LDN Video Interviews and Presentations

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.

Laura Dankof, MSN, ARNP, FNP-C 26th June 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: Today, my guest is Laura Dankoff, who is a functional medicine nurse practitioner, speaker, and author. She has her own practice, which is a path to health and healing. Thank you for joining us today, 

FNP Laura Dankof: Linda, thanks for having me on. I'm looking forward to this. 

Linda Elsegood: Now, we interviewed you about three years ago, and as you well know, so much can change in a period of three years. What has been happening in your practice? 

FNP Laura Dankof: Well, I've noticed in my practice over the last three to five years, that the interest and number of people seeking out LDN as a treatment option has increased. And that's certainly been mostly due to word of mouth, but also some people have actually found me through your website as well.

Many have travelled to meet with me to determine if LDN is an option for them, as they are really frustrated with their healthcare. Sometimes they are not getting answers, or perhaps feel that there's another path that they could be exploring, and they're wondering if low dose Naltrexone is an option for them. 

Linda Elsegood: And we didn't say where your practice is did we?

FNP Laura Dankof:   That is correct. My practice is located in a little town called Westcliffe, Colorado. I used to practice in Iowa for several years in internal medicine, and so I still am licensed both in Iowa and in Colorado. And, I offer virtual and in-person appointments. 

Linda Elsegood: Oh, that's very interesting. All right, so then what would you say your patient population consists of?

FNP Laura Dankof: My patient population is a lot of people with autoimmune disease, digestive issues, hormone issues---et ceteria. Quite frankly, they're generally people who have already been through the conventional healthcare system with a traditional workup, and either has been handed a laundry list of medications or been told that there is nothing wrong with them, and there's nothing that can be done.

And they, of course, are looking for answers. They don't want to settle for that conventional diagnosis and treatment. They want to figure out, with functional medicine, what the root cause is that is preventing them from feeling well. And so, this is where we start to look at lifestyle and what's happened along their life timeline.

And in the process of that, particularly people with autoimmune conditions, such as Hashimoto’s, and other conditions such as fibromyalgia, chronic fatigue, and even severe depression, people have come to me wondering if LDN would be something that could help them.  And a lot of times I also learn from my patients, and so will look to find what research is available out there and to determine that there is no contraindication, say, for example, them being on narcotics.

Then I would tell them, it's not going to hurt us to try LDN, to see if it helps you. 

That certainly has been true with a couple of cases of severe depression that came to me.  I had never really used it in that way, and so that was one of LDNs use that kind of surprised me, that it did seem to help anecdotally, just from my experience with these patients.

 With one patient Debbie, LDN did seem to help some with her depression.  I used it in one patient with Lyme disease, a lot of cases of Hashimoto's, where we looked at and monitored their antibodies, along with other things, that can certainly contribute to Hashimoto's. You need to look at gut health, hormone balance, detoxification pathways, and a lot of other things.

So it's just not using. Low Dose Naltrexone alone. You certainly want to look at all these other things, and for people that have fibromyalgia and chronic fatigue, one of the things that I'm looking for is if they've had evidence in the past, of exposure to various viruses. That can be a possible indication of one of many contributing factors to their condition.

 For these patients, I may try anti-virials on them.  If that doesn't work, we move on to Low Dose Naltrexone, and for some, I do a phenomenal type of response to it, and I'm always amazed by this result.

Linda Elsegood: Well, it's interesting because there are so many people with autoimmune diseases that suffer from depression.

I always think if you took a healthy person who never had depression, and gave them all the symptoms and the quality of life that some of these people have, you're going to feel depressed by having to cope day after day with these symptoms. So for the people that are listening at home, who might be feeling hopeful that their depression can be helped, in several different ways, what is the first thing that you do if somebody comes to you suffering from depression? 

FNP Laura Dankof: So there are a few things that I'll do. First, I want to get an extensive history on them. Things like, does depression run in the family? What emotional or physical traumas have they had? What's their nutrition like?

Though many people do not know this, gut health is so important to our mental health. So if we don't have a healthy gut, we're not going to have a healthy brain. I may also do a few genetic tests on them looking for MTHFR, and other gene mutations and deficiencies.  The reason for this type of testing is that those mutations and deficiencies can play a role in how people process their nutrients, particularly like folate.  We need to take a really comprehensive look at things.

We also need to know what things have they previously tried that did not work.  And from that, you really need to take a thorough history from each patient and make sure you've ruled the possible contributing factors to their depression, and then decide the suitable treatment.  We need to know if they are using natural herbal remedies in combination with Low Dose Naltrexone, or in combination with their prescription medicine.

I would never just pull anybody off a prescription antidepressant if they are on one, but I may add Low Dose Naltrexone or other nutrients, and nutrients such as B12 and folate and things like that if needed to, but would cross that bridge at that time, and see if that's an opportunity to work in conjunction with those things.

I may be that they will be able to wean down to a lower dose or even off of these medications? So you basically just have to take an individualized approach in each case. 

Linda Elsegood: And how long would it take if somebody came to you that had been suffering from depression for quite a while, and we're currently not taking any medication, for you to do all the testing and begin implementing a treatment plan, such as herb's and supplements, LDN, whatever, before they could start to feel an improvement?

FNP Laura Dankof:  First, I would do the evaluation and workup, and then I’d certainly look at their hormones, gut health and test for the MTHFR gene.  Then after I get results, I will create a treatment plan based on my experience in the few cases of depression that I've had, and see if they maybe want to try that.  In my experience, patients see a difference within the first month of taking it.   Now, I know in some cases, with other conditions, you need to give them a longer time, but generally speaking, when I'm seeing them back in a month, they're starting to notice a difference. Well, then they're excited about it. 

Linda Elsegood: Yeah, I bet. You know, there are people that think if you start LDN, by the end of the first week, you're going to feel better. But anything takes time, doesn't it? And you have to be patient. What dose do you normally start your patients on?

FNP Laura Dankof: I will start them on anywhere from 1.25 to 2.5 milligrams of compounded LDN.  If a patient tells me that they're very sensitive to things I will adjust the dose.   I had one person one time that was concerned about that, and we started her a little bit lower. The maximum is usually around 4.5 milligrams.  I would say that the average range is 3 milligrams of LDN.  I maybe have a few higher, a few lower, but I'd say the majority seem to have best results in the 3-milligram range.

Linda Elsegood:  Oh Okay. And what age range are your patients? 

FNP Laura Dankof: Previously to starting the path to my health and healing practice, I was working in internal medicine. So I would see people generally age 18, you know, on up to the end of life. But I would say people that were generally seeking LDN and other treatments for their autoimmune would be anywhere from age 20 to the mid-fifties.

Linda Elsegood:  Oh okay. And what about now in your new practice, will you do any consultations for children? 

FNP Laura Dankof: Yes. I am trained as a functional medicine nurse practitioner and family nurse practitioner, so I can see the whole life span. So I do see some children as well.  

Linda Elsegood: And what's your experience with LDN in children?

FNP Laura Dankof: I have not used LDN on children yet. I'd say the youngest patient that I have used LDN on was around 17, and that was prior to starting my current practice. So I have not started any children on it in my practice as of yet, not I wouldn’t consider it.

Linda Elsegood: Exactly, that's what I was going to ask. If there was anybody there with a child, close to you, would you be able to do it for them?  So that's very good. Okay. So what about pain? Have you noticed LDN has been a good source of helping with pain? 

FNP Laura Dankof: Yes, it can be.  I would probably say that my greatest experience using it for pain, would it be in helping people with fibromyalgia and their pain symptoms? But certainly, as we know, we must not use somebody on a narcotic. I've had some people come in and asked me to prescribe it, and they were on a narcotic, and I said, well, you've got to be weaned off that first before we can start that. I don't want him to have any kind of withdrawal symptoms, so you just have to be careful about that.

But otherwise, I'd say my primary experience with chronic pain symptoms, is in patients with fibromyalgia.  

Linda Elsegood: And have you seen any people with skin conditions that you've used LDN on? 

FNP Laura Dankof: No, not that I can recall right now. I think I maybe had one gal that had idiopathic urticaria, which is an itchy skin condition. And what I would say there is that a lot of times when somebody comes in with a skin condition, I'm looking at their gut microbiome, and they may have small intestinal bacteria overgrowth.  I know LDN can potentially help in that way as well to help support the immune system, so I have prescribed it for that. So yes, if we're looking at skin conditions, a lot of times those conditions can relate back to a digestive condition so then we may use LDN in that way.   

Linda Elsegood: Yes, I mean, there were a lot of people who use LDN for psoriasis, with very good results, but that isn't a quick fix either.  I've had people tell me that their skin has stayed just as flaky and patchy for six months, and then they start to have fresh skin appearing, and all the scaly bits go, which is just totally amazing. But it is very hard if you've been taking LDN for months and you haven't seen any benefits. It must be hard to continue having faith that it's going to do something for you when you've been taking it long-term.

FNP Laura Dankof: Yes, and I would say that what I generally tell people is that I recommend they stick with it for six to nine months, to see if they begin to see some benefit if they aren't somebody that responds quickly. And I would say the majority of people; they do want to stick with it because they have kind of come up empty-handed from other directions.

And this is—an avenue of hope for them, to see if this is something that will help them. 

Linda Elsegood: Hmm. And it must be very satisfying to be a nurse practitioner where people have been to so many other doctors, nurses, whoever can prescribe for them and have come up with nothing. You know, to actually be able to help these patients, you must get quite a buzz from it.

FNP Laura Dankof: It's very rewarding and humbling as well. You know, as a functional practitioner; you really care about helping people. And of course, trying to get them the answers that they deserve and that they're looking for, I don't take that mission lightly at all.

And I try to do my best to try to help them in any way that I can, and as naturally as possible, to support their bodies in a healthy way.  Certainly, LDN is just one of the tools in my toolbox to do that, and I will forever be grateful to the first person that brought LDN to my awareness, who is no longer with us.

She was a woman with stage four breast cancer, who came to me asking me if I would prescribe it. At that time, this was many years ago, I didn't know anything about it. And I thought, well, I need to look more into this. And so, had it not been for her, I might not have ever known the benefits of LDN and what it can do, and to see how many people have benefited from it, 

Linda Elsegood:  It's really so rewarding to hear that you are able to listen to one of your patients. It’s “kudos to you” for listening to your patient. You know, there are so many doctors that are so busy. I'm sure patients always recommend different things they would like to try, but doctors don't always listen and act upon what the patient says, so that's really good. 

FNP Laura Dankof: Oh, thanks. I think 90% of figuring out what's going on with the patient is listening. If there's something we don't know about, that doesn't mean it's not true and doesn't have value, and it's up to us to hear them, and for us to look into what they're saying, and see if there is merit and value in what they're bringing.  This day and age, with the internet, people are searching everywhere, so it's up to us to try to figure out and decipher what is relevant or not. 

Linda Elsegood:  Yes. So here in England, the doctors have 10 minutes per patient, and that includes getting up from the waiting room, walking into the doctor's exam room, and coming out.  So if you've got somebody who has an autoimmune disease which has a myriad of different symptoms, what can the doctor actually achieve in 10 minutes?

I mean, 10 minutes is nothing, is it?

FNP Laura Dankof: Very little. That's why quite frankly, many of us that have worked in the conventional medical setting, know that the healthcare system is broken, and you cannot begin to figure out anything and listen to a patient in that amount of time. So it's like, what are your top symptoms, and how are we going to either run a lab or give you a medication in that short amount of time and out the door?

I've never. I've never practiced that way.  I've just kind of bucked the system a little bit, I guess, and kind of flew under the radar. And now, now that I have my own practice, as many functional practitioners do, I don't take insurance because it dictates too much of that. And it allows me to spend a lot more time with patients as well.

You know, my initial visit with a patient is going to be 90 minutes. And follow-ups, depending on the situation, could be 30 to 60 minutes or more. So, that's the beauty of having your own practice and don't take insurance. And that's why a lot of functional practitioners don't, because it dictates those very things about the volume of patients you need to be seen in a day.

Linda Elsegood: Well, that's pretty good. So you really work it out and give the patient the amount of time that you feel they need. 

FNP Laura Dankof: Absolutely, because I always worry if I don't give them the time to tell their story, what am I missing, and are we going to go down the right path with their healthcare if I don't hear their journey there?  You know, like what has happened to bring them to this point that they're sitting in front of me now.  And so it is important that I hear that because there are so many clues that help put the pieces of the puzzle together. 

Linda Elsegood: And how long of a waiting list do you have? 

FNP Laura Dankof: Currently people can get into my practice pretty quickly because I just started my virtual practice in the last six months. I had been working in internal medicine, large corporate healthcare system for many years prior to that. So right now, it’s pretty easy for people to get in to see me for a consultation. 

Linda Elsegood: Well, that's really exciting, isn't it? So, the telephone consultations that you give, if they need lab work done, how do you go about doing that?

FNP Laura Dankof: If they're in Iowa or Colorado where I'm licensed, we can either run it through Lab Corp with their insurance, or I use a discounted lab called Ulta Labs. The discounted lab charges a fraction of what patients would pay running their labs through LabCorp.  So, if you have a high insurance deductible, or it's not covered, you're better off going through a discount lab. And if they are in another state other than Iowa or Colorado, we can use Alto labs where they can do some testing. They can even order it themselves.  If they need a prescription for LDN, I have to see them face to face once a year, if they're in a state other than Iowa or Colorado where I'm currently licensed.   They certainly could come to see me face to face, even if they live in a different state.  Otherwise, I would be talking to them more in a consulting role, I could not diagnose them in another state.

Linda Elsegood: Well, that's really interesting. So would you like to give us all your details? 

FNP Laura Dankof: Yes, of course. If people want more information, they can find me at wwwdotpathtohealthandhealing.com that's “path to health and healing.com” and there you'll find more information. I write a health blog there. You can kind of read my story, and why I'm so passionate about taking a functional or natural medicine approach to healthcare, along with the different kinds of conditions that I treat, and how to schedule an appointment or contact me directly. 

Linda Elsegood: You've got me intrigued. Now tell us why did you go down the path of functional medicine? 

Laura Dankof: Okay. So for many people who go into functional medicine, there was a health crisis in them or a family member, and that was certainly true in my case.  I had a daughter born with a hereditary blood disorder.

And she was very sick when she was young.  She ultimately had her spleen and gallbladder removed, and they put her on antibiotics for an extended period of time, which then led to skin conditions, eczema and so forth. So, I took her off the antibiotics, against medical advice, because of what it was doing to her.

And we healed her gut, and healed her body, through natural medicine, because the answer conventional medicine wise was to give her steroids and immunomodulating agents that would have increased her risk for cancer. And it was just going down a very deep, dark rabbit hole with her at a very young age.

And then on myself, I had thyroid and hormone-related issues when I was in graduate school and did not want to go down that pathway either. And so I started really diving deeper into functional medicine throughout that whole journey with her and with myself.  

Linda Elsegood:  Wow. I’m sure all your patients are really pleased, not that you had those obstacles, but that you chose to become a functional medicine nurse practitioner. It has been absolutely amazing speaking with you today Laura and I hope you continue with your practice and success, and we wish you all the best.

FNP Laura Dankof:  Well, thank you very much, and I've enjoyed talking to you again Linda.

Linda Elsegood: Okay, thank you. 

FNP Laura Dankof: Thank you. 

Linda Elsegood: This show is sponsored by Mark Drugs, who specialize in the custom compounding of medications, assuring that the client gets the proper prescriptions for their unique needs and conditions. They work with practitioners, integrating knowledge and treatment of experts to create comprehensive health plans.

Visit Mark drugs.com or call Roselle (630)-529-3400. Or Deerfield (847)419-9898.

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.

Martha Grout, MD - 10th April 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Martha Grout, MD has an integrative medicine center in Scottsdale, Arizona, dedicated to natural treatments of cancer, Lyme disease, diabetes, metacarbolic, irritable bowel, and other chronic diseases. She endeavors to treat the whole person, body, mind, and spirit, and in searching for the root cause to patient symptoms. She has conducted much continuing education on a variety of subjects not taught in allopathic medicine.

Dr. Grout first heard about low dose naltrexone (LDN) when she moved to Arizona in 1997, and began using it on her pain patients, and those with brain function issues – adults with brain fog and confusion and early memory loss – but not yet for children. She learned that not everyone could tolerate LDN 4 mg – some could not tolerate the endorphin boost – and she had to lower the dose, and now prescribes between 1 – 4 mg LDN. She finds it boosts the immune system, but hasn’t done controlled studies on this.

New patients undergo standard and functional testing. Standard testing provides a very gross delineation of organ function long after they have been functionally incompetent. She tries to get patients before they get to that point. For functional testing, she uses labs like Genova diagnostics and Doctor's Data International, Hygenics, and DNA Connections and several labs like that that do more specialty testing, particularly for immune system dysfunction. Thyroid testing is an example, where patients have symptoms of low functioning thyroid but normal conventional test results. So she looks for other means, and in such patients LDN is helpful.

Linda Elsegood asked about unraveling all the issues that a Lyme disease patient has getting a diagnosis, being told it’s all in their head, and how Dr. Grout treats it. Dr. Grout responded that first is to get adequate testing, typically not through conventional testing. Many that have had Lyme infection or any of the varieties of co-infections, have been sick for a long time, and many are also nutritionally depleted, their brain and immune system aren’t working well. Often they have such gut dysfunction and microbiome dysfunction or abnormality that they can't even absorb nutrients very well through the gut, so IV nutritional therapies help get them filled faster so they can begin to function better faster. She also uses IV antibiotics if they can’t take them orally; but orally they take longer to reach the effectiveness of IV therapy. They promote healthy probitics and healthy diets - non genetically modified, basically organic when possible.

As to IV antibiotics, Dr. Grout relates that they may be needed for a long period of time, and relates Katie’s story (video on Dr. Grout’s website). Katie was on IV antibiotics for 18 months virtually every day. This is an unusual case, but she has had no relapse. Other people require much less.

Dr. Grout wrote a book with Mary Budinger, An Alphabet of Good Health in a Sick World, using a lot of information from her website. The book is available on Amazon, and through Dr. Grout’s office, and she’s happy to inscribe it. The book is about nutritional status being paramount. It's when our nutrition goes off the rails that things start to go south and it can take many years depending on where we started out. If our mothers were healthy, we started out with a better base. If our mothers ate junk food, then we started out with a less good base, and it probably won't take us as long to get sick.

A person low in vitamins may feel fatigued, without energy, have poor memory, and sometimes insomnia. Testing for vitamins is done through Genova Diagnostics, using both urine and blood, and measures functional levels of vitamins, fatty acids, and chemicals that are produced by the gut. It measures if there is an unhealthy gut, if there are products of protein in the stool, or if there are markers for unusual and unhealthy organisms in the blood. So long as the patient is doing well the test is not repeated; and it’s quite expensive, but a useful test.

Summary from Dr. Martha Grout’s LDN Radio Show from 10 April 2019. Listen to the video for the show.

Keywords: LDN, low dose naltrexone, brain fog, early memory loss, pain, endorphin vitamins, nutrition, integrative medicine, Lyme disease, thyroid, microbiome

Dr Annette Johnson from Germany - 27th March 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda: Today, my guest is Dr Annette Johnson from Germany. Thank you for joining us today. 

Annette Johnson, MD: Thank you for having me. 

Linda: Could you tell us how you got into medicine? Was it something you wanted to do as a child? 

Annette Johnson, MD: As a child, I wanted to go to Africa to help children that are not in a wonderful position as we are here in Europe, in Western countries. In the beginning, I thought it's only in Africa where they have problems and we don't really have problems in Europe, only luxury problems. Then I found out that's not true. We have lots of problems in Western countries, such as chronic diseases and the suffering that nobody cares about anymore because we tell our patients they are not curable at all. I wanted to help and change things.

Linda: When did you hear about LDN? 

Annette Johnson, MD: Actually I was so much into fibromyalgia and other patients that I was searching all over the world to find solutions for my patients. I am caring for about 700 fibromyalgia and around 600 Borrelioses patients and around 500 Hashimoto patients. 

I was very happy to hear about your radio show and your book. To start with, some other doctors in the area are pain specialists and who were experienced in this therapy.  

Linda: How long ago was that? 

Annette Johnson, MD: I think this is three years going by now but already I would say I can see success after some weeks, sometimes after the first week also. I also found a good psychological effect on the mood of my patients. So I'm really very positive about using this on patients who are so chronic. Sometimes I find them to improve very fast.

Linda: All right. You said that you have 700 patients with fibromyalgia. How many of those have you now got on LDN? 

Annette Johnson, MD: I don't want to disappoint anyone but I would say around 50 patients on LDN. Some patients do well only with diet changes with meditation techniques, plus therapy and private practical interventions. So I'm sort of doing my worst cases and that is why it's only around 50 from 700 because it's such a good help in the hard cases, in the difficult cases. 

Linda: Okay, so from those 50 patients, what have the outcomes been in the percentage?

Annette Johnson, MD: I did some research before our interview. I think it would be a 90% success. I'm separating my patients to those who best fit the criteria, which may be why my success rate is higher.

Linda: How do you prescribe LDN? Are you using capsules, or sublingual or cream? And how do you titrate the dose up? What is the starting dose? 

Annette Johnson, MD: Yes. I use a compound pharmacy that you recommended in Ireland off into South of Germany, and my first recipe is a 0.5 milligram, one milligram and two-milligram capsule on one recipe.

That means that the patients only have to come to me twice and then can proceed through. After they ask all their questions after they have understood the system, after they have read your book and then we keep in contact every two weeks by telephone or personally and then they increase.

The dosage until the four or 5.5 milligrams, if they use it if they need it, or they can stop if they don't need such high doses. Many of the myalgia patients only need very low doses to get a quick improvement. I have found with speaking to fibromyalgia patients and LDN prescribers that people with fibromyalgia and chronic fatigue syndrome, are very sensitive to all medication and LDN, even though it's a very low dose, is still a prescription drug.

Linda: Do you find you have to start very low and do you find they react to it negatively initially?

Annette Johnson, MD: I think they react very well if we start with 0.5 milligrams and I remember two cases who couldn't even tolerate that. So we made them buy empty capsules and divided into two pieces so they could start with 0.25 milligrams. This worked out very well. In the end, when they started it and then they increased the dosage over four weeks instead of two weeks, they could in the end or come to two around two milligrams. That's really interesting because we have some patients who want to give up, saying the side effects are a problem. Pharmacists and prescribers who say that they can get success with all patients, providing you use a very low dose and increase it very slowly. Some people need a longer gap to let the body get used to that dose before you increase it further.

Linda: Some people never have a higher dose than say, two milligrams. It's really individual to each patient, don't you think? 

Annette Johnson, MD: Yes. 

That's so wonderful, isn't it? We can give them the confirmation that in the end they'll find their individual doses and they can increase it if they just take their time. Also,  I tell about 10% say it didn't work well, then later say it did work and I didn't notice because  I did so many other things.  I didn't notice that I was so well, and this is a new effect and we want to go back on the medication. Isn't that interesting?

Linda:  It is very interesting. When I was really ill and every week I had a new symptom, I knew I had a new symptom. The numbness went from my toes to my ankle, to my hip, to my shoulder, and you noticed every single thing that was going wrong. But when things start to improve, it's certainly a case of, oh, my left side isn't as numb as it was before. The pins and needles aren't this bad, but you don't remember it daily like you do when things go wrong, and I think you probably think I'm okay now and you don't think about it.

Annette Johnson, MD: It’s just something that happens. It's only when you stop, as you say, and all these things come back that you remember. That's why I encourage them to have a little book, where they write down their everyday symptoms in a good way. We don't call this a pain book, but we call these recurrent feelings.

We'll see. Then they can go and read how bad they were years before or months, or even weeks before. Because patients with fibromyalgia and fatigue syndrome are often not very good at remembering things. So it's really necessary to write things down and then to go back and look at how many symptoms have already resolved.

Linda: We do have an LDN app for those people who are English speaking. You can have a journal, but you can also record sleep, mood, diets, supplements, exercise, set alarms, do graphs and charts and printouts. It's amazing, but it's in English. So if you have any members who are English speaking, they might find that as a value and help. It's on our website so they could look into that. 

Annette Johnson, MD: These days, they want to take their health in their own hands and they come with ideas.  I just had a patient who was suffering from fibromyalgia for 30 years. She had to do the suggestions to her doctors, what they could do to help her. This is so wonderful that we now understand pain and psychology effects much better than we used to.

As a doctor, you always need some patients that bring you on the way. You need nice colleagues that support you and give the support that you will manage and they will happen. There will be nothing difficult or illegal behind it and the doctors are very busy.

They don't have the time to look at everything themselves and to find out. If you have a doctor who's willing to listen to the patient, giving them new information, that is the way to educate them, isn't it? The busy doctors, when they don't have to search for it to be given the information is a big help.

This is so wonderful and I'm always asking the patients once they'll be better if it's allowed to then call their old doctors. That's what I do once they are better.

I go and call very nicely. They're all doctors and just tell them in a very collegial way how we managed to bring the patients back. It's the insurances that send me patients because they notice they don't have to pay for them anymore because they're going back to work after months or weeks.

So this is wonderful to see that in Germany. That government insurance ascends patients to my office because they know they'll be helped with LDN or other methods. I'm in close contact to Amin who also did lectures at the conferences for Augsburg for calming labs, and it's around 80% of my fibromyalgia patients who actually are triggered.

Borrelioses is a tick-associated diseases. So astonishing if isn't that bad that we are not finding the Berlioz if we don't use the right tests.

Linda: So would you say the Barrios SIS is Lyme disease itself, or would you just say that's a co-infection.

Annette Johnson, MD: I would say it's, it's triggering to see if you have the genetics that for example, you cannot get rid of, phosphates, which professor Paws and Amanda in Los Angeles found. And then you have a tick infection, then everything will compensate and everything will be bad. And you'll start to get autoimmune. And bad reactions. And that's where the LDN comes in. It doesn't replace the antibiotics or the plants that we use or the therapies that we use but it's keeping us from getting all these other diseases like Hashimoto or like other autoimmune diseases from infections.

And I find it very useful. I've had lots of prognosis patients. The Borrelioses and fibromyalgia are really so common in South  Germany. We have a lot of patients who have Lyme disease who have been told by their medical professionals that it's all in their head.

Linda:  They're just depressed. There's nothing really wrong with them. So that automatically makes them very depressed, not being believed when they can't get out of bed, they can't function. Do you have patients who have chronic Lyme disease that you treat because they are getting fibromyalgia from borreliosis?

Annette Johnson, MD: They're coming with fibromyalgia symptoms. And then I find very high numbers.  Actually, I had very bad Borrelioses last year.

It was 16. Unbelievable. And then I could just help myself with some physical therapies,  some foot photons to appease and some electric therapies. And I took LDN in the end after that, I just wanted to try it on my own. And I found that it was very useful and that I'm not having nightmares or something, but I have very nice dreams. it's really interesting and it's nothing scary about it, but it's wonderful to dream. And also it helps with my Parkinson patients who are not dreaming anymore. It helps with my dementia patients if they're not dreaming anymore because a deep sleep would DRI with dreams is so important to heal your disease.

Annette Johnson, MD: people talk about the vivid dreams with LDN., I feel robbed. I never had any vivid dreams, but I've heard so many people tell me about their dreams. I had vivid dreams, I wasn't scared. It was just interesting. It was like watching a video. It was not scary at all and I never felt that I should stop it or something. I think it's a wonderful thing and I want to take it one and a half years just to find out what it does with my body. I'm so convinced about this therapy I just wanted to take it. Just getting back to the Lyme disease patients, how long it takes to get better.

Linda: How long would you say that would take with using all your different therapies as well as LDN and the earlier they come, the faster they are healed, but already if they have it for a long time, we can help within half a year. Wow. Yeah, it is because it takes so long to initiate all the things and to get your vitamins on the internet and things.

Annette Johnson, MD: If people come from somewhere else very far away, you have patients from Egypt and from Portugal and from Scandinavia. So if, if they come from far away, I have to be very fast and I'm starting all things parallel because I don't care which of the things heals in the end. I just want to hear and. Then I'm faster.

Sure. The more they can do, in parallel, the shorter time they are here.

Linda:  Now, how do people get hold of you? What's your website?  And do you have a waiting list?

Annette Johnson, MD: Sure. https://www.annette-johnson.de/ But this is only three months, I think. Okay. So if anybody would like to come and see you, the sooner they can make that appointment, the better. If you have to wait three months. But if they come in the beginning of the week and they have had their massage already, then we could start, take the early spot LTT um, and know if it's Borrelioses triggered that why they are so fatigued or while they are so painful for, and then it would be just faster.

So we can take blood in the morning about vitamins and Borrelioses if it had their massage in the week before. And then. They don't need to come so often, but maybe three times or so. 

Linda: Well, thank you very much for being our guest today and sharing with us your experience. I appreciate it so much and thank you for your work.

Annette Johnson, MD: Take care. All the best. Thank you.

This show is sponsored by Dixon's Chemist, who are 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 far in excess of what is required. Why would you choose to get your LDN from anywhere else? Call 0141404654 five today to speak to LDN experts. 

Doctor Annette Johnson asked me to add, I may not have pointed out enough how important it is to start the titration with a compounded product instead of diluting tablets. Local pharmacies, unfortunately, suggest this in order to avoid the high costs of the raw material.

And the extra effort. Patients nightly believe that diluting a 50-milligram tablet is accurate doses of no 0.5 milligrams, which it isn't. I found incorrect fillers and self dilution. The reason why I initially didn't receive the results I do now, some colleagues are still not aware of this.

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.

Pol de Saedeleer PharmD, Talks about Lyme Disease and LDN (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Dr Darin Ingels Lyme Disease Interview (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: Today. I'm joined by Darin Ingles from California, and we have had Darin on the show before. Thanks for joining us today, Darin. 

Dr Darin Ingels: Thank you for having me. 

Linda Elsegood: Now you did a presentation for us for the LDN 2017 conference on Lyme disease. Could you tell us about your new book called The Lyme Solution?

Dr Darin Ingels: Sure. Well, you know, I had Lyme disease myself back in 2002. So I had the, uh, uh, I guess, uh, the experience of being a Lyme patient as much as a Lyme doctor. And, uh, the book was really kind of written out of my own experience of what I went through, uh, dealing with Lyme disease. And you know, I went down the typical path that most people do, use antibiotics and they helped me temporarily.

But, uh, it just so happened, I got infected three weeks before I opened my own practice. And when I opened, I was, you know, the doctor or the bookkeeper or the receptionist doing everything and working, you know, very long days. And after about eight months, I started to get symptoms again. And when I went back on antibiotics, it didn't help.

And I changed antibiotics, and it didn't help. And I went through a cycle about eight or nine months of changing antibiotic protocols and really got worse. So I was fortunate to have a handful of patients in my practice that had seen a doctor in New York City named Dr Zhang. He's a doctor from China, a medical doctor who works as an acupuncturist, and he developed a line of Chinese herbal formulas.

So I went to see him, and he started treating me. And really in about three or four weeks after starting the herbs, I was about 80-85% better. So I had a pretty significant turnaround just by, you know, going on herbs. So it was really kind of my realization that, you know, for myself, and certainly, for a lot of other people that, you know, antibiotics have their place, but they also have their limitations. And, uh, I kinda had to go back to my naturopathic roots and, you know, go back to, you know, herbs and diet and lifestyle. So what, after applying what I did to myself too, you know, thousands of other patients, I found that there was kind of a path that people could take to really, you know, try and overcome Lyme.

So, you know, that's really what prompted me to write the book. 

Linda Elsegood: Hmm. And do you start your book by describing testing because so many different tests will come back negative? 

Dr Darin Ingels: Yeah. Well, you know, the testing has always been terrible. It's never been good. And I was a microbiologist before I was a doctor, actually used to do this test for a living.

So I have a lot of experience with it. And in really 40 years of research, we've really never changed. The criteria of this test and I don't think what a lot of people realize, is that this test was never ever designed to be diagnostic. It was really designed to monitor people that had known Lyme disease.

And you know, at least in the US if you go to the CDC website, the Centre for Disease Control, um, they tell you that Lyme disease is a clinical diagnosis. And I think that's, that's. Pretty well known around the world. Yet so many doctors put stock into the testing as being really the definitive way that you diagnose somebody with Lyme disease.

And unfortunately, it's just not true. It really is based on your signs, your symptoms, particularly if you happen to live in an area, part of the world that's endemic with Lyme. And you've kind of ruled out everything else, you know, they call Lyme the great imitator, the great mimic. It looks like a lot of other things.

So you have to go through and rule out other possibilities. But you know, when we see that people have a positive test, um, you know, false positives are actually quite unusual and false negatives are extremely common. So a positive test gives you a pretty good idea that you've probably had exposure and a false negative or a negative test doesn't necessarily exclude the possibility.

And I mean, I guess on the heels of that, you know, the good news is, is that we are having new labs coming out that are testing in different ways. You know, the gold standard for years is really just then this two-tiered antibody test. And you know when the antibody test is really just measuring your immune response to exposure.

So at best all the test really tells you is you've been exposed, you know, whether you have Lyme disease or not. Really comes down to whether you ever actually expressed any of the symptoms. You know, because theoretically, you could have gotten bit by a tick that carries Lyme, your immune system did what you wanted it to do.

You never got Lyme disease, but you'll show evidence in your blood that you had exposure. Uh, so that's why you always have to take consideration, the symptoms you experience in conjunction with the test. And you know, you put two and two together. But like I said, now the good news is we do have some new labs coming out, that are starting to look at cytokine activity, which is not measuring antibodies. There's the fact. There's a lab in Germany called Armin Labs, uh, that does great testing for cytokine activity. And then there's a new lab that just came out in the US where they look at a common sequence to all species of Borrelia.

You know, the test that's been out there only really looked at Borrelia burgdorferi, which was the first strain of line that we discovered, we now know that there are 300 strains of Borrelia worldwide, and yet the test only looks at one of them. So we now have a lab that's starting to look at a sequence that's common to all Borrelia.

So I think, you know, these kinds of labs as they develop, will continue to increase our, uh, our likelihood of picking up Lyme in people.  

Linda Elsegood: And you were saying about looking at the symptoms and how Lyme can mimic other conditions. So if you had the symptoms of MS and chronic fatigue syndrome. How would you try and rule out that it wasn't MS or chronic fatigue, that it was Lyme?

Dr Darin Ingels: Well, you know, I think those two examples, particular, you know, it could be both. You know, I think a lot of these diagnoses out there are really vague. I mean, even if it's MS or chronic fatigue or fibromyalgia, you know, these are just sort of descriptive diagnoses without really an understanding of why.

And if you ask your doctor, why do I have chronic fatigue, why do I have fibromyalgia. More often than not, you're going to get kind of a blank stare. And I think, you know, Lyme can be a trigger for MS I mean, that's what happened to me. My Lyme turned into MS. And you know, if you talk to a radiologist, they'll tell you that the lessons you see on the brain with Lyme are identical to the lesions you see in MS.

Um, so, you know, I think a lot of these diagnoses that tend to be kind of you know, vague or really without a specific understanding of, you know, what the underlying causes, you know, Lyme and some of these co-infections particularly can be a trigger. And what's really interesting is if you go into the medical research, you'll find there's a tremendous amount of information about microbes as a whole being catalyst or triggers for autoimmune diseases.

So it's not really, you know, fringe medicine anymore that, you know, different microbes, you know, bacteria and viruses, uh, can cause a lot of these, you know, chronic illnesses. And I think it's something that most doctors really just aren't trained to look for. But again, there are literally thousands and thousands of articles out there showing how, you know, ms is a great example.

We know that Lyme and ms have an association. We know the Epstein BARR right. And ms have an association, and we know that chronic fatigue has been associated with numerous viruses and other bacteria and so forth. So, you know, I think it's just the process of trying to go through and identify, you know, what these potential underlying microbes might be, um, that is.

You are potentially triggering that reaction. Because if you know what the microbe is, you know, there may be a way, whether it's an antibiotic and herbs, you know, some of the way to try and help deal with the infection. And if that really is the trigger, once you deal with the infection, often we find that the symptoms get a lot better.

Linda Elsegood: And what about the different trains of thought that, um, Lyme disease can be sexually transmitted? What's your take on that one? 

Dr Darin Ingels: Yeah. You know, it's, it's been a controversial topic. And what's really interesting, you know, when I wrote the book, of course, I was doing a lot of research, and I was really surprised that in, in the research, they have not shown that it is sexually transmitted.

And I think a lot of Lyme experts, and in fact, I was at the ILADS meeting last October, and one of the gentlemen stood up and basically felt, uh, that it is very hard, uh, to acquire Lyme sexually transmitted, you know, through sexual transmission. You know, the way you get Lyme is through a tick bite.

And of course, it's specifically in the saliva, the tick, you know, that's the route of entry. Uh, so through sexual contact, you know, the research says, no, I don't think it's impossible. Um, I mean, I certainly have had partners where one developed Lyme and then months, years later, their partner developed Lyme.

Now, is it because it's through sexual transmission or is it just because they live in the same environment and that person just happened to get their own exposure? Um, you know, I think it's a bit of a grey area because it's a really a kind of bloodborne pathogen, I think, unless there's probably the transmission of blood, it might be fairly hard.

Um, however, there was an article that literally just came out last week that did find a Borrelia in the genital secretions of both men and women. Um, so I think that's some of the newer evidence that it's possible. Um, but just because it's in the secretion doesn't mean that it can still, you know, penetrate the mucus membrane and create an infection the way that we think of it that you would normally get through a tick bite.

So, you know, I guess the truth is we really don't know. Uh, I, my advice, uh, to patients with Lyme is to be cautious, uh, with, uh, sexual activity and use, uh, you know, protective measures. But, um, I think, uh, the. We're still trying to figure out, you know, what that possibility really is.  

Linda Elsegood: And what do you cover in the chapters in your book?

Dr Darin Ingels: So the book is really designed to be a patient guide. Uh, of course, it's very appropriate for practitioners who really just want to learn more about Lyme and a sort of a natural way to approach it. But I really break it down into five steps to sort of simplify the plan. And the first step is really about addressing the gut.

You know, we know that the gut, uh, accounts for up to 80% of our immune function. So if the gut is not functioning well, often, you know, the immune system doesn't function well in many Lyme patients I work with, you know, have a history of some sort of gastrointestinal problems even before they got Lyme.

And whether it was chronic constipation or diarrhoea or gas or bloating, you know, there's some evidence that they really weren't assimilating their food well. And that things weren't functioning quite the way it should. So I really talk about, you know, different nutrients you can use, uh, to help, you know, rebuild the gut, repair the gut if it's been damaged.

Certainly for anyone who's already been on antibiotics that might've wiped out a lot of their normal gut flora, or perhaps they've been on other medication that's damaged the gut, such as, you know, perhaps chemotherapy if they've been through cancer treatment. So it's really outlined and designed to give you a step-by-step, uh.

Plan on, you know, different nutrients you can use to really help, you know, restore the gut back to its normal balance. And then the second part of the plan is really about diet. So I've tried various diets on myself and certainly with my line patients, and there's paleo, and there's keto, and there's, you know, specific carbohydrate.

You know, there's just numerous diets out there that get purported to help you know, everything. And what I really found is a, what's called an alkaline diet seems to really work best for Lyme patients. And an alkaline diet is really kind of a. Uh, perhaps a hybrid of paleo in that, you know, it really kind of reduces a lot of your carbohydrate intake.

But what it really boils down to is, I think as to what we probably ate when we really were true hunters and gatherers, where it really is a plant-based diet. So you're really eating mostly vegetables. And we try and limit animal protein to less than 20% of your total dietary intake for the week. And then there are certain foods that we know are just very acid-forming in the body.

It doesn't, things like, you know, dairy products and junk food, processed foods, which of course are a huge problem here in the US and a. And even things like coffee, you know what we know is. From a chemical standpoint, you know, the more acidic your body becomes, the more prone it is to inflammation. So at the end of the day, with the diets really about is, is reducing inflammation in your body.

And inflammation could be in your joints, and it could be in your brain, it could be in your gut. It really applies everywhere. So I give you a two week, you know, plan on, you know, this is what you should be eating. And then I've actually partnered with a nutritionist, uh, at. Prep, dish.com and, uh, we put together a one month a meal plan, uh, for people who really want to follow this diet through.

And it just gives you some great recipes and easy to follow guidelines on how to prepare your food. I mean, a lot of times when people have Lyme, they're just tired and exhausted. And the last thing they really want to do is spend hours and hours slaving over a stove. So we really wanted to try and simplify it and just make it easy for people to really start.

Start eating well. Uh, the third step of the plan is about treating infection. And as I mentioned, you know, I went through both antibiotics and herbs, and I found that herbs actually work really well. So I go through a series of herbal protocols. I've used myself personally, and I've also used in my clinical practice, I find give me the best clinical results. And what I like about herbs too is that not only are they trying to go after the bug, but they're also dealing with all the other things that Lyme does to the body. So it's helping reduce inflammation and improve circulation and improve blood flow. And, uh. Help support your immune system. So it really deals with a lot of the things that Lyme does. And you know, one of my contentions in the book is that you know, Lyme initially is an infection, but at some point it really kind of becomes an autoimmune disease. And so if we really start thinking about Lyme more like an autoimmune problem than just a straight-up infection. I think, you know, we get better clinical results. So I really, you know, walk you through step by step, you know, here are the herbs to take, here's the amount to take. And you know, these herbs, at least in the US are readily available online, so it's easy for people to get access to it. 

The fourth part of the plan is really about the environment. And we know that a lot of people with any kind of chronic illness tend to have a high body burden of different, you know, chemicals and toxins, which all just makes it hard for your cells to work well for your immune system to work well. So it's really about reducing your exposure at home to different chemicals that you might be using. You know. Yeah. Window cleaner and tile cleaner and bathroom cleaner. You know, most of these chemicals tend to be fairly toxic and have a lot of things that don't do anything good for your body. And I really focus a lot in this chapter about mould, you know, certainly here in the US and then I'm guessing in the U K as well. You know, you've got a lot of mould issues, and mould is the one thing I find mimics Lyme probably more than anything else. And if you write down all the symptoms of mould toxicity and all of the symptoms of Lyme disease. There's quite a bit of overlap. So when we've had someone who's been on Lyme treatment, and they haven't been responding very well, you know, one of the first things that always pops in my head is mould.

And do we need to go through that process of trying to identify if they've got mould exposure in their environment, but mould is definitely a big part of that environmental evaluation? And that's part of the plan is really about lifestyle. And I find so many people, you know, again, when they're chronically sick, and certainly, with chronic Lyme, you know, a lot of lifestyle things really change.

You know, I mean, I used to be a very physically active person, and when I had Lyme, I was exhausted. And the thought of doing anything physical was just—a lot. So, uh, but you know, moving your body is really very important for your physical health, for your mental health. And I think no matter what your physical state is, there's something you can do, uh, just to get you moving a little bit.

And it could be as simple as stretching. It could be yoga. It could be Tai Chi. It could be Qigong. It could be swimming. You know, there's a lot of low impact activities that people can do to really try and get their body moving. And again, that's what helps move the blood, which ultimately moves the lymph. And the lymph is where a lot of these organisms like to hang out. So it really is kind of a way of cleaning out the toxic stuff in your body. Bringing in oxygen, bringing in fresh nutrients, and I think it's also just good for people's mental health. 

Um, I also talk about the importance of sleep. You know, I find a lot of people after they've been exposed to Lyme, really don't sleep very well, and sleep is, you know, when your bodies actually get the chance to restore and repair itself. So people miss out on that. Deep restorative sleep. It's just really hard to get well. So I talk about specific nutrients that people can use to encourage deeper sleep, better sleep. 

And then the last part of that is really about stress management. You know, again, when you're chronically sick, it's stressful for you. It's stressful for your family, your loved ones. And I think there are so many people out there with Lyme that have a good support network, but you know, I know how it was for myself. At some point, people kind of get tired of hearing about not feeling well, and. They ask you how you do on a day, and you're polite, and you say, great, and deep down you don't feel great at all. Um, but you know, nobody really wants to hear your truth. So I think it's important that people have that place, that space, that they can really share how they do feel and whether it's a therapist, whether it's a Lyme support group, uh, to have some avenue that's not your immediate family or friends that you can kind of unload on. And, and. It's okay that, you know, you feel that way. Um, again, I, I think that's an important part of our mental wellbeing. And you know, our, our brains and our bodies are very well connected. So if we're only taking care of our physical body and not our mental body, uh, I think that becomes an obstacle to really getting well.

So I just encourage people, and I give you some ideas in the book about, you know, different places that you can reach out and help, you know, kind of complete your support network. So, you know, that's really the essence of the book. And then I have one chapter in there is really on therapies that need to be physician-guided. And so, of course, I talk about low dose naltrexone and other therapies that need to be done during done under the auspice of a physician  

Linda Elsegood: When you get somebody who comes to you, and we have many members that are so sick that. They are disappointed. Some of them that they wake up the next morning because they have had enough, you know, they feel so ill, they can't see any way out of feeling better.

Now, if they read the book, where do they start? Where? What? Because when you're that sick to do anything is a struggle. As you were saying about following a, a diet for four weeks, what. There are many steps that you talked about there in the book. Where is the first point of starting to try and feel better to be able to do all the things that you suggest?

Dr Darin Ingels: Yeah. I think, you know, kind of what the first step in the book is, there's no kind of coming back to gut health. You know, your gut health, because that's your intestines. It's your stomach, and it's your liver. Your liver is what does the heavy lifting for detoxification. And look, I've had patients that have gone through every therapy under the sun, and nothing really works for them.

And sometimes they start, you know, dealing with their gut or dealing with some sort of detox protocol. And then, you know, that's the thing that really starts to get them feeling better. So, you know, for someone who's really kind of down in the dumps and discouraged and just trying to find something to give a little, uh, a shred of hope, uh, I think, you know, this is something, again, that's not expensive that.

Anybody can do it again, no matter what your state is, is, you know, start, you know, working on building your gut health. Start working on, you know, detoxifying your body. And I mean, I've got patients that, you know, do home enemas. I've got patients that, you know, jump into a sauna if they have access. I've got people that, you know, there are various ways that aren't, uh, you know, hard on the pocketbook that is doable, that you can at least start that, that process.

So I think that's a good place for people to start. 

Linda Elsegood: Cause many people, as you were saying with Lyme, have tried so many different therapies and it's financially broken them because, you know, they spend a lot of money and many times don't feel any better than when they started. So to have a plan that you can follow through, um.

And if you can get your gut health sorted out, so you feel stronger and more able to do other things, you know, has got to be the way. But if somebody came to you who was in a really bad way, and they asked you the question, it may as well be how long is a piece of string, but how long would it be before you know, I start to feel better.

And by following all these steps, could I put my Lyme disease into remission? What would you say? 

Dr Darin Ingels: Well, my expectation, when people start following the plan, so to speak, you know, my expectation is that you would see improvement in the first six to eight weeks. Now to get to a point where you really felt, you know, completely a hundred per cent; well, I mean, realistically, I mean, it could be a year or longer.

I mean, for me it was, you know, after I got off antibiotics, it was a little over two years before I really felt like I got my life back. But again, when I started on the herbs, you know, I felt an improvement, you know, a significant improvement in the first month. So I think just having that inkling that you know, you're feeling better.

You know, you know you're on the right track, you know, then it's easier to kind of go forward and do some of these other things. You know, where I see a lot of stuff fail. I think there's a lot of therapies out there that are very expensive, at least here in the US that is really designed to target just killing the bug.

And I think if that's the only thing that therapy's designed to do, you're going to get very limited improvement. And you know, I've seen, you know, patients that have flown over to Germany for hyperthermia treatment. I've had a lot of people here who do ozone therapy and other oxidative therapies like hyperbaric oxygen, uh, IV, you know, ultraviolet stuff.

And again, I mean, these therapies all have their place, but you know, they're really all designed in some way to kind of, you know, kill the bug. And I don't know that they necessarily address. I know a lot of these other issues that Lyme has created, and again, they tend to be very expensive, and you have to have a provider, you know, apply these therapies.

So, you know, I wanted to know the book to be really something anybody can do at home, no matter where you are in the world, pretty much. At least if you have access to the internet and you can get some of these things. But a lot of these things are things that you can really do on your own. And I mean, for a lot of people, uh, you know, it makes a huge difference.

And again, this was my journey. This is what kind of turned the corner for me. You know, I really never did any high tech anything. Um. Yeah. It really wasn't accessible to where I wasn't in the States at the time either. But, uh, I think, you know, you have to look at the the the risk-benefit of any therapy and the cost of course, and you know, what is going to give you the biggest bang for your buck.

And, um, I'm sure if you talk to every Lyme doctor out there, they'll probably have a different opinion on what that is. But again, I, I. I think the book that I've written is really a great way for people who are trying to be budget-conscious, uh, to be able to sort through the therapies. Uh, I try to talk about, you know, the price, uh, about what these therapies are.

So people have a pretty good idea about whether it's something they can do or not. But again, most of the stuff in there is pretty affordable. 

Linda Elsegood: Could I just ask you about the long-term use of antibiotics? I know you were saying, you mentioned about how it affects your gut. Um, I'm just thinking myself, when I was on a long-term antibiotic, I got, um, thrush in my mouth and I could not clear it up.

I had it for about a couple of months. It was terrible. Absolutely 

Dr Darin Ingels: Awful. Yeah. The long-term antibiotics, well, you know, even short term antibiotics are going to have a damaging effect on your gut microbes. I mean, that's just the nature of the beast. You can't kill the bad guys without killing the good guys.

So there's always going to be collateral damage when you're using antibiotics. And then we know from the research and in rats anyway, you know, when you give a rat a single dose of antibiotic, I mean, that's not what, even one day, that's one day. Dose, it takes six months for the rat, got to repopulate back to where it was prior to the antibiotic use.

So I can only imagine what happens in humans when we've been on antibiotics for, you know, weeks, months, and I mean, I've even had one patient who was on continuous antibiotics for 12 years. You know, in addition to, you know, wiping out your normal gut flora. And of course, again, we've had a, just a ton of research coming out about the importance of your microbiome and how it modulates not just your immune system, but your weight and your mood.

And you know, all these other aspects of our health are really tied into our gut microbes. The other thing about the long-term antibiotics that people really don't know about and they should, is that it's very damaging to your mitochondria. And we know that Lyme itself damages your mitochondria. And for people who don't know, mitochondria are the part of your cell that literally create energy.

So part of the reason, you know, you're sorry darn tired. When you get these chronic infections, and to a certain degree, it's that damaging effect to these mitochondria. Well, again, we know that when you're on antibiotics long-term, that compounds the problem, makes it worse. So, you know, I'm certainly not opposed to using antibiotics.

Again, I think they have their place, and certainly, with acute Lyme disease, I think they can be very effective. But you know, if you're in the state of chronic Lyme and you've been on antibiotics for months to years, and you're not feeling any better, I guess, you know, my feeling is, at what point do you draw a line in the sand and say, no, this really isn't the best path for me, and I need to find something different.

I knew that in the effort to try and kill the Lyme, you're also damaging other really important aspects of your own body. So. Uh, you know, it makes it even more confusing that you know, we don't even know if you ever really get rid of Lyme. You know, we can't measure Lyme easily in the body. And I think there's been some pretty compelling evidence that we, I've never actually done get rid of Lyme.

You know, once you get it, it's kind of part of you, but I sort of equate it to like, you know, when you get a Chickenpox when you're five years old, you can get shingles when you're 55 years old, and it's the same virus that stays in your body. You know, the difference is your immune system. Something happens that you know, it tanks, and then that virus becomes opportunistic.

I think, again, you know, we need to think about Lyme disease and how it affects your terrain. And if we can correct your terrain, correct your immune system, you know, it should be able to keep it at bay, uh, and not cause problems. You know, why is it there? Some people who get Lyme and you know, they'd get over it, and they're fine.

And other people, you know, it goes on for years. Um, I'm sure there's a lot of reasons, but I think a big part of that is certainly what was going on in the body prior to getting Lyme and then what happened thereafter. But again, I think the more we make our body more toxic, more acidic, uh, all of these things just kind of add up, and it just makes it harder to get well.

And of course, the antibiotics are also very acid-forming in the body. So again, from a chemical standpoint, uh, it's not. It's not doing the kind of things in the body we really want. So, you know, people really need to weigh that risk-benefit when they're considering doing long-term antibiotics. And you know, I've seen, you know, I, I heard from people online and said, Oh gosh, look, I was on antibiotics and saved my life.

Great. You know, I, I think anything that works, you know, again, there are some people who do really very well on it, and it changes their life. And that's wonderful. But again, I think, you know, I'm, I'm focusing more on the people who've been down that path, that haven't responded well or gotten worse, and they need, you know, other solutions.

Linda Elsegood: Great. Well, we've come to the end of the show and if people would like to go to https://dariningelsnd.com he has a lovely website there with all the information about the book he's practised. There's a blog, a store, events, absolutely everything, and you can even order the book online. So it's been amazing having you with us today and thank you so much for sharing your experience for this.

Dr Darin Ingels: Great. Thank you, Linda.

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.

"Bullseye" - Low Dose Naltrexone and Lyme Disease (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Dr Sajad Zalzala - 4th July 2018 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Dr Sajad Zalzala shares his Low Dose Naltrexone (LDN) experience on the LDN Radio Show with Linda Elsegood.

Dr Sajad Zalzala, commonly known as Dr Z, combines unique qualities of an experienced doctor passionate about disease prevention and longevity, and a serial entrepreneur. Sajad has been passionate about slowing down and reversing age-related diseases for 20 years. 

He decided to become a doctor after reading Ray Kurzweil’s books. He became interested in integrative and functional medicine as a medical student. He currently sits on the board of the International College of Integrative Medicine (ICIM).

For the last several years, he has run an online clinic dedicated to prescribing LDN to patients across the US and most of Canada and has treated over 1,000 patients with LDN.

This is a summary of Dr Sajad Zalzala’s interview. Please listen to the rest of Dr Z’s story by clicking on the video above.

Dr NicolaMcFadzean – 6th June 2018 from LDN Research Trust on Vimeo.

Dr Nicola McFadzean who's actually English and she grew up in Australia. She's now in San Diego and is sharing her experience with Low dose Naltrexone.

In America, you can actually be a naturopathic doctor but that qualification just doesn't exist in Australia and I think not in England either so I went to Seattle and I studied for four years and got my doctorate of naturopathic medicine and then moved to San Diego in 2003.

I was invited to work in a clinic where the medical director was a fairly well-known autism doctor and so I was introduced to Low dose Naltrexone around that time through him.

I started LDN  mostly autism then I started seeing Lyme patients. And today, the majority of my practice is Lyme, probably 95% is chronic Lyme.

I experienced pretty good success with LDN in autism patients.

I did the treatment in conjunction with dietary changes, addressing candida and all those kinds of things. I think with any of these sorts of chronic health issues, there's not one thing that's going to be like the be-all and end-all there.

There's just no one thing out there on the planet like that.

With Lyme disease, there is a chronic infection and it is complex because the immune system is suppressed.

I see a lot of Hashimoto's thyroiditis patients with Lyme which is another area LDN helps and then mold toxicity, heavy metals etc.

So it's a question of trying to gather as much information from the patient to do as much functional diagnostic testing as possible.

Sometimes testing for Lyme can be a little bit unreliable. So we have to just kind of put all the pieces together and figure out what makes sense.

 I typically will start people on natural therapies. First I do prescribe antibiotics and some patients I'll actually prescribe LDN right out the gate in the first visit.

I do have some patients that I put them on some herb and they come back six weeks later, like pretty much symptom-free. That's the exception, unfortunately, so I usually tell them anticipated boots two years or more of treatment. But it's not actually taking that long to get them on the road to recovery but to really get to that point that we can confidently say they're in remission.

We never say we cure Lyme once it's chronic, but if someone's just being bitten by ticks, they get antibiotics and we can potentially eradicate Lyme at that point when it's a very young new infection. In chronic Lyme, we do use the words remission. I do have some patients that are sort of 90% of where they were before. I do have some people that just do have flares along the way, and we need to go in and do a month or so of treatment just to knock it down and then they're okay again.

And I've seen that a few times with people have come back feeling like they're having symptoms, but once we did adrenal work, then those symptoms went away.

Sometimes patients do not follow all the treatment because they start feeling better and want to do all things that they haven't done for a while and they get adrenal fatigue in the gut health. The first thing to do is to remove anything that's causing inflammation in the gut. So I get people off gluten, dairy, whatever food intolerances they might have. So I do a lot of IgG food sensitivity testing, just to see if there are any foods that are inflaming a person's gut, that they might not be aware of. Some people are sensitive to garlic or bananas or pineapple and they wouldn't necessarily know that. So I do check and sort of work on the diet first and then I'll usually do a combination of stool testing. And I like a test called a microbial organic acid so I do stool testing to check bacterial imbalance, make sure there are no intestinal parasites showing up, do the microbial organic acid to look at candida and work on getting the microbiome back in balance.

Then at the same time, we want to work on healing the gut. So I've use Colostrum liposomal claustrum, L-glutamine to calm the gut and heal the leaky gut. Usually between gut bacterial imbalance, parasites, yeast, getting inflammatory foods out then, that starts to put things in the right direction.

There's a number of different ways to test for candida. Just looking at symptoms in the body of somebody who's got gas bloating, white coating on the tongue, foggy brain fatigue. They're all kind of indicators of candida. From a testing standpoint, you can do blood antibody testing. So IgG, IGA, and IgM markers to candida. You can do a stool test. It's like a comprehensive stool analysis and it will often show up there but my favorite is this microbial organic acid test.

If the results are high I do antifungal therapy and then you check it again and it's down.  You're on the right track, not finished yet, but you're on the right track.

Whereas to me, you don't get that clear cut feedback through the stool testing or the blood test

The treatment for candida. I use a lot of herbs like grapefruit and Pau d'arco.  We all have candida, but where is the overgrowth coming I do use some prescription antifungals in my practice, especially if I do have patients on longterm antibiotics. I put them in antifungals that don't cause a lot of side effects. Some patients with Fibromyalgia are very sensitive to medications and I think that probably comes down a lot to genetic issues with methylation.

But the trick is always just to start with very low doses of things and work people up gradually because especially with candida they can be that die off kind of effect.

And I'll use a lot of binders too, with my patients, activated charcoal to help draw toxins out of the body, especially if we are doing any kind of therapy, that's killing bugs, whether they are bacteria or candida. So doing binders can help to get them out and then obviously replenishing with probiotics.

I have also patients with depression and it's based on looking at depression from a couple of different angles. So I see this sort of two elements of depression in my patients.

One is depression is a very natural response to being in pain, chronically to being homebound, bedbound, not being able to be out in the world and in life and enjoying friends and family and children. And then as a reaction to two circumstances, depression and anxiety, a fairly understandable emotion.

Then we have the other half that the infections themselves, cause depression and anxiety just as realist symptom as knee pain or fatigue.

These infections through inflammation in the brain miss neurotransmitters working on their central nervous system and kind of creating depression and anxiety as well. To some extent, it's just a matter of treating the infections to help the depression.

I do have some patients who do antidepressants while waiting to treat the underlying causes. I strongly encourage my patients to get counselling, something to help them deal with navigating their illness and just the sense of loss and sense of grief and the fears that come up.

And I'm a strong believer that a lot of Lyme patients have PTSD because of what they've been through in the medical system so far on their way to getting to the right doctor. I also use amino acid therapy and natural agents to help take the edge off depression and anxiety as well.

Another one that my patients talk about a lot because Lyme is kind of an invisible illness and they look fine, you don't look sick by close family and friends too.

Some of my patients come into the office and they look like a million dollars, she's done the nails but if I really sat down and asked them about it, they could be in bed for days, just recovering from the effort it took to do that.

If people want to find me I do give telephone or Skype consultations

The biggest restriction on doing that is I can't prescribe anything for a patient I've not met in my office at least one time but a lot of people if they have a local doctor to do the prescribing, I can still give recommendations.

Summary of Dr. Nicola McFadzean interview. Please watch the video for the full interview.

Sunjya Schweig (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.