Low Dose Naltrexone & Thyroid Disease

Hi everyone. This is Dr. Kelly. Welcome back to Dr. Talks. Today we have an expert guest. Her name is Dr. Suzanne Turner, and she’s going to talk to us today about LDN and her practice and how it fits in with hypothyroidism in thyroid patients. Welcome, Dr. Suzanne.

Suzanne Turner, MD, FAARM, ABAARM

Thank you, Kelly. So nice to be on with you.

Dr. Kelly Halderman

Great. Thanks so much for your time today. Well, let’s begin by telling the audience a little bit about yourself and your practice and like why? How did you get into medicine and you’ve gone beyond medicine. Really, your practice is so much more than that and the levels that you’ve taken it to. But just tell us about yourself.

Suzanne Turner, MD, FAARM, ABAARM

Sure. So we have a practice in Alpharetta, Georgia, which is just a suburb of Atlanta. There’s a large population of people there. This is where the Falcons have their training camp. It’s where a lot of technology is. So there’s a lot of people in that area that are interested in things like biohacking and taking care of their health. So we have a great population of patients to to work with. Our practice is primarily 40 to 60 kind of year old patients who are active and who have passion about things in their lives, their children, their families, their careers, whatever the things are that are driving them. Some of them have created businesses from things that we’ve done with them. So I have a client who used one of the peptides and created a whole skin care line based on his that. Yeah. So super exciting to work with them and to have them as clients. 

So that’s been really fun to work with them. I’ve been in practice for about 20 years and about halfway through I realized I didn’t have enough tools in my toolbox and I needed to do some more things to figure out how to take care of patients. Because there were, as we were just mandating things for a long time. And then someone introduced me to bioidentical hormones and my kind pharmacist, compounding pharmacist locally said, Hey, it doesn’t look like you know what you’re doing. Can I send you to a conference? And so I, I sent they sent me to a conference and then I would just the world was opened up for all the things that are also available to us as providers for care. So I went on and did a bunch of training and worked with a forum and worked with American College of Advancements in Medicine and have learned and learned and learned and learned. And every day I learned more and more from every person, even from getting your book. Kelly It’s been really great to learn more from you even.

Dr. Kelly Halderman

Thank you. Thank you so much. Yeah, you’re really eclectic in your background and yet you’re so cutting edge. You’re so, so cutting edge. And we’re on a group chat together with a bunch of doctors. And Dr. Suzanne is always putting like the latest and greatest out there. And again, you teach for a forum. You are a biohacker yourself. You just want to tell the audience about what you just want, what competition is amazing.

Suzanne Turner, MD, FAARM, ABAARM

It’s so fun. So I just competed in my first powerlifting competition. It was really great. And now I’m the record holder for my age and weight for bench press and deadlift.

Dr. Kelly Halderman

Wow. So she walks the walk, everybody. She’s not only talking as she’s walking it and that’s terrific. And I do want a quick circle back because people are going to ask, what is the company that the peptide for the topical? Can you just mention that real quick?

Suzanne Turner, MD, FAARM, ABAARM

Sure. Vitali. VITALI.

Dr. Kelly Halderman

Okay. And I believe that’s a GSK carpet, is it? And that’s a best right? I mean, that’s the best kept secret. So I hope it’s not a secret anymore. You guys, the that peptide really, really changes it’s a game changer for skin and in Dr. Suzanne I’m sure you prescribe that as well subcu but the topic today, you know, to kind of come back at it is is thyroid health because we could talk about peptides and I’d love to talk about that. Maybe we can have you back and talk about peptides and thyroid health, but today we’re going to focus on LDN, low dose naltrexone, something that I only discovered probably about five years ago. But I myself have Hashimoto’s from Lyme and mold infections and it really it really helped move the needle for me. I was a little bit hesitant because I just didn’t know any information on the doctors that I were working with to help for my health really weren’t, you know, up to snuff on the research. But the research is rich, it’s robust. And I think that it’s exciting for having you to come on to introduce us to that. So let’s start by when you have a thyroid patient come into your office, what are your first steps? And then we’ll kind of move into your LDN placement for that.

Suzanne Turner, MD, FAARM, ABAARM

Right? So the this patient that’s going to come in with thyroid symptoms, often they’re going to report fatigue or weight gain that they’re unable to get rid of. They’re going to tell me that they are having difficulty with even things like gaining muscle. Thyroid hormone is involved in muscle mass gain. They may have high cholesterol. So a thyroid is would be the first thing I would look at if their cholesterol was high. There are things that we can there are lots of reasons why patients would come in that would trigger me to think of thyroid. There are periods being irregular, especially if they were in premenopausal and there’s those would probably be the things that we would see first. Not everyone comes in very symptomatic or even aware that their symptoms might be related to their thyroid hormone. But most of my patients are pretty smart and they come in the door knowing, Hey, I’m tired, I want you to check my thyroid, my hair’s falling out. I want you to check my thyroid, my skin is dry. I want you to check my thyroid. 

So that’s been really good to be able to partner with really smart patients. So that’s what we’ll start with. And then if we discover we do a fairly thorough panel of thyroid hormones and that will include four or five or six different lab tests, it’s not just looking at a TSA page like a regular doctor might. Do you we need to look at the whole panel of what they’re doing, including antibodies. If they’re producing antibodies, a reverse T3, which is sort of anti thyroid hormone. So we’re looking at a whole panel. We’re also looking at some of their sex hormone binding globulin to see how that is affecting whether their albumin is adequate. All of these are proteins that are involved in how thyroid hormone works, and we want to make sure that all of that is functioning optimally. We’re going to take a fairly thorough history because most of the time thyroid disease is not the primary disease. Your thyroid is very sensitive and the way that your body makes thyroid hormone is very sensitive to other illness that’s happening. 

So your fatigue may not be primarily related to your thyroid hormone, it may be related to the other illness and the expression of thyroid hormone. And the pattern of expression of thyroid hormone is in response to is your body’s way of protecting you in the face of the things that the body is dealing with. So a lack of energy, a lack of nutrients that the cells need to function may be causing a change in the way that your thyroid gland, your liver and kidneys are able to produce thyroid hormone appropriately for function. Right. So we’ll see them have that and then we’ll ask them about their history. Things like viral illnesses, things like have they? I have a patient who’s in her twenties sorry, who’s in her 50th who when she was in her twenties, had a three month history of a terrible mono case of mono. She’s extremely fatigued. And we know now from research that’s coming out very recently that things like M.S., rheumatoid arthritis and atrial fibrillation are all directly correlated with the presence of Epstein-Barr virus. 

So very interesting. And those are things that we’re going to see with a correlation with their thyroid hormone. So so we want to find out what was their original illness, what may have happened to trigger them. And then we do a bunch of other labs that are going to help us know what might be causing the thyroid hormone deficiency that we see. And so it’s not always about just replacing thyroid hormone. Sometimes it’s about nutritional deficiency, like a selenium or iodine or zinc or sometimes it’s about a protein deficiency. I can say a good majority of my patients over 40 aren’t taking in enough protein to be able to make adequate amounts of thyroid hormone. So all of that comes together and we take a very thorough history. And then based on what we find out, we direct our treatment towards those things. At some point we may use thyroid hormone to help act as a bandaid. In the meantime, while we’re working on the underlying problem. But the underlying problem is really where we need to focus.

Dr. Kelly Halderman

That’s great. And that was highlighted in the book that you mentioned that Dr. Eric Markovich and I wrote. It’s really about finding those root causes and that’s the care that if you’re listening and watching this, that’s the cure that you deserve. You know, that your thyroid is not just broken, your body is not just broken. There are root causes that skilled practitioners like Dr. Turner will help you uncover because a life of being on a synthetic replacement and never addressing the cause and just going on and on and having more destruction, be in place, have more other outside the thyroid gland problems such as high cholesterol. They they just need to be rectified. It just needs to be stopped in its tracks, slowed down, identified. And so it brings a lot of hope, Suzanne, when you talk about the way that you practice, it brings hope to I mean, thousands of people who continue to suffer and don’t see a way out. They just they see the medical model that you and I were both trained in. We know it’s antiquated and we know that there’s more that we can do. So that being said, tell us about LDA and low dose naltrexone in a patient that has thyroid disease and when it’s appropriate and when it may not be or or any sort of information where you can direct someone who possibly can’t come and see you, let’s kind of go through all of that information or so.

Suzanne Turner, MD, FAARM, ABAARM

So lda refers to low dose naltrexone. Naltrexone we probably know from addicts. We use naltrexone to help with people to come off of narcotics. And if that’s in a much higher dose, it’s commercially available in 100 or 200 milligrams for treating people who are narcotic addicted, getting them an alcohol. There’s a whole that’s a whole other story for another day. But so if you’re doing research on Naltrexone, you may find some articles or some information about using it to treat addiction. Don’t let that scare you. That’s a very different way to use Naltrexone than what we’re talking about here. The research on specifically low dose naltrexone and what we’re talking about is 0.25, up to about six milligrams, maybe as high as ten. They’re sort of, you know, debating whether that’s appropriate or not. But the kind of sweet spot lives around three, four milligrams, one, two, three, four milligrams where we see that the binding to receptors really works on decreasing inflammation and specifically working on those antibodies. 

So if we do your thyroid panel and we see that you are producing antibodies, this is fairly significant thyroid disease. And so we know that you are the antibodies that are being created are against both the way that the thyroid holds on to and creates thyroid hormone, but also the way it converts thyroid hormone from T4 to T3, which is a whole process. But these antibodies are created just like you might have antibodies created after you get a vaccine. These are created, but instead against your own body’s proteins and specifically those that are created for making thyroid hormone. So you can imagine if there’s a problem with making thyroid hormone, if there’s antibodies against making thyroid hormone, we’re now talking about destruction of the whole mechanism of creating thyroid hormone, which is critical. And so when I begin to see those antibodies created, one of the things I worry about is the creation of antibodies for other things and other autoimmune diseases, not just Hashimoto, which is enough of itself, but then I get concerned about that.

So that’s when we’ll start to think about using something like low dose naltrexone. This the way that this chemical works is by blocking the entry of inflammatory signals into the nucleus to cause things to happen. So this is sort of it is it decreases inflammation in the cells so that they’re still able to function optimally and producing thyroid hormone. So that’s kind of great because one of the things that happens is this whole inflammatory process in the thyroid. Glenn We aren’t able to produce hormones like we want to, and if we can decrease that inflammation, we decrease the whole process. We allow the cells to do what they need to do on their own. So rather than replacing or mandating what we’re doing is helping decrease inflammation. Now, we also need to work on whatever the cause of the inflammation was to begin with. But this can be a really good way to help to have patients able to function again and restore their own production of their own thyroid hormone.

Dr. Kelly Halderman

Great. And is there a population that is even more appropriate? I just did a long haul COVID summit and some of that activation in long haul or Lyme or mole can you talk to us about that?

Suzanne Turner, MD, FAARM, ABAARM

Absolutely. So the way that this works is it blocks the entry of inflammatory chemicals into the nucleus. So now we’re decreasing that inflammatory response, both in long COVID. If you’re talking about patients who have this, there’s lots of great research that’s, of course, just come out in the last five years about using LDN to help decrease that. Look at those long COVID symptoms because they are so inflammatory and so decreasing that inflammatory trigger and this original trigger, it’s called Nuclear Factor Kappa B will increase the all a lot of other inflammatory chemicals that the body will produce. So if we can stop the original trigger, we then can stop the entire inflammatory process and keep your cells and your immune system from being overly responsive. It could decrease that stimulus for the immune cells. So you’re not having this persistent immune response. You should have an immune response. When you have something like COVID that should kick in and then it should go away as soon as the COVID is gone or the other illness is gone, when we don’t when we have this persisting influent, inflammatory response, that’s what we’re trying to stop or trying to reverse so that the immune system responds appropriately rather than in a persisting manner.

Dr. Kelly Halderman

Okay. And that sounds a lot like Sears chronic inflammatory response.

Suzanne Turner, MD, FAARM, ABAARM

Yes. Yes, absolutely.

Dr. Kelly Halderman

I did the presentation on the link between long COVID in the Sears and it’s like, are we talking about the same thing? So it’s interesting reading. Yeah, that a lot of it is a chronic inflammatory response. And so I see LDN whether or not let’s go back to thyroid, you know, let’s assume you don’t have the long haul, but it’s that chronic inflammatory response. Now if you look up the work of Andy Hayman, Richard Shoemaker, they’re going to be calling Sears a specific thing. When I was interviewing Dr. Eric Gordon, he’s like, no, it’s more of like a lot of things are chronic inflammatory response, right? And I tend to agree with that. Like we have that subset. It’s a subset definitely with water damage buildings in my seats. But you could be looking at that chronic inflammatory response with the thyroid patient. And definitely it’s something that we want to cool off. And so my first thought as someone may think, is this just another Band-Aid? But I think you nailed it when you were saying, like, we’re trying to shut we’re working on all the other things. We’re not just handling it as prescription and walking away. Right, right. We’re working on all the other things. And so this can was just something again for me personally, my phenotype. It moved the needle for me and I can see what this with the biochemistry of what is going on in the body. I guess another question would be are there any side effects?

Suzanne Turner, MD, FAARM, ABAARM

So some people will have nightmares. That’s probably the first thing I hear people have, and usually that’s because the dose is too high. So what’s interesting about using Naltrexone and this is one of the reasons why we get it compounded is because it doesn’t come in a dose as low as we need to use to do what we want it to do. So you have to get this from a compounding pharmacy. The only available doses at your regular pharmacy are 102 hundred milligrams, so we need to get it compounded. So we usually start at very low doses like a .0.25 or point five or a one milligram. And we’ll say, let’s slowly titrate this up. If you get to the point where you have nightmares, that’s too much. We back down on your dose. If you don’t tolerate it and it gives you nightmares regardless of the dose, then we will give it to you. Earlier in the day so that it’s not causing you that problem. And these people say nightmares that my ex my delving into that a little bit more it’s not usually scary nightmares. They’re more like vivid dreams.

Dr. Kelly Halderman

Yes. Right.

Suzanne Turner, MD, FAARM, ABAARM

Where they can see things. They could hear things. It’s a very intense situations around them. And so they are people are excited about it. Come to me excited about, oh my gosh, I have this very vivid dream and it seems to keep them from sleeping more soundly.

Dr. Kelly Halderman

That’s right.

Suzanne Turner, MD, FAARM, ABAARM

One of the things I also talk to them about is maybe this is because you’re actually getting REM sleep for the first time in months and it may be a matter of persisting through it. It depends on how severe and how uncomfortable they are. But if they’re vivid dreams and not nightmares, it may be that you’re actually getting some REM sleep for the first time. And maybe what we need to do is persist with it so that your body gets its sale of REM sleep. Again, that’s a whole talk for another day about how that will affect your thyroid hormone.

Dr. Kelly Halderman

Right. That is very important. Everybody just prioritize your sleep. Right. We’ve done a couple of podcasts on sleep, but interesting. I definitely had those vivid dreams tapering up was something that actually the doctor who prescribed it for me did it taper me up, just put me on three milligrams and so I had to move it to the morning. So you don’t see any downside of people if they’re prescribed this, taking it in the morning.

Suzanne Turner, MD, FAARM, ABAARM

I haven’t seen anyone have a problem. If they take it in the morning, theoretically it would make you sleepy in some people it would make you sleepy. But I think your pre selecting those patients by the ones who tolerated it at night, it makes them sleepy. The ones who get that, that more excitable responds to it. They tolerate it better in the morning.

Dr. Kelly Halderman

That’s okay. And then recently I read a paper that suggested that LDN be given five days a week, a week with a two day break because so we can reset the receptors. Are you a fan of this?

Suzanne Turner, MD, FAARM, ABAARM

I think that’s a great idea. It’s not how I practice. I’d love to see that article. That’s a great that’s a great piece of information. I think it makes sense why you would want to do that, because you don’t want to shut off production of nuclear or nuclear Kappa B all the time. I think anything we don’t really want to turn off all the time, I think that’s a great way to think about it.

Dr. Kelly Halderman

Yeah, I’ll send that over. It’s absolutely new, brand new information to me. But I was like, Wow, that actually does make a lot of sense to give those receptors some time to reset and then go back on and and certainly work with your practitioner or whatever they tell you is probably appropriate for you. But really physiologically, people do respond differently. And I’ve seen people where they’re trying to taper up and they get restless legs. I mean, and there are some different symptoms where it’s like, okay, you’ve met your you’ve met your, your dosing. And so I also want to ask you, I know this is not we’re not our topic isn’t cancer, but I’ve heard a lot of doctors on podcasts and things saying I don’t have I don’t have Hashimoto’s, I don’t have thyroid disease or I don’t have X, Y and Z, but I’m taking it for cancer prophylaxis. Can you comment on that?

Suzanne Turner, MD, FAARM, ABAARM

I would say it’s for the same exact reason because a cell under stress is going to respond in a way that is more cancer like than a cell that’s not under stress. So if we can decrease the inflammatory response, you know, cancer isn’t caused by estrogen cancers caused by inflammation, cancer isn’t caused by this cancer. The whole talk for another day. But it’s not caused by testosterone or whatever. It’s caused by the inflammatory response and the cell under stress. So if we can make that cell less under stress, if the immune system can see what’s happening, then we know that we can get the immune surveillance going. That immune system will clean up whatever looks like it might try to be cancer and then we can clear it out. That naltrexone makes sense because it is helping with decreasing the stress on the cell from inflammation. That’s happening around it.

Dr. Kelly Halderman

Okay, great. And sometimes when people hear that they have to get medications compounded, they think expensive, pricey, not covered, etc., etc.. Can you just give us an idea of cost per month? And I know it varies, so I do want to put you on the spot, but it’s sometimes like an idea because we talk about or we listen to podcasts or we hear seminars and they talk about therapies and then it’s just way out of the price range. So it’s a little bit about cost.

Suzanne Turner, MD, FAARM, ABAARM

And then it’s one of the reasons I really like LDN because it’s probably going to run about what your insurance co-pay would be for another medication. You’re probably going to pay between 30 and $50 a month, which is probably what you’re paying for most insurance for a branded drug anyway. So very affordable and the compounders are so nice and helpful and available at least in my study. I love my compounder. Just a shout out to Josh Morgan at Northland Compounding. We love, love, love our compounder and they provide so much great information. They’re really, really valuable.

Dr. Kelly Halderman

Yes, I totally agree. Compounding pharmacies are a wealth of knowledge and definitely I love that yours sends you to a class that was that. It was great. You know, like when we’re out of our wheelhouse, they’re like, I think you should do this. Great. So I think we’ve covered a lot of really great aspects of LDN. My last question for you is and then you can follow up with anything that we missed. So if we’re on LDN and we have a procedure that’s scheduled, we’re, we’re, we’re going to need pain meds. Is that something that we should I’ve actually had this happen where if someone was on LDN, they had a I think they had nasal reconstruction and then they never got taken off of the LDN and then the pain meds didn’t work.

Suzanne Turner, MD, FAARM, ABAARM

Right. So one of the ways it works is as an antagonist at that receptor. So it’s going to block the access of regular narcotics. The doses we give are probably small enough that it may not affect. And if this is really very beneficial for you, where you are very aware of the benefit when you stop taking it, then I would encourage you to maybe cut your dose in half and persist with taking it. But I think that’s not usually the case. What we see is people are able to keep that inflammatory inflammation down for several days after not taking it and will go ahead and have them stop around the time when they’re requiring pain meds for surgery.

Dr. Kelly Halderman

Got it. Okay, great. Because that LDN was actually even on their med list and their surgeon didn’t have any idea that the two would, you know, that would one would block each other. So just if you’re going in for something and you’re on LDN and you happen to be on it, just just to have that in mind, like listen to what Dr. Turner said.

Suzanne Turner, MD, FAARM, ABAARM

And keep in mind that you may not notice some people don’t notice a big benefit because this is a slow onset. So I don’t even repeat antibody levels for 3 to 6 months, probably before I. So this is something that’s going to be slow. What people usually will notice is that they will stop. If they say, I don’t notice anything, I’m going to stop this and then two or three weeks later, they call me up and go, Hey, can you refill that? Oh yeah, definitely notice a difference because it’s such a slow onset, gradual improvement. It’s hard to notice it unless it’s stopped. And then you. Oh, wow. I definitely notice a difference.

Dr. Kelly Halderman

Right? Definitely. That’s a great piece of information for people because I have heard that over and over. That’s not doing anything. And then they stop and then, of course, like, okay, I want to go back on that. Oh, yeah, great. Super great. So is there anything else that we missed regarding just kind of a LDN 101.

Suzanne Turner, MD, FAARM, ABAARM

Right. This is a yeah. Again, the probably the most important thing is this is one of the things we use in the whole treatment process to get patients on the road to recovery. Sometimes just decreasing that immune response really makes a great benefit for the patients in general. So this would be prescribed by a physician and it would be something that you’d get from a compounding. Those are probably the biggest things to remember. And yeah, I think we covered it. You did a great job, Kelly. Thank you.

Dr. Kelly Halderman

You did too Dr. Turner. I was like, yes, this is a perfect topic. People are starting to get really aware of this. And I want really good information. And so it was just a blessing to have you on as the expert in this area. So before we go, let’s wrap up by telling people where they can find you and your practice and are you on social media or do you have a website and all that?

Suzanne Turner, MD, FAARM, ABAARM

I’m outside Atlanta, Georgia, and so if you go to VineMedical.com Vine is in Grapevine vineMedical.com. That’s where we are on Instagram. I’m DRSTurner. Dr. Turner and on LinkedIn I’m DrSCellular Medicine. I have a YouTube channel, which is Dr.. S Cellular Medicine and I think that’s it.

Dr. Kelly Halderman

Cool, very cool. Well, I’ll be checking that. I did not know you had a YouTube, so I know what I’ll be doing with my Saturday. And I was just we began this by I was kind of complaining about how there’s been no sun and now we’re getting more snow here in Minnesota. So nothing like a good YouTube channel to put me up for today. But it was a pleasure. Suzanne, I’m so happy that you could come on and you were so generous with your time and just thank you for sharing your knowledge about this topic.

Suzanne Turner, MD, FAARM, ABAARM

Always great to see you, Kelly. Thank you so much for inviting me. 

Dr. Kelly Halderman

Thanks.Take care. Thank you for joining me. Dr. Kelly Halderman on the Thyroid series for the DrTalks podcast. I hope you found this episode informative and engaging, and if you did make sure to subscribe to our podcast so you don’t miss out on future launches. Don’t forget to follow DrTalks on social media platforms, including TikTok, LinkedIn, Twitter and Instagram to stay informed about our latest updates and events. For more information on thyroid conditions and other health topics, visit our blog at DrTalks.com/Blog where you’ll find a wealth of in-depth articles and resources to help you manage your health effectively. If you want to learn more about the latest medical breakthroughs or how to prevent, treat and reverse chronic conditions, sign up for one of our free summit at doctor talks dot com backslash calendar. You’ll find that DrTalks Summit features some of the leading health experts in the world, and they’re a great way to stay up to date on the latest research and protocols. Thanks again for tuning in. We look forward to bringing you more valuable insights in our next episode. We’ll see you next time on the DrTalks podcast.