LDN Video Interviews and Presentations

Sabrina Knowles LDN Story (low dose naltrexone) from LDN Research Trust on Vimeo.

Hi, my name is Sabrina Noles. I'm 44 years old. I live in the beautiful Bahamas, and I have a husband and two kids. I was healthy for years. I mean, I was living the fast life. My career was taking off. I was in IT. I was working. I was travelling for the company I was working for, the bank I was working for, and I was very much into my career, and everything was going really well.

I got married when I was 21 years old, and things are still going really well and then I would say a scale of one to 10, my quality of life at that point was probably a 10. Now, I would say if I go back to when I was a child with asthma and the complications from being a bit overweight or whatever, I would say it was, I was more like a seven, you know, that's six, seven.

But at that point once I lost that weight and weight later, teens and I just stayed there and I, you know, focused on my career. I focused on my college.  I was really booming and it was going really good, you know, so I definitely was a ten then, and that went on for a good few years, I guess.

I got pregnant.  I was three years married, and then I got pregnant.  Four years on and I was still feeling really good. You know, things are going well. And then just, just one day.  I actually started to lose the baby, and I had to go on bed rest because I was spotting and stuff like that.

So I had to go on bed rest, and I did not know that was the start of a whole lot of things coming for me. So I would say for most of the pregnancy I was on bed rest. And then when I was two months pregnant then and  I stayed on off and on for the majority of it. Then it got diagnosed with this and that, and it was a struggle in the pregnancy.

The entire pregnancy was just a real struggle and then I actually lost the use of my hands when I was about seven months pregnant. In fact, we had a baby shower. You know, it was all a surprise. It was really rough. But I couldn't open the gifts. You know, everybody sits down and opens the gifts and my husband and I just sit next to me and actually open the gifts for me because I literally could only put my hands in my lap. I was able to use my hands minimally, but to do pretty much intricate things or just things. I was in so much pain, and they were always so swollen. And you know. Then, I didn't know that that was definitely a start or something bigger. And so I went on, my son came prematurely actually.

He ended up in the hospital and there was a rough time too with that whole situation. So it when he actually couldn't take my breast milk, and that's what was making him sick. And he found that out when he was about seven weeks.. And we had to just cease him breastfeeding. And once we did that, his condition cleared up right away.

You know, you should go for your six-week visit. And I ran for that, and I noticed that the shoulder was painful. And so I rang my doctor had told me prior to that, she was like, Oh, your hands are going to get back to normal after the pregnancy. And I said, okay, great. Glad to hear that. And everything is going to get and that was great to hear that. But no, this is now. Seven, eight weeks later, and my hands and still a mess, and even worse than they were at that point when they started. And then my shoulders now a mess, and she's now saying, Hey, my doctor's saying, Hey, you probably need to go see your rheumatologist.

I rang to see a rheumatologist, a local rheumatologist here, and I just told him what was happening with my hands and my shoulder, and  he said, okay. He just rolled up with some steroids, and he said, take them. And I'm like, what?  what am I taking them for? And he said, well, just take them.

And he never gave me any explanation, and I'm kind of stubborn. So I knew steroids weren't good for you, so I just decided not to take them. I ain't really, honestly never did. I got prescribed them many times after that. But my stomach felt, decided not to go back to see him, and I would just wait this out because I'm going to be fine.

So I tried, you know, I ran to the gym, and I was working out thinking that if I lost the weight, which I was told by the doctors who want you to lose the weight, you're gonna feel better. And so I said, okay, sure. So I, you know, watched what I ate and I worked out and. My hands were far worse at this point.

And then the shoulder went and then it was like, okay, now we're, we're, I maybe I damaged this in the gym, you know, and that's what I'm thinking. And so I, at that stage,  I finally, I needed help with my house cause I needed to, I went into, my son was about a year old, cause I didn't want to do anything until I knew he was able to at least walk around. So I went to see another doctor who said, Hey, you have Quervain's severe disease. So I said, okay. So he said, you have to get an operation on both hands. So I said, okay. You know, but I also have a shoulder issue, and then I have a left knee issue. Yeah. But they're not related at all.

You know, you have to get the surgery in your hands in order to feel better. So I had to go and, I think I took about two months before I actually went to go to the surgery with him. And I remember I was laying there and they cut up on both hands and then did whatever they do. And I was definitely without using my hands for about four weeks after that.

So I was, everything had to be done for me at that, at that point and it's good. I have a pretty good husband cause he had a whole lot during this whole process. So now I'm 25 years old and I, you know, I had my first child, my hands are a mess, and I'm healing with these hands and I'm wondering what's going on with my body because it's not just my hands anymore.

As I said, it's both shoulders and now a knee, and I'm being told by a doctor, this is all in your head. All of this is in your head. Okay. So it's all in my head. So I said I even, at one point I got prescribed antidepressants because it's all in my head. And so that didn't go well. 

So the quality of life is going down rapidly here, you know?

I'm sorry, I went back to work after my son was born.  Then I, as I said, I had gotten the surgery not too long after, and then I was like, you know, something isn't right, and I'm not feeling right, and maybe it's the stress of going back to work. So I ended up quitting my job and staying home with my son, and I said, okay, for one year, because honestly I like to work.

That's just how I am. Plus, you know, he was starting to go to a preschool, and I was like, you know what, let me just go back to work and. So I went back to work and the pain now in my lower back so bad. I cannot forget those pains because that stayed with me for, you know, I'll get to that, but many years after that so I went in to see another specialist locally, and

she said to me, Hey, you have fibromyalgia. So I said, okay, what does that, well, at that point, I think it was 2003, and they didn't seem to know much about fibromyalgia at that point. So, she was like, well, you know. Right. And I think that was one of the first times I got prescribed the anti antidepressants because it was a treatment for fibromyalgia.

And then she said, well, if it's your low back and your neck pain, it must not be related to the fibromyalgia. That makes no sense. She said I think it's because you have large breasts. And I did. So I was like, okay. She said I think you need to get a breast reduction. So I said at that point, it was so much pain, I was like, whatever it takes, let's just do it. I must say, my mother, tried to talk me out of it. Kind of wish I listened to her, but I was in so much pain, especially in my neck. I went,  whatever it takes. And I went under the knife again, and I got a breast reduction done. And I say a few months later. I may have had a slight bit of relief in my neck.Probably slight. I'm not sure this remained the same. She did tell me to, my shoulders should clear up too, because of the bra strap. Straight in the shoulders. I was like, okay. And I mean they did do some quite a bit, but still, you know just a slight change in my neck. 

So then my husband and I, we went to New York, and we went to the New York Centre for joint diseases.

I have been to quite a number of places other than doctors locally. And they, um. They couldn't come up with anything really. You know, it was kind of like a dead end again, I hit a lot of dead ends, I think after that, that was probably 2005. Um, and then I, uh, I would say, um, I'm just trying to remember, I said, I saw another specialist, thyroid specialist as well.

Nothing was wrong with that, right? Then, the doctor who did suggest I get a breast reduction and said that there is some issue with my thyroid, but it's minor. Nothing to worry about. So that's why I ended up pursuing a thyroid specialist here who then told me, no, nothing's wrong. You know, everything's fine.

So I said, okay, now this time, every joint in my body is just feel like it's collapsing. The pain is just all through my body. My muscles are twitching. Yeah, my muscles were burning. You touch my skin. My muscle was burned. It was just intense. Um, I had, uh, I had so many symptoms. It was from one thing to the next..

It was a lot of stomach issues, a lot of dry skin, I could not sleep. I did not sleep for about 17 years properly. I will never forget that and off all things, and to be honest with you, I don't think anyone who knew me knew who I was going through because every day I had to be a normal person because like a lot of doctors told me it was all in my head.

So I wanted to believe that and just be normal like everybody else. So I just lived in all the lights. 

I did get some relief when I was pregnant with my son too, until I came across the best thing ever, um, was in 2008, I went to Cuba for treatment, and I did ozone therapy, and I did, um, you know, a lot of rehabs and.

Uh, different things like that. And I must say, I think where I took myself out of a stressful situation, it's just home. And as well as we are just opening up our first business a couple of years prior to that, um, I think maybe I was like, okay, maybe that's what it is. It's just a bunch of stress.

So I had relief for about eight months. 

It came right back, and when it came back, it came back worse than ever. And I was like, wow, I really thought i was getting somewhere, but it came back and it, it's terrible, and at that point, I started to want to give up. I was like, forget it I'll just suffer.

So, uh, but I didn't think it could get any worse, but that was another lie I was telling myself, besides, it's all in my head. Um, in 2011 and of course, I'm, I'm missing out a whole lot of, um, doctors I in between all of that. Besides fibromyalgia, I was told I had thyroiditis. I had, Myasthenia gravis I was told, um, ankylosing spondylitis was the, when I was diagnosed actually from 2003 in my, and I was told you know, ten years, I'll be in a wheelchair, you know, and that I, that was, yeah, so I would've been in 2012 I guess I would have been in that wheelchair.

 

But anyway, and So, and all that time, I'm being diagnosed with a whole lot of different things., I IBS, uh, chronic fatigue. Well, of course, I come that came with another doctor who I had already been diagnosed well two years before that. Um, and all of these things, Oh, um, arthritis. When I'm getting to that, I, I'm sitting there, we're watching this program called

The street diagnosis. I came, I know it was this, a doctor who had a patient had exactly what was going on with me. That's how it just seemed. And so, you know, we got the doctor's information who helped her and really liked, she was in Texas, and we were like, yo, we're going to Texas. And you better believe in a few months we were in Texas seeing that doctor, and when we went there she said you have PCOS. And she showed me. And it was really like a podcast busier, as I said before on the answer again. So, Oh, I was planning, and I was prediabetic. And that is where, um, she said that, well, these pains and joint issues and problems, they don't seem to be related to the PCOS, but let's go see a specialist.

And. I'm between hunting specialists. I was told like, polyarthritis but, um, I was like, yeah, it's just another label being put on me. I think I was getting used at that point, but I didn't mind treating this PCOS. I saw you've been on glucophaseh and, um, I think it was something else. I don't remember it was okay in some ways, um, but at this point, you know, um, brain fog and, Oh, I will never forget this.

Music used to play in my head at a very loud tune all day, every day until he went to bed. And, and like I said, sleep was not good. So I woke up in the morning and the music was loud and loud, and that went on for years. That was one of the worst symptoms ever. And I, uh. I would say at this point this is now 2011, quality of life is really poor.

I am, I thought it couldn't get any worse, but if I were to give it a number out of the worst, I would say I was probably about a four at that point. Trust me it got to a one though, and um after I saw the doctor in Texas and they did what she told me to do and things, so it wasn't getting any better. I definitely, I'd given up then, and I justt wrote it off for years after that. I said I didn't even talk about it. I just like, whatever.   I think what really hit me when I felt like, you know, uh, I'd say about maybe 2015 I said, you know what? I think I’m going to die. And that's, that's when I started to realize I gotta do something cause I have two kids and I'm feeling like I'm gonna die, you know.

So I said, uh, you know what? Let me start looking into this again. I, I'm forgetting the whole giving up  thing. I'm going to start looking into this again. I always, I'm subscribed to a lot of the functional medicine doctors, and I get their emails, and sometimes I'll read them and sometimes i won't.

And dr Hyman was definitely one of the ones that I, um, you know, loved his, uh, everything he had to say, you know, so I one day, an email popped up, and it was, uh. It was related to a series he came out with. I thought the series was so different, cause I've never seen any, any of them, how a series comes on.

So I was like, you know what, let me read about it. So I read about what's called the thyroid secret. And so, of course, the thyroid is almost always buzzing around me with my condition, even though it was all in my head. Um, so I, I always, I always felt it was related to my thyroid. I'm; still, I'm still. I know that it is related to my thyroid, it to some degree.

Um, but as you know, with autoimmune diseases, once one thing starts, another one and then another one. So anyway, um, I, I decided to watch this series. Uh, initially I didn't, I was like, I don't know. Watch, I'm wasting my time. It's just another waste of time. But then I, then I remembered, I said, you remember you didn't want to give up, so you've got to do everything it takes.

So I said, you know, I never saw it was done by dr Isabella Wentz. And I watched that first series, and I couldn't believe what I was watching. I was like, this is another world to me. I didn't know who that, uh, you know, that this type of help and these solutions are out there. I would say I saw, I learned about, um, AIP, which is the, I still follow the AIP diet today.

I, well, I, I bought it. Some things blocking are important things. Um, and then I learned about LDN, and I was like, I, you know, as she spoke about LDN,  It can be. I've seen all these doctors. No one has ever said those three letters to me. No one has ever said that. So I just, so I got more interested. I, and I read, I listened to, I think it was 12 shows in the series.

So I, and I, I bought it, and I listened to the can, and I even got the, um, transcript. And I read that I ain't got so into it. And I was like. You know the, I think this was like late 2015 or early 2016 now coming in, I was like, you know what? I am going to do everything she says and that, and I didn't know how I was going to get my hands on LDN.

I'll be honest. 

So in 2016 late 2016 right? That's when they started to make all these changes, and then it was unbelievable. I know. Amazing. I started that AIP diet is very strict. I, along with the LDN and when I saw the LDN, I, um, I got, I got like, I'm sick and I was like, what am I doing wrong? And then I went and saw him do a little research and I, I was taking too much of it.

So I did, I had to pull back a lot. I started to take like just 0.25. Then I, uh, and, and along, as I said, I was doing the AIP then I was doing, being very soon, I wasn't taking any supplements. I was doing everything extremely slowly. And they realized that I had, I just had a sensitive, very sensitive body.

All of that exposed me to what was really going on. And I could almost say overnight. I just became a brand new person. I hit my 10 then with feeling my best and that. I have started in, uh, 2017, early 2017. That's when I started to change between the LDN and the AIP diet and, and that I, I, I, I wouldn't say I'm a ten still.

I'm like nine now. Cause you know, a couple of little things are showing up, and I'm trying to figure out, okay, how to deal with those little things. But that's fine. That's fine. But, um, since 2017 to today, 2020,  I am doing a whole lot better. A lot of, I have even forgotten so many symptoms that I used to write down symptoms every so often just to remember.

And I had to literally go back and read some of them just to be able to recall them. Um, I mean, I'm running now. I do, uh, uh, well, I didn't do a marathon, but I was a part of a relay team for a marathon recently. And I, I ran one of the legs, one of the longest legs. I do, um. I always placed in the Run's too, I want on Saturday and hoping to place it.

And it's amazing how the change in me has just come about from just making . I'm not going to say the diet is easy, so let me say that. The diet wasn't easy, but I believe the diet was definitely, me helping the LDN to work, and the LDN was also just helping overall. Um, everything I could think of has pretty much just cleared out.

I am like, like I said, a brand new person, you know, and I, I, I can't believe how well I've done, cause Just, again, the diet is very, very hard, It's just really hard to public pill. But I had to learn how to use it pretty much. And I've been on it for the past three years, and I'm not planning to come off it at any time.

So when I, um, well for me, I never thought it would be possible to come from where I was to where I am now. I had an unbelievable change. I, if that can happen to me. And that can happen to anyone.  Oh, well over the past three years, well, even before I started LDN, I read a whole lot, and I couldn't believe what they were saying.

I wasn't a believer because how could this one pill do so many things? So, but if I can sit here and tell you what I went through to, to get to the point I'm at. With, just the LDN and, and like I said, the dye, but I know I've read a whole lot of stars where people didn't change anything, and that's doing the LDN, and they're fine.

They're fine. Then I, I'm definitely a believer that LDN can help in so many situations. So many people have approached me, since I had changed my life and.  a lot of them come to me, and they noticed the weight loss initially cause I lost about 70 pounds now, so that I know when I tell them about the conditions I had and all that very, they're even more, uh, amazed by it.

Um, and then I tell them about LDN and then they're like, okay. Like, you know, it's hard for them to really believe . You know, I'm, I'm sitting here, and I'm telling you that this is real and this is, um, possible. And so I, um, always make that a part of my,  story to, to people,  if this, if we can, as a country be able to accept something like this very cheap drug to, come into this country to help them.

Many, many, many social the sicknesses we have in this country, and we have a whole lot of challenges is no joke about that. You know, um, we can see so many changes. Uh, it, it would be great if we can get, um, a team of people who would beready to back what LDN is able to do. Um, as I said, I can talk about it and tell him blue in the face.

The problem here is getting access to it. I have to get mine out of the US, and brought in. Nobody here has said, I've tried to find it here. In fact, um, I probably have a pharmacy there to really help to try to get it there. But I think because of the compounding side of it, it's where it's a challenge for them.

I'm not sure. I'm not, you know, uh, I don't know much about pharmacies, but, but if we can get away to get it set up here and for doctors to jump on and learn about this, and it's a lot of if I can find the literature out there to show that this, this thing is real, and this works, I'm certain they can also see it for themselves.

Uh, it's side effect free. It's, it's not like you're taking a chance on a drug that's gonna be a concern for your patient. You know, it's almost side effect free. I mean, there's, I, I, I'm one of those who had the vivid dreams. That's fine. Who, who cares? I mean, I've had,  when I go up in dose, I have like a slight headache, but that goes away, and it's very small things compared to the suffering I had prior to that. And it's for people who are worse than me. I would sit here and say, Sabrina What's worse than what you felt? But I know there are people who are worse than me, you know? Um. Then I would say that it is something that we really have to consider using in this country for so many.

I know it's not just for autoimmune diseases. Cancer and a whole lot of things it helps. So if we could get on board, that would be an amazing thing for us. You know, we could see a lot of things change in this country.

Pain Seminar Q&A Panel - Feb 2020 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Pharmacist Gene Gresh - 20th May 2020 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Gene Gresh has been a pharmacist for 20 years and works with his son who is also a pharmacist in Vernon, Connecticut.

In this presentation Gene Gresh discusses how when he started 20 years ago Low Dose Naltrexone was compounded but there was little known about it until many years later when scientific studies started to be conducted.  He set out himself to really study LDN beyond the anecdotal evidence he knew to exist through his own customers.      

In his survey of over 600 patients they got a lot of good information and one of the key points that they found was that most of the patients that discontinued LDN did so because they didn't ask questions. They experienced side effects or they didn't see the results they wanted in the time-frame they wanted so they stopped it without any kind of information. With some of these conditions, it's so important for them to get the good information which enables them to persist with it and deal with unwanted effects. 

Pain Specialist Dr Pradeep Chopra Feb 2020 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

My name is Pradeep Chopra. I'm a pain specialist, and my area of interest is complex pain, pain conditions. So I'm just one of those weird guys who like treating complex pain conditions. Someone has to do that. Right? So I took up that job. No, I don't have any, this is a standard disclaimer. I don't have any conflict of interest. 

We're going to talk about naltrexone, it's the oddest drug you'll ever see. So we'll talk, and we'll talk about naltrexone, and then I'll talk about low dose naltrexone. And Dr Goldstein will talk about very low dose naltrexone. And then he's gonna talk about ultra-low dose naltrexone.

Is there an ultra low dose Not yet. Not yet. Okay. So let's talk about naltrexone for a minute. This was in 1984, it was approved with the FDA for the treatment of alcohol addiction and opioid addiction. And I believe even with heroin addiction, it didn't take off as the drug for detoxification for various reasons, mostly political reasons.

Now they found that in 1982 naltrexone affects cell growth differently depending on which dose you use. So at a low dose, it affects cell growth differently from a high dose. In the mid-1980s, we were hit with the HIV epidemic, and there was no solution to it.
And what happened was. In New York, there was this neuroscientist neurologist by the name of dr Bihari, and he was working at a detox centre, and he saw two kinds of HIV patients. There was a sexually transmitted HIV, and then there were heroin addicts who are sharing needles. So we had two different kinds of HIV.

So the patients who had HIV from addiction were given naltrexone, obviously because he was trying to detox them, but people who had sexually transmitted HIV were not given naltrexone. What he noticed was that the incidence of lymphomas and kaposi sarcomas, like immune conditions, were far less in the, in the patients who had been given naltrexone as compared to those who had not been given naltrexone. So that was one of his observations that he saw. And then later on, of course, different scientists picked it up, and they did some research on it. So what is naltrexone? It's a reversible competitive antagonist at the mu and Kappa receptors so that we know that it's a reversible antagonist. It also works on the Delta receptor to a certain degree, but it's the active metabolite. So when this gets metabolized to six-beta naltrexone it is also working the same as naltrexone to a certain degree. The plasma half-life is six hours.

So for the half-life of the metabolite is about 13 hours. So in general, you know, half-life times four is what is where it takes the full drug to be metabolized. So it takes about 24 hours for it to be metabolized. So remember this fact that this is an important take-home fact. Now commercially available Naltrexone is a 50-milligram pill. And the dose you should have recommended those is 150 milligrams a day. We're not talking about that today at all. Today we're going to talk about 1.75 milligrams to 4.5 milligrams. I'm going to talk about that. A lot of Goldstein is going to talk about some really crazy low doses.

I think you basically sniff naltrexone. Anyway. So the dose we're talking about is four and a half milligrams of low dose naltrexone. That's LDN in short. Now, remember, it gets fully eliminated in 24 hours. So let's talk about LDN.

LDN is, again, it blocks the Mu receptors, but it does it transiently. So it's such a low dose, instead of giving somebody 150 milligrams, you're giving them four and a half milligrams. So it blocks the immune receptors very, very, very transiently.
It's so transient that it’s enough to cause a positive feedback mechanism, to increase the production of endogenous opioids, also known as endorphins. So in these patients, what happens is endorphin levels, and enkephalin levels are increased persistently. So let me go through that again. When you use LDN, you're blocking just a few Mu receptors for a very short time, and so the body in turn, by positive feedback, produces more endorphins and enkephalins. 

So what happens when it produces increased levels of endorphins is it promotes healing, inhibits cell growth, and it reduces inflammation. And I'll go through all of those again. It also works on something called the opioid growth factor, also known as a Met(5)-enkephalin.
The opioid growth factor is a pentapeptide and endogenous pentapeptide produced in the body. Uh. Opioid growth factor activates a specific receptor called the opioid growth factor receptor. So you have OGF opioid growth factor that activates opioid growth factor receptors.

This forms a complex called the growth factor-opioid growth factor receptor complex. There is an increase in the number and density of OGF receptors. So what's happening is because there's so little endorphin, so little. There's so much endorphin being produced that there's an increase in the number of and density of the OGF receptors of this complex. This combination regulates tissue growth, wound repair, it inhibits certain cancers. I'm not going to talk about cancers. I'm a pain guy. I'll talk, talked a little bit about pain stuff, but there's tons of literature on it, working on cancer, especially pancreatic cancer, head and neck, squamous silicones, ovarian cancers, and they must be at least 20 papers on the treatment of skin warts for some reason.
I'm not sure why, but um, they're like at least 20 papers. Let's talk about the cell called the glial cell. Glial means glue. So the nervous system, the brain and the central nervous system are made up of—70 % to 80% of the brain. Our central nervous system is made up of glial cells. And the idea being like, okay, so the rest 20% are neurons and the, and it's packed by cells called glial cells, which were in the old times known as glue.

They didn't know what it was for but now we know that glial cells have a very important role to play. They are part of the immune surveillance under basal conditions. So the glial cells in the central nervous system which actually make up most of the brain, are part of the immune system.

When, when these glial cells get activated they get really angry. They release inflammatory cytokines and chemokines. So you don't want to piss off these glia cells. Neuroinflammatory conditions ……  there's a lot of work being done on Alzheimer's, complex regional pain syndrome, chronic pain conditions where actually the theory being is that these glial cells are the culprit.

These substances, in turn, increase the excitability of the nearby neurons. So in reality, if this is a neuron in the brain, the glial cells are almost right next to it, grabbing onto it. If you ever look at it under a microscope, they're literally next to the neurons. So when these glial cells release inflammatory chemicals, they cause inflammation of the neuron itself.

So let's confuse you a little bit more, I'll bring this all together. Don't worry. So toll-like receptors, toll-like receptors are a class of proteins that play a key role in innate immunity in the immune system. They are usually expressed by macrophages and dendritic cells when there's an infection these microbes are recognized by TLRs. There are about 10 of them which activate the immune system. The one we are interested in as a TLR4, this is predominantly expressed with the microglia. Remember I told you about the glial cells, the different types of glial cells, and one of them is called the microglia.

The expression of toll-like receptors is increased under neuroinflammatory conditions. Now, this is a key thing, remember, opioids caused glial cell activation by acting on the TLR4 receptors. And that causes increased proinflammatory cytokines. Now you must have heard of opioid hyperalgesia and you know this whole thing about why opioids are not good and all that, that's controversial. We'll talk about it later on. But what happens is in patients who are in high, especially high doses of opioids, glial cells get activated. And when these glial cells get activated, they cause inflammatory cytokines to be produced. And that is the basic theory between certain pain conditions that don't respond to treatments is because of this.

And one of the theories behind opioid hyperalgesia is this, is that they're causing glial cell activation. So the idea was that, okay, so if glial cells are getting activated, if I use something to deactivate these glial cells, I'm golden. I can do something, but I can help patients with their dementia or their pain.

So opioid antagonists, like Naloxone or naltrexone block TLR4 signalling, which in turn decreases glial cell activation, which decreases neuroinflammation. This is a very powerful sentence because we don't have any other glial that are de-activators in the market right now. We don't. And this is probably the only drug is a disease-modifying agent. Everything else is not a disease-modifying agent. This is the one that works on the TLR4 signalling, which in turn decreases glial cell activation, which then decreases neuroinflammation. So LDN blocks release of proinflammatory cytokines, including interleukin-6, 12, TNF alpha and NF- k-beta.
It modulates T and B lymphocyte production, which is an immune system, and it also causes a shift in the immune system response from TH2 to TH1. So I'm going to summarize the mechanism of action over here: It is the reversible antagonism of the opiate receptors resulting in increased production of endorphins, which then up-regulates the OGF, the opioid growth factor and opioid growth factor receptor access. So in short, uh, when you give someone LDN, it causes a reversible antagonist on the opioid receptor, which causes OGF or OGFr axis, to increase it blocks TLR signalling, which then decreases glial cell activation, which decreases the production of cytokines and then hence decreases neural inflammation.

LDN also blocks release of proinflammatory cytokines, including interleukin-6, 12, TNF alpha and NF- k-beta. It regulates cell proliferation through p16 and p21 dependent inhibitory kinases. This is more for cancer research. The only part that where I want to just talk about cell proliferation is - there's been some really good data on how it works in patients with diabetic ulcers, it has been shown to improve that. 

So let's talk about pain. Let's say what are the uses of low dose naltrexone, where can you use it? If you look up, if you ever look it up in a textbook, or if you look up online, they're like 30 different conditions. I just picked up the ones that I'm a little more familiar with.
The first one being pain, especially neuropathic pain. So we know pain. There are different kinds of pain. nociceptive pain, which is structural pain, there’s neuropathic pain, which is nerve pain. Most of our pains are a mix of both nociceptive and neuropathic—the differences, which one is more. So, for example, if somebody had back pain, he has both structural pain as well as neuropathic pain.
And so this patient, if you can take away the neuropathic component, you're going to get somewhere with this patient. It works on immune conditions like Crohn's disease, ulcerative colitis, Hashimoto's and cancers, works on autism, Lyme disease, and fibromyalgia. So I'm going to break it down to specific conditions.

In Crohn's disease. This study was done. I'll give you the ref, the citation in a minute, but this was an amazing study on Crohn's disease by Jill Smith.  And what they did was they saw a remission in two-thirds of the patients and 89% of the patients reported improvement to some degree. That's a huge figure in Crohn's disease, and they've been able to actually show colonoscopy pictures of before and after, and you can see how it improves. She did this work with Ian Zagon, who's one of the pioneers of LDN. So these are the two citations if you're interested. (See presentation).

So for IBS, they took 42 patients. It was an open-label study. We gave them low dose naltrexone, just 0.5 milligrams for four weeks. And there was an improvement of 83%. 83% of medicine is huge. I mean, we are looking for a 50% improvement. So they went onto a phase two trial. This was a phase two trial, 50 patients, four weeks. patients reported a hundred, 140% increase in the number of pain-free days. Clinical improvement, bowel urgency, stool consistency, number of stools per day were also reported by week four in both genders, males and females. They've never been able to show a difference. LDN between males and females, if there's any difference in how it works.

LDN and fibromyalgia, actually, there's been another study after this one. This was done in Stanford, by Jared younger. but after that, there'd been a couple of other studies. So, and this was a pilot study, single-blind crossover trials, ten patients with fibromyalgia.
You know, I don't know if you remember those, those things called Palm pilots? Well, half the room remembers. It was like a cell phone without the phone part of it. And so they gave these ten patients Palm pilots, and they said, record your pain all day long. And so they would enter it all day long and then bring them up, and then they would download the data.

So they took ten patients with fibromyalgia, gave them four and a half milligrams daily for eight weeks. It reduced fibromyalgia symptoms, diffuse pain, the sensitivity of mechanical stimulation greater than 30%. Their ESR dropped, indicating a general inflammatory process going on in fibromyalgia, had the greatest reduction of symptoms in response to low dose naltrexone.
I don't want to go into autism today because it's not my field, but this was a book written by Jacqueline McCandless called “Children with starving brains”. And there's some really good information on the use of LD in autism. And I don't think it works in everyone, but it works in more than 50% of the cases.

So I started early and back in 2005 and I was getting a lot of pushback from people like, Oh, this is an addicting drug. People were confusing naltrexone and methadone, I don't know, but I would get pushback from physicians saying, Oh, this is an addictive drug.
So finally, and I didn't have the funds to do whole big research, so I wrote two case reports which we published in 2012. Well, I, you know, I was seeing a lot of complexes or pain syndrome patients, and we really don't have any great tools to treat this condition as one of the most horrible pain conditions known to mankind. We didn't have any tools to treat this.  There were two cases. The first case was a 48-year-old male with CRPS. I know this is one case, but this is what we mean. I've been saying since 2005, and this is what people around the country are now seeing. So it's not just this one case that I'm talking about.

He had CRPS to his foot, which spread to his entire body, developed blisters, dystonic spasms, yet failed everything. This is what he looked like when he came to my office. You had all these scabs, you had these blisters, uh, and you can see the difference in colour over here. Started him on LDN. Two months later, he had improved physical activity, decreased frequency and duration of pain.
I mean, it's a pain didn't go away, but he was much more functional. it didn't change his dystonic spasms. LDN does not work on dystonic spasms as far as I know. This is what he looked. Uh, finally, and you can see a huge difference. This is just LDN. There was nothing else.

This is a 12-year-old girl, she's now much older, had Ehlers-Danlos syndrome, CRPS in the right foot, unstable ankle joint, started around four and a half milligrams once a day. It improved her dystonia, decreased her pain and symptoms of CRPS after two months. This is what she looked like when I first saw her. You can see how red the foot is and how it's dystonic. This was just stuck like this, that you couldn't fix it and we thought it's never going to get better, and this is eventually, this is what happened. 

So let's talk about real life. How do you and your practice use LDN? You start two milligrams in the morning  and I have them take it for four weeks,  I'm sorry, two weeks. I have them take it for two weeks. And I'll explain to you why. One of the things about low dose naltrexone is when you introduce the LDN, it does cause some headaches and causes some insomnia. I don't want to give them four and a half milligrams, and then they'll come back and say, but then I can't, I'm not going to take this drug anymore because it causes headaches or I can't sleep.

So I introduce it slowly. And there are some patients who are very sensitive to drugs. So I like to start at two milligrams, and then I use a compounding pharmacy that has the big scored pills. Um, and then I increase it to four and a half milligrams. They can take it in the morning or at night. Some patients will tell you that makes them sleepy and then some will tell you that it makes them, keeps them awake. So depending on that, you can decide they can take it at night or take it in the morning. In the past, the literature talked a lot about taking it at night at ten apparently at 10:00 PM at night, because then it, your endorphins are the highest at 2:00 PM at 2:00 AM in the morning. But now we don't think it's necessary, all you need to do is take it at once a day.

The usual side effects are headaches, insomnia, and colourful dreams. And I don't tell them about the colourful dreams on the first visit. I'll mention it later on once they've started to improve. So they're more receptive to it. But I do warn them about the headaches and insomnia. Generally, all these side effects go away.

They all go away. Rarely colourful dreams might persist. Um, so all you get is a free movie every night. Now don't be in a rush to see effects. You're not going to see an effect overnight. It takes a while. Um, I usually tell them to expect at least wait four or five weeks to notice a difference.

The common thinking among physicians, in fact, the last conference that was our thinking was I used to do it for three months. I said, give them a trial for three months. But physicians around the country now use it for six months. That's what they feel is the trial. Um, now sometimes you get a patient that'll come back and say, I just couldn't take this drug.
It made me really nauseous because, you know, you're, all of a sudden you're producing a boatload of endorphins in these patients, and so they don't like that effect. Some don't like it. Don't give up. What I do is we, we then back off to 0.5 milligrams a day. And they'll leave it there for a few weeks to a few months, and then maybe go up by another half a milligram to one milligram.
And that might be all that they need. So there are, we do have a bunch of patients who are at say one or two milligrams. On the flip side, if you don't see an effect that four and a half milligrams. There's no harm in going up a little higher. We've had physicians have used six milligrams. I've, I've never had gone higher than six, but I know of physicians have gone up to 12 milligrams, and I've still seen a benefit.

As long as you block the new receptors transiently, you're good. And it should be once a day. You can’t give it, give it to them three times a day or four times a day. You, you have to block it and then all of a sudden the naltrexone goes away, and you're left with a boatload of endorphins. 

It must be ordered from a compounding pharmacy.  It can be a pill, liquid, or cream. The cream, I brought it up because in autistic kids use some, they have a problem. So, but Jacqueline McCandless had mentioned she was using it as a cream in autistic kids. As I said, it doesn't matter what time of the day you take it as long as you take it once a day.

Then, when it's compounded, one of the things, most compounding pharmacies are now aware of how to make LDN, and they know exactly how to make it. They know the whole process.  but one thing to be careful was, is that you don't want an extended-release LDN. And because then that beats the purpose - It should be an immediate release LDN. So there's a, there's a big question about fillers that you should use with LDN. Uh, the one filler you can use is called avicill acidophilus and calcium carbonate, sucrose, lactose are used. Um, some patients are intolerant to certain fillers.

So if you, if you prescribed LDN to somebody, they're like two milligrams or four and a half milligrams, and they start having this bizarre reaction. Think of the filler. Say, if they come back and they say like, I get this flushing or I get this itching, or I feel really, really nauseous is probably not the LDN is probably the filler in that.

So the question that I get a lot is, Oh, the patient has an early, and I'm sorry, we can give this patient opioids, and they really worry about that. What if they need surgery or what if there's an emergency or they need an opioid? When in the beginning when they first, when some of us started using LDN, we were all nervous about this issue, but we've got now about two decades of experience on this thing, and we know that it's fine to take an opioid and.

Personally, I've tried it myself. I took an LDN, and Vicodin together, nothing happened. Uh, it was prescribed to me legally. Okay. But, but what I'm trying to say is that the number of mu receptors that are blocked is so small. I mean. LDN, four and a half milligrams early, and from 150 milligrams of naltrexone, you're blocking so few new receptors that if you gave someone a vitamin or a Percocet, it's really not going to make a difference.  They're not going to have a withdrawal effect. And most emergency room physicians don't even care about it. They'll give them whatever they need, and they're probably gonna get some boatloads of morphine or fentanyl or whichever. So it's okay for them to take it. But if you have a choice. Supposing the patient has an elective surgery coming up and as a question like, okay, what should I do?

Remember I told you his half-life was, um, was four hours, six hours, and then you multiply that by four. Um, so I tell them to stop 24 hours before the surgery and then start their LDN after their last dose of whichever opioid they were given for the, for postoperative pain. You can do that but just being very careful, it doesn't really make a difference. So we've never, I've never read in the literature and talking to multiple physicians. We've never seen withdrawal on patients taking LDN and a low dose of opioid. This is really good web research. You can go to this as an organization called re LDN research trust.

It's a nonprofit organization that, um, you'll find tons of literature on it. In fact, they published a book also. Thank you.

We have time for questions right.
Yes. So, the question was, if patients who have fibromyalgia and are on other drugs, have you been able to get them off that right? Yes. So you don't stop the Lyrica, you don't stop whatever Gabapentin or whatever they are on, don't stop it, but you just add LDN to it.

So the question she asked was, have you ever had patients present with hypomania or bipolar disorder for LDN? No, we haven't seen any issues like that.

I don't really start patients on patients who are already in opioids. I don't start them on low dose naltrexone because it beats the purpose. You're blocking them, your receptors, you're, it's, you're activating the glial cells at the same time as you're trying to deactivate those glial cells by blocking the toll-like receptors. So it kind of beats the purpose 

Diabetic for diabetic neuropathy? Yes. Same dose, approximately four and a half milligrams. So you're killing two birds with one stone. You're helping their tissue. Uh, they have fiber tissues here. You're helping that, and it does work on diabetic neuropathy.

Dr Asher Golstein (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Dr Asher Goldstein: My name is usher Goldstein. I'm a pain management physician, and physical medicine and rehabilitation is my first board. Anaesthesia pain is my second board. I practice in Hackensack, New Jersey, so it was a little bit of a trip to come here, but well worth it. I feel that LDN has changed my practice significantly.

I came into it three years ago, and it was sort of a disaster with one patient, didn't go anywhere, and then circled back to it about a year ago, and it's been really, really helpful. Unlike Dr Chopra, I do not seek out the complex pain patients, but, okay, Usually, I get them. And for those patients that, you know, you want to pull your hair out for, you know, so it's been very helpful and been helpful for the fibromyalgia patients, the patients who happen to have back pain and IBS or and crone or those patients with CRPS or knee pain.

 I've been treating some entities that don't directly relate to pain just because LDN has the ability to treat it. And I had a patient come to me who had fibromyalgia and had never come to me before. And, and I treated her performance. I started her on the LDN, and I'm like, two months later she comes to me, and she goes.

Does LDN treat breast cancer? And I'm like, well, what's the story behind the question? She said, well, I didn't tell you, but I had breast cancer, and I had a double mastectomy about five years ago. And they've been following my numbers, you know, for five years. I, every couple of months I go to my doctor, and they draw blood, and they look for tumour markers, and everything's been, you know, stable at 130.

And oh, we've been okay. And then, I went like, two weeks ago. And my doctor called me up and said, I need to speak to you. And I came in yesterday and she said, what are you doing? And she's like, what do you mean? She said some did you do something that changed? And so she said to her, well, why you're asking me?

She said because your numbers went from one 30 to like 22. And she said, what'd you do? And she said, nothing. I'm just taking LDN. She said, well, go back to Dr. Goldstein, ask him the question, and I said, well, you don't actually say that LDN treats cancer, but you know, it can be very helpful. And so hopefully her cancer never comes back even after five years.

But I can just say that you know. That was black and white. You know, her numbers just dropped. And the only thing that she changed; she didn't change anything else. We just added LBN on. And from her fibromyalgia perspective, it's been helpful. I've had patients that had much better response and patients that have not had a response, but her pain went from like a seven or eight in a total body pain to about a five.

So she's much more functional, and she's not taking any opiates, which is great. And I'm, she's happy. One issue that I had Dr. Chopra didn't mention is that because it's so cheap to manufacture, to make, you know about a buck a pill, or, you know, $60 for 90 days, which is what my compound pharmacy charges.

It's very hard to get money for research. And then, so you've asked about a head to head trial. Who, who's paying for that. Right. The drug, this thing has been manufactured since 1982 it's off-patent. It's very cheap. There's no money in it. When there's no money in it, nobody's paying for any trials unless you can convince the government to pay for a trial.

So there are not going to be any head to head trials because all the other drugs have money and this has no money. We always put it in like, no financial interest. Nobody has a financial interest in this because nobody's making any money on LDN. Right? So that's the catch 22, you know, it's helpful, but everybody wants to research.

They want strong research. They want, you know, a thousand patients and they want double head blinded and placebo. You can't do that. There's no money unless, you know, Bill Gates writes a check. There's no money in it, you know? So that's that. That's, you know, it's, so patients have to pay for their medication.

It's not expensive, but sometimes, you know, 30 bucks a month can make a difference. And the insurance companies, unless it's an accident, they do not cover the medication every once in a while that goes through, but very rarely. So I just, I just tell the patient straight up, but you're just going to, you have to pay for out of pocket.

Q: Is low dose naltrexone approved by the FDA for chronic pain or for pain? 

So naltrexone is approved by the FDA period at 150 milligrams dose. Okay. So do you think you need to get approval for a four and a half milligram dose? The answer is no. Not FDA approved for four and a half, but nobody's, nobody's applying for that because there's no money in it.

Right, right, right. So. 150, four and a half. And I'm going to be talking about one microgram, you know?

All right. A byproduct of what I do, I treat, I don't have a problem with treating my patients with opiates. Okay. So I still do, I, I do procedures, I do injections. I send my patients to acupuncture, the chiropractor, you know, it's like, what is Dr. Goldstein doing?

I'm doing everything because pain is not simple. And everybody, you need to have a big toolbox. And as part of what has happened in the past couple years, you know, so patients started asking me, you know, please, can you take me off the opiate? So I said, Oh, sure. And so I started, you know, doing stuff like, as best as I could. And then about a year and a half ago, I said, there's got to be a better way. So I asked some people questions, and I took a course by SAMHSA. SAMHSA is an excellent organization, and it was like an eight hour, online course and wasn't too expensive and CMEs and everything else.

And then I got certified, and I got knowledge of how to take patients off their opiates. And the bottom line is it takes me if the patients listen to me, it takes me about four hours, to take patients off their opiates. Now I'm not taking patients off complex substance abuse. I'm not taking them off cocaine and heroin, or, you know, but if it's just heroin or it's just oxycodone.

Then I can help them up. So, okay, so ultra-low-dose naltrexone and MAW, and it's me. That's what I do. I'm at Holy name Hospital, which is in Teaneck, New Jersey, which is a town that I live in, but I have a private office in the next town over, which is Hackensack, New Jersey. Okay. There we go. So no commercial interests or conflicts because there is no money to be made here.

And ultra-low-dose naltrexone is not currently, there you go, an FDA recommended treatment, all you know, but many drugs we prescribe off label because we know they have more than one use. And this is the case in this drug. Okay, what do we call it? Right? 

No. This one. Yeah, that's not working. Oh, there it is. Okay, so naltrexone is the 50 to 150 that's what it was. Prescribed them naltrexone, you know is five. You know, we talked about a 0.5 Dr Chopra talked about 12, and some people talk about 16, but the current sweet spot is about four and a half milligrams.

Then there is, we'll skip here—Ultra-low dose naltrexone. Which is a one to 20, but I actually don't go above 12, and then there's a little higher from 50 to 500 is very low dose naltrexone. So these are basically the four categories of ???naltrexone not track somewhat what we call it. And there are some of the edges of each category. tere's, you know, it's a little blurry, a little grey, but that's fine. Also just keep bear in mind with the lower levels of naltrexone, the theories of how we give it out and what dosages, and you know, where we start and where we end. It's still evolving. It's evolving. Like I said, three years ago when I started, with one patient, I ran into a disaster because I was told two milligrams, four milligrams, six milligrams, eight milligrams in one month.

And patient had no, positive response. So I stopped and, and it took me about two years to come back. Okay. So low dose naltrexone. So I use it for medication-assisted withdrawal. I tell the patients to come in to stop taking their medications 18 to 24 hours before their appointment time. They come in to see me. They're a little uncomfortable. So we want to get them, there's a scale called the COWS scale that runs from zero to 24 we want them to be uncomfortable around 15. In 12 to 18 but 15 so the reason we want that is because when we give Suboxone, we want them to feel it working.

So if they, it's too mild, they're not in enough withdrawal, and they don't feel it working. And if it's too severe, they just take a pill before they come in. Cause it does just not help cause they're just uncomfortable. So 18 to 24 hours. And so they come in and then, I start the medications to the withdrawal with Suboxone.

But that's not what we're talking about here. We're talking about ULDN. So when patients come that are my patients and they've been taking, or somebody else's patients, if they take medication for a long time and say, okay, we're ready to come off. I said, okay, when do you want to schedule this? And they say, well, we want to do it in June because I have my daughter's wedding in May.

And I'm scared to come off my opiates before June. June is like four months from that. I said, perfect. I'm not going to rush you. You're going, it's fine. We're going to start you on ultra-low dose naltrexone. Why so? Because when they, when patients go through the MAW, so they, they have sometimes had some side effects during that period of time in the office or before they offer it to us right after the office.

And one of the issues is anxiety. You know, the literature says prescribed Klonopin for the anxiety. So I'm like, why do I want to prescribe Klonopin to another controlled substance to help the side effect from this controlled substance? It's like a whole really bad cycle. So instead, I give ultra-low dose naltrexone.

They stabilize after six to eight weeks and when they come off when they do the MAW, when they come off their opiates, there are almost no side effects. Almost no side effects. So it's very helpful for that. And then in general, the second reason, besides a medication-assisted withdrawal is to enhance the analgesic effects of opiates in general.

So I find that if patients, my patients are like, Nope, I'm not coming off my Percocet, I take Percocet five times a day and I'm fine. I'm like, okay, what am I going to say? You know, just, that's what's working for you. That's what's working for you. But I give, I say, you know. Take the, ultra-low-dose naltrexone.

And what happens is that patients tend to drop one or two pills a day overtime. They just, they find that the opioid works better or they need it less. Whatever reason, they tend to drop it. So instead of five times a day are taking it three to four times a day. Okay. And then hopefully we can then convince them once they know about the molecule to come off  the opioids totally.

And then go on LDN to treat whatever their pain. Okay, so this is just a slide of inpatient detox versus office space detox. Basically inpatient detox. It's very expensive. You're away from your home. There's a lot of treatment, and you have no familial safety net. Maybe you need it for the really hard quote-unquote addicts to go away.

But you find that for most patients or mild to moderately or whatever, they're there, they have an addiction. But in the office, it's much cheaper. It's not even $5,000. It's probably around $2,000. It's 10 to 12 office visits over four weeks. And that includes both me and the mental health professional, not just me.

So it's not that bad. And then you have your family around, and you don't have to go away, and you can still work, and you can still go to school, and you can still do whatever you need to do. So I'm a big fan of Ultra low dose naltrexone. None of the commercial pharmacies will give you LDN.

So you have to go to a compounding pharmacy to get LDN. And then ultra-low-dose naltrexone don't even the compounding pharmacies have a lot of difficulty with it. So you have to go to a very good quality compounding pharmacy to get a quality ultra dose naltrexone because it's so small.

Okay. So 0.5 micrograms, right. You know, so 150 milligrams is the regular naltrexone for that, that's prescribed. And then the low, low dose naltrexone this four and a half. And then ultra-low dose naltrexone A four and a half milligrams to one microgram, like passing the floor at a very, very small dose.

And then I increase one to two micrograms every seven days to about 12 to 15 micrograms. And I tell them. Usually, it comes in a liquid. I tell them, put it up sublingual under the tongue for about a minute, then swish it around and swallow it. That's, you know, that works. Okay. So that's the ultra-low dose naltrexone.

And this is the very low dose naltrexone. I use it in two different ways. So when my patients are on Suboxone, right? So I get them onto some level of Suboxone. It stabilizes their withdrawal from the medication. Then at a certain point, I want to get them off Suboxone. I don’t want them, What? What did I do? I traded Percocet for Suboxone, so we started titrating down. So usually when they get to four milligrams of Suboxone, I then add in 100 micrograms of naltrexone. And then as the Suboxone comes down, I increase the naltrexone, and then we get to zero, and we were at 0.5 for LDN starting dose.

Now my starting dose is lower than Dr. Chopra’s starting dose. I start, and you know, as I said, it's just different. It's everybody. Eventually, we all get the 4.5 or somewhere around there, but I start my patients on 0.5 and slowly work them up over seven weeks to four and a half milligrams. I just found that that works for me, and I have less side effects, fewer complaints as headaches, but almost everybody has vivid dreams, which is, you know, most people like, they're like, cool, that works for me. The other way, is sometimes I can't get the patients to go down to four milligrams of Suboxone. They're like they're an eight or ten and just that's where they are. So I decreased the Suboxone to the lowest level tolerated, and then I begin at a hundred micrograms, and then I increase to up till I get the 400 micrograms, and then I just stop the Suboxone.

And usually that works just fine. Every once in a while, it doesn't work, but usually, that works fine. So either it's the plateau or the steady decrease, and that's how I use the very low dose naltrexone. Okay. So we talked that Dr. Chopra spoke about opioid hyperalgesia. This is my patient who had opioid hyperalgesia, and you're going to see, so 55-year-old male motor vehicle accident and crush injury to the right femur.

He was in New York city standing by a fire hydrant when a bus jumped the curb, a New York City bus and pinched him between the bus and the fire hydrant. Okay. And this was a guy who, you're the very traditional guy. He worked really hard, worked for his family. He was a man of the house. And so multiple surgeries, he had a little bit of lower back pain, but he was taking four milligrams of dilautid. That,s a lot a day.

And that's what he was on. All right. And he was telling me his pain is eight out of 10. He's still depressed, he's not working. And this is like really, you know, messing them up. So MAW was six months ago, not three and a half. I'll take this light. And MAW, I finally convinced him, it was like four years, finally convinced him that I said, you gotta just come off the medication and I'm going to, I said to him, I'm going to do a spinal cord stimulator for you, and we'll take care of the pain.

I said, because enough, enough of this, I, I know I can control the pain with a spinal cord stimulator. Or a peripheral nerve stimulator actually for him. So he came off and then he's on Suboxone six milligrams a day, and his pain is 1. So the opiates were causing his pain! Okay. Good mood participating at home, and he's looking for part-time work.

So medication-assisted withdrawal can actually not just take patients off opioids, but it can actually help with their pain. Okay. Thank you.

Dr Phil Boyle - Women's Health and Low Dose Naltrexone Part 2 - 26 Feb 2020 from LDN Research Trust on Vimeo.

Dr Yusuf Saleeby - 19th Feb 2020 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

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

Dr. Saleeby is a 1991 graduate with a medical degree from the Medical College of Georgia in Augusta Georgia. Upon completion of post-graduate training at East Carolina University School of Medicine in Greenville, North Carolina, he had a two decade career in Emergency Medicine serving Emergency Departments in NC, SC and GA. He held leadership positions as medical director in his career. In addition, he pursued training in functional and age-management medicine since 1998. 

Currently, he practices holistic integrative and functional medicine in North & South Carolina at Carolina Holistic Medicine. From 2000 until 2006 he was appointed as co-medical director of the Emergency Department at Liberty Regional Medical Center, Hinesville, GA. In 2007 he was promoted to medical director of the Emergency Department at Marlboro Park Hospital in Bennettsville, SC until 2010.

With over 400 patients being treated in his practice currently, he has around 60 currently on Low Dose Naltrexone (LDN). In this interview Dr Yusuf Saleeby explains his interest in Chronic Lyme Disease and how LDN can help to combat the disease.

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

Dr Julia Piper - 12th Feb 2020 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: I'd like to introduce my guest today, Dr Julia Piper from Private GP Services in Leicester in the UK. Thanks for joining me today, Julia. 

Julia Piper: Oh, it's a pleasure. Lovely to speak with you Linda and all your listeners. 

Linda Elsegood: Thank you. First of all, let's get to know you, what made you decide to become a doctor. 

Julia Piper: Oh gosh, Linda, that was years ago. I think it was only six years old, and I always wanted to become a doctor.  I remember my cousin was a doctor and I was completely obsessed with how wonderful she was. To do this and want to do it. And eventually, she became a haematologist.

I just never wanted to do anything else. My father said, why didn't you become an engineer? And I could, I just couldn't relate to anything else and that was it really. I mean, people tried to dissuade me over the years for a number of reasons, I guess, you know, to do with the number of hours you're going to have to work, but it didn't quite work, you know, it's like, I'm on my right path, let's put it that way. 

Linda Elsegood: Oh, wow. So where did you study?

Julia Piper: Nottingham University. I chose that because it was very beautiful and green, and I liked being out of doors.  I could have gone to London I guess because we lived in Kent at the time but, I chose Nottingham, and it had quite a different course. You were assessed by continual assessments so that you had exams at the end of every term.

You became a bachelor of Medical Science, so you learned how to be a scientist as well and apart from that it was very similar to other courses, but it was just this, that didn't have to sort of leaving everything to the finals. After two years you really sort of kept on top of things as you went through  

Linda Elsegood: okay. So when you qualified, what path did you take then? 

Julia Piper: Well, I always wanted to be a GP because I loved being out in the community with families and so on. And so I went into vocational training, and I did my own vocational training course, which, in those days, we were able to choose different specialities.

And we did that for two years. And then we had to do a year in general practice. And then I went into a GP practice in Yorkshire where I lived at the time and moved down to Hertfordshire in general practice there and now, and then moved up to Leicestershire, which is where I am at the moment. So I had quite a lot of experience in the NHS, you know, before I, I actually then eventually moved into the private sector.

I mean, it wasn't really planned this move into the private sector only that  I guess I wanted a little bit more time with people and just to have a morning a week where people could just ring me up and say, can I have half an hour? I need more time. Because it was so, you were so stretched for time in the NHS, and so that was meant to be anything else but of, you know, we all know their life changes and evolves, doesn't it?

It changes, and they both send. Eventually, as I say, I went into the private sector and started to see a few patients privately. Interestingly over the years that changed because, I suppose with the regulatory framework changing with the care quality commission, and so on, we had to professionalize our systems and we were the first in the UK to be registered with the care quality commission.

And eventually, I had to make a decision to leave the NHS and some of it, a lot of the locum work I was doing at the time and move totally into the private sector. So I've been doing this now for 25 years, so it's a long time, isn't it? 

Linda Elsegood: Very long time, but it must be very frustrating being a doctor if you have a patient that has a chronic condition, how do you possibly understand all the symptoms and everything they are going through in 10 minutes. 

Julia Piper: Well, absolutely. It's interesting. I think that the way we were trained at medical school and the way doctors, in general, have been trained, up until recently things are beginning to move in different directions.

Now maybe.  but I think we would, we were trained very much to give a label to a disease that that disease has certain evidence-based treatments with drugs or surgery. But what I found as I've moved through life, in particular as we had illnesses in our own family and also with my son's illness of schizophrenia, I have a son who’s has been in incredibly poorly and you know, I, I began to seek other routes to understand what I could do because I felt so frustrated it was like he would give me a prescription on your pad when it became a doctor, and you had to write on it, you know what the medication was or refer to a specialist or to surgery and it seems like we didn't really, we weren’t taught to do anything else. But as I moved into the private sector and I had a bit more time, I think I felt quite guilty that I actually thought I have people coming to see me who are really poorly and there must be more than this. And I think at a very young stage, especially with my sister dying from ovarian cancer, I started to look into alternative routes to heal people and to help to really understand, you know, why both the Chinese chose acupuncture?

I mean. There were clever. They had no science in those days, but they had observed and you had thousands of years of observation and knowledge that, you know, we didn't seem to be taking any notice of. So I trained in acupuncture, I trained in hypnotherapy. And moreover the last few years, I've been training into functional or biological systems medicine.

So that was the root really. It was just frustration. You know that we stopped too soon or we seem to diagnose a disease when it got there, but we didn't seem to do anything to help reduce the risk of developing it. And we didn't seem to do enough when we had made that diagnosis, we didn't have enough tools.

Linda Elsegood: And of course it would seem to me that doctors treat the symptoms rather than the cause, to find the underlying problem, and then the symptoms go away, but you don't actually need to then treat the symptoms. 

Julia Piper: I see. Yes, that's right. I mean, that's really the way we're trained. I think that was my biggest frustration that and I can understand that, you know, once we’ve got a diagnosis, but sometimes medications can be incredibly helpful in the right place but they're not necessarily a panacea, sometimes say, Oh, but you know, we need to have these the tools and understanding this as a body so that we can recognize the causes and the pathway to illness. Because if we don't understand that we a) can’t prevent problems. But b), you know, it's more difficult to turn around some of the symptoms that we see, as you say at the root cause. I agree with you on that one completely.

Linda Elsegood: So how long ago was it when you first heard about LDN? 

Julia Piper: Mmm. Interesting. Low Dose Naltrexone, I mean,  I knew about it for many years actually with those patients that came to see me when I was working in the NHS who were taking Low Dose Naltrexone. So at that time, it wasn't on our list of things that we should be doing.

And so I, probably because I was too busy, you know, seeing so many patients with the NHS, I didn't really look into that further. But I came across it again about five or six years ago. Again, when looking at patients who are chronically ill, studying to a much deeper level with functional medicine and biological systems medicine and not trying to understand what was happening with the immune system because it seemed to me, that it became apparent anyway way to me, but actually much many of our symptoms in our bodies, be it headaches or tummy aches or you know, all the root of chronic illnesses such as MS, Parkinson's disease, where are due to inflammation. And that is so closely tied to the immune system. And that there’s a disruption in our immune system. When I think of the immune system these days, I suppose, I think of it as rather than an army who goes and tries to sort of kill the baddies. I tried to think of it as an intelligence service like MI5? It's very complex, actually working out who is for us and who is against us. Because actually, you know, under different circumstances, you know, that those situations can be, can co-exist right? So I think that's, in terms of, as I began to understand the immune system and look at, say for example, for those people who are au fait with the immune system, the TH1 & the TH2 parts of the immune system and how they become imbalanced, for many reasons and often associated with underlying conditions, depending on how unbalanced they are, you know, it became much easier to understand why a medication such as Low Dose Naltrexone would work and I think, you know, my first foray into that was with people who had autoimmune conditions and whose cellular immunity was not working as well as it might do. And who, probably alongside, developed chronic stealth infection but actually LDN was a very good tool to be able to correct some of the imbalances that had developed.

and as we know there are many, many autoimmune conditions. And as we develop the how-to, how to phrase it, sort of imbalances in the immune system or in the intelligence network that, you know, we need, we need more tools to be able to correct those. But also remembering that as we develop a problem within the immune system, that that really runs alongside some of these chronic stealth infections that then are allowed to develop.

So as I say, what I found with low dose naltrexone, it's a great adjunct. I mean, sometimes it's very good on its own but I find that on its own, the body becomes so complex that no one thing normally is enough to, to get us better. You know, if I've introduced Low Dose Naltrexone, it's on the background of someone that understands the importance of the gut and understands the importance of, you know, having a great diet that is tailor-made to suit them. We all have different idiosyncrasies with our diet, but really we've got to be able to work with our lifestyles and our relationships, our exercise patterns, you know, everything really, as well as having these tools that can help to modulate the immune system and give us that extra bit of support at a much deeper level.

Linda Elsegood: Mmm. Yes. What have patient outcomes been? Could you quote us any case studies? 

Julia Piper: Well, interestingly, I suppose my son was a very good case study in that he had a diagnosis of schizophrenia many years ago. He's 34 now, but he's done incredibly well. I mean, he initially was, had drug-resistant schizophrenia and eventually was switched onto something called Clozapine, and he remains on that for various reasons because we're still working with him. He now on a combination of Clozapine and low dose naltrexone, and he takes a lipotherm glutathione. but along the way, we had, you know, remember when the brain is inflamed, when you have neuroinflammation that our cognitive processes in schizophrenia and in many conditions, but particularly schizophrenia, completely change.

And therefore our perceptions completely change and there are times when the brain becomes fragmented. Schizophrenia is a form of dementia, okay. So that we've managed to turn that around a lot by diet and by diagnosing underlying stealth infections, which were treated. But interestingly, this combination of the medication, which again would be working, eventually, it may be to reduce that, but at the moment, he is stable on the medication. Plus, we initially had IV glutathione and now we're onto the liposomal form, remembering that that enters the cells and can pull out metal such as mercury, which we’ve measured, And we know that that's at the root of his particular problems.  Part of it.  the LDN availability the Low Dose Naltrexone in him has been a great success because with schizophrenia, the microbial activation that happens when you've got cytokines. Cytokines are little messengers produced by the immune system when there's a lot of these around, you know, the immune system of the brain, which is called the microglia, becomes activated and Low Dose Naltrexone, we know, calms that down and it restores the TH1 to TH2 balance. So it means that the tendency towards infection in autoimmune conditions and there are many of them, you know, obviously the inflammatory bowel diseases, Crohn’s disease, rheumatoid arthritis. I mean, there are over 100 different conditions.  And many people may not realize that schizophrenia, for example, it's an autoimmune condition, but they are all helped when we address this TH1 to TH2 balance and increase T regulatory cells. That's a lot happening when we're using this, I've had great success, Linda, in David, my son, but we use it as part of a multidisciplinary approach because we're looking for particular weaknesses, if you like, of, or dials that we can turn in our biological systems that the body will be up to shift with. And when, when we're working on each of those dials simultaneously, at some point, there's a shift and the body is more able to sustain itself in a healthy manner. And I'd like to see more if this biological system of medicine really taught to university, I believe it's becoming more mainstream, I know Bristol university have a scientific department which teaches science underlying functional medicine and I know, a colleague of mine, her daughter's training there. So, you know, things are beginning to shift so that we understand, you know, what it is we're trying to do in modulating and change things at the root level. I think that's good, don’t you?

Linda Elsegood: Yes, definitely. Now, when a patient comes to see you and you've got more than 10 minutes, who obviously has some chronic disease, but they don't know what's wrong with them. How do you go about helping that person when they've walked in, and you know nothing about them? How do you set about treating them? What's the road map? 

Julia Piper: That's a good question. I have a detailed questionnaire, because I really need them to fill out because I like to gain as much information on paper before somebody walked through the door, so it includes the multiple systems questionnaire, for example, I can see quite quickly if somebody is scored like two on the multiple systems questionnaire, then those two symptoms might be incredibly distressing

but I suppose somebody who's scored 165 and like you sort of just gets this. I think I know the questionnaire, I  know what I'm looking for. You know, and we’re asking quite deep questions sometimes to get people to try and think down to the root. You know, what may be their pathway to illness and with functional medicine, we're looking at the detailed question, detailed history. And a road map. They're doing a flow chart as often as someone's life, just to see where these pivotal points are. And when you do that, it becomes much more obvious at what point and what are the triggers and the mediators and you know, the, um, the pathway to wellness, the antecedents, if you like.

So, for example, I mean, I suppose tick bites and the Lyme disease, or even what may turn out to be a chronic infection, for example. We refer to Lyme disease as something which is a chronic and difficult, in fact, the wording and the nomenklatura the naming of these long term conditions now and not so much Lyme as something called M-S. I. D. S. multiple systemic inflammatory disease and infectious disease. So disease syndrome of multiple systemic infectious disease syndrome. And these conditions can become chronic. But if you look at this questionnaire, and you look at the flowchart as someone comes in, you can see how they had, what are the triggers, you know, if there's something recent that suddenly made them present and pick up where your pivotal points are.

And if say for example, in the case of M-SIDS or Lyme, we can, if we can pick up someone lives in a forest or lives in an endemic area of the new forest in the UK, for example, and has had tick bites. Okay. That's not the only thing that's made them ill, but that's a pretty important point that we need to not to miss.

And we asked a lot about toxicology. We ask about—exposures about sensitivities. You know, people have multiple chemical sensitivities. At the root of functional medicine, in the end, two things. One infection and two, toxic insult to the body.

And we want to know what is burdening this person's body that they are suffering from so many symptoms. Almost list numerous systems, too many to this, or you can look at the systems that are going that had been affected that may be producing these symptoms.

So my map, if you like, to gain as much information, particularly about, it's about everything, but it's particularly at the root cause and particularly in a section of the body burden. Does that make sense? 

Linda Elsegood: And how long does it take on the first consultation with a patient to go through.

Julia Piper: Well, I would say we normally try to allow an hour because by the time they've come to see me,  people's often seen in quite a few different doctors. Physical a few little tests. They've been with them and then they've completed this questionnaire, which I find enormously helpful because I can get, I can, I get a really good feel quite quickly.

 With what is going on because there's, you know, once you've understood and you've worked for systems biology for a long time and studied hard, you can start to see where the pivotal points are even sometimes before you've tested. There's that first time.  Well, I'll do a flow chart to see exactly what's been happening over their lifetime, and I can pull it, pull into any tests that may be completely personal to just, you know, pinpoint and a little bit more exactly which dials we need to turn to get somebody better.

So we normally. Sometimes you can get a few little tests done on the day, but I don't normally like to do tests the first time I see someone, because I like to email everybody with potentially a few tests they may need and then you can have a little think about them. And then we can have another little chat often by phone.

because people would sometimes come from quite a distance so I don't want to drag them back. We usually do a little examination at the end of the first hour, and then I'll send them a list of things that I think would be sensible. And then you know, the sort of little few little thoughts about, how, I think the road map is and why we need these tests if any.

The test can be quite expensive, unfortunately. See, we don't always test, but sometimes it can just target you a bit easier. It's quite in order for patients to go back and get the simple tests and that GP of course, and we can sometimes, well since example, I do less just to give an example, less a food sensitivity test now I tend to do the elimination diet and take out things that we know can cause problems. And so it's possible to do things more pragmatically as well. So but that's, that's what I did today. So I'm kind of, I've got to go back and do a couple of emails to patients and, you know think about exactly which tests that we do.

Then when we get the results, we can start with low hanging fruit and then move forward. I'm actually in a situation to see a lot of people, people who are seeing different doctors. So I'm usually, they've had most of the tests done by the way. So my job is seeing where the gaps are and how else we can support, you know, in ways that haven't been considered at that point.

Linda Elsegood: And of course, a lot of people are still unaware that if they've had tests done by their own GP that you are allowed to ask for a copy. You can be charged, but everything you are allowed to have access to everything. 

Julia Piper: And very important people know that they can have a test by the GP  and go back and get them. I can write them down what you need, and you then go and ask them. And it's difficult because some people don't like to go and ask their GP for tests because you know, they, they feel that they might get upset or something. So that they'll only know if you could, I can write them down for you and then I can always write to GP’s if that’s necessary.

I think this is a shame really because a lot of doctors, understandably, I mean, I would have been in the same position if I'd been in the NHS. You know you haven't got time and having the study date, it takes years of study and understanding. When you look through a lens of root cause medicine, it's really hard, you know, because we were trained in such a different way.

But to me, the two can live together well. And the new young doctor at the DePaul side plan, bring out the functional medicine because there's a frustration in the way that they and I do some work at the investor heavy recently in Leicester. And we had a few students, one by one coming in, one sitting with me, and then we had a meeting with them at the end. And I just sat down with them for a day, and I just tell them my son's story, you know? And I said, how much nutrition training have you had? And it's actually zero. Yeah. And it was a shame and I feel so sad and I think to myself, you know, really when I trained, I didn’t know anything about it either, you know, and I say, I think life has changed.

It's for the better. I know we, so, gosh, there were on the internet and wifi, and EMF obviously, we have to limit our exposure, but I feel like there's a lot that's getting better because people understand so much more now. But having said that. I'm thinking it must be very frustrating if you're on an HSG PA traditionally trained these days because a lot of patients that got anything about being ill will know more about it than you do as they come through the door, because they've looked at some of the root causes, and I think it must be very frustrating to be

A doctor in this day and age with such knowledgeable patients because I'm contrary to what a lot of people, and I think Google is amazing. I think the knowledge has got on there, you know? 

Linda Elsegood: Well, we're nearly at the end of the show Julia, but just wanted to ask if a patient goes to the doctor and explains that they've been to see you, would you be happy to work with the GP as well?

Julia Piper: Oh, gosh, yes, very much so. I mean I think a lot of GP’s are very, very busy and you know, again, some people probably feel a bit upset because they feel a bit threatened and that's a shame. You know, it's difficult I think in some cases we have quite a few patients who, especially when their children are involved, you know we have to look after the family and communicate to all agencies because a lot, there's a lot of misunderstanding around children with multiple symptoms and where traditional diagnosis could not be found. Sometimes there’s a lot of pressure put on the families that maybe they're making them up or making the child ill or whatever. So, you know, I do a lot of work with working on explaining carefully what we're doing and actually that is some problem going on and here with the test results. And so we do do that. And sometimes it can be very difficult, you know because people do feel a bit threatened, especially when they don't understand something. Obviously you were working with weird situations and with thought processes,..... mass guidelines.

And so I haven't set up, I mean, B12 injection, somehow we use B12 is something that's actually within the nice guidelines and sometimes you end up, you know, just explaining, well actually you can give this because this person has their neurological condition. And that's what it says in the novice guidelines that sometimes you have got that backing.

But I think the answer is yes, we will work with the NHS under the doctors, and we should be working as a team, and we should be trying to separate things out that sometimes, in reality, we have to, but that's, that's the decision. If the patient, when it comes to a child that has no choice because it's not that time particularly.

Well, you know. Cause of child children in need or child safeguarding. We all compelled to communicate, and we have to communicate. So am I making that up? Yes, I am. I'm just kidding. Basically, yes. And sometimes that's a choice in it, and sometimes there isn't. 

Linda Elsegood: Okay. Now if people want to come to see you, do you have a waiting list?

Julia Piper: Not at the moment no, we don't. We have, I don't, you know, I think at the moment, I don't work all day, every day seeing patients because I tried to keep a balance but we have other doctors here who I work with and we have a lovely coach, health coach and a nutrition coach and a nutritionist who came in and went with us as well.

So, that's the way we do it. So sometimes if you know, I didn't need to do everything, then I can ask them, and I'll tell them certain things. And I find that you know, you can sort of work out what you might need to do in life and then you need that little bit of extra sort of access from a motivational perspective.

She may not change, cause sometimes that isn't so easy, you know, so it's not just me we've got other people that we know that can help as well. Wonderful. 

Linda Elsegood: So could you give us your website address, please do. There. 

Julia Piper: Yes it's https://www.privategp.com/. We rebranded this year before we were very much more like a traditional practice, but I think my daughter said to me, mum, you need to make your website who you are. And so she helped me to, to do that and it was difficult—the time. I remember my father was very poorly. I mean, we lost him in the end.

I found it somehow we've managed to do it despite everything and which we did it. We launched it in May this year. And I hope you like it. So, any feedback would be gratefully received. 

Linda Elsegood: Well, all I can say is thank you very much for sharing your experience with us today. It's been really interesting.

This show is sponsored by Dixon's Chemist who are the experts in LDN at associated treatments in the UK. Dixon's Chemist is the most cost-effective for LDN in all forms within the UK and Europe, maintaining safety standards in excess of what is required. Why would you choose to get your LDN from anywhere else?

Call 01414 046545 today to speak to the LDN experts.

 

New for 2020 LDN radio shows will be available on Spotify and iTunes. They will also be transcribed and added to our website, https://www.ldnresearchtrust.org/

Any questions or comments you may have, please email us at Contact@ldnresearchtrust.org. I look forward to hearing from you. Thank you for joining us today. We really appreciate your company. Until next time, stay safe and keep.

Pharmacist Steve Hoffart - 5th Feb (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Pharmacist Steve Hoffart shares his Low Dose Naltrexone (LDN) experience on the LDN Radio Show with Linda Elsegood.

Steve Hofart received his Bachelor of Science in Pharmacy with highest honors in 1994 and a Doctorate in Pharmacy from the University of Texas at Austin in 2000. He also holds a board certification and fellowship through the American Academy of Anti-Aging.

In November of 2002, Dr Hoffart saw a need for a more personal pharmacy that could make an impact in the community on a larger scale. Magnolia Pharmacy strives to best work with the "triad". The triad is a strong working relationship between the patient, physician, and pharmacy to solve medication problems and provide real solutions for patients to achieve better health and wellness. 

Cultivating this working relationship has ultimately produced a unique pharmacy experience for each of his patients.

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

Michelle Resendez FNP-C - 15th Jan 2020 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Michelle  Resendez is a certified family nurse practitioner. She combines her love for alternative and natural medicine alongside traditional medicine.

She has successfully treated patients with a diverse range of health conditions that have not responded well to conventional medical treatments.

She said" I first learned about LDN about 10 to 12 years ago, first learned about it from a naturopathic medical. The first patients I treated had thyroid conditions, Hashimoto's, Graves thyroiditis. And so I was really using it to try to the modulator assist the thyroid in functioning better. And from that point, it really expanded and opened the horizons, treating other things.

So we found that people with thyroid conditions, if they're taking thyroid medication, usually have to reduce the amount of thyroid medication.

When I start someone on Low Dose Naltrexone (LDN), easily around 0.5 to one milligram at night, and I will either reduce their thyroid medication in half, or I will just reduce, if they're on a T three medication, I'll reduce that down.

 A lot of times, their autoantibodies will start going down, and that will help the thyroid function better.

Sometimes you'll get some adverse side effects like tremors or palpitations, or just feel a little bit more excitable than her used to feel.

I have a lot of patients start noticing the effect almost immediately within a couple of days. Depends on what condition I'm treating.

A osteoarthritis type pain or structural type pain people usually notice the effects within a week of taking that.

Once they move out to one or two milligrams, they start feeling some relief.

Antibodies are a little bit more resistant, and it might take, two to three months to see antibodies go down with LDN. And that's because of the treatment approach for that is really multifactorial.

And the LDN is just an adjunct to that. And usually, we do lifestyle modifications and diet and, and other interventions to help those antibodies come down as well.

Anyone starting Low Dose Naltrexone (LDN) can experience negative side effects. The most common would be that when they get a rebound effect it at night with those endorphins kicking up, they can get some anxiety. They can get some insomnia.

Patients that we treat for viral conditions or reactivation syndromes like Chronic Fatigue Syndrome, they can actually get more severe adverse side effects such as sweating, fevers, flu like symptoms, feeling sore throat, things like that.

All of that is expected and typical. I don't like to stop treatment if they're experiencing those side effects because that's telling you that it's working. We're getting the endorphin release that we're looking for, and we're getting the immune system enhancements that we're looking for.

Those side effects are what I would consider good responses.

I haven't had anyone had any side effects that  I would consider to be adverse like hives—rashes, vomiting, anything so severe that I'd have to stop them on it.

I treat GI conditions as well. I've had probably the most success with gut issues. It's one of my top responders. Some of my earlier patients were Crohn's patients.

LDN seems to work pretty well for the exhaustion, the fatigue and the pain.

The conditions that I treat teenagers for could be anything from Attention Deficit Disorder, Depression, pain conditions, allergies, sleep issues.

Some of my kids are on the autism spectrum, so I do treat that as well.

I do have quite a few teens and young children on LDN. And I'll actually have them on liquid if they're too young to swallow a pill or won't tolerate a gummy or a sublingual lozenge.

I do have a traditional medical doctor referring to me, Neurology, Cardiology, Rheumatology. Dermatology because there's a lot of dermatologic conditions that can be treated very successfully with both topical LDN called Xeno top and then oral LDN.

The skin conditions I am treating it for it would be the Legos, Psoriasis, Rosacea, Eczema. Those are probably the top of all the skin conditions that respond really well to it. It takes normally 3 months to see results.

There's trials to find if there are some food triggers associated with that.

A lot of it is when they're having fires and because it's triggered by something and I want to find out what that trigger is.

And then the LDN just helps the body heal itself. So it's keeps them in a remission state.

When I first see a patient I typically wll do labs tests first that looks at allergies, hormones, thyroid, inflammatory markers, genetics, things like that. I try to find triggers if I can identify any and remove those before then starting on LDN. I like to see how they respond first to that.

I like to do things in stages so we can really see how impactful each thing is at each stage. So I'll take away the food triggers first if I can identify them and then add LDN onto that at some point.

Right now we've just moved into our new office. So my business partner and I have been here for three months. I'm at a two-month waiting list right now. Once we hire some more back-office staff, I'll be able to stack more appointments and that will trim down for maybe a month or two and then we'll probably get booked up again. I do keep appointments open early morning and sometimes I'll see patients after my last appointment for the day. If there's something urgent or somebody's not responding favourably to meditation or something.

I leave those time slots available for that so I can get people in if I really need.

I would say on average, patients see me every three months. That would be somebody who is stable, doing well on their regimen and not needing any further testing or imaging or interventions done.

So some patients I will see on a monthly basis if they have a lot more chronic illnesses and conditions because I like to do those steps, plan out, maybe CBO treatment, diet.

Also with hormones, thyroid continue to add things to optimize how they're doing and their quality of life.

I have some come in annually. They're probably not my patients on LDN. They're probably more. They're doing our mono treatments, pellets, injections. Yhey're doing other treatments other than just LDN.

Summary from Dr Michelle  Resendez YouTube interview. LDN Radio Show Listen to the video for the full interview.