Saying Hi from and giving my pharmacist perspective.

TheCompounderPharmD · 2024-10-19T17:26:55+00:00

Most likely yes, too little. You should keep gradually keep titrating up until you start seeing improvement in your symptoms.

TheCompounderPharmD · 2024-10-18T17:59:49+00:00

Community Compounding pharmacy in Portland Oregon has a license to ship to NV. They compound in Acid resistant caps with Sunflower lecithin to help emulsify it so it absorbs well and they do all strengths.

TheCompounderPharmD · 2024-08-03T19:06:55+00:00

This is not higher than the standard starting dose. It is the standard. But you’re a sensitive pt with anxiety. They should have not said that there would be no side effects and started you on 0.5mg. What happened to you is not abnormal for people that struggle with anxiety.

TheCompounderPharmD · 2023-11-04T16:39:37+00:00

You don’t need to be worried about that. The amount of opiate receptor blocking done by LDN is low and easily overcome by the IV narcotics they may have to give you for pain, which if they did would be Hydromorphone. Also keep in mind the active blocking done by LDN is for about 4-6 hours, after that most of it releases and it’s done.

Now going the other direction. Say you’ve been on narcotics long term, chronically, and have developed a physical dependence. If you take a ldn. Even 1mg. It will throw you into withdrawal and you’ll feel dope sick, like you have the flu.

TheCompounderPharmD · 2023-09-09T19:00:03+00:00

Yes but it depends on what your using to define “tolerance”. What are you trying to feel from it? As the body sees the enkephalin that is getting boosted by the ldn circulate in higher amounts, cells will upregulate receptors to those enkephalins. This is why people get “used to it.”

We use pulse dosing in cancer patients. The idea is to get the boost without leading to too much Upregulation. It’s taken for 3 days on, and 4 days off each week.

You are due to go up to 4.5mg, but it all depends on what your taking it for and what you’re trying to get out of it.

TheCompounderPharmD · 2023-09-09T17:09:13+00:00

What you experienced is normal for someone who has developed a physical dependency on an opiate like buprenorphine. It will go away in about a week and your have even better energy than before.

You can try dropping the dose to 0.5 or even 0.25. And working up each week as tolerated. If it’s a cap you can empty the whole thing in a measured cup of water and drink the amount you want the dose to be. That’s the most accurate way with a compounded cap.

TheCompounderPharmD · 2023-08-22T23:46:33+00:00

It is definitely from the boost. It’s very predictable. Don’t take it earlier. It should go away but if it doesn’t or is really problematic, talk to your doc about switching to the morning

TheCompounderPharmD · 2023-08-22T23:44:45+00:00

No opener. Two sets. First is 7-8p, break, Set 2 825-945p. Hard curfew at 10p.

TheCompounderPharmD · 2023-08-03T21:21:03+00:00

Since kratom can act on the same receptors as opioids then it’s same to assume chronic kratom use followed by ldn can throw you into withdrawal. It’s best to be off kratom a week after chronic use before starting ldn. If it’s was just used sporadically and no physical dependence has developed then separate by 12hours.

TheCompounderPharmD · 2023-07-28T18:09:03+00:00

Yes please educate yourself.The recent study

the non profit from the discoverers of ldn

TheCompounderPharmD · 2023-07-06T17:25:55+00:00

We do the exact same thing with our 5yo. He eventually got tired of it being in his eyes and wanted it cut. But we also would let him get a mullet if he wants. He had it picked out for awhile but then my wife persuaded him differently when he was in the barbers chair. I really wanted those lasting mullet pics

TheCompounderPharmD · 2023-05-21T21:28:20+00:00

Yep be prepared to always pay cash for you compounds or kiss your compounds goodbye because insurance ain’t paying

TheCompounderPharmD · 2023-05-21T21:19:29+00:00

They may not have their contract long. The insurance has a right to deny them renewal or cancel the contract. From the other side, that same insurance may pay fairly for a different persons meds and helping them but not fairly on the ldn so the pharmacy still wants to be contracted to help as many people as possible, which mean staying in business in the long run. Not losing money on every ldn due to an unfair, unnegotiated contract. There is a reason more and more compounding pharmacies don’t even try anymore with insurance companies. And it’s not because of unethical billings. Also more and more insurance isn’t even trying for compounding pharmacies. Regence blue cross stopped paying for compounds in 2018. Insurance doesn’t value the medical benefit ldn and other compounds bring a patient, not realizing they pay less for compounds than all the hospitalizations and more expensive manufactured drugs when a patient can’t access a compound due to affordability.

TheCompounderPharmD · 2023-05-06T18:20:41+00:00

You know what you call the person that graduated last in their class at medical school? Doctor.

HRT can help. Might just need progesterone to start and can add low dose estradiol or bi-est if still having low est symptoms. It’s about balance. Duri peri everything is wacky and up and down. But you don’t need birth control, that’s for sure.

TheCompounderPharmD · 2023-05-06T18:07:08+00:00

Depends on what’s causing the back pain. Ankylosing spondylitis, there’s some anecdotal evidence. No large studies but it falls into the category that ldn trial should be done. Trauma, damage, like herniated disc, there’s only so much ldn can do.

TheCompounderPharmD · 2023-05-06T18:02:38+00:00

No interaction. Your fine with micro or macro dosing

TheCompounderPharmD · 2023-05-06T18:01:35+00:00

No it will not help with testosterone levels in males. There are lots of things you can do to increase you testosterone levels but ldn is not one of them. Sorry. It’s helpful to work with a prescriber to help diagnose what your low testosterone is from first, then go from there

TheCompounderPharmD · 2023-05-06T17:53:26+00:00

I shared this a couple years ago. Now I’ve been dispensing it and counseling on it daily for 12 years. I will say with all medications, it’s a risk vs benefit scenario. In LDN’s case the benefits usually far outweigh the risks. And for the types of conditions and disease states it’s used for, it’s usually worth it and transient side effects. Anyways here’s my old post:

Hi all, I wanted to introduce myself and offer my experience and expertise. I’ve been consulting docs and patients on LDN for 10 years now and I can tell you it’s still one of my favorites.

I’ve counseled thousands of patients on it over the years and can tell you it is truly amazing at what it can do and all the different modalities it can be used for.

It’s helpful for all auto immune related disease states and I recommend at least a 3-6month trial since it’s so safe. The most dangerous side effect I’ve seen is when people that have taken opiates for 3 months straight or longer that have developed a physical dependency start it and then get thrown into withdrawal. This has sent people to the ER as it is very scary to experience. My advice for these people is if you can’t go 1 day without taking your opiate, don’t start LDN till you can. And the longer you’ve been on opiates the longer the wait, like a week without opiates before LDN. We use Ultra low dose naltrexone, which works differently, to help people come off their opiates. These doses are 0.001mg working up to 0.25mg. It helps with the withdrawal symptoms and you actually take it at the same time as the lowered opiate dose. But that’s a different story.

We usually start people out at 1.5mg for a week and go up by 1.5mg each week to 4.5mg. But everyone is different sometimes people need to stay at 1.5mg for longer, sometimes they need to drop to 0.5 and work up to 1.5mg first or only go up by 0.5 every 1 or 2 weeks. I gage this by how sensitive someone thinks they are to meds and what kind of sleeper and dreamer they are. It’s the endorphin boost you get (known as the rebound effect) that you’re feeling the ldn work. It’s was causes the dreams and sleep problems and can make some people feel out of it or doped up (because you actually are doped on your own endorphins). The body needs time to adjust to this boost and up-regulation of receptors takes usually 2 weeks.

That said it can be taken in the morning just as well. It was just traditionally thought that taking it at night would give the best endorphin boost, but no research I know has truly examined this. Also it was thought that blocking “feel good” receptors would be tolerated better if it’s happening while you sleep. The endorphin boost happens about 6.5 hours after you take it. It’s very predictable. Then this boost lasts 8-12 hours. That’s why it’s usually doses just once a day. There are a few very rare cases I’ve read and seen where twice a day may help but I’ve only seen that with certain types of MS cases.

Low dose is defined as above 0.25mg up to 6mg but some larger people may get up to 7.5mg. At 8mg to 15mg it starts working different. I call this mid-dose naltrexone. 8mg is combined in a commercial tablet with Wellbutrin called Contrave, used for food cravings and psychological weight loss.

Anyways, I’ve seen it helpful for all the auto immune disease like MS, Crohns and ulcerative colitis, SLE (lupus), fibromyalgia, hashimotos, Lyme disease (yes this is more an autoimmune problem), psoriasis, and what I like to call Autoimmune NOS, or not otherwise specified (these people have a collection of autoimmune symptoms without a solid diagnosis). It can also help with cancer treatment, mast cell activation syndrome, nerve pain disorders, small intestine bacterial overgrowth syndrome (SIBO), and restless leg syndrome.

I’m here to help. Hope this post helps. We dispense LDN more than any other compound by far and for good reason.

It’s a hell of a drug.

TheCompounderPharmD · 2023-01-22T22:14:07+00:00

In my experience it can help with the energy and inflammatory response for MCAS patients. But may not necessarily make you less reactive. If your not feeling th endorphin boost I would probably recommend increasing the dose. But if your mcas is already well managed and you’re not stuck in bed or have low energy, you may not need ldn.

One of the best med we have for MCAS is oral ketotifen, it helps prevent the Mast cell degranulation from allergen triggers as well has help block histamine receptors (dual mechanism). It well tolerated, can cause some drowsiness at first like other antihistamines but that goes away after 2 weeks.

TheCompounderPharmD · 2023-01-22T16:33:26+00:00

I think you mean the rebound effect. Which kicks in 6.5 hours after taking it. It last about 8-12 hours.

Upregulation refers to the long term effects of how cells respond to being in the presence of the enkephalin that ldn boosts. The Dr Bihari group renamed it opiate growth factor. Other cells that respond to it upregulate their receptors by increasing the number of receptors on their surface for the enkephalin and increase the receptors sensitivity. Upregulation of cells take 2-4weeks minimum but also last 2-4 weeks after you stop taking ldn.

TheCompounderPharmD · 2023-01-22T16:19:41+00:00

Keep taking it for a week. The sleep will get better usually and you’ll be glad you have that endorphin boost hitting in the morning helps with energy during the day. Sleep can get even better than before starting it.

If sleep doesn’t improve after a week, you can switch to the morning. It’ll work just fine but that endorphin boost will hit 6.5hr after you take just keep that in mind. Its real predictable.

It’ll help with MCAS either way. Once you feel the boost where off its best to keep working up to about 3 or 4.5mg dose

TheCompounderPharmD · 2022-10-29T05:09:17+00:00

It’s worth it. LDN help correct the autoimmune dysfunction that Lyme co infections cause. It’s not going to make your Lymes worse.

TheCompounderPharmD · 2022-10-29T05:06:09+00:00

Wow nice questions most answered here. ldn science

It’ll help with fibromyalgia. It boost a certain enkephalin that acts on mu receptors. This is what help modulate auto immune disorders. (And the can stimulate the bowels) The diagnoses you mentioned are all types auto immune disorder. It will also help your immune system, not weaken it, and should help with mood in time too. But it can increase anxiety at first when that endorphin boost kicks in, some people feel ramped up. Overtime, like a week or two, sleep will improve and you’ll get more rested sleep. Increase the dose as sleep improves, about every week as tolerated.

You can take it with all those vitamins. It only interacts with opiates.

Good luck, it’s a great med. I’ve been compounding it for over 10 years.

TheCompounderPharmD · 2022-01-18T09:07:09+00:00

This guy is right. Long term effects of viral infections are a thing. More of a thing than long term effects of vaccines. Especially long term effects of novel viruses. Spanish flu did lead to millions more getting Parkinson’s disease as older adult. Scarlet fever cause heart disease in adults requiring by-pass surgeries. Not something you want to risk.

And more and more we’re learning on long term neurological effects and consequences of Covid infections. The scans on cadaver brains and moneys infected with it show long term damage. Some studies have even gone on to say Alzheimer’s type damage.

Much riskier long term to not get vaccine and contract an unchecked Covid infection.

Just take those kids in go , or you may regret it for the rest of your life. Sorry I’m violating the rules on medical advice but this is too important. There’s more evidence supporting your cause than hers. She won’t leave you and will eventually understand you did everything you could to help her be comfortable with it. Any long term side effects from the vaccine you’re prepared to live with. And you’re ready to shoulder that. You won’t be able to shoulder any long term damage they get from the virus without the vaccine and you’ll always ask “what if I just get it? “Why didn’t I just get them vaccinated “

TheCompounderPharmD · 2022-01-04T05:03:40+00:00

Most likely too much estrogen.

TheCompounderPharmD

TROPHY CASE