LDN Video Interviews and Presentations

Pharmacist Mark Mandel, LDN Radio Show (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Dr. Mark Mandel, owner of Mark drugs, compounding pharmacy in Illinois, United States shares his experience in prescribing and compounding Low Dose Naltrexone.

I first heard about LDN in the mid 1990s. One of my patients husband was using LDN, for a couple of conditions that he had at that particular time.

He had been diagnosed with cancer and with autoimmune diseases.

We compound LDN the simple way. LDN one compounded alone with lactose sugar is the most readily absorbed available source.

For those patients who are sensitive to lactose, the only other modification or alteration we do was we put it in combination with probiotics, and that seemed to have a beneficial effect for many patients as well.

We have the ability to put chemicals into any dosage form that was effective.

We do ship LDN all across the domestic United States.

We help patients with Cancer,  Multiple Sclerosis, Chronic Fatigue Syndrome, Fibromyalgia, Rheumatoid Arthritis prescribing LDN with success.

Dosing on the Low Dose Naltrexone can vary anywhere from a minimum 1.5 milligrams at bed time to the maximum effective dose, approximately 4.5 milligrams at that time. And then it's actually the 4.5 milligram dose is typically the most common dose.

There's a variety of different patients have different response rates.

And depending on the condition that's being treated, different concentrations at different dosages may be appropriate for different patients.

We probably have about 2000 physicians who are ordering Low Dose Naltrexone (LDN).

We have physicians in the Chicago land area in central Illinois, and in Northwestern Illinois. We also work with physicians in Wisconsin and Indiana, which are the States surrounding Illinois surrounding the Chicago area.

Talking about LDN side effects, the majority of patients that report any, would be the very vivid dreams. The dreams are typically not disturbing. However some of them can be quite disturbing. Some can cause some anxiety, if the patient knows in advance that their dream cycle may be effected.

We found from a server that we carried out that only about 5% of people experience side effects at all.

We find that we're able to give the patients a lower price with a larger quantity of Low Dose Naltrexone, or they tend to get three to six months supply at a time. As you get to a three month or greater supply, the price of the LDN dropped to less than $20 a month.

So other medications that are available to treat these autoimmune conditions have awful toxicity, from simple nausea to complete fatigue, which is some of the things that you're trying to combat with conditions such as Multiple Sclerosis, Rheumatoid Arthritis.

I've been amazed since I first learned about Low Dose Naltrexone, which was quite some time ago, at the positive results and the positive benefits that our patients have seen. I've had patients have been diagnosed with breast cancer, who decides to use Low Dose Naltrexone in conjunction with other treatments who've seen a reversal of the breast cancer, colon cancer and prostate cancer.

I encourage patients to contact me if they have questions. I can be reached through our website at Marc drugs or you can email us through our website@infoatmerckdrugs.com.

Summary from Dr. Mark Mendel interview. Listen to the video for the show.

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.

Dr Akbar Khan on Cancer, LDN Radio Show (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: Today we're joined by Dr Akbar Khan, who works with LDN and cancer in his Medicor Cancer Centres. He has treated over 2000 patients with LDN, so we are very interested in hearing what he has to say.

Dr Akbar Khan: Thank you very much for having me on the show.

Linda Elsegood: Could you tell us when you first heard about LDN?

Dr Akbar Khan: Well, I first heard about LDN about nine years ago, and that was through some discussion on the internet, in which a patient pointed out to me there were some alternative medicine forums, and I guess people were discussing LDN and other non-traditional cancer therapies, and so a patient pointed out that there's a drug that you should look into and it's called LDN, and the patient was interested in trying it. So that's really how I got acquainted with LDN.

Linda Elsegood: And how soon after hearing about it did you start prescribing?

Dr Akbar Khan: Well, so I had to do a little bit of research on it, and then I found Dr Bihari and Dr Gluck's website, which is ldninfo.org and from there I learned about how LDN was effective in cancer treatment and autoimmune disease.

And you know, basically, because our clinic was dealing with just cancer, it was very interesting for me that there is an option for a very simple and cheap medicine that has almost no side effects, that could effectively treat cancer. So, I did do some research, and I found some publications on LDN.

Dr Berkson, for example, published case reports of pancreatic cancer, which is one of the most difficult cancers that was successfully treated with LDN. Then I found out the type of dosing that was being used, and so at that point, we started using it. It took just a few months, and then after that research was completed, we started using the drug.

Linda Elsegood: Do you use LDN as a standalone treatment or part of a protocol?

Dr Akbar Khan: So, it can actually be used as a standalone treatment. We have used it for patients who have no other treatment options, and then they start searching for other treatment options, and then they find us. In those types of situations, we use LDN as a standalone. It is actually effective, and what we find is it's more effective in patients that have lower amounts of cancer in the body; if it's an earlier stage, then it's also more effective, but it can actually be used as a standalone therapy. We have many cases of patients successfully treated like that. It can also be used as an adjunctive treatment, which is in combination with chemotherapy, for example, and there is a new publication which I know you're aware of that illustrates exactly how that can be done.

Linda Elsegood: And from the 2000 plus cases that you have treated with cancer, do you have any examples that stand out?

Dr Akbar Khan: Oh yes, for sure. We've treated well over 2000 patients with non-traditional treatments, including LDN. We use other gentle medicines as well, and the most notable example would be a case that we actually published; it's a fellow with tongue cancer.

So, I'm just going to get some of the details here for you. He was about 60 years old when we began treating him, and he had a rare type of cancer of the tongue, which is called adenoid cystic. It was probably about an inch and a half in size and had not spread at the time, but it was large enough that his doctor was concerned, and he was told to have radical surgery in an attempt to cure it.

So the standard treatment involved for this type of cancer was the removal of the entire tongue. Also, because it was close to the voice box or the larynx, the surgeon had said they wanted to remove the entire voice box and remove all the lymph nodes that were in the region. So major surgery of the mouth and of the neck, with a very significant reduction of quality of life, like, you know, he would not be able to taste, he would not be able to speak after the surgery, and so this was an attempt to cure this cancer. So, this fellow was very upset and unhappy about the proposed treatment, and he did ask for a second opinion from another specialist. I believe the other specialist also said they could do surgery, but maybe a more limited surgery, and then they did offer some chemotherapy and radiation as well.

So, none of these options was acceptable to this fellow, and he ended up finding us somehow; I believe on the internet. When he came to us, he said he wanted a treatment that had zero side effects. So, I told him, well, of course, there's no such thing as zero side effects, but probably LDN is the closest thing to that. It does have very few side effects. So, we offered him that and he was very interested. He did start LDN, and we also added some vitamin D because it has some anticancer effects as well; it does improve immune function also, and so what happened when he started LDN and vitamin D the mass stop growing, and then over a period of a few months, it actually started to reduce, and he didn't contact me for a while.

He kept up with his LDN, and then after two years he just mysteriously appeared and sent me his MRI scan report. He had just had a new scan and it said the cancer was completely gone. So naturally, you know, we were quite excited, and this fellow is now at over five years cancer-free.

His scans are clear. He just had a visit with his specialist. He inspected his entire mouth, and there's no sign of cancer and so that is, I would say, by far the most notable case in my experience with LDN.

Linda Elsegood: Wow. That's totally amazing, isn't it? 

Dr Akbar Khan: It is stunning yes.

Linda Elsegood: Exactly. Have you had any other remarkable results that you've seen? Maybe not quite as stunning.

Dr Akbar Khan: Yes, we have. I mean, he's definitely one of the best, but we have other results, which are more real world, that is, I expect that cancer might reduce or it might stabilize; those are more common responses that we see. You know, we use it for almost any cancer type. Other good cases: a bladder cancer case that I used it for recently; a 65-year-old fellow with a fairly aggressive type of bladder cancer. It's called high grade, which is when they look under the microscope, they see the appearance of the cells, and they appear quite aggressive. And this fellow is treated with standard treatment, which is to remove the bladder tumour by a surgical procedure, and then to burn the area where the tumour was located, to try to kill off as many cells as possible. And so, his tumour recurred, and it was invading into the muscle wall of the bladder. At that point it gets concerning that it may be starting to spread, so he was told to have his bladder removed; complete removal of the bladder, and then a procedure to collect the urine in a loop of bowel that's inserted into a hole in the wall of the abdomen, so it collects urine into a bag from this, it's called an ileal conduit, that's the medical name for it, but basically the removal of the bladder and the urine drains into a bag that's attached to your abdomen, and he was obviously not too happy with this.

So, he came to us and said, look, do I have any other options? We chose LDN. He did have a little bit of insomnia with it, so he got a sleeping pill to go with that. He also took one course of immunotherapy called BCG, which is a bacteria that gets injected into the bladder.

With that and LDN, after four months of treatment, there was absolutely no evidence of cancer. He was cancer-free, I think, for up to about seven years. It was when we had the last contact with this fellow. So again, very, very dramatic results. In this case, it was combined with an immunotherapy called BCG, but he received only one course of BCG, which is really very limited and is not expected to be curative when you have cancer that's invading into the muscle wall of the bladder. So, I'm sure the LDN contributed to that quite significantly.

Linda Elsegood: I know people always ask these questions and it's probably not that easy to answer, but how long does it take being on LDN before you notice that it's doing something for your patients?

Dr Akbar Khan: Well, LDN, it is, as you know, a gentler drug. You cannot compare it to chemo. If you do chemotherapy for cancer, typically that's effective very quickly, within weeks, whereas for LDN, just because of the mechanism; the way that it works, we usually say, give it about three months to judge if it's effective or not for your case.

With LDN, we want to give it to a patient that has cancer where you have that kind of time. You have the luxury of some time to allow treatment to work. You know, if it's slow-growing cancer, or if they really have no other option, then that's appropriate to use LDN. So yeah, we recommend at least about three months to give it a good try.

Linda Elsegood: Okay, right. Well, we're back and I would like to ask a question first before we start taking callers. I had a message from a lady called Tracy, who asked if LDN helps with chronic leukaemia.

Dr Akbar Khan: Yes, we have used LDN for chronic leukaemia. She's probably talking about chronic lymphocytic leukaemia; that's the most common type of chronic leukaemia. We have used it for that, and yes, it is effective for that type of cancer.

Linda Elsegood: How would they go about approaching a doctor to prescribe LDN?

Dr Akbar Khan: Okay, so basically, I think what I would recommend is that they present the doctor with some published research on LDN, and probably the easiest way is to go onto the LDN research trust website, and they can find some links through there.

They could go on our website as well, where we have links to different studies on LDN, or they could even email me if they need some assistance. You can provide them Linda with my email, I'm happy to take direct emails from patients, but I think that the best approach is really to introduce LDN by presenting some published research to the physician. Otherwise, they're going to be very sceptical of the potential benefits of LDN. When you think about LDN when you know how it works, and what is normally used for, you would not connect it with cancer treatment. So, I think that the patients will encounter some resistance initially from their physicians, and so it’s really important to arm yourself with the scientific information first.

Linda Elsegood: And I have to say, you do an amazing job as one of our medical advisors, and I know you're always happy to help doctors who have questions, and want to know about cancer and LDN, and that is so kind of you to take the time to help and support people wherever they are. It's very good. Thank you very much.

Dr Akbar Khan: No problem, and it’s a pleasure to help.

Linda Elsegood: Thank you. So now we have Robyn who has got a question for you about Hodgkin's lymphoma. Would you like to ask Dr Khan your question, Robyn?

Robyn: Yes. Thank you. Yes, I'm wondering if you've had any experience with LDN and Hodgkin lymphoma specifically, there's like five kinds of Hodgkin, and four are classic, but there's a fifth one that's a bit rarer called nodular lymphocyte-predominant Hodgkin's lymphoma, which acts a little bit more like non-Hodgkin's in that it's slow-growing. I guess I'm curious what your experience has been with either non-Hodgkin's, you know for slow-growing cancers, for that specific Hodgkin's.

Dr Akbar Khan: Okay. So, we do use LDN for lymphoma. In our practice, we mainly see non-Hodgkin's lymphoma. Probably because the oncologists treat the Hodgkin's cases with more of curative intent, but that's that. You can use LDN for both Hodgkin's and non-Hodgkin's lymphoma.

We have used it successfully, mainly for non-Hodgkin's, as I say, but by the mechanism of action of LDN, it is considered a very broad sort of cancer treatment. It doesn't matter so much what subtype of lymphoma you have, or what subtype of leukaemia you have, you can try it, and especially for slow-growing cancer, it's considered safe to try.

Especially if there's no other treatment option at that time, then definitely it's appropriate. If there's a conventional treatment being offered, then you may want to combine it initially, but for slow-growing cancer, it's actually quite safe to try.

Robyn: Great. I appreciate it. I think it sounds like something he should try. Thank you for taking my call. Bye-bye.

Linda Elsegood: Bye-bye. Thank you. Would you like to reply to some of the emails that were sent in Akbar?

Dr Akbar Khan: Oh, for sure. Yeah. So, I'm, I have a message here from Jill, which says ‘I've been reading about theories that some cancers might actually be a form of autoimmune disease because inflammation helps feed the tumour.

Can I share any insights or explain?’

So, there is a connection between autoimmune disease and cancer, and the connection is that chronic inflammation in the body does predispose to forming cancer. So, there are many examples of that; for example, if you have a chronic infection of, let's say the liver, like chronic hepatitis, then you are more at risk of getting liver cancer.

If you have chronic acid reflux, like acid backing up from the stomach into the oesophagus, that creates inflammation. That inflammation can result in cancer of the oesophagus. If you have an immune disease, like Crohn's or Colitis, that also creates chronic inflammation and long-term inflammation of the bowels and then you have a high risk of colon cancer. So there definitely is a connection, and on that basis, LDN can be used as cancer prevention. Now we are using it in our practice for that, even though it has not been formally studied. At this point, it's more theoretical, and it makes good sense that there's solid science that supports the use of LDN as cancer prevention in the case of autoimmune disease.

However, as I said, specific research has not been done. It's a very complicated study that would have to be done. It would take about probably about 15 to 20 years to conduct such a study. So, you know, we really don't have time to wait that long for this kind of study, and the funding for that study is also not in place, so we are actually going ahead and using LDN for cancer prevention in the case of autoimmune disease,

Linda Elsegood: What would the protocol be? I mean, would it be part of several things that you would do for prevention, or would it just be purely LDN?

Dr Akbar Khan: We would probably do several things. I think you know, LDN is definitely a useful component. We also believe in using high doses of vitamin D; that's well researched now. We believe that diet can definitely play a role; physical activity, and there are other supplements that can often be useful for cancer prevention. So, we usually do a comprehensive program for our patients. It's quite simple and very, very cost-effective as well. I believe it can be quite powerful. Would you like me to go on to do further questions?

Linda Elsegood: Before you go any further; it was interesting what you said about diet. We had a program last week on diet and exercise, supplements and so on, but what would be the ultimate diet for somebody who had got cancer in the family, and was taking steps as a preventative, alongside LDN? What kind of diet would you recommend?

Dr Akbar Khan: I think there are a few things. So, I'm not the expert on diet, but, one of the most important things is a diet that's low in processed sugars, and probably low in carbohydrates in general. That has been shown to be detrimental in cancer patients because cancer actually uses glucose or sugar as the main energy source and having a diet that's high in glucose, well first of all, if you have cancer, that can be a problem, that has been studied already if you're consuming a lot of sugar then it increases your blood sugar levels and that can drive cancer growth. Whereas prevention, if you take a diet that's high in simple sugars than processed sugars, that one is it can increase your glucose levels in the blood, but then your body does combat that with insulin secretion. So, the other thing is a high insulin level can also tend to drive cancer growth, so we recommend for that reason, a diet low in carbohydrates, and especially those that raise the blood sugar.

I mean, the diet's a very complex topic and really I'm not the expert, but this is one of the key areas, and the other thing that's very important now is to look at the quality of the foods that we're getting because there are many chemicals that are added to the foods. There are genetically modified foods that we're eating and they also have the potential to cause inflammation, which can lead to cancer as well.

So I think if the listener wants a more detailed explanation, they're going to have to consult with your other experts because that's not my area of expertise, but these are some of the basic points that we emphasize to our patients.

Linda Elsegood: A friend of mine, Sammy Jo, has sent a question and she says

that it's a great show and to thank you very much. She said she has a relative with mild breast cancer who followed her advice to find an integrative oncologist to try LDN. Her question to you is, out of all the patients you've treated, how many had similar breast cancers and what was the outcomes?

Dr Akbar Khan: Yeah. So what was the type of breast cancer that you said?

Linda Elsegood: It just said mild breast cancer.

Dr Akbar Khan: Oh, okay. Yeah, so actually it’s very interesting. We just treated a lady, she's about 50 years old, and she had a very aggressive type of breast cancer, which is called triple-negative. So, it means it has no estrogen receptors, no progesterone receptors, and no, HER2 receptors. Those are proteins on the cell surface that are tested when the cancer is removed at surgery, and they help guide the treatment. So, if it's triple negative it has none of those receptors; what that means is it doesn't respond to anti-estrogen drugs like Tamoxifen, and cancer also does not respond to one of the newer targeted drugs like Herceptin.

So, it has very limited treatment options. Basically, in conventional treatment, it’s limited to chemotherapy. So, this lady had surgery done and then she did have residual cancer in the body, which we detected through the blood, and we treated it with LDN. You know, typically for this type of aggressive cancer, I would not expect LDN to really be effective, however; it reduced her cancer and kept it under control for over a year, and then it did start to grow again. I was very impressed; I totally did not expect any results with LDN in her case, but the reason we chose LDN was that she wanted a very gentle therapy that had almost no side effects, and she was scared to take other drugs at the time. So, to me, that's very impressive; to treat a triple-negative for over a year, and we could prove that cancer actually had reduced and was under control for that time. I was very impressed.

Linda Elsegood: Yes. If you could read out another question that would be great.

Dr Akbar Khan: Sure. So, we have a question from Lynn, which says, ‘for 18 months I have been treated for low-grade bladder cancer—initially resected, but it has recurred a couple of times; very small and been treated with diathermy. So, I am told if it recurs, I will need local chemo to the bladder, which I want to avoid. I take 1.5 milligrams of LDN for autoimmune disease and am feeling very well. I take vitamins under naturopath supervision. Can you offer any advice?’

So,1.5 milligrams of LDN may be effective, but it may not be enough. You know, for our patients for cancer, we usually try to get them up to at least 3, up to 4 or 4.5 milligrams of LDN every day. I think that, you know, for somebody who has bladder cancer, who is taking LDN, and despite the LDN at 1.5 milligrams per day, that the cancer is recurring, then I think the LDN dose needs to be increased. So that's the first thing I would do if this was my patient. Then the second thing is, well, she's already under the care of a naturopath, so that's very good because then they will be combining other vitamins and probably other supplements that have anti-cancer activity.

And so then the other thing is, you know, we can look at other drugs which are sometimes more powerful than LDN, drugs like maybe DCA or maybe, like in the case I mentioned before, LDN combined with an immune therapy called BCG. You know, she could definitely consider trying that, but she'd have to speak to her urologist about that, and then...what would you like me to go on to? Any further questions?

Linda Elsegood: Before you go onto another question that just occurred to me. Many people say when they have cancer, what dose should they start on? And what should they try and work up to? And you did say 3 or 4.5, but what does do you normally start the patient on?

Dr Akbar Khan: Okay, so we usually start the patient on...for adult patients we start at 2 milligrams because there is quite a variability in what their responses are going to be to LDN, and what their side effects are going to be. So, we use, this is just my preference, we use one-milligram capsules because it’s convenient.

We start them with two capsules at bedtime, and then we gradually increase up to 3 and then up to 4 and to me, you know, I know the standard dose is 4.5 between 4 and 4.5 is really not a huge difference. So, we just target 4 milligrams as the highest dose that we would use. We start at 3, and we work our way up to 4, and along the way, some people have a lot of sleep disturbance, maybe at 3 milligrams, so we'd tell them, hold the 3 and then see if that settles down, and then if they eventually start to settle down, their body gets used to the LDN, then we would probably try one more time to step it up. Then if they get a lot of side effects, then we'll go back to 3, but generally, my target dose would be 4.

Linda Elsegood: And have you noticed any other side effects other than sleep disturbance?

Dr Akbar Khan: Well, usually it's an asleep disturbance or sometimes vivid dreams. They report that they remember their dreams; they're very intense. Other than that, really nothing significant. I had a couple of patients report some strange side effects, which to me did not seem like LDN, but one patient reported some ringing in her ears and it seemed to resolve after she stopped the LDN, but to me, that didn't really seem like it was LDN. It’s probably coincidental.I don't think it was really LDN side effects, then there were other patients that report other things, but they're not consistent. So, I really don't think they're LDN side effects. So, pretty much sleep disturbance and dreams; I really don't see much else.

Linda Elsegood: And one another question that a lady asked us was when you start LDN for cancer, do you have to continue taking it?

Dr Akbar Khan: Yes, you have to continue taking it, you know unless cancer disappears. If it disappears like that tongue cancer patient, then, you know, theoretically you could try coming off it, but then you have to follow very closely because it's possible that the cancer is in remission, but there's still some microscopic disease.

In other words, there are still some cells there, and the LDN has suppressed their growth and killed a number of the cells, but there could still be a small amount of cancer that's not detectable. So generally I do recommend people continue, however, if they do achieve a full remission at some point, you know, they can consider coming off the LDN with very close monitoring to make sure that cancer does not come back.

Linda Elsegood: If you have time for another question, that'll be good.

Dr Akbar Khan: Yes. We have a question here from Carolyn, and she says, ‘I was diagnosed with pancreatic cancer stage two B in October. I've taken Tramadol 50 milligrams for pain since September. My clinic wants me on LDN, so I have been slowly weaning off Tramadol using ibuprofen and CBD topical cream and oral sprays’. The CBD is a marijuana preparation for those who are not aware of that. ‘I take Tramadol, once every eight hours, and now the pain is starting to break through more often. What else can I use for pain, so that I can finish tapering off the Tramadol, with the intent to go on LDN?’

Okay. So, this is a very important question. One of the reasons that you cannot use LDN is if you're taking a pain medication which is of the morphine family, the opiate family, that includes Tramadol, morphine, codeine, oxycodone, hydromorphone, fentanyl, and those class of drugs because LDN will interfere with those drugs.

It will either cause more pain, or it may cause a full-blown withdrawal reaction, which consists of pain, vomiting, abdominal cramps, or sweats, and it’s really very unpleasant. So, anybody taking a chronic, long-acting painkiller of the opiate family, they really should not be on LDN.

They should not try LDN. So, since she is on a short-acting opiate painkiller Tramadol, she's trying to wean off that, and now the pain is breaking through. So, basically the point is that we need to transition her over to a different type of pain medicine that's not related to a Tramadol or morphine or Codeine.

So, in the case of pancreatic cancer, there is, based on the location of the tumour, a lot of nerves in the area of the pancreas and the tumour often pinches or invades those nerves, and that creates a type of pain that can be resistant to Tramadol or other drugs in the opiate family.

What I use for this type of pain is an anti-seizure drug. There's a couple of choices. I prefer a drug called pregabalin; the trade name for that is Lyrica. There's another older drug, which is called carbamazepine; trade name Tegretol, which is also highly effective. The older drug, the Tegretol has more drug interactions, so I tend to use the newer drug called pregabalin. I find that highly effective in patients with pains related to pancreatic cancer. Since that is a non-opiate drug, it is safe to combine with LDN, and LDN will not interfere with the action of that drug. So for Carolyn, and I would say, please speak to your doctor and go over the pain, the nature of the pain, explain how it feels and where it is, and if the doctor feels that it is nerve pain, it's called neuropathic pain, then ask the doctor to consider using a drug like pregabalin or carbamazepine.

Hopefully, that will successfully allow you to come off the Tramadol completely, and then you can be prescribed LDN, and it will be completely safe.

Linda Elsegood: Thank you. And you had spoken there about medical marijuana. Do you use that in your practice? Is it something you use in Canada?

Dr Akbar Khan: Yes, actually we do. There probably has been a lot of international news about Canada legalizing marijuana, so it's coming, so it is available now, and I think that because people know the law is coming, it's already widely available, and so we actually do use it. Since I'm not an expert on the cannabis oils, I refer to naturopathic doctors who are experts, and one of our own naturopathic doctors in the office is training, and he's learning about it, so we do prescribe it. In fact, the first case that I saw that sort of made me into a believer in using cannabis oils for cancer treatment was a very interesting fellow with bladder cancer stage four. You know, multiple areas of tumour spread into his abdomen, and he was treated with cannabis oil only. He came to us for consultation, we offered some other treatments to be combined. He declined those, and he said, no, let me kind of continue on the cannabis oil, for now, I want to see if it's working. That was his remark to us. We said, okay, no problem. We can do some monitoring of your cancer; we'll get some scans done. So, in fact, we scanned him when he first came to us, and then we re-scanned him about two or three months later, and we found that tumour had actually shrunk, and so that was the first case that really prompted me to have more interest in using cannabis oil as an actual cancer treatment.

You know, we documented very clearly tumour shrinkage in this fellow with stage four cancer using just cannabis oil treatment on its own. So, based on that, I'm more interested in it. Also, there is a naturopathic doctor in the Toronto area who published the world's first case of a child with leukaemia treated with cannabis oil successfully.

He showed very clearly the reduction in the cancer cells in the blood using the cannabis oil, and so that case is now published, and that's further evidence that cannabis oil can be successfully used as a cancer therapy. 

Linda Elsegood: That’s really interesting. Thank you. We'll just have another quick break, and if anybody has got any more questions, please do call in or email me linda@ldnrt.org.  We'll be back in just a minute.

The LDN research trust is very proud of the LDN book, which was launched at the LDN 2016 conference in Orlando, and has 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 home page of the LDN Research Trust. Discounts are available on bulk orders of the book, which is ten or more. For details, email me, linda@ldnrt.org telling me how many copies you wish and where you live. I will then be able to get Chelsea Green Publishing to contact you.

Medicore Cancer Centres in Toronto, Canada are at the forefront of cancer prevention and treatment. They have developed numerous inhibitive programs backed by science with a goal to bring advanced cancer strategies to you. Learn more about Medical's approach and therapies@medicorecancer.com. Call +1 416-227-0037.

Linda Elsegood: Okay, thank you. So, do you have any other remarkable stories you could share with us Akbar? 

Dr Akbar Khan: Definitely. Yeah, sure. So, I can tell you about a patient with lymphoma. There's a lady in our practice, mid-fifties with the non-Hodgkin's lymphoma. And she herself is a homoeopathic practitioner; doesn't believe in taking drugs and definitely not taking chemotherapy.

The standard treatment for this type of lymphoma would be chemotherapy. She approached us and wanted to start a very gentle treatment. And so again, we thought of LDN. It's really the most gentle drug treatment that I have for cancer. So, we started her on LDN, and she worked up to about 4 milligrams a day at bedtime. In addition, our naturopathic doctor gave her some glutathione intravenously, which is a natural product, and then she did have some sleep disturbance. So, for sleep disturbance, we added a Magnolia tree extract, which contains, the natural chemical called honokiol. The trade name of this particular product is HonoPure, so it has 500 milligrams of honokiol

This natural product is actually excellent for sleep. It helps calm anxiety, and it has anti-cancer effects; multiple mechanisms of an anticancer effect that are defined by published research. So, we gave her that as a sleep aid, but also as a booster for the LDN. Her initial imaging, her ultrasound, showed extensive disease in her abdomen; deep in the abdomen where you typically see a non-Hodgkin's lymphoma which is called a retroperitoneal enlargement of lymph nodes, so that was measured and we continued the LDN, and then we repeated the ultrasound after the number of months. The largest tumour initially was about 3.4 centimetres, so, I don't know what's that, about an inch and a half, I guess for your UK listeners. Gradually it reduced to about half that size over a period of one year. The patient felt well, her appetite improved, and so she continued taking LDN, and she continued her own homoeopathic and natural regime on top of that. She actually started cutting back the LDN, I think, more through laziness, you know, but also she was taking her own supplements on top of that, but she's alive and well at this point; I think it's about four to five years. So, clearly, you know, in her case, at least at the beginning of therapy, we demonstrate that the LDN, with potentially a boost from this natural product, called honokiol was very effective for her non-Hodgkin's lymphoma. Again, a very good case, you know, with minimal side effects. I think that's probably one of the most remarkable things about LDN if it happens to work for your cancer, it is truly remarkable, because of the minimal frequency of side effects, and also the trivial nature of those side effects.

It is so dramatically different than almost all traditional cancer therapies, drug therapies, I'm talking about like chemotherapy, you know, I mean, I think most people are well aware that chemotherapy has very severe side effects, including death because it can severely depress the immune system and it puts you at risk for infection.

People die every day from infection caused by chemotherapy. This is well known, and one of the accepted risks of chemotherapy, yet nobody dies from taking LDN, and we have people with cancers that shrink and stabilize and occasionally go into full remission using LDN.

So, I'm really happy to be here on the show and getting the word out because I want doctors to understand that this is a potential therapy that can be part of their arsenal against cancer, and not every patient needs to go and take a traditional toxic therapy, especially those that are risk-averse, and those that understand the risks and benefits of therapy like LDN, which is unapproved, yet still has extensive research that supports it.

Linda Elsegood: And I have another question for you. It says, would you recommend LDN for patients with a history of basal cell carcinoma and family history of melanoma? 

Dr Akbar Khan: That's a very interesting one. You know, basal cell carcinoma is a type of skin cancer that is often cured by surgery, and it does not really spread through the body. It's actually quite rare for that cancer to spread, so it's non-aggressive cancer. If it's caught early it can be removed surgically, unusually it's cured, so we don't tend to get patients with basal cell carcinoma in our practice. They're usually referred to the plastic surgeon to have these removed, so I can't say that I personally have experienced treating that cancer type, however; due to the nature of that cancer it tends to be slow-growing, and it does give you the opportunity to treat with LDN. So, if there's a patient who's interested in treating that cancer with LDN, I would say speak to your doctor, and I think it is worthwhile to give it a try, especially for anybody who has recurrent basal cell carcinoma. If you have new cancers continuing to pop up, I think LDN has a role in prevention, as well as treatment, and it can reduce the need for surgery if, if it does in fact work, and I believe it will work in a percentage of cases. So, I do think it's worthwhile treating. In addition, if there's a family history of melanoma, then the LDN can be used as part of a cancer prevention program.

I do also recommend that the patient speaks to the doctor about using vitamin D. I recommend high doses ranging from 5,000 units a day, up to even 15,000 units a day with a regular blood monitoring to make sure that you're at the correct blood levels. And then also to make sure there are no side effects from the high dose vitamin D, like a high calcium level in the blood, which is a rare side effect. I do recommend speaking to the doctor about LDN, I think it's a very good choice.

Linda Elsegood: And I have a question here from Dennis for you, and I apologize, I probably won't pull out some of these words correctly. He says, ‘my wife has recently been treated for bilateral ILC stage one, grade two, lumpectomy surgery, clear margins.

BRAC therapy and two rounds of TC chemo. She stopped early due to severe neutropenia’.

Dr Akbar Khan: Okay. Yes. All right. So, that's neutropenia, which means low white cell count. This is a patient with cancer of both breasts. An ILC is, I'm assuming, that's invasive lobular carcinoma, which is one of the types of breast cancer.

The patient's having side effects from chemotherapy, which basically amounts to severe immune suppression. So, she stopped and chemotherapy, so, I think that's a good opportunity to get onto LDN for a couple of reasons. One is obviously because as we've talked about, LDN can be an effective treatment for residual microscopic disease. That is microscopic cancer that’s present in her body, and also it can be an immune modulator; it can enhance her natural immunity, and so with the low white cell count, this is probably a good time to get on the LDN to boost your immune system. This is why she should look into using vitamin D, which is probably also an important part of improving her immune function, and you never know, she may be deficient in vitamin D, which makes it even more important. So, she should have her vitamin D blood level checked by her physician and then take the appropriate dose to bring the vitamin D level up into the higher normal end of the range; that's usually our target in our practice, and we find that's quite safe.  You know there's a theoretic concern of overdosing on vitamin D and causing a high blood calcium level and leeching calcium out of your bones, and I can tell this nurse that we monitor everybody with routine blood tests, and I have not seen that once yet in my practice in, I would say probably, well, first of all, in hundreds of patients treated with high dose vitamin D over a period of about, I would say now less than five years. So vitamin D supplementation is very safe, I think, very important to go along with LDN, but you have to do it correctly; you have to monitor the blood levels and make sure there are no side effects from that.

Linda Elsegood: And he did go on to say that she also has Hashimoto's disease, and had bilateral Thyroidectomy in 2014. Would the use of LDM possibly be preventative for a reoccurrence of cancer as well as helping with the Hashimoto's?

Dr Akbar Khan: Yes, so actually the LDN can prevent recurrence by controlling a microscopic residual cancer that's present in the body. You know, we've shown that, with the blood tests, in which we measure cancer cells that are floating in the blood.

This is not a standard test that most oncologists will be doing, but there are labs in the United States and in Germany that are doing these tests. We happen to use a lab in Germany, but there are other labs too. I'm sure in the UK there are labs that are doing the same type of testing. So, we measure cancer cells floating in the blood, and we can show that a treatment is effective or not effective, even though there's no obvious residual cancer showing on a scan. So, in the case of somebody with a thyroid removed for thyroid cancer, you know, you can monitor with blood cancer cell count. You can also monitor with a blood marker, which is thyroglobulin, for example, in the case of thyroid cancer, and you can make sure that these blood levels are staying in the normal range, which in the case of thyroid, it should be zero. So, these are ways to monitor that the LDN is actually effective, but the answer is yes, it can be used in the case of a patient with thyroid cancer that's been removed and she wants to prevent a recurrence.

Linda Elsegood: Now we have one last question, and I'm hoping that you'll be able to answer it. It's very controversial. You probably remember from the last three conferences I'm sure, that it's a question that came up Tramadol. Now, there are some doctors who, and pharmacists, that don't consider Tramadol as being an opiate, but say it works on, it’s a synthetic opioid, and it works on different receptors and can still be taken with LDN. I know that you just said that you get your patients off Tramadol. Do you look at Tramadol as being an opiate rather than a synthetic opioid?

Dr Akbar Khan: Well, to my knowledge, it is an opiate, but I don't happen to use a lot of Tramadol in my practice. I think if these doctors are using it and they're finding it can be used together with LDN, well that's, that's news to me.

I don't have the experience to be able to say yes or no to that. I would be very interested to know more about it, put it this way. So, as far as I know, if it's safe or not to use it with LDN, but I think maybe if you could ask  one of the other consultants from the LDN Research Trust, if they have experience using LDN together with Tramadol, that would be very interesting, and I would like to know. I think the listeners would like to know. Maybe you could post it on the research trust website. I think that would be very informative. 

Linda Elsegood: Okay. We have literally like three minutes left. Could you just give us another case study quickly?

Dr Akbar Khan: Absolutely. So, there's a question here from Jim.

He says, ‘I have friends with prostate cancer and have been treated. I have read LDN is effective for untreated prostate cancer. Is this correct? And in treated prostate cancer, would it be helpful in preventing metastasis?’ So, we do have experience with LDN and prostate cancer, and we find that it is effective.

It can stabilize, or it can reduce prostate cancer, and we measure that with a blood test called PSA; that's the most common way to monitor prostate cancer. Now, in addition to scans, and you know imaging of course. So, untreated prostate cancer, yes, we have patients who have come to us and don't want to take the standard hormone treatment because of all the side effects, you know, testosterone-blocking drugs are the standard treatment for prostate cancer, and there are numerous side effects from those treatments. So, I have successfully treated untreated prostate cancer; people who have not taken hormone treatment with LDN, and it does work, I can say that. That's very clear; we've documented that. In people who haven't been treated for prostate cancer with hormone treatment, and it's failed, Dr Bihari’s experience as reported on the LDN info website, is that the LDN is not effective for those cases. So, based on Dr Bihari’s experience we've avoided using LDN for hormone resistance cases of prostate cancer. So I can't really comment on those, because we tend not to use LDN for those cases, and whether it helps in preventing metastasizes in previously treated and hormone-resistant prostate cancers, based on Dr Bihari’s information, LDN probably should not be used in those cases, but I can't say firsthand, because we were going by Dr Bihari’s experience.

We don't want to waste the patients’ time in treating them and get a lot of failures. So, we really don't have experience with LDN in hormone-resistant prostate cancers.

Linda Elsegood: What cancers would you say of that 2000 plus that you have treated, is the most common cancer that you've seen?

Dr Akbar Khan: We see a lot of breast cancer. I think LDN is very good for breast cancer. We've treated many lymphoma cases, it's good for those. I think probably for melanoma, although I haven't used it as much for melanoma. I think again, that's a good one that seems to be responsive to immune-based therapies. So, LDN should be good for that. I've had a number of cases of bladder cancer; we've had good results. So, all of those cancers, and rare cancers too. I mean, f there's cancer that is quite rare, and so there's not a lot of research done on that particular type, and the oncologists are not sure what to use to treat that cancer. If it's slow-growing cancer, if there's time, to give it the opportunity for LDN to work, then I think that LDN is an excellent choice as something to start with, while the patient is looking around for different treatment options. So those are kind of the most common cancers that we've used it on, and we've seen some excellent results.

But in theory, it can be used for any cancer, and in my experience, it should preferably be used for cancers that are slower growing, not really for very rapidly growing cancers, because you don't have enough time to give the LDN adequate chance to work, and also for patients with low disease volumes, so not an extensive amount of cancer in the body.

Linda Elsegood: I'm going to have to stop you there. Thank you very much, and I'd like to invite you back next year and we'll talk about the conference.

Dr Akbar Khan: Thank you very much.

Linda Elsegood: Medicor Cancer Centres in Toronto, Canada, are at the forefront of cancer prevention and treatment. They have developed numerous inhibitive programs backed by science with a goal to bring advanced cancer strategies to you. Learn more about Medicor’s approach, and therapists that medical cancer.com or call +1 416-227-0037

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.

Bridget - US: Ankylosing Spondylitis, Fibromyalgia, Insterstitial Cystitis, Depression (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Bridget from the United States shares her experience of LDN for ankylosing spondylitis, fibromyalgia, cystic cystitis and depression. 

Bridget first noticed symptoms when she was  ten years old. It was 1994, and she started having problems with her left hip and she ended up on crutches for 3 years, then it started to speed to other joins and the other hip.

By the time she finished high school, she was half-crippled.

When she was 21, 11 years later she was diagnosed with ankylosing spondylitis, fibromyalgia, depressions and interstitial cystitis, she was on a lot of medication which wasn't helping.

Before LDN, her quality of life was 3 or 4 out of 10. on a good day. And now it is a 6 to 10!

To listen to the full story click the video link.

Any questions or comments you may have, please contact us. I look forward to hearing from you. 

Angela - Wales: Multiple Sclerosis (MS) (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: I'd like to introduce Angela from Wales who has Multiple Sclerosis. Welcome, Angela!

Angela: Hi, Linda!

Linda Elsegood: Could you tell us when you first noticed your MS symptoms?

Angela: I think it was about 6 years ago, but I didn't know obviously that it was MS.

I think the first sign was when I noticed I woke up in the morning and one of my legs was feeling very numb.

 I think that went on for a couple of months and I just put it down to sleep. Being busy, working and with a family, I just ignored it, and it just went away. So I didn't think anything more of it. I think about 5 years ago I'd come back from a holiday in Canada and thought I had a virus.

I went back and forth to the doctors. They couldn't diagnose what was wrong with me. Then I lost all the feeling in my legs from my feet right up to my head and obviously got admitted into a hospital for tests and was eventually diagnosed.

 Linda Elsegood: What impact did it have on you being diagnosed?

Angela: It was very tough. I recently got divorced and it wasn't a great time. And it might've been to do with the sort of stress of that situation. My mother-in-law from my ex-husband had MS, and she had it for many years. I just thought I was going to end up the same state as she was, which wasn't great.

There was no real treatment that she seemed to have. She could hardly walk. She's in a wheelchair and basically didn't do anything with her life so I thought it was tough ending up like that.

Linda Elsegood: It's a very scary prospect, isn't it?

Angela: It was. When the consultant when I first was in the hospital said: " I think you're too old to have the MS." I was 46 at the time and then, of course, when they did the MRI scan and I came back to see her, and he said, well, no, actually you have MS. And thank you very much. Bye-bye. And handed me over to be off the floor. The consultants aren't that great at dealing with this sort of thing.  I just found it really difficult to talk to anyone because I just had in my mind this picture of my mother in law so it wasn't great.

But then you pick your server, and I think, they review you after 3 months, that to see whether you've got the real nasty type, and after 3 months then, maybe you realize it's not as bad. Your life still can carry on even with this diagnosis.

Linda Elsegood: So what was your MS like before you found LDN?

Angela: I think it was getting steadily. They say I have a benign type. I don't think I have the relapsing-remitting type, but every day I have symptoms.  I remember it was a Christmas time, and my daughter had come with me to try and go shopping, and I literally walked into a max shop with my daughter.

We just really walked into the shop, and I just had to say to her," I'm sorry, I've got to turn around and go home." I just felt I couldn't even walk around the shop. My legs just felt so bad that day, so it was like the numbness and the weird sensation, you know?

So I just knew. They weren't going to carry me the shop. So I, it had a huge effect on the quality of your life because I was still working, I'm still working now but I wasn't there without the LDN if I would still be working. The sort of extremes of temperature really affect and we were having a pretty cold winter. It just sort of really limit what I could do. I don't think the LDN has had any miraculous effect, but I think, most of the time keeps me stable and it hasn't gotten worse. I've had a bad virus of that time, and I've had a few problems since then with the mobility, but I think that's bound to the virus.

I think in terms of the fatigue it's had a huge effect on just keeping going and keeping outdoors. I think it's kept me stable.  I don't know where I would be  but I know at that time I was really starting to struggle.

For the next two years after I had this virus My mobility hasn't been perfect by any means but it definitely improved things. I think it gave me a bit more confidence. You sort of tending to sing like, no, I can't go out. I can't do this. I can't do that.

I mean, the only side effects I had when I first started to take it, I have a lot of spasms in my legs and I had a lot of muscle stiffness for the first two weeks, so I said: " Oh my goodness, this is going to make me worse."

But I persevered with it, and it's been fine. I haven't had any sort of bad sleep or anything like that. I tried to take the LDN in the morning and that doesn't suit me. It suits me better to take it in the night. So I just take a tablet at night from and that seems to work better for me.

Linda Elsegood: Did you have any other side effects?

Angela: I had the usual, sort of a nice fog, bad headaches, feeling a bit spaced out, dizzy and fatigued basically.

It was just horrendous, lots of sensation, bladder problems. I was taking antibiotics because I was having constant infections but now I realize all these years later that it was probably the MS. Now I haven't taken antibiotics for over 18 months I think. So I think it's definitely had an effect there. It's helped the bladder problems, the fatigue. At one point I was starting to get, not depressed, but starting to get very down about it all so it's helped to keep me positive with things. Once you lose your positivity, then you might as well give up.

Linda Elsegood: So how would you compare your quality of life now with before LDN?

Angela: Until I had this recent virus I would push myself to do more or less what I used to do. But within limitations I know I can't go walking huge distances but  I kept working. I've kept trying to keep the standard of what I do in my work up to what I used to do. I just feel it stabilize me somehow. I really didn't know where things were going to end up. I just thought my general wellbeing was a lot better. I think it lifts my energy levels really.

The other things that I used to have was problems in my eyes, flushing lights and  I'd see lots of spots in front of me. I don't seem to have so much in that either so I guess I got to rely on LDN and keep on thinking,  I'm afraid not to take it now because I don't know where I would be. Some people might think it's a placebo but I just feel it stabilized me certainly.

This virus has given me a bit of bronchitis but LDN keeps me stable.

Linda Elsegood: What would you say to other people who are contemplating trying LDN?

Angela: In the job I do, I've got lots of people, 9,000 people at work.

Some of them unfortunately also have MS, and they're very scared to take anything without a neurologist or doctor's advice. And what I would say is,l:" As far as I'm aware, there are no side effects." I think for the type of ms that I have, there are no treatments, no drugs so it's not doing me any harm.

It may be going good. I don't think you've got anything to lose really. Some of the drugs and I've been lucky enough not to need them, like Methotrexate it is basically poison, isn't it? So you're poisoning your system. I mean, they are drugs that they use for chemotherapy. As I understand it,  there must be a body of research in LDN to show that there aren't huge amounts of side effects. It goes to your system for four hours and it doesn't affect any of your major organs or anything else. So why wouldn't you try it?  I would just say give it a try. It might work for you, It might not,  It might have fantastic results just like me,  to keep you stable. All I can ask for is to try it. The medical profession doesn't have all the answers. If enough of us are taking this and finding benefit from it, then just gotta be something in there.

Linda Elsegood: Okay. Well, thank you very much for sharing your story with us.

Angela: You're welcome.

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.

Katie gives an update on taking LDN for Fibromyalgia, Interstitial Cystitis, GERD, IBS (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Katie from the US gives as an update on taking Low Dose Naltrexone (LDN) for Fibromyalgia, Interstitial Cystitis, GERD, IBS.

Katie suffers multiple autoimmune conditions including Fibromyalgia, which caused pain, extreme fatigue, and foggy brain. She eventually learned about Low Dose Naltrexone (LDN). After experimenting with various doses, she found her sweet spot at around 4 mg. She is excited about her new energy and pain relief. She is thankful to be thinking clearly again!

Review by Ken Bruce