LDN Video Interviews and Presentations

Astrid from Norway, MS and Low Dose Naltrexone (LDN) from LDN Research Trust on Vimeo.

Linda Elsegood: Today, I'd like to introduce Astrid from Norway who uses LDN for MS. Thank you for joining us today, Astrid. 

Astrid: You're welcome. My pleasure. 

Linda Elsegood: Can you tell us how long ago was it when you first noticed your MS symptoms? 

Astrid: That's a good question. I was diagnosed in 1996 at 29 years old, and I was diagnosed during a period where our boss was getting sick too and the diagnosis was three weeks.

I have all kinds of strange methods for this because normally people are kind of sick for a long time and don't figure out what's wrong with them. But my MS was like a big surprise for me when I got this, I was kind of shocked. But I had a friend who I had grown up with, who had played with us.

Both these ladies were real role models. I can say they were very happy, had a good life, even though they were using a wheelchair and you can really see they were sick, but they have a very good life and are very happy. I was like, not so scared, but of course, very surprised when I got the diagnosis.

But when I look back, from a research perspective, I can find episodes and also some issues that had been bothering me. During the year before I got MS but I didn't recognize it as something. The doctor would. I got to the Agnos and at the moment I was kind of … didn't manage to put the buttons on my blouse and had the talk that I needed to use the wheelchair for a while, but kind of recovered, kind of. I felt like it was nothing to worry about, so kept ongoing, as I did before, and didn't want to recognise that I was sick really. This went on, for almost two years.

Then I had to have surgery for my back and a couple of weeks after that surgery, I got another attack which kind of put my feet away. Then the doctor explained the reason for this attack was the... what do you call it? I was completely awake during the procedure and they explained that it was you that triggered this attack, they explained. 

I still didn't get any offer for any medicine for MS. Only for pain. I use all this bad stuff for this medicine for epileptic normally and I was kind of more and more affected by the fatigue, the new neural pain, because of MS more and more. 

Then the doctor couldn't really help me. I wasn't qualified to get the medicine to slow down the MS because I was still considered different. Or whatever you can call it in a different category at the time, considered to give medicine to slow down their progress.

Today, I know the Norwegian doctors are starting to give this right away, but in 96 and 98 when I had these two big episodes, it was not common yet. Then I had my daughter in 2002 and I had a really good pregnancy and I was feeling very sick. MS unusually got better during pregnancy.

Of course, I was concerned that the birth could trigger another attack. I was right because this is what I did during the birth. I did use only the needles for pain relief and I didn't get any help to do it all or things like that.

They were careful with what they gave me when my daughters started to grow, I had more fatigue and more pain. Whatever the doctor was giving me didn’t help with the pain or fatigue. There wasn’t really any medicine which was working. I was trying it and it's something called for a while, but… What do you call it? A tree gets it. It was like more fatigue. Then I met this lady, I don't know if you know about this program that we had in Norway in 2013, it was the program in general. The lady with MS who was telling her story in that program, I met her in a training camp for MS and she told me about LDN, and then I figured out that this is something I want to try because she was like all over the place, the allergy and I find out I would give it a try. I ask the doctors, they said this is not proven, so we can't give it to you.

But they told me how to get it. They said if I go to a primary doctor and the primary doctor was given the risk perception... But prescription, it's okay, and we can't really say that you shouldn't take it, because of policy and blah, blah, blah, they have decided that all of the Norwegian neuro doctors will not write this prescription.

In May 2012 I started using LDN, and I have been reading a lot on Facebook because it started to pop up groups in Norway and in Denmark. Sharing stories and also a special group only MS and LDN and I read and concluded that if I start, I need to start with the low dose, very low dose and increase very slowly.

And I did. So I started in May and at the end of July, I was able to go on holiday with my family for 10 days. We started at a wedding which normally was so exhausting that I would be on the couch for the rest of the week after just one night. We went on to a park for my daughter who was 10.

I was for the first time able to spend the whole day walking around in the park together with her. Then we went on for a long ride with the car and we were away for 10 days and when I came back I was exhausted.  It was like, wow, something has changed.

Some radicalized change. I still was taking some pain medicine but I started reducing it. By February 2013, my doctors stopped prescribing the drugs with the opioids for me.

I went back to work, not full time, but I have been 100% since then. Like you call it auto work since 2001. I have been more or less, sometimes also in more than a hundred percent in hours working in pay and stuff today, no pain at all. I very often had this problem with my bladder, so I had to... what is the name of it in English? I didn't really manage to consolidate. So I had a lot of accidents, of course, but I also got a lot of infections. 

Linda Elsegood: In your bladder? 

Astrid: Yeah, yeah. In my bladder. Yeah. It was constantly infected and two times it almost cost me my life more or less because I got this sepsis, what they call it in Norway, the blood then got infected. So two times I went to the hospital and was really, really critical. After I started on LDN I have never any cold or any flu or things like that. My allergy has gotten better. I also use the catheter to help to empty the bladder because it didn't empty completely itself. That's the reason. 

Linda Elsegood: So you're self catheterizing?

Astrid: Yes, I did for several years. Of course, that was a nope. Done that. I haven't done that since I started on that. All-day I can feel like I need to go to the bathroom for an hour and I don't have the accidents anymore either. So definitely affected my bladder in a very good way. Who is really saying that you can't?

You are, so you can't see it. I feel like I'm more or less without any diagnosis really at the time. It's the combination with the LDN and I also take something called… natural medicine based on D mannose. Take it to flush out your bladder. I think it's like a drink. I drank it and the oils from seeds with black cumin seed in it. It's like the respiratory seed and it's shadow make rapeseed.

Then this is also very good for them. For infections, prevent the faction infections and so this should combination with the LDN. So it's been like life-changing. 

Linda Elsegood: If you were to say, what's your quality of life was like before you started on LDN and 10 being the best, what would it have been?

Astrid: I would say between three and four, maybe. 

Linda Elsegood: What would you say it is today? 

Astrid: Wow. Wow. Yeah. Amazing. Oh, I can do whatever I like to do. I can say yes to what I like to do and I don't need to say no. I'm measuring. If anything was supposed to happen, I needed to value, is this going to cost me too much or is it gonna give me any value? Everything was like that. Of course, since I have a little daughter, everything was focused to give her the best possible life. So when she went to kindergarten and school, I was residing on the sofa, doing nothing so that I can play with her. When she came back from her with school so that she could have friends over and so on.

So everything was kind of focusing on giving her the best what I really wanted. I'm the kind of person who is used to, I went to school and I went to college and high school and university, I was working. Besides, I have also been always using use to have a very high capacity of what I thought something used to work a lot and to enjoy working and always kind of this.

Suddenly I had to be this no person in many aspects. Even though I wanted, I knew that this is gonna cost me, so it wouldn't be worth it. Everything is back to where it was, I'm the person I am. I can say yes to what I like to do. It works.

Linda Elsegood: Oh, that's fantastic. You don't get the pain anymore? 

Astrid: I said, that's gone. No. That was really the big difference. The biggest, I think because the pain gave me a sleep disorder because I was having very bad sleep, even though I was always tired and being on the couch, I didn't really like... if I was lying on the couch and I felt like going to the bathroom because I needed to, it was like, I wait a minute, did two, I wait the five minutes. It was exhausting just to go to the toilet. So everything was so hard. It was like constantly like something was going on. I felt like my whole body is like when you take your muscles on you, you squeeze them as hard as you can and you feel like how the body's anxious and in a strain, it felt like this all the time, even though I was lying in bed.

The body was relaxed, but it didn't feel like it. This pain is all gone. When I lay down now it feels like I'm relaxed and I don't have any pain or neuro pains. They’re gone. Also, it's more like pain in the ears, eyes, and mouth.

It's like lightning balls coming and give you pain for just a few seconds to a minute. I had a lot of these neuro pains and they are also all gone. It's very good. It's so many things that disappeared. I don't remember all the pain though, because it's since 2013 I felt like my life, we started again.

I'm talking a lot about it and gave everybody's psyche, you have to try. So they are always asking me all, you're selling this or what? I say you have to go to the doctor and ask for it. So when I started, I had to order a box with a special delivery to my pharmacy in my city. So in the beginning that was like a special order. Out of curiosity, asking if I go to a new pharmacy and if the people know about them, ask them if they have a lot of customers and a lot of them say that it's been common and there are more and more people using it for more and more sickness. They recognize that this is something that is working. It’s good for so many people for so many reasons and different reasons to use it. They recognize it in the pharmacy too.

Linda Elsegood: We've come to the end of the show and we're so pleased to have heard your story today, Astrid. Thank you so much for sharing it with us. 

Astrid: My pleasure and I hope everybody is able to try it, LDN, because I think it's worth a try. Anyway, thank you very much. 

Linda Elsegood: My pleasure. 

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 the radio show and thank you for listening.

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

Dr. Michael Ruscio, DC - 14th August 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: Today, I'd like to welcome back my guest, Dr Michael Ruscio. Thank you for joining us today, Michael. 

Dr  Michael Ruscio: Thanks for having me. 

Linda Elsegood: Now you're a speaker at the LDN 2019 conference in June in Portland, Oregon. This is a prerecorded radio show, so we've actually had the conference. Could you tell us about the presentation you're going to be giving at the conference?

Dr  Michael Ruscio: Sure I'd love to. There is a growing problem in progressive thyroid care that I'm seeing at an alarmingly increasing rate. And I think it would really benefit providers of all stripes to better understand this: essentially there are maybe two or three big misses that are occurring in thyroid care. One is over-diagnosis of hypothyroidism, or you could turn this another way - when someone isn't truly hypothyroid, but they're being offered thyroid medication as support. What often happens is the patient doesn't realize that this is being used as a temporary support. The provider doesn't make that clear delineation that they're not truly hypothyroid. Some of your levels look a little bit low, so we're going to give you this medication to try to improve your symptoms. They don't make that delineation. The patients stopped seeing that provider, but they kept taking the medication. And now, there are a fair number of patients who've been on medication for years that they don't really need to be on. And so without getting too far into details of that, that's one key component, and we can fill in some of the rationale and the facts there in a moment. But over-diagnosis of hypothyroidism in cases that are not truly hypothyroidism is becoming fairly endemic in functional medicine. 

Linda Elsegood: And where is the source of the problem coming from, because of course, clinicians are trying to help these patients?

Dr  Michael Ruscio: I don't think anyone is over-diagnosing hypothyroidism with malicious intent. I think we're all saying, well, here's the patient presenting with fatigue, depression, brain fog, constipation, dry hair, skin, nails, whatever it is. What can we do to help this patient? 

And I think what we can do to help these patients in part is better to understand the importance of gut health. There is documentation to show that various maladies in the gut can contribute to thyroid function. Autoimmunity can contribute to non-responsiveness and malabsorption of thyroid medication. And by addressing these things, we can finally see these patients respond who had otherwise been unresponsive. And sometimes it involves using no medication, or even a reduction of the thyroid medication. So that's kind of the 30,000-foot view. And I’m happy to go into more detail on any of those points. 

Linda Elsegood: It's really interesting. I've met over the last few years, many people with thyroid conditions, and they don't generally tend to reduce their medication until they're on LDN and find that it's more effective than it was before. But that was interesting you saying, and I took it to be less, was more in some cases that you don't need such a high level over time. How, how does that correlate to the gut. I know that a lot of people with thyroid conditions say that they improve greatly if they don't take gluten. What else should they be doing? Say, if you've got a patient who's got thyroid conditions, what do they need to do to try and get that gut health in the right place? 

Dr  Michael Ruscio: You make a great point, which is therapy like LDN, through its ability to positively modulate the immune system, can positively modulate the gut. And that could help with malabsorption that could be occurring because of a problem in the gut. So that's one area that is sometimes overlooked, where someone may have various digestive symptoms, and the clinician may not fully connect that. Those digestive symptoms indicate that the person is not adequately absorbing their thyroid medication. And this may account for some of the instability seen when tracking someone's thyroid levels. And there are some papers that are documenting this now, most namely in either H pylori infection or those who have ulcers, showing that the treatment of H pylori specifically can actually lead to a reduction of thyroid medication.

And of course, as you noted, there are papers published on those who have celiac disease, who when they follow a gluten-free diet, can reduce their thyroid medication. Most clinicians are probably having their patients experiment with a gluten-free diet, so that is a great recommendation. It's probably not offering the clinician anything new that they haven't heard before, but looking into something like small intestinal bacterial overgrowth or H pylori, that may offer benefit. And again, sometimes we attribute this to healing the thyroid.  This hasn’t been fully borne out by the research yet, but my thinking is when you see a change in the need for thyroid medication where someone actually needs less medication that occurs over the course of a few months, that is almost for certain not going to be due to healing the thyroid gland, but more so due to improved absorption of the thyroid medication. We see this in some of the H pylori studies where patients were able to decrease their dose of medication. And we've published on our website a handful of case studies where we've been able to reduce, in some cases as much as half someone's thyroid medication dose.

At the same time, the patient is losing weight in a positive direction, meaning they were a bit overweight, and now they're at a healthier weight. They have better energy, better skin, less joint pain. 

And there's another parallel here that reinforces the same finding, which is using the liquid gel tab form of thyroid hormone known as Thyroxine. And also some research has been performed showing that in patients who have been unable to obtain stability in TSH and T4 and/or the resolution of symptoms use Thyroxine and actually are able to get many patients to a more stable TSH and T4 and improve their symptoms. And this is almost again for certain because Thyroxine being in a liquid gel tab is much more easily absorbed than some of your more traditional tablet forms. That's just a couple of ways in which the gut can directly impact the absorption of thyroid medication, which again, I don't think is being given the amount of attention that it deserves. And I can say in clinical practice. That can be the difference between success and failure in some of these cases.

And I'll just juxtapose that with - sometimes the clinician is really floundering with a patient on Levothyroxine and maybe they need to add in some T3 Cytomel, or maybe they need to switch them into a desiccated form something like Armour Thyroid or even WP Thyroid or Nature-Thyroid, or anyone of these medications that's a T4-T3 combination. 

And that's not really what the cause of the problem is. The cause of the problem is inconsistent absorption, and that is oftentimes addressed by improving the diet. As you noted, with something like gluten-free or if someone's already gluten-free, then considering some type of dysbiotic or infectious issue in the gut can then be what improves the gut health and allows the patient to more consistently absorb the medication, and then their blood levels look better and then their symptoms also look better.

Linda Elsegood: So how do people know what their gut health is? Like? How, what are the symptoms?

Dr  Michael Ruscio: That can be one of the biggest challenges because we're starting to learn that you can have - and actually, some of the older celiac research has shown this for a while - that you can have an active inflammatory issue in the gut that only manifests extra-intestinally. Meaning you have no digestive symptoms, but you may have something like atopic dermatitis or depression or fatigue or joint pain.

So one of the challenging things can be figuring out whether the gut is the root cause of this problem. Because you may have no gut symptoms, testing is oftentimes offered as a solution here, which it can be; but the testing is really imperfect, in my opinion. There are a number of things that we can test for, but there's also a number of things where the testing still hasn't been fully mapped out yet. And just as one example, we know that small intestinal fungal overgrowth does exist. Dr Satish Rao has published some research on this. But because doing a sample directly from the small intestine is impractical, then that's not something that we can really readily assess in clinical practice. So if someone could do a breath test for SIBO and a stool test for other types of bacterial and fungal dysbiosis, that's a great start. But we still might be missing something like small intestinal fungal overgrowth. 

So, in answer to your question, what can be used to help assess the health of someone's gut? Testing gives us a slice of information that can be helpful, but it doesn't give us all the information and the way I look at this is to consider taking steps to optimize your gut health kind of proactively. Even if you don't have a diagnosis of H pylori or small intestinal bacterial overgrowth, consider taking those steps to proactively improve your gut health.

If you've improved your diet, if you have a healthy lifestyle, but you're still not following optimally, well, so you're still not feeling optimal. Well, then. I think it's a good idea at that point to just, again, proactively and almost more so - empirically take steps to improve your gut health, because it can be challenging to get that definitive diagnosis on a lab test of various sorts.

Linda Elsegood: I've had people with thyroid conditions ask me questions about gut health, and they say, how do I know if I've got leaky gut? I've read that there are people that have leaky gut, and I seem to have the same kind of problems. What tests do you do for leaky gut? You mentioned that.

Dr  Michael Ruscio: Great question. And this is another area where the testing is really imperfect. We just performed a comprehensive review of the literature, literally looking at every test in humans on the markers, serum zonulin, which may be one of the better markers for assessing leaky gut. No marker really is perfect. Zonulin, that may be the best test now. Zonulin is a marker essentially of tight junction proteins in the gut and can be assessed via blood or stool, and it does correlate with various diseases like diabetes, metabolic syndrome; and in some cases, inflammatory bowel disease and IBS.

So it does seem to correlate with diseases or symptoms, but not in every case. But where the argument falls apart a little bit more, unfortunately, is when we look at what happens when we treat people, we put people on a healthy diet or on a probiotic or what have you, and this is where there are much more inconsistent findings with zonulin.

There had been a few studies showing that in people with symptoms and with high zonulin, meaning leaky gut, they then improve their diet and see a drastic improvement in their symptoms. Yet their zonulin gets either worse or stays the same. Now to be fair, there are also studies showing that zonulin can improve after using something like a probiotic, but there are also studies showing that people will see no improvement in zonulin after taking a probiotic, even though their symptoms have improved. I know this may be a little bit unpopular for me to say, uh, that zonulin may not be quite fully ready for the routine clinical application, as there are some inconsistencies with testing for leaky gut.

So this is why I say testing gives us a slice and it can be helpful, but we really cannot fully hang our hat on test results alone. Because when you look at the data behind these tests, in many cases, what you see is the tests do not perform perfectly. They're only partially informative, and so the best test, arguably, for leaky gut would be zonulin, but it certainly is not something that I think is highly reliable. So it's one slice. But we also want to take the patient's symptoms into account. And so maybe to just paint a scenario here, if someone came in with rheumatoid arthritis and they wanted to know if their gut was contributing to that rheumatoid arthritis, or even their thyroid condition, what we could do is perform some testing, and that would be maybe one-third of the data that informs how we're going to proceed. And if we find something on testing like small intestinal bacterial overgrowth or H pylori, we can treat those. However, if the testing comes up negative, one still may want you to consider a round of treatment. And this is where using things as herbal medicines and probiotics make a much more of a tenable approach, because these things I don't think, require the same rationale as using something like an antibiotic or what have you. But treat the patient for a presumed imbalance in the gut and then monitor their symptoms. If their symptoms are improving or if the dose required for the third medication becomes more stable, or even they start to appear hyperthyroid like they need less medication, then that tells you that you're on the right track.

And again, I know it's easier if I were just to proclaim one or two tests to be the best and one or two markers, and that's the easy message I think we all want. But unfortunately, when you take that easy message into clinical practice, you get really confused. And if you take my message, which is a little bit more nuanced, albeit being a little bit more complicated, I think you'll see, it really interfaces into the clinical practice more consistently and delivers better results.

Linda Elsegood: Well, I mean, unfortunately, your stomach and your bowels, you can't see, can you? It's not like psoriasis on your hands or something that you can see what's going on there. When I have spoken to doctors and asked what they think are the top four supplements that people should be taking, probiotics are always number one that people should take. What kind of a probiotic would you suggest to patients who wanted to take that to improve their gut health? 

Dr  Michael Ruscio: That's a great question, and I would certainly agree that especially for someone who's trying to improve their gut health, then a probiotic is a fairly inexpensive intervention and very safe, or even now showing some secondary health benefits. For example, one analysis has documented improvement of mood. Other research has shown a small but significant ability to improve cholesterol, blood sugar, and even blood pressure. Again, the effects there are small, and I would say not clinically significant, but at least you're getting a small movement in a healthy direction.

So I'm just trying to showcase here the neutrality, or at least small side benefit, of probiotics rather than there being some downside. We know that probiotics can improve things like H pylori and, and be synergistic with H pylori antibiotics. And in my opinion, may help to kind of re-establish a healthier balance of H pylori colonization. And they can help to eradicate things like SIBO, and intestinal fungal overgrowth. So certainly the end reduces leaky gut and there's a lot of benefits that we can attribute to probiotics. 

It's your question that’s a more challenging thing: what probiotic do I use? And this is where I think both the clinician and the consumer are confronted with just a dizzying array of options in terms of the probiotic formulas out there. One of the things I write about in my book is organizing probiotics into three different categories. And this greatly simplifies the landscape in probiotics. And when, when you read enough of the research on probiotics, and you sift through enough of these meta-analyses that summarize the high-quality clinical trials, you start to see that we can break probiotics down really into technically four categories. But one category is hard to obtain, especially in the US, so I typically focus the conversation on the three categories. 

Category one is a blend of lactobacillus and bifidobacterium strains. The exact formulas differ slightly from product to product, but then, the underlying and unifying theme is you will see the strains in the formula are predominated by various strains of lactobacillus and bifidobacterium. Your category two is just one strength, typically, which is the healthy fungus, Saccharomyces boulardii. And then your category three - you have typically anywhere from one to maybe five or six strains that are often known as soil-based or spore-forming probiotics. What I like to do with patients is have them use a moderate dose of all three of these; or in more sensitive cases, they will likely have reported some reactions to probiotics in the past.

And what you want to identify as a clinician is what category do they seem to be reacting to? Because oftentimes people are taking a category one probiotic that's the most popular and common probiotic out there. They may have tried two or three or even four different probiotics, not realizing that each one was a category one, a category one, a category one, a category one. And so they come in and say they just can't do probiotics, they react really negatively. And that's where taking a quick history and seeing if they know the names of the probiotics, quickly looking them up and determining, okay, all of these were in fact category ones. So then you can have them start with category two and category three. There are some patients by just going through that exercise of having them try a probiotic category one at a time, you can pinpoint that that is a category that you react negatively to. Now we can use the other category or categories that you do tolerate, and then you can obtain that fairly impressive benefit that can be vectored by probiotics and help the patient navigate around that reaction that had been kind of slowing their progress previously. 

Linda Elsegood: Well, the first time I wanted to buy some, I went into a whole food shop, and they had rows and rows of probiotics, and some started at 10 pounds, and some went up to 50 pounds. And I was trying to read on the bottle what was in the 10-pound one, what was in the 50, and what everything in between was. And I was just so bewildered by the end of it I asked for some help, and the young man didn't know either, really. So I just went for a middle-priced one to try it to see what it was like. But you have to do your research. It's not easy to find out. It's a minefield because there are so many things on the market and some that are similar like you're saying category one, but they're still not the same price. You know, the convenience. Sometimes if it's a really well-known brand, I think you may pay more for the name as well. 

Dr  Michael Ruscio: So thank you so much for making that comment, and you're absolutely right, which is the quality of a probiotic does matter. We want to be careful not to think that more expensive automatically equates to better. And we also want to be careful that if something is drastically cheaper than others, then there may be some corner-cutting that is occurring.

So there are things that you can look for. These can be, I think, challenging for consumers, and also probably challenging for clinicians if you're not used to fact-checking these types of things. But you can look whether a company is following good manufacturing practices and is also having third party testing to ensure that their probiotic meets its label claims. And then also looking for companies that aren't using fillers. That can be irritating, especially when we're talking about people who have sensitive guts. Some probiotics, this more so happens with cheaper probiotics, they're not very potent, and they're kind of watered down with other fillers or things like prebiotics, which are significantly less expensive.

Another way around this is just finding a couple of companies that are fairly reputable and just try to use the probiotics that fall into the category system. Find those reputable companies - that's quite a bit easier than just going into a health food store and trying to figure out their 15 different probiotics. Which ones can I trust? Which ones can I not? 

Linda Elsegood: And of course, it's the same in America as it is over here. I mean, supplements aren't regulated, so you can have labels that make claims of what's inside it, but they don't have to put a percentage, so if it's not like pharmaceutical grade, where they can prove, as you were saying, what is actually in there is on the label. It is reassuring to know that you have done the best you can to try and find out what is in the probiotic or supplements of any kind, because the layperson just wouldn't know - so trying to get a good manufacturer, that's what I'm trying to say, is really the starting point, in my opinion, as a consumer. Someone that you can trust, because you can spend a fortune on the cheaper brands that, as you said before, might have fillers and all of this kind of thing. And actually not have that many ingredients that are actually going to help you. But you know, if something is a quarter of the price, it's a waste of money if it's not going to work, isn't it? So sometimes you have to pay that bit more to make sure that you've got a product that is going to do what it says it's going to do. 

Dr  Michael Ruscio: The way that I learned was with protein powders, where I was using the most expensive protein powder and I noticed it. You make your shake, and sometimes you put it in one scoop, maybe sometimes you're a little more hungry, you want a thicker shake, so you put it in maybe two or three scoops. And if I ever had more than one scoop, I would get bloated. And I later learned from one of my friends who owns his own manufacturing company, that you have to really watch out for companies putting in excipients, which are powders that help the machines run more quickly. And he explained to me that because the machines run more slowly when making his protein powder, he had to pay extra to have them not put the excipients in. So it is a legitimate thing, and especially if you have a sensitive gut, just making sure that who you're getting your product from cares about these things. And it may not be that a manufacturer is trying to do you harm, but they may be saying, well, we're trying to cater to a market that is very price sensitive. So we're gonna use excipients to cut down our costs. 

We're trying to provide these items that are most gut-friendly and maybe a little bit more expensive. But I think the customers that we're trying to appeal to understand that. A slight increase in expense, the quality would be worth that. So, yeah, it is important to find a company who is going to be attentive to these things and, and make those tough decisions of making the product more expensive when it's really in the best interest of the consumer.

Linda Elsegood: Let me ask you, what's your diet like, Michael?

Dr  Michael Ruscio: I loosely eat a paleo diet. I do eat quite a bit of dairy, and thankfully I have no problem with dairy; most meat, vegetables, fish; and I don't eat much in the way of grains. I do have some rice. I do generally avoid gluten. I do notice if I eat too much gluten, I do have a problem. Even though the healthcare consumer is told that everyone should avoid gluten, I think it is incorrect. And that's not borne out by what the best research on this topic has found. But essentially - lots of vegetables, meats, healthy fats, fish, moderate to kind of lower-carb diet. So some gluten-free grains, but not a high amount. Some kind of a moderate lower carb, paleo diet with some dairy would maybe be the best label that we could put on it. 

Linda Elsegood: Some people say that they find diets for eliminating food really restrictive. And they will ask if once they’ve started down that road of eliminating these foods, will they ever be allowed to eat them again? So you were saying that sometimes you still have gluten and you know when you've had it, so obviously you don't exclude it completely. 

Dr  Michael Ruscio: Right, and you make a great point, which is we want to be careful with diets. Not to think that an elimination diet means you eliminate forever. Most elimination diets follow the pattern of cutout foods that could be a problem for maybe a month, maybe two months. And then once you feel you've improved, then bring the foods that you can back in a kind of systematic manner, where you're bringing maybe one or two in at a time, so you can identify what foods sit well with you and if any foods are triggers.

And then it's not to say that because a food is a trigger you can never have any, but you want to be a bit more judicious with how you use it. That is really, in my opinion, a key distinction to draw because what I see happening with patients is they become so scared of food, and they may have little to no reactivity, let's say, to gluten. So they can get away with having some on some occasions. Now, if you're noticing some reactions to gluten, would I recommend making a dietary staple? Absolutely not. Right? There's also this ability to live in the world without being afraid. 

And this is where I think some of the hard-line messaging on gluten is really damaging people from a psychological perspective, because now these people are at a restaurant with their friends and should be enjoying themselves, and they're worried. They're sitting there frantically worrying internally, trying to hide it behind a smile on their face, about is there gluten in the sauce here? And now again, there are some people who are exquisitely gluten sensitive, and they have to operate like that, but I don't think that they would wish that on somebody else who at worst may feel bloated in forty-five minutes if they have some gluten. So, your level of avoidance should be required with your level of intolerance. I know that the gluten-free staunch advocates will take issue with that, but you have to weigh that against the psychological damage we do to people who don't have much of a physiological reaction but are inculcated and feared into thinking that they will have massive damage if they have gluten. And now every day in their life, they have this baseline level of fear that is damaging their health. And so when you weigh these all out, I think it's clear to see that, yes, we want to identify gluten as being a problem in those that it is and help them avoid it as best they can. But people that have little to no reactivity, they have some leeway, and we don't want to fear them into thinking that they have to eat like they have celiac disease. 

Linda Elsegood: Wonderful. Well, we've come to an end and where's the time gone? It's been amazing. Thank you so much.

Dr  Michael Ruscio: Yeah. It's been a pleasure chatting. Time always flies when you're having fun, right? 

Linda Elsegood: Well, we'll have to have you back again, so thank you very much for having been my guest today. 

Dr  Michael Ruscio: Thank you again. It's been a pleasure.

Linda Elsegood: Healthy Gut Healthy You by Dr Michael Ruscio is a long-anticipated and comprehensive guide to completely resetting and healing the gut. Arm yourself with the education tools to heal yourself from the inside out today. Visit drruscio.com for details.

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 healthy.

Laurie - 7th August (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Laurie is from the United States, and uses LDN for complex regional pain syndrome (CRPS). In 2005 she suffered a stress fracture in one foot that healed slowly, during which time she was in a cast and immobilized. Toward the end of the time for the cast she started feeling burning in her foot, like fireworks going off. When the cast came off her foot was bright red, shiny, and hot to touch, and her doctor recognized her symptoms as CRPS. Drugs normally prescribed were ones she did not want to take because of side effects. She researched and found a study on CRPS at Stanford using LDN, and took information on LDN to her doctor, who researched it and was eager to prescribe it. She ramped to her current dose of LDN 4.5 mg daily, but does note short-term side effects as the dose increased, such as difficulty sleeping, or a headache.

Laurie’s pain stopped after about 3 weeks on LDN; after 4 weeks on LDN the swelling and redness were decreased, and at 2 months the color was normal and there was no swelling. Before, she couldn’t tolerate wearing anything on her foot; and now wears normal shoes and has hiked and traveled extensively, without symptoms. She did have to give up running because of arthritis and several surgeries.

Laurie relates that while the CRPS developed in the foot she broke, as common with CRPS, the other foot became involved. Similarly, one time she hurt an elbow nerve, and the CRPS symptoms jumped to her elbow.

Her first surgery was a joint replacement in her foot. Because she might have needed narcotics for post-operative pain, her doctor took her off LDN a week before surgery. In that week her CRPS flared so badly that her feet and elbow were untouchable. Post-op, when she restarted LDN, it took a month of gradual improvements before she got full effect. During that time the redness and swelling from CRPS had increased, in response to the surgery.

She learned that for subsequent surgeries, if narcotics might be needed, to stop LDN only 2 to 3 days before surgery; however the trade-off seems to be less effectiveness from the narcotics. The solution that works for her is to take Tylenol or ibuprofen before surgery; and ibuprofen normally is all she needs after surgery. In total she has had 5 or 6 surgeries, and this routine has been successful.

Laurie tried to follow an autoimmune diet, but found it pretty difficult to be true to it. She eats a lot of vegetables, and stays away from foods known as being very inflammatory – meat, dairy, sugar. She works out at a gym 5 days a week, and swims.

Laurie is so grateful for the valuable information from the LDN Research Trust (LDNRT), and became a volunteer who has contributed greatly to the Trust. Through the website she has been able to not only find information, but to connect with compounding pharmacies truly knowledgeable about LDN and options for it. She appreciates that with LDN there is hope other than some of the drugs that have difficult side effects.

Summary of Laurie’s interview, please listen to the video for the full story.

Keywords: LDN, low dose naltrexone, complex regional pain syndrome, CRPS, LDN Research Trust, LDNRT, pain, opioids, autoimmune

Shonna - 7th August 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood. Today I'm joined by Shonna from the United States who uses LDN for chronic fatigue syndrome, Sjogren's, and she has had other conditions that we will learn about.

Thank you for joining us today. Shona. 

Shonna: Hi, Linda. It's my pleasure. I join you from Alberta, Canada. Oh, 

Linda Elsegood: Oh sorry. 

Shonna: Yeah, a proud Canadian. Thank you for having me on. 

Linda Elsegood: wonderful and sorry for calling you an American. Anyway, could you tell us, your story up until finding LDN? What was your story?

Shonna: Well as a young girl I had always been a Stickley as a toddler, I had been bitten by a rabid dog. And at that time I was given antibiotics for that with seven injections of live virus. And, in the same time period, I had untreated strep and developed a traumatic fever. So I was a Stickley wimpy young gal, I struggled through my teen years, tried to be like the other people that I knew and have lots of energy. And I mean I just always struggled. And then in 1988, I finished my nurse's training, my first job as an RN out in rural Alberta, and within two weeks, I caught mononucleosis.

Part of my job was paediatrics, and I  was very, very sick with that. I actually was hospitalized for a few days for dehydration and weakness, and I never fully recovered from that I was up and down for decades. That was 30 years ago, and I raised four kids in 1996. I had an acute episode of fatigue and weakness. I was a single mom raising four kids. I was working and all of a sudden I I had to be off work for four months. I couldn't even go downstairs and change laundry loads and carry up my dry load in one go I had to lay down, but in four months it kind of resolved and I went on up and down, up and down. 

In 2020 in the fall, I was working as an emergency nurse in our rural hospital here just outside of Edmonton, Alberta, and I caught a virus. I gain a viral load. And in a few months, it started taking me down within a year and a half, I could no longer get out of bed. And my cognitive abilities had declined drastically, and I was wasting away.

I was bed-bound, I was isolated. I would say things and have no recollection that I had said to them. I would do things and have no recollection that I had done them. My doctor had nothing to offer me. He looked at me with such, sorry, eyes over at the top of his glasses and he had seen me go through many of my episodes before and reassured me that you'd rally through this.

He sent me to a rheumatologist who had nothing to offer me. And that went on for months, Linda, I had no socialization. I couldn't go down the back deck stairs to go outside, and I was quite certain that my life was over, that this was me dying. And my kids went into fear mode. Their fears were shocking I was the strong person. I was the matriarch of the family. They depended on me and. And they literally were supporting me financially and physically. And we're talking about maybe mom needs to go into a home. And so in that process, I was diagnosed with Sjogren's, which greatly affected my eyesight.

I had stopped crafting, I had stopped reading. I couldn't read anymore. I had stopped driving, I didn't have the energy, I couldn't see, and I was really happy when I found some treatments for that and my eyesight came back. I had difficulty holding conversations. I was absent.

In the conversation's only partly there. And I had such great difficulty finding the words and expressing myself that I stopped speaking because I was afraid of what would or wouldn't come out of my mouth. And so as my eyesight cleared, I realized that the reason that I couldn't read was that I couldn't discern the words on the page. I couldn't comprehend the text. I realized that that went along with not comprehending the conversations with. When I went to smile, my face wouldn't really smile. I couldn't feel a smile. So I went into my doctor, and he gave me another wild look over his glasses and sent me for a brain MRI, which came back negative.

And he sent me to a neurologist and the neurologist was right on the money, young man, and he said I had Sjogren's. And in the meantime, I had been diagnosed with myalgic encephalomyelitis ME the new word for chronic fatigue syndrome. He said that the issue with those conditions, it's not neurological as an anatomical, it's an energy issue, a cellular energy issue.

Oh, okay. So. I began my journey with LDN. I went to my doctor and I said, I want to try this. And my doctor agreed as he had a patient on LDN and in a short time, within a week, he started to see results.

I came in a year later. This man had been stable on LDN. I came in with my beginnings of research from your Facebook group and presented it, and he said, well, I don't know if it'll work, but I have nothing to offer you, so let's give it a try. And I, what I found initially, Linda, was that I had weekly victories at the end of the first week, I found that my reading comprehension tension came back at the end of the second week. People around me were commenting that they noticed I wasn't word searching as much anymore, that my sentences actually were not fragmented anymore and that I was making sense. By the end of the third week, I went in and had a full-blown discussion with my doctor about it.

What I had experienced and what is next for me in my recovery. And within four weeks I could comprehend my writing. I had lost my ability to write. I looked like my writing looked like a dementia patient rating, although I had passed the clock test at the neurologist. And my writing was now legible.

So with that, I took other treatment requests to my doctor, and he monitored my LDN I started at 1.5 milligrams and uh, kind of broke the norm. I couldn't wait a month to go up. I really was desperate for results. So within two weeks, I went to three milligrams, and then within another three weeks, And that did not work for me. I have had wonderful success on the three milligrams and have added other treatments to this in, in that time period, because I was bed-bound, I had kind of forgotten how to walk. My body couldn't support itself. I had difficulty holding my head up even though I had more energy. I had muscle wasting in my joints and tendon and muscular, so I took five solid months of intense treatment and had lots of love and attention poured into my recovery by many people. And, um, in the fall time I was cleared to go back to work. Uh, I am, although not to act active bedside duty.

My doctor, the rheumatologist, my neurologist and those that no one loves me are just simply amazed by my recovery. As time went by and more unfolded about other aspects of my poor health. And I talked to my doctor, and I asked, are there any other specialists that I should see?

These things are unfolding and Linda, he's a very brave man. A very well seasoned, very knowledgeable, and he actually took off his glasses and set them down, and he said to me, the help and the knowledge and the direction that you have received from your Facebook support groups have undoubtedly helped you more than an unknowledgeable or not up to date specialist. Wow, those were such brave words. I have such respect for him to speak to them. I had at the very beginning, not at the very beginning after actually, I was on LDN. I was able to get the LDN book and bring it in, and I gave it to my doctor. And he keeps it in his office. He, uh, every once in a while when I go in now, he'll say, you know, I shared this with my colleague about this and that, and this and that. I'm just really happy to be sharing my journey—It’s kind of not quite short of miraculous.

Linda Elsegood: I have to say it's such an amazing story. And if you've listened to my story, there's a lot of similarities there. So I know exactly how you feel. And I have to thank you for point out to everybody that you also had help with our Facebook group and to give something back, I think it is amazing. So I'd like to thank you very much for your time that you donate to spread the word and to help others.

Shonna: Thank you, Linda. It is. It's my pleasure. I am so thankful to be in a position of renewed health. Now. That I'm able to do that. I'm, I'm just, uh, eternally thankful for the research that has been coordinated and the answers that have been brought to my life through this medication, this application of the medication.

Linda Elsegood: as I say, once again, thank you very much for sharing your experience with us today. 

Shonna: Thank you for calling. Take care, Linda. Thank you. 

Linda Elsegood: 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 the right year of the show.

And thank you for listening.

Linda Elsegood: Any questions or comments you may have, 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.

Michelle Moser, Pharm - 31st July 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Christian Stella PharmD RPh - 24th July 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Christian Stella, PharmD RPh shares his LDN experience on the LDN Radio Show with Linda Elsegood.

Christian Stella PharmD RPh is a 4th generation pharmacist and has been the Pharmacist in Charge for Precision Compounding Pharmacy since its inception. He oversees and is responsible for all aspects of clinical operations.

Through PCCA, Christian is also a registered Hormone Replacement Therapy (HRT) specialist.  Throughout his extensive training at PCCA, Christian has also become knowledgeable in Low Dose Naltrexone (LDN) that treats a variety of health conditions.

Through his practice, Christian has witnessed how LDN truly benefits his patient’s quality of life.

On a daily basis, Christian routinely interacts with doctors and their patients creating a triad of care between the patient, the doctor and the pharmacist.  He consults and subsequently customizes a complete pharmaceutical regimen for the patient.

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

Low Dose Naltrexone (LDN) in Scotland and beyond. Documentary with Spanish subtitles from LDN Research Trust on Vimeo.

Low Dose Naltrexone (LDN) in Scotland and beyond. Documentary with Serbian subtitles from LDN Research Trust on Vimeo.

David Borenstein, MD - 17th July 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: Today I'd like to welcome back Dr. David Bornstein from New York. Thank you for joining me today. David. Now I know you've been prescribing LDN for many, many years, but first of all, could you tell our listeners your medical background, please? 

Dr David Borenstein: Sure. Well, I initially trained in medicine at the Technion, Israel Institute of Technology in Haifa Israel.

I came back to do my internship in Staten Island hospital in New York, and I did additional training in radiation oncology and rehabilitation medicine at the State University of New York at Stony Brook. And then I opened up a private practice here in Manhattan. And I've been working here in Manhattan ever since.

Linda Elsegood: So tell us a little bit more about your practice, what you actually do there. 

Dr David Borenstein: Sure. I have an integrative medical practice and I do various different sorts of integrative approaches in functional medicine, approaches to issues such as, um, we work with a lot of patients with chronic fatigue, fibromyalgia, autoimmune diseases like MS and Crohn's, hormone replacement.

Dr David Borenstein: I work with patients who have issues with their guts. And we also do a lot of work with patients who have chronic pain. We do a lot of work with STEM cells, platelet-rich plasma, uh, and prolotherapy. We also do intravenous drips for our patients. So we offer a wide, wide variety of options for people looking. 

Linda Elsegood: I haven't had anybody explain about STEM cell treatment and possibly you could get in England, but it's not something that's been on my radar. Could you tell us a bit about the STEM cells? 

Dr David Borenstein: Sure. Basically, a STEM cell is by definition, the cell that can become any other cell in the body, so it's a very primitive early-stage cell that eventually can become lung tissue or hard tissue or bone. So what we do is we obtain, um, cells from either adipose fat tissue or we use umbilical cord, um, cells from other people, and we use it primarily to treat orthopaedic conditions. People with neck, back, shoulder, knee pain, hip pain, and we do a lot of work, uh, with that, uh, with that regard.

Um, we used to do some more work with Crohn's and autoimmune diseases, but we're primarily focusing now on orthopaedic conditions with a good amount of success and saving a lot of people from joint replacements, which is a good feeling. Wow. Yes. But you were saying. That the STEM cells can help replace all these different things.

How does the STEM cell know what you want it to do? The mechanism of action is poorly understood. We think that it either listens to a homing signal and does repair of the cell, or it actually may differentiate into that particular tissue. The mechanism, again, is poorly understood. Um, but you know, the basic science researchers are looking into that.

Dr David Borenstein: We do know from people doing STEM cell deployments for many years, that there is a good efficacy in treating orthopaedic conditions, and it's promising for treating things like cardiopulmonary diseases, neurological conditions, and um, and various other chronic medical conditions. The potential is unlimited, and this is like a very exciting field of medicine today.

Linda Elsegood: So if somebody needed a hip replacement. How would you treat that with STEM cells? 

Dr David Borenstein: Well, we would do is we initially evaluate the patient, have them come to our office, um, do a complete history, physical examination, look where the tender points are, looking at their range of motion, look at any scans, CAT scans, MRIs or x-rays.

And we will see if the patient is a candidate for having STEM cells for the hip. We generally like to use patients who are younger, uh, because. You don't, you know, the older patients, they're also candidates, but you don't want to put an artificial hip into patients who are in their thirties forties or even in their 50s because chances are because people are living into their eighties and even their nineties they're probably going to require revision of that.

And that's something you probably don't want to do. And what we would then do is we would inject. Either adipose-derived cells or umbilical cord cells into the hip joint, as well as all the attaching ligaments around the hip to make sure that the hip is nice and stable and roughly success rates depending on the age, depending on the severity of the disease, roughly in the high 70th percentile success rate, which is pretty good for, uh, having to avoid a hip replacement.

Linda Elsegood: Oh, definitely. Um, a friend of mine, his sister had problems, um, birth and she had to have a hip replaced, I think when she was. Like 15. She was very, very young. Uh, cause she couldn't run. One leg was longer than the other, and it just wore the hip. And she had another one. Uh, when she was thinking was about 35 and then another one just before she was 60.

So if she was able to have saved herself from having all these surgeries. I mean, that would just be amazing, wouldn't it? How long does it take for those STEM cells to do their work? 

Dr David Borenstein: It can take anywhere from several weeks to several months, and sometimes I have to have the patient come back. A few months later and we can boost the area where we treated with either something known as platelet-rich plasma, which are platelets we extract from, from blood, whichever, a lot of growth factors or another procedure known as prolotherapy, which is the oldest.

The oldest regenerative medicine technique will use sugar, water, dextrose, and lidocaine, and we can add some other things there. It causes localized inflammation. Okay. And it causes growth factors to come to the area and help tighten up the ligaments and, um, help improve the, um, and repair, uh, the local tissue in the joint.

So it's exciting stuff. It is, isn't it? Very, very exciting. And of course, the injection into the joint is far less traumatic for the body than having surgery to replace a hip, isn't it? You know? Not only is it less traumatic, now that's way less traumatic. It's done under local anaesthesia. So the risk goes down tremendously.

You don't have to be in a hospital. You can return to work in a relatively short period of time. I mean, if you're doing a desk job, for example, if you're getting a procedure done on a Wednesday, you can go back to work on Monday. Obviously, if you're doing, if you're working, you know, as a lineman on the, uh, for the electric company, you probably want to, you know wait a little bit longer to go back to work, but most people with desktops can go back within five or five to six days, and they don't have to be in an inpatient hospital, do any outpatient physical therapy. Now in the future, you know, two or three months, four months down the line, they may, we may need to give them some physical therapy, but it's not the inpatient type where you're stuck in a hospital or a subacute facility and you have to be there for a while.

Linda Elsegood: So it's, you know. It's nice because it allows you to go back to work in a relatively short period of time.  and when you were saying you prefer younger people, I'm just wondering if I'm in the age group. Older people.

Dr David Borenstein: Let's put it this way. Well, let's, we have a couple of ways we can, we can look at it for patients. We're using adipose-derived cells. You know, usually, I like.  If their patients are in there anywhere from the 30s too, let's say their early seventies they usually should have enough cells for doing the job.

But for patients who are in their mid to late seventies eighties even nineties I prefer sometimes to do the umbilical cord cell because I know well, they're not coming from the patient. I know they're probably going to have a high level of cells as you get older. The number of stem cells in your body are going to come down and they, they will drop.

There's no question. Someone who's, you know, 20 is going to have more STEM cell than someone who's 50, and someone who's 50 is going to have more STEM cells than someone who's 70 on, on average. So, um, usually I find that if the patient is going to be, you know, past your mid-seventies I may want to, you know, use only the umbilical cord cells because they know they have a, a good number in them.

Now, some patients will say, you know what, Dr Bornstein, I don't care. I want to use my own cells and I'll respect that and I'll use, I'll use the adipose. Fine. But you know, I have to give the patient the option. Of course. Yeah. No. 

Linda Elsegood: You have first-hand experience and knowledge about LDN? When did you first start prescribing?

Dr David Borenstein: Oh, at least 15 years ago. And the history is very interesting because I had a patient come in, and this is well before there were LDN websites, well before LDN research. Well before the information that we had, and a patient came into me and wanted LDN and I said, well, let me look into it. I was a little sceptical.

I didn't know much about it, so I did my research and said, uh, all right, let me give this a try. And I tried it on this patient. I think it was for, I believe it was either for Multiple Sclerosis or Crohn’s and, um. I got some very, very good results. So I, um, discussed LDN with a number of different compounding pharmacists, uh, one here in New York and one in, uh, one in Florida.

And I learned more about it. I did some research on it, and I started using more and more LDN in my practice. And I got some really amazing, amazing results and it just mushroomed. That has continued and we’re using it for the vast majority, everything that people are using today. I was using LDN for, you know, at least, you know, almost 15 years ago and great, great success stories, uh, multiple different, uh, conditions, and I just never looked back.

Linda Elsegood: Could you share some of those success stories with us? 

Dr David Borenstein: Oh yes. I said, for example, a number of different people with Crohn's disease, and for some reason I find the inflammatory bowel, Crohn's disease respond beautifully to LDN. I have had maybe two or three patients who really did not respond the way I wanted to, but they were very severe cases, but the vast majority of my Crohn's patients did beautifully on LDN, and this is, you know.

This is my early experience. So the vast majority of my patients were either Crohn's or MS and the MS patients also experienced quite, um, quite great results, lack of progression of the disease, some improvement in their fatigue and optic neuritis. The patients many times tried the, you know, the ABC, uh, medications, you know, and just didn't do well on them and didn't want to take them. So he did the LDN and they've never ever looked back again. So. Those are the two biggies. We also started using LDN for patients with various sorts of malignancies. I had a patient with a lung tumour, for example, and we put on LDN and it was just stable.

Didn't go anywhere. It was just sitting there, you know, and she was on it for many, many years. I lost contact with her after a while. I think she moved out of the country, but from a number of different years, she had a very stable, um, um tumour in her, in her lung, didn't, didn't do very much for it. And also we've been using it more and more since the studies came out from Stanford University on fibromyalgia.

And we've got some, you know, some positive results. I mean, I work with, in my practice, we incorporate LDN. We also use it in conjunction with other treatments. I find for fibromyalgia, it definitely takes the edge off. And, but you have to, you know, do a vast, um, uh, treatment option, um, working with their hormones, their sleep and infections.

I also find it's beneficial for Lyme disease. I do some, some work with Lyme disease, but overall, it's primarily MS, uh, autoimmune-related diseases that I use LDN for.  

Linda Elsegood: Do you ever use it for mental health issues? 

Dr David Borenstein: Yes. We've been getting more requests for that. Uh, primarily with the osteoarthritis, uh, conditions.

And I do have patients who swear up and down that it does improve their pain. Again, have patients who do not get any sort of relief. Um, I find that works better with the osteoarthritis and it does with the rheumatology conditions, but I, the number of rheumatoid patients that I have been a little bit more limited in that regard.

I also, patients have been using it for reducing alcohol cravings, which we find has been, uh, more, and we're getting more requests to do, LDN for that as well.

Linda Elsegood: Have you been asked to use full-dose naltrexone, the Sinclair method for alcoholism? No, not at all. I haven't gotten any, you know, I'm aware of it, but I haven't gotten any requests for it yet. Okay. Because they have very good success rates with that, whereby you can continue drinking and you take the tablet.

I can't remember now, it was an hour or two before you start drinking, but it takes away the craving. So where you would probably. You know, have 10 pints of beer, you might only have two. And then gradually you get, so you can take it or leave it. You don't actually need to carry on drinking. That's really interesting for people who, um, they call it now, don't they?

Alcohol use disorder and it is, uh. Yeah. A bonafide condition. You know, it's not a case of saying to people, stop. These people can't just stop. So that is an alternative for, maybe you'll have more people coming to you asking you for that. Now. It's interesting because you know, you know, one of the side effects of LDN can be projectile vomiting with alcohol consumption, although I don't see too much of it.

Dr David Borenstein: I know we've had cases of that, and it is a known, um, side effect of taking LDN. So even that alone may discourage people from, uh, from trying to take alcohol. Uh, we've had, um. Probably one, two, three, four, maybe five or six patients who've used it for addiction. Um, and they're quite happy. Um, again, most people who take LDN for the condition that they want to be treated, tend to want to continue on, on the LDN for the condition. It is very rare for people to stop it. Very rare. I find most people just want to continue it for whatever condition they have. Well, it's also the boosts the endo endorphins, which is the body's own natural feel-good fight or isn't it? So that should really give you a boost anyway, shouldn't it?

Linda Elsegood: I know people say, and I've been taking LDN 15 years or over 15 years. That it protects them. They don't catch viruses or colds or become sick in any which way. I mean, LDN works amazingly for me. I'm not complaining whatsoever, but I still get colds and flu and whatever's going around, it doesn't protect me in that way.

Um, but there are many people that say that you know, they haven't had a cold since I've been on LDN, so I don't know why I'm different, but, uh, it can happen. Well, that's amazing. You mentioned that, cause I did a consult, uh, late last week and it was for an ms patient and the patient had ms and you know, we renewed her LDN.

Dr David Borenstein: But the comment always comes up that treating for MS, but they'll say, Oh, I haven't got a cold all winter. And I get that over and over and over again. So, people, it's very rare people come to me and say, I just want it necessarily to boost the immune system. I get that. But they usually have another condition.

They usually get colds and this season, last season, the season before they've, they've never gotten colds. So it's definitely a benefit to taking LDN and we see it all the time.

Linda Elsegood: Now people can come and see you and have a consultation face to face, but you also do telemed consultations. Could you tell us about that?

Dr David Borenstein: Sure we do, uh, telemed consultations all over the United States, and we do it all over the world. So we've had patients who we've done it in the UAE, Middle East, Mexico, uh, Europe. So yes, we have patients from all over the world. We're interested in getting, uh. Getting LDN. And um, many of them come to see me here in New York because I'm right in the middle of Manhattan, and they may come to see me first and then we can do everything over the phone and we do everything over the phone initially.

So yes, we can certainly do telemedicine anywhere. There's a phone connection. 

Linda Elsegood: So how does it work? I have people say to me. Do you know what happens if I need blood tests? Do you know what happens? So if somebody came to you today and said they would like a telephone consultation and there, I don't know, in France, how would you go about, um, finding out all their medical details, etc.

Dr David Borenstein: Well, many times they'll email me all the medical reports before the initial consultation, so I'll have all of their medical records sent via email, or if they want to fax it to me, they can. But today email's much easier. And we do a complete history over the phone. We get all the information we can.

The most important thing is, one thing about LDN is it's, it's really safe as long as you're not taking narcotics. Um, and it's only, you're not mixing the LDN with certain other medications that can. Um, go against LDN. For example, we know with MS there are certain medications you're not supposed to take with LDN.

Um, as long as you, you're clear with that, it's usually not a problem. I remember using medication at less than one 10th the prescribed dose. So long as you're not having any, um. Taking any narcotics, you stopped in narcotics before doing procedures. You know, you're not drinking alcohol at the same time, knowing you can have projectile vomiting.

We, you know, it's a pretty safe medication and then we can prescribe it. Uh, some people, um, will. Get it from pharmacies here in the United States or, um, that's usually, or they come to New York, um, and they can get it here in New York or any other pharmacy that can be prescribed here in the United States.

So it's usually pretty straight forward. Um, our dosing, you know, we can tell them how to dose. Um, I find that certain, you know, for example, certain patients, they want. The maximal dose all the time, but they don't understand is that the maximal dose for a person weighing 250 pounds is very different from a patient weighing 125 pounds.

And, um, even Dr Bihari when he was doing it, found that many times. You would. If you give too high of a dose, you can cause too much, uh, to prolonged blockage. You want to lower the dose. So every patient, it's not so easy. You just, you know, give the maximal dose and have a nice day. You also have to, uh, take, you know, take sex and weight into account when you are prescribing and take an account.

There are side effects, you know, difficulty sleeping, vivid dreams. So all of these have to play an account. Also, a patient has neurological disorders. Certain patients over a certain dose get increased specificity. So, you know, it requires, you know, some experience in prescribing. It's not, here's the medication, have a nice day.

And every, every, uh, disease, we're going to approach it from a very different perspective. For example, in patients with inflammatory bowel disease. I find giving a full dose at the beginning is a better way of treating them as opposed to stepping up the dose. With Hashimoto's, you've got to go very, very slowly and the blood tests have to be done just to make sure the antibody levels are dropping and that they're not getting hyperthyroid.

And that's where he gets a little bit tricky. But most of the patients do their blood tests. They do them locally with their local doctors. They send it to me with theirs, when we get their LDN prescriptions and you know, everything works out well. . 

Linda Elsegood: So how do they go about having the blood tests from you? Do you send them a kit or the information to take to their own doctor? How does that work? 

Dr David Borenstein: Well, generally, generally. Uh, with most cases, yes. For what we do, we don't need blood work. The vast majority of patients either have blood work from their local doctors, or for example, if they're having Hashimoto's, someone's prescribing their blood work and prescribing their medication, and we'll just get copies of that lab work just to make sure that the antibodies are going down and not becoming hyper.

We have to warn the patients that as the antibodies come down, you're going to need a dose adjustment and they should get blood work to reduce their dosage of medications. Um, and you know, the antibody levels can drop quite dramatically. And you know, if you're, if you're having a good dosage, it can actually make you a little bit hyper.

So you have to warn the patient about that and just check the, have them check their blood levels locally. And usually, everything's fine.  and people always want to know. 

Linda Elsegood: How soon would you say in your experience that patients notice an improvement on LDN? 

Dr David Borenstein: It varies. I find that inflammatory bowel disease patients usually notice an improvement quite quickly.

I think some of the other autoimmune diseases may take a little bit of time. It all depends. Um, people react differently. We're all bio-individual. None of us are exactly the same. We're not all Toyota Corollas, so it can be anywhere from several days to several weeks, even to several months. I usually recommend that the patient be on the LDN for at least four to six months before you even think of discontinuing it because it can take that long in order to see if they're responding or not.  

Linda Elsegood: Exactly. I mean, I've had some people say to me. Um, I'm taking liquid LDN and I've nearly finished the bottle. I've been on it nearly a month. Uh, it hasn't done anything, you know, I'm thinking of stopping, you know, it's not a miracle that it's going to happen. You know, just like that. You've got to give it time, haven't you? 

Dr David Borenstein: Exactly. As you were saying. Well, several things are sort of, you got to give it time and you have to make sure that you're getting it from a place that's reputable, that you're using a good quality LDN. And I only use, you know, a number of different pharmacies that I use. Sometimes I'll change the patient from an oral to a, say, a transdermal, just to see if there's going to be any difference in the way they're, they're feeling. Remember a lot of patients with severe, for example, inflammatory bowel disease, they may not be absorbing the LDN, so doing it transdermally may be beneficial.

I find many times in kids, for example, it may be more beneficial to do a transdermally then than orally, and sometimes they have other cofactors. They have just poor absorption. You've got to say, Oh, well, why aren't you absorbing it? Maybe you have low stomach acid, so. The vast majority of the time, the patients are quite pleased.

But, um, and this would make the difference between someone who, who does LDN and someone who does LDN is knowing if there's a problem, what do you do? What's the next step? What do you have to look for? And that's the that makes all the difference in the world. 

Linda Elsegood: So if somebody would like to have a telephone consultation with you, is there a waiting list.

Dr David Borenstein: We can always accommodate patients if they, um, depending on the day, the month of the year, uh, you know, typically you're very busy, sometimes very slow if they are interested in having a telephone consultation, they can just call our office. The number is 212-262-2412 or 212-262-2413. And if they want to learn more about the practice, they can go to my website at www.davidborensteinmd.com and they can look at the website and see what we offer and if they're interested in making a telephone consultation, just call the office and we're more than happy to schedule them at the earliest possible time.

Linda Elsegood: Well, thank you very much for having been our guest today. 30 minutes went very quickly. Oh, thank you for having me.

Dr. David Bornstein is New York's leading integrative and functional medicine physician. His patients are diagnosed and treated in an integrative manner to promote recovery and continuing good health. Call 212-262-2412 for an appointment. Telemedicine appointments are available for LDN prescriptions.

Any questions or comments you may have pleawse 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.

What the Bleep Can I Eat?! Making Sense of Conflicting Autoimmune Diets (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Improve gut microbiobes to heal leaky guts, to prevent or halt autoimmunity. Help low dose naltrexone (LDN) via adequate Vitamin D, good nutrition. Difficulty adhering to diets being studied, resulting in practical strategies.