LDN Video Interviews and Presentations

Michael McCaughley, MPharm IP - LDN and Long COVID - 2022 Conference (LDN; low dose naltrexone)

Linda Elsegood: Today we're joined by pharmacist Dr Dawn Ipsen who's the owner of two pharmacies in Washington state. Kuslers Pharmacy and Clark Pharmacy. Could you tell us what it was that inspired you to become a pharmacist? 

Dawn Ipsen: I knew early on as a high schooler that I wanted to have a doctorate degree in something and was sort of a little bit torn between pharmacy and optometry and with long heartfelt discussions and soul-searching I became a pharmacist and very early on in my career not only was I trending towards being a pharmacist but I had an opportunity to intern at a compounding pharmacy and just absolutely completely fell in love. It was the art and the science and the way of being able to help individual patients in manner of which no other pharmacist in my area was able to do so, of providing very personalized therapies. I was able to really listen to patient needs and work with their doctors, to formulate the exact therapeutic tool that they needed to improve their quality of life. That is really what has driven me in my career. 

Linda Elsegood: When did you open your first pharmacy? 

Dawn Ipsen: I had been a pharmacy compounding lab manager for about 10 years for the Kusler family. When they were ready to go do other things in their life I was given the opportunity to purchase Kusler's Compounding Pharmacy. It had been a pharmacy I had worked at as a staff member for 10 years and took over as the owner and I've now owned that pharmacy for almost 10 years. In January it will be 10 years. That was my first pharmacy. 

I was doing all my good work up at my Snohomish Pharmacy and suddenly had a random phone call on a Friday afternoon in which the Clark family was looking for a new owner for their pharmacy. They were ready to retire and go do other things as well. I've also owned Clark's compounding pharmacy down in Bellevue Washington for six years. I've been an owner for almost 10 years total and have had multiple locations now for about six years. We service not only the entire state of Washington but we also work within nine other states as well. Our boundaries go quite deep and it's a really great way to help all types of patients all over the nation. 

Linda Elsegood: What would you say is the most popular form of LDN that you use the most? 

Dawn Ipsen: I would say primarily we use the most customized strengths of capsule formulations of low dose naltrexone (LDN). It gives patients really great consistency yet opportunity to get the doses titrated in appropriately where they need it to be. What's really great about how we approach our making of capsules is we use hypoallergenic fillers. We're also able to work specifically with patients who have sensitivities. We can customize what that filler might be and I think that's really what sets our pharmacies apart and why doctors and patients choose to work with us. 

We are experts in autoimmune and chronic inflammatory diseases and therefore we're very used to working with patients where the normal just isn't what they need and isn't what's best for them. We can customize that to be appropriate for them. Along with capsules of course, we are able to do transdermals. That's really popular in pediatrics, especially for patients with an autism spectrum disorder. We are able to make flavored liquid tinctures of it so patients are able to use various small doses to titrate up doses. We also make sublinguals. I would say capsules are pretty popular for us. 

Linda Elsegood: What kind of fillers are you asked to use? 

Dawn Ipsen: Most of the time I will steer a patient towards microcrystalline cellulose (which is a tree based cellulose). It is very hypoallergenic for a lot of patients. However, some patients know they have tree allergies and those patients primarily prefer rice flour. I do have a couple of patients, but very very rare that actually do better on lactose filler. They tend to not be my autoimmune patients. They tend to be patients in the chronic pain spectrum area. 

We have also worked with other fillers, like tapioca flour. We can be very customized into our approach of how patients need it. I've got one patient that comes to mind that loves magnesium as their filler and that's very relaxing for their muscles. I've also seen probiotics being used. There is not one right answer to how we do things. We are that pharmacy that is able to have a conversation with a patient. We talk about what their needs are and customize it based on that approach. 

Linda Elsegood: From the prescribers that you work with, do you have many consultants that you fill scripts for? 

Dawn Ipsen: We definitely do. What's also kind of a little side thing that I do. I've always been very passionate about teaching. I'm on faculty at University of Washington School of Pharmacy and also Bastyr University which is one of the top naturopathic doctor schools in the nation. I teach there during summer quarter. I teach nationally to providers continuing ed-based content that is often LDN in nature or ties into LDN. Especially with autoimmune and chronic pain and chronic inflammatory conditions. We consult a lot with doctors. I probably work with three or four hundred functional med type providers on any monthly basis even on being able to customize therapies for their patients. We are really big in the post COVID syndrome arena of helping patients that are really struggling and LDN. We're finding it pairing quite nicely in that condition as it's very inflammatory based. 

We work quite heavily within the MCAS arena for patients who have a lot of mast cell instability and need other therapies. LDN is one of the tools that is used quite frequently by those types of providers and for those specific kinds of patients. 

Linda Elsegood: Do you work with any pain specialists, dermatologists, rheumatologists, gastroenterologists? 

Dawn Ipsen: We do. Honestly, I'm quite proud of our little Seattle area of Washington because we do have MDs that are pain specialists that are now really turning towards using LDN in their toolbox of things they have available for patients. They're getting quite savvy at it. They're doing a really great job. It is super exciting. I have some dermatologists. I consult a lot with my functional med providers that are seeing dermatology conditions like psoriasis. I have an email I need to work with a doctor on after this to help them with this patient with a psoriasis case. We are seeing it in the GI world as well for Crohn's and irritable bowel disorder. Those chronic inflammatory conditions. I would say the MD pain specialists are really turning around over here. Obviously with the opiate crisis that has occurred in our nation I think most doctors of any type of credentialing or medical training or experience are quite interested in what LDN is doing for their communities and what opportunities it affords for patients who are trying to make sure they aren’t addicted to opiates but yet have something to improve quality of life and their day-to-day living. Low dose naltrexone (LDN) has been an amazing tool for that. 

Linda Elsegood: I'm always excited to meet different LDN prescribers and nurse practitioners who are providing lots of scripts. When you get an MD or a DO that is prescribing LDN and it is completely out of their comfort zone, I always think yes, you know we've got another one on board. We're making it right. We're getting it. MDs are already working outside of the box. That is normal for them to look into LDN it's not normal for MDs to look at LDN but as you know I've interviewed so many people and so many MDs when they have a patient that they can't help and fix their issues. They've tried everything and they feel as if they've failed this patient and then they try LDN. Once they have had amazing results with the first person it's then so easy for them to look into prescribing not only for other patients with that condition but for any autoimmune disease, chronic pain, mental health, etc. I mean it's really amazing and this is where people like yourself come into play. The hand-holding with doctors because a lot of them haven't got time to do the homework. They're very busy and they need somebody to tell them exactly what it is, how to prescribe it, what to look for, what to do and have somebody on hand to say, like you said, I've got a patient with psoriasis. What do I do? Can you help me? That is the way to get more doctors involved is the pharmacist doing the hand holding. 

Dawn Ipsen: There is a local psychiatrist in our area that works with younger adults with substance abuse disorders and teenagers that are having a lot of trouble with mental health. I had an opportunity to get him thinking about LDN and his patient population. I love when I get to reconnect with him every few months because he just raves He finally has a tool that actually does something. He felt the antidepressants and all these other things were not really fixing any of the issues or fixing the symptomatology. We still have the same abuse issues, we still have the same addiction issues and we still have the same levels of depression and suicide risk. But with LDN he's finding that he's actually causing positive change in his patient population and that's the only thing he really changed within his practice. 

We're really affecting the health of our community in a very positive manner with something that's really safe and low risk and not expensive. It doesn't get any better than that. It's the best compliment I could ever have. 

Linda Elsegood: It's really nice when patients take all their information to the doctor. Once you've got a doctor really hooked on prescribing LDN they can change the lives of hundreds of patients. Dr Phil Boyle uses LDN in his fertility clinic He also uses it in women's health for things like endometriosis, polycystic ovary, painful periods, heavy periods. Right across the board he uses LDN. He gets patients coming to see him with women's health problems who also have Hashimoto's or long COVID etc. 

Dawn Ipsen: I refer to his work all the time. I get questions a lot from local providers such as we have somebody who wants to become pregnant or they did become pregnant and they're on LDN and they want to know what the standard of care is and can we continue, and what's the risk and benefit are. It is so great to have providers like him out there that have been doing this work for so long that we can very confidently share those case experiences and history of using the medication long term for those patients. 

Linda Elsegood: There have been so many of our members who were skeptical about using LDN during pregnancy. Doctor Boyle is always very generous with his time. I will send him details and he will answer the patient and share his experience. You know we used it once up until birth rather and breastfeeding, etc. We have those people who have done two or three pregnancies using LDN who are happy to talk to other people. This is my experience with 20 years as the charity next year, which is totally amazing, but I’ve found that word of mouth and with the education it is just spreading. 

Dawn Ipsen: Linda, you've done an amazing job with the LDN Research Trust and I thank you for that. You have made the Research Trust, its website, resources and its books into a trusted referral point that I can use with our doctors and our patients who are wanting that next level of information beyond what I'm able to say to them. They want to go see those studies themselves. They want to go read the book themselves and I know that without a doubt I can send them to your resources for them to receive complete in-depth and correct information. Thank you, Linda. You're doing amazing things and this is all because of you. 

Linda Elsegood: How can people contact you? 

Dawn Ipsen: We have two locations in Washington State. We have Kusler's Compounding Pharmacy in Snohomish Washington and the website there is www.Kuslers.com; and then we have Clarks Compounding Pharmacy in Bellevue Washington. That website is www.clarkspharmacywa.com. The WA stands for Washington. We are happy to help patients all over and talk with doctors that need guidance and assistance in learning more. I love being an educator and I love being here to support my community. 

Linda Elsegood: Any questions or comments you may have please email me Linda linda@ldnrt.org. I look forward to hearing from you. Thank you for joining us today. We really appreciated your company. Until next time stay safe and keep well.

D

Today we're joined by pharmacist Dr Dawn Ipsen who's the owner of two pharmacies in Washington State, Kuslers Pharmacy and Clark Pharmacy. Could you tell us what it was that inspired you to become a pharmacist? 

I knew early on as a high schooler that I wanted to have a doctorate degree in something and was sort of a little bit torn between pharmacy and optometry and with long heartfelt discussions and soul-searching I became a pharmacist and very early on in my career not only was I trending towards being a pharmacist but I had an opportunity to intern at a compounding pharmacy and just absolutely completely fell in love. It was the art and the science and the way of being able to help individual patients in manner of which no other pharmacist in my area was able to do so, of providing very personalized therapies. I was able to really listen to patient needs and work with their doctors, to formulate the exact therapeutic tool that they needed to improve their quality of life. That is really what has driven me in my career. 

When did you open your first pharmacy? 

I had been a pharmacy compounding lab manager for about 10 years for the Kusler family. When they were ready to go do other things in their life I was given the opportunity to purchase Kusler's Compounding Pharmacy. It had been a pharmacy I had worked at as a staff member for 10 years and took over as the owner and I've now owned that pharmacy for almost 10 years. In January it will be 10 years. That was my first pharmacy. I was doing all my good work up at my Snohomish Pharmacy and suddenly had a random phone call on a Friday afternoon in which the Clark family was looking for a new owner for their pharmacy. They were ready to retire and go do other things as well. I've also owned Clark's Compounding Pharmacy down in Bellevue Washington for six years. I've been an owner for almost 10 years total and have had multiple locations now for about six years. We service not only the entire state of Washington but we also work within nine other states as well. Our boundaries go quite deep and it's a really great way to help all types of patients all over the nation. 

What would you say is the most popular form of LDN that you use the most? 

I would say primarily we use the most customized strengths of capsule formulations of low dose naltrexone (LDN). It gives patients really great consistency yet opportunity to get the doses titrated in appropriately where they need it to be. What's really great about how we approach our making of capsules: we use hypoallergenic fillers. We're also able to work specifically with patients who have sensitivities. We can customize what that filler might be and I think that's really what sets our pharmacies apart and why doctors and patients choose to work with us. We are experts in autoimmune and chronic inflammatory diseases and therefore we're very used to working with patients where the normal just isn't what they need and isn't what's best for them. We can customize that to be appropriate for them. Along with capsules of course, we are able to do transdermals. That's really popular in pediatrics, especially for patients with an autism spectrum disorder. We are able to make flavored liquid tinctures of it so patients are able to use various small doses to titrate up doses. We also make sublinguals. I would say capsules are pretty popular for us. 

What kind of fillers are you asked to use? 

Most of the time I will steer a patient towards microcrystalline cellulose (which is a tree-based cellulose). It is very hypoallergenic for a lot of patients. However, some patients know they have tree allergies and those patients primarily prefer rice flour. I do have a couple of patients, but very very rare, that actually do better on lactose filler. They tend to not be my autoimmune patients. They tend to be patients in the chronic pain spectrum area. We have also worked with other fillers, like tapioca flour. We can be very customized into our approach of how patients need it. I've got one patient that comes to mind that loves magnesium as their filler and that's very relaxing for their muscles. I've also seen probiotics being used. There is not one right answer to how we do things. We are that pharmacy that is able to have a conversation with a patient. We talk about what their needs are and customize it based on that approach. 

From the prescribers that you work with, do you have many consultants that you fill scripts for? 

We definitely do. That's also kind of a little side thing that I do. I've always been very passionate about teaching. I'm on faculty at University of Washington School of Pharmacy and also Bastyr University, which is one of the top naturopathic doctor schools in the nation. I teach there during summer quarter. I teach nationally to providers continuing ed-based content that is often LDN in nature, or ties into LDN. Especially with autoimmune and chronic pain and chronic inflammatory conditions. We consult a lot with doctors. I probably work with three or four hundred functional med type providers on any monthly basis, even on being able to customize therapies for their patients. We are really big in the post-COVID syndrome arena of helping patients that are really struggling and LDN. We're finding it pairing quite nicely in that condition as it's very inflammatory based. We work quite heavily within the MCAS arena for patients who have a lot of mast cell instability and need other therapies. LDN is one of the tools that is used quite frequently by those types of providers and for those specific kinds of patients. 

Do you work with any pain specialists, dermatologists, rheumatologists, gastroenterologists? 

We do. Honestly, I’m quite proud of our little Seattle area of Washington because we do have MDs that are pain specialists that are now really turning towards using LDN in their toolbox of things they have available for patients. They're getting quite savvy at it. They're doing a really great job. It is super exciting. I have some dermatologists. I consult a lot with my functional med providers that are seeing dermatology conditions like psoriasis. I have an email I need to work with a doctor on after this to help them with this patient with a psoriasis case. We are seeing it in the GI world as well for Crohn's and irritable bowel disorder. Those chronic inflammatory conditions. I would say the MD pain specialists are really turning around over here. Obviously with the opiate crisis that has occurred in our nation I think most doctors of any type of credentialing or medical training or experience are quite interested in what LDN is doing for their communities and what opportunities it affords for patients who are trying to make sure they aren’t addicted to opiates but yet have something to improve quality of life and their day-to-day living. Low dose naltrexone has been an amazing tool for that. 

I'm always excited to meet different LDN prescribers and nurse practitioners who are providing lots of scripts. When you get an MD or a DO that is prescribing LDN and it is completely out of their comfort zone, I always think yes, you know we've got another one on board. We're making it right. We're getting it. MDs are already working outside of the box. That is normal for them to look into LDN; it's not normal for MDs to look at LDN but as you know, I've interviewed so many people and so many MDs when they have a patient that they can't help, and fix their issues. They've tried everything and they feel as if they've failed this patient, and then they try LDN. Once they have had amazing results with the first person it's then so easy for them to look into prescribing, not only for other patients with that condition but for any autoimmune disease, chronic pain, mental health, etc. 

I mean it's really amazing and this is where people like yourself come into play. The hand-holding with doctors because a lot of them haven't got time to do the homework. They're very busy and they need somebody to tell them exactly what it is, how to prescribe it, what to look for, what to do and have somebody on hand to say, like you said, I've got a patient with psoriasis. What do I do? Can you help me? That is the way to get more doctors involved is the pharmacist doing the hand holding. 

There is a local psychiatrist in our area that works with younger adults with substance abuse disorders and teenagers that are having a lot of trouble with mental health. I had an opportunity to get him thinking about LDN and his patient population. I love when I get to reconnect with him every few months because he just raves He finally has a tool that actually does something. He felt the antidepressants and all these other things were not really fixing any of the issues or fixing the symptomatology. We still have the same abuse issues, we still have the same addiction issues and we still have the same levels of depression and suicide risk. But with LDN he's finding that he's actually causing positive change in his patient population, and that's the only thing he really changed within his practice. We're really affecting the health of our community in a very positive manner with something that's really safe and low risk and not expensive. It doesn't get any better than that. It's the best compliment I could ever have. 

It's really nice when patients take all their information to the doctor. Once you've got a doctor really hooked on prescribing LDN they can change the lives of hundreds of patients. Dr Phil Boyle uses LDN in his fertility clinic. He also uses it in women's health for things like endometriosis, polycystic ovary, painful periods, heavy periods. Right across the board he uses LDN. He gets patients coming to see him with women's health problems who also have Hashimoto's or long COVID etc. I refer to his work all the time. He gets questions a lot from local providers such as we have somebody who wants to become pregnant, or they did become pregnant and they're on LDN and they want to know what the standard of care is and can we continue, and what's the risk and benefit are. It is so great to have providers like him out there that have been doing this work for so long that we can very confidently share those case experiences and history of using the medication long term for those patients. 

There have been so many of our members who were skeptical about using LDN during pregnancy. Doctor Boyle is always very generous with his time. I will send him details and he will answer the patient and share his experience. You know we used it once up until birth rather and breastfeeding, etc. We have those people who have done two or three pregnancies using LDN who are happy to talk to other people. This is my experience with 20 years as the charity next year, which is totally amazing, but I’ve found that word of mouth and with the education it is just spreading. 

Linda, you've done an amazing job with the LDN Research Trust and I thank you for that. You have made the Research Trust, its website, resources and its books into a trusted referral point that I can use with our doctors and our patients who are wanting that next level of information beyond what I'm able to say to them. They want to go see those studies themselves. They want to go read the book themselves and I know that without a doubt I can send them to your resources for them to receive complete in-depth and correct information. Thank you Linda. You're doing amazing things and this is all because of you. 

How can people contact you? 

We have two locations in Washington State. We have Kusler's Compounding Pharmacy in Snohomish Washington and the website there is www.Kuslers.com; and then we have Clarks Compounding Pharmacy in Bellevue Washington. That website is www.clarkspharmacywa.com. The WA stands for Washington. We are happy to help patients all over and talk with doctors that need guidance and assistance in learning more. I love being an educator and I love being here to support my community. 
 

George Yiachos, MD, FACC, FASNX: How to Treat Chronic Inflammation to Help Prevent Heart Disease (LDN; low dose naltrexone)

Paul Anderson, NMD discusses his presentation on Immune Modulation in the Age of Long-COVID and Related Illnesses.

Yusuf (YP) Saleeby, MD - Update on COVID, Long COVID and LDN (LDN; low dose naltrexone)

The LDN 3: To Purchase with discounts before 1st September 2022 Go to ldnresearchtrust.org/ldn-book-3 for full details

LDN Webinar Presentation 18 May 2022: Dr Sato-Re - How and why I prescribe LDN in my integrative and general practice

Sponsored by Innovative Compounding Pharmacy https://icpfolsom.com/

LDN Webinar 18 May 2022 (LDN; low dose naltrexone)

LDN Questions Answered Live by

Pharmacist Dr Masoud Rashidi - LDN Specialist
Dr Sato-Re
Dr Mathewson

Sponsored by Innovative Compounding Pharmacy icpfolsom.com

Yusuf (JP) Saleeby, MD - LDN to help Long Covid patients; March 2022 (LDN, low dose naltrexone)

A high percentage of Covid patients continue to suffer debilitating symptoms well after the initial infection. This is because of the increased inflammation and reduced autoimmunity. Low Dose Naltrexone (LDN) bolsters and regulates our systems quite effectively. Dr. Saleeby observes many conventional doctors are finally recognizing LDN as a primary treatment for Covid long-haulers, as well as other autoimmune conditions. He cited the Ldnresearchtrust.org site as an invaluable source of information on LDN. He looks forward to Linda Elsegood’s 3rd LDN  Book coming out soon.

Review by Ken Bruce

How LDN is helping Long Covid patients - Dr Yusuf (JP) Saleeby (Trascript)

Linda Elsegood: Today we're joined by Dr Yusuf Saleeby, also known as JP. Thank you for joining us today.

Dr. Saleeby: Hey Linda, it's always a pleasure.

Linda Elsegood: Now, you're going to talk to us today about Covid and Covid long-haulers, so I'll hand it over to you. Thank you.

Dr. Saleeby: Sure. So you know, two years into the pandemic we're seeing still a few cases of acute Covid infections but as of today, and this is the first of March 2022, we are not seeing too many acute cases. But what we are seeing is quite a number of long haulers or long Covid and also post Covid syndrome. It's also referred to as the syndrome of post-acute Covid infection, and the sequelae involved. And we're seeing also some issues with folks who have been vaccinated, some post-vaccine injury, but essentially what's happening is we're seeing a good bit of folks who had can't shake the initial Covid infections. And we've seen cases where a person has been infected two or even three times with different variants.

But the focus in general right now, moving forward, is a large number of folks coming in with the post-Covid infection, and some still suffering from long-haulers. There's a protocol we follow. The FLCCC has a very relevant protocol that's fairly frequently updated based on this new science coming in, and peer-reviewed articles. And that's kind of what we adhere to, with a few modifications. We're a little bit more aggressive with some of the dietary supplements that we prescribe. But essentially, low-dose naltrexone, which was offered as a second or third line agent, has now, in the recent month, been moved up to a primary intervention. So along with things like ivermectin and prednisone and omega-3 fatty acids, which is essentially what's derived from fish oil, and high doses of Vitamin D. The other agent is naltrexone, as in low-dose naltrexone. They're asking folks to begin at one milligram daily and increase to four and a half milligrams in a very short period of time. They are also stating that it's best to have people on this for two to three months to see full effect. So as with some of the other interventions, like they're recommending ivermectin, weight dose dosing, which is 0.2 milligrams per kilogram body weight, until symptoms resolve. Not necessarily for 14 days or one month, but until symptoms resolve.

And the same thing can be said for the use of low-dose naltrexone in my patient base. A lot of my patients actually are on it for a number of reasons, whether they're suffering from Lyme disease or autoimmune disease. So my patients actually have a benefit of being on LDN at the therapeutic dose, whether it's three and a half to four and a half milligrams a day. So they have the benefit of that. And then if they do get Covid, their symptoms are usually quite less. We've not really had but one or two hospitalizations. The stays are usually very short, maybe two to four days, just for high flow oxygen, and then they're discharged home. To my knowledge we've only had one or two patients ventilated during this whole pandemic. So adherence to early treatment, and the implementation of naltrexone as part of that regimen, has been very successful for us. Now our attention is focusing on folks that have long haulers still - brain fog, fatigue, loss of smell and taste, are the predominant ones; hair loss - we're seeing that as part of the syndrome. But it's mostly the fatigue. And so naltrexone is becoming a big part of our protocol for them,

Linda Elsegood: And how open-minded are other physicians to prescribing LDN.

Dr. Saleeby: As you know, it's like a certain segment of the physician population, at least in the United States, I don't know how it is worldwide, but there seems to be a better embracing of the use of low-dose naltrexone than other interventions like ivermectin and hydroxychloroquine, because those two other agents have been politicized a bit, whereas naltrexone has not. But there are certainly other interventions that are embraced by folks that are open-minded to integrative, more holistic, and what we call functional medicine, than the standard mainstream medical doctors, although the FLCCC in truth is actually established by conventional doctors who are open to using early treatment with ivermectin and hydroxychloroquine, Alinia/nitrazoxanide, along with their traditional medications like prednisone, Singulair, some antihistamines Pepcid, things like that that are used in the protocol. But what they've also introduced are things like curcumin, Nigella sativa - which is the extract of black cumin seed oil, a very potent anti-inflammatory; higher doses of Vitamin C, melatonin, probiotics, and H2 and H1 receptor blockers. H1 would be your traditional antihistamines like Benadryl or Zyrtec or Claritin, and your H2 would be things like Pepcid/famotidine.

Some of those other agents - montelukast, which is Singulair, is also prescribed for those with MCAS - that's Mast Cell Activation Syndrome, which is part of the long haulers syndrome. It's where mast cells become destabilized and release a lot of histamine, so you have things like hives and rashes that appear, and some other complications. That's why the antihistamines and the leukotriene inhibitor Singular are used. There are some that will use anti-androgen therapies. There are some studies out of Brazil that showed that that was effective. And statins. I'm not a big fan of either of those two last agents, so I don't prescribe them in protocols for my patients. There's another SSRI (serotonin reuptake inhibitor) called fluvoxamine or brand name Luvox, which has been used, but it's not very well tolerated, so that's one that we have to be super careful with, because a lot of folks don't tolerate it. They have a lot of nausea or psychiatric kind of manifestations.

But LDN obviously is a great agent to use, because number one, it is very well tolerated; number two, it's very inexpensive. And it seems to be working very well. I mean, it was moved up from second and third tier to primary tier or primary agent to use by the FLCCC. And they're heavily research oriented. In other words, they don't make a move in that direction unless it's substantiated by large observational encounters with patients, or peer-reviewed journals.

Linda Elsegood: So, the million dollar question; put you on the hot spot here. What do you think that has done for LDN? Has it leapfrogged it forward far quicker than it would have done previously? And the second part of the question is, what do you think of everything that's been happening with using LDN for the symptoms of fatigue? What's it going to do to people with chronic fatigue syndrome?

Dr. Saleeby: Right. So yeah, I certainly think that the pandemic has elevated LDN to the top of mind for a lot of clinicians, both those that have been using it and were familiar with it to some degree in the realms of integrative and functional medicine, but also to the mainstream doctors who were unaware of LDN previous to the pandemic. Now it's front and center. I mean, it's one of four or five interventions that are considered top tier to use for people recovering from long haulers or post-Covid syndrome. So I think it did leapfrog it, I mean, in the minds of many doctors. To be put top of mind, that's a fantastic thing. That's kind of a good thing that came out of this horrible pandemic, if you will.

And the second question you had was, what about its effects on chronic fatigue. Well I've been using that in chronic fatigue and autoimmune patients and people with MSIDS (Multiple Systemic Infectious Disease Syndrome) or CIRS (Chronic Inflammatory Response Syndrome). Those are all different acronyms for almost the same essential issue. It's a syndrome that involves the immune system and inflammation, and we know that LDN and naltrexone in research is an anti-inflammatory from several different mechanisms. It helps suppress inflammation, and the post-Covid syndrome, and certainly the long haulers, is a problem mostly with inflammation. The virus is long gone. It's already out of our system. Usually 9 to 14 days after you first get infected, the virus has done its bad thing, and it's sort of kind of gone away, and what's left is the sequelae of that, which is lots of inflammation. And that's what actually hurts people. It destroys their lungs and other organs: liver, kidneys, things like that; and affects brain and cognitive issues, and things like that. So one of the interventions used is high doses of curcumin and black cumin seed oil. Those are potent anti-inflammatories. Even those that decide to use statins, they're using it for the anti-inflammatory nature of the statin, like atorvastatin. But then LDN comes in, which has a very safe and effective mechanism of lowering inflammation. I think that's why it's important.

Linda Elsegood: Well let's just hope that, as you say a good thing has come out of this. If we can get more doctors prescribing LDN and finding the benefits that patients have, hopefully they will prescribe it for more conditions. Mental health, autoimmune, cancer, pain, the list goes on. But I think it does make a big difference, the first time a doctor actually can see that LDN has done amazing things for a patient. It gives them the encouragement and the confidence to prescribe it for further patients.

Dr. Saleeby: Right, I think I definitely. And Linda, your website does a phenomenal job in helping me put together a PowerPoint presentation for your organization as well as for upcoming symposium I have. I've gone to your website, which is a great resource, and it lists all the different conditions that LDN is being used for, or would be useful. There’s this long list of conditions, categorized. Pulmonary, neuropsychiatric, cardiovascular. You've done a great job in enumerating all these conditions, and I think it's just a matter of time now for doctors to start embracing that, looking at the literature, looking at the peer-reviewed literature that backs up the use of this agent, a very unusual drug. It's one of my probably top five of my safe and effective drugs that I prescribe, and that's what I would grab. I tell my patients if I had to grab an agent to take with me on a deserted island, one of the top three would be naltrexone for the LDN. It's a powerful drug with a lot of uses, and it's backed up by research. That's the important thing.

Linda Elsegood: Talking about the website, we do update it monthly, so any doctor that tells us of a condition that they treated a patient for with LDN and had good results that's not on our list, we add it. We also add the latest clinical trials and peer-reviewed papers, and LDN in the news, things that have been happening. So we try and make it a one-stop, where a doctor, a researcher, a pharmacist who's looking to do a presentation, just like you were saying, that they can find the information quickly and easily. It's a never-ending job.

Dr. Saleeby: I know it is it's a great thing you offer, and I do send patients to that website in particular when we have a discussion in my office about LDN. I have some material I hand out to them, but I also direct them to the LDN Research Trust website so they can glean a lot of information. It's great resource for them.

And I understand there's a new book coming out, Linda?

Linda Elsegood: Yes, we've got the third LDN Book, which should be coming out in the fall. And we're covering different conditions. Many people have asked if it is the first book updated the third time. No, it's a series of books. So we've got Volume One and Two, now we've got Volume Three. And you put me on the spot to try and think what's in Volume Three. But it's really exciting, and you've written a chapter as well. So I think watch this space, and it will be available in a few months.

Dr. Saleeby: I mean reading Volume One and Volume Two I thought well, maybe that would be just an update, like a second edition. But it wasn't. Some novel things were discussed in Volume Two, and I'm assuming that like you say, Volume Three will be more novel stuff.

Linda Elsegood: The whole idea is to have every volume cover conditions that haven't been covered in the previous books, where we have the latest research, and we will have a section so the latest papers will be referenced at the back. I mean, we have every book, hundreds of references, and of course as time goes on, every year there are more papers coming out, which is fantastic.

The LDN Research Trust has been going over 18 years now, and initially, published papers were slow coming through. But every month there is something somewhere in the world. Somebody's done something, had something published. So it is gathering momentum

Dr. Saleeby: And Linda, I think really, with the last two years of us being in a pandemic, where a lot of focus has been on Covid 19 and what we can do for it with, let's say, off-label use of certain medications, and LDN. That's going to even push more research money towards researching LDN. I'm sure. Now that it's on the protocol,and it's like in the number one section of early interventions for long haulers, I think you'll see probably more and more papers. Actually, it should be exponential, in the number of researchers wanting to take this on and do more research, for sure.

Linda Elsegood: Fingers crossed!

Dr. Saleeby: So Linda, I've got a very interesting case that I saw in my office a few months ago, and this is actually a post-Covid vaccine injury type case. This lady, unbeknownst to her, had an underlying tick-borne infection. She actually had Lyme disease that was activated by the first dose of a Covid vaccine. I'm not going to mention which one it was, but it was a first in a series of two that she received. And within 48 hours of receiving the first dose, and then for the subsequent weekend, to two weeks thereafter, she suffered some neurological conditions that put her in a wheelchair. So this is a woman, and she was in her late 40s, and she was very ambulatory; didn't really claim any health issues. Next thing you know, within a very short period after her first vaccination, she was wheelchair-bound, couldn't walk, and had a very staggering kind of staccato that almost looked like a Parkinsonian kind of gate. It took her literally three minutes to get up out of the wheelchair and walk a few steps across the room to the doorway of my office. Now, we put her on a pretty heavy-duty protocol involving a few off-labeled drugs, but also I rapidly escalated her dose - she was never on LDN - but I placed her on low-dose naltrexone and escalated her dose pretty quickly, because I knew time is of the essence here, and I didn't want her neurological problem to progress. And during that time, it was when we discovered that she had Lyme disease as an underlying etiology, and it was just exacerbated by probably the spike proteins in the MRNA vaccine. We were able to get her rapidly up to 4.5 milligrams, which she tolerated very well. And the second time I saw her, she had transitioned from a wheelchair to a walker. On the third visit, which was a month later, she was using a cane. Now she was able to ambulate without the use of any help like a cane or even family members, but again it was extremely slow with her ambulation, and it looked kind of almost Parkinsonian in nature. Kind of like this leaning forward, kind of unsure, took her a long time to actually turn. But once she initiated the walk, she could carry on her day, and it was a little bit slow. But now I have not seen her back in about a month or two. She should have an appointment with me again soon, but I thought that was a pretty interesting case, where I think I'm pretty sure that the naltrexone had a big part to play.

Linda Elsegood: Well, thank you very much for having shared your experience with us today.

Dr. Saleeby:  Well Linda, it's always a pleasure. Have me back anytime. It's always good seeing you.

Linda Elsegood: Thank you. Any questions or comments you may have please email me, Linda, at contact@ldnresearchtrust.org. I look forward to hearing from you. Thank you for joining us today we really appreciated your company. Until next time, stay safe, and keep well.