LDN Video Interviews and Presentations

Low Dose Naltrexone (LDN) in Scotland and beyond. Documentary with Danish Subtitles (low dose naltrexone) from LDN Research Trust on Vimeo.

"The Game Changer" - LDN & Cancer - Low Dose Naltrexone - Spanish Subtitles from LDN Research Trust on Vimeo.

If you were to ask me does low dose naltrexone kill cancer cells, I would say it supports the actions of your classic cancer-killing drugs, such as your platinum; such as your radiation. These drugs and these modalities do work, and they work well in a lot of patients. However, there are a small fraction of patients that don't respond as well, and what low dose naltrexone can do, is that it can open up to these patients that are non-responsive. The whole idea that yes, you can use these treatments in your case, which  I think is fantastic. And if you were to say, do these patients see that as a cure to their cancer, in that situation, you must say it's helped them, and the help it's given them means the world.

I had a patient who I really thought their advanced cancer should be progressing and was delighted and surprised that she hadn't progressed in a certain time. And I asked her if she was taking anything else that I didn't know about because lots of patients do take all sorts of things, and she told me she was taking low dose naltrexone, and this is well over 12 years ago, if not longer. And I asked her where she got it and the whys and the wherefores, and I learned she was getting it from Dr Bihari in New York. And she told me a bit about the background and said that I should go and visit next time I was in New York, which is essentially what I did. And I realized he came from a proper clinical background, that he had been a narcotics expert and was weaning people off morphine heroin, which is how he knew about naltrexone and had been convinced that at low doses and not at high doses, that a lot of chronic conditions seem to improve.

So that's how I got interested, and I became more interested in it the fact that it might have a role in cancer when I noticed that other patients were doing very well on it. And at the end of that, often when there were no therapeutic options, I started prescribing it myself and being impressed that there seemed to be more to it than a placebo or smoke and mirrors, which is what many doctors regard something at a low dose.

Well, what really excited us is that I've taken the clinical observations from this seriously and because some of the results I saw are being really quite remarkable. For instance, I had a patient who had very serious melanoma of the head and neck, and he'd been on a vaccine program for about four years.

And when he started to progress, he wouldn't take any chemotherapy, but I did discuss with him about my suspected properties of low dose naltrexone. And he did agree to take that and rather than be grateful for taking the low dose naltrexone, he came and complained to me two weeks later that he had broken out in vitiligo, which means you get white patches all over.

And often just in the arms sometimes subtly on the face. In fact, about 5 to 8% of people have some form or other of it, except this appeared quite dramatically a few days after taking the low dose naltrexone. He didn't like the cosmetic aspect of it. I basically said I was delighted because it was a sign that the immune system's responding and had targeted the melanoma, and that's exactly what it is. It is due to the killer T cells recognize a major component of melanoma and the normal melanins taken out and bystander a friendly fire as it were. Well, he is still here. I mean, he had a dramatic clinical response to this. And what that showed me was that low dose naltrexone had to be stimulating part of the immune receptor pathway. And that was the start of our research. I said to the guys in the lab, this strike, isn't just working through opiate receptors, it's working through immune receptor pathway, and we sat down and worked out how to do it, did a strategy, and actually hit gold, and we found a very important, immune pathway was indeed heavily interactive with low dose naltrexone, which explained the clinical observation I think. With vitiligo being switched on; there's no defined time period, it can occur at any time, but with an effect of immunotherapy, this usually takes some weeks, months to occur. And we found out with the new checkpoint inhibitors, we basically don't really look to see if you're getting a response for a couple of months, because it is that slow. So, the fact that the vitiligo was induced very quickly suggested it had just flicked that switch which was already programmed, but the vaccine hadn't done it for four years, it just took the LDN, and it flicked it. Well, obviously we're going to be very focused on researching it; doing it properly. I mean, LDN is being used, anecdotally and off-license for a long time. There are fantastic results out there, but it ought to be taken forward; it really wants to be put it into proper clinical trials and getting it to the right niche. And because there are so many possibilities, we would like to do everything properly; get it properly approved by the FDA, EMEA, et cetera, and then go for a condition that we know the chances of working are very high and don't take very long, and of course, two of the conditions it's effective in are Multiple Sclerosis and Crohn’s, which are very difficult studies to get approval for. They're very hard and expensive trials to do. And you mention about taking it with something; this is what we've found with all of immune modulators, that they're much better in combination with other agents than by themselves. One of the things that we have been researching independently and it fits beautifully is that it is great, with what I would call an endemic, epidemic of a low vitamin D in the population. and it's particularly in the winter months and the further North you go. And this is one thing that we are looking at very carefully because we think that there is a positive interaction here, but that's not a big surprise, because if you're low in vitamin D, you don't respond to a whole range of things, like chemotherapy or whatever, so that's one particular thing. Combining it with another immune modulators/vaccines is the next obvious way to go, as is enhancing the anti-inflammatory aspects of it.

So, all of these things we have been looking at in our research, both in the lab and taking it forward into the clinic. Given how non-toxic it is and how relatively cheap it is compared to other interventions could be applied to, I would say the vast majority of people who have incurable cancers where you can't cut them all out because the anti-inflammatory aspect for most cancers is now well established and the need to boost the immune system when you have cancer. In fact, one of the pieces of research that we did early on, that  I’m most proud to have done, was we showed that even patients with very early colorectal cancer have a major suppression of the immune responses. And we proved that this was due to the bowel cancer patient group we use, because we repeated the assays a month after the tumour had been completely removed, and the immune system all bounces back into the normal range. So after that, and the colleagues elsewhere showed that they got the same sort of thing with other solid tumours, lymphomas, gliomas et cetera. So it means that tumours immune suppress, and if you can't cut them out you want to go some way to correct it.

There are some very fancy, toxic, expensive ways of doing that, but low dose naltrexone provides a lot of those properties without any of the toxicities, et cetera. So as a universal supplement, as well to be an anti-inflammatory, immune booster, I can't see why it would be limited to any particular tumour type.

Low dose naltrexone works on a number of processes in cancer cells. So, if a patient has cancer at whatever stage, if that cancer exhibits the same malfunctions, the same profile for one of the better term, then naltrexone prefers or low dose naltrexone likes, then you should see some kind of responses.

Like the first thing is that there is no drug in the world, and that would include LDN, that is active in everybody. But, if you’ve got advanced cancer and basically don't want to take anything else, but you’re happy to try something that might help you feel better, then to my surprise, I have seen the LDN is very effective in that scenario.

It shouldn't be looked upon as a cure again, to work on everybody, but I'm impressed with people who do have their disease stable after finishing chemo, having given up, and they take LDN, and they feel much better on it, and they request for repeat prescriptions that basically provides the evidence that they're doing really well just on this treatment.

One thing we did, first of all, was to explore the effects that low dose naltrexone had on immune cells, as well as on cancer cells. And I suppose one thing that people tend to forget is that drugs that you give to patients will have an effect on immunity as well as on cancer cells.

So, these so-called indirect effects versus the direct effects, and the beauty of naltrexone, especially at low doses, is that it can have an effect both on the cells in your body, as well as on the cancer cells. So it's like a double-edged sword, I suppose, one edge that kills cancer directly, and one effect which modifies the body's own natural ability to kill cancer cells. So, this drug naltrexone being a potential agent, or at least a semi-synthetic, we could then explore that further. And we showed that in addition to the effects on immunity, which made it a fantastic stimulator of immunity, which allows the body's cells to be re-educated to re-engage cancer cells, low dose naltrexone was also capable of targeting cancer cells directly. How does it do that? And that's the exciting thing. There's lots of data to suggest that it binds to certain proteins on the surface of the cancer cell and in doing so can manipulate the cancer cell to make it much more sensitive to the treatments.

There's also other trains of thought that suggest that it might enter the cell independently of these receptors, but nevertheless what we're finding is that the mechanisms that control cancer, the mechanisms, in fact, that makes a cancer cell, a cancer cell, is being turned off. it's been tweaked in such a way to make that cancer cell much more sensitive to cell death.

So, if you were to go along or come along, treating patients with low dose naltrexone, in addition to other drugs, which are focused on killing, then we have a fantastic partnership where one prime the cell and the other does the killing. And that's, what's exciting about low dose naltrexone.

So it was in about 2007, 2008 that I first discovered LDN, and we started using it immediately as a cancer treatment because there was some promising data presented by Dr Bahari. So, when we started using LDN for patients with stage three or stage four cancer with low disease volume, in other words, small tumours, or patients who had had surgery already but were not completely cured, we started seeing better results. One of our earliest patients that we used LDN on was a 65-year-old gentleman with bladder cancer. He had a tumour in the bladder, which was treated by conventional means, which means surgery, so they would go in and removed the tumour; they would burn where they had removed it from with a cautery and inevitably the tumour would return some months later.

So this gentleman had a few surgeries and the doctors had told them it was an aggressive type of cancer, which is called high grade, and that because of the depth of the growth of cancer into the bladder wall, it was growing into the muscle, they felt that he was at risk of cancer spreading in a short time.

So, this fellow was offered an aggressive surgery, which meant the removal of the entire bladder, and he declined that. At that point, he came to us and we started him on LDN. And he did very well on it, he had a little bit of sleep problem, but that was easy, we just gave him a little sleeping pill with that, and he did very well. And at the same time, his conventional doctor gave him a single course of an immune therapy called BCG. It's a bacteria that they instil into the bladder, and it can trigger an immune response. So while he had the one course of BCG, he was on LDN, and he took LDN for about four months, and then he had gone back to see the surgeon; they took a look in the bladder, and the cancer was completely gone. So, this gentleman continued LDN for about a year. He had no further conventional therapies, and cancer remained in full remission, and it's been about seven years now, and this gentleman is still in full remission. So, in his case, he did extremely well, and I believe that the LDN and the immunotherapy worked in unison, and one synergized with the other in order to give him an excellent result, which in this case would be considered a cure.

Another one of our earlier cases that really intrigued me was a 58-year-old gentleman that came to see us for rare cancer that was present in the base of his tongue.

He had about a three-centimetre tumour in the tongue, which was an adenoid cystic carcinoma; that's just the type of cancer, but it's an unusual type of cancer of the mouth. So, this gentleman went to see his specialist and he was told that in order to cure his cancer, the entire tongue would have to be removed surgically, and because of the location, in order to really give them the best chance of cure, they would have to remove his voice box as well. And then there was discussion about possible chemotherapy and radiation after all that surgery. So naturally, this gentleman was upset because of the dramatic change in his quality of life that would follow after cancer treatment.

So, he declined conventional therapy. He came to see us requesting a therapy that had no side effects. So, the first thing I told them was there's no such thing that has no side effects, however, immediately I thought of LDN because it's one of the gentlest therapies I know. So, he ultimately started LDN, and he combined it with vitamin D because that's considered to be a medicine that can potentially enhance other cancer therapies. It can work on the immune system and improve anti-cancer immunity. Vitamin D can also change the behaviour of cancer cells into more harmless behaviour so that they don't grow and aggressively spread. So, this fellow has started taking the treatment with the LDN combined with vitamin D, and within a few months he felt that the tumour was shrinking, and so continued therapy, and we didn't hear from him for a while until about two years after he started treatment., and he sent us a new MRI report, which is a scan of the tongue that showed complete disappearance of cancer. So, he continued on LDN and vitamin D and he has now over five years cancer-free. His specialist is quite surprised and pleased, to the point that he no longer repeats his scans frequently, and he just sees him once a year for a regular checkup.

A couple of years ago, a 53-year-old gentleman came to see me requesting treatment for bowel cancer. It was present in the sigmoid colon, and it was believed that cancer formed as a result of his inflammatory bowel disease called colitis.

So, this fellow was offered surgery by his specialist that would have been the standard treatment and potentially curative. However, he was afraid of surgery. He was afraid of the complications. So, as a result of his concerns, we offered him a few treatments, and he ultimately chose LDN. So, he started LDN, and we were monitoring him with a blood test for colon cancer called CEA, and in addition, we also monitored him with colonoscopies. So, his specialist would have a look within the colon and see what was happening with the tumour. It took about four months to see some improvement. We actually started to see the CEA, the cancer blood test numbers fall, and it was falling progressively over about a period of about three to four months subsequent to that.

And then it was maintained at a steady value of about 30% below the original value. In addition, he did have a follow-up colonoscopy, which confirmed that the cancer was stable or smaller, and his symptoms of bleeding in the bowel actually improved as well. Now this fellow did decline traditional surgery, which was not exactly what I had recommended either because I thought that cancer could potentially be curable.

However, the case does demonstrate that in cases where let's say a patient refuses surgery, or if surgery were to be too risky, then LDN could be an option for patients to try, especially if the cancer is non-aggressive.

In addition to using LDN, we almost always recommend vitamin D. The dosing of vitamin D is very controversial, but there's adequate research now that supports using high doses of the vitamin. So, that's what we're doing: we're using typically in the range of 5,000 to 10,000 units per day of vitamin D3, preferably in a liquid form because it's easier to take, and so patient compliance is high. Sometimes we even need upwards of 15,000 units or 20,000 units of vitamin D per day. As an aside, I personally take 15,000 units of vitamin D myself, and I've been taking that for about a year now. I take it from my allergies, and I find it to be highly effective.

So I became acquainted with Naloxone and Naltrexone, the drugs, in my training over 20 years ago in emergency medicine, and early in my career in general medicine began to explore the use of low dose naltrexone for a variety of illnesses, including auto-immunity, pediatric disease and then cancer. As the years of practice went on, we developed more and more cancer patient care where we were using the low dose naltrexone as an integral part of the patient's therapy.

We began adding low dose naltrexone with a variety of cancers, not knowing for sure which ones would be more or less responsive. And back at that time, the data was very sparse, so we were basically asking patients if they were okay with us trying it, So, many would come in with articles they had read, and we would start the therapy with them.

We have had a number of responses that run the gamut from—stabilizing disease, to being very supportive of other therapies that were being done, both natural and standard chemotherapy and radiation in some cases. And then one of the most beneficial uses we have seen is in the patient who has come back from the oncologist, and there is the report there's no more we can do for you. So, we use it in our program for stabilizing those patients where the standard of care has run out. I think the persistence of our using the low dose naltrexone as therapy is owed to the fact that we see positive results frequently enough, that we keep using it with many therapies that are nonstandard. You'll find that they work in a very narrow margin or for only certain types of cancer or certain types of illnesses, and so we'll reserve those for those certain type things. Low dose naltrexone at this point, as they say, eight or more years has impressed me enough that I keep it at the beginning of treatment when I'm working with patients all across the board with cancer.

So, the results are quite varied. We have had some patients, especially elderly patients, where they're very sensitive to medications. They've been told by their oncologist that they are not a candidate for standard therapy, because they're too elderly or frail. We have had a few of those patients where their disease, their cancer, has stabilized with basically the addition of low dose naltrexone on its own.

We don't expect that in everybody, but it's been curious to me to see one agent do that in cancer, which is very unusual. Most people, what we see is, it is a very good synergist with the rest of the care, and sometimes what will happen is, a patient will stop taking it and not tell us, they'll come back and they'll have some regression or some addition of symptoms from their cancer, we'll find out they've gone off low dose naltrexone. They'll go back on, and often those symptoms will go back away. So, we do see it as an integral part of care. I would say the number of patients with cancer that we have prescribed low dose naltrexone for in the last seven or eight years amongst myself and my colleagues at my clinic would probably reach a number between 250 and 350 patients.

As I said, we've seen a wide spectrum of response all the way from it was the only thing that they could tolerate, due to age or frailty, and we saw a stabilization of their disease, meaning it didn't progress, which is a very positive finding, to the person on multiple therapies where it's being used as part of a team approach, and as I mentioned, it being withdrawal caused a reversal of the positive. So, I would say in at least 30% of people, we have some verification, either based on it being the only drug used or it being taken away from their therapy, and them having regression that we could really point to clinical success. The rest of the patients, it's not that it made or broke their therapy, but we definitely left it in their therapy and never withdrew it to see if that was part of the success or not. But we definitely have seen, and as I say with either on standard oncology or natural therapies, I've seen it to be useful and positive in cancer cases, more than most other therapies I've used.

I would say that of all of the integrative and standard therapies that I have seen both in chronic illness, but especially in cancer in the last 20 years, low dose naltrexone has been one of the top treatments that have impressed me as far as outcomes. Improving the quality of life and stabilizing disease.

For patients, it's largely letting them know that it has a very low incidence of side effects and downside., and the most we can do is share case reports with them that match their cancer, and normally we have some positive ones. Of course, you can't guarantee anything in cancer, but to me, it's a low downside, low cost, and high-value therapy.

 

So low dose naltrexone isn't the cure to cancer, unfortunately, and I suppose there's no such thing as a true cure to cancer, but what low dose naltrexone will do, is it will support the actions of other drugs that are out there, which have been shown to have an effect. For instance, chemotherapies are efficacious in lots of patients, but they could be boosted. Irradiation is also effective in lots of cancers, but again, they can also be improved, and these agents that can support the activities of other drugs, these so-called agents, is a class of agent that low dose naltrexone will sit-in, which makes it an incredibly exciting piece of the compound.

So, what we did with all this genetic data, we went on to see if these cancer cells that we brought into lab could be sensitized or could be affected upon by naltrexone. So, we use in vitro experiments, experiments performed in a lab to see if we could kill these cancer cells.

And the disappointment was, that by using naltrexone at low concentrations continuously, we were having no effect on a number of cancer cells. However, the genetic fingerprint told us that it should work. So, by changing the schedule in the way that we gave this, this treatment to the cancer cells, based upon our understanding from the genetic fingerprint, we could actually cause these cancer cells to undergo cell death.

So, to summarize all that, we have a situation where if you were to use low dose naltrexone continuously you'd have no effects or effects will be minimal. However, if you were to use a schedule that involves slightly different aspects, you would end up killing those cancer cells. And that's something that armed with, we can take forward to the clinic and convince clinicians to start using low dose naltrexone, not on its own, possibly in combination with other therapies such as these chemotherapies, as I alluded to, as well as other newer drugs, such as the immunotherapies. So, the results of our studies that have allowed us to understand the action of low dose naltrexone much, much better than we did a while ago. And armed with this knowledge, we can design new treatment regimens, these new, different strategies that can be used in patients. And in that regard, it’s a game-changer. We now know how best to use naltrexone. In the past, we used to think naltrexone should be used continuously, and that would induce some effects in the number of patients. However, the data that we've generated very recently, suggests that we can actually improve on that. And it's these small step changes that will lead to a situation where these patients with cancer will benefit. We've worked on a number of cancers in our lab-based studies, and these cancers have involved cancers of the colon, of the breast and also of the lungs, and in these cell lines, we've shown that the effects of other drugs can be enhanced by using low dose naltrexone. And we are yet to find cancer that doesn't respond in this positive way, but we've only just started very recently and in the three cancer cell types that we've used, we've had a response that's always been positive.

Our results suggest that doctors who prescribe naltrexone need to be very wary of the way it's given. We've shown that depending on how the drug is given, you may get responses that are not optimal. Indeed, our results specifically showed that by giving this drug continuously over four days, would result in effects, although good on its own, was inferior to if you were to use the naltrexone on a different schedule altogether. What our data suggests, is that low dose naltrexone effects can be improved if you were to modify the schedule to involve breaks in treatment.

 My hope for low dose naltrexone is that it's incorporated in treatment regimens, in treatment strategies in patients with cancer. Naltrexone, especially low dose naltrexone, will enhance the actions of a number of chemotherapies in a number of cancers, and my hope is to see it being included in treatment.

Well, in a word, with the findings that we've captured here, gives a complete scientific justification for taking this forward into the clinic and giving evidence to the commissions, and the regulatory authorities and say look this does this, that, and the other, it should be incredibly useful in these conditions, and here you have this enormous amount of anecdotal evidence that it is. So basically, we want to go forward and capture it so it can actually be used and prescribed in the clinic on the NHS.

Our data gives us a better insight into low dose naltrexone, but better understanding, low dose naltrexone, we can better understand the ways that you can treat patients with cancer. So, I suppose the take-home message would be, we need to know how this drug works to maximize its uses in cancer patients. Patients are not interested in how the drug works, they are more interested in whether or not the drug works or not.

What our data suggests is that we have the best understanding. And by understanding the drug better, we can design better treatments that will benefit patients.

Well, the NHS and the government say, and various people say, that they would basically like drugs which are non-toxic cheap.

The current drugs being used to treat cancer are coming in at an average of about 5,000 pounds a month. And when you finish one, there's another one, so these costs are totally unsustainable. Whereas the advantage for a drug like this, that's a cheap, non-toxic can extend life, possibly, we don't know until we try that, but you can see it's a doctorate. It does improve the quality of life in a lot of people; that's an enormous potential that could save I believe you know, millions and all the treatments that we currently use to try and improve the quality of life and extend, et cetera.

One of the issues with LDN being a generic drug is that if it has been proven to be effective as a treatment for a disease like cancer, it could certainly prove to be challenging for the pharmaceutical industry. The reason is that this very cost-effective medication could potentially compete with branded drugs that are out there already.

So, I think that there is going to be a bit of a challenge moving LDN forward as more of mainstream therapy because it would likely be opposed by the pharmaceutical industry. Well, at the current rate of growth of cancer around the world, and looking at the cost of cancer therapies right now, it’s pretty clear that in a short number of years, the treatment of cancer is going to be unsustainable, so we actually desperately need more cost-effective therapies. Now with the current research model, there's really no motivation to conduct large formal scale clinical trials with LDN, because it is not a profitable drug. So, what we really need is a different model for researching LDN. One in which there should probably input from the government, in order to fund large scale trials to finally put to rest the idea that LDN is in fact, a valuable therapy and potentially from the insurance industry there should be funding because they're probably going to benefit greatly from the reduction in the cost of cancer therapies.

Low dose naltrexone increases what's called the OGF and OGF receptor. These are little peptides, basically proteins, that when connected together inside the cell, they give a signal to the nucleus that inhibits the cancer cell production. The amazing thing that they found is this is present in 90% of the human cancers, over 47 different lines of cancer, they've shown that this mechanism is present, and after reading their papers regarding this, I found the science to be good enough to be legitimate to try for people who have cancers that really have no other choice; stage three, four cancers that really are done with their therapy. It also increases what's called the P16 and P21 pathways, that are the key components to inhibiting the cancer cell division, and what they found interesting enough is in the cancer cells, they don't have a lot of OGF and OGF receptors. So, what it does is it boosts the body's own way of inhibiting cancer cells. We don't know that it really destroys tumours., it just inhibits cancer cells from dividing. So, in doing so, I took it upon myself to do research on it before it would use it.

You know, I'm a scientific type of person. I like the science to be there. Dr Zagon published articles regarding ovarian cancer cells specifically with naltrexone and OGF, and since ovarian cancer’s, the fourth leading cause of cancer mortality with women, and it's the leading cause of gynaecological cancer; this is a tough cancer and it’s critical to understand the cancer mechanism. And they found that the OGF receptor mechanism was present there. They showed it reduced cancer cell proliferation, and he's had a number of other articles showing the same thing.

So, I have a patient who is 2004 had initial ovarian cancer, and as Dr Zagon points out in his articles, 65% of the patients with ovarian cancer recur within two years. Well, she went six or seven years, and then she had stage four metastatic ovarian cancer everywhere. Her spleen, liver, colon, she had the surgery, she had some chemo, and then she heard about me through a friend, and so I started her on low dose naltrexone in 2011. And as a matter of fact, I just talked to her two days ago. She's doing very well. Her liver metastases have stabilized, and she's now in a stable state, and this is four years, four and a half years later, which is significant, because I was anticipating that she wouldn't have lasted more than four or five months with metastasis through her whole abdominal wall cavity, and the other areas I mentioned.

I had another patient who at 38 years old had a discovery that he had stage four squamous cell carcinoma of the tonsil. And he was treated with the usual chemotherapy, radiation; he elected not to have a radical neck dissection. He just said I'm not doing that. So about eight months go by, and he's just not doing very well.

He was tired, fatigued, and so I said, well, come to my clinic. I did a bunch of body chemistry tasks; hormone levels and found that the chemo and radiation destroyed all those, which is very common. Once I got those balanced, he was feeling better now, and he's doing great, but I also put him on LDN and Squamous cell carcinoma that tonsil does not do very well when you're stage four. This is four years later now. There are no signs of cancer. His oncologist says we really don't even have to follow the PET scans anymore because there's really no evidence of any recurrence. And he now is doing very well. He's doing worldwide trips, working two jobs, and he takes the 4.5 milligrams every day and hasn't had a problem since. In regards to how well he's done, well, maybe half the people last five years with that diagnosis, he met two other men who had the same diagnosis, same exact diagnosis when he was at MD Anderson, they have now both passed away a couple of years ago, so as long as he lives, it's another telling sign that LDN could be very positive for people, you know, long-term, and maybe preventing the recurrence by inhibiting any other cancer cells that are residing or starting to rise again.

I'm a stickler for facts. I want facts. I want proof. I want black and white. I want to know this is how it works. It increases the endorphins in the body, we know this. We know what endorphins do to the tumour cells; they block those tumour cells, and they block the receptors on the tumour cells. They cut down the inflammation around these tumours because this inflammation around the tumours helps it to grow, helps it to get blood vessels to grow out of those tumours so you can get more metasticies et cetera. So low dose naltrexone plays a role directly there at the tumour surface at the tumour cell.

However, it has another mechanism. This is what's also fascinating. And that was, as I said before, it down-regulates some of the T suppressor cells; the ones that are the most important in suppressing the immune system, it blocks those. So, the immune system can go up, and you can get the immune system up by down-regulating these T suppressor cells it's called foxp3, for those who are in biochemistry or studying this area. The foxp3 cells are blocked by low dose naltrexone, and so you're raising your immune system, you're working directly against the inflammation at the tumour cells, and you're helping the patients to be able to reverse their own tumours,  but not as one drug alone, but in combination with other things. If any of my cancer patients have cancer, they should all be on low dose naltrexone, because of the fact that it is helpful for them in every area of cancer therapy…period. If I had it myself, I would be on low dose naltrexone, and I'm a physician and a pharmacologist and a former FDA official, and I would recommend it to any and every one of my patients. It's imperative, as far as I'm concerned as a support measure, and we need to realize this. We need to realize this is not a cure. We need to realize that this is something that is an agent that will help tremendously, and that when patients are in remission, it will help to keep them in remission. The fact that low dose naltrexone cannot do any harm, and we've been showing efficacies in autoimmune diseases as well as cancer, it's something that I think the FDA is going to have to recognize this as a support measure for many of these illnesses.

A very diligent radiographer went back through all my medical notes and said, perhaps we should look at the pathology of the spots you had removed from your leg seven years ago. And sure enough, it showed that there were some suspicious cells there that hadn't been removed. So, it was then decided that it was probably melanoma, and I had my lymph glands down my right leg removed. And then I was having a few spasms in my right arm and my right hand. My GP, my same GP, suggested that I was just anxious about my golf swing and that I shouldn't be too worried at my age. So, off I went on holiday and while I was walking on holiday, I had the most amazing spasms in my right leg, and I knew something was wrong. Thinking I'd got a trapped nerve, I went straight back to the doctor when I returned home. By the afternoon, I was seeing a neurosurgeon. He sent me for an MRI, and the result came back that yes, I had I think five-centimetre tumour in my left side of my brain. So, I had a pet scan, and it revealed I had a tumour on my adrenal gland and tumours in my lungs.

My name is Annette Manabi, and I'm a physician in Illinois. My background is in osteopathic medicine, and I have two board certifications, family practice, and neuromusculoskeletal medicine. I was diagnosed in December of 2014 with cancer, and at that point, it was a stage one endometrial cancer and the initial treatment plan is always surgery, which I asked to defer in an attempt to hopefully avoid surgery. And so they were willing to work with me. I said, you know, there are a lot of options that they do with women who are still trying to have children, and once you're menopausal, they just want to go straight to surgery. So, I said give me a chance to try some of these things. I, unfortunately, wasn't able to find a practitioner in my area who was versed in using LDN in cancer patients, and so I was having to navigate a lot of that on my own, but I worked up to the four and a half milligram dose, and over the course of six months incorporated a lot of integrative holistic treatments as well into my cancer treatment regimen. During that time, my tumour markers continued to rise. So ultimately, I did have surgery in June of last year. However, at the time of the surgery, what was of note to me, and I feel assigned that the LDN and the supportive treatments I did were helpful is the tumour itself did not invade systemically. So at the time of the surgery, it was still only a half-centimetre into the wall of the uterus. It didn't go into the lymph nodes. It didn't go into the circulation or metastasize anywhere. It did grow into the uterus. So, the tumour itself increased in size, but not into my own tissues, and so I feel had I got it sooner and had I caught cancer when it was much smaller, I may have had success in actually avoiding the surgery, and I'm continuing on the LDN at this point to prevent any recurrence or continue to boost my immune system because we don't really understand all the mechanisms of why cancer occurs and there's still a risk for recurrence or metastasis, and so I'm trying to boost my chances, and there's so much promising research coming out, showing it is effective in fighting cancers of all types and all stages. And so, I have no qualms in continuing to use it to support my own immune function.

So, I went away and I followed a very strict diet, then I was very conscious that I needed to rebuild my immune system and really fight cancer through my immune system. So, I followed that for the whole of that year. In July of that year, there were some more slight spots on my brain. So, the gamma knifed it again, and then I had seven sections of my small intestine removed.

So it wasn't until mid-2007 when I collapsed and was taken into hospital, ended up in Hammersmith Hospital. And I had a ruptured tumour on the outside of my liver, which caused me to bleed internally. And I was very seriously ill. You know they basically resected my the liver at that stage and shut everything down and that was the start.

So, Professor Dalgleish said, well, I wanted you to have LDN anyway because I think it's going to be good to build your immune system. He also advised me at that point to take vitamin D3, 25 UGS, high dosage every day. I was having B12 injections because I had so much that my intestine removed and I was trying to drink a lot of green tea.

So, he put me on green tea extract at that point, which was much easier.

So, it was about that time that I have an old school friend and his wife plays tennis with Professor Angus Dalgleish, and she said, why don't you go and talk to him? He's a top oncologist. And so I did, ‘cause I really didn't know what I should be doing at that stage.

So, I thought, well, I've got nothing to lose. And I went and spoke to him; had a consultancy session, and what he did tell me, he said, look, you know, it's just not quite my field, but he said, I can tell you, he said, I can't recommend it, but I can tell you that I have a dozen or so patients who are self-prescribing low dose naltrexone for malignant melanoma, and remarkably they've been symptom-free for 18 months, and he said, that's very interesting.

So here I am, just over seven years with, I hate to say it, but at the moment…good scans. And that’s really about where I am now. I suppose I love it, that's all I can say. My lungs are completely clear and that's only happened since I took the LDN. Up until that time, it was still growing. So, from my point of view, that's very positive. It's had no impact on my life whatsoever.

When I initially started taking the low dose naltrexone, I started at one and a half milligrams worked up to four and a half. I'm currently still on four and a half milligrams of the low dose naltrexone.

Initially, I did notice an improvement in my energy and an overall sense of feeling better. And aside from the initial disruption of sleep, which took place, my quality of sleep improved dramatically on the low dose naltrexone. And that persist, like if I miss a night or during the surgery, when I had to stop because of the pain medications, I could see a difference when I was off the low dose naltrexone than when it was back on the low dose naltrexone. So, I find overall, it's helping my overall wellness and state of health.

So, following on from that, I got more information from him and I didn't do anything about it immediately. I don't know why. I think it was because I'd been around the alternative market, and I was talking to all sorts of odd people. One of them selling mistletoe therapy.

I consider the impact of low dose naltrexone on myself and potential negative side effects. I did experience initially some of the sleep disruption that is commonly reported, where I was a little bit more awake at night, or I woke up a little more frequently.

And after about two weeks that passed and the quality of my sleep actually improved. Other than that, I've not had any other types of side effects from it that I'm aware of, and in general, I am feeling much better in how I feel my sleep energy and I haven't noticed any other specific side effects.

And so I was a bit sceptical about following Professor Dalgleish’s advice at that time, so I didn't do anything about it for 18 months. Anyway, within that timescale, I had two further recurrences of. HCC, which is hepatocellular carcinoma. It's a tumour in the liver. It doesn't spread in the body, but all the same, it destroys your liver.

When I came out, I did a bit more research, following up on what Angus Dalgleish had told me, and I researched  Dr Buhari in New York, and I thought, well, this is very interesting. And it kind of supported what Professor Dalgleish had said to me. And I also got to know about Dr Berk Berkson’s books and who's in Las Cruces, New Mexico, who was doing very interesting work as well with LDN and also using antioxidants, in particular, alpha-lipoic acid and some other things, and so, based on my research, I thought, well, I mean, I've got nothing to lose so I'll give this a whirl.

I have in terms of ways to take the low dose naltrexone, I am taking the capsule form that I obtain from a local compounding pharmacist. In terms of the future of LDN in the US I think in the ideal world, I would wish that all the major cancer centres would incorporate it into their treatment regimens immediately. Unfortunately, change in medicine is very slow, and it's challenging, and because it's already a patented medicine, there's not a lot of profit to be made. It's inexpensive, and so that becomes a barrier I think, in realistic means, the integrative medicine and holistic medicine community will be embracing it as the word gets out, as conferences are held, they will be the ones to hold the torch and get it available, as the patients also demand access, it'll be, I think, through that population of physicians who offer it to their patients. I would like to see it as a frontline for anyone who's got a suspicious diagnosis that's potential cancer. They should be started immediately.

So, I started without any expectation. I started taking the LDN and hey presto, miraculously I went into remission for three and a half years. Three and a half years. And that in itself was remarkable. And I was being treated then by someone at Hammersmith Hospital who was a bit dismissive about LDN. He'd never had great faith in it. And what he said to me was he said, look, your liver is recovering,

I don't think your recovery and your remission has anything to do with this low dose naltrexone you're taking. So, he was so dismissive I discontinued it, and I rue the day I listened to him basically. So, I discontinued it, and then within nine months, I'd had another recurrence of another tumour in my liver. But after I’d had this news, I decided I'd go to America to see Dr Berk Berkson, because I'd heard about him. And I thought, well, I'll go and talk to the guy. So I went out there and started on the LDN again with him, and I came back to the UK again with no expectations, and when I got back to the UK, I'd only been on the liver register for six weeks I think it was, and I  just sitting at home one day and I had a phone call saying we've got a liver for you. And I almost fell off my chair and we had to make a sort of an instantaneous decision about where to go. So, I said, yes. Interestingly, when they removed my liver and replaced it with a new one when they sectioned the old one, they said, oh, that's interesting, all your liver cancer has disappeared. Your tumour has completely necrosed. So, I don't know how to explain that, but since that day, that was over three years ago now. So well, I shouldn't really judge, but I suppose in my mind, I know that what did LDN do for me? Well, it gave me three and a half years of remission from the time when the doctors were actually saying, he's going to have another recurrence in three months time and it doesn't look very good, to basically getting me through that period. It's gone very well indeed, and I have no recurrence of any sort. So, do I believe in LDN? Yes, I do. I know, I know it worked for me.

So, more commonly we are getting many inquiries from patients who have been diagnosed with various types of cancer for low dose naltrexone. And it's quite important that if you are going to look at using low dose naltrexone for your cancer therapy that you talk to your individual GP and your oncologist first, because you may be on certain types of pain medication, which are contraindicated initially unless they're very carefully handled. A lot of people have come to us because they've gone onto the internet, and they’ve found something that they can buy. A lot of those are not real, or they are fake medications, which are dangerous, and you should not randomly decide to treat yourself for cancer by buying naltrexone tablets on the internet. I know it sounds very simple, but we find out the great number of people who do that.

So, looking at the possible side effects you can have from taking LDN along with cancer chemotherapy, that's extremely individual, dependent upon the type of cancer chemotherapy that you have. So, for example, there is a growth in biologics and vaccines, versus original chemotherapy drugs, like the platinum and things like gemcitabine, which has a slightly different mechanism of action. So, if you are taking, or you’re being prescribed many different types of cancer chemotherapy drugs, and each individual cancer is specific; cancer is not one disease, it uses multiple different types of treatments for different types of cancer, and the guidelines are always changing.

So, there are biological drugs that are chemically drugs called the plantains, and there are also drugs which can change your immune system, like vaccines. So, it's going to be very individual when and where you're able to take LDN in your treatment cycle or your treatment pathway. Now, there has been some information that we are aware of, which has not yet been released.  And I think over the next year we're probably going to hear more about that along with vitamin D. So, I’d certainly say, if you have been diagnosed with cancer and you're looking at using LDN, the first thing you should do is start taking vitamin D, and the dose for that, you can decide with your practitioner, but really it would be aiming for between five and ten thousand units per day, and LDN seems to work much better when it's being used with that, but LDN itself should not be taken when you're on any strong painkillers without direct medical supervision. So to speak to your doctor or pharmacist, and before embarking upon this journey and make sure that you get someone who is very qualified, who is capable of reading the most recent research and keeping you up to date and make sure that your treatment pathway works as well as possible.

Linda Elsegood: Thank you for listening to this presentation. All past conference presentations can be found on our website, https://ldnresearchtrust.org/

Julia Schopick - 11th September 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: Today, my guest is Author Julia Schopick who wrote the book Honest Medicine and she has a new book out now called The Power of Honest Medicine. Thank you for joining us today, Julia. 

Julia Schopick: I'm delighted to be with you, Linda, thank you. Thank you for inviting me.

Linda Elsegood: Tell us a bit about the first book first, please.

Julia Schopick: Okay. I'd be delighted to. My first book, Honest Medicine, which was published in 2011 resulted from experiences I had with my husband, who was a 15-year survivor of a cancerous brain tumour. And what I found was that, then, you know, things that we did for him, including nutrition, you know, things like that made him live longer. He was supposed to live three years maximum, he lived fifteen, and I found that the doctors were not at all interested in anything we were doing, they did take credit for him being a miracle patient, by the way. They didn't deny, you know, but so I decided that there must be treatments that doctors don't know about, but that is very, very effective and that patients would want to know about.

So, I wrote Honest Medicine. I really looked for, you know, these treatments they have to beat, I won't go into detail, but they had to be really reputable science-based treatments. One of them was a silverlon, the treatment that healed my husband's non-healing wound, head wound, when he wasn't healing from the second craniotomy, the second brain tumour surgery and then, of course, there was intravenous alpha-lipoic acid, you know, for liver disease and some cancers, and the ketogenic diet for pediatric epilepsy and finally, Low Dose Naltrexone. What I found was, you know, I went on over 200 radio programs and the book was reviewed in lots of places.

Everyone was more interested in LDN, Low Dose Naltrexone. So I decided that another book should be just about LDN. So that's a brief snapshot.  

Linda Elsegood: So the second book, tell us a bit more about that. 

Julia Schopick: Well, the second book, you know, was very long and calming. It took me several years to complete it. I wanted it to be, it was, you know, about Low Dose Naltrexone, but I wanted it to be universal. I wanted it to be international. So I got very active on Facebook, and I use Facebook to, you know, get the people who were going to be part of it. You, as you know, are part of the book and people from all different countries were part of the book. And I wanted it to be representative of not only the first book, Honest Medicine, the stories about LDN were all about people with MS, and this one has MS, but several other autoimmune diseases as well. It's just a very, I think, a very interesting book, you know, especially for the lay public because to get the word out about LDN for all different conditions

Linda Elsegood: And from all the radio shows you have done and all the publicity you have done. What would you say has been the main condition that LDN is being used for? that you've been dealing with? 

Julia Schopick: Oh, what an interesting question. I haven't, you know, I haven't really analyzed that, but I would say probably, you know, MS is its poster child, you know, that, I mean, that was the first of the MS patients, you know, we're the first ones to get active in getting the word out about LDN.

But I also think fibromyalgia is a big one and a Crohn's disease. Oh, my God. Crohn's disease, even Parkinson's, you know, the conditions that I write about lupus, I think all of them I'm hearing from people with all of them. And I try to pick the ones, by the way, Linda, that was most, do you want to say popular?

I don't know if that's the right word, but you know, that most people had, Hashimoto's was a big one I thought of including Graves' disease. But Hashimoto's is actually, you know, there's a, there's a website, excuse me, a Facebook group dedicated to the thyroid, but most of the people who participate are Hashimoto's.

So I would say that. If I sound like I'm hedging in a sense I am because I think that all of these conditions are equally important. What do you find you, you interview lots of people, even many, many more than I do. What do you find? 

Linda Elsegood: There are hot topics at the moment, as you probably know.

And the biggest one, I mean, we're doing a documentary to address the opioid crisis. And I know maybe ten pain specialists who are using ultra-low-dose naltrexone to wean people off of opioids. It's really, really interesting. I don't know how much you know about that. 

Julia Schopick: Not enough. Okay. Um, yes, very interesting.

Linda Elsegood: So what they do is use micro-dosing. So I mean, if you think. You know, 0.5 milligrams of LDN is low. The ultra-low dose is 0.001; it's so minuscule. But when used with an opioid, it makes the opioid far more effective. So that means you can actually titrate the opioid down whilst titrating the ultra-low-dose naltrexone up and these pain specialists are getting patients who are legal drug addicts, should we say, because they have become addicted to prescription-only drugs through no fault of their own but can't come off them because they're so addicted. These pain specialists are managing to get patients off without withdrawal and onto LDN, and it's more effective than their pain medications were, but without the awful withdrawal. It's just an absolutely amazing story. So that to me is what I've been working on the last quite a few months now, and I find that totally amazing. And what the doctors say, Oh, well, it took quite a while. It took five weeks or something. I'm thinking, what, you know, that is such a short period of time and I've had the pleasure when I went to America to talk to some of these patients who have managed to come off the opioids. And it's just—mind-blowing. Absolutely mind-blowing. But of course, the pain that people have. I mean, you mentioned fibromyalgia there, but there are so many other types of pain that LDN is being used for.

And I interviewed a doctor, he was a podiatrist, and he was really interesting. Now it's being used by dentists. It's been used in eyedrops, not only for Sjogren's but other ocular eye problems. And it just keeps growing. You know, the list of conditions that LDN can help with is growing and growing.

Julia Schopick: So much so exactly. In the United States. 

Linda Elsegood: Yeah. And we are going to have a second LDN book, which will address more conditions because obviously there's only so much you can get in a book cause you know. But dementia is another really good one, Alzheimer's, memory loss as to quite a big, hot topic.

But I could talk all day and every day, and l probably do about LDN, but it's so interesting. It's evolving the whole time and with the microdosing and we're finding, okay. In your opinion, what would you say the success rate is? Mainly for people with chronic conditions using LDN. 

Julia Schopick: Pretty high. 

Linda Elsegood: Give me a number at a rough number.

Julia Schopick: Um, would you say 80% 

Linda Elsegood: okay, let's go for 80%, so that's 20% LDN isn't working for, but we have to use the ultra-low dose. And doing different dosing protocols depending on the condition, whether it's a mental health condition where they're using double dosing, sometimes they're using three times a day dosing for different conditions, but by tailoring the dose in microdoses going up, coming down, working with an experienced prescriber, that 20% of people who haven't had success with LDN, it's nearer to the hundred than the 80%. 

Julia Schopick: So this is like the huge, this is like a huge story.

And now my question, I have a question for you if you don't mind.  How can we get the mainstream media to, this is one of my big bugaboos, you know when I go on interview shows, but also in the book and The Power of Honest Medicine that the mainstream media, you know, because they're so controlled, at least in this country, by pharma? They wouldn’t do that but maybe for the opioid crisis they would. 

Linda Elsegood: well, the documentary will be out soon we’re finishing filming it next week. But what we did, we did a pilot trial a few weeks ago in America. I was invited to the PCCA, which is the compounding pharmacy, whatever the PCCA stands for ...

Julia Schopick: Yeah exactly 

Linda Elsegood: And they wanted me to tell my story and that of the LDN Research Trust and what we'd been doing and it was quite funny. I did a talk in Madison, in Wisconsin as well, and another one we did in New Jersey. So there were three very, very exhausting and tiring all the different meetings that went along with the talks.

And we did some filming of the pain documentary but we're not going to have a conference next year. The conference will be in 2021. But next year it’s planned that every four months we will have a whistle-stop tour in a state or  States and do seminars for mainly prescribers.

But patients can come as well. And this, this was the two talks that I did, not the BCCA one, but the other two and the one in New Jersey had around 200 - 250 doctors there. It was amazing. So actually taking the word out there and teaching the doctors, it wasn't me doing the teaching, by the way, and showing the facts and the research and new dosing protocols and getting doctors on board to listen to the new way. And some of these doctors had been prescribing LDN for ten years or so, and they were totally blown away with the new concept and idea so that we don't have this 20% that LDN isn't working for. They're the people that we're trying to help.

When I say we're tried to help, I mean we're trying to help everybody, but we wanted to have a better success rate, and it's proving to be working. So next year, by putting in the effort and doing more training, we're going to see if we can then roll it out. And doctors are really, really busy. So it's going to be pharmacists that will become educators who will be educating the prescribers in their area. So it's all to do with education and training and that is how the word is going to ... LDN is just going to explode this next 18 month it’s going to be phenomenal. 

Julia Schopick: And you said you're doing a documentary on the ultra-low dose for opioid? And when will that come out? 

Linda Elsegood: The filming will finish next week. It takes—a long time for editing. I mean, we'll probably take another six months after filming is finished to have it all edited and put together but it is going to be amazing. I mean, we have so many really good pain specialists who were so eager and keen to be filmed sharing their experiences.

Julia Schopick: Would you be open to having that be shown on HBO or Netflix? 

Linda Elsegood: Well, we would, yes. 

Julia Schopick: Let's try to talk about that, Uh, not on the air. Okay. 

Linda Elsegood: Okay. Because whatever I can do, you know, I will. 

Julia Schopick: and that, that, by the way, that would do it. Do you know what I'm saying? Because then you would get the people who are addicted and want to get off.

I mean, who doesn't? They're not, you know, the doctors aren't prescribing the opioids in many cases. So the patients, if they were on HBO or Netflix, the patients would start demanding it. And then, you know, what happened in Norway with Frank Mel, with his documentary in Norway. the prescribers went from 300 to 15,000 overnight. I mean, the prescriptions. Yeah. And so my theory is that, if we can get something about LDN on something like HBO or Netflix, you know, a station by the way that does not depend on advertisers, because who do you think is most, is most of the advertisers in most of the media is, of course, pharma. So, uh, but you would be open to it? 

Linda Elsegood: Oh, yes. Everywhere and anywhere we could get it out there for sure. 

Julia Schopick: I will put my thinking cap on, and if you don't mind, I will start taking it up a little bit. 

Linda Elsegood: Okay. 

Julia Schopick: Yeah. All right. It's exciting. 

Linda Elsegood: It's very exciting. And this is why I am just so busy the whole time.

And it's too exciting to stop, you know, got to keep going. 

Julia Schopick: You know, from a, I call you one of my LDN heroes in The Power of Honest Medicine and I was very careful because all of the people in my book are heroes and heroines. Do you know what I'm saying? I didn't want to but I did single out four people, and you were one of them. And you know why I mean you, you're the Energizer bunny, you know, and you won't quit until you, you make an, you're gonna. You are succeeding. I don't mean you're going to succeed. You are succeeding. It's amazing. 

Linda Elsegood: Yes. Well, I'm stubborn. I think that's what it is.

I've started, so I want to finish, but I've been doing this 15 years now and. We had last Monday we had two people die that we know very, very well. In a 24 hour, less than a 24 hour period, and that knocked me for six and I was thinking, okay, so this is what I've done in 15 years. Have I got 15 years left?

How many more years have I got? Can I complete everything that I would like to complete in my lifetime? It's a bit of a reality check, isn't it? You know, I'm not, I'm not a young person anymore but still, I hope I have many years left to continue.  

Julia Schopick: you know, your legacy is huge, and I know you do have many.

You know what? You're too stubborn to die. Isn't that great? 

Linda Elsegood: I do believe though when you're time is up your time is up. 

Julia Schopick: Well I think you have a lot more to do and I'm very excited about this ultra-low dose. Uh, you know, for the opioid, and I think this could be the way we get to mainstream media, as I said, not with stations that are pharma, you know, supported.

But now with cable, there's so much more. And with things like Hulu and Netflix and, you know, there are so many more options. So this may, this may be it. 

Linda Elsegood: Well, we can hope. But then in your book, Julia. Off the top of your head, and I'm sure you must have a list there. What conditions do you cover?

Julia Schopick: Okay. The conditions that I cover in the book, and you're right, I do have a list, they are, let me get them out for you: They are MS, Chronic Fatigue Syndrome, Lupus, Fibromyalgia, Hashimoto's, Crohn's, Parkinson's, Psoriasis. Oh, I didn't mention that the first time around. Um, and also, are you ready for this?  I decided to include one that is not an autoimmune or even autoimmune connected, and that's Haley Haley Disease and it's a rare skin condition. I'll bet you know why I decided to include it, but I'm gonna tell the listeners anyway, I was gobsmacked, as we say, in England, when I heard that LDN, you know how LDN is hardly ever covered by the mainstream press, although that is getting better JAMA -  Journal of the American Medical Association, the JAMA dermatology, a magazine journal, actually did case studies, published case studies of Haley Haley Disease being helped by LDN.

And I was like, Oh my God, this is big. Do you know?  So that is one that I included, even though it was not an autoimmune disease. It's a genetic disease.  I was talking with Jackie Bihari about it, and I don't know the name of it, but there is a related autoimmune disease, but it is not Haley Haley.  So it works not only as, you know, it works for not only autoimmune but many others, so those are the conditions. 

Linda Elsegood: I was surprised because of the people with rheumatoid arthritis, you can understand that that's an autoimmune disease but people with osteoarthritis, it also works for, after speaking to pain specialists, there doesn't have to be an autoimmune component.

LDN helps with pain. Yeah. You know, and all of this is just coming out daily. You know, there's more coming out all the time. 

Linda Elsegood: Yes. Yes, exactly. So it's really exciting. And, you know, we are also going to put together an ebook for our 15th anniversary, which is this year. I haven't had a chance to

promote that too much right now, but I will be later on where we will be having stories of patients from all around the world, but not just patients from prescribers and pharmacists and researchers, which will be really interesting. It will be like an ebook, we're not having it printed. We have it just as a  free download. So that would be interesting. Just as a celebration of the 15 years.  

Julia Schopick: I don't know how you do it all, but I'm going to ask a favour. Is there any way that I could get a sneak preview of the LDN, the ultra-low, you know, with the opioid, when it's done before you would do it because I would love to see what I could do to get it out there in the mainstream.

Linda Elsegood: Yep. Remind me nearer the time points it's done. 

Julia Schopick: Yeah. You know, because it's, it's much more powerful if you say, you know, it's powerful. If I say, I know this woman, I know her work, and by the way, here are links to her other work. Do you know what I'm saying?  but if you say, I have seen it, and it's most impressive that can really help. So I'm excited. 

Linda Elsegood: I'm excited. How it's all evolved and as I say, these protocols to help those people where LDN, for whatever reason, they couldn't get the results to actually be able to increase that number. 

Julia Schopick: What do you think is the reason why some people just don't have any luck with it? You know, the 20% we were talking about?

Linda Elsegood: Because they might be sensitive, they might need to do it very gradually, very slowly.  They might need to take it twice a day, three times a day. Yeah. Sometimes you have to go higher, but you need a prescriber who understands how to do the titration. But you know, for the most majority of people, LDN works really well without having to go to those measures. But there are some people who need that help and support.

Julia Schopick: I think there's another reason and that is sometimes you know, on Dr Gluck's website http://lowdosenaltrexone.org/ he has an article about why choosing the right compounding pharmacy is important. And some of them say they do it, but they really don't.

Linda Elsegood: But even the ones that do it correctly with the rapid release. The patients still don't get 100% or more than 90% or 80%. So it's not just the compounding. There are further reasons, you know, and a lot of these compounding pharmacies listen to the patients if they want a different filler or different formula. They're open to that, it’s what compounding pharmacies do, yeah. So, you know, not meaning to contradict you and please don't think that that's why I was trying to do, 

Julia Schopick: I'm out to learn. 

Linda Elsegood: But I would still think there are other reasons, you know, just by everybody doing the same formulation with the same product, they're not going to be able to help everybody how it is at the moment. It is really, you need to tailor that dosing protocol for the patient, which is really exciting, very exciting, and the prescribers are excited by it too.

Julia Schopick: And they're growing. I think I asked Crystal. Now I know that there are many lists out there of prescribing doctors, but I believe she told me that it's over a thousand now on her list.

Linda Elsegood: So it's pretty good, huh? 

Julia Schopick: And her list doesn't have everybody, I'm sure. 

Linda Elsegood: Well, we had eight and a half thousand, so I'm surprised her list is so low. But with, we have in the UK new GDPR laws, which are data protection, and we now can only list on the website prescribers or pharmacists that have given us their permission to be listed in 2019 if they haven't given us our permission, they had to be removed.

And we were telling people. And I think we did a big culling, I think at the end of March, we have sent ten emails to faxes, and we now have a lady who's literally calling all these prescribers and saying, you've now been removed, would you like to be back on the list? Fill in this form? So any pharmacist or prescribers out there who are now not on our website, please get in touch. We would love to put you back. But it is an annual requirement that we have to check. And I understand we have to now have a data protection officer who does a fantastic job if you were listening. Thank you, Laurie. But we have to check because you know, people die. People stop practising. People move away. So the information you have. Not necessarily if they've been on the list for 15 years, like some of them had are still there that the listings aren't current. So by doing it annually, you know, at least at the end of the year, that information is only a year old and then you have to start the next year again. It's an awful lot of work. You would not believe the months that it's taken, but still, we weathered the storms and with Brexit, who knows what else we have to do. But we've come to the end of the show. Julia, 20 minutes went to 30. And I thank you very much for being our guest today. 

Julia Schopick: Oh, well, I want to thank you for inviting me and this is wonderful. Thank you so much. 

Linda Elsegood: Thank you, Julia. 

This show is sponsored by Mark drugs who specialize in the custom compounding of medications, assuring that the client gets the proper prescriptions for their unique needs and conditions. They work with practitioners integrating knowledge and treatment of experts to create comprehensive health plans.

Visit https://www.markdrugs.com/ or call Roselle 630.529.3400 or Deerfield (847) 419-9898.

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

Bullseye - Low dose naltrexone and Lyme disease with Serbian Subtitles (LDN) from LDN Research Trust on Vimeo.

Bullseye - Low dose naltrexone and Lyme disease with Dutch Subtitles (LDN) from LDN Research Trust on Vimeo.

Low Dose Naltrexone (LDN) in Scotland and beyond. Documentary with Portuguese Subtitles from LDN Research Trust on Vimeo.

Dr Kirsten Singler ND - 4th September 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: Today, my guest is Dr.  Kirsten Singler, who's a naturopathic doctor from California. Thank you for joining us today, Kirsten. 

Dr Kirsten: Thank you so much for having me, Linda. 

Linda Elsegood: So first of all, can you tell us,  what made you decide you wanted to become a naturopathic doctor? 

Dr Kirsten:  I was in my twenties going to graduate school on a completely different life path and I got really ill. And I think this is common amongst other physicians that are really passionate and have that drive for good patient care and have that personal experience.

In my twenties, I got really, really sick. I wasn't able to go to my graduate program, and I wasn't even really able to leave the house. And I went to multiple doctors and at that time I only knew really about mainstream medicine. And so I would go from doctor to doctor, and no one could figure out what was going on.

 I thought that I was so healthy because I was a raw food vegan and was so conscientious of what I put into my body, but still couldn't function properly. And a friend of mine took me to a naturopathic physician who did acupuncture as well, and it was so phenomenal. The doctor that I saw, a Dr.Brennan McCarthy in Arizona,  told me I would be better within two days, and this was after two years of really being ill. And in two days I was better and after that, I was determined that this was going to be my life path. I was so struck by it and even to remember it now I get goosebumps that something that was so grievous in my life turned out to be maybe the best gift that ever came into my life.  

Linda Elsegood: if you don't mind sharing what’s the issue that you had what? What was, did you get a diagnosis. 

Dr Kirsten:  I won't go into too much detail because it was female problems but it did have to do with hormone imbalance so severe that  I was basically very, very anaemic and that's why I wasn't able to function.  Now that I look back on it within the mainstream, none of the physicians I saw really evaluated my iron, my ferritin, those main indicators that now, of course, I run on every female patient that comes in our office, but at the time, nobody did that workup on me.  

Linda Elsegood: okay, when did you qualify as being a naturopathic doctor?

Dr Kirsten: That was in 2015. I graduated from SCNM in Tempe, Arizona. Before becoming a naturopath, I did work as a nutritionist and a herbalist and did consultations for ten years prior to that.  

Linda Elsegood: so knowing that acupuncture works so well for you, do you do acupuncture in your practice? Is that a.therapy option?

Dr Kirsten: Absolutely. Currently, our practice is so busy that just this year really, I haven't been doing acupuncture on patients directly, because it's more time consuming for each patient. So I refer to another person too. I did do the acupuncture prior to that  I absolutely did perform it, and I love it as a therapy.  

Linda Elsegood: okay. So when did you hear about LDN? How long ago was that?

Dr Kirsten: So in fact, the first time I ever heard about LDN was due to your book, the LDN book, it was my first Hashimoto's patients in the clinic. So this was when I was a student, and I had my first autoimmune case and my supervising physician,  handed me the LDN book, which I poured over. And then tentatively started my patient on it and had such good success. Then it's been part of my toolkit ever since. 

Linda Elsegood:  So what conditions would you say you have seen to date.

Dr Kirsten:  I don't mean conditions, which is broad, you know, autoimmunity covers like Hashimoto's, rheumatoid arthritis, lupus,  autoimmune, hepatitis,  dermatomyositis. That's a skin condition, a case of polymyositis. And that's—kind of a muscular, joint pain type condition. Ulcerative colitis, Crohn’s of course and fibromyalgia. I use it a lot for those cases. I've had pain conditions like trigeminal neuralgia work successfully with that. Also undiagnosed chronic fatigue.  

Linda Elsegood:  Well, I know that you said it was one of the tools you have in your toolbox. You know, if a patient came to you with let's say, Hashimoto's, what therapies would you use?

Dr Kirsten: Well, we want to primarily work them up for figuring out what's their root cause, right?  And figuring out what are the obstacles that they're facing. And then also evaluate their basic function. So we want to always pull back. 

You can look at the big picture of their health, and it's kind of zooming out from what their symptoms are, like the trees in the forest, and we want to zoom out and look at the forest and evaluate them for external environmental triggers. Which for Hashimoto's I feel is almost always the case that they have some form of, and for autoimmune in general, some form of external stressor, whether it's a psycho-emotional stressor or a toxic exposure like heavy metals or chemicals or some kind of physical trauma. Or exposure to some kind of pathogen, like a mould or a viral or a bacterial thing going on.

So we want to assess them for what's going on externally and then treat that. Say a patient comes back with high Epstein. Bart titers. Then we're also going to accompany the LDN with an antiviral protocol and an immune-boosting or calming protocol. Then we also want to look at what's going on with them intrinsically. Such things as what kind of inflammatory or immune dysfunction is maybe inherent. Or could have been going on lifelong, like how intact is their gut function, were they breastfed his children, were they put on multiple antibiotics, what's their formative nutrition were they raised on condensed milk, sugar and formula? Or were they fed a nutrient-rich diet, or is there a genetic polymorphism going on right. These are snips, changes in their DNA that affect their enzymes. And that can lead to saying, an inability to convert something like selenium in food. The active form in a Hashimoto's patient, their thyroid needs the conversion to perform adequately.

So if they have those kinds of polymorphisms and we want to be moving forward and making sure they get the right form of the vitamin and then evaluating them for other intrinsic type conditions like what's going with food intolerance. Do they have some kind of lactose intolerance or a food sensitivity that's affecting their gut that may be leading to an inflammatory cascade that's affecting their whole body or inhibiting their ability to absorb nutrition?

So it's really zooming out and figuring out what are the areas that need addressing and creating a pretty comprehensive plan for them. And then just taking baby steps with that plan wherever the patients are, you know if they're, say, a mechanic in a garage and they're getting lots of chemical exposure at their profession. And  I'm thinking, Oh boy, this guy's got to get out of that garage. Also, I'll start them on a detox plan and educate them about learning how to make better food choices. So at least he's reducing his toxic burden in his food. And then with the goal of figuring out how he can still maintain his profession without having so much exposure. 

Linda Elsegood: You mentioned heavy metals. How do you treat somebody who's been tested for having had? 

Dr Kirsten: So there are chelation protocols. And for the most part, naturopathic doctors are trained in this. We all take classes in environmental medicine and it's required, at least it was required in my program, to have an environmental medicine shift.

And the chelation can range from oral chelators (those are substances that will bind up certain metals, like bind up, lead, bind up mercury, and pull it out of the body through the alimentary canal).  There are other chelators, more aggressive, like IV solution. Now I don't do IV chelation.

If a physician is going to do IV chelation, that's all they should do because there can be so many side effects and patients have varying degrees of tolerability, especially when they're sick. But, the oral chelators are slower going and keep the body more in a state of homeostasis.

Linda Elsegood: Okay. How long does it take if you do it orally?

Dr Kirsten:  It varies on the vitality of the patient, the severity of their condition. You know, if, if they have like a severe Parkinson's and are wheelchair-bound versus mild exposure to lead that was stored when they were children. And then they don't have a current exposure and don't really have symptoms. So the vitality of the patient matters. The severity of pathology matters and then the degree of exposure. So has it been like lifelong, for example, you know, were they raised with it? Out on the dock here in California, we have a lot of dockworkers and there's a lot of pollution from the ships coming in, you know, a lot of inhalants.

Were they always there, out there on the docks, since they were kids up until adulthood and now adults, they're working on the docks or you name it. It really does vary based on the individual and their exposure. 

Linda Elsegood: Sure. Okay. So if you had a severe case, and they were on oral, would they have to be on it for a year or longer? You know, if it was a really bad thing. 

Dr Kirsten: If it was a really bad case. Okay. Say, somebody came back, and they had a severe pathology plus very high levels of heavy metals in their system. We would want to start figuring out where's the exposure coming in and remove that access. And second to that, take it really,  really slowly because it takes energy to detox. So when a patient's really sick, and they don't even have the energy to get up and walk around, perform daily activities, you want to drive up their vitality. So that could be starting with doing IV therapy, like IV vitamin C so that you're boosting up their immune system, boosting up their vitality, and then  build them up while you are slowly, intermittently, chelating them. So for a severe case, I guess the rule of thumb is for every disease a patient has, you're spending a month of active therapy. So if somebody has been ill for 20 years, you want to anticipate 20 months of active therapy. 

Linda Elsegood: Wow. 

Dr Kirsten: Okay. 

Linda Elsegood: Yeah. I'm just thinking of the age that I am. If you went back it would take 

Dr Kirsten: forever. It depends on vitality too. So some people inherently have phenomenal vitality. I had a Parkinson's patient, and she was wheelchair-bound and she had a full manifestation of Parkinson's and her medications were not adequately treating it. That's why she ended up on my doorstep. She was looking for something else. Actually, her children were looking for something else for her. She just inherently had such good vitality that as we started doing the IVs, it was really within three months that she was up out of her wheelchair. And walking around and could smile and could talk. And, you know, the first day I met her, she was mute, she couldn't smile or talk to me. So it does vary from patient to patient. Absolutely.  

Linda Elsegood: It's interesting that you said about Parkinson's patients. I have a friend who I went to college with who has Parkinson's and she came last week, and it's very difficult for her to get up.She's still walking, but when she goes to go through, or whether it's the stress of going through the door, I don't know, but she starts to do what she calls a dance, and she's popping up and down, and she can't get her legs to move. And it's every door that she goes through. Where would you start with somebody like that? Do you think maybe she has some of these conditions cause it's not that easy in England to see a naturopathic doctor. So that is a challenge in itself. 

Dr Kirsten: In England, do you all have evaluations? Do they evaluate for heavy metals and chemicals? Do they have tests like that? 

Linda Elsegood: I wouldn't know. I've never had a test. I have multiple sclerosis, but as far as I know, I've never been tested 

Dr Kirsten: There is a lab company that we use a lot. It's called great Plains labs and, I think that they are available internationally and their evaluation is through either urine,  stool, and saliva evaluations.And I think that that might be a place to start. She could look into that lab company and see if one of her physicians would be willing to run that lab and find out what kind of chemicals are going on. If there's heavy metal exposure, usually heavy metal testing is within the mainstream, you know, it's like a urine evaluation. I could look into it further and find out resources in your area. I can always email you. 

Linda Elsegood: Okay. That would be really interesting. That's good. We will have to have a look at that. She certainly could use some help. So have you found that your patients that take LDN and thyroid medication that they have to be very careful and reduce their thyroid medications?

Dr Kirsten: Well, yeah. Thyroid in my experience is ever-changing.  I've had patients that reduce their thyroid script just based on removing inflammatory foods from their diet.  So the better the gut functions, obviously the amount of inflammation is going to go down, which calms the autoimmune response. Number two, they absorb their medications more efficiently. So, a good rule of thumb that I always follow is I  run my labs every six months on the patients, and I'm always expecting them to change. Every once in awhile patients will come back stable. You know, these are people that have already seen naturopaths for years. They know their body. They're on a really good health program. But when people are first starting out, I am expecting to modify their scripts.  

Linda Elsegood: now you talk about the guts, and you did say at the beginning that you used to be on a raw vegan diet.  Is that the diet you're still on. 

Dr Kirsten: I'm not, but I do really subscribe to a philosophy of eating a lot of vegetables.

I get most of my nutrition and most of my food from vegetables. But they're going to be cooked and varied. And I'd say I'm definitely omnivore.  I think everybody should get most of their nutrition primarily from a vegetable source. 

Linda Elsegood: Now looking in supermarkets, and especially people that have several children to eat healthily,  it's very expensive.  I would think it's out of the reach of a lot of families where they have several children, you know, do you think in years to come, we're going to get rid of this high sugar, high salt, snacky type food? Do you think we will be able to educate people? You know what you eat, you know what goes in the gut really does affect your health.

Do you think that is likely to happen or is that just me being in cloud cuckoo land and you know, cheap food is going to always be there, and it's going to be full of sugar and salt, and people are going to continue to become type two diabetics because they are upsetting their immune system and having autoimmune diseases and thyroid problems and the like, you know, what's your opinion?.

Dr Kirsten: You're right. Similarly, I might be too idealistic, but I think that as they're teaching in the schools, and they're teaching children how to grow vegetables and cook,  that it all comes down to being able to cook for yourself. So I'm going through school. You know, when I was too broke to even buy toothpaste, right? I put myself through medical school and worked full time during that time and definitely knew financial pressures. Even during that time, I still cooked for myself. And you know, what I cooked was a lot of beans. I cook rice, and I cook a whole grain and actually did grow vegetables in my little garden in Arizona.I was successful in that way, but that all comes down to education. You know, cause I was raised in a family, that taught me how to grow vegetables and taught me how to cook beans and sprout seeds and like that. So for me, it comes as like second nature. I know it very well, but I think that with education, that will change.

And that's what I'm really hopeful for and excited about out here in California. There are lots of programs,  to educate kids on how to grow food and cook and changing the food systems within the school districts. And I hope that it just spreads throughout the United States, everywhere.

Linda Elsegood: Yes. And you know, if you went to buy, if you've got four children and you went to buy four apples, you know, the mother might go for the cost of the four apples of buying what we would call biscuits. You call them cookies and crisps, which you call chips and could end up with a basket full of snacky foods for the same price as for apples.

Which would be gone in minutes, you know? And that's what I find really hard. You know children are being given the wrong foods when money is a problem, which then causes lots of other issues further down the line.  I don't know if we can get healthier food at a more reasonable price. Yes, that might be an answer, but of course, it all costs money too for the farmers and things to supply the supermarket chains that also have to make a profit. And so it goes on. But it would be nice if all the snacky foods became slightly healthier as we go on, we have the sugar tax here. I don't know whether you have that yet, and they're trying to reduce the amount of salt that's being put in pre-packed food. So that's the style. But I think things have got to go a lot further. I mean, we were far healthier. I'm 62. My mother, when she was growing up, she grew up post-war, and they were very limited to what they had.  I think she was quite old when she had her first banana. She'd not seen a banana or an orange.But they lived on a farm. Had a pig, and a cow, and then when they slaughtered one of them, all the neighbours had bits and pieces, and then when they slaughtered something else, everyone got some of those, it was all similar to a barter type system. And they grew vegetables, so she only grew up with fresh meat, fresh fish, and vegetables. And  I think they as a generation were far healthier than my generation where, you know, fast food came in, you know, all of these prepacked foods, which I mean, in my mother's day, they didn't have, 

 I think we need to, instead of carrying on the path we're doing is to revert. Act how it was years ago in that eating your own vegetables. But for some people, that's still not an option if you live in a flat.  And you've got no way you could, you could grow things, but that's really interesting, What do you say about, if you had to give me the names of four top supplements that you mostly use. What would they be? 

Dr Kirsten: Oh, that's a great question. The pharmacist that I talk to the most, I send a lot of the patients to our compounding pharmacy and he was teasing me that I use magnesium for every single patient, which I have. I would say, okay. Magnesium is definitely on the list. I do think that people benefit from magnesium and commonly vitamin D. I've run a vitamin D lab on every patient, and they almost always come back in the deficient category. You know, I don't think it has to do with sun exposure. Everybody's either using sunblocks or staying out of the sun, and not eating vitamin D rich foods.  I almost always prescribe vitamin D3.  I would probably put some B vitamins in that cluster of supplements too,  so many of our patients, again, are compromised with their absorption. So either they're having issues, they're on like a. Proton pump inhibitor or there's something going on in the gastro system, and their B vitamins are deficient. Whether it's a B6 or a B12.  So I'd maybe put a B complex for those. And, getting back to the gut, I put almost every patient on a probiotic eventually. So it might not be the first go-round that we meet. But most people I think are gonna benefit from a good pharmaceutical grade probiotic.  And then. I will eventually put most patients on a detox.

So that could be mild. I could be taking botanical teas that helped move their liver and get their liver to function better. Or it could be more aggressive, like a box kit,  like something like the Standard Process detox kits cleanse that takes them through a list of foods that they can eat, have a list of foods that they can't eat, and then supplements that are really going to be pushing their liver through the phases of detoxification. I think that that would be my general toolkit for most patients. 

Linda Elsegood: So with the box detox kit, how long would you have to eat certain foods and restrict. 

Dr Kirsten: Well, there's a low intervention kit, by a company called Metagenics. That's a ten-day cleanse. And I like that when patients that have never done a detox before in their life, it helps them get confidence, know what to expect and get results. So usually, it's a one week cleanse and usually they're gonna feel more clear-minded, have good energy, and almost always lose weight because that's another component. Patients are always tracking their weight. Usually. And, it bolsters them. So after they've done a ten-day detox, then they could graduate to, you know, the next time they need to do a detox. they could do a month-long,  a 28 day cleanse.  I like to start patients where they're at. You know, sometimes I get a patient that has done multiple detoxes and then we can go straight into month-long cleansing. But I usually am going to start where they are. 

Linda Elsegood: Well, it's been amazing talking to you. I'd love to have you back another day and find out more from you. 

Dr Kirsten:  I would love that. 

Linda Elsegood:  Well, thank you, Kirsten. Absolutely amazing talking to you, and thank you. 

Dr Kirsten: Oh, absolutely. It is so nice to get to talk with you, Linda. It really means a lot to me. I've admired everything that you've been doing for a long time. 

Linda Elsegood: Thank you very much. This show is sponsored by Mark Drugs who specialize in the custom compounding of medications, assuring that the client gets the proper prescriptions for their unique needs and conditions. They work with practitioners integrating knowledge and treatment of experts to create comprehensive health plans. Visit Markdrugs.com or call Roselle (630) 529-3400 or Deerfield (847) 419-9898.

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

Brooke Hutchison, PharmD - 28th August 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Pharmacist Brooke Hutchinson is the pharmacy manager from Skip's pharmacy in Florida.

There is some changings since we start with LDN 25 years ago. We realize that not all people need to be on the 4,5mg of Low Dose Naltrexone and that's not wrong or the patient doesn't need to worry if he doesn't reach 4.5 mg. That's absolutely fine. And we've seen with a lot of patients chemical sensitivity where they're not able to tolerate the standard dose, specifically Lyme disease and Fibromyalgia's patients.

So I do in fact have patients starting off on a quarter milligram, some less. And they never achieve the three milligram. But the benefits are still there.

It truly does decrease inflammation in the body. We're seeing it used in micro dosing, Ultra Low Dose Naltrexone for pain management when patients are on opioid therapy to help them get on lower doses or actually get off of the opioid pain management and move over to the Low Dose Naltrexone.

When a patient does want to taper off of opioid based pain medication, we are using anywhere from 20 to 50 micrograms a few times a day, and it really helps patients decrease the opioid and avoid the withdrawal side effects of getting off of the opiod based pain medication. So everybody again presents a little differently, but it could be nausea, vomiting, flu like symptoms like your bones ache constipation, diarrhea.

Patients are avoiding having to go through this type of transition, trying to get off of their pain medication. And I can say it's been very beneficial.

So this process of transition from opiods to ULDN allows the brain to reset and help our body recreate our own natural endorphins to help with the pain.

I would like to say about Hashimoto's patients out there, if you have true Hashimoto's and you initiate Naltrexone. I have had patients within three days responding where they need to start backing off of their thyroid medication.

So patients present with heart palpitation, cold tolerance, irritability, anxiety. This can happen literally within the first week of initiating the Naltrexone where the patient has to start backing off of their thyroid medication.

Do not be afraid to do that. It will cause problems if the patient doesn't start backing off of their thyroid medication.

Lab values is a very helpful tool, but it's a snapshot of that day of that time. There is a fluctuation with

the TSH, FT3 but I'd say after three months of a patient going through the titration, majority of my Hashimoto's patients are completely off of their thyroid medication or there is combination.

Naltrexone takes time. When somebody has been suffering from something for such a long period of time, the healing process takes time. And that's what I always try to convey to my patients.

For my patients, for GI issues, Ulcerative colitis, Celiacs,  we also offer an oral liquid that gets absorbed through the membrane and the mouth, and it kind of avoids any kind of GI upset.

In addition to that, we also offer transdermal cream, which I use a lot in my pediatrics and adolescents, or again, patients that have sensitive GI tracks where it's applied topically to the skin and it's absorbed into the systemic circulation, bypassing the gut.

I compound anywhere from a quarter of a milligram up to nine milligrams if needed.

We have seen in different areas like autism and pandas we are using dosing twice a day. So these patients might be taking four and a half milligrams twice a day or nine milligrams twice a day.

I'm capable of compounding any milligram you could possibly think.

As LDN is a long term therapy, I usually ask my patients to be on LDN for at least six to eight months before they discontinue therapy.

Now, patients usually see change when they've gotten up to typically three milligrams,  within a few months. Healing process takes time. It doesn't prevent you from getting sick, but it does optimize immune system functioning and patients that would usually get sick five times a year, they only got sick once that year, and that's a big deal.

 We're trying to get the body to function as optimally as possible. And we're trying to decrease inflammation.  I wouldn't believe it unless I talked to so many patients all of my years of being with skips pharmacy. It was incredible.

Summary from pharmacist Dr. Brooke Hutchinson's interview. Listen to the video for the full interview.

Astrid from Norway, MS and Low Dose Naltrexone (LDN) from LDN Research Trust on Vimeo.

Linda Elsegood: Today, I'd like to introduce Astrid from Norway who uses LDN for MS. Thank you for joining us today, Astrid. 

Astrid: You're welcome. My pleasure. 

Linda Elsegood: Can you tell us how long ago was it when you first noticed your MS symptoms? 

Astrid: That's a good question. I was diagnosed in 1996 at 29 years old, and I was diagnosed during a period where our boss was getting sick too and the diagnosis was three weeks.

I have all kinds of strange methods for this because normally people are kind of sick for a long time and don't figure out what's wrong with them. But my MS was like a big surprise for me when I got this, I was kind of shocked. But I had a friend who I had grown up with, who had played with us.

Both these ladies were real role models. I can say they were very happy, had a good life, even though they were using a wheelchair and you can really see they were sick, but they have a very good life and are very happy. I was like, not so scared, but of course, very surprised when I got the diagnosis.

But when I look back, from a research perspective, I can find episodes and also some issues that had been bothering me. During the year before I got MS but I didn't recognize it as something. The doctor would. I got to the Agnos and at the moment I was kind of … didn't manage to put the buttons on my blouse and had the talk that I needed to use the wheelchair for a while, but kind of recovered, kind of. I felt like it was nothing to worry about, so kept ongoing, as I did before, and didn't want to recognise that I was sick really. This went on, for almost two years.

Then I had to have surgery for my back and a couple of weeks after that surgery, I got another attack which kind of put my feet away. Then the doctor explained the reason for this attack was the... what do you call it? I was completely awake during the procedure and they explained that it was you that triggered this attack, they explained. 

I still didn't get any offer for any medicine for MS. Only for pain. I use all this bad stuff for this medicine for epileptic normally and I was kind of more and more affected by the fatigue, the new neural pain, because of MS more and more. 

Then the doctor couldn't really help me. I wasn't qualified to get the medicine to slow down the MS because I was still considered different. Or whatever you can call it in a different category at the time, considered to give medicine to slow down their progress.

Today, I know the Norwegian doctors are starting to give this right away, but in 96 and 98 when I had these two big episodes, it was not common yet. Then I had my daughter in 2002 and I had a really good pregnancy and I was feeling very sick. MS unusually got better during pregnancy.

Of course, I was concerned that the birth could trigger another attack. I was right because this is what I did during the birth. I did use only the needles for pain relief and I didn't get any help to do it all or things like that.

They were careful with what they gave me when my daughters started to grow, I had more fatigue and more pain. Whatever the doctor was giving me didn’t help with the pain or fatigue. There wasn’t really any medicine which was working. I was trying it and it's something called for a while, but… What do you call it? A tree gets it. It was like more fatigue. Then I met this lady, I don't know if you know about this program that we had in Norway in 2013, it was the program in general. The lady with MS who was telling her story in that program, I met her in a training camp for MS and she told me about LDN, and then I figured out that this is something I want to try because she was like all over the place, the allergy and I find out I would give it a try. I ask the doctors, they said this is not proven, so we can't give it to you.

But they told me how to get it. They said if I go to a primary doctor and the primary doctor was given the risk perception... But prescription, it's okay, and we can't really say that you shouldn't take it, because of policy and blah, blah, blah, they have decided that all of the Norwegian neuro doctors will not write this prescription.

In May 2012 I started using LDN, and I have been reading a lot on Facebook because it started to pop up groups in Norway and in Denmark. Sharing stories and also a special group only MS and LDN and I read and concluded that if I start, I need to start with the low dose, very low dose and increase very slowly.

And I did. So I started in May and at the end of July, I was able to go on holiday with my family for 10 days. We started at a wedding which normally was so exhausting that I would be on the couch for the rest of the week after just one night. We went on to a park for my daughter who was 10.

I was for the first time able to spend the whole day walking around in the park together with her. Then we went on for a long ride with the car and we were away for 10 days and when I came back I was exhausted.  It was like, wow, something has changed.

Some radicalized change. I still was taking some pain medicine but I started reducing it. By February 2013, my doctors stopped prescribing the drugs with the opioids for me.

I went back to work, not full time, but I have been 100% since then. Like you call it auto work since 2001. I have been more or less, sometimes also in more than a hundred percent in hours working in pay and stuff today, no pain at all. I very often had this problem with my bladder, so I had to... what is the name of it in English? I didn't really manage to consolidate. So I had a lot of accidents, of course, but I also got a lot of infections. 

Linda Elsegood: In your bladder? 

Astrid: Yeah, yeah. In my bladder. Yeah. It was constantly infected and two times it almost cost me my life more or less because I got this sepsis, what they call it in Norway, the blood then got infected. So two times I went to the hospital and was really, really critical. After I started on LDN I have never any cold or any flu or things like that. My allergy has gotten better. I also use the catheter to help to empty the bladder because it didn't empty completely itself. That's the reason. 

Linda Elsegood: So you're self catheterizing?

Astrid: Yes, I did for several years. Of course, that was a nope. Done that. I haven't done that since I started on that. All-day I can feel like I need to go to the bathroom for an hour and I don't have the accidents anymore either. So definitely affected my bladder in a very good way. Who is really saying that you can't?

You are, so you can't see it. I feel like I'm more or less without any diagnosis really at the time. It's the combination with the LDN and I also take something called… natural medicine based on D mannose. Take it to flush out your bladder. I think it's like a drink. I drank it and the oils from seeds with black cumin seed in it. It's like the respiratory seed and it's shadow make rapeseed.

Then this is also very good for them. For infections, prevent the faction infections and so this should combination with the LDN. So it's been like life-changing. 

Linda Elsegood: If you were to say, what's your quality of life was like before you started on LDN and 10 being the best, what would it have been?

Astrid: I would say between three and four, maybe. 

Linda Elsegood: What would you say it is today? 

Astrid: Wow. Wow. Yeah. Amazing. Oh, I can do whatever I like to do. I can say yes to what I like to do and I don't need to say no. I'm measuring. If anything was supposed to happen, I needed to value, is this going to cost me too much or is it gonna give me any value? Everything was like that. Of course, since I have a little daughter, everything was focused to give her the best possible life. So when she went to kindergarten and school, I was residing on the sofa, doing nothing so that I can play with her. When she came back from her with school so that she could have friends over and so on.

So everything was kind of focusing on giving her the best what I really wanted. I'm the kind of person who is used to, I went to school and I went to college and high school and university, I was working. Besides, I have also been always using use to have a very high capacity of what I thought something used to work a lot and to enjoy working and always kind of this.

Suddenly I had to be this no person in many aspects. Even though I wanted, I knew that this is gonna cost me, so it wouldn't be worth it. Everything is back to where it was, I'm the person I am. I can say yes to what I like to do. It works.

Linda Elsegood: Oh, that's fantastic. You don't get the pain anymore? 

Astrid: I said, that's gone. No. That was really the big difference. The biggest, I think because the pain gave me a sleep disorder because I was having very bad sleep, even though I was always tired and being on the couch, I didn't really like... if I was lying on the couch and I felt like going to the bathroom because I needed to, it was like, I wait a minute, did two, I wait the five minutes. It was exhausting just to go to the toilet. So everything was so hard. It was like constantly like something was going on. I felt like my whole body is like when you take your muscles on you, you squeeze them as hard as you can and you feel like how the body's anxious and in a strain, it felt like this all the time, even though I was lying in bed.

The body was relaxed, but it didn't feel like it. This pain is all gone. When I lay down now it feels like I'm relaxed and I don't have any pain or neuro pains. They’re gone. Also, it's more like pain in the ears, eyes, and mouth.

It's like lightning balls coming and give you pain for just a few seconds to a minute. I had a lot of these neuro pains and they are also all gone. It's very good. It's so many things that disappeared. I don't remember all the pain though, because it's since 2013 I felt like my life, we started again.

I'm talking a lot about it and gave everybody's psyche, you have to try. So they are always asking me all, you're selling this or what? I say you have to go to the doctor and ask for it. So when I started, I had to order a box with a special delivery to my pharmacy in my city. So in the beginning that was like a special order. Out of curiosity, asking if I go to a new pharmacy and if the people know about them, ask them if they have a lot of customers and a lot of them say that it's been common and there are more and more people using it for more and more sickness. They recognize that this is something that is working. It’s good for so many people for so many reasons and different reasons to use it. They recognize it in the pharmacy too.

Linda Elsegood: We've come to the end of the show and we're so pleased to have heard your story today, Astrid. Thank you so much for sharing it with us. 

Astrid: My pleasure and I hope everybody is able to try it, LDN, because I think it's worth a try. Anyway, thank you very much. 

Linda Elsegood: My pleasure. 

This show is sponsored by our members who made donations. We'd like to give them a very big thank you. We have to cover the monthly costs of the radio station software, bandwidth, phone lines, and phone calls to be able to continue with the radio show and thank you for listening.

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

Dr. Michael Ruscio, DC - 14th August 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: Today, I'd like to welcome back my guest, Dr Michael Ruscio. Thank you for joining us today, Michael. 

Dr  Michael Ruscio: Thanks for having me. 

Linda Elsegood: Now you're a speaker at the LDN 2019 conference in June in Portland, Oregon. This is a prerecorded radio show, so we've actually had the conference. Could you tell us about the presentation you're going to be giving at the conference?

Dr  Michael Ruscio: Sure I'd love to. There is a growing problem in progressive thyroid care that I'm seeing at an alarmingly increasing rate. And I think it would really benefit providers of all stripes to better understand this: essentially there are maybe two or three big misses that are occurring in thyroid care. One is over-diagnosis of hypothyroidism, or you could turn this another way - when someone isn't truly hypothyroid, but they're being offered thyroid medication as support. What often happens is the patient doesn't realize that this is being used as a temporary support. The provider doesn't make that clear delineation that they're not truly hypothyroid. Some of your levels look a little bit low, so we're going to give you this medication to try to improve your symptoms. They don't make that delineation. The patients stopped seeing that provider, but they kept taking the medication. And now, there are a fair number of patients who've been on medication for years that they don't really need to be on. And so without getting too far into details of that, that's one key component, and we can fill in some of the rationale and the facts there in a moment. But over-diagnosis of hypothyroidism in cases that are not truly hypothyroidism is becoming fairly endemic in functional medicine. 

Linda Elsegood: And where is the source of the problem coming from, because of course, clinicians are trying to help these patients?

Dr  Michael Ruscio: I don't think anyone is over-diagnosing hypothyroidism with malicious intent. I think we're all saying, well, here's the patient presenting with fatigue, depression, brain fog, constipation, dry hair, skin, nails, whatever it is. What can we do to help this patient? 

And I think what we can do to help these patients in part is better to understand the importance of gut health. There is documentation to show that various maladies in the gut can contribute to thyroid function. Autoimmunity can contribute to non-responsiveness and malabsorption of thyroid medication. And by addressing these things, we can finally see these patients respond who had otherwise been unresponsive. And sometimes it involves using no medication, or even a reduction of the thyroid medication. So that's kind of the 30,000-foot view. And I’m happy to go into more detail on any of those points. 

Linda Elsegood: It's really interesting. I've met over the last few years, many people with thyroid conditions, and they don't generally tend to reduce their medication until they're on LDN and find that it's more effective than it was before. But that was interesting you saying, and I took it to be less, was more in some cases that you don't need such a high level over time. How, how does that correlate to the gut. I know that a lot of people with thyroid conditions say that they improve greatly if they don't take gluten. What else should they be doing? Say, if you've got a patient who's got thyroid conditions, what do they need to do to try and get that gut health in the right place? 

Dr  Michael Ruscio: You make a great point, which is therapy like LDN, through its ability to positively modulate the immune system, can positively modulate the gut. And that could help with malabsorption that could be occurring because of a problem in the gut. So that's one area that is sometimes overlooked, where someone may have various digestive symptoms, and the clinician may not fully connect that. Those digestive symptoms indicate that the person is not adequately absorbing their thyroid medication. And this may account for some of the instability seen when tracking someone's thyroid levels. And there are some papers that are documenting this now, most namely in either H pylori infection or those who have ulcers, showing that the treatment of H pylori specifically can actually lead to a reduction of thyroid medication.

And of course, as you noted, there are papers published on those who have celiac disease, who when they follow a gluten-free diet, can reduce their thyroid medication. Most clinicians are probably having their patients experiment with a gluten-free diet, so that is a great recommendation. It's probably not offering the clinician anything new that they haven't heard before, but looking into something like small intestinal bacterial overgrowth or H pylori, that may offer benefit. And again, sometimes we attribute this to healing the thyroid.  This hasn’t been fully borne out by the research yet, but my thinking is when you see a change in the need for thyroid medication where someone actually needs less medication that occurs over the course of a few months, that is almost for certain not going to be due to healing the thyroid gland, but more so due to improved absorption of the thyroid medication. We see this in some of the H pylori studies where patients were able to decrease their dose of medication. And we've published on our website a handful of case studies where we've been able to reduce, in some cases as much as half someone's thyroid medication dose.

At the same time, the patient is losing weight in a positive direction, meaning they were a bit overweight, and now they're at a healthier weight. They have better energy, better skin, less joint pain. 

And there's another parallel here that reinforces the same finding, which is using the liquid gel tab form of thyroid hormone known as Thyroxine. And also some research has been performed showing that in patients who have been unable to obtain stability in TSH and T4 and/or the resolution of symptoms use Thyroxine and actually are able to get many patients to a more stable TSH and T4 and improve their symptoms. And this is almost again for certain because Thyroxine being in a liquid gel tab is much more easily absorbed than some of your more traditional tablet forms. That's just a couple of ways in which the gut can directly impact the absorption of thyroid medication, which again, I don't think is being given the amount of attention that it deserves. And I can say in clinical practice. That can be the difference between success and failure in some of these cases.

And I'll just juxtapose that with - sometimes the clinician is really floundering with a patient on Levothyroxine and maybe they need to add in some T3 Cytomel, or maybe they need to switch them into a desiccated form something like Armour Thyroid or even WP Thyroid or Nature-Thyroid, or anyone of these medications that's a T4-T3 combination. 

And that's not really what the cause of the problem is. The cause of the problem is inconsistent absorption, and that is oftentimes addressed by improving the diet. As you noted, with something like gluten-free or if someone's already gluten-free, then considering some type of dysbiotic or infectious issue in the gut can then be what improves the gut health and allows the patient to more consistently absorb the medication, and then their blood levels look better and then their symptoms also look better.

Linda Elsegood: So how do people know what their gut health is? Like? How, what are the symptoms?

Dr  Michael Ruscio: That can be one of the biggest challenges because we're starting to learn that you can have - and actually, some of the older celiac research has shown this for a while - that you can have an active inflammatory issue in the gut that only manifests extra-intestinally. Meaning you have no digestive symptoms, but you may have something like atopic dermatitis or depression or fatigue or joint pain.

So one of the challenging things can be figuring out whether the gut is the root cause of this problem. Because you may have no gut symptoms, testing is oftentimes offered as a solution here, which it can be; but the testing is really imperfect, in my opinion. There are a number of things that we can test for, but there's also a number of things where the testing still hasn't been fully mapped out yet. And just as one example, we know that small intestinal fungal overgrowth does exist. Dr Satish Rao has published some research on this. But because doing a sample directly from the small intestine is impractical, then that's not something that we can really readily assess in clinical practice. So if someone could do a breath test for SIBO and a stool test for other types of bacterial and fungal dysbiosis, that's a great start. But we still might be missing something like small intestinal fungal overgrowth. 

So, in answer to your question, what can be used to help assess the health of someone's gut? Testing gives us a slice of information that can be helpful, but it doesn't give us all the information and the way I look at this is to consider taking steps to optimize your gut health kind of proactively. Even if you don't have a diagnosis of H pylori or small intestinal bacterial overgrowth, consider taking those steps to proactively improve your gut health.

If you've improved your diet, if you have a healthy lifestyle, but you're still not following optimally, well, so you're still not feeling optimal. Well, then. I think it's a good idea at that point to just, again, proactively and almost more so - empirically take steps to improve your gut health, because it can be challenging to get that definitive diagnosis on a lab test of various sorts.

Linda Elsegood: I've had people with thyroid conditions ask me questions about gut health, and they say, how do I know if I've got leaky gut? I've read that there are people that have leaky gut, and I seem to have the same kind of problems. What tests do you do for leaky gut? You mentioned that.

Dr  Michael Ruscio: Great question. And this is another area where the testing is really imperfect. We just performed a comprehensive review of the literature, literally looking at every test in humans on the markers, serum zonulin, which may be one of the better markers for assessing leaky gut. No marker really is perfect. Zonulin, that may be the best test now. Zonulin is a marker essentially of tight junction proteins in the gut and can be assessed via blood or stool, and it does correlate with various diseases like diabetes, metabolic syndrome; and in some cases, inflammatory bowel disease and IBS.

So it does seem to correlate with diseases or symptoms, but not in every case. But where the argument falls apart a little bit more, unfortunately, is when we look at what happens when we treat people, we put people on a healthy diet or on a probiotic or what have you, and this is where there are much more inconsistent findings with zonulin.

There had been a few studies showing that in people with symptoms and with high zonulin, meaning leaky gut, they then improve their diet and see a drastic improvement in their symptoms. Yet their zonulin gets either worse or stays the same. Now to be fair, there are also studies showing that zonulin can improve after using something like a probiotic, but there are also studies showing that people will see no improvement in zonulin after taking a probiotic, even though their symptoms have improved. I know this may be a little bit unpopular for me to say, uh, that zonulin may not be quite fully ready for the routine clinical application, as there are some inconsistencies with testing for leaky gut.

So this is why I say testing gives us a slice and it can be helpful, but we really cannot fully hang our hat on test results alone. Because when you look at the data behind these tests, in many cases, what you see is the tests do not perform perfectly. They're only partially informative, and so the best test, arguably, for leaky gut would be zonulin, but it certainly is not something that I think is highly reliable. So it's one slice. But we also want to take the patient's symptoms into account. And so maybe to just paint a scenario here, if someone came in with rheumatoid arthritis and they wanted to know if their gut was contributing to that rheumatoid arthritis, or even their thyroid condition, what we could do is perform some testing, and that would be maybe one-third of the data that informs how we're going to proceed. And if we find something on testing like small intestinal bacterial overgrowth or H pylori, we can treat those. However, if the testing comes up negative, one still may want you to consider a round of treatment. And this is where using things as herbal medicines and probiotics make a much more of a tenable approach, because these things I don't think, require the same rationale as using something like an antibiotic or what have you. But treat the patient for a presumed imbalance in the gut and then monitor their symptoms. If their symptoms are improving or if the dose required for the third medication becomes more stable, or even they start to appear hyperthyroid like they need less medication, then that tells you that you're on the right track.

And again, I know it's easier if I were just to proclaim one or two tests to be the best and one or two markers, and that's the easy message I think we all want. But unfortunately, when you take that easy message into clinical practice, you get really confused. And if you take my message, which is a little bit more nuanced, albeit being a little bit more complicated, I think you'll see, it really interfaces into the clinical practice more consistently and delivers better results.

Linda Elsegood: Well, I mean, unfortunately, your stomach and your bowels, you can't see, can you? It's not like psoriasis on your hands or something that you can see what's going on there. When I have spoken to doctors and asked what they think are the top four supplements that people should be taking, probiotics are always number one that people should take. What kind of a probiotic would you suggest to patients who wanted to take that to improve their gut health? 

Dr  Michael Ruscio: That's a great question, and I would certainly agree that especially for someone who's trying to improve their gut health, then a probiotic is a fairly inexpensive intervention and very safe, or even now showing some secondary health benefits. For example, one analysis has documented improvement of mood. Other research has shown a small but significant ability to improve cholesterol, blood sugar, and even blood pressure. Again, the effects there are small, and I would say not clinically significant, but at least you're getting a small movement in a healthy direction.

So I'm just trying to showcase here the neutrality, or at least small side benefit, of probiotics rather than there being some downside. We know that probiotics can improve things like H pylori and, and be synergistic with H pylori antibiotics. And in my opinion, may help to kind of re-establish a healthier balance of H pylori colonization. And they can help to eradicate things like SIBO, and intestinal fungal overgrowth. So certainly the end reduces leaky gut and there's a lot of benefits that we can attribute to probiotics. 

It's your question that’s a more challenging thing: what probiotic do I use? And this is where I think both the clinician and the consumer are confronted with just a dizzying array of options in terms of the probiotic formulas out there. One of the things I write about in my book is organizing probiotics into three different categories. And this greatly simplifies the landscape in probiotics. And when, when you read enough of the research on probiotics, and you sift through enough of these meta-analyses that summarize the high-quality clinical trials, you start to see that we can break probiotics down really into technically four categories. But one category is hard to obtain, especially in the US, so I typically focus the conversation on the three categories. 

Category one is a blend of lactobacillus and bifidobacterium strains. The exact formulas differ slightly from product to product, but then, the underlying and unifying theme is you will see the strains in the formula are predominated by various strains of lactobacillus and bifidobacterium. Your category two is just one strength, typically, which is the healthy fungus, Saccharomyces boulardii. And then your category three - you have typically anywhere from one to maybe five or six strains that are often known as soil-based or spore-forming probiotics. What I like to do with patients is have them use a moderate dose of all three of these; or in more sensitive cases, they will likely have reported some reactions to probiotics in the past.

And what you want to identify as a clinician is what category do they seem to be reacting to? Because oftentimes people are taking a category one probiotic that's the most popular and common probiotic out there. They may have tried two or three or even four different probiotics, not realizing that each one was a category one, a category one, a category one, a category one. And so they come in and say they just can't do probiotics, they react really negatively. And that's where taking a quick history and seeing if they know the names of the probiotics, quickly looking them up and determining, okay, all of these were in fact category ones. So then you can have them start with category two and category three. There are some patients by just going through that exercise of having them try a probiotic category one at a time, you can pinpoint that that is a category that you react negatively to. Now we can use the other category or categories that you do tolerate, and then you can obtain that fairly impressive benefit that can be vectored by probiotics and help the patient navigate around that reaction that had been kind of slowing their progress previously. 

Linda Elsegood: Well, the first time I wanted to buy some, I went into a whole food shop, and they had rows and rows of probiotics, and some started at 10 pounds, and some went up to 50 pounds. And I was trying to read on the bottle what was in the 10-pound one, what was in the 50, and what everything in between was. And I was just so bewildered by the end of it I asked for some help, and the young man didn't know either, really. So I just went for a middle-priced one to try it to see what it was like. But you have to do your research. It's not easy to find out. It's a minefield because there are so many things on the market and some that are similar like you're saying category one, but they're still not the same price. You know, the convenience. Sometimes if it's a really well-known brand, I think you may pay more for the name as well. 

Dr  Michael Ruscio: So thank you so much for making that comment, and you're absolutely right, which is the quality of a probiotic does matter. We want to be careful not to think that more expensive automatically equates to better. And we also want to be careful that if something is drastically cheaper than others, then there may be some corner-cutting that is occurring.

So there are things that you can look for. These can be, I think, challenging for consumers, and also probably challenging for clinicians if you're not used to fact-checking these types of things. But you can look whether a company is following good manufacturing practices and is also having third party testing to ensure that their probiotic meets its label claims. And then also looking for companies that aren't using fillers. That can be irritating, especially when we're talking about people who have sensitive guts. Some probiotics, this more so happens with cheaper probiotics, they're not very potent, and they're kind of watered down with other fillers or things like prebiotics, which are significantly less expensive.

Another way around this is just finding a couple of companies that are fairly reputable and just try to use the probiotics that fall into the category system. Find those reputable companies - that's quite a bit easier than just going into a health food store and trying to figure out their 15 different probiotics. Which ones can I trust? Which ones can I not? 

Linda Elsegood: And of course, it's the same in America as it is over here. I mean, supplements aren't regulated, so you can have labels that make claims of what's inside it, but they don't have to put a percentage, so if it's not like pharmaceutical grade, where they can prove, as you were saying, what is actually in there is on the label. It is reassuring to know that you have done the best you can to try and find out what is in the probiotic or supplements of any kind, because the layperson just wouldn't know - so trying to get a good manufacturer, that's what I'm trying to say, is really the starting point, in my opinion, as a consumer. Someone that you can trust, because you can spend a fortune on the cheaper brands that, as you said before, might have fillers and all of this kind of thing. And actually not have that many ingredients that are actually going to help you. But you know, if something is a quarter of the price, it's a waste of money if it's not going to work, isn't it? So sometimes you have to pay that bit more to make sure that you've got a product that is going to do what it says it's going to do. 

Dr  Michael Ruscio: The way that I learned was with protein powders, where I was using the most expensive protein powder and I noticed it. You make your shake, and sometimes you put it in one scoop, maybe sometimes you're a little more hungry, you want a thicker shake, so you put it in maybe two or three scoops. And if I ever had more than one scoop, I would get bloated. And I later learned from one of my friends who owns his own manufacturing company, that you have to really watch out for companies putting in excipients, which are powders that help the machines run more quickly. And he explained to me that because the machines run more slowly when making his protein powder, he had to pay extra to have them not put the excipients in. So it is a legitimate thing, and especially if you have a sensitive gut, just making sure that who you're getting your product from cares about these things. And it may not be that a manufacturer is trying to do you harm, but they may be saying, well, we're trying to cater to a market that is very price sensitive. So we're gonna use excipients to cut down our costs. 

We're trying to provide these items that are most gut-friendly and maybe a little bit more expensive. But I think the customers that we're trying to appeal to understand that. A slight increase in expense, the quality would be worth that. So, yeah, it is important to find a company who is going to be attentive to these things and, and make those tough decisions of making the product more expensive when it's really in the best interest of the consumer.

Linda Elsegood: Let me ask you, what's your diet like, Michael?

Dr  Michael Ruscio: I loosely eat a paleo diet. I do eat quite a bit of dairy, and thankfully I have no problem with dairy; most meat, vegetables, fish; and I don't eat much in the way of grains. I do have some rice. I do generally avoid gluten. I do notice if I eat too much gluten, I do have a problem. Even though the healthcare consumer is told that everyone should avoid gluten, I think it is incorrect. And that's not borne out by what the best research on this topic has found. But essentially - lots of vegetables, meats, healthy fats, fish, moderate to kind of lower-carb diet. So some gluten-free grains, but not a high amount. Some kind of a moderate lower carb, paleo diet with some dairy would maybe be the best label that we could put on it. 

Linda Elsegood: Some people say that they find diets for eliminating food really restrictive. And they will ask if once they’ve started down that road of eliminating these foods, will they ever be allowed to eat them again? So you were saying that sometimes you still have gluten and you know when you've had it, so obviously you don't exclude it completely. 

Dr  Michael Ruscio: Right, and you make a great point, which is we want to be careful with diets. Not to think that an elimination diet means you eliminate forever. Most elimination diets follow the pattern of cutout foods that could be a problem for maybe a month, maybe two months. And then once you feel you've improved, then bring the foods that you can back in a kind of systematic manner, where you're bringing maybe one or two in at a time, so you can identify what foods sit well with you and if any foods are triggers.

And then it's not to say that because a food is a trigger you can never have any, but you want to be a bit more judicious with how you use it. That is really, in my opinion, a key distinction to draw because what I see happening with patients is they become so scared of food, and they may have little to no reactivity, let's say, to gluten. So they can get away with having some on some occasions. Now, if you're noticing some reactions to gluten, would I recommend making a dietary staple? Absolutely not. Right? There's also this ability to live in the world without being afraid. 

And this is where I think some of the hard-line messaging on gluten is really damaging people from a psychological perspective, because now these people are at a restaurant with their friends and should be enjoying themselves, and they're worried. They're sitting there frantically worrying internally, trying to hide it behind a smile on their face, about is there gluten in the sauce here? And now again, there are some people who are exquisitely gluten sensitive, and they have to operate like that, but I don't think that they would wish that on somebody else who at worst may feel bloated in forty-five minutes if they have some gluten. So, your level of avoidance should be required with your level of intolerance. I know that the gluten-free staunch advocates will take issue with that, but you have to weigh that against the psychological damage we do to people who don't have much of a physiological reaction but are inculcated and feared into thinking that they will have massive damage if they have gluten. And now every day in their life, they have this baseline level of fear that is damaging their health. And so when you weigh these all out, I think it's clear to see that, yes, we want to identify gluten as being a problem in those that it is and help them avoid it as best they can. But people that have little to no reactivity, they have some leeway, and we don't want to fear them into thinking that they have to eat like they have celiac disease. 

Linda Elsegood: Wonderful. Well, we've come to an end and where's the time gone? It's been amazing. Thank you so much.

Dr  Michael Ruscio: Yeah. It's been a pleasure chatting. Time always flies when you're having fun, right? 

Linda Elsegood: Well, we'll have to have you back again, so thank you very much for having been my guest today. 

Dr  Michael Ruscio: Thank you again. It's been a pleasure.

Linda Elsegood: Healthy Gut Healthy You by Dr Michael Ruscio is a long-anticipated and comprehensive guide to completely resetting and healing the gut. Arm yourself with the education tools to heal yourself from the inside out today. Visit drruscio.com for details.

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 appreciated your company. Until next time, stay safe and keep healthy.