Pharmacist Jim Hanser who is the founder of Los Colinas, pharmacy compounding and wellness in Texas since 1984 shares his experience with Low dose Naltrexone.
I do want to start up by saying that thank you for what you do Linda Elsegood, because you have been an inspiration patient to me, even in inspiration to a lot of patients with your own personal case and putting that out there, which might've been painful for you, but I do appreciate what you've done and the work that you've put in to help patients achieve better health.
And I read your book and it was inspiring to me and an important read for my patients because that's what's most important is how we take care of our patients.
We started our pharmacy back when I was a kid. We had family, friends that were pharmacists. They owned their own pharmacies and drug stores.
I got a degree in pharmacy.
It's quite a struggle to get your own pharmacy and I really applaud those who have done.
After working about two, four years, for some of the chain pharmacies, I had an opportunity to start my own pharmacy. And at first it led us into dermatological compounding. And we were having early successes with that.
I started realizing that that western medicine, traditional medicine did not have all the answers. It's not they're trying to do a good job. Most of my friends are traditional doctors, but I thought there's got to be something more out there. So I started investigating integrative medicine or functional medicine.
And in the late eighties we opened the store.
We have our providers doctors who write prescriptions for compounds, we tested our products.
We become accredited in 2014.
We compound LDN capsules, liquid, cream and a spray nasal.
Summary of Pharmacist Jim Hans interview. Watch YouTube video for the full interview.
The number of patients with autoimmune disease Dr. Cottel is seeing has increased, particularly thanks to her presence on the LDN Research Trust website. She also is treating more patients with alcohol use disorder (AUD) with LDN than before, with very good results.
Q: In a patient with a pain disorder, on 4.5mg LDN without good result, should he increase his dose?
A: Essentially, if you’re not getting relief on lower doses, it may work increasing the dose, but it is not well studied. Linda commented on reaching opiate blockade and the need to reduce the dose.
Q: Address where a patient with Sjogren’s has GI side effects from LDN even at ultra-low doses.
A: Have compounding pharmacy prepare LDN in water at 1mg/ml and start at a very low dose eg 0.1mg and increase by 0.1mg as tolerated, slowly. Take at bedtime. Linda commented that sublingual drops work very well also to avoid GI absorption.
Q: In a patient with MS on LDN 3.0mg developed double vision, is higher dose LDN advised? What about Vitamin K2 for MS, will it re-wrap the nerves? Can Mediterranean diet decrease inflammation?
A: Always have double vision checked to be sure of cause. If from MS, increasing LDN to 4.5mg may help. As for Vitamin K2, some studies suggest K2 may inhibit inflammation of anti-microglial cells, and perhaps the body could heal itself. Yes, that diet decreases inflammation; diet is very important in treating autoimmune disease.
Q: Patient with Hashimoto’s starting LDN, what side effects should be looked for.
A: Typically, LDN is well tolerated. Perhaps headaches or vivid dreams early on, and patients with GI problems may have diarrhea.
Q: Can LDN help fibromyalgia and cancer prevention?
A: Yes for fibromyalgia, but not everyone goes into full remission. Probably yes for cancer prevention; there are animal studies to support that, as well as that LDN is used in treatment of cancer.
Q: Patient on prednisolone for polymyalgia and can’t get off steroids. Will LDN help?
A: Yes, recommend adding LDN then tapering steroids. There are complications from chronic steroid use.
Q: Can LDN and thyroid medications be taken at the same time?
A: Thyroid medications are to be taken alone, at least 1 hour from other medications.
Q: Is LDN for real?
A: Yes! There are lots of sources for information from prescribers, patients, and through small studies.
Q: Use LDN in post-polio syndrome?
A: In her one patient with post-polio syndrome, LDN has helped with the pain, but in post-polio syndrome there are many sources for pain, and as LDN is so well tolerated, she recommends its use.
Q: How do you know LDN is working (patient with Hashimoto’s)? Can gluten ever be re-introduced?
A: Clinical response is the indicator of success in Hashimoto’s. Dr. Tom O’Bryan has a series on this. Once you have antibodies to gluten, they will increase when exposed to gluten, and can interfere with how LDN works.
< Note: the LDN App was retired >
Q: Will LDN help with pernicious anemia and rheumatoid arthritis (RA) and how do I get it?
A: Get information from the LDN Research Trust website to take to your doctor. LDN is an immune modulator and calms RA. Pernicious anemia is an autoimmune disorder, traditionally treated with B12 injections so use of LDN and pernicious anemia would be interesting to study.
Q: Can you take LDN and Chantix, a medication used for smoking cessation? Are there studies on LDN and vitiligo?
A: LDN may help with smoking cessation and Chantix. Linda has heard of patient using LDN for vitiligo with great success.
Q: Can going on/off LDN be a problem?
A: For those on LDN for a long time, it’s not likely to cause a problem, but you may notice a return of symptoms.
Q: In Type I diabetes and alopecia universalis
A: Dr. Cottel has seen few cases but has not seen great success with LDN. Linda noted she has spoken with patients who had great success with LDN for alopecia; but LDN is not a miracle drug nor does it work in all people.
Q: Is it ok to take LDN for fibromyalgia with thyroid medication?
A: They can be taken together, but be sure to take them at least an hour apart.
Q: Hashimoto’s and Sjogren’s who is pregnant. Is LDN safe during pregnancy?
A: Dr. Phil Boyle covered this at the last conference: no problems taking LDN during pregnancy
Q: Can LDN be used in Crohn’s disease the same way as the immunosuppressants used?
A: LDN is effective in some patients with Crohn’s disease and might allow tapering off other immunosuppressants.
Q: Can LDN be used in patients with glioblastoma?
A: Many prescribers use LDN in treating cancer as part of a complete treatment program.
Q: If LDN helps with pain in a neuropathic pain condition, does it mean the condition is autoimmune?
A: No. You can get pain relief from the endorphin effect of LDN.
This is a summary. Please listen to the full interview.
Dr Jill Cottel shares her Low Dose Naltrexone (LDN) experience on the LDN Radio Show with Linda Elsegood.
Dr Jill Cottel is a medical advisor for the LDN Research Trust and was a presenting doctor at the LDN Conference in Portland Oregon.
Now, she has developed a tele-medicine system in her practice whereby she can do medical appointments by phone in the states of Virginia and California. This added service is invaluable for patients who cannot travel for one reason or another.
She has been a solo-practitioner with a private practice for over 20 years with a focus on holistic medicine. Dr Cottel is very knowledgeable not only of how useful Low Dose Naltrexone can be in treating autoimmune diseases, but also for treating alcoholism through alternative methods such as the Sinclair Method.
This is a summary of Dr Jill Cottel’s interview. Please listen to the rest of Dr Cottel’s interview by clicking on the video above.
Welcome Jill! How does it feel to be our first guest on the new LDN Radio Show?
Dr Jill Cottel: Hello, Linda. It's very exciting.
Linda Elsegood: Thank you! Isn't amazing? I mean, you're out there in the West coast of the US and I am in England. Amazing!
Could you give us an overview of your LDN experience, please?
Dr Jill Cottel: Sure. I've been prescribing Low Dose Naltrexone since 2008 and have had a lot of success with it. It's been exciting to watch patients as they respond. I have a general internal medicine practice, so I get to see a little bit of everything. And so I've had a chance to try LDN out on a number of different clinical situations. It's kinda nice to get that, the rounded experience and try it out for different things that aren't typically used. It's been interesting.
Linda Elsegood: What would you say the main conditions that you've seen?
Dr Jill Cottel: Well, let's say in the beginning mainly I was treating autoimmune arthritis just because that was where I was seeing the main focus and a lot of the reading I was doing, and a lot of patients that I had already in my practice had different types of autoimmune arthritis.
So that was where I started. And then those patients would refer to other patients, and then I started branching out. And then kind of, it's a mixed path that I have a lot of patients with fibromyalgia or just muscle type pain and then different types of chronic pain syndromes, and then just a wide variety of other things, asthma allergies and some neurologic issues.
Linda Elsegood: One of the questions that people like to know before they start is what are the side effects likely to be. Have you noticed any side effects?
Dr Jill Cottel: Well, it's, it's really well tolerated. When you compare it with just about anything else that a doctor would prescribe. All-day long we write prescriptions for various things, for high blood pressure, diabetes and high cholesterol.
You look at any one of those numbers of things and plot the prescribing information. It can boggle the mind about the list of things that can happen. And so when you look at Low Dose Naltrexone, very, very minimal side effects are really good profile. I would say when people report a side effect, that usually has to do with sleep.
And I would say, in my practice, that's really only maybe 10 to 20% of the people will have sleep interruptions or vivid dreams. Sometimes that will pass and sometimes not. If it is an issue, they can always move it to dose at a different time of day. And that will usually clear up the problem.
And aside from that, pretty uncommon, I've had maybe in the past couple of years, a handful of patients who've had kind of a strange headache and that usually passed within the first week. And then some patients who their stomachs are very sensitive. In the beginning, they might get a little bit of loose stool.
But again, that tends to be just in that group of patients. Even that will generally pass after the first week. So not a lot of side effects to report.
Linda Elsegood: What drugs can't you take alongside with LDN?
Dr Jill Cottel: Basically it's the narcotic medications, Oxycodone, Hydrocodone, Morphine, those sorts of pain medications. Other medications for pain like Tylenol and ibuprofen are fine.
There's really a wide variety of things that can be taken with Low Dose Naltrexone and in the way of drug interactions I haven't seen any problems except with the narcotic type medications.
Linda Elsegood: Because I know there have been people who've asked questions about Methotrexate, Interferon drugs, steroids, and I believe all of those can be used with LDN.
Dr Jill Cottel: Right. In my practice, I've not had any issues, and I know there are a number of other clinicians using them together and haven't reported any problems. so there's some good experience there.
Linda Elsegood: What would you say has been your greatest success with LDN?
Dr Jill Cottel: I would say, probably the autoimmune arthritis patients.
They respond really dramatically and quickly. That's exciting to see when that happens. With fibromyalgia patients, every now and then you'll get someone who responds really quickly and complete response. That's exciting too. It doesn't quite happen quite as often as the other ones.
Linda Elsegood: It's amazing, isn't it? That you can get people on very, very strong painkillers where elsewhere it doesn't control the pain. They come off then, try LDN and suddenly are playing free.
It always astounds me that such a small pill can do. It's like using a sledgehammer and it doesn't work, and you tickle it with a feather and It does.
Dr Jill Cottel: Exactly. One of my first patients came off large doses of pain medication a few years back. He was on almost a 100 mg of Oxycodone or something similar and wanted to try LDN. I thought: "Well, this is just no way that this is going to work." And he tapered off on his own. And a hundred milligrams hadn't been controlling his pain. Then he was completely pain-free on 3 mg of LDN.
It was amazing! It worked! How can 3 mg of LDN work better than 100 mg of Oxycodone? There it was. He was pain free. That's amazing!
Linda Elsegood: Always amazes me too.
Dr Jill Cottel: Think about some of these studies showing that narcotic medications can actually cause hypersensitivity to pain and possibly central pain.
Look at it that way. Maybe it makes sense that patients are going to do better off of those medications and better on LDN.
Linda Elsegood: I've also been told that if you take a cocktail of pain medications, you can then take too many and then they don't work either.
So that's interesting as well.
Dr Jill Cottel: It's hard to sort out. Often a patient with chronic pain will come in, be on a lot of different types of medicines from different classes, usually off label, l because everyone's trying to help them and it's hard for those patients.
They've got a lot of side effects. I was getting them off of those medications slowly, then LDN may start responding. You can start weaning off some of these other medications. A lot of the medications that we use for chronic pain have many side effects, so people tend to feel a lot better being able to come off of them.
Linda Elsegood: That's good. Well, we'll take a break now, and when we come back, we'll take questions.
Today's show is sponsored by the Poway integrative medicine centre who take a holistic approach to provide the highest level of health care, combining internal medicine with alternative therapies, including acupuncture and Chinese medicine.
If you're in the San Diego area, they'd love to see you or if you're in the state of California, they offer secure video conferencing appointments when clinically appropriate.
Go to www.pimchealth.com or call 858 312 1672. On Facebook, follow Jill Cattell MDs page.
Linda Elsegood: Welcome back! Now we've taken our first caller. Can you hear us?
Blanca: Yes. Thank you so much. I am here.
Linda Elsegood: Okay. What question would you like to ask Dr. Cottel?
Blanca: Doctor thank you so much for listening to my question. Did you have any experience with Multiple Myeloma?
It's a bone marrow cancer. My husband has it, and he has been taking LDN every day for four months and we have seen these numbers stable. So I was just wondering if you have any experience with Multiple Myeloma?
Dr Jill Cottel: Not so far, but that's a great question.
I would expect, based on the positive results that other people are getting with different types of blood disorders, that LDN would be something that could be beneficial. And you said that his numbers had been stable over the past four months.
Blanca: Yes, stable., stable. He's not using any chemotherapy for now. He did chemotherapy in 2013. I heard about Low Dose Naltrexone, but actually I wasn't sure where to get it or which doctor will give it to me. So finally, back in April, we got a prescription from a doctor, and he's been taking, it six months already. He's stopped taking it for like three weeks because he developed some anaemia because and we were afraid of any interactions of any with supplements. So we stopped the Low Dose Naltrexone, and I've noticed that his numbers raise a little bit. So we went back right away to Low Dose Naltrexone, and the numbers went back to a little lower but stable. It's not a huge change, remission or something, but at least it's keeping cancer at bay.
Dr Jill Cottel: How does he feel on it? Can you tell the difference taking LDN now versus when he wasn't taking it?
Blanca: He has a sleep problem many years ago, sleep apnea and he's not having any episodes of apnea anymore, and I've noticed that he sleeps deeper. He wakes up because he has that problem from before, but it's not as acute as it was before. I think it's helping like to get more like deep sleep.
Dr Jill Cottel: That's good. I've had some patients report they're sleeping better on it. Their quality of sleep improves.
Blanca: Exactly. I wasn't sure if he has a little bit of anaemia if it's okay to take Low Dose Naltrexone or with Tylenol, but I heard Tylenol is fine.
Dr Jill Cottel: That'd be fine.
Blanca: And so having anaemia, do you think there's a problem?
Dr Jill Cottel: No, I can't see any reason why that would be a problem with anaemia.
Blanca: That wasn't all his concerns because he didn't, he his thinking about introducing other very, very lows that were chemotherapy capsule. So I wasn't sure if it has any interactions with chemotherapy or immunosuppressant.
Dr Jill Cottel: I don't have any experience in patients specifically with Multiple Myeloma, but I've had other patients where I've used LDN in combination with immunosuppressants, and we haven't seen any problems.
Blanca: Okay.
Linda Elsegood: Thank you. We will get to our next call on now. Hello Sabba. What question do you have for doctor Cottel?
Sabba: I'm a pharmacy student. I just learned about LDN and how it works. I'm really interested to know more, and I just wanted to see if the doctor can explain to me the exact mechanism of action.
What's happening with this medication? And in pharmacy school, I learned that it's mostly used for alcohol dependency, but they never talked about other indications for Low Dose Naltrexone. So I just wanted to see if the doctor can explain more about the medication.
Dr Jill Cottel: That's a great question, and I'm so glad to hear it. From the best pharmacology standpoint, this is a fascinating compound.
There's an article that was published in 2014 in clinical rheumatology, and the lead author is Jared, Younger. The title is "The use of LDN as a novel anti-inflammatory treatment for chronic pain." It outlines different pathways and receptors. Also in the LDN book, which just came out this year, the first chapter is by Dr Steven Dickson, and it goes over the pharmacology of LDN in detail. There are several different ways in which we think it works. This chemical is a mixture of both up left-handedness and right-handedness. A number of these medicines that we use are like that. The left-handed side does a number of things with different receptors that have to do with inflammation. The right-hand side has to do with the effects that it has with the opioid receptors.
Sabba: Okay. Thank you so much.
Linda Elsegood: We'll go to our next caller now, James. Hello, what question do you have for Dr Cottel?
James: I've been taking Low Dose Naltrexone for 27 months now. I began taking it for a Non-Hodgkin's Follicular Lymphoma and I'm almost 70 years old. I feel like I'm 50 years old again. It cleared up my depression; my brain fog, my fatigue. I'm physically about twice as strong as I was.
I've always done heating, and air conditioning work and I'm actually back doing it again now.
It cleared up the ringing in my ears that I had for years. Anyway, my question is, after taking 4.5 mg for 27 months, I was wondering if I should dosing and scheduling. In this last Research Trust documentary, they talked about different dosing protocols. And I was wondering if I should get off of it for a few days and then take it seven days a week. If I should skip a day now and then, or skip a couple of days every so often if it would help.
Dr Jill Cottel:That's a very good question. I know that Dr. Dalglish in London is looking at intermittent dosing and it seemed like when you were in the treatment phase of the disease, it was continuous, and then off, somewhere in the distant future if you were in remission, you would maybe fiddle with the schedule a little bit. But I would say that for lymphoma, I would probably continue taking it daily, but I'm not the most experienced person for oncology with it.
James: Thank you so much for all the good work! LDN just really given me my life back and I feel great.
I really appreciate all you did.
Linda Elsegood: That's good to know. Thank you. Well, we'll go to our next caller Harry. What question would you like to put to Dr Jill Cottel?
Harry: Well, I don't have a question. Mine is a real success story with LDN. I had Ulcerative Colitis onset 15 years ago. And for the first eight or ten years after that, I was being given everything you could think of, 5,600 mg a day of Mel Salomon Emeran?, 50 mg of Oxycodone day, which didn't solve my pain problems, which nobody could figure out. And we finally, through dr Julian Whitaker, we got some information on Low Dose Naltrexone and started reading up on it and finally found a doctor who would prescribe it. And basically with me, we went, no dairy, gluten-free, making probiotics and 4 mg of LDN a day.
And I had resulted in less than a month.
And doctors, all of them would admit that there was no way that LDN could possibly hurt me, but none of them would prescribe it.
They did want to take out my colon. They were doing colonoscopy on me literally every four to six weeks.
The last one I had here this last August, they again. The gastro doctors will say, no evidence of active disease Ulcerative Colitis. They just won't admit it's gone. Literally, at this point, I have no dietary restrictions at all. I just take my 4 mg of LDN every night, and I eat anything and everything and have zero problems.
So I would just encourage anybody who has not found a doctor where they can talk to them about these problems and can maybe get something to just quote off-label to do so. Because at the very least, if all of the doctors admit that the LDN can't hurt you, it would seem to me that it would be inventory just to at least try it for some of the more drastic things.
And they had me on all kind of stuff and none of it worked. And there are some really nasty side effects to some of those drugs they use, just like with chemo drugs. So mine is just a good story, and I realize that may not work for everybody, but it's certainly worth trying.
Dr Jill Cottel: I agree.
James: One quick aside on the pharmacology student that called a while ago. There is a video out to YouTube called "LDN, how it works." which talks very specifically about how this works. I take it with me to every doctor I go.
It's something that a normal person can understand.
We need to try and get as much information out to everybody we can about this because there are so many things that people are taking that are so terrible on their system, and then they don't work.
That's all I had. I do appreciate the time.
Linda Elsegood: Thank you, Harry. Well, we'll go to our next caller, Theresa. Hello. Would you like to ask a question to Dr.?
Theresa: It has been wonderful. I have been taking it since May. It has helped me tremendously. Unfortunately, it hasn't 100%, maybe 80, 85% but I do understand that it doesn't correct things that have been of an old issue.
Maybe I didn't catch my problem in time, but I was able to find my doctor who wasn't familiar with the medication, but he did allow me to try it. And it's been wonderful ever since. But it hasn't corrected everything so I still look at a couple of things, and I'm looking at something called Sam-e, which is an amino acid and it does suppose to help with arthritis but my concern is with stiffness. And so I'm wondering. Will it affect that? I know it affects your brain. The Sam-e and the LDN also work in the brain and I don't know if that would be an issue with mixing those together or not.
And there's the other issue, which is Wilson's Temperature Syndrome, which may be an issue with me.
Dr Jill Cottel: That's a good question because I often will have patients and taking Sam-me and then we'll start an antidepressant if we're treating them for depression. And then it's important to know, what herbs and supplements they're on because not everybody will bring that up. And so there are some interactions with Sam-e and different types of antidepressant drugs. We do know that Low Dose Naltrexone has some interactions with the different neurotransmitters, but it's so mild in terms of the effects with LDN that you should be fine taking it with LDN.
Actually, I do have one patient who is taking Sam-e with the LDN, and she actually did better with the combination than she did with the LDN by itself.
Theresa: That's great to know. Now my other concern is that we haven't looked into this part yet, but because my issues have been so evasive, Wilson's Temperature Syndrome, so we may be going down that road looking at certain protocols that may require some Cytomel for a small amount of time to regulate the body temperature. And this may resolve a lot of my issues. Is there any complication with using LDN and the Cytomel and maybe the Sam-e? I also use Ashwagandha.
So combining all those, I mean, I don't know what I'm doing, but I do know I feel so much better, but I don't want to pose another problem that may be worse down the road. So there would be the Cytomel and then the ashwagandha and the Sam-e.
Dr Jill Cottel: So the Ashwagandha should not be a problem. The Cytomel I would just be very careful with that because some people will respond fairly dramatically Cytlmel just on their own when you're treating for low thyroid. And sometimes it's difficult to get the thyroid adjusted with that. So just, I would say talk to your doctor about dosing it very low and watch your thyroid numbers pretty closely.
I would say getting them checked, at least within the first six weeks of starting it.
Theresa: He's, really unfamiliar with the LDN but my thyroid numbers are always fine, but with Wilson's temperature syndrome, the body temperature is always low.
So this is an indication of chronic infections so it can be mixed, but very, very cautiously.
Right. Well, I appreciate your time and thank you.
I heard about it about four years ago, and so lucky to have a compounding pharmacy online. Advertising it in my area, so that got the news out. So it's wonderful that the news is getting out and more people are going to be able to be a little bit less painful.
Linda Elsegood: Okay, well, we're going to have another break, and we'll be back with some more questions later. Today's show is sponsored by the Poway Integrative Medicine centre who take a holistic approach to provide the highest level of health care—combining internal medicine with alternative therapists, including acupuncture and Chinese medicine.
If you're in the San Diego area, they'd love to see you or you for in the state of California they offer secure video conferencing appointments when clinically appropriate. Go to www.pimchealth.com or call 858 312 1672
On Facebook follow Jill Cottell, MDs page.
Linda Elsegood: Welcome back and this time, which went by Cynthia. Hello, Cynthia. What question do you have for Dr. Cottel?
Dr Jill Cottel: I have PMR for the second time. I had been using LDN since July 2015, and when it came back again this July, it was significantly less pronounced than the last time. However, I'm not on steroids yet. I'm doing a low inflammatory diet, but if things get worse, is it alright if I do go into steroids? Also, there's a possibility I might be developing giant cell arthritis because I have a very painful jaw, sort of extreme tenderness on top of the head, but no headaches yet. Last time I was probable GCA, but,I had been in touch with my rheumatologists just yesterday.
Just in case they want to do a biopsy, but I really want to know where I stand beside the LDN and steroids.
Dr Jill Cottel: That's a very good question. If you were just dealing with the PMR alone, that would make it a little bit easier and it definitely, it would be fine to combine steroids with the LDN for PMR.
I've had patients do that. And you can generally get that away if you think less steroid and come down off of it more quickly. But if there's any possibility of the temporal arteritis, you have to be more careful about that because of having your vision affected. So I'd be more vigilant about that and getting your eyes checked frequently and making sure they are watching you closely.
Cynthia: Well, I'm hoping that I haven't got the GCA and I'm really hoping, but I up to what level can I take steroids because I know that with GCA they will often a GCA, sorry, start at 25 milligrams. The steroids, is that all right with LDN?
Dr Jill Cottel: It should be fine.
Cynthia: Oh great. I mean, I'm hoping not to because last time I was on steroids for three and a half years and then I was on methotrexate as well for the last year probably, and I didn't like either of them, like all the side effects combined, so I'm hoping to keep off the steroids. I just wanted to know where I was because I'm hoping to see my rheumatologist who will obviously know nothing about LDN.
Linda Elsegood: Sure. Well, good luck. with that. Bye-bye. Okay, next we have Linda. Do you have a question?
Yes, I do. I have severe Crohn's. I've had three bowel resections, and the last one I ended up with a hospital, a bug on a ventilator for two months and almost died. So it's very important that I take my LDN all the time. I've been on it for about six years, but here's my problem.
Now that they look in my colon and basically in remission I still can't control the bowel movements and diarrhoea all the time, but it's better than it used to be. I also have multiple pain issues, Fibromyalgia, myofascial pain, Stenosis and I've had to have my ureters replaced with tubes that have to be changed out every 90 days or so. I have not been able to let go of my pain medication. I worked out a plan for myself because I couldn't go off the pain medication. I don't take any pain medication after 3:00 PM in the afternoon and when I go to bed at 10 pm I take my LDN.
Do you see a problem with that?
Dr Jill Cottel: I don't.I mean if my patients are on pain medication and they're taking it so frequently that they've always got some in their blood it can be a problem. So even if their last dose, is it three, if they've already taken, a certain amount of medication that day already, it may not be completely out of their system by bedtime. But if you're on a small enough amount that you're getting enough space out from it, you should be OK. And if not you should know already because the pain would come back, and you get some withdrawal symptoms. There is the issue of course, while your chronic narcotics, the hyperalgesia of the central nervous system, pain effects from being on them.
It's risk versus benefit and with all the different pain type syndromes you're having if it's something that you aren't able to come off of you have to just do your best.
Linda: I have tried, and it just has been impossible for me. I ended up becoming homebound and in bed, and I refused to accept that, and I fight as hard as I can, so I take the minimal dose.
The earliest possible during the day and then just do the white knuckle teeth-gritting when it gets to be there in the day so that I can have my naltrexone at night. And I think it's working because my colon is still beautiful.
I so much wanted somebody to tell me if that was an acceptable way to combine them or not. So thank you very, very much.
Mary: I have been looking at LDN for a long time, and I haven't gotten a doctor to prescribe it for me. I had to ask a couple of doctors in the UK. We live in Sweden for three and a half years, and I went to the UK for treatment with finally identical hormones and I asked the doctor there to prescribe it, but she wouldn't, she just didn't think it made any difference. But she said she didn't believe there was any research that proved that it would help. I've gone to the seminar in Las Vegas and I thought that it would help me. I currently am not taking much pain medicine. I take Arthrotec now and then. I have Fibromyalgia, Chronic Fatigue, and the fatigue is bothering me much more than the pain now. Do you think LDN would help me?
Dr Jill Cottel: I do. Well, based on my experience. With my patients who have Fibromyalgia and Chronic Fatigue, for the Fibromyalgia, almost all of my patients have had some benefit, and a very few have not.
Almost everyone has had some. And then I've had patients where they've had dramatic improvements with the Fibromyalgia, and same thing with Chronic Fatigue. Most of my Chronic Fatigue patients are feeling much better. We do have a good couple studies looking at Fibromyalgia with Low Dose Naltrexone and you should be able to find someone to prescribe that for you.
Mary: Now we just moved about two weeks ago to Austin, Texas. Do you have, do you know of any doctors in this area that is familiar with it?
Linda Elsegood: We have a list, and there are some doctors around that area. If you would like to send me an email, contact@ldnresearchtrust.org, and we will get back to you with some of the doctors that we know of that prescribe.
Linda Elsegood: And we will quickly get to the next person. So thank you very much, Mary, for your call. Next calleris Robin. Hi there.
Robin: Hi there. My question regarding Chronic Fatigue. You just answered part of my question about Chronic Fatigue Syndrome. But I wanted to be a little bit more specific. My son, who is 18 years old, has been suffering from CFS for about two years. He seems to be improving with, nothing, I guess He's on an antiviral that doesn't seem to be helping to me, but he's just gradually getting better and specifically, do you think that it would help his, like these setbacks and crashes that he has that we're trying to really put an end to? I mean, what specifically with CFS doesn't seem to help other than just the fatigue?
Dr Jill Cottel: I would say, probably energy improves. And also a lot of times mood improves.
And so patients, sometimes the symptoms aren't as much improved, but their ability to cope with the symptoms is better. Does he have any muscle type pain at all, or is it just the fatigue?
Robin: He really doesn't have muscle pain. He has suggested that his limbs feel heavy at times. He occasionally has a headache, but not often.
It really just seems this excessive fatigue. If he doesn't get enough sleep, it's stress and emotional stress or concentrating in school, that seems to cause these setbacks the most. And then he can't basically, get off the couch for a couple of days.
Dr Jill Cottel: I would think it'd be worth trying.
Robin: I agree. Okay. I just wanted to confirm because I hear it used more with pain and Fibromyalgia, but not strictly with Chronic Fatigue syndrome though. Thank you very much. I appreciate your help. Bye-bye.
Linda Elsegood: Sarah on Facebook wanted to know if you'd had any success with LDN for treating Epstein-Barr.
Dr Jill Cottel: I have a patient who, she had had, illness with Epstein-Barr, and she just hadn't been able to bounce back from it.
And it had been, I'm going to say at least six months, and she started taking the LDN, and I want to say within about a month she was feeling much better and then it wasn't much longer after that she kind of felt back to normal.
Linda Elsegood: Okay. And Diddy said, can LDN be taken with high doses of Manganese?
Dr Jill Cottel: I don't see any reason why not.
Linda Elsegood: Does LDN help with adrenal insufficiency?
Dr Jill Cottel: That is a good question. I don't know the answer to that. I do have patients who've come in with the diagnosis of Adrenal Fatigue, which is kind of a nebulous sort of thing, and I'm not sure anyone knows why LDN helps those patients, but it might just be the endorphins themselves helping with energy food.
Linda Elsegood: Another question. Is endorphin buildup a real thing and should people occasionally skip a dose? And if so, how often?
Dr Jill Cottel: The patients that I've had generally when they skip doses, they feel worse. And sometimes not right away. But they can usually tell the difference sometimes after four or five days off.
I think in general, probably not skipping doses. And you figure it takes a while for the endorphin levels to decline anyway. So how much difference you're making just by skipping a day or two here and there, I'm probably not making too much of a difference.
Linda Elsegood: I must admit sometimes. I'm just drifting off to sleep, and I think, I haven't taken my LDN.
Do I get up and take it and wake himself up or just miss a dose? And I sometimes miss a dose, and it doesn't make any difference. I think sleep sometimes it's better than getting up and not going back to sleep. Another question here from Kaylyn. Does LDN stop the progression of the disease?
In her case, she's got Rheumatoid Arthritis?
Dr Jill Cottel: That's a good question. I don't know that anyone knows the answer to that for sure. I think that we look at terms like remission and how people are doing clinically. So, I mean, just matter of semantics, whether you say, stopped progressing or it's in remission.
We go by how the patient is feeling clinically.
Linda Elsegood: Okay. And another one there about dosing. The benefits of splitting the dose into two over a day for CFS/ME.
Dr Jill Cottel: So again, that's a very good question. I generally discouraged my patients from doing that just because that's not the way it's classically been dosed.
And it's not the way it's been dosed in the small studies that we've had. And the mechanisms of action is to briefly block those endorphin receptors. And it has to be brief, and it has to be in and out of your system. So what the implications would be of doing that again, only 12 hours later? We don't know and Naltrexone has metabolites that stay around in the body afterword. So I would tend to discourage it.
Linda Elsegood: okay. We've got time for one more caller.
What question would you like to ask Joe?
Joe: I would like to ask for a group member who has been trying to get an answer to this question. If Dr Jill has ever treated or know of anyone treated for a condition called a Stiff Person Syndrome, also known as a Stiff-Man Syndrome and I'll start there, and then there's a part two.
Dr Jill Cottel: That doesn't sound familiar.
Is there anything else that goes by?
Joe: No. Those are the only two he stated and that I know of is the stiff person or stiff-man syndrome, but is, I'm pretty sure, I believe.
Linda Elsegood: It is actually on our list of conditions that LDN can treat.
Dr Jill Cottel: Okay. I'm looking at it just in front of the computer since I'm sitting here and it says a rare neurologic disorder of unclear cause with progressive rigidity and stiffness mainly affecting the trunk muscles with spasm. So no, I don't have any personal experience.
Joe: Okay.
Linda Elsegood: I'm really going to have to stop you there.
When the hour's up, we stopped. So I'd like to thank you very, very much for taking our calls. As always, Jill, the next Wednesday we'll be joined by doctor Jim, Dr John Kim, full details are on the website.
Thank you. We would like to thank today's show sponsor, Dr. Jill Cottel and the Poway Integrative Medicine Centre.
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 Jarred Younger shares his Low Dose Naltrexone (LDN) experience on the LDN Radio Show with Linda Elsegood.
Dr Jarred Younger describes his continuing studies on LDN and has written papers on them. There is an interview with him in March 2017 where he explained his testing for pain levels.
He concentrates his studies on Fibromyalgia women and measures the reduction of pain, fatigue, and inflammation with the use of LDN. His work will someday be recognised in the training hospitals for doctors.
This is a summary of Dr Jarred Younger’s interview. Please listen to the rest of Dr Younger’s story by clicking on the video above.
Linda Elsegood: Today I'm joined by Dr Jackie Silkey, who's from just North of Salt Lake City in Utah. She's a functional medicine practitioner. Thank you for joining us, Jackie.
Dr Jackie Silkey: Thank you for having me.
Linda Elsegood: Could you tell us how long have you been prescribing LDN?
Dr Jackie Silkey: I've been prescribing LDN for about five years now. I’ve treated quite a wide range. I started out using LDN for all autoimmune disorders including Hashimoto's, lupus, and now have branched out into other areas and using LDN for other applications as well.
Linda Elsegood: And what kinds of results have you seen so far?
Dr Jackie Silkey: I've seen very good results. I always use LDN as part of a program where I'm addressing more of the root causes of what's going on and putting a comprehensive program, both nutritional exercise, stress reduction, those type programs into place, as well as doing quite a bit of a functional medicine testing. And then I bring LDN as an anti-inflammatory as the extra treatment arm. In most of my patients, I see they are successful in implementing base therapy.
Linda Elsegood: Have you seen any negative side effects?
Dr Jackie Silkey: Yes. When patients first, start LDN. Sometimes patients will complain of vivid dreams or difficulty sleeping—those sort of common complaints. I'll either move them to morning dosing or depending on how significant the symptoms are, I'll dial back on the dosage or just tell them to go ahead and push on through. And I find that it improves easily within a week.
Linda Elsegood: Have you any people that you have treated who have had marvellous results? Do you have any case studies you could quote?
Dr Jackie Silkey: Most of my patients actually come to me to get a comprehensive program put into place, and then. I actually don't see them routinely. They go back to their primary care physician once I'm able to get them improving in the right direction. And so I don't have patients that are coming in monthly for checkups or checking in with me. So most of my patients will go back to their primary care physician once I feel like that they have plateaued on their healing with me and have put into place all of the aspects of healing that I find to be important.
Linda Elsegood: Well, that's good, isn't it? So if so, when a patient comes to you, you, you look at everything, that lifestyle, that diet, exercise, supplements, all this kind of thing to try to get them.to have a healthy lifestyle as well as treating the disease. Is that right?
Dr Jackie Silkey: Most definitely. Yeah. In fact, a lot of times I try not to even look at the disease per se. I try and look more at the patient and say, you know, why is this disease happening in the first place and see what we can do as far as reinforcing them foundationally.
And that's where I think LDN really plays a significant role, is to reinforce people foundationally. You know, just like we do with nutritional aspects that exercise aspects, stress reduction aspects, all of this just to reinforce not only a nice environment for healing to take place, but also to prevent relapse.
Linda Elsegood: What would you say is the best diet? We're always being asked this for people with autoimmune diseases.
Dr Jackie Silkey: Well, it truly depends upon the person in my opinion. I don't even like the word diet. There are so many negative connotations associated with it I try to use nutritional plan because I really want people to think about this being a nutritional plan, one that they don't come on and off of. So diet, we always think of, I'm going to go on a diet and then I'm going to come off of the diet. And those things tend to be, you know, somewhat more extreme.
When I set up a nutritional plan, let's say for somebody with autoimmune disorders, there are some people that come to me and have read every book and have tried, you know, multiple nutritional plans have had limited success with them. I don't go back and try to recreate those. I just learned from what they've worked on and what they haven't had work in the past. Sometimes they'll do some functional medicine testing, some food sensitivity testing to dive deeper into that person's metabolism of foods and, and their sensitivities and what their blood is doing when they eat certain foods. And that way, I can kind of make a more personalized approach.
Linda Elsegood: Are you a fan of vitamin D?
Dr Jackie Silkey: Oh, yes. You know, we can get a lot of sunshine in the summer, but I would say the majority of patients that I test, and I do test everyone, are low. That may be an absorption issue from the GI tract. They're not absorbing it. A lot of people don't know about vitamin D, that it's a fat-soluble vitamin and that you have to take it with fat. Otherwise, you won’t absorb it. And there are some people that I don't think absorb their fats very well, to begin with, and so they can have absorption issues. I try and address all of those things. Testing vitamin D levels, also taking a look at the GI tract and how well they're absorbing their vitamins.
Linda Elsegood: But I would have to say both my husband and myself, after listening to Dr Tom O'Brien at the conference last year, we both stuck to the diet religiously and I have been a diabetic type two, and I was diet controlled for four years. And then I was on Metformin, and I was told a few months ago after being on a diet, say six months or so, that my sugar levels were prediabetic, and I was told that I could stop taking the Metformin.
So I'm thinking, Oh if you're going to take the medication off me, what happens if. They go upon, I don't know, and I have kidney problems. I was really panicked, and they said, don't worry, we will take your blood again. And it showed that I was at serious risk of becoming a diabetic, but I was prediabetic, and I didn't need to take the Metformin.
I've been assured enough seeing the results, and I'm not worried about it. And I'm sure if I keep my diet. As it is, but apparently once you've been diagnosed as a diabetic, they can't remove that from your records. So I'm now a diabetic in remission. So I'm, I'm really pleased about that. You know, one less drug.
Dr Jackie Silkey: I think that there's a lot of people they can say that they are diabetics and in remission as well, you know, or a diabetic, in the, making one or the other. I think that you know, nutritional plans play a significant role as well as exercise plans and then implementing those exercise plans and then stress. Obviously, stress is going to play a significant role.
Linda Elsegood: Let’s briefly talk about exercise. Now one of the questions that we are always being asked, sick people, can appreciate the fact that they should be exercising people with, say, someone with MS who suffers from severe fatigue, where any exercise, just moving, showering is too much for them, and they spend a lot of the time in bed. What can people do too? Try an exercise when they are that fatigued. What is your suggestion?
Dr Jackie Silkey: You're absolutely right. I want to make sure that your listeners know that we always talk about implementing exercise programs and try not to make people feel guilty for not implementing exercise programs. But there are some people that that can actually be quite detrimental for. And, and you know, if you do an exercise program and you're recovering for two days because you did too much, then obviously, you have to build up your base before you’re ever able to really do a formal exercise program. You really have to spend quite a bit of time working with the patient and talking with the patient about what they've done in the past. What was too much for them in the past and if you can dial into what it is that their body needs. Because you take the same person with MS, and then you take the person down the street with MS, they're going to have two very different exercise tolerances, and they're going to have two very different levels of benefit from any sort of a formal exercise program. So you have to make it, in my opinion, very individualized. And that's where I find that it can be very difficult and, and can make people worse initially if physicians to a physical therapist or nurse or anyone is not listening to the person about what's been too much for them in the past and, you know, starting low and going very slow.
Linda Elsegood: So you learn to become fit enough to start to exercise basically very slowly and gradually and not to give up. Forget the idea that you're not achieving anything by baby steps. You do get there. It just takes a while, doesn't it?
Dr Jackie Silkey: That's exactly right. And everybody has a very different starting point, and so it doesn't really matter where your starting point is, it's important that you start there and that you move forward from there.
Linda Elsegood: I think it helps to keep a diary of what you can do and try and improve on that. If you've only managed to do an extra five steps in a week, at the end of the month, you know, you may have done 20 steps or something like that. It's all just very, very slowly and gradually. And then once you become fit enough, you can then, as you were saying, do a plan. You won't fatigue yourself too much, doing
Dr Jackie Silkey: too much
Linda Elsegood: too soon.
Dr Jackie Silkey: You're absolutely right. And I think that's where pedometers, you know, really play a significant role is then measuring steps and, and there's a lot of things that people can do and in their homes, just depending on where they are. Other things, you know, take more pressure off of the joints, sign up for a program that's actually done in the water, taking some, some of the pressure off of the joints themselves. So if somebody tells me that they had quite a bit of soreness and joint pain, well, there are supplements that you can take before then there's hydration that you can do before them. But there are also ways in which, if their joints are quite uncomfortable that you can do exercise in the water. Even just some gentle movements and walking within the water itself can take the pressure off of the joints enough to where you can slowly build from there. And there's actually a treadmill that's available, it's almost like it's built into a shower and certain physical therapy places will have it and where you can get in there, and you can just very slowly walk on the treadmill, and water just to take some pressure off. Those are just some examples of different things that I'll have people do.
Linda Elsegood: I went to a class to do cross therapy, and I was in my fifties, and I turn up, and I was the baby. They were people who were 70. It really made me smile. They were all so kind to me. And you wore a band around your, your middle. So you floated like a cork no strain on your arms and your legs, and you just bobbed. And it was difficult. It was really, really difficult. So I was saying, you know. I don't think I'm going to be able to do an hour so that I did set it all up, but that's fine. We'll just do it gradually. I could only do 20 minutes.
Dr Jackie Silkey: For some people even just going to the facility, changing into a swimsuit, getting into the water, getting out of the water and going back home, wipe them out completely. It just depends on where people start. If people are quite ill, and then you obviously cannot start with a formal exercise program.
Linda Elsegood: I couldn't walk when I got out of the water suddenly, suddenly all the weight was on my legs, and it's like, Whoa, I can't do this. I went home, I went to bed, and I couldn't get out of bed and move without really severe problems until Thursday. I did too much, but I didn't realize it. It just seems so easy, but my legs just, Oh, it was unbelievable. We will just go to a break, and we'll be back in just a moment.
Today's show sponsor is Care First Speciality Pharmacy. They're leading compounders of LDN and other custom treatments servicing patients in over 18 States coast to coast. They're credited to provide you with the highest quality demanded by the industry and the expert service. You expect to learn more. Call (844) 822-7379 or visit CFS pharmacy.com.
Back to stress, that's another thing we've never talked about so far on the radio show. What do we do when we're stressed and maybe defining stress versus depressed. I mean, when you have a chronic condition lots of things become a problem to you mentally.
Dr Jackie Silkey: Yes. I think that you know, when we talk about, it's really important for me to teach patients when we're talking about implementing a stress-reduction plan, is that it's not at the moment necessarily to relieve stress. It's about implementing a plan. It's like a nutritional plan. It's not like you implement a nutritional plan that day, and you lose 10 pounds that same day or gain 10 pounds of muscle that same day. It takes time for you to see the fruits of your labour, but by implementing a stress-reduction plan you're putting more resilience into people's lives and into their body to be able to, to be more resilient with relapses or more resilient with a major stressor that comes along, a car accident, anything that's gonna be a big stress in somebody's life. Stress reduction versus depression, I believe you said stress versus depression, they tend to in a lot of people go hand in hand and that's where these comprehensive programs, including low dose naltrexone, really helps. People with mental health issues and, and with depression. Now, did they have a formal diagnosis of depression?
Maybe or maybe not, but still low dose. And by reducing inflammatory factors within the brain is able to help. Most people that are dealing with a chronic illness because a chronic illness, by definition, is depressing to the body. It's stressful for the body. It's living in a body that's inflamed and living with a brain that's inflamed is very difficult.
Linda Elsegood: Let’sget to some questions and answers.
Dr Jackie Silkey: Yeah, that sounds good.
Linda Elsegood: We have a Marie, and she says she has a seven-year-old who was diagnosed with Crohn's four months ago, and she would like to ask, are the children taking LDN with success and when would she expect to see improvements? And what would the improvements be besides better sleep? Would it assist with pain and quality of life? She was hoping that he would have more energy and be able to go through a normal day at school.
Dr Jackie Silkey: Well, we were talking earlier about patients that I have on LDN and my success stories, and. You know, a lot of times I won't see them routinely, but one of the success stories that I have and that I still speak with this patient often is with a Crohn's disease patient.
So Crohn’s disease you know, quite a bit of inflammation within the gut. So people that are dealing with a fire brewing inside their body, whether it be in their gut or their brain or their blood or wherever. It's going to fatigue them. It's going to decrease their energy levels. Initially, it might make somebody more agitated, but initially, what initially fires somebody up and makes them hypermetabolic then to close them down later in the disease process. What I tell people what to expect is variable. I put patients on low dose naltrexone and we watch, we take a look, we dial them up. I do tend to increase their doses slowly and watch for their most prominent symptom, for example. And the patient that I was referring to earlier, one of the hallmark symptoms she would have was diarrhoea, and so she would be having eight or nine loose bowel movements per day when she was in an active Crohn's flare, she also had some abdominal pain.
So once we were able to start her on low dose naltrexone and then dial-up her dosing, we ended up doing something a little bit different for her. We ended up doing twice a day, smaller doses instead of once a day, larger doses. So you have to keep reassessing. But I will tell you that for some people the response is dramatic and swift. But just because somebody does not have a swift or dramatic response doesn't mean that they aren't going to have a response either later or that it be kind of this slow uptick. I would say that, what I would tell the mother is, you're absolutely doing the right thing. See what the symptoms that are most predominant at the beginning of starting low dose naltrexone. And then always stay in contact with whoever's prescribing it so they can help guide you on the correct dosage, the correct frequency. We were talking about stress earlier. Here's my patient who was a student and every time finals would come around, she would have a flare. And so knowing this, we knew how to put into place a stress-reduction program that really dialled up a week or two before she started studying for all of her finals. And preparing earlier for her tests. So there was less last-minute stuff. So we were able to, you know, figure out what her relapse risk factors were, and then specifically guide that around my plan. We ended up not needing the plan, but my plan was also going to think about going towards a higher dose two weeks before those stressful events, but we ended up not needing it. She was able to keep the progress that she had made for throughout the rest of the semester into final examinations by just preparing earlier and knowing what she needed to do would affect what her final result was. So, I don't know if I've given any specific timeframe. I will tell you, it varies from person to person.
I would definitely take a look at the symptoms that your son is having and that energy, in my opinion, energy usually comes around quicker in kids. But it tends to lag behind the other symptoms, their GI symptoms. So if he's having quite a bit of abdominal pain, an improvement upon the abdominal pain might come first. Then energy might come after that. Imagine that the fire that is brewing inside the person's body is sucking them dry of energy. Well, you have to first, turn off the propane to the fire, and then you have to extinguish the fire and then with time, then that energy will then come back. There are really very few side effects. The only time that it really plays a significant role is if I tell people about they have to have surgery or if they accidentally fall out of the tree and break their arm and they have to go on pain medicine, any of those sorts of things where you're going to be stopping the LDN for a period of time.
Or I am trying to use no narcotic pain medications, which would be even a better choice.
So, do I feel that, LDN is safe in children? Yes. And, even in pregnancy I have a couple of patients that are pregnant, and that stopped LDN during their pregnancy, and resumed it, after they deliver the baby while they're breastfeeding. And I personally, don't even think that there's any reason why anybody needs to stop it during pregnancy.
But there are no studies that have looked at LDN in pregnant women because there's, you know, there are no studies that have looked at other medications in women, but we use them. You know, and people that are addicted to opiates will use high dose naltrexone and sustained release naltrexone because the risk to the baby is much greater than the potential risk at high dose naltrexone. Low dose naltrexone is an immediate release Naltrexone compounded formula that can be used in children and young women.
Linda Elsegood: Well Ithink many of the listeners will have heard of Dr Phil Boyle using it in his paternity clinics where they use LDN to get pregnant during pregnancy and during breastfeeding. He did a very good presentation for the conference last year. And it showed that babies born were of better weight, had less need for antibiotics. Apparently, some babies need, antibiotics for chest infections and the like, and they weren't contented. And I thought that has to be good if you've got a baby that cries all the time. So in his experience, LDN has been really good, and he did a small study. I'll have to send you the link to it, which was very interesting. Very interesting indeed. Okay. We have another question here from Lucy, and it's with atopic dermatitis. I know that you do a lot of skin conditions in your practice.
Dr Jackie Silkey: Atopic dermatitis. Cyclosporine is a common Western medicine drug that is used for autoimmune. So it's going to, you know, decrease somebody's immune system reaction to themselves. So the thought is, is that you know, that autoimmune disorders are really yourself, you know, attacking oneself, you know, the whole idea of that, without looking at their foundational, a lot of times what I find is foundational people with autoimmune disorders. Really, their immune system is woefully inadequate for foundational reasons instead of hyperactive, if that makes sense. So people on cyclosporine can take low dose naltrexone . Now, cyclosporine levels are normally checked for somebody who had a transplant who was trying to keep their levels at a certain parameter. And I would say initially when starting any new medication or any new supplement I tell everyone that is taking for transplant reasons to have their levels checked after starting any new medication or any new supplement because everybody's going to react a little bit differently. So would it, would it potentially affect their levels? Possibly, but not usually.
Linda Elsegood: Okay.
Linda Elsegood: And we have another one, about eczema on steroid treatment. This lady has been using it for 30 years, and she says, my skin is very inflamed. I have no quality of life. My dermatologist's about to put me on what the drug we've just been talking about, and she's been off topical steroids for 18 months. And do you think LDN would help?
Dr Jackie Silkey: As part of a comprehensive program? Absolutely. I find that part of a comprehensive program LDN plays a significant role in all of the autoimmune disorders that affect the skin, that affects the brain, that affects the GI tract. I try not to treat a disease with a drug or a supplement. I try and treat the person who is having symptoms associated with the disease and look for what their rate-limiting stuff is. So, you know, there are some people that are not absorbing their fats well. They're not digesting. They've got some digestive enzyme insufficiency. They've got maybe some small intestinal bacterial overgrowth symptoms. They've got a lot of gas and indigestion, fatty stools, things like that. Well, with that person, I'm gonna think about why the eczema is just being a symptom of the problem. And by far and away, I find that things like eczema, psoriasis, all of these things tend to be more of a symptom of the problem. Instead of me worrying about labelling people with their diseases, I say, this is a symptom of the problem and we're going to follow this symptom as we address, you know, your insufficiencies as we find them. And that's where functional medicine testing, I believe, plays a significant role.
Linda Elsegood: And at the time you've got the body working correctly. Do you find a lot of the symptoms resolve anyway?
Dr Jackie Silkey: Oh yes. That's exactly, that's when you know. There can be several things that you uncover that may not be directly related. Let's just take eczema. It might not be directly related to their eczema, but yet play a very significant health benefit if you can address those things as well. So, but yes, I mean, anytime I'm seeing anybody with anything from acne all the way to psoriasis. I'm definitely treating internal parameters instead of just treating, okay, is your acne better? I'm following many different things, but I think the skin makes it nice because you have an external way of evaluating how well your treatment is going. You just look at your leg, and you say, yes, the treatment seems to be doing much better.
And people do that with depression. People do that with getting pregnant. You were talking about infertility treatment. I mean, that's obviously the goal and obviously the goal is to improve eczema to where it's completely asymptomatic. But. I don't find that putting topical treatments or putting people on a cyclosporin to be that helpful in getting down to the root cause.
In fact, I think it just masks the symptoms. I have people come in all the time that are on steroids or cyclosporin or other autoimmune medications. Humira is big here in the United States, and it just masks the symptoms, even if it controls the initial disease or the initial symptom that you're trying to control. Your body just has a way of showing that in some other area.
Linda Elsegood: And what's the downside on using. Steroid creams longterm over the years?
Dr Jackie Silkey: Well, first of all, it changes the quality of the skin you're using it on. And second of all, you absorbed some of the steroids through the skin. So, you know, you're interrupting the barrier protection of the skin. Are you making it less of a good barrier to disease and to infection and all the rest? Depending on if you're just using a small amount of steroid on one area, but some patients have to put steroid creams on multiple areas of their body, and so that ends up being a fairly large dose of steroids. Some of that is going to get delivered systemically as well as just on the skin. So the problem with steroid creams is that they can thin the skin. So we use the thickness of the skin as a measure of. Health. So think about somebody's face. Think about an older woman's face versus a younger woman's face.
Part of that ageing process is this thinning of the skin, and so it, therefore, can't withstand pressures as well.
Linda Elsegood: We willjust go to a break, and we'll be back in just a moment. Today's show sponsor is Care First speciality pharmacy a leading compounders of LDN and other custom treatments servicing patients in over 18 States coast to coast.
They're accredited to provide you with the highest quality demanded by the industry and the experts' service. You expect to learn more: call eight four four eight two, two seven, three, seven, nine or visit. CFS, pharmacy.com welcome back. Another thing I wanted to ask you, there's a lot of buzz going around at the moment about detoxing teas that you can have to flush out all of the builds up that you have in your bowels. Are they a good idea?
Dr Jackie Silkey: Well, I think. When we talk about detoxification, we talk about trying to find out, first of all, what you're detoxifying from, trying to get down to kind of a root cause. If it's, you know, just general toxins that we're exposed to, then I think, you know, ramping up your own detoxification pathways is the best way to do it and pooping every day is an absolute mandatory in my clinic. Everybody that comes in, whether they're coming in for eczema or low dose naltrexone or functional medicine. One thing that I always talk to them about is how often they're having a bowel movement. To work on detoxification when you haven't worked on proper bowel function is not gonna work. You're going to do one flush of tea and they might feel better for a day or two, and then they're going to go back to their regular bowel habits. And so, sorry. No, no, no, no. So it's like anything else, doing it once might be enlightening but you want it to be something that they implement from now on. It's not a diet that they go on and off of, but something that is going to stick with them can be life-changing.
Linda Elsegood: Out ofinterest. How would you make yourself go every day?
Dr Jackie Silkey: A bowel movement? Oh, well, it depends on where I feel people are deficient in, you know, so if they're magnesium deficient, which I would tell you that the majority of us are, even our soil which we grow our vegetables are magnesium deficient. People tend to be very deficient in vegetables in general. So I try to calculate, I try and get an idea of how much, um, how much fibre people are taking in during the day, and, um, what sort of bowel, um, irritations they've had in the past. So treating somebody with irritable bowel syndrome, they've had multiple episodes of small intestinal bacterial overgrowth, and it's a very different process than treating somebody who comes in and just says, yeah, I have chronic constipation, but they don't have any abdominal pain, so you have to, you have to treat them very, very different. But somebody who's not having any abdominal pain, not having any abdominal symptoms, then I start, usually start with magnesium and ramp up their magnesium dosing and see if I can't either tests them to find out on a cellular level, what their magnesium levels are, or see what sort of improvement we get from, ramping up their magnesium, but ramping up also fibre intake, water intake.
Linda Elsegood: So keep flushing and eating those vegetables.
Dr Jackie Silkey: Yeah. I love magnesium too. Magnesium is great, and it's great to help people sleep better. It helps. It's helpful with nighttime leg cramps. It's helpful with bowel movements. It's helpful with slight blood pressure elevations.
Linda Elsegood: Oh, sounds a good one to take, doesn't it? Does that come in like pill form?
Dr Jackie Silkey: Yeah, it comes in pill form or in a granular form as well.
Linda Elsegood: We'll certainly have to look into that.
Dr Jackie Silkey: Maybe we can start combining that with low dose naltrexone, low dose naltrexone and magnesium together. Maybe we can get one of the pharmacies to compound that for us.
Linda Elsegood: That’s food for thought. We have a question here from Elisa. It's about allergies and fibromyalgia. She says, I stopped LDN for a few months but again,I feel tired and cannot sleep. I wanted to start again, but at this moment in time, I use melatonin. Come melatonin be taken with LDN, and I start at 1.5.
Dr Jackie Silkey: Yes. Both of those, LDN, melatonin can be taken together. You can also take melatonin I mean, take LDN during the day if it's affecting your sleep. You know, I think the majority of people have been using it at night because that's the original way in which it was prescribed. But I think that a lot of physicians now realize that we can use it during the day in effect, depending on what your goals are for therapy. They can sometimes be even more appropriate than night use depending on what your goals are. The first time I took it, I had a nightmare the second time I had the best dream. I mean, it was kind of more of an intense dream, but it was, you know, worthy of a book when you could have written a book about the stream and it would have been a bestseller. And the third night I was so excited to get back to that dream and nothing. So it just depends.
Linda Elsegood: I had no vivid dreams at all, so I feel I've been roped even though only one you had one
Dr Jackie Silkey: and I still talk about that dream, and I still try and recreate it, and I think in my spare time, may need to write a book about that.
Linda Elsegood: Melatonin is easy to get over the counter in the US, but we don't do that over here. I don't like medication at all. And when I flew to Las Vegas for the conference, my body clock was complete upside down. It was an eight hour time difference. And the first night I woke up at three o'clock in the morning. I had to work, I had to see people, and I was on breakfast television on one of the television stations. And I think the next morning it was like four o'clock. And then the next day, it's like half-past four. And I went into one of the local pharmacies. And the. The gentleman said, how can I help you? I said, can you give me anything? I don't care what it is, anything. I'm just so tired, I can't function. And he said I didn't need a drug that I could actually have melatonin and take it an hour before I went to sleep. And to try and relax. It worked really well.
Dr Jackie Silkey: Well, with prescription medications there's this whole degree that really we should have to put medications, you know, on this grading scale. You know, one is a very benign medication, one that potentially has a much higher benefit to risk ratio all the way up to 10, where those are the riskiest drugs. And the benefit is lower than the risk. And that way it would provide patients with an idea that not all pharmaceutical medication is bad. Not all supplements are bad, but there is a whole grading system, you know, and I think it would be very helpful. I know I have a lot of people that are concerned about taking supplements on a daily basis. And I completely understand. I think as we age, melatonin is one of the hormones that really starts dropping off. There's a lot of good things that melatonin does. We have a way of measuring it. You can do a salivary measurement with people, and it's very helpful to get that sort of salivary measurement from people who are waking in the middle of the night to look at salivary cortisol and look at salivary melatonin. Who would go, drive to get their blood drawn, in the middle of the night? But by looking at salivary levels, we're able to see, you know, what, what's going on in the middle of the night. And as people age, our melatonin levels do drop off. I really feel like melatonin can be very useful in some people, and some people don't even realize. I mean, it can increase what we call the lower oesophagal sphincter in the oesophagus. So if people are having a lot of reflux at night, melatonin is helpful and in decreasing reflux at night.
Linda Elsegood: Hmm. I used to have to take medication for reflux, but since I've changed my diet, that's another medication I've stopped.I don't need to take that anymore. So that was a really big plus. I think people who can't sleep and then go to bed thinking, I've just taken my LDN, and I'm not going to be able to sleep tonight because I didn't sleep last night and get stressed about it.
Dr Jackie Silkey: Oh yeah.
Linda Elsegood: It's a cycle, isn't it, where you're thinking, I can't sleep, I can't sleep.
And that's on your mind when you lay down, and I think. Yeah. You need, I don't know what techniques you tell people when they can't get to sleep. I used to do yoga I meditate and I can, put myself to sleep ordinarily that way without having to take anything. But just by deep breathing and relaxation and, and that kind of thing. What do you recommend?
Dr Jackie Silkey: Yes. So I always find out what the person's tried in the past. So I'm not, you know if they haven't tried anything, then yes. I do always start with trying to learn something that you will have with you, whether you're travelling to Las Vegas or not. You know, I mean, people can't just run out and go and get melatonin in the middle of the night, at 11 o'clock at night, They're in a strange environment. So I think that having any sort of programs within our own body that we have at our disposal is by far and away from the best way for us to put those plans into place. A lot of times what I'll have people do is trying to associate some of the meditation techniques that you're talking about, counting backwards, you know, starting at a hundred and counting backwards by three, and really focusing on the breath, doing a, what we call four, seven, eight breathing technique where you breathe in for four, you hold for seven, you blow out to eight, where you're really kind of tying up the mind and trying to get your mind off of, Oh, I really need some sleep tonight. I can't believe this. I didn't sleep well last night. No, it's going to happen again. That sort of cycle that sometimes our brain gets into is very detrimental, and so the more that you can kind of tie-up that aspect of the brain, those racing thoughts, those, Oh, I really should be asleep now. I've got this big radio interview tomorrow—those sort of things, and, and tying that in with relaxation. If people feel that they, they still cannot sleep. Then, getting up, moving food, different room. You know, I'm reading a very boring book. You know, people don't even talk about trying to, trying to, you know, read a dictionary or something that you would find to be very boring, very mundane. Just again, trying to get your mind on paying attention to something else instead of what you're, what you feel like you should be doing.
And then once you start feeling a little bit fatigued, then you go right straight back, and you lay back down and you stay in that quiet space there. People that try all of the self-regulation techniques and they're still not sleeping well. And for those people that have tried all of those things, obviously we check hormones. I checked melatonin levels. I check progesterone, estrogen, and testosterone. I want to see specifically what sex hormones are doing what their thyroid hormones are doing. Then we go from there instead of me just basing that on guesses. I like to. Individualize the treatment for the patient based on specifically what sort of issues they're having. Obviously, the treatment for high cortisol at night if somebody is going to sleep is very different than somebody who has hormones that barely work. .Those people need, you know, to consider hormone replacement, whether it be melatonin or progesterone, whatever.
Linda Elsegood: And that leads me to another question we’re frequently asked now when I go abroad, I always take my LDN before I go to bed.
Regardless of what time zone I'm in, and some people say that they are a night shift worker, should they be taking LDN when they get up? Should they be taking it when they go to bed? Does it matter? How would you address that question?
Dr Jackie Silkey: Well, I addressed the question of we don't really know whether it matters or not. What I tell people is that we have to get to a point to where you're a responder. So that's my initial goal is to start people on it, to get them to be a responder. Not to say, well, you know, you must be, you know, that percentage of people that don't respond and how do we get you to be a responder to LDN?
Once I know that you are responding to it, then I say, you know, now we get a chance to see if it makes a difference in you because it may not make a difference in you whether you're taking it. At the same exact time every day, or whether you're taking it right before bed, whatever time that is, whether it be one o'clock in the morning or 8:00 AM but you, you don't really know how that person until you get them to be a responder. But once they respond, then I think people will tell you that, you know? I think this is where journaling like you were talking about, journaling can play a significant role. And there's the LDN app, as you know, which can be very, very helpful. And in and helping people out you know, the symptoms that they're having and what sort of symptom improvement that they're having. t I tell people, don't get so hung up on having to take it. Before bed that you end up missing a dose or you know, take it. When you feel like that, you're going to remember every single day to take it. I like the idea of taking it before bed because I like to think about all of the hormones that are going through our brain and, you know, increasing growth hormone and, and trying to optimize the brain to provide healing hormones to the rest of the body. But, I find if that is a stumbling block to somebody taking all the end, then I would much rather they be taking it at other times the day.
Then I'm not taking it at all. And for some people too, you know, you can find out that the right dose, you know? I've had some people that I've changed over to twice a day dosing if they weren't getting a good response with once a day, dosing. So it varies from person to person, just like all of medicine, you know?
Linda Elsegood: I'm going to have to stop you there. We've come to an end. I'm sure we could have gone on for another couple of hours. It's a joy and a pleasure to talk to you now for our listeners if they would like to come and see you or a consultation, how did they go about doing that?
Dr Jackie Silkey: They can just call the office or send me a quick email and we can talk about scheduling that appointment either in person or online or something.
Linda Elsegood: We haven't yet told them how, where your office.
Dr Jackie Silkey: Our office is just north of Salt Lake City. It's in a city called Keysville, Utah. And the office number is area code (801) 882-2200. An, the website is www Utah functional med.com.
Linda Elsegood: And thank you very much for being with us today.
Dr Jackie Silkey: Thank you. Thank you for having me.
Linda Elsegood: Any questions or comments you may have, please email Linda, L I N Dat, LDN.org I look forward to hearing from you. Thank you for joining us today. We really appreciate your company. Until next time, stay safe.
Today's show sponsor is Care First specialty pharmacy by leading compounders of LDN and other custom treatments servicing patients in over 18 States, coast to coast. That is why they are accredited to provide you with the highest quality to mandate by the industry and the expert service. You expect to learn more.
Dr Izabella Wentz shares her Low Dose Naltrexone (LDN) experience on the LDN Radio Show with Linda Elsegood.
Dr Izabella Wentz, Pharm D shares her experience of thyroid issues, LDN and her book "Root Cause" The Definitive Guide for Hypothyroidism and Hashimoto’s Thyroiditis.
She speaks from experience in her books and her lectures, as she has hashimotos, IBS, and thyroiditis. Although she is a Pharmacist her time is spent consulting clients with thyroid and other autoimmune conditions.
She describes how diet, supplements, and LDN are important in correcting thyroid problems. She found going gluten, dairy, and sugar free was the first and most important step in her healing.
This is a summary of Dr Izabella Wentz’s interview. Please listen to the rest of Dr Wentz’s story by clicking on the video above.
Pharmacist Dr Ike is the CEO and founder of Enovex Total Wellness Pharmacy. He is a compassionate health care practitioner, cares about the health of every patient and tries hard to have all the information he needs to guide them to a better health.
He has been a pharmacist since 2003 and has a bachelor degree in biochemistry. He opened his own pharmacy in 2010 and a year ago he opened his Enovex pharmacy. They only do compounding, but will also do screening. They are licensed in six states.
He describes the various conditions where LDN is very effective, and applications for hormone compounding. He also talks about Ultra Low Dose Naltrexone which is very effective in enhancing action of the Fentenol patch. Less pain med is required and it lasts longer. Also the addictive nature of the Fenenol is reduced, which could be an important development in reducing opiate dependence.
This is a summary of Dr Ike’s interview. Please listen to the rest of Dr Ike’s story by clicking on the video above.
Dr. Igor Schwartzman is from the United States. He first heard about low dose naltrexone (LDN) around 2011 when learning about small intestinal bacterial overgrowth (SIBO), a gut flora imbalance and changes in gut motility. Treating SIBO includes treating gut motility secondly. Many of his patients have Hashimoto’s thyroiditis, which is autoimmune hypothyroidism; and a large number also have SIBO. LDN can be used as a prokinetic (pro = for, kinesis = movement).
He also learned about other autoimmune conditions LDN can treat. In addition to Hashimoto’s thyroiditis, Dr. Schwartzman treats patients with multiple sclerosis and other autoimmune conditions, gastrointestinal disorders like irritable bowel syndrome, and Crohn’s disease. He treats SIBO in stages: managing overgrowth, which may include herbal or conventional antibiotics, fasting, appropriate diets; and focusing on motility, which involves herbal treatments, LDN as a prokinetic, and continuing dietary intervention. He sees food as medicine, and where things begin.
Typically, patients with gastrointestinal or endocrine disorders including Hashimoto’s thyroiditis, etc., generally have various food sensitivities or allergies. Patients with SIBO generally are on an individualized blend-specific carbohydrate diet with low FODMAPs, using anti-inflammatory foods. Once the gut and the barriers in the mucosal membranes heal, other food can be reintroduced, but it is a slow process.
The usual side effects of LDN he notes include vivid dreams, for which he recommends taking LDN in the morning if they do not enjoy those dreams. Most patients feel benefit during the first month, commonly describing a sense of wellbeing, and improved tolerance and distress resistance. He estimates 75% of patient see benefit, and the others don’t necessarily see any change.
About 85% of Dr. Schwartzman’s patients have Hashimoto’s thyroiditis, and at least half are on LDN, 100+ patients. People are even coming in requesting LDN – some have read LDN Research Trust’s The LDN Book, so come educated. Dr. Schwartzman spoke his appreciation of Linda Elsegood, for all the work, heart, and soul she puts into bringing awareness to LDN.
Dr. Schwartzman can be reached at Whole Family Wellness Center in Portland Oregon. The website is http://wfwcenter.com/, and the phone number is 802-490-5009. He has patients contact him by phone, or email through the website.
Summary from Dr. Igor Schwartzman, listen to the video for the show.
Keywords: LDN, low dose naltrexone, small intestinal bacterial overgrowth, SIBO, Hashimoto’s thyroiditis, hypothyroidism, irritable bowel syndrome, Crohn’s disease, autoimmune, diet, The LDN Book
Dr Henry Mannings shares his Low Dose Naltrexone (LDN) and Cancer experience on the LDN Radio Show with Linda Elsegood.
Dr Henry Mannings has been prescribing Low Dose Naltrexone (LDN) for over 10 years to his cancer patients and has experienced a great deal of success. In this interview he explains how impressed he is with LDN’s lack of side effects and the positive impacts it can have on his patients.
Having prescribed LDN for such a long duration of time, Dr Mannings is well versed in how effective LDN is in certain cases. For instance, he has found that LDN is successful in treating many types of cancer including bowel, liver and lung cancer.
This is a summary of Dr Henry Manning’s interview. Please listen to the rest of Dr Mannings’ story by clicking on the video above.
