Revolution Health & Wellness

Episode 63 – Low Dose Naltrexone

Episode 63 - Low Dose Naltrexone

Speaker 1: 00:00 This is Dr Chad Edwards and you’re listening to podcast number 63 of against the grain.

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Speaker 1: 01:01 the Super Tall Marshall Morris and I am joined today with Dr. Chad Edwards, who believes that 80 percent of medical recommendations are crap technically speaking here, and he is the author of revolutionize your health with customized supplements. He is the founder of Revolution Health Dot Org and uh, especially this podcast against the grain podcast and he served in the US army. He’s a board certified family physician. The list goes on and on. He including. He is a handsome man, but Dr. Chad Edwards, welcome to the show. Hey, thanks Marshall. I appreciate all those accolades. No, Dr Edwards, we meet every single week here and we talk about against the grain topics, topics and advancements in the medical field and uh, ways that people can not only get better but really optimize their health, get to optimal health. Can you just briefly talk about what the difference is there? Yeah. So, you know, you can go back and listen to our second podcast where we talk about some of the.

Speaker 1: 02:05 Well, the first one was just the intro and the second one we’re talking about labs and we discussed the concept of normal versus optimal. Dave Ramsey, I love Dave Ramsey’s work, you know, big financial guy. And he says, normal is broke, be weird, be weird, so in, in medicine will look at things and we see this every day people will go to their doctor, they’ll get lab work and they’ll say, well your labs are normal, but the patient walks out saying, well, I feel like crap. And we just kind of blew off the fact that the patient feels awful and you know, there’s several anecdotes so we can talk about. And one of them is this is an electrical rhythm, a that doesn’t have a pulse, you know, these people are dying and it’s called pulseless electrical activity. And if you look at the Monitor, the heartbeat looks completely normal.

Speaker 1: 02:51 But if you look at the patient, they’re either dead or dying. And if you are focused on the monitor, you think everything’s fine. If you’re focused on the patient, you understand that that patient’s going to die without your intervention. When we come to something like functional medicine and thyroid, any, any number of things, if you look at the labs and you consider it where the labs are normal, but the patient tells you that they feel awful. What are you going to listen to? There’s something going on with that patient and it’s not just a simple black and white straightforward, here’s your problem, here’s your pill. So we have to be much more open minded about how patients are telling us they are feeling and what we’re going to do about it. I’ve heard you say it time and time again. Treat the patient. At the core of it is treat the patient.

Speaker 1: 03:38 Don’t be treating anything else besides the patient. You’ve got to listen to your patients. That’s exactly right. Yeah. When the patient tells you something’s wrong and the lab looks right or when the patient tells you they feel right in the labs, look wrong. It deserves a second question and that is really been the cornerstone for getting us into a number of different podcasts or topics here. And uh, I know that today we have an extra special one, a one that is a little bit against the grain in how it was maybe utilized in the functionality, the implementation of it, the usage of it. And so I’ll let you get us into this. A hot topic today. Yeah. So this, and this one’s actually very much against the grain because not only because of how it got, how it came about, but because of how it works and what it’s used for.

Speaker 1: 04:27 So it’s a total paradigm shift in the way we use medications. So today we’re gonna talk about a medication and that medication is called Naltrexone and, but we’re going to talk about it in a little bit different form than the way it was originally developed. So the drug naltrexone is what we call an antagonist. So it’s a medication that blocks the function or the action of certain chemicals in your body or other drugs. So it was developed to block the high associated with heroin use. So trying to get people off of heroin and you know, we use, there’s methadone clinics and now suboxone clinics that try and get people off of prescription pain pills or street drugs like heroin, the, uh, the naltrexone. It didn’t have quite the effect that they wanted. It wasn’t getting the results, whatever. Uh, so, but the, the common dosage was 50 milligrams.

Speaker 1: 05:21 And so we’ll use it. It’s an oral medication in the pill. And there’s one that I use in the emergency room, someone comes in and they’ve overdosed on morphine or percocet or, you know, fill in the blanks and we’ll give one ivy called naloxone or Narcan, and this one is, is Narcan, doesn’t work orally. You can’t take it as a pill and it have effect. The naltrexone does work orally and it’s actually combined with pain medication in some medications as a, as a combination together so that if you crush up that medicine and try to inject it, it blocks the action of it or you know, the narcanned is anyway, but the oral effect doesn’t, doesn’t work. So, uh, here with naltrexone. And the idea is that you’re blocking the opiate receptor. Now real quick for all of the listeners out there and just shamelessly myself, um, tell me, for somebody that’s coming in addicted or having overdosed on drugs, why are you, why is the first thing that you’re doing giving them more drugs?

Speaker 1: 06:19 Aren’t we trying to get them off drugs? Yeah. So I mean, the first thing that you know, across the board, whether it’s an acute emergency or it’s something going on longterm where we’re trying to get, you know, trying to get some stability, the first thing that I want to do is get control part of that because I’m a control freak. The say the other part of that is because what, what patient wants to come into the doctor and the doctor says, okay, well here’s your problem and we’re going to do something in five years from now. You’re gonna feel better. Are you kidding? I mean, some things do take time, but you’ve got to get control of this. You got to get them feeling better as quickly as possible. So many times we will use medications to get controlled right up front. Now, in the emergency department, of course, we use medications frequently.

Speaker 1: 07:02 I use them every shift. Uh, so, but in this case, when you’re talking about an opiate overdose, you’re talking about somebody that’s coming in and either they’re not breathing, their blood pressure’s too low, they’re having major problems. So you are losing control. You’ve got to gain control and help that patient right now, that’s where that medication comes in. So we will use a medication to get controlling. So immediately you’re blocking the receptors. You’re blocking the whatever they’ve taken from working on the receptors in the body. That’s right. That’s right. Now, I’ll bet our average listener listening to this podcast is not real concerned about overdosing on morphine. Sure. I’m, I’m guessing that not that many of our listeners are gonna have an issue with that. Uh, so how does this apply to what we’re talking about today and it’s this concept of low dose naltrexone and what we can treat a for, what can we use low dose naltrexone?

Speaker 1: 07:58 Why did my patients in my clinic care about this? And in order to understand what this drug does, how it works, I think it’s important to go back to how this thing got discovered as being beneficial for this. Uh, so briefly just for our listener, so that you got an idea of what’s coming. Let me give it a list of conditions that low dose naltrexone can, can benefit. So it is, and to be very clear, we’re not making medical claims here, we’re not saying that if you have any of these conditions, if you take low dose Naltrexone, you are, um, you’re not preventing, treating or curing any of these conditions. There is anecdotal evidence, meaning that some physicians have seen success with this medication, applied to these conditions. So this is anecdotal evidence. There are not randomized placebo controlled double blind studies validating this, uh, that have been, uh, approved by the FDA.

Speaker 1: 08:59 So I want to be very clear about that. Um, and, and we’ll, we’ll come full circle on that later. But so conditions, things like there’s a whole list of cancers that they have seen anecdotally benefit with. And so we’re talking about a list of cancers. Bladder, breast, carcinoid, tumors, colon and rectal cancers, Glioblastoma, which is a brain tumor, liver cancer, lung cancer, non small cell, specifically lymphocytic leukemia, lymphoma, Hodgkin’s, and not non Hodgkin’s. Lymphoma is a malignant melanoma, multiple Myeloma, neuroblastoma, ovarian cancer, pancreatic cancer, prostate cancer, Renal Cell Carcinoma, throat cancer, and uterine cancer. So we’ve got a whole host of cancers and if you understand cancer, and I’m not a cancer expert, but if you understand cancer, it’s, it is a problem with the immune system that, you know, these, these tumors have gone haywire and your immune system can’t keep those in check. Uh, many people would argue that we get cancer cells in our body all the time.

Speaker 1: 09:58 The immune system identifies them, targets them, destroys them, and it’s done. So in this case, it’s the immune system having a dysfunction and doesn’t not appropriately identify that cancer cell and eliminated. So once you understand low dose naltrexone and how it works and, and what it does, uh, it’ll, it’ll help, makes better sense as to why low dose naltrexone a has been shown to be or has been observed to be beneficial for some patients. Then there are neurodegenerative issues. So, you know, I think most people are aware of all timers, disease and Parkinson’s disease. And so these are where our, um, our neurologic system degrades at Rhodes overtime for a number of potential reasons. Um, so there’s a list of these things like Lou Gehrig’s disease or a mild atrophic lateral sclerosis or als or Alzheimer’s disease, autism spectrum disorders. So you know, your kids with autism disease there, some of them have seen benefit with this hereditary spastic paresis multiple sclerosis, Parkinson’s disease, primary lateral sclerosis, progressive supranuclear palsy, transverse Myelitis, and there’s a lot of neurodegenerative processes that again, anecdotally have been, uh, there’s been observation that these patients have benefited sometimes substantially with low dose naltrexone.

Speaker 1: 11:19 Then where I see the most application in my practice is with autoimmune disorders and we’ll have another podcast where we’re talking specifically about the pathogenesis or how Auto Immune Disorders, uh, we, how we believe that they get started and some things that we can do foundationally for auto immune disorders. But so a list of these things includes ankylosing spondylitis beset syndrome, celiac disease, chronic fatigue syndrome, crest, a Dermato, myositis, dystonia, endometriosis, fibromyalgia, Hashimoto’s, irritable bowel syndrome. My son, he’d grab us, nephrotic pemphigoid, blah, ba Blah ba blah ba blah, blahs, a systemic Lupus Erythematosus and ulcerative colitis, wegener’s granulomatosis. There’s a lot of autoimmune disorders that again, anecdotally have benefited from low dose naltrexone. Then there are some other diseases like common cold emphysema, HIV and AIDS have noted benefit that at least they’d have observed benefits. So you know, what is this stuff, how did it come about?

Speaker 1: 12:23 And I think it’s important to understand how it came about in order to understand how it can be beneficial for patients. So this stuff was originally described by Dr Harry and he basically what happened was, you know, in the 19 eighties there was this big virus that came out and caused all this fear and, and you know, that is going to be a pandemic and everybody’s going to die of this disease and that disease was known as aids and ultimately we discovered the human immunodeficiency virus. And initially they didn’t have a lot of treatment options. There was the first drug that came out was act and it just, it was awful. Tons of side effects. All of these kinds of things. Well, Dr Barry noted that in these patients that they had across the board, you know, on average they had like 20 percent of the endorphins that, that normal healthy people have.

Speaker 1: 13:17 So these endorphins are natural opiate type chemicals in our body. They come and bind to the same receptors as morphine and heroin and those kinds of, the opiate receptor and you know, some people will talk about the runner’s high and you know, different things like that. You were talking about raising these endorphins. It’s an endorphin rush, you know, maybe people have heard of that. So when he noted that these people are low in endorphins, he noted or assumed a presumed that the aids virus, the HIV virus was destroying or lowering the, um, the endorphin levels. So, you know, of course he was aware of naltrexone and kind of how it worked and all of those kinds of things. So he started using Naltrexone, don’t, I’ll describe this more in just a second. So we started using naltrexone and they actually hired some people to come in and evaluate this and they found that in the range of one point seven, five to four point five milligrams, normal dose at the time, 50 milligrams.

Speaker 1: 14:18 So we’re talking less than 10 percent of our, or a 10th of the dose of what the, uh, the normal amount would be that, that range one point seven, five to four point five milligrams would trigger or jumpstart endorphin production during the night. And so he discovered that if they, if you take this medication before you go to sleep and a low dose form that it up regulates the production of these endorphins. And basically what it does is in a low dose form, remember this medication is an opiate blocker. It blocks the receptor. And when you block that receptor, it makes the body think that it doesn’t have enough endorphins. You have to do it at a low dose and you can’t do it all day long. It’s, it’s a brief period during sleep and uh, or, or during the nighttime, I shouldn’t say drink, sleep because it doesn’t matter if it’s day or night.

Speaker 1: 15:14 I mean if you are on shift work, you still take it at night, whether that’s your morning or your nighttime. And uh, so when they, when they took the medication and they noticed that endorphin levels rose like three to 400 percent and, and basically overnight, very quickly, uh, endorphin levels rose, uh, and it is because you’re blocking those endorphin receptors, makes the brain think that it doesn’t have enough and it’ll actually upregulate the receptors and it will upregulate the production of the endorphins. And when you do that, we noticed an increase in these endorphin levels. And what they, what they found is that there is a lot of suggestion that a lot of diseases are actually an endorphin deficiency condition. And when you raise the endorphin levels, it helps balance the immune system. And so it can enhance the immune function. And what they found is the story of this is just absolutely fascinating.

Speaker 1: 16:12 And he found that, and I’m sorry, the endorphin levels go up by two to 300 percent, not three to 400. Um, but you know, it’s still significant elevation. I just want to make sure I get my numbers right. So he noted that when he gave HIV patients low dose Naltrexone, they never got worse. Now many in the eighties, there were a lot of physicians that we’re using this in New York and San Francisco where the largest numbers of HIV patients were and they started evaluating low dose naltrexone because most patients I would argue, haven’t ever heard of this. Many doctors haven’t necessarily heard of the application of low dose naltrexone. And why, if it’s been around since the eighties, you know, why not? Well, when they first started looking at this, they were evaluating. It depends on what question you ask. That’s critical. When you look at research and you’re looking at these randomized placebo controlled double blinded studies across the board, not just low dose Naltrexone, any of them.

Speaker 1: 17:08 If you ask a crap question question, you get a crap answer. So the, what they were looking for is, does the CD four count, which is, that’s one of the main markers that we’re looking at with HIV and aids. Uh, does cd four count rise in response to low dose naltrexone. And the problem is they’re looking for a rise. See, the low dose naltrexone does not cause a rise in the CD four count. What it does is it stops the progression of the, of the virus. It stops the, the, the decline in the CD four count. So if you like Magic Johnson for example, you know, he, when he was, he was diagnosed and I don’t, I don’t know his case well, but he was diagnosed, he was put on medications, you know, very early and it kind of stopped the progression. And many patients when you start them early on therapy, they, they never really get sick with low dose naltrexone.

Speaker 1: 18:02 If you get someone that’s newly diagnosed and put them on low dose Naltrexone, their immune system stays intact. And that’s, that’s according to Dr [inaudible] work, uh, not, not mine. And I can’t say that that is scientifically validated with randomized placebo controlled double blind studies. I don’t know that, but this is what he observed. So these patients, uh, did, did much better, uh, and they had a dramatic reduction in their death rate, like they died at a one slash third of the death rate as those not treated on it. So they didn’t know that that’s a substantial improvement. Um, so a lot of benefit with low dose naltrexone and they found that since it helps the immune system in HIV and aids, they have also noted that it can be beneficial for autoimmune disorders and it helps balance that immune system. So we’re talking about something that is potentially very beneficial and I’ve seen significant benefit in some patients, not all of them.

Speaker 1: 19:05 So not every patient that comes to my clinic with rheumatoid arthritis or Lupus or Crohn’s disease, ulcerative colitis, those kinds of things are going to benefit at all. But I have seen some patients benefit dramatically. I’ve got one with a, um, uh, it’s a, uh, it’s a small vessel vasculitis. And we, uh, we put her on low dose Naltrexone, changed her diet and all those kinds of things and I mean dramatic, dramatic improvement and just in a fairly short period of time, we’re talking about someone that had these vasculitis flares that were almost constant and we got it down to where she would have a flare that lasted a few days and once a month, you know, a huge, huge benefit and a, so it’s this, this study that they were looking at, they were looking for a rise in the CD, four count. They didn’t see a rise to this, it didn’t work well, this is a degenerative condition.

Speaker 1: 20:03 HIV AIDS is a degenerative condition and when you get someone very early in the disease, especially even late in the disease and you stop them from getting worse, that’s fantastic. You know, and so you don’t see them. The eight, uh, the CD four counts rise, but you don’t see them decline and it’s stable like that. And they’ve seen it stable for 17, 18 years. Uh, based on Dr Berry’s work [inaudible] work. So I keep wanting to say his name, it’s all good. Um, so, uh, you know, that’s, that’s a lot of information, a lot of verbal diarrhea, a about a drug. So let’s, let’s take a quick break and then we’ll talk about how I apply this in my practice and some of the potential benefits that we can see and how patients should take it. And then what side effects we may look at.

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Speaker 3: 21:21 back with Dr Chad Edwards and we’re talking about in against the grain topic called low dose naltrexone. Okay. And, uh, and we got into really what low dose naltrexone can really treat and how it works and uh, a little bit of the history and the first part of this podcast. But Dr Edwards, what about this treatment is against the grain? Why is this such a, maybe an in your face topic or why is it a hot topic that all of our listeners need to know about?

Speaker 1: 21:55 Sure, and I think it because I think it’s, it’s against the grain because it’s a paradigm shift away from the way we normally think about the application of medications. Normally when you go to your doctor and you have high blood pressure or you have a thyroid disorder, you tell them that and they say, okay, we’re going to give you this medication that causes this effect in the body. So it’s looking specifically at the targeted outcome with low dose naltrexone. You’re not looking at how this medication affects the illness or the disease. You’re looking at how your body responds to the medication. So the effect, and this is actually very similar to prolotherapy in in concept because we’re not looking at, you know, with prolotherapy, we don’t give the injection and that glues the tendon and ligament back together. We’re giving an injection that causes the body to do something on its own. It’s the same thing with low dose naltrexone. You’re giving a medication that causes the body to change the way it responds. It’s the response to the medication, that’s the body’s response to the medication that causes the effect. It’s not the medication’s effect. Does that make sense?

Speaker 3: 23:09 Yeah, absolutely. So you’re just encouraging a natural, a natural response.

Speaker 1: 23:15 Exactly. And, but we’ve, we’ve done that by altering the dose of the medication. We give them medication, the body elicits a response and that response is what affects the outcome. So again, we just don’t think of it that way in, in medicine, it’s almost a homeopathic kind of approach. It’s the, it’s the body’s response to the medication. So that’s why I would say this is against the grain plus a, it’s the medication itself is Fda approved and we’ve talked about this FDA approval thing before Fda approval looks at you give a medication at a certain dose and you, you test, you know, drug one at five milligrams given once a day causes this effect and it results in these side effects, you know, these are acceptable or not. The FDA evaluates all of that stuff and then they, they make a determination that yes, this is safe at these doses and these kinds of things.

Speaker 1: 24:05 You know, we look at Testa Pell, the testosterone pellet that’s FDA approved, commercially available, testosterone approved or uh, um, FDA approved. It is FDA approved up to six pellets, 450 milligrams. So technically if you’re using seven pellets or going above 450 milligrams, that’s no longer FDA approved and you’re using off label in medicine. We do off label therapy all the time. This is an off label therapy. It has not been evaluated by the FDA, um, for, you know, the doses that we’re looking at. So the medication is approved in this application. It is not, and it’s not FDA approved because it’s not within the, uh, the, um, designed amount of doses. Yes, correct. Yeah, it is much, much less. That’s less than 10 percent. That’s right. Okay. So you’re taking less than 10 percent of this medication and therefore it is not fda approved. That’s correct. I just want to outline that.

Speaker 1: 25:03 It’s Kinda like saying your car is approved to go 100 miles an hour and or, or like the speed limit. So you can go 75 miles an hour on the turnpike, but you have to go above 40 miles an hour. Right? Exactly. So that’s your range that’s approved. If you go 20 miles an hour, that’s not approved. It’s not approved. But that doesn’t mean the car can’t go that fast. Exactly. And I mean, even though you could argue it’s dangerous to go 20 miles an hour on the turnpike, you know, it’s, it’s. I think the concept is, I think the point’s made. I understand a lot better now. Awesome. I’m here to make sure that you understand because if you understand the listeners are good. Well, every, every I, if I can understand it, I’m probably the bottom of the barrel here in terms of, you know, the medical intelligence and so I feel good now.

Speaker 1: 25:52 Um, but you were going to mention a little bit more about the, the application and how to use the treatment a little bit more. How does that work, how does that process work? So when we have a patient that comes in, it’s like, you know, a common would be like rheumatoid arthritis. So you get a patient with rheumatoid arthritis and they have an auto immune condition. Their immune system has gone haywire. It’s recognizing something in itself as abnormal. It starts developing a response, typically antibodies on some level and it targets the immune system to attack itself. Uh, so, uh, it’s, you know, in the military we’d call it a, a, you know, a blue on green and green on blue and you know, these different colors that, you know, you’re attacking yourself sort of. Um, so, um, the, the immune system has gone haywire, low dose naltrexone helps to reset and reestablish normal immune function.

Speaker 1: 26:53 It helps optimize, it’s not an immunosuppressant, it helps to optimize how your immune system works. And again, we’ve seen good benefit with a lot of these autoimmune disorders. So a patient with rheumatoid arthritis comes in or a, you know, Lupus or any of these other conditions and will prescribe this low dose naltrexone and we will see a rise in their endorphin level. I don’t typically measure the endorphin levels, but for these endorphin related conditions which there we, we think that there are many not been well validated and well proven. Uh, but this is where the effect comes in. So you rise, you raise the endorphin levels and the patients feel significantly better and we can measure the success by seeing a reduction in their inflammatory markers, their antibodies and those kinds of things. And their rheumatoid arthritis feels better. And you know, those kinds of things.

Speaker 1: 27:47 Again, in some patients not been proven across the board. And I’m not making claims that we can create clay, that we can cure rheumatoid arthritis. And those kinds of things, some patients see benefit and it’s that simple. Uh, so we would prescribe the medication for one dose at bedtime and I typically would prescribe it based on the patient, based on the condition a one point five, three or four point five milligrams. And sometimes we’ll start low, especially with like with thyroiditis. Hashimoto’s would be a good example. So they’ve got an autoimmune disorder against their thyroid and we’ll give them low dose naltrexone. And if, if this is going to be effective for them, we’ll see an enhancement in their thyroid function. So if you’ve got thyroid disorder where your thyroid’s not functioning well, you give you thyroid medication, now we ramp up your thyroid function and you’re still on medication, then you can go hyperthyroid.

Speaker 1: 28:38 So we’ll often have to decrease the dose of their thyroid medication. And in some cases you could potentially come off of the thyroid medication altogether. But the low dose Naltrexone, you don’t want to start at the high dose because in theory that’s going to enhance the thyroid function the most. So we may start at one point five or even three milligrams and that if they’re doing okay with that and we follow their numbers, uh, their, their thyroid levels, and then we could go up to four point five gradually based on how, how they’re doing and that’s how we’ll use it one dose at night before they go, before they go to bed. For those that go to bed at normal times, if you’re a shift worker, you’d still take it between 9:00 PM and 3:00 AM is when it’s been noted to be most effective. And so how long would you prescribe somebody to be taking this before you maybe measure and see results?

Speaker 1: 29:28 Well, I would. They’re going to get benefit with their endorphins in 24 hours. And that’s what Dr Buhari has noted in his, uh, in his work. So the endorphin piece can be very quick. I’ve seen some patients that noticed benefit very quickly. Normally I would give it two to three months to, to get to the highest dose that we can. Um, and uh, and continue that for, for two to three months, see how they’re doing. We’re not getting any benefit at that point, you know, I discontinued the medication. I don’t want somebody to spend their money on something and to take something that’s not a benefit to them.

Speaker 3: 30:04 Okay. So low dose Naltrexone, uh, in a nutshell, correct me if I’m wrong, I want to make sure that I understand this correctly. Um, but you give a, typically a, you give a medication that is typically given at a 50 milligram dosage and you give it at a one point five, three, a four point five milligrams per dose at nighttime, ramps up endorphin levels, which ultimately helps the immune system. So you, in all these different autoimmune diseases you’re going to see a not going to see, but a has been shown to show improvement. It’s been observed, observed in some patients. I want to make sure that the non doctor here doesn’t get himself in trouble. Um, but, but, uh, but by no means am I a doctor, have I studied and I’m going to say things wrong most of the time, but, uh, Dr Edwards here, providing some more information about low dose Naltrexone, if they want to learn more about this, maybe you’ve piqued their interest about this, uh, this treatment, where can they learn more about it? Yeah.

Speaker 1: 31:12 First thing you can go to revolution There’s also a fantastic website. Low Dose is a great website. There’s a whole host of their. They’ve got research studies out there. They’ll talk about the current research where it is, and there’s, there’s a lot of, um, a lot of information out there. And by the way, a low dose naltrexone has virtually no side effects. They do a, you can during the first week of use. Some patients can have a little bit of difficulty sleeping and if we see that, we’ll just cut the dose back. Uh, you know, if we started a four point five, we’ll go back to three milligrams or something like that. But usually after the first week that even that goes away. I’ve had a couple of patients that have had a little bit of mild nausea, but I, that’s, that’s extremely rare.

Speaker 3: 31:54 What else am I missing about low dose naltrexone

Speaker 1: 31:58 that anybody with an autoimmune disorder should at least try it? Uh, you know, there’s, there’s questions. Some people will say it doesn’t work, and my concept across the board is if it works for a patient, fantastic. If it doesn’t work, okay, we tried it as long as we’re not causing harm. First Dictum of medicine first, do no harm. If we’re not causing harm and this is using 10 percent of a medication that’s FDA approved, uh, if we’re not causing harm, give it a try. It may be a significant benefit to you, even if it’s anecdotal, even if it’s even if it’s just, you think it helps, I think it’s worth a try. I don’t think it’s deceptive to be honest about it and say some patients

Speaker 3: 32:40 benefit from this and patients don’t. It may be worth a try. Dr Chad Edwards getting real and raw with us on low dose naltrexone. Thank you so much for joining us today. It’s as always, it’s a pleasure to be enhanced with your knowledge and your beauty. Look, thanks Marshall and you as well. Until the next time, we’ll talk to you guys later. See you. Thanks for listening to this week’s podcast with Dr Chad and tune in next week where we’ll be going against the grain.