Low-dose naltrexone (LDN) is often confused with naltrexone, which is a pharmaceutical medication used in doses of 50 mg or more to treat alcohol and narcotic pain pill addiction or other opiate abuse. Low-dose naltrexone is a specially compounded capsule of 1.5 to 4.5 mg of naltrexone to help the body combat chronic illness states. It must be specially made by a reliable compounding pharmacist.
LDN acts by reducing inflammation in the brain caused by over-active microglia.
Microglia are a type of glial cell of the Central Nervous System (CNS) and an important line of defense. When there is an assault on the CNS, the microglia are activated and release inflammatory substances to destroy the foreign invaders. When the assault is over, the microglia go back to their normal resting state. However, when they react too often – from repeated injury, infection, toxins, traumas, or emotional blows – they can sometimes remain hyper-active keeping the brain in a chronic state of inflammation. Research on LDN suggests that it’s able to suppress the inflammatory response of the microglia.
You can read more about inflammation of the brain and central nervous system as a major component of pain and illness in Dr. Gary Kaplan’s book Total Recovery.
LDN also improves the body’s immune system by blocking opioid receptors.
You can read more about low-dose naltrexone for auto-immune disorders, and other illnesses at www.lowdosenaltrexone.org.
Because low-dose naltrexone interferes with opiates you cannot continue on narcotic pain medication.
Otherwise, it has virtually no side effects and is very well tolerated by most patients. Most people notice an increase in dreaming, and some people notice a bit of sleep disruption during the initial few days of treatment but this improves over time.
Questions about LDN? Call and speak with a nurse today. Call 703-532-4892, ext. 2.
Patient Q&A on Low Dose Naltrexone:
Q: Does the Kaplan Center offer low-dose naltrexone treatment for fibromyalgia patients? I know of a number of patients with fibromyalgia, MS, and Hashimoto’s thyroiditis who claim to have seen improvement with LDN.
A: Yes, Low-dose naltrexone is a prescribed therapy for a variety of conditions that we treat here at The Kaplan Center. If you would like to learn more about low-dose naltrexone, call the office and schedule an appointment to discuss the possible benefits for your health condition.
Q: I am allergic to NSAIDS, so would I be allergic to this?
A: Low-dose naltrexone is not an NSAID (non-steroidal anti-inflammatory), therefore any allergy to such would not apply. The higher doses of naltrexone can rarely cause liver toxicity, depression, and somnolence, but the low dose naltrexone or LDN has fewer if any side effects in our experience.
Q: The standard dose appears to be 4.5 mg in almost all the information I can find. There are a few chronic pain MDs in the U.S. that seem to be using higher doses with success — a couple say to go up as high as 10 mg while another one is using it up to 4.5 mg 3xday with great success for those who do not respond to one dose of 4.5 mg. Do you have any thoughts on this? What I’ve read is that one should not give up on this medication if not getting benefits at 4.5 mg.
A: At a low dose, the side effects are minimal. Higher doses can cause sleep disturbances and may cause elevation of liver enzymes. Although I don’t usually go higher than 4.5 mg, most likely the doses you are talking about – 10-14 mg – are far from the 50 mg or higher dose that is used to block opioid overdose, and are therefore probably safe. I don’t see any research on the efficacy of using higher doses, however.
Q: I have read that Low-Dose Naltrexone (LDN) should not be taken by people who have had organ transplants. Does this include an artificial aortic heart valve? Also, does it affect INR levels? And should Warfarin dosage need to be readjusted?
A: The short answer is that low-dose naltrexone should not be taken by someone on immunosuppressant drugs because it boosts the immune system by stimulating the body’s own endorphins. There are no known interactions with Coumadin but it is always a good idea to check the INR more often when starting a new medication. Therefore if someone has a valve replacement, yet is not on an immunosuppressant, LDN should be safe.
We are here for you, and we want to help.
Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2
If you haven’t heard of purslane it’s not very surprising. What is surprising is that despite it being so darn good for you most mainstream grocers fail to keep it on the shelf.
It is estimated that human cultivation of the plant goes back 4000 years. It has long been used as a medicinal herb in Chinese medicine and is still a commonly used vegetable in Asia, Europe, Africa, and the Middle East. It grows abundantly across the globe and can be found in crop fields, gardens, orchards, and vineyards.
Here, purslane is often mistaken as a nuisance weed, but in truth, it is a nutritional powerhouse on par with many of the vegetables we find at the grocery store. Its vast nutritional benefits include:
Omega 3 fatty acids – We know that Omega 3 fatty acids offer protection against neurodegenerative diseases, cancers, cardiovascular disease, and other chronic illnesses. When tested, purslane was found to contain as much as 400 grams of alpha-linolenic acid, or ALA, a type of omega 3 fatty acid per serving (100 grams), making it one of the richest vegetable sources of ALA that you can find. Purslane is a great source of Omega 3s for vegans and vegetarians.
Glutathione – Glutathione is the most abundant of the endogenous anti-oxidants in the Central Nervous System, and perhaps the most important. Our bodies need glutathione to keep our bodies in balance. What does this mean? Without enough glutathione in our bodies, we become “unbalanced” in terms of inflammation and anti-inflammation, and in terms of destruction and repair. The depletion of this important antioxidant plays a role in the onset and progression of neurodegenerative and neuropsychiatric diseases. Unfortunately, glutathione levels naturally deplete as one ages, so maintaining adequate levels is important. Purslane contains approximately 8 mg of glutathione per 100 grams, which is more than spinach, broccoli, carrots, and many other more common store-bought vegetables.
Vitamins & minerals – Purslane contains the highest vitamin A content among the green leafy vegetables, which fulfills 44% of the daily needs. Research has shown that eating higher amounts of foods that contain vitamin A may help with vision and protect from certain types of cancer.[i] It’s also rich in vitamin C with 21mg/100g and other B-complex vitamins. Purslane also boasts high mineral content, with potassium (494mg/100g), magnesium (68/100g), calcium (65mg/100g), phosphorus (44mg/100g) and iron (1.99mg/100g) all well represented.[ii]
Note: Like parsley, spinach and other leafy greens, purslane contains oxalic acid, a naturally occurring acid found in vegetables. Oxalic acid binds with calcium, reducing its absorption and also forms compounds called calcium oxalate and iron oxalate. These compounds can be naturally eliminated by the body by most people; however, for some, they can produce kidney stones and possibly other health issues. Therefore people who are prone to kidney stones should limit the consumption of foods that contain oxalic acid, particularly in its raw form. Cooking or steaming vegetables with oxalic acid can reduce the amount present.
In order to prevent oxalate from binding to calcium is to eat foods known to contain oxalic acid 2 hours apart from dietary calcium sources. Doing this will allow enough time for the body to absorb it.
How to use it
Grab a stem, take a bite and enjoy the tangy crunch! Fresh purslane’s texture and flavor make it a great addition to any salad. It also holds up well when sautéed and can be used in soups and stews. Or, try substituting purslane in your favorite pesto recipe! Many recipes call for removing the leaves from the stems, but there is no harm in keeping them in.
Farmers’ markets or farm stands are your best bet in finding purslane. It can also be found at some Whole Foods Markets.
References: [i]Vitamin A Fact Sheet for Health Professionals, National Institutes of Health, Office of Dietary Supplements [ii]National Nutrient Database for Standard Reference Legacy Release, United States Department of Agriculture Agricultural Research Service
We are here for you, and we want to help.
Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2
Naturally people are under the assumption that paying for their medications through their insurance plan allows them the best price available, however, this is not always the case. Consumers are losing out on potential savings because of “gag clauses” that prevent pharmacies from disclosing lower prices for prescription medications if paid “out-of-pocket” instead of using their prescription benefits. In fact, a 2018 study in JAMA found that about 1 in 5 prescriptions are being overpaid!
Unfortunately, the financial burden of prescription medications often causes patients to change the dose to make the medication last longer or choose not to take the medications at all. This is especially concerning for patients taking medication for chronic illnesses. At a time when premiums, deductibles, and copays are far from affordable for the average American, finding ways to make your prescriptions more affordable is essential.
How did we get here?
Pharmaceutical Benefit Managers (PBMs) are companies that act as intermediaries between pharmacies, drug manufacturers and insurance companies. The role of PBMs in the prescription drug marketplace is quite far-reaching, yet surprisingly most consumers know little or nothing about them. PBMs establish formularies (the list of drugs covered by the health plan), decide which pharmacies are included in the network, process claims, and even operate their own mail-order pharmacies. PBMs negotiate deep discounts with drug manufacturers, and in return, those manufacturers benefit from having their drugs widely available to consumers. PBMs reimburse pharmacies a certain percentage for each medication, and charge plan sponsors (insurance companies) much higher rates for those same medications, pocketing the difference. Very simply, PBMs make enormous profits as a result of cleverly crafted contracts and operate with virtually no oversight.
These “gag clauses” that ultimately hurt the consumer are found in many of the contractual agreements between PBMs and pharmacies. If pharmacists don’t play by the rules and volunteer lower-cost alternatives, they risk being penalized and/or dropped from the network.
What is being done about it?
Recently there has been a movement to create more transparency for consumers when buying their medications. Many states have already passed legislation, or have bills pending, that ban the practice of gag clauses. The “Patient’s Right to Know Drug Prices Act” is one of two new bills recently introduced in the Senate. This bill advanced last month for a full Senate floor vote and there is hope that the other, “Know the Lower Price Act” will too.
The bottom line is that you or your trusted advocate must be proactive in every aspect of your healthcare. The only way to really know if you are receiving the lowest possible price for your medications is to do some research and ask a lot of questions. Here are some tips that may help you lower the cost of your prescription drugs*.
Pay with cash: Ask your pharmacist if paying by cash will get you a lower price. Many pharmacists are not allowed to disclose that information to their customers unless they are specifically asked.
Shop around: A recent Consumer Reports’ Special Report on drug costs found that there were enormous discrepancies in costs for several common generic drugs depending on where a prescription was filled. For example, after comparing cash prices from chain pharmacies, supermarket drugstores and independent pharmacies, a one month supply of atorvastatin (generic Lipitor, 20mg) ranged from $10.00 at the online pharmacy HealthWarehouse.com, to $135.00 at CVS & Target!
Look for discount programs: Find out if your pharmacy has an in-store discount program or prescription card that allows you to receive additional savings on your prescriptions.
Use an online service: There are some free, online services that can help consumers quickly get information on where to get the best cash price for a prescription.Good Rx – Collects prices and discounts from thousands of pharmacies. Consumers can get a discount card and/or coupons to present to the pharmacist for savings. Blink Health – Account holders purchase directly through Blink Health but pick up at their local, participating pharmacy.
Ask about alternative options: Generic or other brand name medications may be less costly and a suitable substitute.
* These tips require paying for your prescription by cash rather than insurance. While it may get you a better price, keep in mind that these purchases will not be applied towards a deductible. If you have a high deductible and many medical expenses, it may make more financial sense to pay with your insurance.
The Kaplan Center does not endorse any program or site mentioned in this article. Consumers are encouraged to exercise due diligence to make the best, most informed decision on their own behalf.
Low-Dose Naltrexone: A Little Known, But Effective Treatment For Chronic Pain
/in Treatments/by Kaplan CenterLow-dose naltrexone (LDN) is often confused with naltrexone, which is a pharmaceutical medication used in doses of 50 mg or more to treat alcohol and narcotic pain pill addiction or other opiate abuse. Low-dose naltrexone is a specially compounded capsule of 1.5 to 4.5 mg of naltrexone to help the body combat chronic illness states. It must be specially made by a reliable compounding pharmacist.
LDN acts by reducing inflammation in the brain caused by over-active microglia.
Microglia are a type of glial cell of the Central Nervous System (CNS) and an important line of defense. When there is an assault on the CNS, the microglia are activated and release inflammatory substances to destroy the foreign invaders. When the assault is over, the microglia go back to their normal resting state. However, when they react too often – from repeated injury, infection, toxins, traumas, or emotional blows – they can sometimes remain hyper-active keeping the brain in a chronic state of inflammation. Research on LDN suggests that it’s able to suppress the inflammatory response of the microglia.
Some of the inflammatory conditions that have shown to benefit from LDN include fibromyalgia, multiple sclerosis, Crohn’s disease, complex regional pain syndrome, and cancer.
You can read more about inflammation of the brain and central nervous system as a major component of pain and illness in Dr. Gary Kaplan’s book Total Recovery.
LDN also improves the body’s immune system by blocking opioid receptors.
This, in turn, boosts the body’s endogenous endorphins, our natural painkillers, and important regulators of cell growth.
You can read more about low-dose naltrexone for auto-immune disorders, and other illnesses at www.lowdosenaltrexone.org.
Because low-dose naltrexone interferes with opiates you cannot continue on narcotic pain medication.
Otherwise, it has virtually no side effects and is very well tolerated by most patients. Most people notice an increase in dreaming, and some people notice a bit of sleep disruption during the initial few days of treatment but this improves over time.
Questions? Give Us a Call!
703-532-4892 x2
Questions about LDN? Call and speak with a nurse today. Call 703-532-4892, ext. 2.
Patient Q&A on Low Dose Naltrexone:
Q: Does the Kaplan Center offer low-dose naltrexone treatment for fibromyalgia patients? I know of a number of patients with fibromyalgia, MS, and Hashimoto’s thyroiditis who claim to have seen improvement with LDN.
A: Yes, Low-dose naltrexone is a prescribed therapy for a variety of conditions that we treat here at The Kaplan Center. If you would like to learn more about low-dose naltrexone, call the office and schedule an appointment to discuss the possible benefits for your health condition.
Q: I am allergic to NSAIDS, so would I be allergic to this?
A: Low-dose naltrexone is not an NSAID (non-steroidal anti-inflammatory), therefore any allergy to such would not apply. The higher doses of naltrexone can rarely cause liver toxicity, depression, and somnolence, but the low dose naltrexone or LDN has fewer if any side effects in our experience.
Q: The standard dose appears to be 4.5 mg in almost all the information I can find. There are a few chronic pain MDs in the U.S. that seem to be using higher doses with success — a couple say to go up as high as 10 mg while another one is using it up to 4.5 mg 3xday with great success for those who do not respond to one dose of 4.5 mg. Do you have any thoughts on this? What I’ve read is that one should not give up on this medication if not getting benefits at 4.5 mg.
A: At a low dose, the side effects are minimal. Higher doses can cause sleep disturbances and may cause elevation of liver enzymes. Although I don’t usually go higher than 4.5 mg, most likely the doses you are talking about – 10-14 mg – are far from the 50 mg or higher dose that is used to block opioid overdose, and are therefore probably safe. I don’t see any research on the efficacy of using higher doses, however.
Q: I have read that Low-Dose Naltrexone (LDN) should not be taken by people who have had organ transplants. Does this include an artificial aortic heart valve? Also, does it affect INR levels? And should Warfarin dosage need to be readjusted?
A: The short answer is that low-dose naltrexone should not be taken by someone on immunosuppressant drugs because it boosts the immune system by stimulating the body’s own endorphins. There are no known interactions with Coumadin but it is always a good idea to check the INR more often when starting a new medication. Therefore if someone has a valve replacement, yet is not on an immunosuppressant, LDN should be safe.
We are here for you, and we want to help.
Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2
Purslane: A Super "Weed" Worth Trying
/in Nutrition/by Kaplan CenterIf you haven’t heard of purslane it’s not very surprising. What is surprising is that despite it being so darn good for you most mainstream grocers fail to keep it on the shelf.
It is estimated that human cultivation of the plant goes back 4000 years. It has long been used as a medicinal herb in Chinese medicine and is still a commonly used vegetable in Asia, Europe, Africa, and the Middle East. It grows abundantly across the globe and can be found in crop fields, gardens, orchards, and vineyards.
Here, purslane is often mistaken as a nuisance weed, but in truth, it is a nutritional powerhouse on par with many of the vegetables we find at the grocery store. Its vast nutritional benefits include:
Questions? Give Us a Call!
703-532-4892 x2
Note: Like parsley, spinach and other leafy greens, purslane contains oxalic acid, a naturally occurring acid found in vegetables. Oxalic acid binds with calcium, reducing its absorption and also forms compounds called calcium oxalate and iron oxalate. These compounds can be naturally eliminated by the body by most people; however, for some, they can produce kidney stones and possibly other health issues. Therefore people who are prone to kidney stones should limit the consumption of foods that contain oxalic acid, particularly in its raw form. Cooking or steaming vegetables with oxalic acid can reduce the amount present.
In order to prevent oxalate from binding to calcium is to eat foods known to contain oxalic acid 2 hours apart from dietary calcium sources. Doing this will allow enough time for the body to absorb it.
How to use it
Grab a stem, take a bite and enjoy the tangy crunch! Fresh purslane’s texture and flavor make it a great addition to any salad. It also holds up well when sautéed and can be used in soups and stews. Or, try substituting purslane in your favorite pesto recipe! Many recipes call for removing the leaves from the stems, but there is no harm in keeping them in.
Farmers’ markets or farm stands are your best bet in finding purslane. It can also be found at some Whole Foods Markets.
References:
[i] Vitamin A Fact Sheet for Health Professionals, National Institutes of Health, Office of Dietary Supplements
[ii]National Nutrient Database for Standard Reference Legacy Release, United States Department of Agriculture Agricultural Research Service
We are here for you, and we want to help.
Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2
What Your Pharmacist Can’t Tell You, Unless You Ask
/in News, Treatments/by Kaplan CenterNaturally people are under the assumption that paying for their medications through their insurance plan allows them the best price available, however, this is not always the case. Consumers are losing out on potential savings because of “gag clauses” that prevent pharmacies from disclosing lower prices for prescription medications if paid “out-of-pocket” instead of using their prescription benefits. In fact, a 2018 study in JAMA found that about 1 in 5 prescriptions are being overpaid!
Unfortunately, the financial burden of prescription medications often causes patients to change the dose to make the medication last longer or choose not to take the medications at all. This is especially concerning for patients taking medication for chronic illnesses. At a time when premiums, deductibles, and copays are far from affordable for the average American, finding ways to make your prescriptions more affordable is essential.
How did we get here?
Pharmaceutical Benefit Managers (PBMs) are companies that act as intermediaries between pharmacies, drug manufacturers and insurance companies. The role of PBMs in the prescription drug marketplace is quite far-reaching, yet surprisingly most consumers know little or nothing about them. PBMs establish formularies (the list of drugs covered by the health plan), decide which pharmacies are included in the network, process claims, and even operate their own mail-order pharmacies. PBMs negotiate deep discounts with drug manufacturers, and in return, those manufacturers benefit from having their drugs widely available to consumers. PBMs reimburse pharmacies a certain percentage for each medication, and charge plan sponsors (insurance companies) much higher rates for those same medications, pocketing the difference. Very simply, PBMs make enormous profits as a result of cleverly crafted contracts and operate with virtually no oversight.
These “gag clauses” that ultimately hurt the consumer are found in many of the contractual agreements between PBMs and pharmacies. If pharmacists don’t play by the rules and volunteer lower-cost alternatives, they risk being penalized and/or dropped from the network.
What is being done about it?
Recently there has been a movement to create more transparency for consumers when buying their medications. Many states have already passed legislation, or have bills pending, that ban the practice of gag clauses. The “Patient’s Right to Know Drug Prices Act” is one of two new bills recently introduced in the Senate. This bill advanced last month for a full Senate floor vote and there is hope that the other, “Know the Lower Price Act” will too.
The bottom line is that you or your trusted advocate must be proactive in every aspect of your healthcare. The only way to really know if you are receiving the lowest possible price for your medications is to do some research and ask a lot of questions. Here are some tips that may help you lower the cost of your prescription drugs*.
Blink Health – Account holders purchase directly through Blink Health but pick up at their local, participating pharmacy.
* These tips require paying for your prescription by cash rather than insurance. While it may get you a better price, keep in mind that these purchases will not be applied towards a deductible. If you have a high deductible and many medical expenses, it may make more financial sense to pay with your insurance.
The Kaplan Center does not endorse any program or site mentioned in this article. Consumers are encouraged to exercise due diligence to make the best, most informed decision on their own behalf.