sherry

Sherry [00:13:34] He started me on 4.5 milligrams right away, so I was taking that at bedtime, and immediately for the first couple of weeks, I saw no difference in the pain. I did start sleeping and dreaming, and I hadn't dreamt in quite a while, and sleeping through the night was very restorative.

It was about maybe six weeks of taking the 4.5 milligrams at bedtime that I started noticing in the day time that my pain level was decreasing. It wasn't as bad. It was tolerable. I had been where I would be from a six to eight pain score level every day, and at times more when I had to overdo things too much on my feet, or too much physical activity. I just had to go to bed and there was nothing that really helped me to take the edge off. After about six weeks, I noticed it's starting to work for pain and I was just full of joy about it. I just felt new. I felt renewed. My pain level about six weeks into LDN has gone to a three to a five every day, and that's for me, that's tolerable. That works. And I'm just overjoyed with that. And because of that, I've been able to walk for more than two miles, and hold on to a thing, or lie down, or use some other pain medication to help take the edge off. Those were the first experiences. I was just really just thrilled and told my doctors about it and they were extremely happy about it. Yeah. It set a whole new outlook on life. I don't expect that I would be 100%  a new body, a new person, but my life is definitely tolerable now in my body. 

Linda Elsegood: [00:16:49] And do you have a virus? Would you like to explain what happened when you had a virus? 

Sherry [00:16:57] Yes. It's now six days ago, I started having a respiratory virus, the cough, the congestion and all that. Usually, with lupus, those are triggers to a lupus flare-up. I didn't really know what was going to happen, but when it triggers a lupus flare-up, I get a rash over my total body and my skin becomes very painful. I have increased muscle and joint pain, fatigue, headache. It's not very nice.  It's bad enough you're not feeling well because you have a virus, then you have that on top of it. So six days ago I started with this virus then two days later I woke up and I had a lupus rash all over my body, the same type of experience that I would have prior, with the pain and fatigue, and all that went along with it. I called my rheumatologists and I reported to him what it was. Usually, he would prescribe a taper of prednisone over one to two weeks and my symptoms would be gone, the rash would be gone. And when the rash leaves, 10 days later my skin starts to peel off. The prednisone helps with the pain and the fatigue, but it usually takes about one to two weeks for me to get through an episode of a flare. 

I called my doctor as I was beginning this flare up and he didn't want to start any prednisone. He wanted to be sure that I did not have any type of infection, and afraid of it suppressing my immune system and then the virus really taking over. I agreed and I said I will call back and be reevaluated, so no prednisone next time. And then the rash and the fatigue and the pain exacerbated. And by that evening, ready to go to bed, I took in my LDN, as a backup.  We decided to give me the doses of one-milligram capsules so I could play with the dose and see if I could have a good reaction on just three milligrams of naltrexone, or if I really needed five or six milligrams of Naltrexone tab That's when I found that when I was on the three milligrams I had more disruption in sleep and more discomfort in my muscles and joints. So I went up to five milligrams and I was taking that pretty regularly and I was feeling good. And then I got the virus when I was on five milligrams of LDN. So when the flare started, that night when I went to bed, I took five milligrams of LDN. And when I woke up the next morning, my rash was almost gone. I mean, I could barely, barely notice it. I mean, it was just a shadow of it. And as the day went on the pain and the rest of the rash were totally cleared up. All the symptoms were diminishing. I still had the cold symptoms, cough and stuffy nose and all that, but the lupus flare was fading without prednisone. And that just is another surprise, to be able to do that without having prednisone. It’s just a miracle that that could happen. And every night I still continue with the five milligrams of naltrexone.

And every day, the lupus symptoms, the flare-ups, have diminished. I'm still working through the virus. You could probably tell, I sound probable still a little congested, but to me, it's a miracle. I  called and reported to my doctor and said, I know it's hard to believe, now I don't have the symptoms anymore and I didn't take any kind of prednisone. So that's where I am today. 

Linda Elsegood: [00:23:47] Well, What, amazing story. Truly truly is, and I'm sure those people listening who have lupus or degenerative arthritis, fibromyalgia is going to be so inspired by you, and thank you so much for sharing your story. Sherry. 

Sherry [00:24:08] Oh, I appreciate you giving me the opportunity. I hope this can help someone. I know it's so discouraging for some of these diseases, not getting the help you need.

Linda Elsegood: [00:24:21] Well, thank you for having been our guest today. 

Sherry [00:24:25] Okay. Thank you very much. 

Linda Elsegood: [00:24:29] 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, bandwidth, phone lines, and phone calls to be able to continue with our Radio Show.

And thank you for listening.

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.

 

Judy - 22nd Jan 2020 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Bruce Rose - 18th Dec 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: This week we're not going to be talking about low dose naltrexone We're going to be talking about full-dose naltrexone in 50-milligram tablets, which is used for alcohol use disorder using the Sinclair Method. And today my guest is Bruce Rose from Alcohol Recovery Scotland. Thank for joining us today, Bruce. 

Bruce Rose: No problem. I’m pleased to be here.

Linda Elsegood: Can you tell our listeners about the Sinclair method, first of all?

Bruce Rose: Yeah, the Sinclair method, um, as you were saying, it just includes, uh, using 50 milligrams of naltrexone. And simple way to describe it is an alcohol reduction program leading to either, um, safe drinking or down to abstinence, particularly, uh, where clients will use 50 milligrams of naltrexone alongside alcohol is probably the simplest way.

Linda Elsegood: And can you tell us how you came about to set up this alcohol recovery in Scotland? 

Bruce Rose: Yeah. My background for numbers of years was, uh, in management of alcohol and drug rehab centres. Um, I'm actually based up in the Highlands of Scotland and I moved up to the Highlands of Scotland to manage an alcohol and drug rehab centre.

Bruce Rose: Um, here in the UK at the moment, especially in Scotland, um, funding is so, so difficult to get hold of, um, to run a rehab centre. At the moment, you're probably looking at, you're not getting any change from about half a million times a year to look to run a rehab. Um, and the cost of it was just, uh, it was just impossible.

Um, so the rehab that I was working at initially was privately funded. Um, and they basically ran out of funds. They couldn't keep the rehab going on a long period. Um, so I, I just started looking around and researching on the internet. I started looking around and I thought, there must be a cheaper way. It was difficult to get a cheek, a model with a successful model, which was the battle.

Um, so I looked around and looked around and I searched the internet and search the internet and essentially came across a video that was talking about the Sinclair Method within how people could work without couple, um, issues from the comfort of their own home simply by using medication and being on a support program that came with it.

Um, I have to be honest, when I first heard about it and the first short, my whole background was abstinence-based. It was stopped and clean, um, grab hold of the Munis chair and hopefully if they would come to me in recovery and three to four years clean, um, can I just ask you that button? Sorry. How successful.

Linda Elsegood: Was the program you were using at that time? I mean, were people able to come off alcohol and if so, did they stay off? Did they relapse? What would you say the success rate was in the rehab centres? It was difficult to judge it on a long-term basis because obviously once clients left, you couldn't really see them much.

Bruce Rose: Um, when they were with us, actually in the centre, the success rate would be probably quite high. I would estimate about the sort of 60% mark, 60 to 70% mark. Um, but that's, whilst they were in a very controlled environment, they would be tested on a regular basis. Um, the challenge came when they left. Naltrexone works, uh, without going into too many of some medical details, but the whole foundation, it was such as the process of addiction and takes away the craving that people have.

So the challenge that you had, we haven't been. In most of the rehab centres were one's people left. Then the craving and the addictive side of the alcohol was still there. Um, and all it took was a life situation, some sort of issue that happened in life, and then people would then relapse and then they went back into the whole cycle again.

Um, so I think longer-term, yeah, I've seen different figures vary. They referenced, so three to five years, you're probably looking at about seven to ten per cent success rate.

So yeah, no, great. And then when I show the same Sinclair method, they were saying that it was a seven to 8% success rate. Which to be honest with you, that's why they looked at it enough. You know, it's just not possible. Um, so did some research. I spoke to lots of different people. Um, they were claiming that there were 120 clinical trials done.

Um, I spoke to Claudia Christian in America. Um, I saw the Little Torch Association. Uh, there's a book called The Cure for Alcoholism. Um, it's a lot of medical information in there. Um, the more I looked at it, I spoke to some people, um, different places who use them in the program already, and it all seemed to stack up.

Um, and I thought, this is crazy. This, this looks like it will work. Um. So, yeah. So that's not been led me to leave the rehab centre. I never want to knock at the rehab centres cause they do, they do a lot of good work for the people that it works for. But it's just, no one size doesn't fit all in the recovery world.

Linda Elsegood: I have interviewed some people who have used this method and they've managed to come off of alcohol. So could you tell us? How your experience has been with helping people with the Sinclair Method. 

Bruce Rose: Yeah. It's been a learning process from, from the start. So, um, at the moment in Scotland, I believe I'm the only person that's doing it in Scotland. Um, so I have a doctor that I had worked with in Edinburgh who does all the prescribing. Um, and all the medical, um, work for me. Um, but a lot of it was initially it wasn't trial and error as in the medication and the lessons that were all medical. Um, the trial and error came in the support programs. Uh, we ask people to keep drink diaries, um, we phoned them on a weekly basis, uh, once they've got into the program.

Um, there are lots of different suggestions that we made for people to change habits, to change processes. Um, so we've been learning a lot as we've been going along with the whole process. Um, so initially, um, I would guess we would probably have about a 50% success rate with the things that I've been learning from it recently.

Um, the success rate has now gone up. Um, and I would say it's probably around about. I'd have to go back and check my figures, but we're talking about 65 to 70% success at the moment. So the idea is that you take the 50-milligram tablet before you start drinking alcohol, which then yup. Um. Doesn't affect you.

Linda Elsegood: You don't get any high or a buzz from the alcohol. You just stay exactly the same as you did before you started drinking, which then decreases that desire because it doesn't give you what you're looking for from the alcohol. How? How long before you start drinking? Do you have to take the 50-milligram tablet?

Bruce Rose: They take one hour before they drink. Um, so we always recommend people to take, take a pill one hour before you drink. Um, and then people will then consume alcohol. Um, after the the hours go on. I'm not just giving them an hour two to get into the system and to allow to get to work properly. Um, and then from there, people, they initially stopped off.

We're seeing in the first, I was checking this morning, um, in the first three to four weeks, we're seeing about 40 to 50% drop in individual's alcohol intake in the first three to four months. Um, and that seems to be a very regular pattern with people that we have on the program. Um, and then from then that tends to level out for a few weeks, and then it drops a little bit.

We ask people to send us a graph every week, so we. Well, it's a good switch then correlates into a graph. Now we have a fairly clear picture from a week to week basis on where people are at. So what we find is people will drop a little bit, they might increase a little bit the next week, and then they'll drop bit more.

Linda Elsegood: But the average as the months go on, it definitely just drops and drops and drops and drops. Compliant with taking the medication? 

Bruce Rose: Yes, yes. If you don't take it, it doesn't work. I interviewed one gentleman who said that you know, he would open a bottle or can or, I can't remember. And once you'd open the first one, he would have the second, the third and so on.

He couldn't stop drinking and he was taking the 50-milligram tablet and the number of beers he had started to reduce until he got to the stage where he opened it. And he actually put it down and went and did other things. You know, he didn't have to drink it all in one go. And that came as quite as a surprise to him that he could walk away from it.

He didn't, you know, have to drink it. And then the desire to drink. Every day started to go because there was no reason for it and he started doing other things. So it is altering your lifestyle, as you were saying, alongside taking it to fill the gap of what you would normally be doing. Absolutely.

Bruce Rose: Yeah. We, we have a big discussion that we have with people and we always talk about the difference between addiction and cravings versus habit. Um, but what the naltrexone does is it starts to work without going into too many details when at the time it breaks down the neurological pathways and it's an opiate blocker.

So it stops the release of endorphins, which is what people are addicted to. That’s the treasure and the reward is the brain gets from that. So the medication deals with the craving and the victim addiction side of it, and then you have the habits. So I have a lot of people that have been on the medication for two or three months.

The alcohol levels sometimes haven't dropped as much as they want too. So prior to that stage, and then starting to talk to people and counsel people and say, okay, at this stage, the medication stopped them to do the work that it needs to do. What we meant to look at now is the habits. So instead of coming and home understanding just to, okay, enough with a book and glass of wine, um, take the dog for a walk for a couple of hours or.

Just change the lifestyle or the habit, the routine that you do. And I've had a number of occasions where people have just, they've come home, they've changed the plan. When they come home, they've gone out for a walk that on something else, and then by the time they get home, they've realized or they're starting to understand them, that the medication has done the job.

So they're not craving alcohol at night, which is what they're used to it just to do it out of habit. So they woke up the next day and say, “Oh, I can stop now.” Why? No, no. We've got to get, we've got to do this slowly. Insurance of the whole process works properly. Um, but it is, it's definitely two sides to, it was craving the addiction versus the habit, and we slowly separate the two of them as time goes on.

But the medication tends to the craving. The main difference. I'm Simon sheer compact. She knew that the abstinence side of things. The medication stops long-term craving is the longterm Cleveland, the relapses in a normal, the normal recovery program.  I mean, you can stop the craving once somebody who stopped the drinking with them, or you can choose the relapses by the crucial and a number of papers who've told me. Oh, I have to have a glass of wine in the evening, stroke, beer, stroke, whiskey, whatever it may be after a busy day because it helps relax me. So their thought pattern has to change. You know that you don't need alcohol to relax. 

But of course, it's very easy when you are not addicted to it to see that. But it's not always easy to see it if you do have a problem, because I'm sure until you get to the stage where you want to ask for help, you've had the problem for quite a while. And if people were to suggest you had a problem with alcohol, people would say, no, I don't.

I, you know, I don't have a problem. So, you know, the people that come to you. How long would you say that had a problem with alcohol? It can vary from just a few months up to 10 years, 10-15 years. Um, what I am finding at the moment is that most wine is the biggest shoe that I've got at the moment. Um, I would say that 75 to 80% of my clients have a moment of wine when they start.

Um, it's becoming a huge epidemic in this country and it's, we're not having, Wayne used the word, um, words, alcohol use disorder rather than alcoholism. Um, because when people mentioned the word alcoholism, they think of someone who is what I would classify as a chronic drinker. Someone who's drinking a bottle of vodka a day or that kind of level.

Um, most people that I speak to, they, they're not strategic Scottish word. Cool.

Um, that they're not staggering around the place. It might come. Um, they coming home, having a bottle in lunch and a glass of wine, the full meal and having a glass of wine with a meal and then finishing off with what the lecture on at night, but they're doing it on a day to day basis. But the main crux, every single one of them was telling me is.

But I'm not in control. I just could quite easily turn into two or three bottles. Um, and the whole life and the whole thinking and the whole structure to what we're doing on a day to day basis. Um, they're going up to work. I've got to get to the supermarket before it was kind of clocked here in stockings.

Um, I've got to get to the supermarket in time of put a whole day on. The whole routine was, are structured around when can I get my drunk? When come, when can a bargain one. Um, and I've been from just a few months, but the main thing as well that we're saying is that we all know bumps and. For the control of how much they drink doesn't work anymore. I suppose the main thing that I'm hearing as well. 

Linda Elsegood: Hmm. Um, and what about binge drinking? I mean, we used to hear a lot about binge drinking a few years ago where youngsters would not drink during the week, but then just drink as though it's going out of fashion at the weekends.

Bruce Rose: Yup. Yeah. I mean, just, you know, I've worked with youngsters who think that by doing that, because they don't drink during the week, they're not going to become addicted. Yeah. Yup.

There are two different ways of getting to that level where some people will start out just by doing their own drinking during the week and then they'll binge at the weekend. And then what then happens is they binge on a Friday, Saturday, and then the, which then turns into Thursday, Friday, Saturday, and then it's Thursday, Friday, Saturday, Sunday, and then it breaks pathway.

What happens quite often we'd see it with guys in the rehab centres. They would come in, they'd go for periods of absence, like whatever, a month or two months or three months, they'd hold steady. We reached a stage of addiction with, with the alcohol. So then what they'd do is they would stop drinking. They would have a month off.

Drink or two months or three months. Um, but then what, uh, what's actually been called the alcohol deprivation principle kicks in. So the lumber, they off the drink, the more the cruising boats and boats and boats, and I'm essential, they'd give them to it. They have one drink. Um, the, such a big reward. Then, the declaration transport has built what people then wash them, couldn't get a high on metal than when they did before.

It only just attends to build and build and build. So they were drinking probably when people are young, when they just, they go out on a Friday night. And, um, that's how it comes to start. Um, but once people are established drinkers, uh, if you're an established junk and you're drinking a lot, you hear a lot about dry January and things like that, but there'll be different schools of thought in it. But from the people I've worked with, um, it's not a good concept because the craving builds and builds, builds, all the way to January, and then at the end of the month, if I had not drunk all January, twice as much weekend the first weekend, and then they go off drunk crunching much, so they stopped for another one.

But then what you're doing is you're creating a binge drinker, which is actually worse, your system. Mm. It's trying to get people to reduce the and then just try and spread it out a little bit rather than just a big bind of alcohol and system. I mean, nothing. Again,

And I'm sure a lot of our listeners have children or grandchildren. And the worry is that when they are not school children anymore, you know, or even some school children, unfortunately, experiment with alcohol. What can we do this, like he was saying, buying alcohol from supermarkets? It's so easy to get alcohol.

I mean, on cigarettes there are warnings. There is nothing on alcohol and it's relatively easy to get hold of. Many children find where the parents keep their alcohol. What can we do to try and keep our children safe from becoming addicted to alcohol? I asked about 40 of them. One of the hardest questions that are a little bit like cigarettes or I don't know, 20 years ago, 25 years, um, was a lot of education that's needed with children need to be taught.

And made aware of the dangers of alcohol, but when you've then got the other side of it where it's so socially acceptable, what the parents are contained in the friends and families and everybody's drinking. So the kids are all looking at the pants and the door and the adults. Can we go? Um, so I said, I personally think it needs a huge intervention as we did with the cigarettes where they very slowly stopped to reduce the TV spot. Um. 

We, everywhere in the workplace, we're starting to notice there's a lot more, um, drink awareness campaigns that have gone into workplaces to speak to people. Um, it's just the stop. It doesn't stop the problem, but it's, it's, it's growing and it's actually making the start and making people aware of how much they're drinking and what sports being does and what's not doing.

Cause, um, I don't want to take the social away from it. There was a. What social sites, but it was actually very dangerous on Twitter. I must admit, when we go out, my husband will have a bottle of, um, alcohol-free beer. He says it tastes as good and it doesn't give him a headache. Um, he has, uh, a beer probably once a month or something, but he does like this zero alcohol beer.

But that's the other thing, isn't it? Is peer pressure. If you are out with friends and they're all drinking beer, you probably feel uncomfortable drinking a Coke or something. Yeah. But if you can have an alcohol free beer, that might be the way to go. Do you think, and um, do they have alcohol free wine? I think they have types of, um, wine without alcohol.

I mean, do you think bringing those kinds of products to the market will help with the problem? Yeah, absolutely. Because it's, uh, it's just another one of these RESILIA there's, I think in Sculpin that they've introduced, uh. They increase the price of some of the cheaper alcohols that you can buy in the supermarket and in the shops.

So a lot of people are saying, well, it's not solving the problem, but most people are expecting that one issue to solve the whole frame. But I think it's just, it's a much bigger picture, so that needs to be a lot more alcohol-free. On the market and bars and pubs and places where people can go and have enough to hold drug and alcohol-free term, um, as well as looking career stuff as well as, uh, education for children as well as, um, I was, I was looking at some cities this morning and it was just, it was showing that um.

I caught onto the dates, but in years ago, most of the drinking was done in pubs, and most of the drinking was done with others. Nowadays, the majority of Trenton was actually done at home, and it's one, so the whole culture has changed. Um, so we need to target the numbers of the number of women that I'm speaking to at the moment. You were saying that it's so socially acceptable amongst their friends and, um, just to go around to the house and, and open up a better wine. And, um, whereas if you go around and have four or five cans of beer, and if the MailChimp's slightly frowned upon.

Hmm. So it's just, again, it's just another cultural thing. What needs to be changed. And of course, they had, um, when my children were younger, these are. I will call pop drinks. Yeah. I mean, where you would think it was a soft drink. Dick was got fought coronial something, but going out with friends and having a good time and laughing and joking, you don't need the alcohol to be able to do that.

You can still have a good time without it. So I think if. I mean, would you say youngsters are more aware now than they were? I mean, what age group would you say of the biggest drinkers? I would say I would, um, in the field when I was in it and hadn't been central about the scoping for awhile. Um, and things are very, very distant.

Gotcha. From 35 years upwards. So 35 years up with was all alcohol. Um, actually when you spoke to that 55 years and plus that uncomfortable, um, I'm under 35 now. I'm slightly different up here in the Highlands. That can come on to that in a second, but I would say the most of the rest of Scotland, um, under 35 is.

So the drug area, it's hitting the drug sector, the real epidemic amongst the young ones at the moment. Um, the up here in the Highlands, there's such a drinking culture up here that you find the under 35-year-olds drink, um, took drugs, but cocaine, um, was a horse tranquillizer called ketamine that's on the market at the moment.

Um, that's very common amongst children. Um, so it's, it's difficult, they still there. Then the the drug side of things is, it's become huge amongst them. And that's the next area we want to watch out for. Scary, isn't it? But you were saying about charts and graphs and things. Um, Dr Jill Cottel. Um, did a very good presentation on, um, LDN.

Oh, Oh, Naltrexone for alcohol use disorder, and you can watch that video. She did it for, um, our 2017 conference. If you go to our YouTube channel and put Dr Jill Cottel, alcohol use disorder, you'll find it. It's also on our YouTube channel. And Dr. Cottel also got us to add extra things to the LDN app to be able to monitor patients.  That we're taking for alcohol use disorder. So it's free. The app is free. Um, if you go to LDNapp.org you'd be able to download that and you can put in there your alcohol intake, and then you can print out graphs and charts. So once you've got the app, which can be used on an iPhone and Android, PC or Mac and whichever device you log into, they sync automatically.

So you only have to go in it and put how many units or what. However you measure your alcohol in there, and it does wonderful things. It shows you over a period of time. So if anybody's interested in that, it's free and you can download that from LDN. I guess I'm just on that as well. It's, it's amazing the motivation and encouragement it gives people just to see, um,  how much they drink on a weekly basis.

So just to see that on paper, on a cross, on some form format is great. And then to see it reduced as well is a very, very good.

Like you say, it boosts your confidence that you're actually doing something and it's that feel-good factor, isn't it, that you know on making a change. But I'm afraid we've run out of time. But I would say it's been amazing talking to you, and I'm sure, I'm sure people will have learned a lot, even though, as I say, it wasn't low dose naltrexone, but it is something where I'm sure everybody has been touched by somebody who may have alcohol issues.

Linda Elsegood: So really, thank you very much for being my guest today. Bruce. No. Thank you. I really, really appreciate that. Thank you. This show is sponsored by Alcohol Recovery Scotland, helping individuals break free from alcohol addiction using the Sinclair Method TSM in Scotland. Contact them through their website at www.alcoholrecoveryScotland.co.uk.

Any questions or comments you may have, please email me 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.

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.

Shivinder Deol, MD - 27th Nov 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: Today, my guest is Dr Shivinder Deol, who's an MD, certified in family medicine and anti-ageing and regenerative medicine. Dr Deol has served at Bakersfield, California community as medical director of the anti-ageing and wellness centre for over 35 years. He specializes in integrative preventative and family medicine as a primary care provider.

Thank you for joining us today, Dr Deol.

Shivinder Deol: Thank you for having me. 

Linda Elsegood: So could you give us your background? Where did you train?

Shivinder Deol: Sure. I studied in a private school in India, one of the top leading medical schools for some medical college. Graduated from there in 1975 and then I came. I did a course a year off a residency in India, and then I came and joined a University of Tennessee, Memphis and did my training in medicine, psychiatry, and family practice.

And then, I've been in practice, since 1982 in Bakersfield, California. I've taken extensive courses in regenerative medicine and anti-ageing. So my training, even though it was initially more family practice, and I'm board-certified three times and family medicine, but my interest went towards more integrative medicine and functional medicine. For the last 15, 20 years I've been doing more of that. 

Linda Elsegood: When did you know you wanted to get into medicine? Were you very young?

Shivinder Deol: No, I wanted to be an army man. My family is a strong army. But my mother wanted someone to be a doctor. So my older sister, then my brother, passed out and did not go into medicine. So my mom said:" You got to do it." And I said: "okay". I got into medicine, but I'm so glad I did because I think it was my calling and I really had an incredible journey.

You know helping people, learning and growing myself with medicine.  

Linda Elsegood: I mean, things have changed, haven't they? I mean, you must have seen it from when you first qualified. What was it? 1975 where you went to the doctors, you told the doctor what was wrong and they, I remember it well.

I got married in 76 that people had their symptoms treated. But they never actually had the root cause treated in those days, which then eliminated the need to treat the symptoms. So, you know, what is it you actually do in your practice? If a patient came to see you with complicated symptoms, why would you start?

Shivinder Deol: You know, we would just, you know, and it was a great business for physicians and all patients came in, they got better and it was just an ongoing process, drug after drug after drug, and then treating.

So no one really was treating the whole body or looking at the real cause of a disease. It was taking care of symptoms now and we'll worry about the things later. 

Linda Elsegood: Yes. So what do you do now? 

Shivinder Deol: Now my focus is changed more.  When a patient comes in, my focus is more nutritional based, first and foremost supposed thing I'm really interested in finding. So this to me, the most important thing anybody can do is improve their nutritional status because a body is constantly working and regenerating itself.

So we estimate we have close to 30 trillion cells, but out of that, almost 700 billion cells are being built every single day of life. And we have hundreds of nutrients and the food that they're eating, which is processed, and with cold storage and with cooking, microwave, we've destroyed a lot of the nutrients that the body does not get all the raw material it needs for all its needs that all the regenerative and repair needs on a daily basis.

So my focus is nutrition and then I do a lot of things with detoxification, removing chemicals, toxins, poisons, reducing inflammation in the body through Iv therapies, chelation, all kinds of different things, hyperbaric. And then we do more stuff at balancing hormones and neurotransmitters to optimize health, brain health, heart health, and overall, you know, endocrine help.

So we do a variety of things to help the body improve rather than just fixing. A sore throat, some,  my aim is if I can prevent a single heart attack, a single stroke, single cancer, we do a lot of protection for breast cancer, for instance. So, basically, if we can reduce any of these massive major diseases, it's far better than, you know, treating the simple sore throats and colds and allergies that most people will have, but they don't really affect on lifespan with these scans.

Linda Elsegood: Okay. What kind of testing do you do when you're probing the patient to find out the wrinkles? 

Shivinder Deol: Yeah. So basically, you know, the insurance companies, of course, we are all kind of stuck with insurance companies to some degree. So the standard blood work that insurance companies cover, I do that but for instance, in a standard blood test, a lot of doctors will do as a free T4 and a TSH. But the key hormone and thyroid, for instance, is there a free T3 which is the active hormone and not T4. So unless we look at three-T3   and reverse T3, you really know what the thyroid function is.

So I look at more in the functional way of looking at health and so we do a lot of hormone testing, but the best way to test hormones are either through a saliva test or a comprehensive urine analysis. And typically insurances don't cover that. We do testing for heavy metals and for chemical toxicities.

So there's a really nice chemical toxicity test that looks at literally hundreds, if not thousands of different chemicals that we have been exposed to. We do food allergy testing, again, not the one that's covered by insurances, which is an immediate food has to be, but more a delayed food sensitivity test.

We look at a comprehensive digestive stool analysis. Look at gut health, gut inflammation, and see if there's an imbalance between the good and the bad bacteria in the gut. So a variety of other specialized tests that we do that can look at the body in a more natural matter. So trying to hit the cause rather than just the symptoms or repair.

Linda Elsegood: And you mentioned hyperbaric oxygen there. For people that are not familiar with hyperbaric oxygen, could you tell us what it is and how it works and what results you have seen?

Shivinder Deol: Sure. So hyperbaric oxygen is basically,  you're in a large chamber, which we are pumping in oxygen under pressure and under the, if you have some, some people remember the physics, the Boyle's law.

They've been, we put pressure, any of the gases are absorbed deeper and greater into the tissues. So when we pump in the oxygen, it goes into every joint, every fluid in the body, including the spinal CSF (cerebral spinal fluid). And so this increase oxygenation. It helps you the healing process in the body.

So if you can put oxygen into any tissues, the body starts to repair process and also discourages cancers, infections of all kinds of any chronic diseases. If we can put the oxygen, the body will start the repair process and use, any of the toxic effects off infections or, other pathologies.

So it's a great way to treat strokes or heart disease or traumatic brain disease, injuries of any kind, surgeries of any kind. So, for any surgery, if you were to get a hyperbaric treatment one before and two or three treatments after surgery, you cut down healing time in half, you cut complications in half.

So it's a very nice way to help repair the body. Also, injuries of all kinds, helps repair, very, very nice treatment, and very safe. I've been offering that for over 20 years. 

Linda Elsegood: Is it covered by insurance in the US?

Shivinder Deol: Unfortunately not. There only seven indication for which a Medicare will pay for and things like diabetic ulcer are non-healing ulcers, but you know, severe diseases they are willing to pay.  For minor issues, you know, they will not pay.

So it is typically a cash payment.

Linda : Elsegood: Is it very expensive?

It depends. So in our office, we charge to believe by the $150 to $200. There are some places, where they are in the three, $400 range. And some places, if they are using a smaller chamber, low pressure, they even offer it for like $125 a soul. But if you use a high-pressure chamber, you know, it's going to be about 150, $200, at least, if not more.

Linda Elsegood: Hmm. It's that for an hour?

Shivinder Deol: That's for an hour. But by the time you get in and out, it's going to almost be an hour and a half. So it takes about 10 minutes To get the pressure optimized in by us, then to brings the pressure down. So it's almost like an hour and a half a treatment. 

Linda Elsegood: I actually had hyperbaric oxygen when I was first diagnosed but it took me about an hour to get there and an hour to get back. It was very, very tiring because fatigue was bad. But I have claustrophobia and I was not really thinking about it, but it was quite a big tank and I think it sat about eight people. So I sat in this tank and I was thinking how am I going to feel when they close the door?

I'm really nice. And then they came out with these masks you had to put over your face. Oh, that was a testiness itself. But I, I have kind of got used to.

Shivinder Deol: We don't use a mask for this reason because it is so much closing feeling and our chamber has three different windows that you can look throughout.

So yeah, there is some claustrophobia, but it's really not that bad. 

Linda Elsegood: This small porthole but they are up high. So you couldn't actually see out. You could just see the other people who were in there with you for that.  Was quite an experience but unfortunately, it was run by a charity and it closed down many, many years ago now, which is a shame because I think they did some really good work though. So with the testing, one of the things that people quite often ask me about is Candida. Do you do Candida testing? 

Shivinder Deol: Of course, and Candida is almost like cancer. So candida basically get thin, and it's very hard to clear Candida out of the body. So yes, we do quite a bit of testing for candida because I think of candida as a very severe, but just to be insidious, it's very quiet, a low-level infection that can just, go on for years causing a lot of damage. But people not even, sometimes be aware of it, and in the long run, can lead to greater complications in losing potentially cancer.

We made it, we believe that it may be a cause of.

Linda Elsegood: Well, so many people have asked me that they do a saliva spit test in a glass of water or something and I don't know how accurate that is. But people tell me that they try these remedies to get rid of it and they can't, and they've been to doctors and they've still got it. You know, if you have a persistent Candida problem, how do you go about fixing it?

Shivinder Deol: Well,  basically that is several things. But candida loves sugar. In fact, every bad bug cancer loves sugar. So to treat any chronic infection, the first thing you have to do is cut out the sugar, cut out the carbs, and remember all carbohydrates except fiber break down to sugar, all of them. So people will cut out sugar, but they don't reduce the carbohydrates, and it's still on getting sugar in the body.

And as long as you're getting sugar, the candida is going to be almost impossible to kill. So the diet, again, comes in really important on a low carb diet. And then we may want to make the environment on hospitable for candida. So whatever the candida likes, we would cut that.

So keeping the body made more alkaline, keeping the body more oxygenated. So using oxygen and ozone therapies. And really helped clear it up candida. But Candida will generally require a prescription medicine plus several strong probiotics, Saccharomyces, and several antifungal herbal supplements to help fight the candida.

And it's a longterm treatment. It's not a quick course of treatment that'll help clear it. 

Linda Elsegood: Wow. 

Shivinder Deol: It requires a long process treatment. Yeah. 

Linda Elsegood: I didn't realize that it was so difficult to get rid of. 

Shivinder Deol: It is. 

Linda Elsegood: So how long ago was it when you first heard about LDN? 

Shivinder Deol: I think it's been, well, over ten years or even longer than that, that I've been using and that I heard about LDN.

And I think, I'm not sure if I heard it in a conference or if one of my patients came to me originally initially and asked me about it, but I think it was over ten years that I used it and the first patient that I actually use it on happened to have such a dramatic result that kind of opened my eyes.

So this lady had severe Hashimoto's thyroiditis and her tilters were in several. And so we treated her with the LDN plus a few other things, lifestyle changes, iodine, cut out gluten and so on. And her tilters started coming down dramatically, and about a year, year and a half or titers were back to completely normal.

So we had cured her now, Hashimoto's, and this was, I believe, strongly related to the use of LDN. And, so that was a very strong eyeopener for me on this, on LDN and its potential efficacy. And since that time, I've used it on a whole bunch of other patients for a whole variety of other conditions. But fortunately for me, that I had, my first patient responded so well that, it really made me a believer.

Linda Elsegood: You said that you've treated in lots of conditions with LDN. Do you have any other case studies that have been remarkable in your practice? 

Shivinder Deol: Yeah, a few others. So I have a patient with severe ms. Was very fatigued, but she's got severe tremors and she was extremely fatigued, and so I put her on LDN, and within days she could tell the improvement in energy level and the fatigue had improved very, very nicely. But unfortunately, I did not see, or she did not see any improvement in her tremors. But as far as the energy level and a mood, she comes in smiling every time. Poor thing is shaking a lot, but she's smiling. And so it improved certain parts. I had another patient who came to me from New York and stayed with me for one week.

She was on heavy pain medicine, fentanyl and morphine for 30 plus years for back pain. I got her detoxed completely within one week, and I use an IV, NAD, which is an incredible nutrient to help with the detoxification, increasing energy level and then up, put her on LDN. And this lady wrote to me about a couple, three weeks ago saying she felt so wonderful and that she has not had a single pain medicine.

In fact, she said, I don't even take Advil orTylenol but rarely for pain now. And she was really grateful that she had done so well and all for 30 years, her life was all around pain, medicine, pain medicine, and so that was a very nice response. 

Linda Elsegood: Oh, that's amazing because if you're in constant pain the whole time, it must make you feel a little bit irritable and short with people because you have to deal with that level of pain. You can't live your life normally in pain. It's not possible. Is it? 

Shivinder Deol: Right. But see, unfortunately, that reality is, what people don't realize is that acute pain and chronic pain are not the same pain.

And it's a completely different set of effects, a completely different disease, acute pain. So somebody has an acute practice, acute injury, acute surgery, that's a completely different, set of effects in the body versus somebody who's had chronic bad back pain or neck pain or whatever for 10, 20, 30 years.

 There our need for pain medicines are different. They are now just dependent on getting that  pill, of course, rather than the true pain itself. So it's become more of a withdrawal-type pain and not a lot of ease. Opioid receptors are tight, are doubted out, and so the effectiveness goes down.

But when we use something like LDN, we recharge our opioid receptors. We reactivate them. We produce a resounding amount of receptors so that we are having much better, pain relief without the need for any external medicines.  

Linda Elsegood: It always amazes me how such a small amount of naltrexone can actually be more powerful than the fentanyl and morphine.

It's hard to understand.

Shivinder Deol: It really is. But you know,  I'm a true believer of this. The body is a true miracle. And the ability of the body to repair and regenerate itself is just incredible. Our challenges that we have, that our diets are horrible. We are living in a really toxic lifestyle. And then we have all these other stresses that are influencing neuro-transmitters and our chemicals and our hormones.

The body doesn't get the opportunity to repair and regenerate itself. So when the state garbage out of the body on necessity, medicines and toxins out, we balance some of the nutrients. We helped the body produce its own good nutrients and endorphins. The repair process becomes really dramatic and the body can pretty much heal anything.

So I see a lot of miracles, but it's really not a miracle. That's what the body is designed to do is to help. He looks healthy all the time, regardless of what's going on. So we are great healers.  

Linda Elsegood: And you were going to give us another case study before I butted in.

Shivinder Deol: I did not understand. 

Linda Elsegood: You were going to tell us of another case study. Another patient. 

Shivinder Deol: Oh yeah.  A cancer patient. Basically patient comes to me with metastatic cancer. LDN is great in supporting cancer. You can literally help stop cancers from spreading.

So this patient basically the doctors told him that just go home and die and he's a relatively young guy and he doesn't want to die. You know, who does? So he came in, you know extremely tired, extremely tired, and just basically depressed, no energy and kind of giving up. But the wife is wonderful.

Wife is so supportive of him. And so we've started him on a high dose, intravenous vitamin C, 75 grams three times a week. And he started feeling a little bit better. And then I added LDN to his regimen. I've got him on a lot of different things. So put him on a keto diet, very strict Keto diet.

And so we put LDN on, and his mood has improved a lot that he can tell, and he is now able to start to do a few things. So I don't know what the status of the cancer is. It's too early for me to do any scans on him, but I'm certainly hopeful that with his mood outlook, comparing his energy is improving that maybe we're going to get a decent result on his very widespread metastatic cancer.

...

Linda Elsegood: Well, I believe we've now come to the end of the show, so that has been amazing. When very quickly, would you like to tell patients how they can contact you if they wish to make an appointment? 

Shivinder Deol: Sure. My website is antiagingwellnesscenter.com. 

My email is support@antiagingwellness center.com and, the office phone is 661 325 7452.

Linda Elsegood: And do you have a waiting list? That's the other question.

Shivinder Deol: Do I have, what? 

Linda Elsegood: A waiting list? Do people have to wait to see you? 

Shivinder Deol: No, well we basically work people in. My philosophy always has been that we are in a service industry. We are providing a service. And  in the service industry, if you have, your electricity is gone, and you call the electrician, and he comes a month later, it doesn't work.

Or your car is broken down, you know? So if someone comes in that needs to be seen now, I'll see them the same date. I don't care. They may have to wait a little bit. We may have to work a little harder, but we take care of somebody who needs to be seen when they need to be seen. So I don't keep awaiting this for this reason.

Linda Elsegood: Oh, that's wonderful! Well, once again, thank you very much for having been our guest today, 

Shivinder Deol: Linda. Thank you very much and you take care.

Linda Elsegood: This show is sponsored by Dickson's chemist which are the experts in LDN at associated treatments in the UK. Dickson's chemist, the most cost-effective for LDN in all forms within the UK and Europe maintaining safety standard of what is required. Why would you choose to get your LDN from anywhere else?

Call 01414046545 today to speak to a LDN experts 

Any questions or comments you may have, please email me, Linda@ldnrt.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.