LDN Video Interviews and Presentations

Radio Show interviews, and Presentations from the LDN 2013, 2014, 2016, 2017, 2018 and 2019 Conferences

They are also on our    Vimeo Channel    and    YouTube Channel

The LDN Book Volume 2 & The Goals of the LDN Research Trust (LDN, low-dose Naltrexone) from LDN Research Trust on Vimeo.


Linda is Multiple Sclerosis patient, founder and volunteer CEO of the LDN Research Trust. She has made it her life’s work to help and support people with autoimmune diseases, cancers, mental health issues etc. Her goal is that LDN will be used as a first-line treatment, where appropriate, globally. In the last 16+ years, she’s achieved a lot.

Linda has organised 7 Conferences, numerous talks, and she has edited both of The LDN Books. Linda is the LDN Radio Show Host, has planned 6 Documentaries and the 15th Anniversary eBook. She also oversees the day-to-day running of the charity along with other volunteers.

Pharmacist Kim Hansen, LDN Radio Show 30 Oct 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

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

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

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

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

Linda Elsegood: So where did you study?

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

Linda Elsegood: So you haven't moved far? 

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

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

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

Linda Elsegood: How did you hear about LDN?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Whereas he was in pain and uncomfortable before. 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Linda Elsegood: Thank you.

At Town and Country Compounding Pharmacy in Ridgewood, New Jersey, owner, pharmacist, John and his team are passionate about low dose naltrexone. They have compounded LDN for over 15 years. And they're committed to compounding high-quality medications and serving as an educational resource for patients and practitioners alike. Visit https://tccompound.com/ or call (201) 447-2020 with any questions or comments you may have. Please email me at ontact@ldnresearchtrust.org. I look forward to hearing from you. Thank you for joining us today. We really appreciated your company. Until next time, stay safe and keep well.

Dr. Judy Tsafrir, MD - Oct 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: I'd like to welcome my guest today, Dr Judy Tsafrir. Thank you for joining us today Judy. 

Judy Tsafrir: Thanks for having me, Linda. 

Linda Elsegood: I mean, you were telling me you were from Boston, um, in your practice. What's the patient population that you treat with LDN? 

Judy Tsafrir: Um, I'm a psychiatrist, a holistic psychiatrist. I see both children and adults, the more adults and kids, and people seek me out because they do not want a conventional psychiatric approach to their depression or anxiety, or whatever it is that's troubling them, which is typically just the prescription of pharmaceuticals and perhaps, um, some sort of counselling. So my approach is essentially functional medicine where I am looking for the root causes of what's going on with them and having conversations with them about their diet and their lifestyle and sleep and exercise. Um, also I trained with someone named Dr William Walsh, who is a biochemist from Chicago, and he has correlated certain laboratory studies with psychiatric symptoms, for example, elevated copper or, um, high histamine, and there are protocols of nutrients that can be prescribed instead of pharmaceuticals. A lot of patients come to see me because they are chronically ill and they're not getting help from other doctors like they're, I'm not usually the first stop so they may have many patients who have autoimmune conditions, um, which often presents psychiatrically; like there's an anxiety piece. And I've developed, um, over the past couple of years interest and awareness about mold toxicity. And so patients will come to see me because they are suffering from symptoms related to mold toxins.

And, uh. When that is addressed, that can have a big positive impact on health. 

Linda Elsegood: But isn't it amazing that you could take some supplements like iron and copper instead of a pharmaceutical drug? You know, because all drugs have potential side effects, don't they?  

Judy Tsafrir: Yes, and that, you know, the model is conventionally is to identify symptoms and suppress them. And instead of seeing the symptoms as communication that there's something wrong and looking for what it is, that could be corrected. 

Linda Elsegood: But when you said that you help people with autoimmune diseases, I mean, there were so many people, um, that I know of who have had, say, fibromyalgia or chronic fatigue, MS and before they managed to get a diagnosis so many of them are told it's in your mind, you know, that there is nothing really wrong with you and that is very depressing. 

Judy Tsafrir: and very invalidating. That's an experience that many patients have when they come to see me, that somebody, there's such relief that somebody believes them.

Linda Elsegood: And it's getting people to listen to you, isn't it? Rather than just brushing you off without investigating. 

Judy Tsafrir: Right. You know, I just came back from a conference. I actually was in a conference over the weekend in California, which was all about electric hypersensitivity and the effects of electromagnetic frequencies on our health, and this was on my radar but in a much less focused way then it will be now going forward because I would tell my patients to turn off their routers at night and tell them to not carry their cell phone in their pockets. But, um, it goes much further than that. There really needs to be a lot of avoidance and awareness about the way that electromagnetic waves are impacting our health. And I think there may be a number of patients in my practice who I've been treating for mould who may have mould or who do have mould, but maybe they would be so much better if I would also be addressing the, um, electric hypersensitivity. So this is something that has newly, like really come into focus for me,  just over the weekend.

Linda Elsegood: And what about children? You said that you treat children as well, and it's very ... 

Judy Tsafrir: yes. I mean children have an attentional problem, and they have anxiety, and uh, there can be, just the same as with adults, there can be imbalances, and I think that a lot of these kids are actually tremendously affected by the electromagnetic frequencies, like all of the screen time, that kids are doing. It's really, um, there was a child psychiatrist who spoke at the meeting who, um, kids who were so behaviorally dysregulated and suffering so much, and the families were in such a terrible state because of the child being, um, so, uh, symptomatic that with the screen, you know, with the electronic “Fast” of one month, the symptoms completely resolved. 

Linda Elsegood: Wow. But if a parent had a problem with a child, with, let's say, anxiety, I mean, how old are they normally? the youngest that you see in your practice? 

Judy Tsafrir: Oh they can be very young. They can be, you know, six years old.

They can be five years old. Just a kid who's not sleeping, who, you know, can't separate. Um, you know, I'm, I'm trained originally as a psychoanalyst and my model, previous to learning all of this functional medicine, would be to really think that there was some kind of, um, psychological dynamic going on between the parent and child, which they may also be, but there is so much to be understood in terms of what can be going on biologically In addition to all of that.  

Linda Elsegood: And would bed wetting come under that umbrella as well? 

Judy Tsafrir: Of course. I mean, that is often like a, um, an immaturity of the neurological system. And that can be developmental and can improve with time. But, um, everything that is going on, you know, can be due to, um, many different factors. Including trauma and, um, adverse experiences. But it's just, it needs to be looked at from so many different angles, including the spiritual. 

Linda Elsegood: I mean, you said that you look for the root cause, but to find the root cause for a child, obviously, you listen to the child, but their communication is going to be limited.

And of course, then you'd have to listen to the parents. How do you …?

Judy Tsafrir: And the school 

Linda Elsegood: Okay. And the school, how do you get to the root cause if you know, if there's somebody listening with a child that is having problems, what would be the process you would go through to find out what you could do to help a child?

Judy Tsafrir: The most important thing is the history and to try and get a sense from the parent, you know, what is going on, what has gone on, you know, like even going as far back as ancestrally, like, was there a lot of trauma in the parent's history? Because that can also be passed along epigenetically. Um. But then to learn about the birth and the child's development and the child's diet and the whole environment.

And when did the symptoms start? You know, was there any kind of car accident or death? I mean, our whole being is so, uh, it's such a mixture of mind, body, and spirit that it's really complicated, and you can't just typically pinpoint one thing, like you may have a car accident, but then that completely dysregulates the immune system and sets off a mass cell activation disorder.

And then they're having all kinds of very weird symptoms and maybe not tolerating foods and having strange neurological things. And, and this all may be totally exacerbated by the electromagnetic frequencies. It's just. It's very complex. So you want to try and understand as much as possible what are all the factors and try and support the person from many different directions. But it's usually not like one thing. It's like a whole confluence of different things coming together to create a kind of perfect storm. 

Linda Elsegood: So your approach would be more of a natural approach rather than, um, prescription medications? 

Judy Tsafrir: Absolutely. I mean, a lot of times people seek me out because they're on medications and they want to get off of medications.

And the typical approach for a person to get off medication, many psychiatrists are not willing to take patients off of medications, they're afraid that the patient will become destabilized and then they'll reduce the dose of medications way too quickly and then a person will have a reaction, like a withdrawal symptom; a syndrome from withdrawing from the medications and then the psychiatrist will mistakenly believe that this is as proof that “you see, you do need it for your anxiety because you are having problems”. But in fact, it's like a withdrawal syndrome and not the original problem. So. Like I, if somebody calls me and they want to simply, you know, get stimulants for their attentional problems, I tell them that I'm really not the right doctor for them.

And you know, if somebody is interested in working with me to come off of their medications, that is much more what I find interesting. And, um, I'm feeling it’s like a useful, valuable thing to do. 

Linda Elsegood: And what's your success rate with getting patients of pharmaceutical drugs? 

Judy Tsafrir: I would say probably about 75%. It's not everybody. You know, like some people, it's really difficult, particularly, um, some of the antianxiety medicines can be really hard to get off of, but you know, like this is like, I recommend, um. Low dose naltrexone to all of my patients, essentially. And you know, I also make dietary recommendations to all of my patients, and I make recommendations about, you know, hygiene with their electronics equipment and about exercise and about sleep, um, and all of those things together make it much more possible to withdraw from medications rather than just trying to withdraw from the medication without supporting the person in any other way.  

Linda Elsegood: how long do you think it takes a patient with anxiety problems taking LDN for them to notice it's doing something for them? 

Judy Tsafrir: It's so variable. I mean, I feel like low dose naltrexone is really unpredictable in terms of if it's going to be helpful, how it's going to be helpful, for what it's going to be helpful. So for me, because it's so safe and inexpensive and potentially so effective that I really recommend it to everyone for whom it's not contraindicated, like if they're on, you know, some kind of cancer protocol and immune suppression or, but I recommend it to everyone. And, um, it really is variable in terms of the response, quite variable. 

Linda Elsegood: And what sort of dose do you start the patients on?

Judy Tsafrir:  0.5 and then I asked them to work their way up as tolerated, as fast as it is tolerated for them to 4.5 milligrams. And that's, you know, in some people, you know, they feel well at three, but when they go up to 3.5, then they don't feel as well. So then we stay at 3, it's really titrated according to how the individual feels.  

Linda Elsegood: I mean, that's the thing with LDN, isn't it? It’s unique to that person. You know, you can't say ..

Judy Tsafrir: Unique to the person

Linda Elsegood: Exactly. Cause some people to find that 2.5 works really well. They go up to three that don't feel as well. But 

Judy Tsafrir: right. 

Linda Elsegood: Sometimes they've read everything online, and they feel that if they're not on 4.5, they're doing something wrong, that they should push themselves. But that isn't the case, is it? 

Judy Tsafrir: No, that's a misunderstanding. And you know, it really is like so helpful for so many different things. And so it makes sense to me that the dose would also not be one size fits all.  

Linda Elsegood: exactly. I mean, some people try to justify a dose by saying how tall they are and how much they weigh but that ... 

Judy Tsafrir: Right, that doesn’t make any sense

Linda Elsegood:  it doesn't because, I mean, there are some men who are rugby players who can't get any further than three. And then a small lady who's very petite, like five foot tall can take 4.5 no problem. So I always think that's a, a good rule to tell people that you, you just can't pigeonhole people. It's how your body responds. With depression, and you were saying that you treat people with autoimmune diseases. Um, would you say depression for somebody with an autoimmune disease might be to do with all the symptoms and the things that they have to live with that cause the depression? 

Judy Tsafrir: Well, again, I think it's such a multifactorial situation. I mean, very often depression is either caused by or mediated through cellular inflammation. So like when a person has inflammation in their body, they have inflammation in their brain, and they feel depressed. But then when a person has, Um, chronic illness and they're living with chronic illness, and they can't find anybody who's going to help them, and, uh, they're being told it's all in their head, and it's a very hopeless and depressing situation. Another thing that I recommend to my patients that I haven't mentioned so far is dynamic neural retraining system, DNRs, which is, it's like a program of visualizations and meditations and affirmations and something that you do with your consciousness that, um, helps rewire and retrain the limbic system, which is the deep structure in the brain that is associated with trauma. And when it's activated, it can cause all kinds of physical problems and all kinds of psychiatric problems, anxiety, depression. So if a person works with this program, uh, consistently, very often they're able to really calm down their autonomic nervous system and they will be in a state of, um, not in a constant state of like sympathetic overdrive, fight or flight.

And they'll just feel much calmer and much better, but it's not also alone. It's also, you know, in combination with diet, in combination with low dose naltrexone, with this combination with other supplements that are helpful for inflammation and for rebalancing, whatever it is that is troubling the person and in psychotherapy can be very helpful as well, having a relationship with someone where you can talk through things and someone who understands and who can help you make connections and can help you see that you're responding to the present because of something that happened in the past and that's not really relevant to today. I mean.

Everything together and, and, and I recommend the spiritual practice to my patients. Uh, prayer can be very helpful. Performing rituals can be very helpful. Uh, gratitude journals can be very helpful. It's just - there are so many different things that need to be recruited together to heal a person holistically.

And before I take a person into my practice, I have quite a long conversation with them on the phone and try to assess how motivated they are to make all of these different kinds of changes because it's not like taking Prozac. 

Linda Elsegood: It’s definitely something you have to work at, isn't it?  

Judy Tsafrir: Absolutely. It's a lot of work, but you know, instead of, you know, your health being degraded, you're optimizing your health  

Linda Elsegood: it's very easy to keep things to yourself in like a family situation, not talking to family and friends, but to actually be able to talk to somebody outside of your circle.

You can say what you like. You're not going to upset anybody. They're not going to feel guilty.

Judy Tsafrir: You don't worry about burdening them. And also there's somebody who is hopefully very trained and experienced in listening to people and knowing about what are dynamics like in the family and understanding a lot about human nature and the way people feel. I mean, I also think that meditation and yoga and Tai Chi and all of these kinds of, um, mind, body, spirit practices are tremendously helpful and stabilizing and help one not totally identify with whatever, you know, upset emotion one is feeling at the moment, that there are more equanimity and more peace brought into the person's life.

Linda Elsegood: I used to do a lot of yoga and I learned at a very early age, to put myself to sleep. And it still works today. You know, the deep relaxation and your breathing and focusing.  And I can, you know, even if my mind is spinning, if I can just stop my mind and actually relax and focus, probably about two minutes and I can be asleep.

Judy Tsafrir: I say that that's just like a practice, something that you've learned and it can be taught and um, it's just so useful and so much better than taking Ambien, you know, instead of taking a pill, but, you know, maybe then you feel like very tired the next day and forgetful and, um, spaced out. 

Linda Elsegood: I was going to say, who would want to feel like that? Waking up feeling like that at the start of the day.

It doesn't sound like something we would want to do. But I can remember when I was very sick, and people would say, you know, family, and look at you, how are you? And I would say, Oh, I'm fine. Because you didn't want to say, well, actually I’m anything but fine. 

Judy Tsafrir: Right, right, right. And I mean, and also when you're feeling that way, you feel like you don't want to burden people and you know that you can't really turn to people for help. And there's some kind of shame involved in the whole thing. Like, what's wrong with you that you don't feel fine? And, um, I mean, a lot of times for, you know, that there's like, we're not, for many people, like in my, in Boston, we're not living in a war-torn area.

You know, like, it's not like there are food shortages and bombs going off, and yet people are feeling terrible, but there's nothing to point at like that. 

Linda Elsegood: Yes. Yeah, well, I can remember being rather concerned that every week I was deteriorating and it was noticeable. And I can remember lying on the sofa, my cat lying on my chest and it hurt. And, um, my mother was here, and she took him off me because it was uncomfortable for me. And I was thinking, if I keep going downhill like this, I'm going to die. You know? And it was really scary, and it was frightening. And I had nobody that I felt I could say that to, you know, “Am I going to die?” 

Judy Tsafrir: .. terrifying and lonely, so lonely, and yeah you know, like, it's not surprising that people become suicidal in that situation. They just feel so alone and so desperate. And there's no light at the end of the tunnel. 

Linda Elsegood: Yes. But luckily for me, there was LDN at the end of the tunnel. So I had, I had the light. So, 

Judy Tsafrir: that really just turned things around like really quickly? 

Linda Elsegood: uh, in three weeks.

I mean, I just very quickly, the left-hand side of my body was numb with pins and needles. I had cognitive problems. It was like English had become my second language, I couldn't recall vocabulary. Everything muddled. I slurred my speech like somebody had had a stroke. I started choking on my food, forgetting things, tripping, falling, stumbling over nothing.

I lost my leg. Strength in my left, like at double vision, lost the hearing in my left ear, had twitching muscles, restless legs and pain. Um, and I'd been told at that point by the neurologist who checked me over and sat me down and put his hands across the desk, shook my hands and said, “I'm really sorry you're secondary progressive now, and there's nothing more we can do” and he opened the door to show me out  

Judy Tsafrir: you had multiple sclerosis?  Terrible, that’s terrible, and you're sort of taught in medical school, If a person has one symptom, okay, then you try and help them. If they have ten symptoms involving ten different organ systems, then it's all in their head.

You know? Then it's, it can't be real, you know, not understanding that that is more and more and more common these days with all of the toxins in our environment and all of the electrosmog and the GMOs and the degraded food supply that this kind of chronic illness is more and more commonly seen with involving multiple organ systems.

And it doesn't fit any kind of classically recognized pattern. 

Linda Elsegood: But in three weeks, um, and I'd lost my bowel and bladder control as well, but in three weeks I started cognitively -  in my head, it was like a television set, not tuned in, and suddenly somebody was tuning it in - and I started to be able to process thoughts, being able to see properly.

The hearing had completely gone in my left ear, and that started to come back, and it was amazing. It was absolutely amazing, but it did take me 18 months to feel like, yeah, I mean, I still know I have MS and I have learned to work around things, but I can achieve things again, which was very devastating.

I can remember I had to go and see the company doctor and he said he sent a letter, and it said that I was, I'm a workaholic. And he said that I was unemployable for the foreseeable future, and that was just like a punch in the stomach. It physically hurt. Um, and I kept this letter for quite a while, and they don't come across it, and I'd read it, and I'd have the same reaction.

One day I thought, well, why am I reading this letter. If I shred it, I haven't got it anymore, and I won't be able to read it, and it won't depress me, you know? I know it was there, but I don't need to physically keep seeing it. But my whole point was to prove everybody wrong. 

Judy Tsafrir: Right. So I mean it was the only thing you did was Low Dose Naltrexone or did you also do other things in addition to that? Did you, I mean you attend to your diet? 

Linda Elsegood: Because I was in the situation that I couldn't cook for myself my diet actually got worse originally. My husband did the best he could do which was just to put something in the oven that was frozen but gradually he learned to cook. Um, because I couldn't get out of bed

I was asleep most of the time, which was a blessing because I really didn't feel well. But, um, as I improved and he improved, we started to get a better diet. But I didn't become gluten-free, dairy-free and process sugar-free for quite a while. Um, I was given three courses of intravenous steroids in an 18 month period, and the first two were only six weeks apart.

I'm a very pale person, and my face blew up and I looked like a tomato. I was so red, and so round. And I gained, um, 50 pounds in these 18 months. And then, Hey, I was type two diabetic. Um, so I was then put on the Metformin, but once, and it was very difficult to lose the weight, not being active enough and exercise was too tiring.  Still is to a point. Um, but there are certain things you can do. But once I changed my diet, I managed and I'm now classified as a diabetic in remission so I don't have to take the Metformin anymore. And I'm really pleased and I didn't realize I was told that I'd have to have Metformin for life. Nobody had actually said to me it can be reversed. I did not know that. 

Judy Tsafrir: Right. And nobody told you that, you know, if you limited your carbohydrate intake or you didn't, you know, eat gluten and dairy or sugar, that that would be beneficial to you? 

Linda Elsegood: No. Um, my mother, I, um, unfortunately, she had cancer, and it was lots of other issues, and LDN didn't work, which knocked my confidence in LDN a little bit because I really wanted it to work. But anyway, my mother knew that she was dying and all she was worried about was the trauma that it would cause me with her dying. You know, what's going to happen? I'm not going to be here to look after you. You know, she was completely selfless.

And the, she asked the doctor to look after me after she'd gone. So the doctor wanted to see me. I went to see her, and I said, you know, I was doing fine. Um, and that I really watch my diet. And I was telling her, and she said, why are you doing that? And I looked at her, and I was feeling very sad cause I just lost my mother and I looked at her and I thought “seriously, you're asking me why I have changed my diet?”. What do I say? 

Judy Tsafrir: Incredible. 

Linda Elsegood: And I just said, “because it makes me feel better”. I couldn't bare the thought of explaining to a doctor why I had changed my diet, but I was really pleased, the fact that I don't have to have the Metformin, but it was quite funny because I was given Metformin initially, and it was a, I don't know what brand it was, but it was so strong - the nausea was so bad - I couldn't, I really couldn't tolerate it. I couldn't bear to eat anything or move my head or talk to anybody. It was awful and I suffered with it for about two and a half weeks and I went back to the doctor because “I was going to die” in inverted commas if I didn't take this Metformin.

So I went back, and I said to her, well, I think I'm going to have to die because I really can't take it, it is making me feel so ill. I just can't do it. And she laughed, and she said, “Oh, there are other versions you can have” And I thought, well, I'll just come back sooner. And I didn't realize that, you know, after the first two or three days.

So then I had Glucophage, which was a slow-release Metformin, and I can tolerate that. That was fine, but apparently, it was far more expensive, so they tried to get people on the cheaper ones first. 

Judy Tsafrir: Right. But all the money, 

Linda Elsegood: thanks actually, luckily, but it's been amazing talking to you, and I realize we've run out of time.

Thank you for having been my guest today.

Judy Tsafrir, MD is a board-certified Harvard faculty member with a private practice of holistic adult and child psychiatry in the Boston area. A special area of interest is environmentally acquired illness, in particular, mold toxicity and the chronic inflammatory response syndrome. Her website is https://www.judytsafrirmd.com/.  Phone number (617) 965-3020.

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

Dr. Anna Cabeca - 8th May 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Dr Anna Cabeca is a board-certified gynaecologist and obstetrician from Georgia in the United States. She trained at Emory University, Atlanta, Georgia, then went on to also be boarded in integrative medicine, as well as anti-ageing and regenerative medicine. She is a pioneer for women's health, to solve the problems that so many women suffer with as a part of hormone imbalance; to do it naturally, and to regain control of our health to the best of our ability.

As many women age, muscle flexibility decreases and fascia tightens, with the result of discomfort with intercourse. In 2000 Dr Cabeca started using low dose naltrexone (LDN) in topical form for such patients, and developed a formulation of LDN, arginine, and pentoxifylline, that she calls “Joy Gel”. The vasodilators in it improve blood flow, moisture, etc.  It is applied to the pelvic floor prior to intercourse; or on a daily basis for relief from pelvic pain syndromes, vulvodynia, vestibulitis. Joy Gel includes LDN 2.5 – 3.0 mg per 0.5 ml and is measured into a syringe. A large pea or dime-sized is about 0.5 ml.

Dr Cabeca also uses LDN in capsule form for clients with difficult insomnia, typically with a very slow titer-up to 4 mg; and those with Hashimoto’s, autoimmune diseases, or suffering from toxic mould syndromes.

At around age 38, Dr Cabeca underwent menopause, looked for answers, that reversed menopause completely, and she conceived at age 41. At age 48 she and her family underwent a traumatic incident, and despite being on hormones, she became menopausal again. At that point, she tried a ketogenic diet but had side effects. She studied and hypothesizes that as protective neurotransmitters decrease with age, eg estrogen and progesterone, the ketogenic approach is not complete.  In her book The Hormone Fix, she writes about the keto greenway and the greens; adding on the alkalinizers, the high micronutrient-rich micro foods, and microgreens, like broccoli sprouts, and alfalfa sprouts; and using kale, beet greens, chard; lots of deep dark, deep leafy greens. Using the best to get the body into ketosis, thus using ketones for fuel. And checking urine to get an alkaline urine pH. She has developed a test strip to urinary pH and ketones, to help understand what’s working and what’s not.

In the book is a 10-day quick-start detox, a 21-day menu plan, chapters on stress and vaginal health and hormones, and functional testing, and quizzes, and inventories to do. She has programs and menus on her website as well. Once stabilized, clients may be able to reduce the medications they take.

In The Hormone Fix, she notes that it’s insulin, cortisol, and oxytocin are the major hormones that give the quality of life. Stress reduces oxytocin, and depression follows; healing comes through nutrition (25%) and lifestyle (75%). The book has a chapter on stress, developed through personal experiences and traumas. When cortisol’s up with stress, it lowers oxytocin; and you get into a critical phase of low cortisol and low oxytocin - and that feels like burnout.

The Hormone Fix is available from Dr Cabeca’s website: https://book.thehormonefix.com/get-the-book and that link includes a bonus offer.  The book also is available wherever books are sold – Barnes & Noble, Books-A-Million, and others; and on Amazon, where it’s #1 in menopause.

Summary from Dr. Anna Cabeca’s LDN Radio Show from 08 May 2019. Listen to the video for the show.

Keywords: LDN, low dose naltrexone, vulvodynia, vestibulitis, hormone, insomnia, Hashimoto’s, autoimmune, toxic mould, ketogenic diet, The Hormone Fix, insulin, cortisol, oxytocin

Lauren - 1st May 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Lauren is from the UK, and uses low dose naltrexone (LDN) for chronic fatigue syndrome (CFS), myalgic encephalomyelitis (ME), fibromyalgia, and Ehlers-Danlos syndromes (EDS).

Before starting LDN she was housebound for about 2 years. She lost mobility in her legs; and had constant migraines and dizziness, and a myriad of other symptoms. She was only 20, and rates her quality of life as a 2 at that point. Having no quality of life, she was on suicide watch. One day she decided to do some research, and came across LDN, and found Clinic 158 in Scotland, which arranged for a consultation with a doctor, and the prescription. Within 2-3 weeks on LDN 0.5 mg she was cleaning the house; and as the dose increased, she felt like a new person, with her independence back. She was able to return to work, and has her own home now, although she does have some bad days.

Her fibromyalgia began at age 13. She was a champion Irish dancer, and suddenly her fibromyalgia symptoms began, and soon she was wheelchair bound. It took 5 years to get a diagnosis. Living with fibromyalgia was very traumatizing, not only because of the chronic fatigue, but also the pain in her body. She was told her leg muscle mass was pretty much gone. Because of the fibromyalgia in her joints, at age 22 she was preparing to have a shoulder replaced because of loss of her rotator cuff and frequent dislocation. Now on LDN she only suffers a dislocation maybe once a week.

A couple months after being diagnosed with fibromyalgia she was diagnosed with chronic fatigue syndrome (CFS) and myalgic encephalomyelitis (ME). A year later she was diagnosed with Ehlers-Danlos syndrome type 2, the hypermobility EDS. Things like cold weather, or a temperature her body wasn’t used to, would cause her shoulder to pop out. Her whole body was affected, but it tended to show most in her shoulder joint.

Now on LDN her pain is not gone, but it’s down to minimal, and a level she can cope with. She coped with excruciating pain daily for years, and now on LDN, having slight twinges here and there over her body is manageable. She is able to enjoy her life as a 23 year old.

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

Keywords: LDN, low dose naltrexone, chronic fatigue syndrome, CFS, myalgic encephalomyelitis, ME, fibromyalgia, Ehlers-Danlos syndromes, EDS