Dr Sally Boyd Daughtrey, LDN Radio Show 2016 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.
Linda Elsegood: This evening. I'm joined by Dr. Sally Boyd Daughtrey, who's a licensed naturopathic doctor from Hawaii. Thank you for joining us.
Dr Sally Boyd Daughtrey: Aloha. Thank you for having me. This is a great opportunity to share my experience with naltrexone.
Linda Elsegood: Could you tell me when you first heard about LDN?
Dr Sally Boyd Daughtrey: Well, this is a very interesting question, because it just sort of - I don't know if you know the word grok, but it just sort of grokked towards me from the universe and just different layers. There's not a particular time that I went, Oh wow, naltrexone is amazing. It just sort of became clear to me. But the first time I prescribed it for a patient, it's something I will never forget. It was astonishing. I'm sitting in my office, and I hear this banging on the wall of my waiting room, just this thump, thump, thump; and my receptionist was at lunch. So I was alone; what is that? So I am flying out to the waiting room, and there's this lovely waifish ill woman laying on the floor of my waiting room, and she was trying to drag herself through the waiting room to get to the reception desk by banging, by grabbing a wall, literally dragging herself through the waiting room; and it was amazing. So I reached out and I picked her up, and I put her in a chair, and I took her in the back and started doing her interview. She was an MS patient who had been through everything and couldn't walk because of the MS, and had no money, low-income, literally stumbled into my office off the street. There was very little I could do for her because I do private medicine, I don't take insurance. But I remembered naltrexone. Someone had told me about this thing called naltrexone. This is about 2007, 2008. I managed to find a compounding pharmacist that knew what the heck it was and prescribed it for her. And within two weeks she walked into my office. Two weeks, and all I had done for her was naltrexone and some vitamin D, because that's all she could afford. I saw her for two years when she could come in and see me. She had no relapses. One more thing we did, I gave her a grounding mat. I don't know if you know what those are. It's just a very simple device that helps connect you to everything, helps you connect to the earth and reduce EMF exposure, basically.
So those were the only things that we really did. And in those two years, she had no relapses at all. And I know people say, Oh, well, MS has spontaneous relapses, but really come on, the chance of that happening was so low. And the only reason I lost track of her is that she got well enough to get married and moved to a different state. So that was the pretty astonishing start and my exposure to naltrexone.
Linda Elsegood: So where did you go from there?
Dr Sally Boyd Daughtrey: As you can imagine, I was pretty impressed, so I started using it specifically for autoimmune conditions at first. But as you know, autoimmune conditions are epidemic everywhere, and the more you look for autoimmune conditions in a wide variety of symptoms, the more you find them. So I started going with a lot of my Hashimoto's patients next. And it's sort of becoming my go-to if someone has thyroid symptoms; there are hundreds of thyroid symptoms. I have a thyroid questionnaire that's 2-3 pages long, with symptoms and overlapping with other conditions, symptoms, and whatnot. If someone shows a lot of thyroid symptoms I run antibody tests on them, and if they're high at all, then it's pretty much an automatic thing now that I put them on naltrexone. And what I love about running antibodies is because, especially with thyroid patients, you can get a baseline antibody level, and you can put them on the naltrexone, and you can watch that number drop like a rock. I had one person come in with 1200 antibodies, and three months later, they're something like 30 to 60. That's not uncommon, to have those antibodies go down that fast. And ANA and anti-TPO and TBG are well-accepted tests.
And it's a good thing to actually have something they can take to their MDs, who tend to be more in the medical establishment. So there's good about that and bad about that. One of the bad things about being in that system is if you're entrenched in that system, it's harder, there are more social stigma and financial stigma for them to break free of that dogma. So it's really refreshing for me to be able to say, here are the baseline autoantibodies when my patient walked in the door, and here are their antibodies ten times lower three months later, what do you think of that? And the more forward-looking of these that my patients also see, because most of my patients see an MD as well because their insurance covers it now - I use that as an educational tool for, for them to help increase exposure to this treatment.
Linda Elsegood: So, do you have any other stories?
Dr Sally Boyd Daughtrey: I can tell you my own story. I've had Hashimoto's thyroiditis for 25 years. I got it in medical school and I remember the reason for getting it, in my mind, was cadaver lab, being exposed to huge, massive amounts of formaldehyde in a high-stress environment, and then autoantibodies started going up from there.
And it was presented to me, even as a naturopath where we treat a lot of things outside the box that isn't supposed to be treatable; even in that context, it was presented as well, we can manage this, but you're always going to have gluten sensitivity and weight problems and fatigue, and we'll check your autoantibodies every now and then, but there's no need to really redo them again because now we know you have this disease and it's not treatable.
So basically the plan that was presented to me - I'm in my early twenties - was here, they'll give me this thyroid medication, and when it stops working, we'll give you more. And then when it stops working, we'll give you more. And then when you reach the max, we'll just keep you on that. And good luck with that. And you think, okay, I'm swimming against the stream by becoming a naturopath, so the things that aren't treatable are supposed to be treatable with our medicine. And you're telling me that this is not treatable, or it's something super elusive like - maybe it's your mercury exposure or something like that. And then 20 years later, take one little pill at bedtime and have that condition dramatically improve, it was amazing. And to be able to actually track that on lab work, and say it's not just me, it's not a placebo effect. I can't really see how a placebo effect would reduce an autoantibody level on a lab consistently. Yes it could take a little bit, but that's obviously not all that's going on here.
So myself starting to take it resulted in my being able to go from a part-time practice to manage my condition, to a full-time treatment centre. So now I have staff, and I have ancillary services, I have an associative MD, and I have all these things that I'm able to manage now because that condition is successfully - I wouldn't say cured because to me cured means you don't need to take anything to not have your symptoms. So I would say that naltrexone has created the ability for me with a wide range of conditions to successfully manage them, and moderate or eliminate the symptoms.
I would say maybe 20-30% of my patients that come into this clinic get naltrexone treatment. Part of that's a reflection of the fact that I treat recalcitrant patients in the first place, meaning I treat patients that have pretty much been through regular medical care and have not been fully resolved with that or satisfied with that. So that population is somewhat self-selected to be a more difficult treatment population in the first place, and that's part of what naturopaths tend to do in this country. When you have a success rate that is high with a population that already has failed conventional treatment, you know you're doing really well. It's a very gratifying profession in that way.
I would say it's an appropriate fit for about a third of my patients. Of those patients, about 60 to 80% stay on the therapy and self-refer themselves to stay on it. Meaning I'm not sitting there wondering how to track compliance. They're calling in to get their prescription refilled. They're choosing to stay on it because they perceive that they feel better when they're on it, and that's pretty quick too.
I'm reading the LDN Research Trust website, which is super useful by the way, this is a great website, and there are all kinds of things on there that I didn't know, that's useful. I've been expecting people to have a significant symptom change within two weeks, and then I'm reading on here that a lot of the chronic pain patients can take three months to have a significant benefit. So I am able to condition people to wait that long to see a benefit. And still I'm seeing 60 to 80% of people staying on it and reporting improvement.
Part of that might be me encouraging them to notice an improvement is having a positive mental effect for sure. Everyone that comes here is paying cash to see me and is paying cash for the therapies because insurance doesn't cover what I can do. So if you're going to keep paying for something, you definitely perceive a benefit from it.
Linda Elsegood: On the flip side, has anybody told you that they experienced any negative side effects?
Dr Sally Boyd Daughtrey: Well, the sleep change, sleep disturbance, insomnia effect is definitely a factor. And for that, I would say maybe 20-30% of people will report that. There are some people of course that come here, see me once to try something and then I don't see them again. I don't know what happened to them. They don't follow up. It's not the right kind of care for them. So I can't say what those people are doing if they have the insomnia effect or not. But people that come in and are consistent and do the therapy, it seems to me like there's a certain subset of patients that have that symptom. I haven't quite pinned down who they are, except that they tend to be more sensitive and more anxiety-prone, more reactive. I do see a lot of chemically sensitive people, canary in the coal mine kind of people, and their dose-response rate is very individual. So I have people on 0.5 milligrams and I have people on 12 milligrams. That's a huge range, and I've come to that with people through very specific trial and error.
A lot of my patients are very intelligent too, they're very motivated and follow instructions well, and can do some self experimenting. Which is a wonderful thing about being a naturopath too, that that population kind of seeks you out. So I'll start them on say one milligram for a week and then have them try 1.5 and then try 2, and change the dose, and keep a log and ask, how did I sleep last night? Did I have vivid dreams? Were they pleasant or unpleasant? Were they disturbing? A lot of autoimmune people have disturbed sleep, so they're not used to dreaming at all, or they're not used to remembering their dreams. So they find that startling at first. But then if you take the time to inquire and ask if it was a bad experience, they say no, actually it was a good dream. Well, maybe that's okay. That's not a bad thing. So part of it's how you see it, but definitely, people will have restless or disturbed sleep the first few nights, but I haven't usually found it to last more than three nights.
What I do now just for simplicity sake is to start them on, let's say three milligrams, but the first night I'll have them open that capsule and pour nearly all of it out. And then the next night I'll have them pour all but a quarter out, and then stay on that for about three nights. And once they're sleeping through the night, then I'll slowly start adding back a quarter of the capsule at a time until they're taking the whole three milligrams without any problems. And that works 99% of the time.
Linda Elsegood: I would say that there are many doctors that actually swapped to morning dosing for people who find sleep is an issue. And it seems to work just as well in the morning.
Dr Sally Boyd Daughtrey: And they're not noticing any downwards depressions spike at any time after taking it?
Linda Elsegood: No. And there are some people who have been taking it in the morning, swapped to the evening and feel that actually taking it in the mornings they have less fatigue. I take it for MS, and I've swapped from night to morning and it didn't make any difference. And there are some doctors that prescribe LDN for chronic fatigue syndrome, double dosing, so the dose that they take in the morning they take in the evening as well because the body doesn't see it as double. So if you were taking 4.5, the body doesn't see it as nine, it sees it as 4.5 twice, because at the time you take the second dose, the first dose has been gone. I tried that as well. That didn't give me any more energy either, but I at least gave it a go.
Dr Sally Boyd Daughtrey: That's a really great idea. And I actually just had someone who just on his own decision, started taking it in the afternoon because he was afraid. We have lava here, this volcano that tends to threaten to cover the town every now and then. So he has severe anxiety and he lays awake at night and worries about the lava covering his farm, which I can't say is an unrealistic worry. So he started taking it in the afternoon and reported an immediate improvement in mood within 20 minutes. And thinking about the path of how it's supposed to work in the body, I don't understand how exactly that's happening, but I can't discount this experience. It's a consistent experience and who am I to say to stop doing that, you're doing it wrong; because for him, it's right. So I just put him on doing it in the afternoon and then trying a very small dose in the evening to see if it helps.
And the wonderful thing about this stuff is that at these doses, it seems so safe that allowing people to experiment with it and find what works best for them, and then tracking their results and making sure that their lab work is in order and they’re progressing in all aspects. I do regular physicals and I can see people's physical parameters improving.
I don't do just naltrexone. In this kind of setting, I'm doing naltrexone and nutrition changes and counselling and lifestyle modification, and I'm doing all of these things together, and it doesn't really serve my patients to just do one thing so we can test it. Now that's a very difficult sell, right? So that's the whole problem with holistic medicine, with testing holistic medicine in general, that it's the sum of its parts and it's a synergistic sum of the parts. So if you try to reduce that down to what's just naltrexone effect versus what's this lovely whole food B-vitamin that I've switched to them too, and taking them off their synthetic kind that was causing anxiety, for example.
That's challenging for the standard medical paradigm to accept as a real therapy. I don't really know what to do with that, except to compare people that get that holistic treatment with it with people who choose not to have naltrexone because some of my patients are against all pharmaceuticals. I have a subset of the population who are seventh day Adventists or Amish or someone like that. And they will not do a conventional pharmaceutical of any kind. Even this one, even this very benign one. So the only way in my mind, can ever really extract what naltrexone is doing individually is to compare the progress of those people in general, with those other people who do all of that plus naltrexone. I've been doing that admittedly in my own head, keeping a tally in my head, since 2007 or 2008, so that's 30 years, and a lot of people. My overall very strong impression is that the people that do everything plus naltrexone do significantly better than the people that choose not to do it for whatever reason they're choosing not to do it.
Linda Elsegood: And if we have people listening to you in Hawaii and they'd like to come and see you, how did they contact you?
Dr Sally Boyd Daughtrey: Our practice is called Vitality Integrative Medicine, and we are a comprehensive integrative clinic in Pahoa, Hawaii. Our phone number is 808-965-2233. Our website is http://www.vitalitymedicine.org/
Linda Elsegood: Is there anything else you'd like to add before we finish?
Dr Sally Boyd Daughtrey: I guess one thing that I'm thinking of doing now is expanding who qualifies for this therapy. What are other doctors finding results with this that are beyond cancer, autoimmune, pain syndrome? That's something that I'm really interested in because it seems like...
Oh, PANDAS, I had an amazing PANDAS. It's a cross - one of the things that we're seeing more and more now is cross-reactivity is in the human body to past infection. So someone who's had an infection in their childhood, say strep, or staph, or Lyme; then their body will mistake the antibody for that bacteria to a piece of their own body, their own tissue, and then they will have chronic problems with that particular organ. I'm having some really interesting results with people like that. They don't even always know that they have an autoimmune condition. They feel like they have a heart condition or a skin condition; or in this case, a mental, emotional psychosis condition. And naltrexone seems to be helping - kind of in layman's terms, it's helping the immune system be happier and calm down, and recognize what’s a friend and what's foe more accurately. The implications of that are huge.
Linda Elsegood: At the conference in February, we had two psychologists talking about post-traumatic stress. But it seems to work for cravings and all sorts of problems that people have. So the more we are using it, the more conditions are coming along that doctors are treating with it. We now have a list of I think 204. Normally, if there's an altered immune component, LDN could well work; and then there are all the different pain conditions, there are these mental health issues that it's helping with as well. So it's very interesting. We're learning all the time.
Dr Sally Boyd Daughtrey: One that I also am treating for - I don't have a large population of people partially because they're self-reporting is poor, there are some shame-based issues with the self-reporting, but the euphoric drugs of abuse like ecstasy and Molly and MDNA. Those kinds of drugs. I think people that use those and use them and use them and use them, end up depleting not only dopamine but endorphin and enkephalin as well. They tend to present with this sort of chronic low-grade apathy, dysthymia, hopelessness, lassitude. The only thing that seems to make them happy is when they're actually on that drug. So, although it's not technically “an addiction or an addictive drug” by classification, their life ends up being cycled around the use of that drug. When I can get them to take naltrexone and stop taking that drug of choice, it seems to make them feel normal. And it makes me feel hope for these people because they're self-medicating in a way. If their endorphins are chronically low and they don't know that, but they know that they get to actually have an experience of having normal or high endorphin levels for a few hours, you can see how their life would then end up revolving around wanting that feeling of actually feeling normal. Here we are saying for the first time in your life, you can feel good, not high, but good every day. And that can be your baseline reality from now on. That's incredibly powerful. That's a life-changing experience.
I've had a couple of patients who have been able to tell me this is the cycle they’re stuck in, and I've been able to say, well, if you can commit to weaning off that drug, not doing it every three nights or every week and/or living for it, and instead, do this because I would think that they would contradict. So I don't want them doing naltrexone and that drug at the same time; I don't know what that would do. So then we actually make a contract: you do naltrexone. If you want to keep doing your illegal drug of choice, don't do naltrexone that day, please. And they find that they need that drug, whatever their drug is, less and less. So that's very successful; that's very satisfying.
Linda Elsegood: Thank you very much for sharing your experience with us.
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.
