Tag Archives: autoimmune disease

Low Dose Naltrexone: A “non-Pharma” Pharmaceutical

More sensitive OGFr

Look at all the new, beefed up Opioid Growth Factor receptors formed on the cell as a result of LDN… So fluorescent!

I’m definitely into low-tech solutions in life: food over synthetic vitamins, fecal transplants over antibiotics (ew gross, right? I talk a big game but it’s not like I’ve ever tried it). However when I started reading about Low Dose Naltrexone last summer, I just couldn’t get it out of my head. Low Dose Naltrexone, known as “LDN”, is safe, cheap, essentially free of side-effects, and remarkably effective at treating a ridiculously long list of ailments, particularly auto-immune disorders, cancer, AIDs and chronic pain.

Most patients with auto-immune disorders (such as Crohn’s Disease, Multiple sclerosis, Hashimoto’s, Rheumatoid Arthritis, Grave’s disease, Lupus, Psoriasis, Alopecia etc.) are put on a regimen of immunosuppressant drugs. Logically this makes sense, because the patient’s immune system is attacking itself – so if you suppress the immune system it loses ammunition for attack. This usually works pretty well at keeping auto-immune disorders at bay. However, and this is a very big however, when you suppress a patient’s immune system she takes on a higher risk for everything from the common cold to Cancer. This is what I call treating the disease at the expense of the patient.

However if you are living with an autoimmune disease, you are probably in chronic pain of one sort or another, and would rather live with a shorter amount of good years than a longer life in pain. There are a million really good reasons to take immunosuppressive drugs, and not a lot of alternatives.

There are many, many different kinds of immunosuppressive drugs at this point, and they all invariably have some acute side effects. But on the positive side, they usually work by a two-fold mechanism: first they act by suppressing the immune system, either by inhibiting the genes that code for T cell proliferation, or by inhibiting B cell and various antibody production; secondly immunosuppressive drugs are usually also strong antioxidants, so that they work by reducing inflammation in the body which tends to reduce immune system reaction (or over-reaction in the case of auto-immune disorders).

I think we can agree that the while the T/B cell reduction is a dicey move if you’re playing a long game, at least the antioxidant part of the drugs is probably very helpful. After all, inflammation seems to be the cause of just about every problem, so curbing it is pretty useful. (Inflammation has its purpose when you have a physical trauma or infection that needs to be sealed off from the rest of the body and healed – but is overkill as a reaction to food choices, stress, and small environmental inputs. More on inflammation another time!).

HERE’S WHY “LDN” IS DIFFERENT

Rather than suppressing the immune system, Low Dose Naltrexone works on another level “upstream” in the healing cascade and appears to regulate the immune system. Some of the doctors (Dr. Ian Zagan et al) who are developing LDN for autoimmune issues claim that it is immunosuppressive, but while this is technically true – LDN is actually concurrently immunostimulating. It seems to be able to curb inappropriate immune responses while simultaneously increasing immune function. In other words, it helps auto-immune diseases without compromising the patient’s immune system. So it’s basically a miracle. People who take LDN only get sick very rarely, if at all, and do not suffer from prolonged infections the way they would if taking proper immunosuppressant drugs.

FIRST, WHAT IS NALTREXONE? SOUNDS INTENSE

Naltrexone is a drug that was first synthesized in the 1960s in America, and determined as an opiate agonist, meaning it could block opiates so that the subject taking naltrexone would not feel the effects of opium and heroin. There was little market value for naltrexone, however the US Governement stepped in and paid for extensive clinical trials hoping it could be used to cure heroin addiction and other drug ills of society. Naltrexone was determined to be completely safe, to have no negative side effects, and to be useful even during pregnancy and breastfeeding – which is very rare for any drug. By the time the trials were completed, the drug was already off patent – though the government extended the patent to DuPont for another seven years. In the ’80s, DuPont started marketing naltrexone as a treatment for alcoholism as it causes drinkers to feel none of the pleasant effects of alcohol yet all of the unpleasant effects. As you can imagine, the biggest issue was patient compliance. Naltrexone never really took off as a treatment for anything, and as of now is off patent, of little value to manufacturers and available pretty freely on the internet without a prescription (!).

One of the main things naltrexone does is bind with Opioid Growth Factor Receptors (OGFr), which are on every cell in the body, and blocks them so that Opioid Growth Factor (OGF) molecules cannot bind to them. When OGF binds with OGFr, cell growth and division is regulated. When OGFr’s are blocked, the cells respond in three ways: by spontaneously creating new OGFr’s on the surface of every cell, by making those new OGFr’s more sensitive, and by increasing the amount of Opioid Growth Factor released in the body. The terms are often used interchangeably, but when I am talking here about “opioids” I mean the natural endorphins created by the body; when I talk about opiates I am using a blanket term for the various natural and synthetic external drugs that act on the central nervous system like morphine, codeine, heroin, oxycodone, alcohol and even sugar and dairy.

In normal naltrexone therapy (full dose), the patient doesn’t get to benefit from the increased amount of more sensitive OGF receptors nor the surplus of circulating OGF caused by the naltrexone because the patient takes another dose and all the OGF receptors, including the new ones, continue to be blocked. And in fact if the patient has other problems, like AIDs or cancer, those problems will get worse. So it was determined by Dr. Bernard Bihari in the 1980s that OGF and OGFr play a tremendous role in healing, and that by blocking them healing is grossly impaired.

HERE’S HOW THE “LOW DOSE” WORKS INSTEAD

A regular dose of naltrexone is between 50mg and 200mg per day. A “low dose”, however, is between 1mg – 5mg per day – much less than 10%. It is available online at 4.5mg compounded doses, which is usually where people start when they are experimenting on their own because they can’t get their doctor to take an interest in it and prescribe it for them.

When you take a “low dose” of 4.5mg, the suggestion is to take it at 10pm. By 2am, the dose is fully working and manages to block your OGF receptors for about two hours, until 4am. What happens during these two sleeping hours is that the body panics and makes more OGF, more OGF receptors and makes these new receptors more sensitive. However when the drug wears off at 4am, you are left with the benefit of all these extra sensitive receptors and a surplus of OGF. You experience a rebound effect which supercharges healing.

It isn’t all about the OGF and OGFr. There are many other endorphins which are blocked and then subsequently rebound to become more effective. Some of them have been studied. Some are still unknown. A pubmed search for LDN comes up with some fifty-four thousand hits on its efficacy for fibromyalgia, multiple sclerosis, Crohn’s disease etc. It is also being used in at least three different fertility clinics around the world, which suggests it is not only safe for pregnancy but also effective for women trying to get pregnant.

SOME TIPS

If you are going to bother to try this out, you might as well go for the best experience. As LDN is an opiate agonist, it works best when there aren’t any opiates in your system! It may be easy enough for you to avoid heroin and oxycodone, but it is more difficult to avoid everyday minor opiates like sugar, dairy and any excess of carbohydrates. If you are going to go out and drink alcohol one night, skip the LDN at bedtime and start again the next night. (If you drink alcohol on a full dose of naltrexone, it can actually make you really sick).

If you want to try this because you have auto-immune disease, you should know that people don’t have the best response when they continue to take their immunosuppressant drugs at the same time. It has been described as trying to drive (taking LDN) with the brakes on (immunosuppressant drugs). However that’s a pretty big decision that you shouldn’t make impulsively just from reading a blog post.

WARNINGS

This isn’t just some natural herb that has always been around and tested by thousands of years of civilization. Natrexone is a synthesized drug – serious business. Even though LDN is in an incredibly small dose, it still makes meaningful changes to your body. Fortunately, just about all of the meaningful changes are positive. However there remains one common side effect:

The side effect is that in the first three to seven days, people who take LDN at night tend to experience vivid dreams that seem to last forever, and sometimes experience nightmares. After a week at most, the body becomes conditioned and the potential for bad dreams is gone.

That is the only negative side effect.

A positive side effect is that people tend to sleep more restfully, their auto immune disease stops progressing or regresses, their chronic pain is lessened, etc. This is being used to reverse both AIDs and cancer, and the doctors doing these trials not only take LDN themselves as a preventative, but have their spouses take LDN as preventatives. It seems to have powerful inhibitory effects on tumor cell proliferation.

MY STORY

I don’t have any auto immune diseases, though I continue to be very interested in them. However I have some special friends who I thought could benefit from Low Dose Naltrexone. I gave them some reading, which they brought along to their doctors. But since their doctors had never heard of it, they all thought it was dangerous and wouldn’t read about it. So I found a way to order LDN online without a prescription, and then proceeded to “test” the product to see if the lack of side effects story was true. I am generally very healthy and thought I would be able to notice anything negative fairly quickly.

In my first three nights taking 4.5mg of LDN, I experienced extremely vivid dreams which momentarily turned dark. These dreams felt like they were days and days long. Having been an insomniac my entire life, and having tried every sedative and sleeping pill on the market, I was very surprised that within half an hour of taking LDN I felt pleasantly tired and fell asleep. Although I normally wake up a couple times during the night, sometimes for hours, instead I slept through until the morning. The vivid dreams remained for three nights and then stopped. However I continued to have an easy time falling asleep and staying asleep. My entire quality of life has changed for the better.

Usually sleeping pills (such as Trazadone, Atavan, Seconal, Neo Citran, NyQuil etc) would give me a feeling of intense physical drowsiness that would drug me to sleep but not help me stay asleep; also the effect would wear off after a week unless the dose was raised. This was never a good solution for me, so I stuck with natural remedies like intermittent melatonin, valerian, magnesium, meditation and elaborate bedtime rituals. But mostly I had just come to accept that I was never going to have an easy time falling asleep and getting the rest I needed.

There is no literature linking LDN with curing insomnia. In fact, most patients report the opposite effect – that LDN initially gives them vivid dreams and restless nights. However for some reason this has worked for me, and I am deeply grateful for the sleep that now forms a regular part of my life.

MY RAT FRIENDS

My one friend who tried LDN to deal with chronic pain went from taking 6 Aleve pain pills a day to taking none. However she found the 4.5mg/day dose made her sleep too much, so she reduced her dose to 3mg yet has maintained the same reduction in chronic pain.

My other friend with auto immune disease could not risk stopping her immunosuppressant prescriptions so tried LDN at the same time. She did not have any noticeable benefit except good quality sleep; if anything, she experienced some of the worst flare ups she had ever had, requiring her to increase her doses of immunosuppressants. Putting the car in drive while the parking brake was on didn’t work for her.

BUT IS IT REALLY SAFE?

I started going to a fancy private doctor so that I could get every blood test ordered and every hormone level checked. I wanted to be able to say without a doubt that eating LCHF (Low Carbohydrate High Fat) and doing all my weird things isn’t just making me “feel” healthier, but is actually making me healthier. So I came clean to my new doctor about taking LDN without a prescription. She was not excited, and urged me to stop taking it, and offered me some good alternatives for sleep aids (holy basil tea etc)…

However three months later, my doctor got back to me after having done her own research on LDN. She said not only did she think it was extremely safe, and probably a great prophylactic against cancer and the diseases of aging, but that she would write me a prescription herself.

I have settled on a dose of 3mg/night at 10pm. When I travel, I take it at 10pm in whatever time zone I am in. I skip it whenever I drink more than a single glass of wine.

NOW GO DO YOUR OWN RESEARCH

Fortunately there is a lot of research available on Low Dose Naltrexone. Right now (July 2014) there are dozens and dozens of clinical trials taking place for myriad auto immune diseases, AIDs, cancer etc. There is a non-profit website devoted to organizing resources for LDN. There are thousands of users online sharing their stories of successes and failures. And there is a small window where LDN is still under the radar and so loosely monitored that you can order it for yourself without too much fuss.

WHY DID I CALL THIS A “NON-PHARMA” PHARMACEUTICAL?

LDN is a “People’s Medicine” because it is extremely safe, non-toxic, inexpensive, off-patent, easy to get, and incredibly effective. This is a “non-pharma” pharmaceutical because there is barely any profit to be made off of it. A single 50mg generic naltrexone pill can be bought off the internet for less than $6. Dissolved in 50ml of distilled water, a regular person can use a calibrated medicine dropper to administer 3ml at a time for less than $0.40/dose. If LDN cures your cancer, it’s a great bargain. If it doesn’t, you only risked $135 for a year’s supply.

FURTHER READING

The Low Dose Naltrexone Homepage is a non-profit website devoted to the latest news and information about LDN

LDN SCIENCE: A group of researchers pooling their clinical trials and information

LDN Research Trust: resources, videos and conferences in the UK. THEIR DOCTORS CAN ARRANGE TO GET YOU A PRESCRIPTION, REGARDLESS OF YOUR COUNTRY, IF YOUR DOCTOR WILL NOT.

This book, The Promise of Low Dose Naltrexone Therapy, from Amazon is useful but already over six years old – you have to go online to find more recent updates and news. However this is a good start if you want a solid book in your hand to take to a doctor.

LDN for chronic pain sufferers, a citation from Clinical Rheumatology publication

A presentation about LDN used to boost fertility in cases with low ovarian reserve (low AMH)

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Luckily I Had Worms

That’s what my mother keeps telling everyone at cocktail parties. She seems to think that as guests are sipping their Opus One bordeaux and nibbling on canapés that they also want to hear about how I got intestinal pinworms not once, but twice as a child. Their eyes say stop talking, but my mother persists because she really wants everyone to know how lucky I am that I had worms.

In Epidemic of Absence: A New Way of Understanding Allergies and Autoimmune Diseases, the author Moises Velasquez-Manoff explains, among other things, that a childhood infection with pinworms can protect you from developing allergies and autoimmune diseases.

SO I SCORED THE BIG ONE!

epidemic of absence

If you have a kid in school right now, you know that peanuts are no longer allowed on the property, that fun-zones have been replaced by nut-free-zones, and that probably a quarter of the kids in your child’s classroom has some kind of allergy to nuts, apples, dairy, wheat, shellfish or all of the above. And you might also remember that in your day, these allergies were extremely rare. And that in your mom’s day, they were completely unheard of. And so you’re probably wondering, like I was, what gives?

A lot of people have jumped on the foods themselves: maybe peanuts are different than they used to be, more prone to aflotoxins and full of concentrated pesticides or genetically modified to some shady degree or other. These factors could all be true, but they don’t explain why some children react to modern peanuts and some children don’t. In Epidemic of Absence, Vlasquez-Manoff attempts to get to the bottom of this discrepancy.

There are probably three ways a person can become allergic to peanuts, for example. The first is if they are introduced to the peanut protein through the skin, in a baby cream let’s say, before the protein is introduced orally. There is a reason babies put everything in their mouths – they are introducing proteins and foreign bodies in the correct order, so that their digestive system can file it away as what it is. When the order of introduction is backwards, the filing goes awry and when a peanut is ingested it will trigger an autoimmune response or allergy. This is why some doctors are now suggesting peanuts should be introduced earlier, not later, to babies and toddlers – revising the introduction time from 2 years to 7 months.

The second way a person can become allergic to peanuts, or anything really, is if their gut lining is compromised and allows proteins to “leak” through the lining into the bloodstream where they act as toxins to both the body and brain. A gut lining becomes compromised when good bacteria is minimized or eradicated by antibiotics or a diet high in carbohydrates or excessive fiber.

The common denominator in allergies and autoimmune diseases is the gut. Not just the health of the gut, the bacterial balance in the gut or the nutritional inputs into the gut – but also the residents of the gut like parasites, helminths and worms. We have co-evolved with these little guys for hundreds of thousands, say millions, of years. And it has only been extremely recently that we decided to get aggressive about expelling them from our guts for good. And yet in every case where well-meaning philanthropic foundations went into poor countries and eradicated their parasites and worms, it only took about five years for autoimmune diseases and allergies to appear for the first time.

I’m not just talking about some gentle sneezing and watery eyes. I mean suddenly children were coming down with multiple sclerosis, type-1 diabetes, lupus, Crohn’s disease and autism in populations that had never seen these diseases before. It’s worth reading Velasquez-Manoff’s book just for the incredible research into these parallels.

His thesis is that when we get a parasite or worm, it wakes up our immune system and forces it to develop. If your immune system doesn’t wake up and strengthen, the parasite will make you very sick and probably kill you (weeding those weak genes from the pool). But for all of those that are up to developing their immune systems and learning to keep their parasites at bay, and to live with a very low level of symptoms, those immune systems are better for it. These parasitically-infested people will live to become adults, reproduce and pass their genes along to the next generation. In a land of parasites and worms, you definitely want those fighter genes, and you want to epigenetically turn them on with your own parasite infestation.

But in a land without parasites and worms, having those fighter genes with nothing to fight leaves them untrained, fidgety and aggressive. Those fighter genes cause your immune system to attack innocent inputs like peanuts, or pollen, or even immunization shots, which will then present as a host of symptoms of autoimmune diseases.

Our autoimmune diseases and allergies are essentially adaptations to parasites that have gone awry in the absence of parasites.

So our third most probable way of developing a simple peanut allergy is by inheriting an immune system that is really well adapted to parasites, but has not been exposed to them. The immune system is hot on the trigger to attack a parasite, but in the absence of parasites, attacks a simple peanut protein.

Now if you are lucky enough to be on “rabbit cage cleaning duty” and the hand sink is really really far away, chances are you might come in contact with some pinworm eggs on the rabbit fur, unknowingly lodge them under your fingernails, chew on them later that night, and finally welcome them into your body. The pinworm eggs travel through the digestive system until they reach the duodenum at the entrance to the small intestine. After about 2 – 8 weeks, the eggs hatch into larvae, which grow rapidly, moult twice and migrate to the colon. The adults mate over the next few weeks. The males die and the females attach themselves to the intestinal wall to feed. When full, the females make their way to the rectum because their growing eggs need oxygen to fully mature. So they start wiggling their way out of your body, and then when you scratch at them, they release their eggs all over you. The eggs can live in virtually any environment for up to 3 weeks. Now you know all about my childhood, and if you catch my mom at cocktails she’ll tell you the rest.

These crawl out your bum

These crawl out your bum

USE IT OR LOSE IT

The thing about the immune system is that it is like a muscle or a brain neuron – if you don’t use it, you lose it. The body is a merciless pruner so that it can provide you with the exact body and mind you essentially order up through environmental inputs. If you are a Polynesian pearl diver from a young age, your eyes will develop the ability to see clearly underwater simply because your repeated actions of diving deep underwater and straining to see have told your body what you need. Our body is miraculous in what it will respond to. But as far as the immune system goes, if you encounter parasites your body will jump to the challenge to develop a stronger support system against the parasite, and eventually to live peacefully with the parasite. We have co-evolved for so long and are so co-dependent with parasites, that not having them is like missing an organ.

Does that mean we all have parasites, even here in the big city in my modern house? Probably we are all living with a very, very low level of pretty benign parasites. Go for a colonic at The Fenomen Clinic in Toronto and Tamara will probably show you a few parasites in your feces. Good times. The traditional perspective of colonic hydrotherapy is that it’s preferable to get rid of your parasites. Now we know better, so let’s bring them on.

REALLY, BRING ON THE PARASITES?

No, not really. I mean, if you are already weak and sick (with something other than autoimmune disease, like cancer or heart disease) or have some other problems, parasites might not be for you. However the author of Epidemic of Absence travels down to Mexico to infect himself with black-market hookworms, in hopes of healing his autoimmune alopecia and allergies. It’s a remarkable story, worth reading for yourself.

My takeaway is that there are definitely some risks involved with purposely exposing an adult immune system to parasites and worms. But that if you don’t mind taking that risk, and potentially feeling like you have the flu for 6 months to a year while worms course through your organs reproducing and feeding – you could be cured to some degree, if not totally. There are a ton of people trying this right now, with mixed results. But you will have to read their individual stories on the internet and decide for yourself. It will be years and years (or never) before any kind of clinical trial comes out on this. It’s not a medicine, after all – this cure is just a naturally occurring parasite which you can basically acquire by walking barefoot in Africa (which is how the black-market hookworms were originally smuggled back to Mexico).

EMBRACE BACTERIA

But my more general takeaway is that we all need to look at bacteria differently. It is who we are. Using anti-bacterial sprays and soaps is like using anti-human sprays and soaps. If they were labelled that way, would you still use them?

We need to be very careful with our use of antibiotics. That means not just avoiding prescriptions whenever possible, but also avoiding factory meat which is loaded with them even if it says it’s not. By law, commercial meat can state that it is “antibiotic-free” if antibiotics haven’t been administered for the two weeks prior to slaughter. That’s not enough, and there are tons of studies showing those antibiotics are still present in our food supply. Not to mention our water supply – full of antibiotics because of the huge doses given to factory animals. Basically you can do us all a favor by rejecting factory farming.

For your children and yourselves, the act of waiting out a fever, cough or cold is actually the work that the body and the immune system need to do to develop. By constantly curing our maladies and nipping them in the bud, we don’t let our immune system learn to do its job. And if we don’t use it, we lose it.

If you have to take antibiotics, at least get your fill of probiotics to replenish your gut. Go for kefir, unsweetened whole fat yoghurts, Bio-K, sauerkraut, kimchi, kombucha and those acidophilus pills. Build yourself back up every way you can.

But let your kids be sick, let them play in dirt and barnyards, let them attend crowded sickly nursery schools, let them be slobbered all over by pets, and let them get pinworms and whatever. I mean, don’t let it get so bad that they end up in the hospital or worse. But lay off on all the worrying and the wiping and the cleaning. Humans evolved rolling around in dirt for the first year of their lives and ingesting crazy amounts of bacteria. Indoor plumbing is still a super new adaptation for us. I’m not saying I want to return to using a chamber pot and dumping it out my window every day, and then walking barefoot in it a few minutes later – but it’s worth recognizing that when we had those low levels of sanitation, autoimmune diseases and allergies were virtually non-existent.

The most important time to be exposed to bacteria, saprophytes, and parasites is probably while you are pregnant, for the sake of your fetus. The next most important time is passing through the birth canal, then the next six months to a few years or so of nursing, and then finally all through early childhood. If you weren’t able to be exposed to a birthing canal, breastfeeding, a farm, raw milk, forests or other stables of endotoxins and bacteria at those crucial stages in utero and in early childhood – then chances are extremely high that you suffer from allergies or autoimmune disease. Sorry about that. Let me know how your helminth therapy works out.

There is so much information in this book that just thinking about it makes me want to go back and re-read the whole thing again. I have barely summarized it, and I really hope you read this book over the summer. It’s not too late to change our behavior about microbes, bacteria and our gut – and epigenetics has left us a window to modify our genetic destiny. Even if you are riddled with autoimmune diseases and allergies, and your children are going the same way – there are still modifications you can make to ease their symptoms and more importantly to revise the genes they pass on.

WHAT HAPPENED TO MY WORMS?

I’m so glad you asked. Both times I acquired the pinworms, I was able to get to a doctor within a week of their exit strategy and started taking de-worming medicine. I feel for anyone who can’t get de-worming medicine, because they would most certainly reinfect themselves over and over again. If my worms weren’t completely gone, I would know about it. It was an itchy hell. But even though they are gone, my immune system benefited immensely by our time together. Whether the full life cycle was four weeks or ten weeks, their pinwormy presence in my gut alerted my immune system to wake up and start fighting. I don’t know if that brief romance was enough to keep autoimmune disease and allergies at bay for good, so I will also do my best to absorb bacteria from the environment wherever I can. This summer I’m considering drinking water straight from the lake all season for a handy dose of free saprophytes.

My daughter is going to be so excited about all the fun plans I have.

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