Crystal's MS,Transverse Myelitis and LDN Website

LDN & Candida (Yeast Infection)

You'd better be checking yourself for candida yeast overgrowth. Go to the link below and do the spit test and be positive you do not have candida. LDN cannot battle candida.

We have seen a number of cases where people were not feeling better with LDN and then they get checked for Candida (overgrowth of yeast in your body - many times stemming from use of antibiotics). If they find they have a high concentration of Candida and they go through the process of getting it under control LDN tends to work much better for them.

Low Dose Naltrexone Forum - Check yourself for Candida (yeast overgrowth)...

http://ldn.proboards3.com/index.cgi?board=forum&action=display&thread=1129136093

Low Dose Naltrexone (LDN) Welcome Package

Dear Friend,

Please find enclosed an information pack about Low Dose Naltrexone (LDN).

As always, we urge you to gather information and decide on your own judgment whether or not you want to try LDN.  The websites listed in the enclosed pack provide a wealth of information. Personal experiences and views on LDN can be found by visiting my website

 http://crystalangel6267.webs.com/index.htm

, the LDN website www.ldninfo.org plus http://thecompounder.com/diseasenaltrexone.html and searching under LDN or Low Dose Naltrexone.

Off label use of medications

In the United States , the Food and Drug Administration (FDA) requires drug companies to conduct clinical trials to prove safety and efficacy so the drug can be approved and taken to market as an approved drug. The drugs manufacturer and FDA agree on specific drug package insert. (Can be found inside the box containing the medications) The dose of the medication, the route and the indications for usage are included on the drugs label. There is more information in the drugs package insert. Once the FDA approves a drug for prescription use, they do not attempt to regulate the practice of medicine. The physicians are allowed to make decision based on their best judgment how to use the medication. There is no requirement to adhere only to the published indication for the specific drug. It is legal in the United States and countries over the world to use drugs off-label, namely use the medications for other medical indication that are not listed in the documents of the FDA , when the drug is approved. Some drugs are used more frequently off-label than for their original, FDA-approved indication.

The biggest thing to realize is that everyone's body is different and reactions vary. It would appear that over 85% of people taking LDN have a good response, with some type of symptom relief or lack of progression. Some people have miraculous recoveries and some only mild help and there is a small percentage of people that it does not seem to help.  A few things are for certain: there are far fewer side effects (and they usually go away within the first few weeks), it is much easier to take and it is much cheaper than the standard Crab medications. 

Introductory LDN Symptoms

For those of you in the first 3 months of LDN therapy Dr. Bob Lawrence from the UK who has MS & uses LDN himself explains why the temporary increase in MS symptoms.

When starting this LDN (Low Dose Naltrexone) therapy in the treatment of MS, there may also be some initial transient, though temporary, increase in MS symptoms.

Experience in using this method has demonstrated most commonly, such as disturbed sleep, occasionally with vivid, bizarre and disturbing dreams, tiredness, fatigue, spasm and pain. These increased symptoms
would not normally be expected to last more than seven to ten days.

Rarely, other transient symptoms have included more severe pain and spasm, headache, diarrhea or vomiting. These additional symptoms would appear to be associated with the previous frequent use of
strong analgesics, which effectively create an addiction and dependency, thus increasing the body's sensitivity to pain. This temporary increase in symptoms may also perhaps be explained when we consider the manner in which this drug is expected to work.

Initially, MS occurs due to a reduction in the activity of the controlling influence of the suppressor T-cells within the immune system. During an acute relapse, the overall number of T-cells is
reduced, the normal balance of helper T-cells and suppressor T-cells is disrupted and the damaging helper (CD-4) T-cells tend to predominate. This is the situation most pronounced during an acute
relapse but occurs similarly, but to a lesser extent, in chronic progressive MS. Under the influence of LDN there will be an expected increase in the overall numbers of T-cells but, because the CD-4,
helper T-cells tend to predominate at this time, an increase in their numbers will expectedly tend to increase MS symptoms. It is only when the numbers of suppressor T-cells effectively "catch up" that the
normal balance is restored and symptoms once again diminish and improve.

In addition, because LDN stimulates the immune system and many of the drugs routinely used by the NHS in the treatment of MS further suppress the immune system, LDN cannot be used in company with
steroids, beta interferon, methotrexate, azathioprine or mitozantrone or any other immune suppressant drug. If there is any doubt, please submit a full list of the drugs you are presently taking so that
their compatibility may be assessed. In addition, because LDN will also block the analgesic effects of any opiate drugs (includes codeine, dihydrocodeine, morphine, pethidine or diamorphine)
presently being taken, the use of LDN will initially greatly increase the level of pain experienced. It is therefore advisable that any opiate-like drugs be discontinued at least two weeks before this
treatment is initiated. When starting the treatment it is essential that any untoward or adverse side-effects are reported immediately so that the treatment process can be further assessed and, if necessary,
modified.

Dr. M R Lawrence

From Dr. Lawrence

Unfortunately, thus far, many GP’s and Neurologists seem unwilling to prescribe LDN as they have little experience or knowledge of Naltrexone being used in this way ie: such a low dosage and for the treatment of MS symptoms, Autoimmune Diseases and some Cancers. Nevertheless, with the enclosed information and an increase in patients demanding LDN, gradually more doctors are prescribing.

Because LDN is an "off-label" use of naltrexone, it is of interest to know if prescribing of drugs in general for "off-label" purposes is common.  Some physicians are hesitant to write a prescription for an off-label use of a compound. The Wall Street Journal reports today that a study has found that about 21% of all prescriptions written (an estimated 151 million out of 725 million) were for off-label use of whatever drug was prescribed. ("Off-label" means the FDA had licensed the drug for some use, but has not yet approved it specifically for this particular use). According to the researchers, 73% of these "off-label" uses were not backed by solid scientific evidence ( as they judged the situation).

The researchers were based at Stanford and Dartmouth medical schools, and their report appeared in the latest issue of Archives of Internal Medicine.

Hope this helps somebody explain the situation to a hesitant doctor.

Dr Lawrence has put together the enclosed pack in order to provide your GP or Neurologist with the information they need to be able to consider prescribing you with LDN.

Please do let us know if you receive replies from the Department of Health or if you are able to obtain a GP or Neurologist’s prescription – this information may help other people with MS to obtain LDN on prescription.

P.S. Please find at the end of this pack, an example letter for you to complete to give to your GP or Neurologist, if you wish too.

LDN Dr Lists

I keep an LDN Dr list of Dr’s that prescribe LDN in the US and Other Countries so if you need one please email me privately at angelindisguise67@yahoo.com and I will email you what I have on my list in your area.

Also if anyone has a Dr that prescribes LDN and you have their permission to be added to my list then please email me their information so I can add it to my list to help others.

Also if anyone has a testimony they would like to share of their experience with LDN please email it to me so I can add it to my website and my newsletter.

Hugs & Blessings,

Crystal

Crystal’s MS, TM and LDN Website

http://crystalangel6267.webs.com/index.htm

What is low-dose naltrexone and why is it important?

> Low-dose naltrexone holds great promise for the millions of people worldwide with autoimmune diseases or central nervous system disorders or who face a deadly cancer.

> In the developing world, LDN could provide the first low-cost, easy to administer, and side-effect-free therapy for HIV/AIDS.

Naltrexone itself was approved by the FDA in 1984 in a 50mg dose for the purpose of helping heroin or opium addicts, by blocking the effect of such drugs. By blocking opioid receptors, naltrexone also blocks the reception of the opioid hormones that our brain and adrenal glands produce: beta-endorphin and metenkephalin. Many body tissues have receptors for these endorphins and enkephalins, including virtually every cell of the body's immune system.

In 1985, Bernard Bihari, MD, a physician with a clinical practice in New York City, discovered the effects of a much smaller dose of naltrexone (approximately 3mg once a day) on the body's immune system. He found that this low dose, taken at bedtime, was able to enhance a patient's response to infection by HIV, the virus that causes AIDS. [Note: Subsequently, the optimal adult dosage of LDN has been found to be 4.5mg.]

In the mid-1990's, Dr. Bihari found that patients in his practice with cancer (such as lymphoma or pancreatic cancer) could benefit, in some cases dramatically, from LDN. In addition, people who had an autoimmune disease (such as lupus) often showed prompt control of disease activity while taking LDN.

How does LDN work?

> LDN boosts the immune system, activating the body's own natural defenses.

Up to the present time, the question of "What controls the immune system?" has not been present in the curricula of medical colleges and the issue has not formed a part of the received wisdom of practicing physicians. Nonetheless, a body of research over the past two decades has pointed repeatedly to one's own endorphin secretions (our internal opioids) as playing the central role in the beneficial orchestration of the immune system, and recognition of the facts is growing.

Witness these statements from a review article of medical progress in the November 13, 2003 issue of the prestigious New England Journal of Medicine: "Opioid-Induced Immune Modulation: .... Preclinical evidence indicates overwhelmingly that opioids alter the development, differentiation, and function of immune cells, and that both innate and adaptive systems are affected.^1,2 Bone marrow progenitor cells, macrophages, natural killer cells, immature thymocytes and T cells, and B cells are all involved. The relatively recent identification of opioid-related receptors on immune cells makes it even more likely that opioids have direct effects on the immune system.³"

The brief blockade of opioid receptors between 2 a.m. and 4 a.m. that is caused by taking LDN at bedtime each night is believed to produce a prolonged up-regulation of vital elements of the immune system by causing an increase in endorphin and enkephalin production. Normal volunteers who have taken LDN in this fashion have been found to have much higher levels of beta-endorphins circulating in their blood in the following days. Animal research by I. Zagon, PhD, and his colleagues has shown a marked increase in metenkephalin levels as well. [Note: Additional information for Dr. Zagon can be found at the end of this page.]

Bihari says that his patients with HIV/AIDS who regularly took LDN before the availability of HAART were generally spared any deterioration of their important helper T cells (CD4+).

In human cancer, research by Zagon over many years has demonstrated inhibition of a number of different human tumors in laboratory studies by using endorphins and low dose naltrexone. It is suggested that the increased endorphin and enkephalin levels, induced by LDN, work directly on the tumors' opioid receptors — and, perhaps, induce cancer cell death (apoptosis). In addition, it is believed that they act to increase natural killer cells and other healthy immune defenses against cancer.

In general, in people with diseases that are partially or largely triggered by a deficiency of endorphins (including cancer and autoimmune diseases), or are accelerated by a deficiency of endorphins (such as HIV/AIDS), restoration of the body's normal production of endorphins is the major therapeutic action of LDN.

What diseases has LDN been useful for and how effective is it?

> Bernard Bihari, MD, as well as other physicians and researchers, have described beneficial effects of LDN on a variety of diseases:

Other Diseases:

ALS (Lou Gehrig's Disease)

Alzheimer's Disease

Ankylosing Spondylitis

Autism Spectrum Disorders

Behcet's Disease

Celiac Disease

Chronic Fatigue Syndrome

CREST syndrome

Crohn's Disease

Emphysema (COPD)

Endometriosis

Fibromyalgia

HIV/AIDS

Irritable Bowel Syndrome (IBS)

Multiple Sclerosis (MS)

Parkinson's Disease

Pemphigoid

Primary Lateral Sclerosis (PLS)

Psoriasis

Rheumatoid Arthritis

Sarcoidosis

Scleroderma

Stiff Person Syndrome (SPS)

Systemic Lupus (SLE)

Transverse Myelitis

Ulcerative Colitis

Wegener's Granulomatosis

Cancers:

Bladder Cancer

Breast Cancer

Carcinoid

Colon & Rectal Cancer

Glioblastoma

Liver Cancer

Lung Cancer (Non-Small Cell)

Lymphocytic Leukemia (chronic)

Lymphoma (Hodgkin's and Non-Hodgkin's)

Malignant Melanoma

Multiple Myeloma

Neuroblastoma

Ovarian Cancer

Pancreatic Cancer

Prostate Cancer (untreated)

Renal Cell Carcinoma

Throat Cancer

Uterine Cancer

LDN has demonstrated efficacy in thousands of cases

Cancer: As of mid-2004, Dr. Bihari reported having treated over 300 patients who had a cancer that had failed to respond to standard treatments. Of that group, some 50%, after four to six months treatment with LDN, began to demonstrate a halt in cancer growth and, of those; over one-third have shown objective signs of tumor shrinkage.

Autoimmune diseases: Within the group of patients who presented with an autoimmune disease (see above list), none have failed to respond to LDN; all have experienced a halt in progression of their illness. In many patients there was a marked remission in signs and symptoms of the disease. The greatest number of patients within the autoimmune group are people with multiple sclerosis, of whom there were some 400 in Dr. Bihari's practice. Less than 1% of these patients has ever experienced a fresh attack of MS while they maintained their regular LDN nightly therapy.

HIV/AIDS: As of September 2003, Dr. Bihari had been treating 350 AIDS patients using LDN in conjunction with accepted AIDS therapies. Over the prior 7 years over 85% of these patients showed no detectable levels of the HIV virus — a much higher success rate than most current AIDS treatments, and with no significant side effects. It is also worth noting that many HIV/AIDS patients have been living symptom-free for years taking only LDN with no other medications.

Central Nervous System disorders: Anecdotal reports continue to be received concerning beneficial effects of LDN on the course of Parkinson’s disease, Alzheimer’s disease, amyotrophic lateral sclerosis (ALS—Lou Gehrig’s disease), and primary lateral sclerosis. Dr. Jaquelyn McCandless has found a very positive effect of LDN, in appropriately reduced dosage and applied as a transdermal cream, in children with autism.

How is it possible that one medication can impact such a wide range of disorders?

The disorders listed above all share a particular feature: in all of them, the immune system plays a central role. Low blood levels of endorphins are generally present, contributing to the disease-associated immune deficiencies.

Research by others — on neuropeptide receptors expressed by various human tumors — has found opioid receptors in many types of cancer:

• Brain tumors (both astrocytoma and glioblastoma)
• Breast cancer
• Endometrial cancer
• Head and neck squamous cell carcinoma
• Myeloid leukemia
• Lung cancer (both small cell and non-small cell)
• Neuroblastoma and others...

These findings suggest the possibility for a beneficial LDN effect in a wide variety of common cancers.

What dosage and frequency should my physician prescribe?

The usual adult dosage is 4.5mg taken once daily at night. Because of the rhythms of the body's production of master hormones, LDN is best taken between 9pm and 3am. Most patients take it at bedtime.

Notable exceptions:

• People who have multiple sclerosis that has led to muscle spasms are advised to use only 3mg daily and to maintain that dosage.
• For initial dosage of LDN in those patients who have Hashimoto’s thyroiditis with hypothyroidism and who are taking thyroid hormone replacement medication, please read Cautionary Warnings.

Rarely, the naltrexone may need to be purchased as a solution — in distilled water — with 1mg per ml dispensed with a 5ml medicine dropper. If LDN is used in a liquid form, it is important to keep it refrigerated.

The therapeutic dosage range for LDN is from 1.75mg to 4.5mg every night. Dosages below this range are likely to have no effect at all, and dosages above this range are likely to block endorphins for too long a period of time and interfere with its effectiveness.

> IMPORTANT: Make sure to specify that you do NOT want LDN in a slow-release form….

Reports have been received from patients that their pharmacies have been supplying a slow-release form of naltrexone. Pharmacies should be instructed NOT to provide LDN in an "SR" or slow-release or timed-release form. Unless the low dose of naltrexone is in an unaltered form, which permits it to reach a prompt "spike" in the blood stream, its therapeutic effects may be inhibited.

Fillers: Capsules of LDN necessarily contain a substantial percentage of neutral inactive filler. Experiments by the compounding pharmacist, Dr. Skip Lenz, have demonstrated that the use of calcium carbonate as a filler will interfere with absorption of the LDN capsule. Therefore, it is suggested that calcium carbonate filler not be employed in compounding LDN capsules. He recommends either Avicel, lactose (if lactose intolerance is not a problem), or sucrose fillers as useful fast-release fillers.

LDN FILLERS

If your Low Dose Naltrexone comes from a compounding
pharmacy and arrives as a liquid, then you’re getting pure
Naltrexone powder dissolved in distilled water. This is probably the “purest” way to ingest Naltrexone. You don’t need to worry about fillers.

BUT -- If you get your LDN in any other form, you're swallowing filler.

A “filler” is an inert, inactive ingredient that accompanies every dose of Naltrexone you take.  

If you make your own LDN --

If you make LDN by crushing ReVia (pronounced REV-yah)
or another commercially manufactured 50mg Naltrexone tablet, you're still ingesting filler, because each tablet is comprised of about 16% Naltrexone and 84% filler.   

What kind of filler is in your tablet? This depends on the
manufacturer. Here are the main manufacturers:

Barr Labs – Barr manufactures naltrexone under the brand
name ReVia for the US and Canadian markets. This tablet
contains 50mg naltrexone and these inactive ingredients:  
lactose monohydrate, colloidal silicone dioxide, magnesium
stearate, crospovidone, microcrystalline cellulose, purified
water, Opadry beige (coloring). [Information from Barr Labs phone representative.]

Bristol Myers Squibb – BMS manufactures naltrexone under the brand name ReVia in markets other than the US and Canada. As of 2002, their 50 mg tablets contain 50 mg of naltrexone hydrochloride, plus these inactive ingredients (filler): lactose, microcrystalline cellulose, crospovidone, silicon dioxide, magnesium stearate, and pale yellow Opadry (colouring). [Information from a 2002 leaflet by Australian Prescription Products Guide.]  

Mallinckrodt – makes a 50mg naltrexone pill called Depade.  This tablet contains 50mg naltrexone, plus these inactive ingredients (filler): crospovidone, hydropropyl methylcellulose, lactose monohydrate, magnesium stearate, microcrystalline cellulose, polyethylene glycol, polysorbate 80, silicone dioxide, titanium dioxide, yellow iron oxide, and red iron oxide. [Information from Mallinckrodt website.]

[Historical Note: The original ReVia was made by DuPont.  
The inactive ingredients were: lactose, microcrystalline
cellulose, crospovidone, silicon dioxide, magnesium stearate, and pale yellow Opadry (colouring). In 2001, Bristol Myers Squibb acquired DuPont Pharmaceuticals. In April 2002, BMS sold the ReVia brand-name rights in the US and Canada to Barr Laboratories. BMS continues to market ReVia outside of the US and Canada.]

If your LDN is made by a compounding pharmacy –

Ask your pharmacist how it is made.

1. Some compounders make LDN by crushing commercially
manufactured 50mg tablets and putting the powder into
capsules, because the amount of powder that goes into each
capsule is not enough to fill the capsule, most pharmacies add additional filler. If this is how you get your LDN, you can find out which commercially manufactured tablet is being used and what kind of additional filler is being added.   

2. Other compounders don’t crush 50mg tablets; instead, they use pure naltrexone powder (purchased in bulk from
pharmaceutical companies), which they mix with filler. From these pharmacists, you can learn what kind of filler you are taking.  

Here are some of the most common fillers used by
compounding pharmacists:

LACTOSE:   Lactose is a naturally-occurring simple
carbohydrate, or sugar, found only in the milk of mammals. For this reason, it is also commonly referred to as “milk sugar.”

Lactose has long been used as a soluble filler in the manufacture of orally administered pharmaceuticals. It is safe, stable, inexpensive, and has a fast dissolution rate. Pharmaceutical-grade lactose powder is highly pure, and specifically produced to meet government standards of safety and purity.

Lactose is easily tolerated by most patients. However, if you
are lactose-intolerant (that is, if milk products give you nausea, diarrhea, abdominal cramping, bloating, or flatulence), you might want to try another filler.

Note:  Dr Bihari asks his patients to use lactose, unless they
have an adverse reaction… not because he believes lactose is better than other fillers, but because he began his study of LDN with lactose, and he wants his records to be consistent.    

ACIDOPHILOUS – (pronounced Ah-SID-uh-FILL-us) – is
lactic bacteria, or one-celled micro-organisms, used by the
body to promote immunity and proper nutrition. Sold over the counter as a nutritional supplement and digestive aid,  
Acidophilus is sometimes used as a treatment for diarrhea and constipation. It is commercially available as powder, tablets, capsules or liquid.

Lactose-intolerant patients sometimes switch to Acidophilus filler in their LDN capsules.

AVICEL – a brand name for microcrystalline cellulose. Avicel has been used safely and effectively for 35 years in the food and pharmaceutical industries. Virtually inert, it is not absorbed into the system, and will not interfere or interact with other nutrients, vitamins or minerals. Avicel is made of wood which has been purified and powdered into extremely tiny particles -- between 0.000039 and 0.0001560 of an inch of pure fiber, with the consistency of a very fine face powder.  

Avicel is the filler used by Skip’s Pharmacy in Boca Raton.   
 

CALCIUM CARBONATE – a mineral that occurs naturally
in limestone, marble and coral. Crushed to a fine, flavorless, odorless powder, it is a natural food additive, and the most common ingredient in calcium supplements and antacids.

Calcium is absorbed by the small intestine and is used by the body to build bone tissue. Calcium supplements are generally well tolerated, but in some patients may cause constipation, bloating, gas and flatulence.  

People with kidney stones, hypocalcaemia, sarcoidosis,
hyperparathyroidism, hypervitaminosis D or cancer should not take calcium carbonate.

People taking calcium supplements are usually advised to take them with food.  

There has been some concern among LDN users that calcium carbonate is occasionally packed too tight in the capsule, which can cause a slow-release reaction, rather than the desired fast-release.

Any questions about filler should be referred to your
doctor or your pharmacist.

Are there any side effects or cautionary warnings?

Ø      Side effects:

LDN has virtually no side effects. Occasionally, during the first week's use of LDN, patients may complain of some difficulty sleeping. This rarely persists after the first week. Should it do so, dosage can be reduced from 4.5mg to 3mg nightly.

Ø      Cautionary warnings:

1. Because LDN blocks opioid receptors throughout the body for three or four hours, people using medicine that is an opioid agonist, i.e. narcotic medication — such as Ultram (tramadol), morphine, Percocet, Duragesic patch or codeine-containing medication — should not take LDN until such medicine is completely out of one's system. Patients who have become dependant on daily use of narcotic-containing pain medication may require 10 days to 2 weeks of slowly weaning off of such drugs entirely (while first substituting full doses of non-narcotic pain medications) before being able to begin LDN safely.
2. LDN should probably not be taken during pregnancy until research into that question is completed.
3. Those patients who are taking thyroid hormone replacement for a diagnosis of Hashimoto’s thyroiditis with hypothyroidism ought to begin LDN at the lowest range (1.5mg for an adult). Be aware that LDN may lead to a prompt decrease in the autoimmune disorder, which then may require a rapid reduction in the dose of thyroid hormone replacement in order to avoid symptoms of hyperthyroidism.
4. Full-dose naltrexone (50mg) carries a cautionary warning against its use in those with liver disease. This warning was placed because of adverse liver effects that were found in experiments involving 300mg daily. The 50mg dose does not apparently produce impairment of liver function nor, of course, do the much smaller 3mg and 4.5mg doses.
5. People who have received organ transplants and who therefore are taking immunosuppressive medication on a permanent basis are cautioned against the use of LDN because it may act to counter the effect of those medications.

What NOT to Take With LDN

Do not take Naltrexone with any of the following without first talking to your doctor:

• disulfiram (Antabuse);
• thioridazine (Mellaril);
• buprenorphine (Buprenex, Subutrex);
• codeine (Tylenol with Codeine, and other brand names);
• hydrocodone (Lorcet, Lortab, Vicodin, Vicoprofen, and other brand names);
• hydromorphone (Dilaudid);
• levorphanol (Levo-Dromoran);
• meperidine (Demerol);
• methadone (Dolophine, Methadose);
• morphine (Kadian, MS Contin, MSIR, OMS, Roxanol, Oramorph SR, and other brand names);
• oxycodone (M-Oxy, OxyContin, OxyIR, Roxicodone, Percocet, Percodan, and other brand names);
• oxymorphone (Numorphan); or
• propoxyphene (Darvon,  and other brand names).

·        Ultram (tramadol) (synethetic opioid)

·        Novantrone

·        Rebif

·        Avonex

·        Betaseron

·        Tysabri

·        Chemo's

·        Cellcept is a chemotherapy

Ø      Cautionary warnings:

Because LDN blocks opioid receptors throughout the body for three or four hours, people using medicine that is an opioid agonist, i.e. narcotic medication — such as Ultram (tramadol), morphine, Percocet, Duragesic patch or codeine-containing medication — should not take LDN until such medicine is completely out of one's system. Patients who have become dependant on daily use of narcotic-containing pain medication may require 10 days to 2 weeks of slowly weaning off of such drugs entirely (while first substituting full doses of non-narcotic pain medications) before being able to begin LDN safely.

I believe that steroids, short term, are ok with LDN.

Dr. Skip

 Drugs that may interact with Low Dose Naltrexone