As part of the LDN 2017 Conference we are proud to offer the recorded presentation as outlined below.
Enkephalins are endogenous compounds secreted as prohormones, post-translationally modified into small neuropeptides, and widely distributed. There are multiple enkephalins, but methionine-enkephalin, also termed opioid growth factor (OGF) is highlighted as a neurotransmitter and ubiquitous inhibitory growth factor. The latter function is mediated by a nuclear-associated receptor termed OGFr. The OGF-OGFr regulatory pathway is prominent in most mammalian tissues, playing a significant role in mediating cellular homeostasis. If dysregulated by disease, the OGF-OGFr pathway becomes a target pathway for treatment. To bring new drugs and therapies to the clinic, preclinical studies must establish the efficacy and possible mechanism of action. With regard to multiple sclerosis, the primary animal model is experimental autoimmune encephalomyelitis (EAE), and can be established to mimic both chronic progressive or relapsing-remitting forms of MS. induction of chronic progressive EAE by immunization with myelin oligodendrocytic glycoprotein (MOG35-55) is the most consistent animal model, whereas the relapsing-remitting form of EAE can be induced by immunization with proteolipid protein (PLP139-151). The pro-inflammatory components of both EAE and MS are similar, as the levels of IFN-γ , IL-1β, and TNF-α are upregulated, thus validating the models for study of the pathophysiology of disease. Our research has focused on the role of enkelphalins, specifically OGF, in both the onset of disease and the response to therapy. We have demonstrated that both exogenous and endogenous upregulation of OGF reduces clinical signs of disease and decreases resulting pathology (activated astrocytes, demyelination, and neuronal damage). The role of OGF as an inhibitor of cell replication has been validated with in vitro studies of activated lymphocytes. The finding of low serum enkephalin levels in both humans and animals has substantiated our hypothesis that MS/EAE is associated with a dysregulated OGF-OGFr pathway, and that enkephalins serve as biomarkers for disease progression and response to therapy.
Autoimmune diseases are a primary cause of morbidity and mortality in the industrialized world. That means it's in our offices every day. The number of people diagnosed with an autoimmune disease is increasing exponentially in our country. Estimates are that anywhere from three to seven out of every ten new patients coming into your office are suffering from an autoimmune mechanism (whether it has been recognized and diagnosed or not). The volume of information now of the underlying mechanisms that set the stage and contribute to the development of autoimmune disease is overwhelming.
Dissociative symptoms (like derealisation, emotional numbing, 'losing time,' the lack of self-awareness) occur in most of the cases of trauma-related disorders. Psychotherapeutic treatment is difficult and slow-moving and there is hardly any pharmacologic strategy that is recommended.
First experiences with the use of LDN as a supportive medication showed that it can be a very helpful element in the treatment on the whole. Compared to previously used drugs in treating dissociation and complex PTSD there is 'something new' about the effects that occur with patients who profit by being treated with LDN. It is not only the fact that a worrying symptomatic declines, but it seems as if a new connection is arising between cognitive thinking and emotional perception which may lead to an improvement of self-awareness, and deepened self-reflection, and a growth of self-empathy.
A first conclusion with respect to 6 years of using LDN may be that it is a 'psychotherapeutic drug' as it helps to get in touch with inner life, and 'the suffering that one had to bear.' It can be a support considering the effort of psychotherapy to develop strategies of self-care and a benevolent attitude toward oneself.
Thyroid hormone affects the overall metabolism of every cell within the human body. Therefore, thyroid disorders are metabolic disorders. Therapeutic interventions for thyroid disease realize their best outcomes when seen through the lens of optimizing metabolic rate. This lecture will expound on this concept demonstrating direct therapeutic strategies and tools for measuring and enhancing metabolic rate. The physician will learn how to accurately measure metabolic rate clinically and how to alter this rate with optimal thyroid hormone interventions. Additionally, this lecture will demonstrate the biological interrelationships with various hormonal systems including sex hormones, insulin and blood sugar regulation, adrenal dysfunction, and gastro-endocrine implications. The entire hormonal milieu will considered in the context of its influence on thyroid hormone metabolism and function and the resultant benefits to metabolic rate and patient symptomatic improvement.
The laboratory diagnosis of tick-borne diseases and other symptom-related chronic infections is based on indirect and direct laboratory tests for different kinds of bacteria and viruses. In each bacterial and viral infection there should be an immune response based on antibodies and/or T-cells. There is a lack of confidence in falsely established laboratory tests for antibodies like the Borrelia ELISA, which are not standardized and often false negative.
Diagnosing doctors need better and improved laboratory tests, such as new microarray SeraSpot (modern Borrelia-Westernblot) and testing for T-cellular immune responses by the Elispot and CD57 cells. Many patients with tick-borne diseases have multiple infections, and most symptoms of all tick-borne diseases are not high-specific for Lyme disease or one of the other tick-borne diseases. Ticks are contaminated with Borrelia burgdorferi and other bacteria like Ehrlichia/Anaplasma, Rickettsia, Babesia and Bartonella. There are many evidence-based studies about Borrelia burgdorferi and Chlamydia pneumoniae as the causing agents in patients with inflammatory arthritis, Multiple Sclerosis or Alzheimer's disease. This presentation provides guidance to assist clinicians in obtaining an individual clinical “ranking” of possible bacterial and viral infections, and discusses laboratory tests with the highest sensitivity and specificity for each possible bacterial and viral infection according to the “ranking” of the coinfections-checklist. This should be done before starting any antibiotic or other therapy. According individual laboratory test findings therapy options can be antibiotics, virostatics or complementary therapies. There are different herbal protocols and immune supporting therapies aiming bacterial and viral infections used by naturopaths.
This presentation shows the clinical “grading” and “ranking” of symptoms according the digitalized coinfections-checklist and the laboratory “staging” processes in diagnosing tick-borne diseases and other infections by the help of modern laboratory tests, shown by several case-reports and evidence-based literature for optimized therapy decisions in the complexity of multiple chronic infections.
Autism Spectrum Disorder is a complex, multi-system condition, now of epidemic numbers, leading to behavioral and developmental signs and symptoms. However, many of the signs and symptoms represent treatable conditions. A combination of therapies and medical intervention at earliest stages provides the best chance for recovery.
The two primary inflammatory bowel diseases (IBD) are Crohn’s disease (CD) and ulcerative colitis (UC). The pathophysiology is complex and overlaps with each other. Genetic predisposition, immune disorders and environmental triggers are thought to be the initial basis for the diseases. Autoimmune factors are involved. Treatment of Crohn’s disease includes a variety of compounds designed to reduce the inflammatory response. Although 5-ASA compounds are very safe and remain the mainstay of therapy in UC, these agents used as monotherapy often do not maintain remission in UC and do not work well in ileal Crohn’s disease. During acute attacks or flare-ups, corticosteroids augment various therapies, but these agents cannot be used for long-term maintenance due to systemic toxicity. For decades, thiopurines (azathioprine and 6-mercaptopurine) have been used to maintain remission in both CD and UC, and the availability of therapeutic blood levels facilitates the management and decreases toxicity associated with these agents. Monoclonal antibodies specific for molecules expressed by the T cell population or antibodies specific for cytokines known to be central to the pathogenesis of mucosal inflammation (i.e., anti-tumor necrosis factor, anti-TNF) are important. Unfortunately, treatment with many of these agents often leads to serious side effects and the overall, long-term success is less than 50%. Among the serious adverse events are the development of serious opportunistic infections and neoplasms, and in children or young adults a fatal condition called hepatosplenic lymphoma has been reported when these drugs are combined. When combination therapy is not satisfactory, there are several concerns and a few options that remain. Adjunctive therapies include antibiotics, probiotics, and restricted diets (elemental liquids, gluten-free, FODMAP-free, and, rarely, total parenteral nutrition). Because of the toxicity and inadequate efficacy of the immunosuppressive and biologic medications used for IBD, novel strategies that are safer are desirable.
Cancer is a pervasive and frightening condition the world over. Standard therapies have a place in treatment in many cases, but lack widespread efficacy and success in treatment. Dr. Anderson has spent the past three decades actively treating patients with cancer, and the past decade involved in cancer research using advanced oncology therapies. In this session, he will discuss how including the latest advances in immunotherapy advances the potential outcomes for patients with cancer.
It is critical to diagnose celiac disease to improve quality of life and prevent autoimmune diseases that are associated with it. These conditions may be avoidable if it is recognized, so that the patient does not have to suffer from thyroid diseases, Addison's disease, a variety of neurological and dermatological diseases, and diabetes. Osteoporosis may be an autoimmune disease as opposed to simple malabsorption of calcium and vitamin D in the setting of enteropathy. Along with the autoimmune phenomenon comes inflammation. This can be associated with fatigue and depression. Even after treating celiac disease with a gluten free diet, it can take 2 years before the mucosa can normalize and during this time inflammation is present. Finally, even after the mucosa is normalized, chronic GI symptoms can persist including bloating and gas. This may be due to a change in the microbiome due to a prior history of active celiac disease. Antibiotic therapy for potential small intestinal bacterial overgrowth has been disappointing. Additional therapy needs further evaluation.
Thyroid disorders are one of the most common hormonal conditions in humans. They can affect every aspect of health and quality of life in those who suffer from them. This session will look at the propensity of thyroid problems in humans, their immune connections and how modern immunologic therapies can assist in treatment and healing. Dr. Anderson will use his many years' experience and thousands of cases to inform this session discussion and detail.
It is critical to diagnose POTS to improve quality of life and prevent severe disability associated with it. This disease is now felt to be an autonomic autoimmune disease and it affects most body systems with widespread symptomatology. This can be associated with small intestinal bacterial overgrowth.
This presentation offers a practical guide to autoimmune diets, and explains how they each take different approaches to healing:
It explains the latest research, provides information on who should consider implementing which approaches (and for how long), and offers tips for making restrictive plans less burdensome.
Explores the science behind the contributory factors for development of lupus then moves into new and novel therapies to approach integrative treatment.
Case studies of patients with a variety of psychiatric disorders treated with low dose naltrexone. Treated symptoms include hyper vigilance, anxiety, pain, depressed mood, anger outbursts, sleep difficulties, nightmares, concentration difficulties, PMS symptoms and behavioural and substance addictions. The presentation will briefly review dosing and strategies for initiating treatment of mental health issues with low dose naltrexone.
Discusses the many disease processes that can mimic or destabilize bipolar disorder, how to identify and manage them.
A collection of case studies demonstrating how low dose naltrexone can be used to reduce PTSD-related symptoms in veterans, improving both their capacity to benefit from psychotherapy and their ability to adapt and function in the civilian world. These case studies will demonstrate how LDN significantly reduced disruptive symptoms of anxiety and depression, anger outbursts, nightmares, sleep problems, etc.
This discussion will highlight three cases of advanced disease responding favorably to the introduction of LDN therapy.
This presentation will summarize the results of a number of studies that have explored treatment of various mental health issues with opioid antagonists. There will be a brief discussion of the shortcomings and strengths of these studies. It is suggested that one cannot assume LDN will work identically to high doses of naltrexone, but in light of what is being learned about the efficacy of LDN, these studies hold out the possibility these disorders might respond well to LDN or, in some cases, even better than to high doses of naltrexone or naloxone.
This presentation will describe the etiology of the phobia of shared positive affect, how it disrupts relationships in the lives of patients, including the clinician-patient relationship, and how to both accommodate/navigate around and treat this issue. Simple principles and guidelines will be offered to reduce its disruptiveness and begin healing this daunting but relatively easily changed phobia.
This presentation will cover the use of re-purposed drugs that have broad spectrum anti-cancer activity through various mechanisms, and are also non-toxic unlike conventional chemotherapy. Various therapies will be reviewed, with an emphasis on oral low dose naltrexone (other therapies include dichloroacetate and dimethylsulfoxide)
Recent research on the use of opioid antagonists for traumatic stress syndromes and dissociative symptoms is discussed. Case studies are presented that describe the adjunctive use of opioid antagonists in treatment of dissociative symptoms. Further, case studies are presented where psychiatric overlay complicates the use of opioid antagonists in the management of pain and autoimmune disorders. A neurobiological rationale for adverse effects on emotional functioning in these cases and how to address these issues are presented. Specifically different dosing strategies and their integration with psychotherapeutic interventions are discussed.
Fibromyalgia is a common condition of widespread pain reflecting central nervous system sensitization. To understand how to direct treatment of this complex illness, one needs to understand the pathophysiology leading to abnormal spinal cord amplification of pain signals, so we'll start with a brief tour of our scientific understanding of fibromyalgia. With this data, it will be clear why fibromyalgia pain has been notoriously resistant to standard treatments.
Fortunately, there are some newer alternative pain relief treatments that specifically target the central nervous system sensitization. One of the best-studied is low-dose naltrexone (LDN), which calms activated glial cells and lowers the volume of pain signals transmitted to the brain.
Several case studies of fibromyalgia patients using LDN in a specialty practice will be reviewed, each highlighting one important aspect of prescribing LDN for this specific population. One challenge to prescribing LDN to patients with fibromyalgia is that many utilize opiate-based medications to manage their symptoms. There are ways to overcome this, including using ultra low-dose naltrexone along with separating dosage times adequately to lessen any interactions.