LDN Video Interviews and Presentations

Dr Jill Cottel shares her LDN experience, LDN Radio Show (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Dr Jill Cottel shares her Low Dose Naltrexone (LDN) experience on the LDN Radio Show with Linda Elsegood.

Dr Jill Cottel is a medical advisor for the LDN Research Trust and was a presenting doctor at the LDN Conference in Portland Oregon.

Now, she has developed a tele-medicine system in her practice whereby she can do medical appointments by phone in the states of Virginia and California. This added service is invaluable for patients who cannot travel for one reason or another. 

She has been a solo-practitioner with a private practice for over 20 years with a focus on holistic medicine. Dr Cottel is very knowledgeable not only of how useful Low Dose Naltrexone can be in treating autoimmune diseases, but also for treating alcoholism through alternative methods such as the Sinclair Method.

This is a summary of Dr Jill Cottel’s interview. Please listen to the rest of Dr Cottel’s interview by clicking on the video above.

Researcher Dr Jarred Younger, LDN Radio Show 08 March 2017 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

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

Dr Jarred Younger describes his continuing studies on LDN and has written papers on them. There is an interview with him in March 2017 where he explained his testing for pain levels. 

He concentrates his studies on Fibromyalgia women and measures the reduction of pain, fatigue, and inflammation with the use of LDN. His work will someday be recognised in the training hospitals for doctors. 

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

Linda Elsegood: Today I'm joined by Dr Jackie Silkey, who's from just North of Salt Lake City in Utah. She's a functional medicine practitioner. Thank you for joining us, Jackie. 

Dr Jackie Silkey: Thank you for having me. 

Linda Elsegood: Could you tell us how long have you been prescribing LDN? 

Dr Jackie Silkey: I've been prescribing LDN for about five years now. I’ve treated quite a wide range. I started out using LDN for all autoimmune disorders including Hashimoto's, lupus, and now have branched out into other areas and using LDN for other applications as well. 

Linda Elsegood: And what kinds of results have you seen so far? 

Dr Jackie Silkey: I've seen very good results. I always use LDN as part of a program where I'm addressing more of the root causes of what's going on and putting a comprehensive program, both nutritional exercise, stress reduction, those type programs into place, as well as doing quite a bit of a functional medicine testing. And then I bring LDN as an anti-inflammatory as the extra treatment arm. In most of my patients, I see they are successful in implementing base therapy. 

Linda Elsegood: Have you seen any negative side effects?

Dr Jackie Silkey: Yes. When patients first, start LDN. Sometimes patients will complain of vivid dreams or difficulty sleeping—those sort of common complaints. I'll either move them to morning dosing or depending on how significant the symptoms are, I'll dial back on the dosage or just tell them to go ahead and push on through. And  I find that it improves easily within a week. 

Linda Elsegood: Have you any people that you have treated who have had marvellous results? Do you have any case studies you could quote? 

Dr Jackie Silkey: Most of my patients actually come to me to get a comprehensive program put into place, and then. I actually don't see them routinely. They go back to their primary care physician once I'm able to get them improving in the right direction. And so I don't have patients that are coming in monthly for checkups or checking in with me. So most of my patients will go back to their primary care physician once I feel like that they have plateaued on their healing with me and have put into place all of the aspects of healing that  I find to be important. 

Linda Elsegood: Well, that's good, isn't it? So if so, when a patient comes to you, you, you look at everything, that lifestyle, that diet, exercise, supplements, all this kind of thing to try to get them.to have a healthy lifestyle as well as treating the disease. Is that right? 

Dr Jackie Silkey:  Most definitely. Yeah. In fact, a lot of times I try not to even look at the disease per se. I try and look more at the patient and say, you know, why is this disease happening in the first place and see what we can do as far as reinforcing them foundationally.

And that's where I think LDN really plays a significant role,  is to reinforce people foundationally.  You know, just like we do with nutritional aspects that exercise aspects, stress reduction aspects, all of this just to reinforce not only a nice environment for healing to take place, but also to prevent relapse.

Linda Elsegood: What would you say is the best diet? We're always being asked this for people with autoimmune diseases. 

Dr Jackie Silkey: Well, it truly depends upon the person in my opinion.  I don't even like the word diet. There are so many negative connotations associated with it  I try to use nutritional plan because I really want people to think about this being a nutritional plan, one that they don't come on and off of. So diet, we always think of, I'm going to go on a diet and then I'm going to come off of the diet. And those things tend to be, you know, somewhat more extreme.

When I set up a nutritional plan, let's say for somebody with autoimmune disorders, there are some people that come to me and have read every book and have tried, you know, multiple nutritional plans have had limited success with them. I don't go back and try to recreate those. I just learned from what they've worked on and what they haven't had work in the past. Sometimes they'll do some functional medicine testing, some food sensitivity testing to dive deeper into that person's metabolism of foods and, and their sensitivities and what their blood is doing when they eat certain foods. And that way, I can kind of make a more personalized approach. 

Linda Elsegood: Are you a fan of vitamin D? 

Dr Jackie Silkey: Oh, yes. You know, we can get a lot of sunshine in the summer, but I would say the majority of patients that I test, and I do test everyone, are low. That may be an absorption issue from the GI tract. They're not absorbing it. A lot of people don't know about vitamin D,  that it's a fat-soluble vitamin and that you have to take it with fat. Otherwise, you won’t absorb it.  And there are some people that I don't think absorb their fats very well, to begin with, and so they can have absorption issues. I try and address all of those things. Testing vitamin D levels,  also taking a look at the GI tract and how well they're absorbing their vitamins. 

Linda Elsegood: But I would have to say both my husband and myself, after listening to Dr Tom O'Brien at the conference last year, we both stuck to the diet religiously and I have been a diabetic type two, and I was diet controlled for four years. And then I was on Metformin, and I was told a few months ago after being on a diet, say six months or so, that my sugar levels were prediabetic, and I was told that I could stop taking the Metformin.

So I'm thinking, Oh if you're going to take the medication off me, what happens if. They go upon, I don't know, and I have kidney problems. I was really panicked, and they said, don't worry, we will take your blood again. And it showed that I was at serious risk of becoming a diabetic, but I was prediabetic, and I didn't need to take the Metformin.

I've been assured enough seeing the results, and I'm not worried about it. And I'm sure if I keep my diet. As it is, but apparently once you've been diagnosed as a diabetic, they can't remove that from your records. So I'm now a diabetic in remission. So I'm, I'm really pleased about that. You know, one less drug.

Dr Jackie Silkey: I think that there's a lot of people they can say that they are diabetics and in remission as well, you know, or a diabetic, in the, making one or the other.  I think that you know, nutritional plans play a significant role as well as exercise plans and then implementing those exercise plans and then stress. Obviously, stress is going to play a significant role.

Linda Elsegood: Let’s briefly talk about exercise. Now one of the questions that we are always being asked, sick people, can appreciate the fact that they should be exercising people with, say, someone with MS who suffers from severe fatigue, where any exercise, just moving, showering is too much for them, and they spend a lot of the time in bed. What can people do too? Try an exercise when they are that fatigued. What is your suggestion? 

Dr Jackie Silkey: You're absolutely right.  I want to make sure that your listeners know that we always talk about implementing exercise programs and try not to make people feel guilty for not implementing exercise programs. But there are some people that that can actually be quite detrimental for. And, and you know, if you do an exercise program and you're recovering for two days because you did too much, then obviously, you have to build up your base before you’re ever able to really do a formal exercise program. You really have to spend quite a bit of time working with the patient and talking with the patient about what they've done in the past. What was too much for them in the past and if you can dial into what it is that their body needs. Because you take the same person with MS, and then you take the person down the street with MS, they're going to have two very different exercise tolerances, and they're going to have two very different levels of benefit from any sort of a formal exercise program. So you have to make it, in my opinion, very individualized. And that's where I find that it can be very difficult and, and can make people worse initially if physicians to a physical therapist or nurse or anyone is not listening to the person about what's been too much for them in the past and, you know, starting low and going very slow.

Linda Elsegood: So you learn to become fit enough to start to exercise basically very slowly and gradually and not to give up. Forget the idea that you're not achieving anything by baby steps. You do get there. It just takes a while, doesn't it? 

Dr Jackie Silkey: That's exactly right. And everybody has a very different starting point, and so it doesn't really matter where your starting point is, it's important that you start there and that you move forward from there.

Linda Elsegood: I think it helps to keep a diary of what you can do and try and improve on that. If you've only managed to do an extra five steps in a week, at the end of the month, you know, you may have done 20 steps or something like that. It's all just very, very slowly and gradually. And then once you become fit enough, you can then, as you were saying, do a plan. You won't fatigue yourself too much, doing 

Dr Jackie Silkey: too much 

Linda Elsegood: too soon. 

Dr Jackie Silkey: You're absolutely right. And I think that's where pedometers, you know, really play a significant role is then measuring steps and, and there's a lot of things that people can do and in their homes, just depending on where they are. Other things, you know, take more pressure off of the joints, sign up for a program that's actually done in the water, taking some, some of the pressure off of the joints themselves. So if somebody tells me that they had quite a bit of soreness and joint pain, well, there are supplements that you can take before then there's hydration that you can do before them. But there are also ways in which, if their joints are quite uncomfortable that you can do exercise in the water. Even just some gentle movements and walking within the water itself can take the pressure off of the joints enough to where you can slowly build from there. And there's actually a treadmill that's available, it's almost like it's built into a shower and certain physical therapy places will have it and where you can get in there, and you can just very slowly walk on the treadmill,  and water just to take some pressure off. Those are just some examples of different things that I'll have people do. 

Linda Elsegood: I went to a class to do cross therapy, and I was in my fifties, and I turn up, and I was the baby. They were people who were 70. It really made me smile. They were all so kind to me. And you wore a band around your, your middle. So you floated like a cork no strain on your arms and your legs, and you just bobbed. And it was difficult. It was really, really difficult. So I was saying, you know. I don't think I'm going to be able to do an hour so that I did set it all up, but that's fine. We'll just do it gradually. I could only do 20 minutes.

Dr Jackie Silkey: For some people even just going to the facility, changing into a swimsuit, getting into the water, getting out of the water and going back home, wipe them out completely. It just depends on where people start. If people are quite ill, and then you obviously cannot start with a formal exercise program. 

Linda Elsegood: I couldn't walk when I got out of the water suddenly, suddenly all the weight was on my legs, and it's like, Whoa, I can't do this. I went home, I went to bed, and I couldn't get out of bed and move without really severe problems until Thursday.  I did too much, but I didn't realize it. It just seems so easy, but my legs just, Oh, it was unbelievable. We will just go to a break, and we'll be back in just a moment. 

Today's show sponsor is Care First Speciality Pharmacy. They're leading compounders of LDN and other custom treatments servicing patients in over 18 States coast to coast. They're credited to provide you with the highest quality demanded by the industry and the expert service. You expect to learn more. Call (844) 822-7379 or visit CFS pharmacy.com. 

Back to stress, that's another thing we've never talked about so far on the radio show. What do we do when we're stressed and maybe defining stress versus depressed. I mean, when you have a chronic condition lots of things become a problem to you mentally. 

Dr Jackie Silkey: Yes. I think that you know, when we talk about, it's really important for me to teach patients when we're talking about implementing a stress-reduction plan, is that it's not at the moment necessarily to relieve stress. It's about implementing a plan. It's like a nutritional plan. It's not like you implement a nutritional plan that day, and you lose 10 pounds that same day or gain 10 pounds of muscle that same day. It takes time for you to see the fruits of your labour, but by implementing a stress-reduction plan you're putting more resilience into people's lives and into their body to be able to, to be more resilient with relapses or more resilient with a major stressor that comes along, a car accident, anything that's gonna be a big stress in somebody's life. Stress reduction versus depression, I believe you said stress versus depression, they tend to in a lot of people go hand in hand and that's where these comprehensive programs, including low dose naltrexone,  really helps. People with mental health issues and, and with depression. Now, did they have a formal diagnosis of depression?

Maybe or maybe not, but still low dose. And by reducing inflammatory factors within the brain is able to help. Most people that are dealing with a chronic illness because a chronic illness, by definition, is depressing to the body. It's stressful for the body. It's living in a body that's inflamed and living with a brain that's inflamed is very difficult.

Linda Elsegood: Let’s get to some questions and answers. 

Dr Jackie Silkey: Yeah, that sounds good. 

Linda Elsegood: We have a Marie, and she says she has a seven-year-old who was diagnosed with Crohn's four months ago, and she would like to ask, are the children taking LDN with success and when would she expect to see improvements? And what would the improvements be besides better sleep? Would it assist with pain and quality of life? She was hoping that he would have more energy and be able to go through a normal day at school. 

Dr Jackie Silkey: Well, we were talking earlier about patients that I have on  LDN and my success stories, and. You know, a lot of times I won't see them routinely, but one of the success stories that I have and that I still speak with this patient often is with a Crohn's disease patient.

So Crohn’s disease  you know, quite a bit of  inflammation within the gut. So people that are dealing with a fire brewing inside their body, whether it be in their gut or their brain or their blood or wherever. It's going to fatigue them. It's going to decrease their energy levels. Initially, it might make somebody more agitated, but initially, what initially fires somebody up and makes them hypermetabolic then to close them down later in the disease process. What I tell people what to expect is variable. I put patients on low dose naltrexone and we watch, we take a look, we dial them up.  I do tend to increase their doses slowly and watch for their most prominent symptom, for example. And the patient that I was referring to earlier, one of the hallmark symptoms she would have was diarrhoea, and so she would be having eight or nine loose bowel movements per day when she was in an active Crohn's flare, she also had some abdominal pain. 

So once we were able to start her on low dose naltrexone and then dial-up her dosing, we ended up doing something a little bit different for her. We ended up doing twice a day, smaller doses instead of once a day, larger doses. So you have to keep reassessing. But I will tell you that for some people the response is dramatic and swift. But just because somebody does not have a swift or dramatic response doesn't mean that they aren't going to have a response either later or that it be kind of this slow uptick. I would  say that, what I would tell the mother is, you're absolutely doing the right thing. See what the symptoms that are most predominant at the beginning of starting low dose naltrexone. And then always stay in contact with whoever's prescribing it so they can help guide you on the correct dosage, the correct frequency.  We were talking about stress earlier. Here's my patient who was a student and every time finals would come around, she would have a flare. And so knowing this, we knew how to put into place a stress-reduction program that really dialled up a week or two before she started studying for all of her finals. And preparing earlier for her tests. So there was less last-minute stuff. So we were able to, you know, figure out what her relapse risk factors were, and then specifically guide that around my plan. We ended up not needing the plan, but my plan was also going to think about going towards a higher dose two weeks before those stressful events, but we ended up not needing it. She was able to keep the progress that she had made for throughout the rest of the semester into final examinations by just preparing earlier and knowing what she needed to do would affect what her final result was. So, I don't know if I've given any specific timeframe. I will tell you, it varies from person to person.

I would definitely take a look at the symptoms that your son is having and that energy, in my opinion, energy usually comes around quicker in kids. But it tends to lag behind the other symptoms, their GI symptoms. So if he's having quite a bit of abdominal pain, an improvement upon the abdominal pain might come first. Then energy might come after that. Imagine that the fire that is brewing inside the person's body is sucking them dry of energy. Well, you have to first, turn off the propane to the fire, and then you have to extinguish the fire and then with time, then that energy will then come back. There are really very few side effects. The only time that it really plays a significant role is if  I tell people about  they have to have surgery or if they accidentally fall out of the tree and break their arm and they have to go on pain medicine, any of those sorts of things where you're going to be stopping the LDN for a period of time.

Or I am trying to use no narcotic pain medications, which would be even a better choice.

So, do I feel that,  LDN is safe in children? Yes. And, even in pregnancy I have a couple of patients that are pregnant, and that stopped LDN during their pregnancy, and resumed it, after they deliver the baby while they're breastfeeding. And  I personally, don't even think that there's any reason why anybody needs to stop it during pregnancy.

But there are no studies  that have looked at LDN in pregnant women because there's, you know, there are no studies that have looked at other medications in women, but we use them. You know, and people that are addicted to opiates will use high dose naltrexone and sustained release naltrexone because the risk to the baby is much greater than the potential risk at high dose naltrexone. Low dose naltrexone is an immediate release Naltrexone compounded formula that can be used in children and young women. 

Linda Elsegood: Well I think many of the listeners will have heard of Dr Phil Boyle using it in his paternity clinics where they use LDN to get pregnant during pregnancy and during breastfeeding. He did a very good presentation for the conference last year. And it showed that babies born were of better weight, had less need for antibiotics. Apparently, some babies need, antibiotics for chest infections and the like, and they weren't contented. And I thought that has to be good  if you've got a baby that cries all the time. So in his experience, LDN has been really good, and he did a small study. I'll have to send you the link to it, which was very interesting. Very interesting indeed. Okay. We have another question here from Lucy, and it's with atopic dermatitis. I know that you do a lot of skin conditions in your practice.

Dr Jackie Silkey: Atopic dermatitis. Cyclosporine is a common Western medicine drug that is used for autoimmune. So it's going to, you know, decrease somebody's immune system reaction to themselves. So the thought is, is that you know, that autoimmune disorders are really yourself, you know, attacking oneself, you know, the whole idea of that, without looking at their foundational, a lot of times what I find is foundational people with autoimmune disorders. Really, their immune system is woefully inadequate for foundational reasons instead of hyperactive, if that makes sense. So people on cyclosporine can take low dose naltrexone . Now, cyclosporine levels are normally checked for somebody who had a transplant who was trying to keep their levels at a certain parameter. And I would say initially when starting any new medication or any new supplement I tell everyone that is taking  for transplant reasons to have their levels checked after starting any new medication or any new supplement because everybody's going to react a little bit differently. So would it, would it potentially affect their levels? Possibly, but not usually. 

Linda Elsegood: Okay.

Linda Elsegood: And we have another one, about eczema on steroid treatment. This lady has been using it for 30 years, and she says, my skin is very inflamed. I have no quality of life. My dermatologist's about to put me on what  the drug we've just been talking about, and she's been off topical steroids for 18 months. And do you think LDN would help?  

Dr Jackie Silkey: As part of a comprehensive program? Absolutely. I find that part of a comprehensive program LDN plays a significant role in all of the autoimmune disorders that affect the skin, that affects the brain, that affects the GI tract.  I try not to treat a disease with a drug or a supplement. I try and treat the person who is having symptoms associated with the disease and look for what their rate-limiting stuff is. So, you know, there are some people that are not absorbing their fats well. They're not digesting. They've got some digestive enzyme insufficiency. They've got  maybe some small intestinal bacterial overgrowth symptoms. They've got a lot of  gas and indigestion, fatty stools, things like that. Well, with that person, I'm gonna think about why the eczema is just being a symptom of the problem. And by far and away, I find that things like eczema, psoriasis, all of these things tend to be more of a symptom of the problem.  Instead of me worrying about labelling people with their diseases, I say, this is a symptom of the problem and we're going to follow this symptom as we address, you know, your insufficiencies as we find them. And that's where functional medicine testing, I believe, plays a significant role. 

Linda Elsegood: And at the time you've got the body working correctly. Do you find a lot of the symptoms resolve anyway? 

Dr Jackie Silkey: Oh yes. That's exactly, that's when you know. There can be several things that you uncover that may not be directly related. Let's just take eczema. It might not be directly related to their eczema, but yet play a very significant health benefit if you can address those things as well. So, but yes, I mean, anytime I'm seeing anybody with anything from acne all the way to psoriasis. I'm definitely treating internal parameters instead of just treating, okay, is your acne better? I'm following many different things, but I think the skin makes it nice because you have an external way of evaluating how well your treatment is going. You just look at your leg, and you say, yes, the treatment seems to be doing much better. 

And people do that with depression. People do that with  getting pregnant. You were talking about infertility treatment. I mean, that's  obviously the goal and obviously the goal is to improve eczema to where it's completely asymptomatic. But. I don't  find that putting topical treatments or putting people on a cyclosporin to be that helpful in getting down to the root cause.

In fact, I think it just masks the symptoms.  I have people come in all the time that are on steroids or cyclosporin or other autoimmune medications. Humira is big here in the United States, and it just masks the symptoms, even if it controls the initial disease or the initial symptom that you're trying to control. Your body just has a way of showing that in some other area. 

Linda Elsegood: And what's the downside on using. Steroid creams longterm over the years? 

Dr Jackie Silkey: Well, first of all, it changes the quality of the skin you're using it on. And second of all, you absorbed some of the steroids through the skin. So, you know, you're interrupting the barrier protection of the skin. Are you making it less of a good barrier to disease and to infection and all the rest? Depending on  if you're just using a small amount of steroid on one area, but some patients have to put steroid creams on multiple areas of their body, and so that ends up being a  fairly large dose of steroids. Some of that is going to get delivered systemically as well as just on the skin. So the problem with steroid creams is that they can thin the skin. So we use the thickness of the skin as a measure of. Health. So think about somebody's face. Think about an older woman's face versus a younger woman's face.

Part of that ageing process is this thinning of the skin, and so it, therefore, can't withstand pressures as well. 

Linda Elsegood: We will just go to a break, and we'll be back in just a moment. Today's show sponsor is Care First speciality pharmacy a leading compounders of LDN and other custom treatments servicing patients in over 18 States coast to coast.

They're accredited to provide you with the highest quality demanded by the industry and the experts' service. You expect to learn more: call eight four four eight two, two seven, three, seven, nine or visit. CFS, pharmacy.com welcome back. Another thing I wanted to ask you, there's a lot of buzz going around at the moment about detoxing teas that you can have to flush out all of the builds up that you have in your bowels. Are they a good idea? 

Dr Jackie Silkey: Well, I think. When we talk about detoxification, we talk about trying to find out, first of all, what you're detoxifying from, trying to get down to kind of a root cause. If it's, you know, just general toxins that we're exposed to, then I think, you know, ramping up your own detoxification pathways is the best way to do it and pooping every day is an absolute mandatory in my clinic. Everybody that comes in, whether they're coming in for eczema or low dose naltrexone or functional medicine. One thing that I always talk to them about is how often they're having a bowel movement. To work on detoxification when you haven't worked on proper bowel function is not gonna work. You're going to do one flush of tea and they might feel better for a day or two, and then they're going to go back to their regular bowel habits. And so, sorry. No, no, no, no. So it's like anything else, doing it once might be enlightening but you want it to be something that they implement from now on. It's not a diet that they go on and off of, but something that is going to stick with them can be life-changing. 

Linda Elsegood: Out of interest. How would you make yourself go every day?

Dr Jackie Silkey: A bowel movement?  Oh, well, it depends on where I feel people are deficient in, you know, so if they're magnesium deficient, which I would tell you that the majority of us are, even our soil which we grow our vegetables are magnesium deficient. People tend to be very deficient in vegetables in general. So I try to calculate, I try and get an idea of how much, um, how much fibre people are taking in during the day, and, um, what sort of bowel, um, irritations they've had in the past. So treating somebody with irritable bowel syndrome, they've had multiple episodes of small intestinal bacterial overgrowth, and it's a very different process than treating somebody who comes in and just says, yeah, I have chronic constipation, but they don't have any abdominal pain, so you have to, you have to treat them very, very different. But somebody who's not having any abdominal pain, not having any abdominal symptoms, then I start, usually start with magnesium and ramp up their magnesium dosing and see if I can't either tests them to find out on a cellular level, what their magnesium levels are, or see what sort of improvement we get from, ramping up their magnesium, but ramping up also fibre intake, water intake.  

Linda Elsegood: So keep flushing and eating those vegetables. 

Dr Jackie Silkey: Yeah. I love magnesium too. Magnesium is great, and it's great to help people sleep better. It helps. It's helpful with nighttime leg cramps. It's helpful with bowel movements. It's helpful with slight blood pressure elevations. 

Linda Elsegood: Oh, sounds a good one to take, doesn't it? Does that come in like pill form? 

Dr Jackie Silkey: Yeah, it comes in pill form or in a granular form as well. 

Linda Elsegood: We'll certainly have to look into that.

Dr Jackie Silkey: Maybe we can start combining that with low dose naltrexone, low dose naltrexone and magnesium together. Maybe we can get one of the pharmacies to compound that for us. 

Linda Elsegood: That’s food for thought. We have a question here from Elisa. It's about allergies and fibromyalgia. She says, I stopped LDN for a few months but again,I feel tired and cannot sleep. I wanted to start again, but at this moment in time, I use melatonin. Come melatonin be taken with LDN, and I start at 1.5. 

Dr Jackie Silkey: Yes. Both of those, LDN, melatonin can be taken together. You can also take melatonin  I mean, take LDN during the day if it's affecting your sleep. You know, I think the majority of people have been using it at night because that's the original way in which it was prescribed. But I think that a lot of physicians now realize that we can use it during the day in effect, depending on what your goals are for therapy. They can sometimes be even more appropriate than night use depending on what your goals are. The first time I took it, I had a nightmare the second time I had the best dream. I mean, it was kind of more of an intense dream, but it was, you know, worthy of a book when you could have written a book about the stream and it would have been a bestseller. And the third night I was so excited to get back to that dream and nothing. So it just depends. 

Linda Elsegood: I had no vivid dreams at all, so I feel I've been roped even though only one you had one 

Dr Jackie Silkey: and I still talk about that dream, and I still try and recreate it, and I think in my spare time, may need to write a book about that.

Linda Elsegood: Melatonin is easy to get over the counter in the US, but we don't do that over here.  I don't like medication at all. And when I flew to Las Vegas for the conference, my body clock was complete upside down. It was an eight hour time difference. And the first night I woke up at three o'clock in the morning.  I had to work, I had to see people, and I was on breakfast television on one of the television stations. And I think the next morning it was like four o'clock. And then the next day, it's like half-past four. And I went into one of the local pharmacies. And the. The gentleman said, how can I help you?  I said, can you give me anything? I don't care what it is, anything.  I'm just so tired, I can't function. And he said I didn't need a drug that I could actually have melatonin and take it an hour before I went to sleep. And to try and relax.  It worked really well.

Dr Jackie Silkey: Well, with prescription medications there's this whole degree that really we should have to put medications, you know, on this grading scale. You know, one is a very benign medication, one that potentially has a much higher benefit to risk ratio all the way up to 10, where those are the riskiest drugs. And the benefit is lower than the risk. And that way it would provide patients with an idea that not all pharmaceutical medication is bad. Not all supplements are bad, but there is a whole grading system, you know, and I think it would be very helpful. I know I have a lot of people that are concerned about taking supplements on a daily basis. And I completely understand. I think as we age, melatonin is one of the hormones that really starts dropping off. There's a lot of good things that melatonin does. We have a way of measuring it. You can do a salivary measurement with people, and it's very helpful to get that sort of salivary measurement from people who are waking in the middle of the night to look at salivary cortisol and look at salivary melatonin. Who would go, drive to get their blood drawn, in the middle of the night? But by looking at salivary levels, we're able to see, you know, what, what's going on in the middle of the night. And as people age, our melatonin levels do drop off. I really feel like melatonin can be very useful in some people, and some people don't even realize. I mean, it can increase what we call the lower oesophagal sphincter in the oesophagus. So if people are having a lot of reflux at night, melatonin is helpful and in decreasing reflux at night. 

Linda Elsegood: Hmm. I used to have to take medication for reflux, but since I've changed my diet, that's another medication I've stopped.I don't need to take that anymore. So that was a really big plus.  I think people who can't sleep and then go to bed thinking, I've just taken my LDN, and I'm not going to be able to sleep tonight because I didn't sleep last night and get stressed about it. 

Dr Jackie Silkey: Oh yeah. 

Linda Elsegood: It's a cycle, isn't it, where you're thinking, I can't sleep, I can't sleep.

And that's on your mind when you lay down, and I think. Yeah. You need, I don't know what techniques you tell people when they can't get to sleep. I used to do yoga I meditate and I can, put myself to sleep ordinarily  that way without having to take anything. But just by deep breathing and relaxation and, and that kind of thing. What do you recommend? 

Dr Jackie Silkey: Yes. So I always find out what the person's tried in the past. So I'm not, you know if they haven't tried anything, then yes.  I do always start with trying to learn something that you will have with you, whether you're travelling to Las Vegas or not. You know, I mean, people can't just run out and go and get melatonin in the middle of the night, at 11 o'clock at night,  They're in a  strange environment. So I think that having any sort of programs within our own body that we have at our disposal is by far and away from the best way for us to put those plans into place. A lot of times what I'll have people do is trying to associate some of the meditation techniques that you're talking about, counting backwards, you know, starting at a hundred and counting backwards by three, and really focusing on the breath, doing a, what we call four, seven, eight breathing technique where you breathe in for four, you hold for seven, you blow out to eight, where you're really kind of tying up the mind and trying to get your mind off of, Oh, I really need some sleep tonight. I can't believe this. I didn't sleep well last night. No, it's going to happen again. That sort of cycle that sometimes our brain gets into is very detrimental, and so the more that you can kind of tie-up that aspect of the brain, those racing thoughts, those, Oh, I really should be asleep now. I've got this big radio interview tomorrow—those sort of things,  and, and tying that in with relaxation. If people feel that they, they still cannot sleep. Then, getting up, moving food, different room. You know, I'm reading a very boring book. You know, people don't even talk about trying to, trying to, you know, read a dictionary or something that you would find to be very boring, very mundane. Just again, trying to get your mind on paying attention to something else instead of what you're, what you feel like you should be doing.

And then once you start feeling a little bit fatigued, then you go right straight back, and you lay back down and you stay in that quiet space there. People that try all of the self-regulation techniques and they're still not sleeping well. And for those people that have tried all of those things, obviously we check hormones. I checked melatonin levels. I check progesterone, estrogen, and testosterone. I want to see specifically what sex hormones are doing what their thyroid hormones are doing. Then we go from there  instead of me just basing that on guesses. I like to. Individualize the treatment for the patient based on specifically what sort of issues they're having. Obviously, the treatment for high cortisol at night if somebody is going to sleep is very different than somebody who has hormones that barely work. .Those people need, you know, to consider hormone replacement, whether it be melatonin or progesterone, whatever. 

Linda Elsegood: And that leads me to another question we’re frequently asked now when I go abroad, I always take my LDN before I go to bed.

Regardless of what time zone I'm in, and some people say that they are a night shift worker, should they be taking LDN when they get up? Should they be taking it when they go to bed? Does it matter? How would you address that question? 

Dr Jackie Silkey: Well, I addressed the question of we don't really know whether it matters or not. What I tell people is that we have to get to a point to where you're a responder. So that's my initial goal is to start people on it, to get them to be a responder. Not to say, well, you know, you must be, you know, that percentage of people that don't respond and how do we get you to be a responder to LDN?

Once I know that you are responding to it, then I say, you know, now we get a chance to see if it makes a difference in you because it may not make a difference in you whether you're taking it. At the same exact time every day, or whether you're taking it right before bed, whatever time that is, whether it be one o'clock in the morning or 8:00 AM but you, you don't really know how that person until you get them to be a responder. But once they respond, then I think people will tell you that, you know?  I think this is where journaling like you were talking about, journaling can play a significant role. And there's the LDN app, as you know, which can be very, very helpful. And in and helping people out you know, the symptoms that they're having and what sort of symptom improvement that they're having. t I tell people, don't get so hung up on having to take it. Before bed that you end up missing a dose or you know, take it. When you feel like that, you're going to remember every single day to take it.  I like the idea of taking it before bed because I like to think about all of the hormones that are going through our brain and, you know, increasing growth hormone and, and trying to optimize the brain to provide healing hormones to the rest of the body. But,  I find if that is a stumbling block to somebody taking all the end, then I would much rather they be taking it at other times the day.

Then I'm not taking it at all. And for some people too, you know, you can find out that the right dose, you know? I've had some people that I've changed over to twice a day dosing if they weren't getting a good response with once a day, dosing. So it varies from person to person, just like all of medicine, you know?

Linda Elsegood: I'm going to have to stop you there. We've come to an end. I'm sure we could have gone on for another couple of hours. It's a joy and a pleasure to talk to you now for our listeners if they would like to come and see you or a consultation, how did they go about doing that? 

Dr Jackie Silkey: They can just call the office or send me a quick email and we can talk about scheduling that appointment either in person or online or something.

Linda Elsegood: We haven't yet told them how, where your office. 

Dr Jackie Silkey: Our office is just north of Salt Lake City. It's in a city called Keysville, Utah. And the office number is area code (801) 882-2200. An, the website is www Utah functional med.com. 

Linda Elsegood: And thank you very much for being with us today.

Dr Jackie Silkey: Thank you. Thank you for having me.

Linda Elsegood: Any questions or comments you may have, please email Linda, L I N Dat, LDN.org I look forward to hearing from you. Thank you for joining us today. We really appreciate your company. Until next time, stay safe.

Today's show sponsor is  Care First specialty pharmacy by leading compounders of LDN and other custom treatments servicing patients in over 18 States, coast to coast. That is why they are accredited to provide you with the highest quality to mandate by the industry and the expert service. You expect to learn more.

Call eight (448) 227-3790, visit CFS pharmacy.com.

Dr Greg Nigh - US, LDN Radio Show (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

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

Dr Greg Nigh first heard of Low Dose Naltrexone (LDN) over 15 years ago through researching alternative treatments to a leaky gut and other autoimmune diseases.

Being a specialist in treating patients with leaky gut and autoimmune diseases such as Multiple Sclerosis (MS), LDN appealed to Dr Nigh as a viable drug to prescribe to his patients given its proven track record.

In this interview he discusses how LDN can positively impact the hormone balances and endorphin levels in our bodies which, in turn, can help in combating such diseases.

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

Dr Gloria Herndon, LDN Radio Show (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Dr Gloria Herndon shares her Low Dose Naltrexone (LDN) experience on the LDN Radio Show with Linda Elsegood.

Dr Gloria Herndon is one of 14 children and has an exciting medical family history. In 2010 she came across Low Dose Naltrexone (LDN) and is a strong advocate for its use in mainstream medicine.

Throughout the last decade she has gained a great deal of experience in prescribing LDN and has had great success in dealing with many patients with autoimmune diseases and helping them to find their optimal doses.

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

Dr Fred Hui, LDN Radio Show (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

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

Dr Fred Hui first came across Low Dose Naltrexone (LDN) around 18 years ago when one of his patients spoke of the LDN Book and the myriad of benefits LDN has to offer to autoimmune patients.

After researching it himself, Dr Hui was convinced that LDN is a safe drug and has been prescribing it for many years, gaining a great deal of experience in terms of prescribing LDN and finding his patients’ optimal doses.

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

Dr Edmund O'Flaherty, LDN Radio Show (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Dr Edmund O'Flaherty shares his Low Dose Naltrexone (LDN) experience on the LDN Radio Show with Linda Elsegood.

Dr Edmund O'Flaherty from Dublin, Ireland first heard of Low Dose Naltrexone (LDN) around 15 years ago and was instantly convinced by the drug’s track record and almost instantly began prescribing it for his patients.

One of his patients was diagnosed with breast cancer in 2002 and was suffering immensely as a result. However, Dr O'Flaherty put her on LDN and over 7 years later she is almost back to full health. The LDN cooperated with her cancer therapy, meaning that she fortunately surpassed her original life expectancy of 2-3 years post-diagnosis.

He has also found LDN to be of great effect in Multiple Sclerosis (MS) patients. Like many other medical professionals who have appeared on the LDN podcast, he explains how LDN can reduce inflammation, which can be the cause of many illnesses in the body.

This is a summary of Dr Edmund O'Flaherty’s interview. Please listen to the rest of Dr O'Flaherty’s story by clicking on the video above.

Dr Deanna Windham, LDN Radio Show (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Dr Deanna Windham shares her Low Dose Naltrexone (LDN) experience on the LDN Radio Show with Linda Elsegood.

Dr Deanna Windham currently works in the Whisker Wellness Institute in California, the United States. She and her institute first heard of Low Dose Naltrexone (LDN) around 12 years ago while establishing their adjunctive cancer treatment program.

However, the process by which she could obtain LDN was difficult. Nevertheless, Dr Bihari phoned Dr Windham to explain the many benefits LDN can have for cancer patients.

At her institute, Dr Windham has established a tried-and-tested prescription program of LDN to ensure that each individual patient starts on the correct dosage of LDN for them personally in order to reap the best possible benefits.

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

Dr David Borenstein, LDN Radio Show (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

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

Dr David Borenstein obtained his medical degree from the Technion Faculty of Medicine in Haifa, Israel and completed his internship at Staten Island University Hospital.

During the course of his career he has attended numerous specialized training courses in order to expand the scope of his medical expertise. He is board certified in Physical Medicine and Rehabilitation, certified in Medical Acupuncture, and is a member of numerous professional societies.

He has held many prestigious clinical appointments and positions in leading medical facilities. He has been published in the European Journal of Ultrasound and has been the Chief Investigator on a research project on Spinal Cord Injuries. He has conducted medical missions in North Korea, Ghana, Cuba, and other countries.

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

Dr David Borenstein, LDN Radio Show 28 Dec 2016 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: Today we are joined by Dr. David Bornstein.  Thank you for joining us, David. 

Dr David Borenstein: Thank you for having me. 

Linda Elsegood: For those people who haven't heard of you yet, could you tell us how you got involved in LDN? 

Dr David Borenstein: Absolutely. I'm an integrative physician. My office is in Manhattan, right here in New York; and about ten years ago, I had a patient come to me who was interested in being put on this medication known as LDN, low dose naltrexone.

Now the first thing I said was, like many people who do not know about LDN is, “Oh, we use naltrexone for drug addiction. What's this LDN?” And he said to me that he would give me literature, and I said, you know what, let me take a look at it; and on your next visit, we can talk about prescribing it.

I did some research. I made a few phone calls. And I said, okay, let me give this a try. And the patient just wanted it for general health. They didn't want it for any particular disease. So I prescribed it, and he was happy. No side effects; work beautifully. And then I had patients come in with various different abnormalities or diseases: Crohn's, MS. So I decided to try it for these patients; and lo and behold, two, three, four, five patients, they're doing okay. The patients with MS weren’t progressing, the Crohn's patients are getting better. I put a few patients who had cancer on it, and I started using it, gaining experience with it. And now it's a very big part of my practice. All thanks to that patient who came in ten years ago. 

Linda Elsegood: I can see on your website a list of conditions.  There’s thyroid, autoimmune, menopause, andropause, hormone imbalance, adrenal fatigue, chronic fatigue syndrome, fibromyalgia, chronic pain, polycystic ovary syndrome, insomnia, sleep disorders, metabolic syndrome, obesity, Crohn's disease, irritable bowel, yeast overgrowth, candida, and allergies. That is quite some list. How do you go about assessing patients to see whether they are suitable for LDN? 

Dr David Borenstein: Well, first of all, any patient who comes to see us gets a complete history and physical examination, and then we evaluate their condition.

We go over the lab work. At that point, I can discuss with them if LDN would be something they would want to consider. Now, remember, when they're coming to see me, they have many different symptoms: fatigue, weight gain, hair loss, dry skin, constipation, depression, mood swings, irritable bowel. They can have a laundry list of different symptoms. So what we first need to do is just evaluate, and treat these different symptoms. And then, especially on the first visit, it's a very long visit and we have to go over many things. I generally don't bring LDN up at the first or second visit. I usually wait until a couple of visits down the road, especially to monitor their response.

I mean, I don't want to use it initially for a first-line unless there are other things we can treat.  At that point, a couple of visits later, we see how the clinical condition of the patient is improving or not improving, and then we can throw in LDN. And now remember, most of these people coming to me have no idea what low dose naltrexone is. A few do; I’d say less than 10% of my patients know exactly what I'm talking about. The other 90% have a natural inclination. And what did they tell me? I will Google it. It's the first thing:  I will Google it. I say beautiful, Google it. I give them a couple of websites, give them your website. I give him some keywords to use, and 90% of the time they come back and say, “I want this.” 

Okay, what conditions do we popularly treat with low dose naltrexone Crohn’s, any inflammatory bowel disease, irritable bowel disease, multiple sclerosis; Parkinson's is very popular; fibromyalgia, and chronic fatigue - it's a biggie now, and we have a lot of that, as well as certain types of malignancies that a lot of patients come in for, for LDN. As you can see, we can treat a wide variety of diseases. But we generally have either autoimmune disorders, or malignancies, or certain neurological disorders. Those are the most common reasons for me to put patients on LDN.  

Linda Elsegood: We have a caller here, called Christina, who would like to discuss LDN with you. Would you like to ask your question, Christina, yes? 

Patient: Hi. Thank you. Can you guys hear me? 

Linda Elsegood: We can; or I can, yes. 

Patient: Yes. So, doctor, I have a few things. I have postpartum thyroiditis, I have hypothyroidism, I have pericarditis. And I have Sjogren's syndrome. I started LDN, and I was on it for about a month, and I got very sick. I got flu-like symptoms, a burning feeling in my stomach, and all of my symptoms came back. I also have vertigo, so they think it's autoimmune, inner ear disease. So my chest pain came back, and my vertigo came back, and I went off of it because it got intolerable. I've read a lot that starting off on a very low dose and working slowly can be beneficial. My doctor doesn't want to do that because he feels that it isn't a therapeutic dose unless it's at least 1.5 mg. So I've read a lot of posts in forums, about LDN, where people have had to try three or four times before they can successfully be on LDN; and that they could have a Herxheimer reaction. And, I did the very sensitive test for Lyme, and I am negative for Lyme. So I'm wondering, is a Herxheimer reaction something that does often occur with LDN? And have you found that people have had to go on it several times before they can successfully be on it? And is a low dose, very low dose, like 0.5 mg beneficial?

Dr David Borenstein: Well, it's a very good question. The first thing I would tell you to do is before you even consider the LDN, is you seem to be having some reaction. I think you need to clear up some of the other issues that you're having. For example, you mentioned to me the Hashimoto's. I think that when I hear Hashimoto's, I hear autoimmune. The first thing I would strongly recommend, way before taking LDN, is cleaning up your gut: I can't stress the importance of gut health. You have to clean up your gut. And what do I mean by that? I mean, adding things like probiotics, digestive enzymes, gut change to improve your gut function; looking to see if you have any parasites, bacteria, any sort of viruses.

Gut health is extremely important in treating autoimmune disease. I'd also recommend some treatments possibly for candida, yeast overgrowth. Looking to see if you have leaky gut, and if you have an autoimmune disease, by definition you probably do have leaky gut, and treating the leaky gut with a gluten-free diet, cleaning it up with adding things like L-glutamine and zinc and aloe, and all these sorts of things. So I think the first approach is, before you even consider going on LDN, is cleaning up the gut. Now, that's a lot harder to do than what I just said. I mean, it takes a lot of work; and you would probably need to find some sort of practitioner to help you with this. But again, cleaning up the gut is key to success with LDN. That's number one. Now, starting LDN, even at a very low dose after that's done, I think the issue is not so much the therapeutic effect. You need to build up your LDN tolerance. So even if 0.5 mg may not be very therapeutic, I don't think that matters. I think you just need to build up the dose so you can get up to a therapeutic dose, and I agree you're probably not going to get very much benefit below 1.5 mg. Maybe not, but I think you just have to have the ability to grow tolerance. So the quick answer is clean up your gut, to start slow, work your way up, and you'll get there.

Patient: All right. Thank you, Doctor. Do you notice that you see a Herxheimer reaction, or flu-like symptoms in patients that maybe start to build up too quickly? 

Dr David Borenstein: It's very rare. You know, when I start patients off at 1.5 mg, and then I go up to 3 mg; and after that, it depends on their condition. For example, with MS I don't try to go up above 3.0 mg unless I have to, because there are issues with spasticity; and remember, we always talk about doses. We have to remember these are doses, but it's going to be different for every person. A person who is 250 pounds is going to need more than someone who's 150 pounds. So you give them the same dose, okay; when you go per kilogram, it's a very different dose. So we have to also remember that. In all the LDN pages, and on the Facebook pages and the Yahoo groups, they will talk in doses. And the problem is it's not the most accurate way of dosing, because you need to consider the weight of the patient as well. So 1.5 mg for me is going to be very different from 1.5 mg for you or another person. That's also another important point to remember when prescribing LDN. Also, some of the practitioners like to go up to 4.5 mg.  I like to keep it a little bit below that. We're finding that you're getting the opioid blockade at around 4.0 mg, and after that, it's not as effective. So recently, in the past year, year and a half, I've been keeping my maximum dose to about 4.0 mg; and I don't really go above that unless the patient has been on LDN 4.5 mg for many years. I don't want to touch it. I leave it alone. 

Patient: Okay, and thank you. I appreciate it. Could I just ask one more quick thing? I do a lot of great things for gut health, the L-glutamine and probiotics; and I stay away from gluten and dairy completely. Could you explain a little bit about how one would go about testing for parasites, bacteria and viruses? 

Dr David Borenstein: There is a test called the CDSA 2.0, from a company in North Carolina; I'm trying to remember the name of the company. I use it all the time, I can see the box. But these are special stool kits you can get, and actually, insurances will help pay for a part of the test. You collect a stool sample for three days. The test looks for parasites. It looks for your digestive enzymes. It looks to see how well you're absorbing food. It looks for bacteria and other viruses. It's a very good test. It's called a CDSA 2.0.

Patient:  Great. Thank you so much, doctor. 

Dr David Borenstein: My pleasure. Thank you. 

Patient: Bye-bye. 

Linda Elsegood: Well before we go to the break, I have another question here that's come in. It's from Susan, and she says, “When do I need to stop taking LDN prior to a minor medical procedure which requires anaesthesia?”

Dr David Borenstein: Excellent question. We know that LDN and its metabolites have a half-life of approximately 59 hours. So 60 hours; you know, technically it's two and a half days. I would at a minimum do probably a week before, and that would be a minimum I would do. Yeah, I'd say two and a half days; or at least about a week before you'd play it safe. And that would be  a good thing to do, especially if you're receiving any sort of narcotics before or after the procedure. So I just say a good solid week would be a good number. You know, you can do a little more. Wouldn't hurt, but I think to keep it safe at least a week. 

Linda Elsegood: And how long would you say to wait after you'd had narcotics before you restarted LDN 

Dr David Borenstein: Let's see, two and a half days. So I would say at least five days afterwards would be a good number. From the last point of taking a narcotic. 

Linda Elsegood: Okay. Thank you. We'll just have a quick break. If anybody would like to call in with their questions or email them, and we'll be back in a moment. 

The LDN research trust is very proud of the LDN book, which was launched at the LDN 2016 conference in Orlando, and it's been a great success, not only for the medical profession but for patients wanting to learn more about low dose naltrexone. Full details can be found on the homepage of the LDN Research Trust. Discounts are available on bulk orders of the book, which is ten or more. The details: Contact us, telling me how many copies you wish and where you live. I will then be able to get Chelsea Green Publishing to contact you.

Belmar Pharmacy is a nationally respected compounding pharmacy. They compound low dose naltrexone, LDN; bio-identical hormones, and custom amino acids, mineral blends. They're based in Colorado and ship nationwide. Their goal is better patient outcomes through quality compounding, combining effective communication between practitioner, pharmacist, and patient.  Call +1 800-525-9473 or visit Belmarpharmacy.com.

Okay. Welcome back. I have a question here for you, David, from a  lady in Turkey or a gentleman. They have a five-year-old son who was diagnosed with nephrotic syndrome at age three. He takes 4 mg of steroid every other day. They would like him to try LDN, but the doctor said no. And through a year, they've looked for a doctor who would prescribe LDN, without success. They say their son's on steroids, and it's very troublesome. He becomes very sick easily at home, and next year he starts school. So they would like to find a permanent solution. The question was, can LDN be prescribed for a child who takes 4 mg of steroids; and do the steroids affect the LDN.

Dr David Borenstein: Well, the second question first. Yes, it can, and that's why I like to keep the steroid dose as low as possible.  In adults, I like to keep Prednisone below 10 mg per day as a rule, and that's just an arbitrary number. I just find that it works best below 10 mg a day. Many of my patients have a lot of autoimmune immune disease and are on much higher doses. So what I do is I start them on LDN, and I have them slowly taper their Prednisone while the LDN is kicking in, in the hopes that, as the LDN dose increases and the steroid dose decreases, the LDN will start working. So far, it's worked pretty well.

Now with kids, you have to be very, very careful, especially for nephrotic syndrome. And you would need a physician to really keep on top of this. But you could, in theory, try the LDN, 80 micrograms per kilos. You do depend on the weight. He's probably gonna need a lot less than most adults would. And with a child, they tend to like to use the transdermal  - just easier to use. And you can certainly give it a try, but again, you're going to have to be under very close care of a physician when you're doing this, to make sure that everything is being watched. This is very different from a patient who's just taking it for fibromyalgia or for Crohn’s. You can have some flexibility. But with a child, you have to really keep on top of them. I definitely think it's worthwhile to try it and see if it has an effect; but remember, you have to keep on top of this, and finding a physician who's going to do that is not going to be easy. People have had a lot of trouble finding physicians prescribing LDN, just to get it for whatever disease they have. But for a child, needing constant watching, that's going to be a little bit tricky.

Linda Elsegood: Especially in Turkey where I think it's very, very difficult to get LDN prescribed anyway. 

We also had a question from Taja, and she says that she was diagnosed with rheumatoid arthritis in December 2015 and she started LDN in March. Her questions, she's got three. The first one is, do anti-inflammatory drugs have an effect on the efficacy of LDN?

Dr David Borenstein: They generally don't. The main issue when you're taking low dose naltrexone is going to be high dose steroids. Not so much the nonsteroidal anti-inflammatories, generally not. But here's the problem. When you're taking a lot of NSAIDs or nonsteroidal anti-inflammatories, it's not good for you.

It's not good for your liver, it’s certainly not good for your kidneys, and certainly not good for your stomach. So LDN would certainly be of benefit to try to help reduce your need for these anti-inflammatory medications, but they're not going to interfere with LDN. 

Linda Elsegood: And the second question is, have you seen any difference in how LDN works on patients following an anti-inflammatory diet?

Dr David Borenstein: Yes, no question, diet is key to helping patients with rheumatoid arthritis and other autoimmune diseases. Now, what do I mean by that? I mean, I always talk about LDN being a tool, not a cure of disease. It's a tool that one can use to help treat disease. Now, if you can approach disease in multiple different ways, then, of course, there's going to be a much better response. So diet is key, especially in rheumatoid arthritis. With diet, we want to make sure that the patient, especially with rheumatoid arthritis, keeps away from nightshades - tomatoes, potatoes; working on fixing the leaky gut we are treating, having a gluten-free diet. These are very key components for fixing the gut. Probiotics, digestive enzymes, stomach acid. And again, looking for parasites and bacteria in the gut. Treating the gut is extremely important in rheumatoid arthritis and other autoimmune diseases. That in combination with low dose naltrexone is a very powerful tool for treating rheumatoid arthritis and other autoimmune disorders.

Linda Elsegood: Okay. And her third question was, I take 4.5 mg of LDN. Should I change the dose if I feel my symptoms increasing? And if so, in what direction? 

Dr David Borenstein: Well, I don't know the patient's weight or their age, so I really couldn't give a super-accurate answer. That being said, you're not going up.

I mean, that's it. 4.5 mg is the max. As a matter of fact, I would probably recommend the patient lower the dose down to 4.0 mg. I wouldn't be surprised if the response improves, because if you lower the dose to 4.0 mg there may be a more effective opioid blockade. So I would probably give a trial of lowering the dose to around 4.0 mg, not 4.5 mg and see if that works a little bit better, especially if the patient is low weight. 

Linda Elsegood: Thank you. And we have a question from Jen, and she says she has MS, and she has taken LDN for three months with some improvement to her bladder.

She said she started at 1.5 mg, then increased to 3.0 mg.  Should she increase the dose or wait longer, because she's only had some improvement to the bladder? Nothing else. 

Dr David Borenstein: Okay. Well, here's the thing with MS. You have to be concerned about spasticity. Many times we have patients with MS, they have spasticity, but if spasticity is not getting worse, then you can experiment with going up at very small doses - 3.25 mg try that for a little while. Then go up to 3.5 mg, and you can go up a little bit till the spasticity increases. And that's probably the max you want to take.

So yes, that would probably be a way to go. Now, remember, although we've had patients who felt better, the goal in low dose naltrexone for MS is more to prevent exacerbations and to keep disease stable, rather than actually feel a little bit better. So if you had numerous exacerbations in the past, LDN in many cases would prevent exacerbations. If it prevents exacerbations, then LDN has done its job. Okay. So it's more for preventing the disease from coming back and halting in its tracks rather than feeling better. So three months is a little bit short. We'd have to see over a longer period of time. I don't know how many exacerbations this patient has. So the answer will be if the patient has fewer exacerbations than she did, we know the LDN is probably doing its job.

Linda Elsegood: Okay. Thank you. We have another question from Paula, and she asks if LDN is a problem with candida? She took <a medication> to help and it allowed her to get up to 4.5 mg. She stopped the <medication> several months later and some of her old autoimmune symptoms have returned. She says, “Am I getting symptoms of candida, and what would you suggest I do?” 

Dr David Borenstein: Well, the first thing I want to do is, and sometimes patients with severe candida can have problems with LDN. I think the thing you have to do is just clean out your gut and especially with candida. The same treatments that we have getting gluten and dairy-free diets, keeping away from fruits that can contribute to candida, and we all know what they are.

Anything that tastes good or isn’t good for you, it's probably good for candida. And some doctors give a course of Diflucan for a period of a month or two, that may be beneficial. It's not a cure, but it can give what I call an artillery barrage to at least lower the symptoms and then change your ability to do with the candida, with dietary changes and other supplements, cilantro, oregano, garlic, all very good for treating candida.

And just one more, which. I have a little bit of a mental block, but it also works - berberine, berberine-containing substances are very good for treating candida. Treat the candida for a month or two, even three, and then try and restarting the LDN and you'll probably get a better response.  

Linda Elsegood: and we have a question here from Alec. She says, “Could LDN help with prostate cancer and other prostate issues?” 

Dr David Borenstein: We've had patients with prostate cancer who've taken LDN. However, again, when you're treating cancer, you have to use a very combined approach. I've had patients who basically have prostate cancer, but they're not treating it because it's either low-grade cancer or its small cancer, and they don't want treatment yet, but it's certainly worth a try. And as long as your PSA doesn't go up and there are no changes in a digital examination, it's certainly something to consider. That being said, if the patient has received hormone treatments, those who are in a later stage or towards the end stage of receiving hormone treatment, we’re finding the LDN really doesn't work too well with that subset of patients. But as a rule, it's certainly worth a try, as long as you follow the rules, keep away from opioids and do the proper dosing. I think the question is, do you tell your oncologist about it? People ask me this all the time, and you know, I would, and just explain to your oncologist, or your urologist that you're on it and just give them a five-minute debriefing. Bring them some literature. But a lot of the time, urologists and oncologists are not crazy about it. But there'll be someone understanding at least in 2016, 2017. Ten to fifteen years ago, forget about it. Everyone’s mind was closed. I think we're living more open-minded today. So, again, short answer, you should always use LDN with the knowledge that your attending physician, your oncologist, your primary care doctor, whoever's treating you should probably know about LDN and that you're taking it, and just make sure that you don't only use LDN if it's something serious, a more serious disease. Because again, there are other treatment options available for more serious disease.  

Linda Elsegood: And we have a question from Leanora. She says, “What are your thoughts on LDN and a person's genetics, SNPS, and methylation pathways. Are you familiar with MTHFR, COMT, or SNP called CYP-2-D-6?” 

Dr David Borenstein: Well, here's the thing with the MTHFR and the other genetic mutations, there's no problem using LDN with that. You do have to treat the issues of those particular mutations. For example, I'm going to use MTHFR, because that's certainly by far the most common that we see. How do you treat the MTHFR? Even this is controversial, and I think this is going to change, so this is not in stone. When we have MTHFR gene mutations, you have to first evaluate to make sure homocysteine levels are normal. This other test you can use, I'm not allowed to use it in New York state, but there are better ways of checking homocysteine levels than just measuring homocysteine, but that's the tools we have, we have to use it. And making sure that you have the B-6, B-12 and methyl folate - make sure that in all your vitamins there is methyl folate - and use trimethylglycine and cleaning up the gut to detoxify.

So that's the best you can do. That being said, if you do all that and use the LDN, there shouldn't be any issues.

Linda Elsegood:. Okay. And she said, “Would know a person's genetic hiccups help determine the dose of LDN.”

Dr David Borenstein: Not really. We've been dosing LDN well before MTHFR became popular, well before. And I know Dr. Bahari when he was doing it, I, I speak with his wife from time to time also, who is in New York; and again, in the eighties and the nineties, we didn't really use MTHFR, and nothing changed. I mean, the dose is going to be basically based on the disease you have, your weight, and your tolerance. MTHFR and other genetic mutations are really not gonna make a big difference in the way we dose you. 

Linda Elsegood: Okay. And she has another question, and she says” Have you seen success with LDN and endometriosis?”

Dr David Borenstein: I generally don't use LDN for endometriosis. Remember, endometriosis by definition, in most cases, is an excess of estrogen: estrogen dominance, as opposed to anything LDN would treat. So when I have endometriosis, I have to look for estrogen dominance and balancing the hormones. So I really wouldn't be using LDN for that.

There are many other things you can do to improve your hormone balance, like measuring the hormones, either through salivary testing; you can do urinary testing; in some countries, all you have is blood testing. And you have to do it on certain days of the month, balancing the hormones. And in most cases, the problem is either too much estrogen to too low progesterone or both. So balancing the estrogen, treating insulin resistance, and that's a biggie. And once you do that, that tends to be some sort of improvement in the endometriosis. So I would do that before throwing LDN at the problem. 

Linda Elsegood: Okay. And she has one more question, and it says, “LDN might not always help or improve a person's condition, but are you aware of any conditions that are known to exacerbate, or worsen, a condition or disease?

Dr David Borenstein: I have not seen that. I've only seen certain side effects from taking LDN - the vivid dreams, the difficulty sleeping, the increasing candida, and Herxheimer reaction. But I've never seen a condition get worse from the LDN. Now, of course, diseases do progress naturally, and if you don't treat them, they tend to get worse, not get better. So many times, this is the natural course of the disease. But as a rule, no, I've never—seen any detrimental effects from LDN. 

Linda Elsegood: Okay, lovely. Well, we'll just have a quick break, and we'll be back in a moment.

The LDN Research Trust has its own forum, which can be found at forum.LDNresearchtrust.org, or via our website. The forum is divided into sections, so it's easy to navigate and find what you're looking for. You can share your experience, ask questions, keep a journal, etc. Unlike Facebook, the posts are always easy to find and don't get buried. We have a private medical professionals only section. To find out more, please Contact Us.

Belmar pharmacy is a nationally respected compounding pharmacy. They compound low dose naltrexone, LDN; bio-identical hormones, and custom amino acids and mineral blends. They're based in Colorado and ship nationwide. That goal is better patient outcomes through quality compounding, combining effective communication between practitioner, pharmacist, and patients. Call +1 800-525-9473 or visit Belmarpharmacy.com.

Welcome back. We have some questions here from Dr Leonard Weinstock, and he says, “Have you measured pre and post LDN antithyroid antibody levels?” 

Dr David Borenstein: Well, the answer is yes, we have, because anytime I have a patient who has Hashimoto's and hypothyroidism, I always measure their antibodies. So, and as a rule, they come down, and they can come down sometimes quite quickly. And you have to be very careful with these patients because if you have them on thyroid medication and their antibodies come down, and the amount of medicine they take may be the same, but their antibodies come down. That can actually cause them to become hyperthyroid. Think of it as driving a car and all of a sudden you're driving with the accelerator halfway down and the brakes halfway down, right?

So all of a sudden you're lowering the antibody, so the brakes, you're reducing the brake and what happens - the car zooms forward. That's exactly what happens. So you have to watch it, and watch it closely. Now here are some of the problems we have in monitoring the antibodies. Many of my patients’ antibodies are through the roof and the lab that I use, which is a very common lab that most integrative doctors in the New York area use, if it's above a certain level - if the anti-TPO is above a thousand and an antithyroid globulin is above 3000, it just says greater than a thousand, greater than 3000. So if the antibodies dropped from 5,000 down to 3,500, I have no way of knowing that. All I'm seeing is that it's above 3000 or when it gets below 3000, and I can see if it's dropping or not. But as a rule, LDN is a very effective tool for treating Hashimoto's, and the antibodies can drop, and it can drop quickly, so you have to watch these antibodies very closely to make sure the patient does not become hyperthyroid. Now, if the patient's not taking any thyroid medication, then it's a very different story than if it drops, it drops, and then you have to still watch them make sure that they're not becoming hyperthyroid, but it's less of a concern because they're not taking any thyroid medication.

Linda Elsegood: Just out of interest, how often do you check the levels if they're on thyroid medication? 

Dr David Borenstein: It depends. If they're on LDN and I'm starting it, I probably would do it every four to six weeks, and I tend to be very, very conservative in the way I give the LDN. I like to start off at 1.5 mg, and then after a month go up to 3 mg and then go to 4.0 mg. However, sometimes I'll do it a little bit slower than that. Especially when I know the antibodies can drop quickly and they're on a high dose of thyroid medication. So you do it very, very slowly. Sometimes I'll just put them at 1.5 mg and have them come back in two months to see how the levels are. And then, all right, they've dropped, we're going to put you on 3.0 mg. But you know what? We're going to change your medications a little bit. Drop your medications a touch, come back in two months. But when we do it that way, you require a lot of constant monitoring. That's the best way to do it. And the safest now, thank goodness, no problems, but you know, there's a theoretical risk of hyperthyroidism, which you have to watch out for.

Linda Elsegood: Okay? And he also says, “What are your thoughts on using low dose oral methylnaltrexone for systemic inflammatory conditions without CNS pain?”

Dr David Borenstein: You know, generally I don't use it. Most of the time I use straight LDN, and I treat those other conditions other ways. As I said, I don't use the LDN only for treating pathology. I use various different ways to reduce inflammation, and there are many different ways we can reduce inflammation in outpatients. Obviously diet is very big. We know that certain foods are more inflammatory than others. High fructose corn syrup is huge. Red meats, certain nuts are huge. Dairy is huge. All inflammatory foods, so you want to change that. Use of anti-inflammatory supplements like fish oil, curcumin, Boswellia, bromelain; there are many different supplements you can take to reduce inflammation. One of the least evaluated, but very, very commonly associated with inflammation, believe it or not, is insulin. Insulin - you have to be very careful with insulin. We know that people who have hyperinsulinemia are very inflamed, and a lot of doctors aren't aware. Physicians treat blood sugar. They look at glucose. They never look at insulin. And while there is a relationship between the two, it's certainly not direct. You can have perfectly normal blood sugar and very high insulin, and that insulin can be very inflammatory. So I like to treat inflammation, look at the root cause of the inflammation, and then I add the LDN to help for any other issue that we're treating.

Again, not the primary treatment for what I do. But it's just a tool that aids in helping me treat disease. 

Linda Elsegood: And he had one more question, “Did Dr Bihari compare measurements of enkephalins with PM versus AM dosing of LDN?” 

Dr David Borenstein: I believe he may have, and it's usually about a third. As I remember, about a third less in the afternoon than in the evening. So, for example, let's say 2:00 AM in the morning is when you have the peak. It's probably three times as much at two in the morning than it is at two in the afternoon, at least three times, maybe a little bit more than that. That's why we don't recommend taking LDN in the morning. I have this question asked all the time because you don't have anywhere near the amount of endorphin peak at 2:00 PM in the afternoon than you do at 2:00 AM in the morning.

Linda Elsegood: Okay. We have another question here. Can you explain how LDN effects and regulates Th1 and Th2 rather than boosting either one?

Dr David Borenstein: Here's the thing. I've seen the charts on them, and it's probably better to explain visually. I think theTH-1 and TH-2, you know, the humoral immunity versus cellular immunity, I think a lot of this is overblown. But basically, the answer is it does affect the relationship between the two. But there's a huge chart that has all this stuff, and I probably have to do a more of a visual presentation than I can explain over the radio. It would be a very visual thing, but there are charts out there that will explain how LDN may affect the Th1 versus Th2 immunity.

Linda Elsegood: Okay. Thank you. And how does LDN affect allergy testings? 

Dr David Borenstein: Well, in theory, it really shouldn't. I have patients on LDN get allergy testing and they certainly still come up positive, so we've never seen it. I mean, it could very well be, I've never done a study, but just from anecdotal evidence, I don't see how it affects the IgE modulated immune response.  

Linda Elsegood: Another question: we're always being asked, while we're talking about testing, people say if I have to have a drug test for my work, would LDN show up? 

Dr David Borenstein: No. Remember, it's not an opioid, it's an opioid blocker. So there's going to be no problem with you going in and taking LDN and having issues at work. 

Linda Elsegood: And does LDN right serotonin levels in the brain? 

Dr David Borenstein: As far as I know, the relationship is not proven. There may be some relation to that because remember, it's working more on the opioids and met 5-enkephalin. The met 5-enkephalin somehow may have some effect on serotonin, but I haven't certainly seen that in my patients. But that would be something that research can definitely look into.  

Linda Elsegood: And we have a question from Kirsty, and she says, a week ago she started on 1.5 mg of LDN for lichen sclerosis, and she’s curious about at what point should she expect to see some relief of symptoms, and when should she increase the dose? 

Dr David Borenstein: Well I think it's still very early, but I would certainly recommend the next couple of weeks trying to go up to 3.0 mg and see how that works, and then moving up a little bit higher. And if you're not getting any results for a few months after that, it's probably less of a chance that it will work. As a rule, I think after three or four months if we’re not seeing results, either you have to clean your diet out and change what you eat, or it's probably not gonna work for what you're trying to use LDN for.

Linda Elsegood: What is the protocol that you suggest to your patients? I know you have said LDN is just one of the tools that you use and it doesn't always work for everybody, but if we were a new patient coming into you, how would you describe LDN to them if they weren't going to go off and Google it. 

Dr David Borenstein: Well, here's the thing. Usually, if I'm going to prescribe LDN, we'd have a specific reason for doing that. So maybe give me a scenario, which type of patient - one with MS, a patient with Crohn's. You tell me, and I can give you better answers. 

Linda Elsegood: Let’s say Crohn’s.

Dr David Borenstein: Perfect. Perfect. Well, most of the time, people with Crohn's maybe on Humira or other medications that would impair the immune system.

So I would explain to them it's very simple. I tell them that there's this medication that mostly integrative doctors use. It has very good success in treating Crohn's disease. It is inexpensive. A dollar a day on average. It has minimal side effects, and it works in most cases really, really well. So they say, doctor - the most common question I have for this - is, “How come my gastroenterologist didn't tell me about it?” This is the most common question I have. Why are you doing this and they're not doing it. So then I have to explain it again: most integrative doctors use this; this is compounded, not pushed by their pharmaceutical representatives. That, and explain the mechanism of action, that we know that opioids have a very important part of regulating the immune system. Then explain to them what opioid blockade is and the increase in met 5-enkephalin and how that can modulate the immune response. Now we also have to educate the patient that this is not a narcotic, because they think naltrexone, and they think drug addiction, so we have to educate them about that. 

Now, especially with Crohn's, not only do I use LDN, but I also use some of the other techniques I mentioned: treating the gut, the inflammation. But here's some good news about LDN and Crohn's. A lot of my patients don't keep to their diet. A lot of my patients don't do what I tell them. All they do is just take LDN, and that's it. And you know what? They do really well despite not having to change their diet; despite not having to do anything I tell them to do; and they respond really, really well. So that's kind of a good thing. At the same time, patients who don't respond well, we may want to have them change their diet and follow my instructions for cleaning up the gut and taking the proper supplements and diet, and then they tend to respond as well. One thing about Crohn's that works so well in our patients. A lot of the patients don't even - that's it - I want my LDN and goodbye. And it works as they come periodically to see me get their refills, and they're the happiest people in the world. 

Linda Elsegood: I have a question here that always comes up. Now, some doctors, pharmacists, think Tramadol is an opiate. Others will say it's a synthetic opioid and can be taken with LDN. Where do you stand on that? 

Dr David Borenstein: It can be taken with LDN. Don't believe anything they say. If you're in pain and you need a painkiller while taking LDN, Tramadol is what you're going to take. It works. How do I know? I've tried it on myself. You know, it's not a problem. 

Linda Elsegood: Okay. Any particular dose. 

Dr David Borenstein: You know, it’s individualized. But the point is, the question is more in general, will Tramadol have a problem working with LDN, and the answer is no. The dose is as you need it. Every pain situation is different. Certain pains, you don't really need Tramadol, you just need Tylenol or Motrin. But other pain, heavy narcotics. In that case, that's where the Tramadol comes in. That being said, in many of our patients who need high dose narcotics, you may want to just get off of LDN for a little while and hope for the best. And then when your need for narcotics goes away, restart the LDN

Linda Elsegood: So would you say with Tramadol there has to be a gap when you take LDN or can they be...

Dr David Borenstein: No, no gap at all. Just use it as needed. But sometimes Tramadol will not be enough for the pain. You may need opioids, and that's when you're going to have to go off the LDN.

Linda Elsegood: Oh, that's good. Thank you. We have people ask us about weight. We know that LDN is used in some weight loss clinics; and some people say when they start LDN, they gain weight. Do you have any experience of weight with LDN? 

Dr David Borenstein: Usually not. Usually, people don't gain weight. It's usually very well tolerated. I wouldn't use it, again, as a primary weight loss medication, although some patients have claimed that they have lost weight on it. Maybe they sleep better after a while on it, and that improves the metabolic rate. But weight loss is an entirely huge separate issue. We can have ten seminars on weight loss because it's such a complicated factor of hormones, adrenals, thyroid, lecithin, insulin. It's a huge, huge topic; and growth hormone; there are so many things that are involved in discussing weight loss, and that's just hormonally, and obviously, we have diet issues and exercise issues that we can discuss as well. But I think, for the most part, it may be a pleasant, side effect. And if you lose weight, that’s great.  

Linda Elsegood: And does LDN help with sensitivities to fragrance or chemicals.

Dr David Borenstein: Here's the thing. It's certainly worth a shot, but chemical sensitivity, and I've seen a lot of chemical sensitivity in my life; it's a very, very, very difficult thing to treat. First of all, many physicians, if not most physicians in the United States, I don't know how it is in the UK or the EU, but most physicians here don't even think that it even exists. It just doesn't exist. Okay. And I think when we're treating chemical sensitivity, we have to work on detoxification of the body. Working on building the methylating pathways, detoxing with things like charcoal or other things. Also, when I hear fragrance sensitivity, when someone has a problem with perfume, the first thing I think of is candida. Candida is the first thing I think of. Look for yeast. Many times it's a very close clinical association. Now, if you want to try LDN that's great, but I don't think that's gonna cure the issue. I think we have to look at the root cause of the problem and address it. And the LDN may be a tool in fixing, addressing that issue, but I don't think it's a cure-all, but certainly worth a shot. Again, we have a medication that's cheap, little in the way of side effects. It may have good therapeutic potential. Why not use it?  

Linda Elsegood: And another question that's always coming up, and I know you were saying about missing doses for a period of time before and after an anaesthetic. Some people say that skipping a dose is good on a regular basis. Some doctors will say once a week, some will say once a month. What is your view on that? 

Dr David Borenstein: Well for the first few years, I don't think it's necessary to skip a dose, but we're finding probably after a number of different years, and patients who've been taking LDN for many years, it certainly wouldn't hurt to skip a dose maybe once a week. First of all, it saves you a few dollars if that's a concern. But if you can skip the dose once a week. Okay, now I wouldn't do this in the initial couple of years. It's just more people that have been on it for a long period of time. Skip a dose once a week and see how you feel, and see if your clinical symptoms change. We do this, believe it or not, in Parkinson's disease, we take as a drug holiday, and it works really well when the medicine for Parkinson's disease doesn't work very well. We take a drug holiday, and it's kind of like what you're doing here. It wouldn't hurt. I don't think there's an exact protocol. I think this is very anecdotal, and every patient is different, and everyone is different. But you know, 5-6 years of LDN - try stopping it one day a week and see what happens. What's the worst-case scenario? You have to go back on it every day. That's the worst thing that's going to happen.  

Linda Elsegood: And you were saying about Parkinson's - we've got many members that are taking LDN for Parkinson's. What has been your experience with that?

Dr David Borenstein: Pretty well. Now I've been doing a lot of work with Parkinson's, and right now in my practice I've been doing a lot of work with Stem cells, and I find that Stem cells are very beneficial. And what I find is that I get the Stem cells to improve the symptoms of Parkinson's and then the LDN to keep it stable. So I've been using LDN and those patients recently with some good results too. We just keep the disease stable. So they may get a big boost in the way they function with the Stem cells, and we use the LDN to keep them that way. So I think it's a very powerful tool for treating Parkinson's and MS, and some other neurological diseases.  

Linda Elsegood: We have a question for Mary, and she says, “Have you found LDN to be beneficial for Alzheimer's?” 

Dr David Borenstein: I have not used LDN for Alzheimer's. The problem is you have a patient who may not have the best memory, and you have to be very careful with the medication. If there's a provider there with the Alzheimer's patients, you can certainly give it a try. I think there are many other things you can do for Alzheimer's patients: treating their vitamin deficiencies, B12, folic acid, lots of fish oil, making sure their thyroid is okay. And look for other deficiencies: low levels of vitamin D, look for MTHFR mutations, high levels of homocysteine. These are things that - aluminium toxicity is the thing that I would look for in treating patients with Alzheimer's. Again, if you have a physician who can work with you, this is very low risk. And very inexpensive. It's certainly worth a try. That being said, look for the other things that you need to address with patients with Alzheimer's and address those, and you'd be surprised just by giving some B12 shots, a little thyroid, and little fish oil - you may actually see some improvement.

Linda Elsegood: That's good. Well, we have time for one more quick question.

Debbie has bipolar, and she wants to know if LDN would help her. 

Dr David Borenstein: I have not treated bipolar in my practice, and I have not had any patients who would be treated with, let's say, Crohn's or MS or cancer, and also have bipolar and have any change in their symptoms. So I honestly couldn't give you an answer to that.

Linda Elsegood: Well, that's us just about over David, and thank you very, very much for taking all these questions and for your time. It's been amazing. So thank you very much. And next week we're going to be joined by Dr Mark Shukhman, who's a psychiatrist, so maybe he'll be able to answer our question on bipolar. But thank you once again, David.

Dr David Borenstein: Oh, my pleasure. Thank you.

Linda Elsegood: Belmar Pharmacy is a nationally respected compounding pharmacy. They compound low dose naltrexone, LDN; bio-identical hormones, and custom amino acids, amino blends. They're based in Colorado and ship nationwide. Their goal is better patient outcomes through quality compounding, combining effective communication between practitioner, pharmacist, and patient. Call +1 800-525-9473 or visit Belmarpharmacy.com.

Any questions or comments you may have, please Contact Us. I look forward to hearing from you. Thank you for joining us today. We really appreciated your company. Until next time, stay safe and keep well.