LDN Video Interviews and Presentations

Dr. Anna Cabeca - 8th May 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Dr Anna Cabeca is a board-certified gynaecologist and obstetrician from Georgia in the United States. She trained at Emory University, Atlanta, Georgia, then went on to also be boarded in integrative medicine, as well as anti-ageing and regenerative medicine. She is a pioneer for women's health, to solve the problems that so many women suffer with as a part of hormone imbalance; to do it naturally, and to regain control of our health to the best of our ability.

As many women age, muscle flexibility decreases and fascia tightens, with the result of discomfort with intercourse. In 2000 Dr Cabeca started using low dose naltrexone (LDN) in topical form for such patients, and developed a formulation of LDN, arginine, and pentoxifylline, that she calls “Joy Gel”. The vasodilators in it improve blood flow, moisture, etc.  It is applied to the pelvic floor prior to intercourse; or on a daily basis for relief from pelvic pain syndromes, vulvodynia, vestibulitis. Joy Gel includes LDN 2.5 – 3.0 mg per 0.5 ml and is measured into a syringe. A large pea or dime-sized is about 0.5 ml.

Dr Cabeca also uses LDN in capsule form for clients with difficult insomnia, typically with a very slow titer-up to 4 mg; and those with Hashimoto’s, autoimmune diseases, or suffering from toxic mould syndromes.

At around age 38, Dr Cabeca underwent menopause, looked for answers, that reversed menopause completely, and she conceived at age 41. At age 48 she and her family underwent a traumatic incident, and despite being on hormones, she became menopausal again. At that point, she tried a ketogenic diet but had side effects. She studied and hypothesizes that as protective neurotransmitters decrease with age, eg estrogen and progesterone, the ketogenic approach is not complete.  In her book The Hormone Fix, she writes about the keto greenway and the greens; adding on the alkalinizers, the high micronutrient-rich micro foods, and microgreens, like broccoli sprouts, and alfalfa sprouts; and using kale, beet greens, chard; lots of deep dark, deep leafy greens. Using the best to get the body into ketosis, thus using ketones for fuel. And checking urine to get an alkaline urine pH. She has developed a test strip to urinary pH and ketones, to help understand what’s working and what’s not.

In the book is a 10-day quick-start detox, a 21-day menu plan, chapters on stress and vaginal health and hormones, and functional testing, and quizzes, and inventories to do. She has programs and menus on her website as well. Once stabilized, clients may be able to reduce the medications they take.

In The Hormone Fix, she notes that it’s insulin, cortisol, and oxytocin are the major hormones that give the quality of life. Stress reduces oxytocin, and depression follows; healing comes through nutrition (25%) and lifestyle (75%). The book has a chapter on stress, developed through personal experiences and traumas. When cortisol’s up with stress, it lowers oxytocin; and you get into a critical phase of low cortisol and low oxytocin - and that feels like burnout.

The Hormone Fix is available from Dr Cabeca’s website: https://book.thehormonefix.com/get-the-book and that link includes a bonus offer.  The book also is available wherever books are sold – Barnes & Noble, Books-A-Million, and others; and on Amazon, where it’s #1 in menopause.

Summary from Dr. Anna Cabeca’s LDN Radio Show from 08 May 2019. Listen to the video for the show.

Keywords: LDN, low dose naltrexone, vulvodynia, vestibulitis, hormone, insomnia, Hashimoto’s, autoimmune, toxic mould, ketogenic diet, The Hormone Fix, insulin, cortisol, oxytocin

Lauren - 1st May 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Lauren is from the UK, and uses low dose naltrexone (LDN) for chronic fatigue syndrome (CFS), myalgic encephalomyelitis (ME), fibromyalgia, and Ehlers-Danlos syndromes (EDS).

Before starting LDN she was housebound for about 2 years. She lost mobility in her legs; and had constant migraines and dizziness, and a myriad of other symptoms. She was only 20, and rates her quality of life as a 2 at that point. Having no quality of life, she was on suicide watch. One day she decided to do some research, and came across LDN, and found Clinic 158 in Scotland, which arranged for a consultation with a doctor, and the prescription. Within 2-3 weeks on LDN 0.5 mg she was cleaning the house; and as the dose increased, she felt like a new person, with her independence back. She was able to return to work, and has her own home now, although she does have some bad days.

Her fibromyalgia began at age 13. She was a champion Irish dancer, and suddenly her fibromyalgia symptoms began, and soon she was wheelchair bound. It took 5 years to get a diagnosis. Living with fibromyalgia was very traumatizing, not only because of the chronic fatigue, but also the pain in her body. She was told her leg muscle mass was pretty much gone. Because of the fibromyalgia in her joints, at age 22 she was preparing to have a shoulder replaced because of loss of her rotator cuff and frequent dislocation. Now on LDN she only suffers a dislocation maybe once a week.

A couple months after being diagnosed with fibromyalgia she was diagnosed with chronic fatigue syndrome (CFS) and myalgic encephalomyelitis (ME). A year later she was diagnosed with Ehlers-Danlos syndrome type 2, the hypermobility EDS. Things like cold weather, or a temperature her body wasn’t used to, would cause her shoulder to pop out. Her whole body was affected, but it tended to show most in her shoulder joint.

Now on LDN her pain is not gone, but it’s down to minimal, and a level she can cope with. She coped with excruciating pain daily for years, and now on LDN, having slight twinges here and there over her body is manageable. She is able to enjoy her life as a 23 year old.

 Summary of Lauren’s interview, please listen to the video for the full story.

Keywords: LDN, low dose naltrexone, chronic fatigue syndrome, CFS, myalgic encephalomyelitis, ME, fibromyalgia, Ehlers-Danlos syndromes, EDS

The Opioid Crisis and how you can help! (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

What is the LDN 2019 Conference (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Silvia Panitch, MD - 24th April 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Dr Silvia Panitch shares her Low Dose Naltrexone (LDN) experience on the LDN Radio Show with Linda Elsegood.

Dr Silvia Panitch was trained in conventional medicine, but found holistic and functional medicine to be more successful in treating her patients.

Dr Panitch explains the nuances between holistic and functional medicine, weighing up the positives of both and how both methods have helped her become more experienced and consequently able to provide better treatment for her patients. 

In this interview she explains how rapidly medicine has evolved during her career while sharing a great deal of optimism about the future of Low Dose Naltrexone (LDN).

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

David Kazarian, BSPharm, CP, RPh - 17th April 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: Today my guest is David Kazarian, who is a pharmacist and CEO of Infuserve America. Thank you for joining me today, David. You were telling me before we started that your father was a pharmacist. Can you tell us about what it was like for you growing up? 

David Kazarian: Thank you for asking me to join you. Well, when I was eight years old, I used to make capsules in the back of the drug store. My dad worked for a chain back in those days, and he decided to open up his own pharmacy right across the street from them. And that's what he did. I was born in 1941 during the war, which kept my dad out of the war because he had a son; and I grew up delivering prescriptions, helping my dad. He was ahead of his time. He would make penicillin kits. I recall 100,000 units of penicillin would kill anything. And now we've got 2.4 million units and we've got some things that it won't kill. But as a child, I made capsules in the back of the store. I helped my dad with deliveries. I did everything there was to do. And I got interested in the pharmacy market, as time went on. I was always restless. My dad passed away and I learned how much I didn't know when he died. I thought I knew everything up until then. And my dad got real smart after he died. He used to tell me I’ll hear the things he’s telling me after he’s gone. He died in the early seventies, and I still hear that.

I got interested in infusion therapy, so in the 80s we started that, hence the name Infuserve America. That was the genesis of the name. We did infusion pharmacy, but as time went on, we got blown sideways into compounding. Well, I shouldn't say that, because back when I got out of school, compounding is what pharmacists did.

That was 50% of what I dispensed - we compounded it. It wasn't a speciality back then, it was what pharmacists’ profession was. As time went on, there was less and less of it. 

And then as time went on, all of a sudden, it started up again. But this time it started as a speciality, and that's why we've been a compounding pharmacy ever since. 

Linda Elsegood: So when did Infuserve America become a company?

David Kazarian: In 1989 I left Connecticut and moved to Florida. I sold my pharmacy there, came to Florida, and I was immediately bored because I was used to working 16 hour days. So I started a little infusion pharmacy called Infuserve America, and in 1994 we incorporated. I suppose you can say Infuserve was born in 1994.

Linda Elsegood: So, what does the company do now, David? How big is it?

David Kazarian: Well, that's a good question. We have 53 staff, several pharmacists who we can call compounding pharmacists, and one staff member who taught at a college of pharmacy and also taught courses in compounding for companies that sell chemicals. One pharmacist had been compounding for multiple years in a compounding pharmacy, and he is our pharmacy manager. We were a small company when we started. We had four employees, and now we're over 50. Wow, it's amazing, isn't it? What's amazing is the payroll. I get frightened every time I look at it. I've been practising pharmacy for over 50 years and I've worked with a lot of people, and I have to tell you, this group of individuals is probably the best of the best that I've ever worked with. They're amazing people. They don't know a time clock. They come to work early, they leave late. They do whatever it takes for us to satisfy our customers. They understand that we're here for the patients that we serve.

Linda Elsegood: And when did you first hear about LDN? 

David Kazarian: Well, that's very interesting because I will tell you that a doctor by the name of Horowitz called and asked if we could compound it. And I said, of course, we can compound it. And when I got off the phone, I turned around to our pharmacist and I said, what's that?

Linda Elsegood: Oh, that's funny. 

David Kazarian: Fortunately, one of our staff knew exactly what it was, and that was a while ago. I've learned more about it ever since. It's a very interesting drug. And of course, your organization has brought out a lot of information concerning the properties of LDN, what it can do.

But you know, I have to tell you, when I was in pharmacy school, we had an old professor, Dr Lauder, and Dr Lauder said, and by the way, he was well known - Dr Lauder formulated Kaopectate for the Upjohn company, at least that's what I was told. At any rate, he was one of my professors and he said to not pay attention to what the drug companies tell you about how good a drug is. Pay attention to how much it sells, because if it's a good product, it'll sell; if it's not a good product and it doesn't work as it's supposed to work, people won't buy it. And I will tell you since we started making LDN, we sell more every month. I believe that the product works, and I think it has been a well-kept secret.

Linda Elsegood: And how do you compound it? Do you do capsules, sublingual liquid, tablets?

David Kazarian: We do mostly capsules. Tablets require a tablet press. Making tablets, if somebody's not paying attention, tablets can be pressed too hard and they won't dissolve. Capsules, on the other hand, will always help. Unique formulations can go into capsules and they work. We have made tablets, but we haven't had much call for tablets. As a matter of fact, I don't even think we have the tablet press anymore. 

Linda Elsegood: Do you get to meet your patients? Do you know for which condition your population is using LDN? 

David Kazarian: When you asked if I get to meet the patients, I have to tell you an interesting story about my dad. When I got out of pharmacy school, I was working the bench. And a physician called and ordered a vaccine. So my dad put it up, and he told me to take it up to the doctor’s office because he had spoken to that doctor on the phone for 16 years and didn't know what he looked like. So I went up and his receptionist was very kind, let me walk into his office and shake his hand. You reminded me of that. 

And because we ship all over the United States and the fact that we are licensed in all 50 States and the district of Columbia, most of our things are shipped. So do I speak to the patients? We do speak to our patients, but I mostly don't meet them face to face. Sometimes I'll go to a meeting and somebody will come over and they'll say they want to shake my hand and say they’ve known our company for years and they’d like to meet me. But most of the time we speak over the phone. I'll tell you a great majority of our patients use LDN for Lyme disease. 

Linda Elsegood: I wondered when you mentioned Dr. Richard Horowitz. He took part in our Lyme disease documentary, so I did wonder if Lyme disease was a big part of your pharmacy.

David Kazarian: When we started, that was our only business, our total focus. It was 100% of our patients. Now it's probably 20 to 25% of what we do. But we still do have a large Lyme disease population, and it's sad because these folks get abused by the system. I've seen many cases where these patients had Lyme disease for years and were never diagnosed, and they were told that they had imaginary pain.

As a matter of fact, early on in my career of treating patients with Lyme, I met a psychiatrist that was ordering antibiotics, and I went to his office and on the wall were these degrees in psychiatry, and I'm wondering why a psychiatrist is ordering antibiotics? He told me that he got many referrals for patients that physicians thought were nuts, so he examined them and thought there's something organic going on, and he treated them with antibiotics and they improved; and his practice moved from psychiatry to Lyme disease, which was very interesting. People were diagnosed as having a mental disorder, when in fact they were infected with bacteria. Well, I'm sure there are some people who have mental issues who do present with maybe Lyme-type symptoms. But there are a number of people who contact me who find it difficult to get off the sofa, that they have difficulty in thinking they have lots of pain, et cetera, et cetera. And then to be told on top of feeling like that, that it's imaginary. You know, you're just depressed. 

Linda Elsegood: It must be absolutely soul-destroying when nobody believes you. 

David Kazarian: You have no idea. I've heard this story so many times I could regurgitate it by memory. People go for years, they're told their pains are imaginary.

David Kazarian: Then their insurance companies refuse to pay, and that's another thing we did. We started this pharmacy because I was involved with another company where I had a partner who enjoyed making money. Uh, I worry about the patient more than making money and some of her practices I didn't agree with, so I said we can't be partners anymore, and I moved to Florida and started this company. I tried to sell products that were used for Lyme disease as cheap as I could because these people broke my heart. They pay for insurance and insurance says, no, we've treated you for 30 days, you don't need any more treatment. So they've got to put their hand in their pocket and pay for these drugs themselves. So we tried to keep our prices as low as possible, and that was the genesis of Infuserve America. That's why the company really started. I felt bad that I was a part of a company that may have charged patients a lot of money who were hurting, and I wanted to repent for my sins, and that's why I started this company. The staff meets once a month, and at least quarterly I remind people why we're here. I tell them we're not here to make a profit, although I'd like to make a profit. We're here for one reason, and that's to treat the patients we serve. 

A lady called because she had a vitamin mixture and I got a call from my case management office. They told me she dropped the bag of IV solution and broke it. It was her fault. It slipped and broke and she needed to order it. It was $165 for that bag of a vitamin mixture that she destroyed, and she had asked if we could ship it to her without charging her for shipping because a FedEx refrigerated box is expensive. I told my person to tell her we'll just give it to her, no charge. Because my heart breaks for these folks there. I don't care. And we've got some wealthy people that are customers of ours, but how many months of paying hundreds of dollars can you sustain? I don't care how much you've got, that hurts. And there are some people who are on Medicaid and they can't get the drugs on Medicaid, so their families are helping them so that they can get the drug. That breaks my heart when these folks have to pay a lot of money for medication. So we've tried to keep our prices low. 

But the other thing that's happened, the regulatory environment has changed a great deal since I started the company. Many things have happened where regulations have actually increased prices of drugs. 'm often amused when people come out, senators and our president and Congresspeople, come out and say we've got to find a way to get prices lower. And when I hear that, I scream at the television or radio for them to look in the mirror, that they are the reason prices are so high is because their regulations have created so many problems for us.

I'll give you one example. We are licensed in 50 states and the District of Columbia. So we get a very rigorous inspection by the Florida Board of Pharmacy. In the old days, that's all that was required. The Board would come in, inspect us, we'd send a copy of the inspection report to the other states and they would accept that. Well, now they won't accept that. Now we're inspected by the boards of pharmacy in Florida, California, Texas; the pharmacy compounding board, the accreditation board. We have to send all of these inspections out when we go to get licensed from that particular state. Now those things cost. In California for instance, we have to pay for the airline ticket for that person to come here. We have to pay for their time when they're here, and then they grab some compounded products that we've made and they send it out for testing. All of that costs money, and it happens over and over and over. Somebody said it won't be long before there'll be an inspector in here every month. 

All of these inspections and all of these are things that they make you do. You can't use non-sterile gloves; now you have to use sterile gloves. You can't use a smock; you must use a sterile smock; you can't recycle this sterile smock. When it used to be - put it on, go into the cleanroom, come out to lunch, hang up that bunny suit that you're wearing, come back in and put the same bunny suit on. Now it's gotta be new. So in bunny suits alone, we're spending over a thousand dollars a month that we never spent before. Well, this trickles down to the patient - that poor person that's sticking their hand in their pocket and pulling out money to pay for their drugs. 

Linda Elsegood: Do you have to be inspected by all 50 states every year or, or is the license longer than 12 months?

David Kazarian: It depends on the state. Some are annual, some are semi-annual. It really depends on the state. 

Linda Elsegood: But you would think, wouldn't you, there would be some inspection that all the states agreed on, that these are the boxes that have to be ticked for California, these are the boxes that need to be ticked for Texas, for example, and that must be more or less the same, even if some States wanted to add on some extra things. And they had an independent inspector to make sure that you were completely compliant for all 50 states, and that one piece of paper would suffice.

David Kazarian: Well, it appears to be moving in that direction. There is a group that represents an association that represents all the boards of pharmacy. And that organization inspected us for the state of Texas, and if you use that inspection, that was more money but did exactly what you said. They had little checkboxes for each of the states that would accept their inspection. It wasn't all 50 states. I think it was 12 or 13 maybe that would accept that inspection, but hopefully  we're moving in that direction. And of course, there will be some states that I can't imagine will ever accept it. California comes to mind because their regulations are so different. We have to keep two inventories, one for California because their rules are so different. 

Linda Elsegood: I mean, cause it would make sense even if you had to pay double for the inspection that you had paid just for one state, if they were doing a thorough one, even if you had to pay double, but then it was able to be used everywhere, it would still be cheaper. It would be less disruptive for you because it must be terrible having all these inspections. You can't continue your normal pattern for your pharmacy when you've got strangers in the building.

David Kazarian: You’re exactly correct. You pull out your key people to be with the inspectors and they ask questions. There are some inspections lasting two days, someone day. Some tell you they're coming. The Pharmacy Compounding Accreditation Board is a longer inspection, but you have to prepare for going through what their criteria are. And it's not so much that you're scrambling to do new things or change the way you do things, but what you're scrambling to do is, getting able to answer a question like - where in your policy manual does it say you do a particular thing. So you want to be able to find it for when the inspector comes in, to tell him it's policy, say, 105.2 where it explains what we do. So the preparation for these things takes a lot of time. And you want to do that before the inspector’s here because if you don't find it and it's there, he'll write down that you're not doing that, that is not in your policy. 

And we've had that happen. Several years ago, the Board of Pharmacy in Florida changed their inspection and they found 23 things that were wrong. Of the 23 things, there were two that were actually wrong, both of which had we had addressed. But they waited until the 11th hour to ask us about how we handle an issue, and we're scrambling trying to find the policy that addressed the issue, and they said we didn't have it and they walked off. And that was problematic because now when you send that inspection report to other states, it puts you in jeopardy. So we send a book to every state explaining that the inspector didn't see this policy. We illustrated the policy and the date of the policy, which was long before the inspection was here.

So there's a lot of things that go on for the inspections. And I'm not saying the inspections are bad. We signed up voluntarily for the Pharmacy Compounding Accreditation Board, which is a very rigorous inspection. I wanted to do that to make sure that we did do things even above as we should be doing.

One little example: in all of my clean rooms I have UV lights. UV light kills bacteria, mould, and fungus. Those UV lights go on at 11 PM for 20 minutes, and they go on at 7:00 AM for 20 minutes. to make sure that if any bacteria do get through the system, they get killed. This is not a requirement, but we do it. We had our clean rooms inspected twice a year when the rules were annual. We do fingertip testing and we do a lot of things on a weekly basis that the regulations say you should do every six months. So we've always tried to be ahead of the curve, and as I said, I don't disagree with inspections.

Linda Elsegood: So is your facility huge? 

David Kazarian: Is it a really large facility considering we can ship throughout the US. We've got a 32,000 square foot building and we occupy all but 2000 square feet of that. We have one tenant in their building and will use that space when they move out.

Linda Elsegood: Wow, that is really big. So you are a sterile and a nonsterile pharmacy? 

David Kazarian: We compound - well actually, there are three things that we do. We compound sterile, we compound non-sterile, we do clinical trials, and we also have a testing lab to test the products that we make, not only for us but for other pharmacies in the United States. They'll send us products that they have mixed and we'll tell them if it's sterile and whether it has endotoxin.  

Linda Elsegood: I can remember meeting a gentleman at one of the conferences back in 2009 I think, and he said that he could bring in some LDN into the UK from India at a fraction of the price. So he sent a sample, which I sent off, and it came back it wasn't compliant in any which way, shape, or form. It just was not acceptable. So I told him, thank you very much, but no. And he said, well, can I get them to up the standard and do it again. Well, he insisted and he sent this second sample - and as you know, testing samples isn't cheap - and it was slightly better, but it still didn't reach any standards. So he had the cheek to ask if he could do it for the third time? And it was like, no, because the quality had not been good enough, even on the first batch; and maybe one batch might be okay, but then from then on, every batch would need to be tested to make sure that they hadn't slipped. 

David Kazarian: Well, that's something. There are a couple of components of testing. First is you test the product that you're buying. There is this other product that we use, glutathione. There was a shortage and we used a company that we had never used. We tested it and found a high level of endotoxin in the product, so we wouldn't use it. We just told our patients we couldn't get it. We didn't want to use this product. That was a couple of years ago, and the FDA just came down and said compounding pharmacists should not use this company's product. We never did. 

So you've got to test the raw material to make sure the raw material is good. Then once you've compounded it, you've got to test the end product to see if the end product is what you say it is, the right weight, the right strength; and with sterile products you have to test the sterility of every batch you make; and the product potency. You test once and as long as you make it with the same product, you test that potency only annually. Now with LDN, it's a non-sterile product. So you check the powder for bioburden to make sure it's not contaminated, and then you check the product. We check the product once to make sure that it's what it says it is, and then you can compound it. Bioburden testing is done every time you get a large batch of raw chemicals. The potency testing, we do on an annual basis.

Linda Elsegood: For the people that are listening, who might be considering buying off the internet - I'm always saying that if you buy something that has bypassed any testing, it can be anything. The MHR, which is the medicines regulatory body here in the UK, says that of drugs that have been imported into the UK, that they have seized, that 85% are counterfeit. And some of them are just a placebo, but some of them are harmful. So I mean, you are inspected, you test all your products. So when people have their prescriptions filled with you, they know that they are getting a very good quality product. 

David Kazarian: Well, you have to do testing because that story I told you about the product that had endotoxin came from a reasonably reputable firm. The company is well known in compounding circles. They have a lot of products. They sell some of the products we use. So yeah, that's why you've gotta be very careful. We are getting pushed by the FDA more and more to be like a manufacturer. And a lot of the things that we're doing is what a manufacturer would have to do.

When we started compounding a lot of things, I went to a friend of mine who has a pharmacy manufacturing firm right down the street, and I asked him about FDA visits and a lot of things, and we watched what they did. And they said when they get raw powder in, they have to test the square root of the powder plus one, of what they got. So if they got four barrels of morphine powder, they'd have to test the square root, which is two, plus one. So they'd test three of them. One barrel wouldn't be tested because if it all was the same lot number, you're testing enough to be able to determine that everything there is safe. We don't get so many things that we have to do that, but we do test our powders when they come in, for bioburden, to make sure that they're okay. And we only buy it from firms that we trust and have faith in the company. 

Linda Elsegood: I'm going to have to say, David, we’ve actually overrun. I'm going to have to end it there, but we will another day interview some of your pharmacists and find out from their point of view what they do. 

David Kazarian: I would welcome that.

Linda Elsegood: Well, thank you very much for being an amazing guest and enlightening us in the world of compounding. 

David Kazarian: You're welcome very much, and I look forward to seeing you at one of your meetings. 

Linda Elsegood: Well, perhaps we can get you to come to Portland the 7th to 9th of June, the LDN 2019 conference. 

David Kazarian: Actually, I won't be there, but one of my pharmacists will. I'll be in China.

Linda Elsegood: Ah, okay. Well, again, thank you very much for being with us. 

This show is sponsored by Infuserve America, an independently owned speciality compounding and infusion pharmacy serving patients in all 50 states since 1994; PCAB accredited and NCPA inspected. A+ Rated by the Better Business Bureau. They have a history of excellent customer service. Visit  infuserveamerica.com.

Any questions or comments you may have, please Contact Us at https://ldnresearchtrust.org/contact_us. I look forward to hearing from you. Thank you for joining us today. We really appreciated your company. Until next time, stay safe and keep well.

Dr Pamela Smith, MD - 6th March 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: I'm joined by Dr Pamela Smith, who is an MD from Michigan. Pamela has written ten books, and she has just released the 10th book, and the 11th book is going to be coming out next year. Thank you for joining us today  Pamela could you tell us about your new book that has just come out?

Pamela: Absolutely, and thank you so much for inviting me on the program. My new book is called "What you must know about vitamins, minerals, herbs, and more". And it really is an anthology of looking at all of these kinds of nutrients. And the whole idea is choosing the right nutrients that are right for you.

We have different sections of the book. We have vitamins as the first part of the book. So we do look at vitamins A, D, E, K, etcetera. We have a section on minerals, one on fatty acids, one on amino acids. We have section number five, which is on herbal therapies. 

Section six of the book I loving call it "other nutrients" because it covers things like Coq10.

Alpha-lipoic acid, probiotics and other things that really don't fall into a traditional category. And then part two of the book is on a health concern, meaning we actually go through different disease processes like hypothyroidism, low thyroid function: hair loss, insomnia, dry eyes, all these different things.

And we make suggestions from the medical literature: which nutrients work better for those clinical conditions.  

Linda Elsegood: So, do you test people of their minerals and vitamin levels, or do you, increase vitamins anyway for certain conditions? How does it work? 

Pamela: Well, basically, that's an excellent question.

You can do many things. You can measure 28 vitamins in someone's body. There's a test called the nutrient testing available worldwide, where literally you can measure all of those levels. You can go by eight. As long as people have normal kidney and liver function, for example, starting at the age of 50, most people make less of some of their vitamin sources.

They make less coenzyme Q10, less lipoic acid, et cetera. So you can make some generalities as well.

Linda Elsegood: Okay. So, once you decide which path you're going to take to treat a patient, what is the next step? Do you titrate them up or do you work out what would be the appropriate dose?

Pamela: Oh, my favourite way is obviously the measure.

I'm a physician. I'm a scientist. We'd like measuring people. So for example, if you measure vitamin D, vitamin D is a fat-soluble vitamin. That one should always be measured because vitamin D you can get toxic in. So we try and measure that, but we want the patient to have optimal levels and not just normal. Vitamin D is so, so, so important.

But the question is: What does perfect mean? So, when you look at vitamin D in American units, which are what is used most commonly internationally when you look at vitamin D, you want the revenue to be 55 to 80.  44 is normal, but it's not optimal. So you want that patient literally to have perfect levels because then vitamin D decreases the risk of developing breast cancer, colon cancer, Parkinson's, ms diabetes, high blood pressure, and really a number of different disease processes if you get the right amount of vitamin D. I mean, we can go through and talk about each vitamin. It is so important to have vitamin K adequate bone mineralization, so you don't get bone loss. It's very important for heart health.

It's very important for blood clotting, and so each different nutrient plays a very important role in the body. 

Linda Elsegood: You mentioned probiotics. Now I've had so many doctors tell me that when I've asked what are the top four nutrients, vitamin supplements that you would always rate highly and probiotics. It's usually maybe number one and in your book, you said that you're talking about probiotics. It's a bit of a nightmare, isn't it?  When I was looking to find out, which was the best for your money because you can pay a ridiculously high amount of money for a very good brand where you may be paying for the name as well.

But how do you assess when you are looking to buy a probiotic, which is the best one that you should be taking? How do you navigate your way around that?

Pamela: That's an extremely good question because first of all, new literature is showing for most people, not all, but the general population, we probably should rotate probiotics.  May mean that they shouldn't take them all the time, the same one. So for most people, take one really good for six months. Then the next six months alternate into another one. A good doctor has prescribed a particularly probiotic for you. Otherwise, for the general population, it's good to rotate them. Most of the really good probiotics do require refrigeration, and so we do keep them in the fridge.

I usually like to take my probiotics separately, so they're not taken with other things because sometimes nutrients interfere with that. So it's nice just to take them by themselves. 

Linda Elsegood: Okay. I didn't know that. And how do you go by the different strains. What we should be looking for?

Pamela: Well, you want a good general probiotic so that it carries a number of different things, and you also want something that's what's called pharmaceutical grade.

Nutrients come in different grades, and pharmaceutical grade means two things. Number one, it means that it's bioavailable meaning it gets into the body and does what it's supposed to do. And it is also, pharmaceutical-grade means that it's guaranteed to be 100% sure with outside verification. When you look at the idea of probiotics, you want a well-mixed probiotic for overall health because probiotics improved digestion. They help the immune system function as well, your gut, your GI tract.  70% of the immune systems is right in the gut. So the gut has to have that good bacteria and also people don't think about it, but probiotics help manufacture biotin, folic acid and niacin so that they're all in the right amounts.

So, if you asked me: Are there three things I suggest for every single patient in the world? There are.  Anybody who's an adult:

1. a probiotic

2. a multivitamin, and then 

3., it may be somewhat variable with people and depending on where they live, most people do need additional vitamin D, unless they're out sunbathing.

Okay? But the third one that everybody else needs otherwise is Omega fatty acids, otherwise known as fish oil. Most people don't get enough Omega 3's. So, I do take two fish oil tablets a day, every day, because I don't eat fish every day so it gives you really good fats.

Linda Elsegood: And there are so many people, patients, that I speak to who will tell me that they have a very good balanced diet. They don't need to supplement it at all. But as you were saying that once you reach 50, your body is lacking in certain vitamins, minerals, supplements, and is this something that you discuss in the book?

Pamela: Absolutely. It is something I discuss in the book. We look at things on what happens with age. Absolutely. There are also interesting things that happen when you combine food with medications. For example, grapefruit. I discussed this in the book. Grapefruit increases caffeine levels, and so, some people, if they eat grapefruit and they drink a cup of coffee, they're going to get nervous.

Great food also can increase the levels of different medicine like warfarin, which is a blood thinner. In fact, there's even a trial showing the grapefruit can cause hives if taken with Naprosyn, which is a nonsteroidal drug. So interestingly, even foods can have an effect on what happens in the body. And we do discuss all of this in the book.

There's a whole chapter looking at mixing supplements, drugs, and food. 

Linda Elsegood: Hmm. Well, I was mixing my probiotic with yoghurt. Is that allowed or not?

Pamela:  You should be taking it by themselves? 

Linda Elsegood: That's interesting. Very interesting. So what else do we learn in the book?

Pamela: Well in the book you're probably going to be surprised to realize that most people cannot eat their way into health. Believe it or not, in today's world, because things get genetically engineered, and we don't always replenish the ground with nutrients, almost everybody does need to take a least a multivitamin.

People tend to be surprised about that. Other things that people tend to be surprised about, and they look in the book, but there are actually many medical trials showing that if you look under health conditions, there are studies showing ways that we can all look at things to prevent cancer. There are studies showing that Chlorella taking a teaspoon a day decreases the risk of developing cancer. Not eating a lot of sugar decreases the risk of developing cancer, eating too many bad fats and salt—just some common sense things. And then again, a lot of it depends on what you're interested in. So, for example, if you're interested in the prevention of cataracts, then, believe it or not, there are medical trials showing that alpha-lipoic acid, B vitamins, bilberry, carnosine, which is an amino acid, N-acetylcysteine, glutathione, your basic vitamins,  Selenium. Those things help prevent cataracts, so a lot of it is prevention as well. It's always best to prevent the disease.

Linda Elsegood: Absolutely. You mentioned multivitamins there. And again, it's a bit like the probiotics. There are millions of different multivitamins, you know? Where do you start? What is a good multivitamin? What should you be looking for?

Pamela: You always want to look for pharmaceutical grade and a broad spectrum. And those are the two things you look for, and the trouble is that you usually if you're in my age group and you're over 60 you will only usually end up with a multivitamin where you have to take a number of them.

It's not like when you're 20, and you may just take two multivitamins in a day, that's enough. I really do have to take a number of them because you want to prevent disease and treat things. I have high triglycerides so I personally take Omega 3 fatty acids, which many studies have shown help lower triglycerides.

So, you know, my goal is that I may still have a heart attack because I inherited high triglycerides from my dad, but I'd like to be 95 when I had that heart attack and not my current age of 64. It's also important to have nutrients to keep the body going well. So, for example, the thyroid gland has to have enough iodine.

So if you'll never,  ever eat any fish, then you probably want to see your healthcare provider, have your iodine levels measured and see if you need iodine. If you're not eating your way into it.

Linda Elsegood: Oh, that's interesting.

Pamela: I think a fascinating one in the book has to do with high cholesterol. Everybody thinks high cholesterol is, I ate too much, this, that, and the other. Of course, it can be, but people don't realize that high cholesterol can be due to buy it to the deficiency.

Biotin is made in your gut. So if you've got reflux, IBS, GERD, all those things you've got, it's not healthy. You're not going to make enough biotin. You have to have carnitine. You have to have some of these nutrients in order to lower cholesterol, including vitamin C. So there's nutritional things that are important for the body but I think sometimes people don't realize So that's part of the reason why I wrote the book. I want people to have a good idea of vitamins, minerals, herbs, and more. More of a personalized approach to them, and it's called a concise guide to better health and longevity and that's what we want people to be, as healthy as they can be.

Linda Elsegood: Well, that's interesting that you talked about high cholesterol. I suffered for many years with acid reflux. My mother had a heart attack in 2000. Well, Christmas 1999, just before the New Year, and she had what they called hereditary high cholesterol, and they wanted to check me and my two daughters.  My cholesterol level was so high that I could have had a heart attack or a stroke at any time.

My eldest daughter's cholesterol level was fine. My youngest one was borderline, so they put me on a statin, and I had to see a consultant. And I said to her: " I would rather not take anything.  Ultimate diet Is something I can do so I don't have to take this statin?

And she said: "If you were to live on a glass of water and a lettuce leaf, you would still have high cholesterol." 

Pamela: Exactly. You have inherited that pattern. That is correct. 

Linda Elsegood: So I altered my diet. I have to say,  listening to doctors, Tom O'Brien. I'd stopped eating gluten and literally in days of stopping the gluten, the acid reflux stopped, and I was able to stop taking the anti-acid tablets. So that was amazing. So that's not a problem. But would I still be able to reduce that level of cholesterol naturally, or even if I have to still take the statin,  I don't care, but I would like to try and bring it down. So because the doctor had said to me, as I get older, I might have to increase the amount of starting I take, and if I can do something new and I'm 62,  I may not have to take a higher dose. Do you see what I'm trying to say? 

Pamela: I can absolutely see what you're saying. The goal is that you take the right dose of a statin drug and so side effects do go up with any drug.

The higher the dose you take. So number one, anybody taking a statin drug, they get deplete on important nutrients. Coenzyme Q 10. So they need Coq10 if you're on a Statin drug. So for you, for example, you're over the age of 50, so you need a 100 mg of CoQ10 and another 100 mg because of the Statin drug.

Are there other ways that come over cholesterol? There are pages and pages in my book. My personal favourite is bilberry. I absolutely love bilberry. Bilberry, 200 mg, twice a day is a great place to start. You can go all the way up to 500 mg,  3 times a day. Very effective to lower cholesterol, even coenzyme Q 10. Gugulipid. People may not be familiar with that one.

It's G. U. G. U. L. I. P. I. D. 50 mg,  twice a day, lowers cholesterol. Policosanol works very well for those out there. If you haven't heard of that one, it's P, O, L, I, C, O, S, A, N, O, L, 20 mg,  once a day or 10 mg, twice a day. Another one of my favourites is tocotrienols. It has a special kind of vitamin E, 400 to 800 international units a day. Very good to lower cholesterol. So, all of these can be very effective, and most of them do mix with a statin drug. Not all, but many of them do. 

Linda Elsegood: It is like a foreign language or hasn't heard of these.

Do you have to take all of those or just one or a combination? 

Pamela: For most people, I suggest starting, like for you, for example, you're on the statin drug, make sure you are on Coq10,  start a little bilberry, 200 mg,  twice a day. As long as you have normal kidney and liver function, that would be great.

Linda Elsegood: okay. Wow. This is really educational, isn't it? And it's all in the book. So people who are listening to this can follow your recommendations, and I'm sure they would get a really good idea of the guidelines of what you're suggesting now. 

Pamela: Absolutely. They'll have all of us in the book and more.

I mean, we didn't talk about amino acids. The body produces amino acids, eat your way into some of the amino acids. They're very important for memory and energy. So yes, we hope everybody picks up a copy of what you must know about vitamins, minerals, and more because there's a lot in here and it's written in bullet style format so that it's easy to read.

Linda Elsegood: Well, that's good because if you see chapters and chapters of text It's hard going, isn't it? But you can pick it up and put it down easily if it's in bullet points and it's easier to remember, I think as well. 

Pamela: I do too. I think people learn in bullet style format now because of computer systems. So it does make it easier.

Linda Elsegood: As we said, this will be the 10th book you've written. What other books have you written? What have they been about? 

Pamela: Well, I've written two books on hormones. My most recent is: " What you must know about female hormones". Let you know about women's hormones. Has done very popular.

Probably my most popular book is: " What you must know about memory loss and how you can stop it."

Linda Elsegood: And of course you're going to be a speaker at the 2019 conference in June, so we will actually get to meet you. So that's really exciting. 

Pamela: I'm very excited myself. 

Linda Elsegood: So, all the things that you talk about in the book, do they complement LDN?

Pamela: They do. They absolutely do. I have the world's best editor. She is so fabulous, and she makes sure, but they all complement each other.

Linda Elsegood: Oh, that's wonderful. And where can people buy your book? 

Pamela: People can buy my book at almost any major bookstore. You can order online from Amazon or any major outlet and online worldwide.  

Linda Elsegood: And do you have a website? 

Pamela: Actually, the website for this is going to be changed as the book is coming out because they're updating it.

So that part I'm not going to give to you because that one would be difficult, but if people can't find my book, they can always email me at faafm63@yahoo.com, and we can give you that new website as it comes up next week. 

Linda Elsegood: Fantastic! Well, absolutely amazing talking to you! But if patients want to see you, do you have a website for that?

Pamela: Yes, people can absolutely come to see me or any of my partners. And probably the easiest way of accessing that is to literally call as opposed to get on the website. But we are, if they want to be on the website and look at us, we are the Centre for Personalized Medicine. So if you type that in, then everything will come up.

If you're going to go on the web. 

Linda Elsegood: And what numbers should they call if they would like to make an appointment?

Pamela: as I'd like to make an appointment. (313) 886-4060  

Linda Elsegood: And are you, not just yourself, but your partners in the clinic there too?  Do you have a long waiting list too? Do people have to wait to see you?

Pamela: Well, our goal is there's not. I do have four partners, so I'm very blessed to have great partners that are all fellowship-trained and metabolic, an anti-ageing and functional medicine. They've all done an entire fellowship, so we hope that people will be happy seeing any of us. So we tried for there not to be a long wait.

Linda Elsegood: Well, thank you very much for joining us today and speaking about your fantastic new book. I mean, I've made so many notes here. I'll certainly be getting a copy and checking it out. 

Pamela: Good! I hope you enjoy it and I hope everybody in the audience enjoys it as well. It truly was a labour of love, but I'm very happy with how it turned out.

Linda Elsegood: Fantastic! And just where we go, you said there was another book to come out. What is that one going to be about? 

Pamela: Yes. That one is scheduled to come out November 2019, and it's called "What you must know about autoimmune diseases." But believe it or not, there are 105 autoimmune diseases. Certainly, all of them are not going to be covered in the book, but the major ones are.

There's more and more to know about autoimmune. So yes, that will be November 2019. "What you must know about autoimmune diseases."

Linda Elsegood: Well, we'll have to have you back talking about that because obviously, LDN works amazingly for autoimmune diseases. Not saying it works for everybody, but it does seem to work really well.

So that would be a really interesting topic as well. 

Pamela: I would be honoured to do that, truly.  There are three things that I do for every single patient with an autoimmune disease, and one of those is to put them on low dose naltrexone, LDN. There's not a single patient in my personal practice with any of the autoimmune diseases that is not on LDN.

Linda Elsegood: The million-dollar question that people will ask is: How long would I have to take LDN before I noticed an improvement? What would your answer to that be? 

Pamela: 30 to 90 days.

Linda Elsegood: That's amazing! So a short period of time, isn't it? 

Pamela: Yes, it is a short period of time.

Linda Elsegood: Awesome! Amazing!  Well, we have to go. We've come to the end, but thank you very much for being with us today, Dr Pamela Smith, and we'll have you back again. 

Pamela: Well, thank you so much! Everybody. have a great day! You as well have a happy rest of it, of everything because I just love this time of year and spring is about to blossom.

It's such a happy time. Thank you. Bye-bye. 

Linda Elsegood: This show is sponsored by Dickson's chemist which are the experts in LDN at associated treatments in the UK. Dickson's chemist, the most cost-effective for LDN in all forms within the UK and Europe maintaining safety standard of what is required. Why would you choose to get your LDN from anywhere else?

Call 01414046545 today to speak to an LDN experts 

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

Carrie talks of Shingles, PHN (nerve damage) & CPRS (pain) - 3rd April 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

I am Carrie from the United States. I  had shingles at a very early age. It's a very complex story so then I had a diagnosis of PHN that's just nerve damage due to the shingles and that then led to CRPS, which is chronic pain syndrome.

Before I had shingles I was extremely healthy. I was finishing my master's degree in teaching and was just wrapping up my thesis project.

I had shingles after coming back from Jamaica from our honeymoon and because the bumps were in my neck and back I didn't notice them straight away so when I went to the doctor

he had a good indication that this was going to be problematic since it took so long to start antibiotics in the first place.

I lost complete use of my left arm within two years of shingles, eventually it shut down the left arm to the point where it was purple and cold. Within three years, I was meeting with surgeons to come up with plans for amputees.

I was taking 32 pills a day before I was 30 years old. My husband attended every single doctor's appointment with me for eight straight years.

Later on we found a doctor who took me off of all those medications in a safe way and who then could help me build a path forward. Ironically, that ended in me getting pregnant because some of the medications that we ended up taking every day, they don't unnecessarily help you regain your health.

Instead they add you more layers to the complexities of our health. I was able to go off every medication that I was left on through the stripping process and my body was able to fix the problem itself. The CRPS went into remission. I didn't even realize I was pregnant until I woke up one day and my arm was warmer.

It became pink again instead of purple, I was able to go back to physical therapy and get full use of my left arm back in  those  nine months.

The thing about autoimmune disease and remission and pregnancy is that it's usually a temporary release and then once you have your child, it does come back. And that's what happened to me.

I support a few groups on Facebook who deal with chronic pain, especially with nerve damage and shingles and so I had heard little stories.

A friend of mine and one of these support groups online reached out and said, "Hey, I want you to look up a drug called LDN."

LDN is literally the only prescription drug I take and helped me. LDN treats the cause, not the symptoms.

It's not necessarily about finding relief in the short term. It's about taking the chance that in the long term, this is going to make your body have better functioning overall.

 It's just a completely different way of looking at treating a problem.  I have been taking LDN for 25  months. I still don't know what my ideal dose is.

I have full use of my arm. It is a different shade. It's colder. It's a little bit more purple. There are days that I drop things with my hands. In the winter when it's colder and raining I can't lift my arm above my head, my shoulder freezes on and off.  I do have my own laser, which is incredibly helpful to recirculate the blood.

LDN gives me everything.  There's a psychological component when you're chronically ill and when you've been through the kind of pharmaceutical trial and error that I have, you become almost afraid of medication.

 I find with LDN It's a completely different safety profile. It's one that I'm extremely comfortable with.

I know if I don't take LDN, the worst that's going to happen to me is that my body is already going to do what it was already doing. It's not going to send me into withdrawal. It's not going to make me unable to care for my child and my family. I've been on medications for the same exact condition that have caused brain damage, and I don't find that with LDN and I'm incredibly grateful.

I'm working and I am living. I would say that my quality of life now is rounding a good nine out of ten.

Listen to the video for the whole story

Martha Grout, MD - 10th April 2019 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Martha Grout, MD has an integrative medicine center in Scottsdale, Arizona, dedicated to natural treatments of cancer, Lyme disease, diabetes, metacarbolic, irritable bowel, and other chronic diseases. She endeavors to treat the whole person, body, mind, and spirit, and in searching for the root cause to patient symptoms. She has conducted much continuing education on a variety of subjects not taught in allopathic medicine.

Dr. Grout first heard about low dose naltrexone (LDN) when she moved to Arizona in 1997, and began using it on her pain patients, and those with brain function issues – adults with brain fog and confusion and early memory loss – but not yet for children. She learned that not everyone could tolerate LDN 4 mg – some could not tolerate the endorphin boost – and she had to lower the dose, and now prescribes between 1 – 4 mg LDN. She finds it boosts the immune system, but hasn’t done controlled studies on this.

New patients undergo standard and functional testing. Standard testing provides a very gross delineation of organ function long after they have been functionally incompetent. She tries to get patients before they get to that point. For functional testing, she uses labs like Genova diagnostics and Doctor's Data International, Hygenics, and DNA Connections and several labs like that that do more specialty testing, particularly for immune system dysfunction. Thyroid testing is an example, where patients have symptoms of low functioning thyroid but normal conventional test results. So she looks for other means, and in such patients LDN is helpful.

Linda Elsegood asked about unraveling all the issues that a Lyme disease patient has getting a diagnosis, being told it’s all in their head, and how Dr. Grout treats it. Dr. Grout responded that first is to get adequate testing, typically not through conventional testing. Many that have had Lyme infection or any of the varieties of co-infections, have been sick for a long time, and many are also nutritionally depleted, their brain and immune system aren’t working well. Often they have such gut dysfunction and microbiome dysfunction or abnormality that they can't even absorb nutrients very well through the gut, so IV nutritional therapies help get them filled faster so they can begin to function better faster. She also uses IV antibiotics if they can’t take them orally; but orally they take longer to reach the effectiveness of IV therapy. They promote healthy probitics and healthy diets - non genetically modified, basically organic when possible.

As to IV antibiotics, Dr. Grout relates that they may be needed for a long period of time, and relates Katie’s story (video on Dr. Grout’s website). Katie was on IV antibiotics for 18 months virtually every day. This is an unusual case, but she has had no relapse. Other people require much less.

Dr. Grout wrote a book with Mary Budinger, An Alphabet of Good Health in a Sick World, using a lot of information from her website. The book is available on Amazon, and through Dr. Grout’s office, and she’s happy to inscribe it. The book is about nutritional status being paramount. It's when our nutrition goes off the rails that things start to go south and it can take many years depending on where we started out. If our mothers were healthy, we started out with a better base. If our mothers ate junk food, then we started out with a less good base, and it probably won't take us as long to get sick.

A person low in vitamins may feel fatigued, without energy, have poor memory, and sometimes insomnia. Testing for vitamins is done through Genova Diagnostics, using both urine and blood, and measures functional levels of vitamins, fatty acids, and chemicals that are produced by the gut. It measures if there is an unhealthy gut, if there are products of protein in the stool, or if there are markers for unusual and unhealthy organisms in the blood. So long as the patient is doing well the test is not repeated; and it’s quite expensive, but a useful test.

Summary from Dr. Martha Grout’s LDN Radio Show from 10 April 2019. Listen to the video for the show.

Keywords: LDN, low dose naltrexone, brain fog, early memory loss, pain, endorphin vitamins, nutrition, integrative medicine, Lyme disease, thyroid, microbiome

LDN in Ireland - The Documentary (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.