LDN Video Interviews and Presentations

Dry Farm Wines are coming to the LDN 2019 Conference (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Dr David J Zeiger, 26th Dec 2018 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: Today, my guest is Dr David Zeiger, who is a D.O. in Integrative Medicine and a practitioner from Chicago, Illinois. He treats both chronic and acute illnesses as well as neuromuscular pain. Thank you for joining us today, David. 

Dr David Zeiger: Thank you for having me. I'm looking forward to talking to you. 

Linda Elsegood: First of all, could you tell us about you? Who is David Zeiger?

Dr David Zeiger: I have originally boarded in family medicine over 30 years ago, and I recently got boarded in integrative medicine as a speciality about two years ago. I've been practising family medicine, functional medicine and for the past 30 years as well as doing things in neuromusculoskeletal medicine, including osteopathic manipulative medicine and using techniques called prolotherapy or neural therapy to treat chronic pain syndromes. So, a variety of different therapies in my practice gives me a large toolbox to work from as I work with my patients.

Linda Elsegood: So what is the age range of the patient population which you treat? Do you do from the cradle to the grave or do you do adult medicine? 

Dr David Zeiger: It's primarily adult medicine, but I occasionally do see some adolescents, some pre-teens. I mostly see patients from about 20 to about 80. I've had a couple of 90-year-old patients in my practice, it varies. I would say more it sways more towards a female population than a male population because I do a lot of hormone therapy in my practice for menopause, premenopause, infertility, fibromyalgia, chronic fatigue, et cetera.

Linda Elsegood: Out of interest, I know you prescribe LDN, and this is why I'm interviewing you, but do you use LDN for your patients with fertility problems? 

Dr David Zeiger: I haven't been using it in that direction yet. I've got a few patients who are interested in that and once they get back to me and I will. I have found LDN to be useful for a lot of autoimmune conditions: Hashimoto’s thyroiditis, Rheumatoid arthritis and lately I've been seeing a lot more patients with what's called small intestine bacterial overgrowth and with people who have a variety of different gastrointestinal dysbiotic syndromes, leaky gut syndrome, the inflammation thereof, I found LDN to be very useful in those patients. 

Linda Elsegood: You were saying about mainly females, I think it's usually the female population that has the most autoimmune diseases as well. I think with MS, it’s three women to one man. So that is probably why as well. When you find a patient who is suitable for LDN, how do you go about treating that patient?

Dr David Zeiger: What happens is I generally spend about a good hour with a new patient to get a complete history, do a very thorough physical, literally from head to toe. There's a variety of baseline laboratories that I may use to try and find out what are some of the targets that I'm to go after, be it dysbiotic, guts, the hormonal imbalance, inflammatory markers. I will then put everything together for the patient to explain, “these are the targets that I feel are probably the most significant avenues for therapy and using various different tools, LDN being one of them, I will then broach the patient with the information. I like to refer them to the LDN network, websites and other sources of information. I think that in the States there was a company that used to sell men's clothing and the owner of the company would say, “our best customer is an educated customer.” I feel that the best patient is an educated patient. I feel that as a physician. It's my responsibility and my calling to help, educate and guide patients towards the therapies that I think that are probably the most beneficial to them and answer all the questions I possibly can.

Linda Elsegood: What dose do you start your patients off at? 

Dr David Zeiger: I usually like to start at around 0.5 milligrams and then slowly increase to around 4.5 over a period of about 14-21 days, depending on how they respond. I haven't had the use of microdose. I have a few patients that are currently in my practice where I think it’s worth considering LDN as a beginning point for their therapy.

Linda Elsegood: You said that you have patients that take it for thyroid conditions, and we have learned that some patients who are on thyroid medications have to reduce the thyroid medications because the LDN makes it work more effectively. Have you found that in your patients?

Dr David Zeiger: Most definitely. I have had a number of patients who’ve had Hashimoto's thyroiditis for 15-20 years and they have been to a variety of different practitioners, including integrative practitioners and their antibody levels have been like in the thousands and what I've often found with many of the patients with autoimmune conditions, and I'll specifically talk about how she noticed for a second, is that about 70-80% of the patients with Hashimoto's have a dysbiotic issue, or they may have parasites, they may have protozoa worms, which is what I found in one patient, and by going after these organisms and then treating the results as an inflammatory condition, using LDN as well as other nutraceutical tools, I have been able to lower the antibody levels of these patients and, to improve this as an analogy, decrease the dependence on medications for thyroid over a period of several months. I have several patients where I've actually normalized levels, they have no antibody levels anymore in their thyroid, their TSH has gone down to normal. Their stamina and energy have significantly improved and many things that were tied into that, clinical wise, have also simply improved.

Linda Elsegood: To come off medications, it’s a box with a big tick in it. To achieve that, it's really something. Have you found, in any autoimmune condition, how important do you regard gluten in the diet? 

Dr David Zeiger: Well in SIBO, Dr Mark has been doing research on SIBO for around 25 years and they have published some of the most seminal articles on this, that diet is one of the hallmarks of therapy and when we look at what the components of that are, it revolves around the antigen load from things like gluten and casein from dairy, iron from corn and those are the things that can be major autoimmune triggers in many of these patients.

Linda Elsegood: How long would you say it takes for your patients to notice any improvement? 

Dr David Zeiger: Generally when I start working with the patient, if I had the lab tests and I like to use what is commonly referred to in functional medicine as the 4R program where you remove, replace, reinoculate, rebalance, et cetera. As well as helping the parenchyma of the gut or the gut lining to repair itself. I find that I can usually start seeing results in patients anywhere between 6-8 weeks within a program. They start to notice things like stamina, energy, less gas, less bloating, improvement in brain fog, inflammation in joints improving. I had one fellow who had been suffering from chronic urticaria for years and we're resolving after about six weeks for the first time in years. 

Linda Elsegood: How many new patients notified you of any adverse side effects? 

Dr David Zeiger: You know, that's definitely a case by case basis. I would say the major adverse effects that I see in LDN is a couple of things. Number one, vivid dreaming. Sometimes patients will say, I've never really remembered my dreams, or now I'm remembering my dreams and these are really intense, or they're in colour. The other thing is that sometimes some of our patients suffer from a lack of sleep. Sometimes a spillover into the next day where they might feel kind of groggy. But that usually is short-lived. Gastrointestinal side effects are usually very minimal and those are usually the people where I recommend to them to have a snack at that time with a good eight ounces water, with any sort of medication to mitigate the problems. Some people may have a hypochlorhydria where they’re not able to take tablets. Aside from that, I haven't had any other major problems like headaches or some of the other symptoms some people complain about simply because I really try to warn my patients ahead of time what to expect and if they had any issues, I tell them to give me a call right away. I can usually handle any minor things and address those issues right away. 

Linda Elsegood: What would you say the average dose is? I know you said you try and get them up to 4.5, but do all your patients get up to 4.5 or do some stick at a lower dose? 

Dr David Zeiger: I've had a number of patients stick around 2-2.5 milligrams and they seem to benefit quite well at that dosage. Well, that’s exactly what we found. It's not the higher the dose, the better the benefit. It's really unique and individual per person because some people do really good on two and then they begin to take 3 milligrams and they don't feel as good. Then, by going back they, they feel fine. 

Linda Elsegood: Have you treated any cancer patients?

Dr David Zeiger: I haven't had any cancer patients in my practice at this time. There are a couple of practices out there that have been dealing a lot more with integrative approaches to cancer and so generally what happens is that I will get a patient, they will come in and say they want a sort of functional medical approach to some relative nutritional deficiencies and they may have some other issues, some musculoskeletal issues that I may treat. Then what I may say is, “if you want more of an integrative and well-balanced program…”, I'll refer them out to these other practices that specialize in integrative cancer therapy.

Linda Elsegood: If you had to pick a condition, would you say thyroid is the condition you treat the most in your practice? 

Dr David Zeiger: It’s very interesting that you mentioned that. I would say 70% of my patients have Hashimoto's thyroiditis. It's very rampant.

Linda Elsegood: That's very high. What do you do in order to lower that number of patients? 

Dr David Zeiger: I came onto the Hashimoto's scene probably around 20 years ago and I remember when I was in medical school, we were taught that this was a very rare condition but when I got into practice, I found that it was much more common and actually close to 20% of the patients that have hypothyroidism and the reasons for that were always something that I was curious about. One of the things that I started looking into were things like what are the possible autoimmune triggers. We know from the human genome project that only 12-18% of diseases are actually genetic in nature. The rest of the diseases are due to epigenetic causes. So what are those epigenetic causes? We're looking at things like different pathogen infestations, microorganisms like Blastocystis, hominins, certain protozoa. Another factor in there is stress on the immune system. Diet and nutrition, nutritional deficiencies, another, another factor. Unfortunately, over the past 60-70 years or more, the population has become more and more exposed to these kinds of pathogenic factors and I think this is what is causing a lot of the autoimmune conditions that we see today. 

Linda Elsegood: Do you think people seek you out through word of mouth that you're the man to see if you have a thyroid condition? 

Dr David Zeiger: That's what I hear. So there are people with thyroid conditions, then, of course, those with chronic fatigue syndrome. 

Linda Elsegood: How do you find people with chronic fatigue syndrome compared with the thyroid? I have found people with fibromyalgia and chronic fatigue who are ultra-sensitive to all drugs. LDN included.

Dr David Zeiger: What I've come to see is that many of these conditions have a lot of things in common. I guess the rubric that I would use since I'm also trained in homoeopathy is inflammation, which causes this inflammation, and as I mentioned a moment ago, there are many epigenetic triggers for this. So, depending upon the person's individual biochemical makeup, they will be more prone to the manifestation, all various different diseases, be it thyroid or be it adrenal or be it SIBO. What I find is that when I work with a patient, I look for those factors that will create an inflammatory condition, and then based on their family history, based on the physical findings, I can then hone that into various different subsystems or organ systems that I need to focus my attention on. Be it the thyroid, be it the adrenal, be it hormone imbalances between estrogen, progesterone, et cetera.

Linda Elsegood: With regards to the neuromuscular pain that you treat, and as you were just saying there, how inflammation plays a big part in these conditions, what techniques do you use to treat neuromuscular pain? 

Dr David Zeiger: Well, I'm an osteopathic physician. So I have been trained in medicine so using osteopathic manipulative therapies, I use that modality. I was also trained in medical acupuncture. I use that from time to time. If there are other certain other kinds of, say ligamentous instabilities, I will use a technique called prolotherapy, which is an injection technique to regenerate the ligaments. The interesting thing is that we talk about autoimmune conditions, one of the things that we find with SIBO patients or some of these other conditions is that you may have a variant of a syndrome, which is genetically inherited weakness of the ligaments. It can also be related to certain inflammatory factors in the body that can be triggered by various different things I've just mentioned. So looking at all these different kinds of moving parts, you try to get a picture of what is the most impactful on the patients and health then focus on those things that you can start to build a foundation of health for them.

Linda Elsegood: You were saying that you are an osteopathic physician, and I have seen a chiropractor. What is the difference between the two? 

Dr David Zeiger: That's, that's a very good question. Chiropractic actually evolved from osteopathic medicine. Andrew Taylor Still, who was the founder of osteopathic medicine in the 1800s hundreds, developed osteopathic techniques. A fellow by the name of Palmer was a student of Still. He was also at that time was a hypnotist and he went off and founded a chiropractic practice. So the evolution of the two professions sort of had a certain amount of parallelism between the two of them. The difference between chiropractic and osteopathy is that osteopathic medicine is basically maintained, all of official allopathic medicine. As a matter of fact, osteopathic medicine was the first medical professional to incorporate x-rays. As an osteopath, I have an unlimited license to practice medicine and surgery, whereas a chiropractor has a limited license to practice, basically manual medicine. They cannot give injections. They cannot deliver babies. They cannot do ICU medicine. Although some chiropractors now are trying to become what they call internal chiropractors, internal medicine chiropractors. It's more of functional medicine, but they cannot prescribe hypertensive and I happen to take medication. They can't prescribe antibiotics, those kinds of things that I, as an osteopathic physician and surgeon can. 

Linda Elsegood: I have MS and before I was diagnosed different things kept going numb and I saw a chiropractor, but he had this way of running his fingers down my spine and would say, does it hurt here? He would press really hard with his thumbs. But then he would also get a hold of your neck and twist it to the side until it cracked. I didn't like that. That put me off osteopathic medicine. 

Dr David Zeiger: The palpatory techniques are highly developed. Being able to feel for joint mobility, tissue texture changes, is this inflamed? Is this boggy? Is this hard? I can tell you that when we are assessing a patient. Structurally, those are the skills that we use with our hands because we're talking in that way. Also we use our visual perception of like, how a person walks, how they stand, how they sit and then listen to the patient. Are they talking? So we're basically incorporating all of these other skills of palpation percussion, auscultation, which is hearing. As any other doctor does, any other physician does. Then we understand the biomechanics of the body. So when we look at how the shoulder moves or the hip moves, and then getting into finer detail within the cranium. Osteopathy, which has been around for 80 years or more, it's where we can actually palpate the very subtle motions of the movement of the cranial bones. These things don't fuse until death or certain disease states. Cranial osteopaths are able to determine how well they are functioning, how the different bones are functioning in relationship to one another. If you were to look inside the head and you look in the brain and you see the brain sitting on top of what they call the tentorium, which is like these membranes, all the nerves. I come off the brain and go through the membrane, which is all the ligaments, and then go down through like little holes in the skull down into these cranial nerves that go into the eyes and the nose or down to the neck, and if there is head trauma, surgical trauma, inflammation or infection, then these membranes can then become twisted, inflamed, boggy and cause basically a restriction of flow and thereby affect the end-organ tissue. So train cranial osteopaths to look at this when they're treating, children with cerebral palsy or children with autism, or people who have had PTSD or people who have had chronic headaches, migraine headaches, et cetera. 

Linda Elsegood: We've come to the end of the show, but for people who are in Chicago or the Chicago area in Illinois, how do they get a hold of you? Where do they go? 

Dr David Zeiger: You could call my office at 312-255-9444 and the name of the practice is Healthworks Integrative Medical Clinic. 

Linda Elsegood: Do you have a website for that?

Dr David Zeiger: Healthworksimc.com

Linda Elsegood: Do you have a waiting list?

Dr David Zeiger: I do but if somebody calls me up and they say “I really need to see you”, I will get them in somehow. 

Linda Elsegood: Thank you very much for being such an amazing guest today. I do appreciate it. 

Dr David Zeiger: Well, thank you for the opportunity to talk to you and thank you for your time. 

Linda Elsegood: This show is sponsored by Mark Drugs who specialize in the custom compounding of medications, ensuring 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 at (630) 529-3400 or (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 appreciated your company. Until next time, stay safe and keep well.

Wendy shares her Psoriasis story 19th Dec 2018 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Gale - Hyperthyroidism and Graves Disease 19th Dec 2018 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Jane - Hashimoto's patient - 5th December 2018 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: I'd like to introduce Jane from England who takes LDN for Hashimoto's. Thanks for joining us today, Jane. So could you tell us your story? When did you first notice there was something wrong with you? 

Jane: I first realised that I wasn't feeling well. This was at the beginning of 2015, um, I was in my early thirties, and at the time I was working as a legal advisor in a bank in London.

Um, up until then, I'd never really had any health issues.  My diet was okay but I did eat a lot of dairies, lots of sugary cakes and gluten-containing foods and my favourites were pasta and pizza, the usual. At the same time, I had issues with my relationship. Um, and in all honesty, I wasn't really happy with my job, and it was a lot of pressure.

So I started to suffer from insomnia. Um, and I started to get allergic reactions to the makeup I was wearing, eye shadow in particular, which was very odd. Um, and then one day after a late night, I woke up and, um, I was gasping for air. I couldn't breathe through my nose, and I couldn't believe what was happening to me.

Um, so I went to see my local GP, and I told her that I wasn't feeling well at all, and, um, I couldn't breathe through my nose, and the GP ran some tests and said that everything absolutely fine. Um, and these tests were blood tests. Um, but I wasn't fine. I was ill and I didn't know what was wrong with me.

So, um, I decided to pay to see a specialist in Harley Street and he was a throat, nose and ear specialist. And after some tests, he was looking at my nose and inside, and he said, you know, there's absolutely no reason why I'm unable to breathe through my nose. And he just gave me a steroid nasal spray and said that I would need to use it on a daily basis for the rest of my life in order to breathe through my nose.  I couldn't believe that response, I was just utterly shocked.   I just thought to myself, well, if everything was fine why was I feeling so ill and why could I no longer breathe through my nose?

I wanted to find the answer. And actually, I did a biology degree, so my scientific mind kicked in and I dwelled farther into this issue. And just as a side note, I can describe to you, I would wake up every morning with a swollen face, huge eye bags and I also started to react to random things. For example, I would try a bit of sushi with some soy on it and I would literally want to collapse.

In fact, any form of sugar - I couldn't eat any form of sugar at all, I would literally want to just die basically. It's like if I had a bag of crisps, for example, I would literally need to sleep it off for like two days. It was, it was absolutely crazy. So that was very odd. So the reaction to foods was a real red flag for me.

So I started doing some research. And it was really struggling to find anyone with this issue, you know, suddenly unable to read through the news. And then somehow I managed to stumble upon a website, which was, um, set up by this woman in the US and she talks about chronic mood congestion and how this was down to, uh, an unhealthy diet, uh, which meant an unhealthy gut, i.e. leaky gut. So she said, um, that she had cured herself by taking, uh, lots of different herbs and some enzymes and various herbs. And I then decided to change my diet and I took her advice on board. I purchased these digestive enzymes to assist my gut and some adaptogenic herbs.

It did help; my insomnia disappeared. I just highlight at this point that I'm still working, I'm going to the bank every day in a state where I've got brain fog, I'm not myself and I'm just putting on a fake persona. Nobody really knew what was going on with me, but they could see visibly that I was ill.  

I used to take pride in my work, I know that sounds vain but as a young lady now, I still would make sure that I had my makeup on point and my hair done and here I was coming to work with sunglasses because I was so ashamed of what I looked like. I looked awful, absolutely awful. So anyway, I changed my diet. I started to take these herbs and it was making me function. I relied on coffee to keep me going at work. And the steroid nasal spray every morning, every night, in order to breathe. But I was a shadow of myself. I just looked terrible. So after a period of six months with this new diet, it's anti-candida diet,  no sugar, no particular carbs, just sort of boring root veg. I couldn't even process any fruits to go through the, um, it was just very much meat and veg. And, and the use of these herbs, I could suddenly start to breathe through my nose. This was a massive achievement for me, but again, when I could breathe through my nose, it wasn't like a full deep breath through my nose.  I could just feel like my sinuses were clogged up, and it was, it was 60% better, but at least I didn't have to use the steroid spray anymore so I was very happy about that. But I continued to have brain fog and pressure in the front of my head. And it really wasn't easy. So if you fast forward to November 2016 I was self-medicating.  I was taking 10 to 15 pills a day consisting of random herbs and vitamins, just so I could function really, I had no energy, I would so fatigued it was unbelievable. My reactions to foods continued. People would look at me very oddly when we went out for after works drinks or whatever, and I would just simply say, you know, I can't drink alcohol, I can’t eat this, I can’t eat that.  People would just not get it really. By this time I was too scared, I literally couldn't eat anything slightly interesting, you know, like outtakes or whatever. But anyway, I continued to look terrible. And one morning I woke up and noticed that my thyroid was sticking out from my neck and I immediately knew that there was something seriously wrong with my thyroid.

I decided to privately investigate and I paid for a complete thyroid test analysis. And the result came back so quickly, and the doctor even 

said that  I was actually suffering from Hashimoto's, an autoimmune disease which attacks the thyroid. My antibodies are high thyroglobulin and thyroid peroxidase.  My thyroid hormone output was considered in normal ranges. All this time I had no idea it was my thyroid. I collapsed, I couldn’t believe it, I was very upset. Then again it sort of made sense because it runs in my family, My Mum’s got issues with her thyroid, My Grandmother had issues with her thyroid.  I then decided to check myself from top to bottom, I’d had enough, I wanted to make sure that everything was checked so I did various other blood tests which came back negative, I even had an MRI due to this pressure in my head and that came back negative - it was all fine aside from the thyroid. So then I went to see the results I got in 2015 which the GP had requested to check the thyroid and I found out that the antibodies weren’t checked, just the hormone levels and I was just so frustrated with that because if only they’d checked the thyroid completely, including the antibodies then I would have had a diagnosis much earlier on but I would say that this is typical of the NHS when it comes to testing the thyroid. So I stopped taking these herbs and vitamins, I just wanted to heal my body naturally through diet, I adopted the autoimmune protocol diet, which I’d heard worked for a lot of people.  However my body was just so used to these pills I just suddenly started to decline, mentally, my anxiety just went through the roof and I basically got the worst depression known to humanity and I couldn’t function and eventually, my body broke down and I was worried that I was going to get a heart attack - my heart rate was averaging 116 beats per minute all day, every day, at night - I was given beta blockers to lower the heart rate. I just want to say that I’ve never in my life had any mental issues or anything like that, no anxiety, I was a really headstrong person, level headed.  When I heard about people suffering from anxiety I used to wonder “Oh how does that work, just go and get some therapy” but no, this was an internal reaction that I had no control over and it taught me a lot - now I’ve got great sympathy for people who suffer from this.   My insomnia returned, I was a wreck and had to basically rely on my family for support.  And nothing would lower the stress.  I was then prescribed diazepam by the doctor and I really didn’t want to go down the antidepressant route.  I just wanted my body to heal naturally. The diazepam didn’t even help to be honest with you, I took it for two months and then stopped. I’d basically reached the end - in my eyes, I was done. I told my family it was over, I was probably going to die of a heart attack and I wrote my will. My family supported me through the whole thing and my sister was a great support to me, she told me that “This too shall pass”. I wanted to live and I wanted to get better so I put some posters around my room, positive ones, with positive statements like “You can do this” and then I just started to read about Hashimoto’s and stumbled on a Facebook page regarding LDN and I thought Gosh what is this, people are saying that its a drug called LDN and it’s helped lower antibodies in certain cases and it had actually cured Hashimoto’s and I was totally amazed, I was shocked. Then I purchased your book on LDN and I couldn’t believe your story, it was just completely amazing. I sought assurance and positivity from your video’s, then started to watch your videos when you would interview individuals who suffer from various autoimmune diseases, including Hashimoto's. And, um, and they all said the same thing. That LDN helps in so many different ways and even for depression and anxiety.

And as I said, I've watched these videos continuously, and that gave me hope. And until then, I had no hope whatsoever. Um, so then I said to myself, I need to get LDN and I need this. There’s just no way out. And then I contacted you because I wasn't sure where to get it from. And um, and then you put me in touch with Clinic158 and, um, had the interview with the doctor from there, and he immediately prescribed me LDN, and I started to take it.

Um, firstly it was in liquid format, uh, but it had quite a lot of sugar in it, which didn't bode well with me. Um, so then I changed it to pill format. And, uh, over time I went up, probably two, three milligrams. And, um, I stayed at this level. And, um, as time went on, I started to feel better. Um, it took a few months for me to get better, for insomnia to disappear. Um, however, I'd say within six, seven months, I was enthusiastic about life. I was feeling happier and more level headed, and over time I could sleep, which was impossible for me, I could make conversation with people without running out to a room full of anxiety.

I could. I could just be normal. I could be myself. And this was shocking to me. Um. And my vile depression and my anxiety had just completely disappeared over time, just completely disappeared. Um, and I say, I'd say it took a year to get to the point where I was ready to go back to work because it's during this time I was healing really from the LDN.

And um. I'm just really thankful to LDN, and I'm thankful to you for raising awareness of it because, without that, I honestly didn't think I would survive my ordeal. Um, essentially I had a breakdown, and it restored me from that. It restored my sleeping pattern. It just, it was like a reset button. Um. And I, I'd lost so much weight during my ordeal, 10 kilograms.

I looked like a skeleton, um, due to the stress and the heart rate and everything. And now I've put weight back on and I look more normal now. My, my hair is not shedding anymore and I can, I can function basically. And. What I would say is that my thyroid is still swollen, but I'm working on healing my gut, and I've got to say probiotics have been absolutely key.

And they've really helped. Um, but it's going to take time. Obviously, it's taken years of me eating badly to, to get to the point where I've had to go through this and now it's going to take a while for me too, to heal my gut. So I'm just ready to continue with that, um, healing process. Um, and then just to live my life because I haven't been able to live my life really all this time.

I've just been totally ruined by not knowing what was wrong with me. So, um, in terms of my diets, it's no paleo based. Well, lots of fermented foods. Um, I juice every day. I try and keep healthy. Um, I totally avoid sugar, dairy, gluten, um, alcohol I can't touch. Um, so yeah, I'm, I'm trying my best now to heal. 

Linda Elsegood: Were you given any thyroid medication once you were diagnosed with Hashimoto's? 

Jane: No, I wasn't because, um, according to the doctor, my thyroid levels were normal.

Linda Elsegood: Okay. But the doctor that said that you had Hashimoto's, he didn't offer you any medication either? 

Jane: No, no

Linda Elsegood: it's just purely the LDN that you have always taken, nothing else. 

Jane: That's right. 

Linda Elsegood: Wow, that's amazing, isn't it.

Jane: It's, it's unbelievable what happened to me.

Um, I, I just hope that you know, if there's anyone out there with the same issue that they can take comfort in knowing that if you do ever have chronic nose congestion, there is a way of fixing it and you have to try and heal the gut. And, you know, I was told to take the steroids to spray for the rest of my life. I mean. Just in order to breathe. It was shocking. 

Linda Elsegood: Definitely. What would you say your quality of life is like now on a score of one to 10, 10 being the best?

Jane: I'd say it's um, nine. 

Linda Elsegood: And are you able to work and function? 

Jane: Yes, I am. Yup. In fact, I've just recently got a new job. Um, it's a legal department, high-pressured role in an investment company, so I'm definitely able to work now, whereas before I couldn't.

Linda Elsegood: Oh, that's good. And at your lowest, I don't want to dwell on that, but on a score of one to 10, what would it have been when you were your lowest. 

Jane: It was one. It was the worst for me. Uh, yeah, absolutely. 

Linda Elsegood: Um, well, thank you so much for sharing your really amazing inspirational story with us and long may LDN continue improving your symptoms.

Jane: I'm thinking, thank you for raising awareness regarding LDN. 

Linda Elsegood: thank you. This show is sponsored by our members who made donations. We'd like to get 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 right idea of the show.

And thank you for listening.

Any questions or comments you may have, please email me; Linda@ldnrt.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.

John Herr, RPh - 21 November 2018 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Paul Battle PA-C - Crohn's Disease (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Dr Melissa Coats, LDN Radio Show 14 Nov 2018 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: Today my guest is Dr Melissa Coats from Arizona in the US. She is a naturopathic oncologist. Thank you for joining us today, Melissa. 

Melissa Coats: Thank you for having me. 

Linda Elsegood: Well, could you just give us an idea of your background, first of all, please? 

Melissa Coats: Sure. Initially growing up, I always knew I wanted to be a physician, I think, or in medicine. And when I went to school far away from home in Lynchburg, Virginia at Randolph-Macon Woman's College I focused on biology. And then after that, I didn't exactly know what part of medicine I wanted to do. So I decided to get a Masters in bioethics while I was deciding, and when I discovered bioethics, I stumbled across naturopathic medicine. Once I read the philosophy and what it was all about, I knew that was where I needed to be. Once I finished my Masters at Midwestern University, I went on to the Southwest College of Naturopathic Medicine, which was in Tempe, Arizona. And I didn't even realize it was in my native state. And so I learned all about naturopathic medicine and went on to school there, and ever since, here I am.

Linda Elsegood: Wow. And when were you first introduced to LDN? 

Melissa Coats: I believe my first introduction was through my mentor and colleague, Dr Daniel Rubin. He had co-written an article about low dose naltrexone, I think back in 2006, for its use in pancreatic cancer. And Dr Berkson who uses it a lot at his clinic, where he does a lot of hepatitis C treatment, also was very interesting to me So I learned a lot from both of them. And from then on, I've been doing more and more research and just using it in a multitude of ways with different types of things beyond cancer. But cancer is obviously one of the bigger ones that we focus on here at our clinic.  

Linda Elsegood: Could you give us an idea of your protocols for treating cancer patients, and which cancers you've actually treated with LDN?

Melissa Coats: Probably one of the bigger ones we typically put people on it for are those who have breast and colon and pancreatic cancer. Those are some that we definitely do, but we know there's some efficacy with ovarian and neuroblastoma and glioblastoma and even squamous cell carcinomas. Pretty much because of the natural killer cell and the immune stimulation that it gives.

We've found it is a very nice adjunctive thing to add on to most treatment protocols, so we utilize it quite often, usually starting with a lower dose. Depending on the sensitivity of the patient, maybe 1.5 all the way up to 4.5 milligrams, depending on what's going on and making sure that we're not conflicting with any pain medication use, of course, if the patient's had surgery or things like that.

We also, me particularly in the clinic, like to use it for other things as well. One of my very first patients actually wasn’t an oncology patient that I utilized it in - it was a person who had undiagnosed celiac disease for 25 years, and her gastrointestinal system was just a giant mess, and she was miserable. It was one of the things that I decided to introduce to a kind of calm her autoimmune issues that were going on, including her thyroid. And it really seemed to calm her gut. And she said it was like a miracle to her, and we even tested going off of it briefly to see if that was truly what was happening. And it was definitely the low dose naltrexone that was helping calm things for her. And so that was one of my first introductions to the power of it. And from then on, I've been utilizing it in many ways since  

Linda Elsegood: What are the therapies you use alongside LDN?

Melissa Coats: Currently, here in Arizona, we have the ability to give IV nutrients, so we use IV alpha-lipoic acid alongside the LDN. Sometimes it's vitamin C, IV. We utilize other supplements, as well, to focus on different parts of what the person needs as far as support if they're during chemotherapy or radiation or other treatments who may have anything going on.

We also utilize sometimes another natural killer cell stimulator, which is mistletoe, but we only give that in a sub Q injection versus IV here in Arizona. There's often a combination of things that we utilize with LDN to help the patient get the best for their immune system and whatever other issues they're having.

...

Melissa Coats: Sometimes, most of those patients are already on LDN, so it's definitely a good part of the mix. We definitely like to make a treatment plan very individualized to each patient, and so there's often quite a multitude of things going on at once, whether it's ... LDN, IVs, a diet plan, whatever it is. We like to bring it all together for them so that they can feel their best. 

Linda Elsegood: And you mentioned a diet plan there. Of course, with cancer, sugar. Is a no, no. What kind of a diet do you suggest patients follow? 

Melissa Coats: A lot of our suggestions as far as diet are either to focus on a very anti-inflammatory or a Mediterranean style diet. The ketogenic diet is obviously big news right now. So that is definitely utilized depending on if the patient's in a good place to do that or not. If they're in a very cachectic state or their weight is very low, we may or may not utilize that, but if they're in a place where it looks like they would benefit greatly from the anti-inflammatory effect of being on the ketogenic diet, we definitely introduce that. Definitely a big part of our consults with patients is spending a lot of time on the diet because we believe food is one of the greatest medicines you can put in your body if you're utilizing it properly.  

Linda Elsegood: And what's the age range of the patients that you treat? 

Melissa Coats: We have little tiny babies all the way up to, I think one of our patients right now that we have that I also believe is onLDN is 89. So we have quite the age range going on here in our clinic. I would say the majority of my patients range in their mid-twenties to like in the seventies and eighties. So we have quite the group. 

Linda Elsegood: And you were saying that you treated the lady with celiac disease. Have you treated any other autoimmune diseases? 

Melissa Coats: Yes. Of the ones that I've seen some benefit, a few patients who have lupus who've seen some benefit; in rheumatoid arthritis we have definitely seen some help in calming some of that; a lot of Crohn's and colitis. I definitely really see a lot of benefit with LDN when you bring in GI issues that are very inflammatory and sometimes immune-mediated. So it's definitely been helpful. I also have utilized it quite often with Hashimoto's thyroiditis to kind of calm the thyroid antibodies, and they seem to note that their thyroid works more efficiently and we see better numbers on labs when they're on the LDN, and less need for medication, which is nice.

Linda Elsegood: So the patients that you know are on LDN for thyroid, do you taper up slowly? How, what is your protocol for that? 

Melissa Coats: The patients mostly have been able to start at three milligrams, and I haven't really had to taper them per se, up or down. Sometimes we just watch the numbers and kind of see how they're feeling, and I may start them at three and just have them check-in with me about how they are feeling, whether that's too much, too little? It hasn't seemed to cause any major side effects, which is why I love using it so much because most people have a great response. 

I forgot about one case that I specifically wanted to tell you about. I have two patients that have autoimmune hepatitis that has been very difficult for them to wean off their steroids. And we have been utilizing LDN probably for the last year and their numbers as far as their liver markers, their AST and ALT have definitely decreased significantly since starting the low dose naltrexone, and I have finally been able to taper to a much lower dose of their steroids, which is wonderful because they hadn’t gotten to a low dose before without the LDN. And we found that using the LDN has made them much more successful and they're very excited about that. The thyroid becomes more efficient with the use of the LDN. They definitely need less medication, which is wonderful. So I usually check thyroid labs when I'm changing things up, every four to six weeks. And so definitely I've had many patients have to reduce their dose because of the LDN, which has been great.

Linda Elsegood: So when a patient comes to see you, let's just say a cancer patient, how would you go about putting that plan together? What is the procedure you follow?

Melissa Coats: When we meet, we initially have at least an hour consultation. We have really extensive forms that they fill out ahead of time, so that I have a really good understanding of their history, and we try to request records so we’re already in the know of what's going on so that we can spend a lot of time talking with each other about goals and where they want to begin.

While we're in consult, we actually type up a protocol so that they leave with a piece of paper that says what labs they are going to get., what treatment plans and treatment options we are interested in doing, whether that's IV or starting low dose naltrexone or some supplements. And then we make sure that there's a clear understanding if we need to check-in and get a diet diary, or what changes should be made immediately.

So they leave with that protocol in their hands so that they feel like not only did we meet and get a good understanding of what's going on, but we have a plan in action that first day, which I think is very powerful in making a patient feel empowered about taking control of their health. And we also kind of keep updating that protocol each time we meet so that if a supplement doesn't work out or we need to add something, they know exactly what's going on and can keep track, which is helpful to everybody involved.

Linda Elsegood: I was speaking to Dr Berkson, and he taught me that alpha-lipoic acid is to be taken intravenously, that it wasn't as effective in tablet form. And the other day somebody was telling me that no, the tablet form works just as well as the intravenous. So I'm now confused. Has it changed? What's your take on it? Exactly. 

Melissa Coats: My understanding is with IVs, you're bypassing the GI and you're getting full absorption; whereas orally you'd have to take a lot more, and obviously the doses are different. The IV amount we go up to is about 600 milligrams, whereas orally we're giving someone up to 1200 milligrams a day. Typically we use both, so when they're not here, they're on it orally. And then when they're in an office, they don't need to take their oral dose that day because they're getting the IV version of it  But from a strengths perspective, and I'll have to check the latest studies, I guess now that you say that, my understanding from Dr Berkson and his protocol that I've been utilizing for a number of years now, that the IV seems to be pretty vital.

Linda Elsegood: That's what he told me, so I've just wanted to check that. 

Melissa Coats: We haven't changed our protocols yet as far as I know. When I can't get numbers to move from oral dosages of things, I definitely bring in the IV protocols, and that seems to make a difference. 

Linda Elsegood: And what about vitamin C taken intravenously? Is that really effective that way? 

Melissa Coats: For absorption issues and things like that? I would say yes, because, from the standpoint of orally, most people can't handle maybe roughly above six to eight grams because it causes a lot of GI distress, even if it's buffered, whereas IV we give people up to a hundred grams, which is way past what anyone could take orally. We know that that creates a different type of stress on the cells, that it can help with reducing vascular endothelial growth factor and other inflammatory markers related to cancer.

Linda Elsegood: And if you read about vitamin C and it talks about water-soluble fat-soluble and it's flushing out of your system if you take too much, or you take too much intravenously.

Melissa Coats: It’s pretty much individualized as well. Some people can't handle certain doses. There are some patients that feel great at 40 grams, and others that can take a hundred grams and feel just as great. So it kinda depends on the person. There are tests to check also whether their plasma level of vitamin C, so that's something that we have utilized in the past.

And then based on our clinical knowledge from using it for a long time. We have kind of figured out where people tend to do well. Yes, it doesn't stay in you forever. It is leaving the body, and there's a lot that's going through the kidneys and being voided out, but for the time that it is in the body and doing what it's doing to the cells.

And if you come on a fairly regular basis, you are creating an environment that is, less available for cancer to grow. So you're creating an environment that is not what they will utilize. So that's why we use it so often. We also use alpha-lipoic acid because it's a powerful antioxidant. And then some of the other nutrients that are out there too. 

Linda Elsegood: A few years ago I had an operation, and as I came to I was in quite a bit of pain, and they gave me intravenous paracetamol, and I was thinking to myself, the pain was quite bad, and I was wondering why they are giving me paracetamol? You know, that's not gonna do any good. And it worked. I was absolutely pieced. I thought, paracetamol isn't very strong, but apparently, it's stronger if it's taken intravenously, as it goes through the metabolism by the liver. It just goes right in. I was surprised at that.

So, vitamin C, minerals, and supplements. Do you have any favourite ones? I mean, obviously, it's individually tailored to the person. But on the whole, what would you say? 

Melissa Coats: We utilize a lot in the oncology world, things that basically kinda change the terrain for cancers. So one of the things that I've utilized a lot is modified citrus pectin, which targets galectin-3, and by lowering that, you allow protection of good, healthy cells and keep other tissues healthy. So, for example, with a woman with breast cancer in one breast, you want to try and protect the other breast. So that we found that this can be helpful. And if she's going to be having surgery or a biopsy, having this on board can kind of help prevent the spread of the other rogue cells. In studies, that's what's been confirmed. So it's something that we've utilized a lot. 

And I use some mushrooms, a whole bunch of different ones. Coriolis mushroom, to help your white blood cells keep your immune system healthy. So that's a big one that we use. And then things that target vascular endothelial growth factor, which is basically kind of a signal for angiogenesis or blood vessels to grow around a tumour.

And so there are numerous things that target angiogenesis. One is a magnolia extract. There are other herbs as well that do that. So obviously vitamin C. And then there's some thought that if you stimulate things like the natural killer cell function with low dose naltrexone, that you may be inhibiting some of those other pathways in a roundabout way. So that's why it's a of things. Quercetin, resveratrol; and curcumin is a huge one, which is the active constituent found in turmeric. There's a lot. And that's why we constantly are trying to throw different curveballs at the immune system to help people fight cancer. And so that's why we utilize so many different things, because if you just use one agent, obviously the immune system and the cancer is going to figure that way around it. And so you want to make sure that we help. 

Linda Elsegood: Do probiotics play a role?

Melissa Coats: Oh, yes, definitely. The GI health and having a really good balanced flora of good bugs in the body is definitely key.

When I'm not focusing on cancer, I really do believe in the gut-brain connection. If your gut is unhealthy, so will your brain be unhealthy. And so making sure that you have good flora can definitely help people's mood and their anxiety and stress responses. It's pretty amazing. So I love probiotics and what they can do. 

Linda Elsegood: I was looking at probiotics, and you start off with what I would call a reasonably priced product. So I was reading the labels - this one has that many million and this one has got different strains in it. I was just lost. I didn't know what it was I should be behind. Which was the best? Is it a case of the more money you spend, the better the product you're getting, or should you be looking deeper than just the price you're paying? 

Melissa Coats: I think it's probably a combination of both. Hopefully, the more expensive products are good. If not, then they're just gouging you. But the main thing for us is it's good to get a variety of strains. So not just acidophilus always. You want to make sure you're getting lactobacillus and bifidobacterium, and you want multiple strains of those types of bacteria depending on what you're trying to work with, with the gut. Also, we're a big fan of billions versus millions because you don't know how much is actually lost or killed off into your absorption and what your stomach acid is doing to those bugs. Depending on how they're put into a capsule, there's always some that aren't going to make it. So the more, the merrier, hoping that you'll be colonizing the gut with some good stuff. I always tell people to rotate brands, and also research the brand and make sure that however they have them, they can prove that when they get their product on the shelf, that those bugs are still alive in there if they're supposed to be, and not been heat shocked in transit and are no longer anything other than a pill filled with nothing. So it may be that that is cost-prohibitive, but normally most of the products that are pretty good are similar in price. 

I think that there's some that are really high in the billions that are intensive protocols that you may only be doing for a week or two, that may be more costly. It just kinda depends, which is why we recommend you usually see someone who has done the research versus just buying a product at the grocery store that's just been sitting on the shelf for you have no idea how long. And so it's good to kind of find that out before you spend the money and then are disappointed.

Oh, vitamin D is another one. Yes, it also depends on the person's absorption. Sometimes I've switched patients from a capsule form to a liquid form and have them hold it under their tongue because they didn't seem to be getting anything from their capsule. And that could be a reflection of the way they absorb through their GI, or if it needs to be more sublingual in their case. And usually, the dose probably needs to be higher than they thought it needed to be. Based on our labs, if someone's our range - here for example, one of the labs we use the range is 30 to 100, and we like to see people between 60 and 80. And so that may take them taking 10,000 units a day for a while, and then they may be able to ramp back, or they may have to take more than that depending on their absorption status. But you kind of play with what seems to work for them. And yeah, there's a lot of different brands on the market. 

Linda Elsegood: What about omega-3s?

Melissa Coats: Yes. The key thing with omega-3s for me is making sure that it's a very pure product, that it's not from fish that are in a farm lot being fed dog food or something horrible like that. They need to be deep-sea coldwater fish, hopefully sustainably raised. And then the capsules themselves, when you're looking at it, you want to make sure that they're fresh. So hopefully the product has some sort of date on it that tells you that those haven't been sitting and becoming rancid.

The key is to look at the EPA and DHA content. If it's fish oil it'll typically show you EPA and DHA, and you want that to add up to over a thousand milligrams within just one or two capsules versus having to take ten capsules to get there because otherwise, you're not getting the benefit of the anti-inflammatory effect, the good healthy cholesterol effect and everything else that goes along with it.

Linda Elsegood: I was talking to a nutritionist a few years ago now. And she was saying if you had an inferior product, they usually have vitamin A in them. And the more tablets you take, the more vitamin A you're taking and you can overdose on vitamin A.

Melissa Coats: Yeah, you've really got to make sure it's a pure product. That could be bad. And that will give you a nasty headache and make you not feel good at all. But the one I believe that we carry here, as far as I know, is just really focused on the omegas aspect of it.

Linda Elsegood: Yes. And what about people who are vegans? Can you take flaxseed oil to do the same?  

Melissa Coats: You could do flax or chia seeds. Also just eating healthy oils like avocado oil, olive oil, coconut oil. You know, there's a lot of different ways to get in. Omega fatty acids that do not necessarily require a fish or krill.

Linda Elsegood: I was reading the other day an article on coconut oil where they were saying that previous research was incorrect and it wasn't as healthy as they made out. What is your stance on that?

Melissa Coats: I don't think it's the healthiest oil, but definitely, but I still see some benefit in using it, particularly the medium-chain triglycerides that come from coconut oil. Or we use MCT oil sometimes instead of just coconut oil. But if someone is just occasionally throwing a little bit of coconut oil into their smoothie, I haven't seen it detrimentally affect them and I've seen some good studies with Alzheimer's and Parkinson's research, that it helps the brain. So the MCT from coconut oil is helpful. 

I think it's also a matter of where you're getting it. If it's this big tub of coconut oil from a big box store, that may not be great versus actually getting small organic coconut oil, which might be a better option. With the ketogenic diet, they often mentioned using MCT oil does help supplement your fat content. And that's been a very pure product, and it usually doesn't have a coconut taste, but it's from coconuts. So people can use that if they don't like the coconut flavour. 

And it's nice because if you need to gain weight, it's a good way to add a hundred calories or more. Most people are not looking for that, but sometimes in the oncology world, we need to help people get more out of their meals. And because that doesn't have a taste like coconut oil, it's helpful. I don't think coconut oil is horrible, but I definitely don't recommend it to be someone's only source of fat for sure. And definitely, it is not an oil that cooks well at high heat. It will actually oxidize it and make it an unhealthy thing. So we usually recommend people use avocado oil for that. 

Linda Elsegood: Wonderful. The half an hour is up. It's gone very quickly. This was Dr Melissa coats and thank you so much. Before we go, can you tell people how they can contact you? 

Melissa Coats: Yes. You can contact us through our website at www.listenandcare.com, or you can give us a call at (480) 990-1111. And you can even have a 10-minute free consultation if you like.

Linda Elsegood: Oh wow, so we have nothing to lose and everything to gain. 

Melissa Coats: Thank you so much for having me.

Linda Elsegood: This show is sponsored by Dickson Chemist, experts in LDN and associated treatments in the UK. Dickson Chemist, the most cost-effective for LDN in all forms within the UK and Europe. They are maintaining safety standards far in excess of what is required. Why would you choose to get your LDN from anywhere else? Call 0800 027 6910 today to speak to the LDN experts.

Any questions or comments you may have, please Contact Us on our website at https://ldnresearchtrust.org/contact_us. 

I look forward to hearing from you. Thank you for joining us today. We really appreciate your company. Until next time, stay safe and keep well.

Dr John Kim, MD - 7th November 2018 (LDN, low dose naltrexone) from LDN Research Trust on Vimeo.

Linda Elsegood: I'd like to welcome back Dr John Kim, who I know many of you have listened to his radio shows in the past. He's always got exciting things to tell us. So welcome, John and thank you for joining us today. 

John Kim: Well, thank you so much. I really appreciate your effort in making Low Dose Naltrexone all front and centre in the integrative functional world.

And I think that it's even going beyond that. I'm even talking to talking to specialists within K U  in Kent, University of Kansas Medical Centre specialists, all talking about low dose naltrexone. So I think that, um, you and the listeners have done a great job putting this issue of light in the middle is the front end centre.

Linda Elsegood: Well, I have to say you're certainly one of those doctors who liked to push the envelope, think outside the box, to try to find solutions for patients who are complex, should we say? Because I mean, some people are harder to treat than others with all the different symptoms. 

John Kim: I think you said it. Oh, you've nailed it.

The word complex and my patients tend to be very complex, the integrative medicine St Paul appears to attract patients that are complex. And it's what's interesting is all part of the training that I had with Dr Andrew Weil was the theory of complexity. How do you, um, approach complex issues?  How do you solve complex medical problems? And he's always said that you want to go to the area where everything gets together like sort of a nexus of issues. So for Dr Andrew Weil it has been inflammation, which we will come back to, to LDN. And to me, it's been autoimmune or immune dysregulation that I've seen.

And it's just very interesting because this all started with one patient, one patient who came to me and said, Dr Kim, I have learned about this new idea called Low Dose Naltrexone and I have a thyroid disorder, and I would like to try it. So I told the patient that I would like you to research it. So because I am used to having complex patients, I researched it and really the potential benefit versus potential harm, I really saw more potential benefit that I didn't see much harm in them trying LDN and to make a long story short this has transformed my practice if anything, autoimmune really gets limited what I can I that acid. Oh, and put them on an anti-inflammatory diet, but a supplement, but I wasn't getting what I call reliable, repeatable results until we went to LDN.  And LDN is not 100% doesn't work 100%, but I think that it has achieved all a form on reliability or repeatability. For me.

Linda Elsegood: LDN is only one of the tools you have in your toolbox. What do you use in conjunction with LDN? 

John Kim: So for, I think that one of the things that I find most fascinating is that, in this day and age, immune dysregulation, I'm seeing a lot more allergies, food allergies, and in integrative medicine, a lot of times people say, Oh, just don't eat it.

And it's easy for the practitioners saying, but really by the time you take out all gluten, I'll take out yeast, take out the milk, it's very difficult. It's very. It can be done. But if you try to go outside, like in a restaurant or social settings, they're difficult. So one of the things that I have discovered again, through a patient, um, who was really suffering a lot because of food allergy, is there's a way to teach your body, in conjunction with Low Dose Naltrexone, to not to react to food allergies, teach it to stand down, and it's called our food allergy drops that all that they can do Amazing work. And then other tools, of course, you think of food as medicine, and I think that we understand better and better how powerful food can be. One example of this, of course, it is a vegetarian diet, an anti-inflammatory diet, and there's also ketosis that is ever more popular. Um, and of course there is Dr Terry Walls, um, modified Palio diet for autoimmune diseases and I think there are some commonalities to all these conditions.

And so we use food as medicine, one of the other tools that I love, that goes very well and hand in hand with LDN, is acupuncture and the reason I say that acupuncture are gone hand in hand is that the earlier we search with how acupuncture works have been shown demonstrated by using Naloxone, a related like a constant of naltrexone and naltrexone.

So we know that if you want to disrupt—the effects of acupuncture you can use high dose naltrexone, meaning it's possible that acupuncture is doing what LDN would be doing, and there's a paper that was written and published by a Dutch professor hypothesizes that cannabinoids, LDN, acupuncture probably share the same pathway.

And I think that that is one of the most exciting, um, ideas that, um, uh, propelled me because I started using LDN more widely than autoimmune when I read an article that LDN may have anti-inflammatory effects and since then, or how, what happened is that patients who couldn't come or could not afford acupuncture because one of the most effective tools about LDN is the cost.

For less than a dollar a day you can treat the most complex conditions using LDN. So all but acupuncture when it didn't work, or it was too far out prescribed, those people offer them, which, because LDN and I've become trusting to do similar kind of things, let's use LDN in view of acupuncture, and I would see amazing results.

And that's where all especially with pain and neuropathy, especially Um, and then now we know the basis of it and molecular basis of it because of dr Jerry younger, uh, did, uh, published articles on fibromyalgia and using LDN with demonstrated LDN is helpful or help people with fibromyalgia. And the mechanism is fascinating because in, um, professor.

Younger is basically proposing LDN. Low dose naltrexone is functioning as an anti glial cell modulator, which there is another anti glial cell modulator but LDN is amazing because of many, many properties. It can penetrate into the brain. I think it's a quarternary. I mean, so he can, he is able to go to the CNS. Um, relatively rapidly metabolized into another compound that can stay in the body for a long time.

So really you're getting the effect of LDN in, um, and it still works as a, um, opioid antagonists, which means that you still, you're getting endorphin in peripheral as well as the central nervous system as well as in the body. It's just really amazing. Um, and then of course, um, the, the anti glial cell modulation, it just opens up all kinds of therapeutic possibilities.

Linda Elsegood: It's amazing, isn't it? Before we go on further with LDN, and I know people are going to pick up on what you said about you teaching your body too, how did you explain it? Eat foods that you are intolerant of to teach your body so you can eat those foods? How would you go about doing that? 

John Kim: So, um, there is a protocol developed in Wisconsin, and that's the poor uncle. Then I modified, what I do is that I do a generalized food allergy test. That, uh, what I call, what a wide-angle or shotgun approach where we can test a relatively large number of allergens, food, allergens at a very low cost. So that as a screening tool, once I have that tool, um, I discuss with patients, usually I give them the results and give them the ordering sheet about tests that's more specific, but more importantly, it is quantitative. Because it's truly quantitative or it's quantitative enough that it can be turned into an allergy drop. So then what you can do is you can use food allergy drops that are specifically targeting specific food at a specific dose. So you can - Well, it's similar to an allergy shot. I think it's safer because it's through the mouth. I think most of Europe is familiar with this approach. Um, and uh, the big advantage is safe because you can swish and spit and you're looking for reactions, any kind of reactions, that means that those may be too high. And then you just simply pull back to those or ask the pharmacy to, uh, formulate a the more dilute a portion.

Linda Elsegood: That's amazing. 

John Kim: and, and it goes well with LDN because a lot of patients, I ask them to do both LDN to all function as an anti-glial modulator to decrease its immune systems or tendency to overreact. And then in the meanwhile, I use the, uh, food allergy drops to lower the dose, and you can do that with environmental allergy combined LDN plus, um, plus the food, the environmental allergy drops. You just don't want to do them together. You don't want to start both of them and simultaneously because you may overwhelm the body and into, um, like a crisis. And we don't want to do that. And patients who I do this too, I prescribed, um, EpiPen to make sure that they have safety. And well, first, those, they have to take it in front of me so that I have to make sure that they are okay. They have my cell phone number. Um, and these days I think cell phone number better than the home number. So they can text me, they can email me, they can call me if they are in trouble. 

Linda Elsegood: Wow. Wow. To have a doctor who would let you text him? That's a very good service. Very good. So what else do you have to tell us? Um, that's new with LDN  John?

John Kim: So, um, the LDN part I find very interesting is that, um, I think when we first connected, the world at that time was using 1.5 milligrams as a starting dose. Now I think that most people are open to starting at 0.5 milligrams.

And even the reason I did that was I saw some, uh, category of the population of my patients who the endorphin levels were so low that at that level people had side effects. And. I've since then cut it down to 0.1 milligrams or a hundred micrograms and um, and that cut out fewer people now have a reaction, but I'm still seeing people with reaction.

So about two years ago, I started people at ten micrograms, and recently something happened with, I think the regulation that, well, I'll be, pharmacies now have to assay and prove that the amount of LDN is what it is and, or, you know, appears to some pharmacies are boarding Turley doing it, which is an excellent practice.

But as a result of it, I think the essay just doesn't work very well below a certain level. So now, um, the, some of the Compounding pharmacies, they are capable of making one microgram, but they can't guarantee it's one microgram. There's no way to assay it. So what I do now is that I, uh, I will get all the pharmacy to make a hundred microgram, all tablets, not, not a capsule, so that patients can break it in half, which becomes 50 micrograms.

And then they break that in half. It goes 25 micrograms and then once they can prove that they can tolerate it, then they can do a rapid offset increase 0.2 5.51 or basically 25 micrograms, 50 micrograms, a hundred micrograms, 200 micrograms, 500 micrograms at which that dose is where people ….

So maybe takes two months to ramp up. But I think that um, that the more complex your patients are and more they are endorphin depleted, um, that I think that is a good thing to do. So I just asked them very simple questions.

How do you sleep? Um, and people tell me its terrible than that, that makes me, uh, think that, that they're, they, they are a good candidate for a lower dose on another thing I ask is. After you get up, do you feel well-rested if the patient said, no, I, I'm sleeping a lot, but I'm not feeling very well rested is another question?

And then the third question is the resiliency question, which I made up. I said, Hey, listen if I give you a limited amount of money and I drop you off anywhere in the world, how confident do you feel you can get back and without having like psychological crises? And. Well, if people say, no, no big deal, I can get back -  just some little bit of stress, but patients, Oh my God, that would kill me. Low dose, then I would choose with a low dose. Um, but I would say if the patient were healthy, I, I don't mind starting them out at 0.1mg, I still don't want to do 0.5 because, um, I experimented with it and, um, on purpose took a higher dose and really, not everyone has a reaction, but once you have the reaction, you don't want to look at LDN. And I think it's, so, LDN can be a fantastical tool, so I don't want to, my patients would lose access to it by having a bad reaction.

Linda Elsegood: What conditions would you say, John, you are using LDN mainly for? 

John Kim: Well, you know, I think that, um, the autoimmune I think is the most popular use. Um, now, of course, we do that, but if you ask most people, most practitioners why it works, um, they will talk about endorphin, and I'm not sure that's entirely correct.

I think the side effect from a high dose of naltrexone affecting people badly is because they're triggering the complete and total depletion of endorphin by blockading the opioid receptor, especially the mu receptor. But I think that it's more likely that the autoimmune diseases are helped by the anti glial cell modulation that professor younger is talking about, and the significance of this is that now you can move beyond autoimmune, you can treat nerve disorders, if there's pain which has the basis inflammation, like fibromyalgia, in theory, is supposed to not have inflammation but stop the population of them.

I've noticed that they have high inflammatory markers, like C reactive protein, even ESR. Then I'll then LDN becomes another tool. But anything where you're suspecting that there is an immune dysregulation or over response of the immune system, especially within the central nervous system, I think that LDN becomes an invaluable tool. And I think that understanding the mechanism allows for flexible use of low dose naltrexone and I would like to invite all the listeners to come to the next 2019 LDN conference in Portland where I am honoured and privileged to share some of my observations, ideas about low dose naltrexone, um, pushing the frontiers on and the use of LDN.

Linda Elsegood: Well, I'm sure everybody would be thrilled to hear that. As I said, you always have new ideas, different theories, different ways of tackling a problem that is faced by many prescribers, with patients with complex conditions. So is there anything else that has been going on in your world of medicine? 

John Kim: Well, I think that all, as I said, I think the most, um, some of the most interesting things that I see with LDN is once you have the LDN mechanism.

So I have a patient that has resistance. Um, depression. And now within the field of psychiatry, there's thinking that some of the depression may have inflammatory components. So within a  short amount of time, less than one month, I have an elderly woman who says, Oh, I'm using it for pain purposes, but the patients are “Oh my God, I still have pain, but I, what did you do with my depression”?

So all that's, that's another tool that I think is all very, very interesting to start thinking about. It's like what other inflammatory conditions do we have? And here's where knowing the mechanism really helps the practitioners to think outside the box. Because if you can view as anything that has brain inflammation or central nervous system, peripheral nervous system, inflammatory condition, um, all of a sudden you have a tool, another extra tool, LDN, which is very affordable and very safe. And the side effects, um, none that I am aware of are life-threatening, at least none that has been reported. Um, so I think that I would urge both readers and practitioners to pay attention and the diligent in reading articles, new articles coming out.

There are more trials that are coming out and to be curious about LDN, and that just don't accept it as, Oh, it just, it's good for treating Hashimoto's disease. It's good for ms, and the next bet would be it's good for autoimmune diseases, but why? Why is it good for treating autoimmune diseases, once you have the idea that this is an anti glial cell modulator, then it opens up a big field, especially within regards to using it as in pain.

For inflammation, inflammation, which causes nerve pain, inflammation. That, and it's very interesting cause nerve pain is how I got started with acupuncture because, um, as you may know, the listeners may know, the tools that we have for nerve pain, um, are very limited. We can use Gabapentin. We can use another medication, in the main Lyrica.  But either you respond to it or don't respond to it. If you respond to it, you're very lucky, but if you don't respond to it, then you have to really suffer. And suffer means that a lot of people say neuropathy. How do you describe it? In the beginning, you would get the tingling, numbness, but as it progresses you, you get burning.

Not just any kind of burning, but really cold burning. And then if it advances even more. You will get like a crushing kind of pain and people can't sleep with this. And the, one of the best ways to make people dysfunctional unfunctional is taking their sleep out of the way. They can't get quality sleep, and then all of a sudden you have a big problem.

So I think that that's what all for me to LDN is doing for complex patients, is that. It's really helping me to push it out there. And then now I'm beginning to combine with treatments. So patients who are weak and they are fatigued, and because a lot of patients who have this condition to reach me takes years, sometimes decades, because they don't have, there's a lack of doctors who are willing to think and solve problems because more of us are more comfortable with protocols.

And so if you have that kind of practice all of us, and understand the mechanism, all of a sudden LDN is amazing, then you can use, if the patient is really weak, then you can target LDN to blockade the conventional way, which is the blockading of the endorphins. But it now, you know you're doing that. Then, the application can be different.

You may. You may be more, um, realize that when equilibration happens, you have to push it a little bit and, and march it out, which is a bit different than, um, the steady-state or the equilibrium that you want to bring about for glial cell. Um, modulation.

Linda Elsegood: Wow. I mean, it would be really interesting if you could just see into the future to see if in say, 20 years time where LDN would be, 

John Kim:  Yeah. I think that one of the danger is that all of us are really happy about more research, more things happening. One of the concerns I have is what happens; one of the pharmaceutical companies find a way to patent it. Cause every time I look at all ideas I had about LDN, someone's patenting it. Someone's patenting it. And as of now, I think there are, um, medications that combine, um, anti-anxiety medication and LDN at 7.5 milligrams. And they use that for weight loss. So if you were to create that combination, you can't, at least in the US because Um, intellectual property. So one, I think that the use of LDN, um, I think is at a tipping point for reaching the conventional, because I hear it from other doctors I hear from and when my fellow wants to use it, um, there is an acknowledgement, even though they say we don't like it. But if they say, yeah, there are some preliminary data, and this is very different than when I first was introduced to LDN, where the evidence was really nonclinical data, but more animal data.

So I think that it's really come a long way. I think it's accelerating. We're seeing a large number of studies coming out of ... Uh, I think in one of the Scandinavian countries, all VA has a bigger study. In, um, formally called RSD or complex regional pain syndrome. So I think we're, we're, we see some things that I think that you know, you and your listeners have done an outstanding job and it's, it's accelerating.

The only thing that I'm concerned about is public may lose access to it, the affordable access to it as, as a pharmaceutical company. And the, for those of you who do not know, um, Dr Bernard Bihari, um, was a pioneer in the field of, uh, low dose naltrexone and he, his title is called normalizing immune system function.

And that's so amazing. He didn't know about glial cells, didn't know about, but that's what he called it. And that's what I think he was right on. And. There's a concept in Chinese medicine and herbal medicine we call adaptogen. adaptogen means is to, something is too high, lowers it is too low it highers it.

So on the example of that, they like to use ginseng, but in the world of botanical medicine, I don't think I've seen as good adaptogen as LDN for normalizing immune system function. 

Linda Elsegood: I'm going to have to stop you there, John. We have run out of time, but we will definitely have you back again.

John Kim: Thank you. 

Linda Elsegood: 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.

Linda Elsegood: 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 well.

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