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I frequently prescribe Low Dose Naltrexone (1.5 – 4.5mg) or even Ultra Low Dose Naltrexone (0.5mg or less) as part of my treatment of the terrain, not just for autoimmune disorders but sometimes for ADD and chronic fatigue (to name a couple). I consider using LDN if the BetaMSH/AlphaMSH index is high and/or the pineal adaptability index is also high and the clinical picture supports needing more beta endorphins to regulate the pace of adaptation and to better “tolerate yourself” in the setting autoimmunity but also in a psychological sense. One note of caution, LDN can lower serum TSH, so if the TSH is already really low, often I will postpone the use LDN until it is addressed. But if Beta/Alpha MSH is high and one goal is to lower serum TSH, LDN can be a great option. In my experience, LDN is NOT as effective at lowering beta/alpha MSH as Viscum album and Eschscholzia californica (+/- Crocus sativus) are.
It is possible to have an elevated Hemoglobin A1c but have a low insulin resistance index if the serum TSH is low. If the patient does have type II diabetes, I still prescribe Metformin, regardless of the oxidation indexes. Simultaneously, I use other treatments to address the terrain of the particular patient, and in many cases I have had success in getting people off of Metformin.
Rosa canina and Grapefruit are well suited for for children. Also Fir (Abies balsamea). For improving Beta production, you could consider SAMe.
Hello Dr Noomen,
In the United States, the “standard” medical approach for treating moderate to severe plaque psoriasis often includes expensive and powerful immunne-modulating medications like TNF-alpha agents, or inhibitors of the IL-17 or IL-23 pathways. But even using these powerful drugs that have significant risk for side effects, the hope is that people will have a 50% reduction in their psoriasis by week 16-20 of treatment. Often if there is not improvement by week 12, patients are switched to a different powerful drug. So when using a more nuanced approach using plants, I try to prepare my patients by telling them that it is going to take several weeks, and it may involve adjusting the remedy along the way to avoid “treatment fatigue.”Back in the 1970s when Inonotus obliquus (chaga) was studied in Russia for the treatment of psoriasis, there was a 76% cure rate and an attentional 16% who had improvements in symptoms after 12 weeks of treatment. This was a small study with limitations, but in my mind, Inontus obliquus has the ability to play a safer and more intelligent role in immune modulation than medications that suppress the immune response.
The approach to drain the emmunctory organs that are involved while simultaneously addressing the primary neuroendocrine imbalance AND immune dysregulation is a sophisticated approach to healing, even if it takes a long time. In the sample prescription I mentioned, the first blend is primarily for neuroendocrine regulation. The Vitex agnus castus is for reducing estrogen excess (and reducing alpha). If your treatment doesn’t include a plant to address estrogen excess, I would recommend including one. The second blend is mostly emmunctory drainage, and there are several plants that you could potentially try to accomplish this (you have included some of my favorites). Your patient may respond to one better to one plant than another. The Inontus obliquus is for immune regulation without immune suppression.
Warmly,
AdamBonjour Dr Nooman,
Aux États-Unis, l’approche médicale “standard” pour le traitement du psoriasis en plaques modéré à sévère comprend souvent des médicaments immunomodulateurs coûteux et puissants comme les agents TNF-alpha ou des inhibiteurs des voies IL-17 ou IL-23. Mais même en utilisant ces médicaments puissants qui présentent un risque important d’effets secondaires, l’espoir est que les gens auront une réduction de 50 % de leur psoriasis d’ici la 16e à la 20e semaine de traitement. Souvent, s’il n’y a pas d’amélioration à la semaine 12, les patients passent à un autre médicament puissant. Alors quand j’utilise une approche plus nuancée à base de plantes, j’essaie de préparer mes patients en leur disant que cela va prendre plusieurs semaines, et cela peut impliquer d’ajuster le remède en cours de route pour éviter la “fatigue du traitement”.Dans les années 1970, lorsque Inonotus obliquus (chaga) a été étudié en Russie pour le traitement du psoriasis, il y avait un taux de guérison de 76 % et un taux d’attention de 16 % qui présentait une amélioration des symptômes après 12 semaines de traitement. Il s’agissait d’une petite étude avec des limites, mais dans mon esprit, Inontus obliquus a la capacité de jouer un rôle plus sûr et plus intelligent dans la modulation immunitaire que les médicaments qui suppriment la réponse immunitaire.
L’approche consistant à drainer les organes émonctoires impliqués tout en s’attaquant simultanément au déséquilibre neuroendocrinien primaire ET au dérèglement immunitaire est une approche sophistiquée de la guérison, même si cela prend beaucoup de temps. Dans l’exemple de prescription que j’ai mentionné, le premier mélange est principalement destiné à la régulation neuroendocrinienne. Le Vitex agnus castus est destiné à réduire l’excès d’œstrogène (et à réduire l’alpha). Si votre traitement ne comprend pas de plante pour traiter l’excès d’œstrogène, je vous recommande d’en inclure une. Le deuxième mélange est principalement un drainage émonctoire, et il existe plusieurs plantes que vous pourriez potentiellement essayer d’accomplir (vous avez inclus certaines de mes préférées). Votre patient peut mieux répondre à une plante qu’à une autre. L’Inontus obliquus est pour la régulation immunitaire sans suppression immunitaire.
Chaleureusement,
AdamDear Dr. Noomen,
Please forgive my reply in English, will post my reply in French below using an AI translation, but AI translations are always a little weird (especially with medical language). I have had a similar case recently.There some key elements from your history and exam:
1) Vivid dreams = high central TRH; 2) Hepatic congestion = over solicited liver for the production of immune elements. Some of the key indexes from the biology of functions are 1) high general quantitive estrogens, 2) Low beta/alpha MSH, 3) low prolactinWhile not all of the indexes in the biology of functions fit perfectly in typical cases of psoriasis, I think there is enough evidence to substantiate that: 1) there is a relative hyper-functioning of estrogen which initiates the proaction of immune elements; 2) there is over solicitation of the exocrine pancreas with excess uptake of proteins, 3) over solicited liver for the production of immune elements; 4) relative hyper alpha > para with high central TRH (despite a low TRH/TSH index).
I’m not sure what forms of plants you have available to you, but this is an example of an approach I would try. It may take 10-16 weeks of consistent use to see improvements in his condition.
#1:
Vitex agnus castus MT 60mL
Ribes nigrum buds GM 60mL
Poterium sanguisorba MT 60mL
Juglans regia GM 30mL
Fabiana imbricata MT 30mL
Directions: 4mL 2-3 times daily#2:
Cedrus libani GM 40mL
Galium aparine MT 40mL
Platanus orientalis GM 40mL
Plantago major MT 40mL
Viola tricolor MT 40mL
Arctium lappa MT 40mL
Lavendula angustifolia EO 4mL
Directions: 4mL 2-3 times dailyIn addition, I would recommend taking Inonotus obliquus (Chaga mushroom) in capsule or tea form and eliminate caffeine and alcohol from the diet. I would also recommend eliminating animal proteins from the diet for 3 consecutive days in a row every week.
Hope this helps.
Warmly,
Adam Johnson, MDCher Dr Noomen,
Veuillez pardonner ma réponse en anglais, je posterai ma réponse en français ci-dessous en utilisant une traduction IA, mais les traductions IA sont toujours un peu bizarres (surtout avec le langage médical). J’ai eu un cas similaire récemment.Il y a quelques éléments clés de votre histoire et de votre examen :
1) Rêves vifs = TRH central élevé ; 2) Congestion hépatique = foie sursollicité pour la production d’éléments immunitaires. Certains des indices clés de la biologie des fonctions sont 1) des œstrogènes quantitatifs généraux élevés, 2) une faible bêta/alpha MSH, 3) une faible prolactineBien que tous les indices de la biologie des fonctions ne correspondent pas parfaitement aux cas typiques de psoriasis, je pense qu’il existe suffisamment de preuves pour étayer que : 1) il existe un hyper-fonctionnement relatif des œstrogènes qui initie la proaction des éléments immunitaires ; 2) il y a sur-sollicitation du pancréas exocrine avec captation excessive de protéines, 3) sur-sollicitation du foie pour la production d’éléments immunitaires ; 4) hyper alpha relatif > para avec TRH centrale élevée (malgré un index TRH/TSH bas).
Je ne sais pas quelles formes de plantes vous avez à votre disposition, mais c’est un exemple d’approche que j’essaierais. Cela peut prendre 10 à 16 semaines d’utilisation régulière pour voir des améliorations dans son état.
#1:
Vitex agnus castus MT 60mL
Ribes nigrum bourgeons GM 60mL
Poterium sanguisorba MT 60mL
Juglans regia GM 30mL
Fabiana imbricata MT 30mL
Mode d’emploi : 4 ml 2 à 3 fois par jour#2 :
Cedrus libani GM 40mL
Galium aparine MT 40mL
Platanus orientalis GM 40mL
Plantago major MT 40mL
Viola tricolore MT 40mL
Arctium lappa MT 40mL
Huile essentielle de lavande angustifolia 4mL
Mode d’emploi : 4 ml 2 à 3 fois par jourDe plus, je recommanderais de prendre Inonotus obliquus (champignon Chaga) sous forme de capsules ou de thé et d’éliminer la caféine et l’alcool de l’alimentation. Je recommanderais également d’éliminer les protéines animales de l’alimentation pendant 3 jours consécutifs chaque semaine.
J’espère que cela t’aides.
Chaleureusement,
Adam Johnson, M.D.Beta blockers and calcium channel blockers are part of the standard of care as “rate-controlling” medications when rate control is absolutely required in the management of atrial fibrillation. This is particularly important when treating atrial fibrillation with rapid ventricular response. Endobiogeny does not reject standard of care. Lowering the heart rate with these medications can convert a-fib back to sinus rhythm. Timely conversion to sinus rhythm is a priority. When medications are not enough, electricity is used. When a person is in a-fib chronically, both anticoagulation and rate control are important. And when a person is in a-fib to too long, often a period of anticoagulation and/or a trans-thoracic ECHO is required before any attempt at converting to sinus rhythm. Endobiogeny does not deviate from this standard.
That said, some people are only in atrial fibrillation intermittently and they don’t want to be on beta-blockers or calcium channel blockers chronically. I have several patients who go into atrial fibrillation for 6 hours or less every 3 months or so. In my patients, their heart rates and blood pressure are normal, and they find beta-blockers to make them too tired. In these cases, my focus is first on decreasing excessive alpha, second on decreasing para if needed, and third on using plants that that help stabilize the myocardium using plants like Rhodiola rosea, Melissa officinalis, and Leonurus cardiaca. In all cases, I make sure they have been adequately worked up to make sure that they are not going into atrial fibrillation more frequently than they realize, and in all cases, I make sure my patients know that converting them out of a-fib by more aggressive means needs to happen if they done convert back to sinus on their own after a defined period.
In general, 3-4mL is a reasonable starting dose for most adults. For patients new to being treated with tinctures, I will often start at 2mL BID for a week just so they can get a sense for how they respond to lower doses. I have found that some patients are extremely sensitive, requiring only a very small dose. Other patients will need TID or even QID dosing. For example, if I’m not mistaken, Dr. Duraffourd was known to use fairly high doses of Fabiana imbricata for really decompensated patients when that plant was indicated. As a rule of thumb, higher doses are more controlling, and lower doses are more moderating or regulating. Sometimes controlling is what is needed. More often a regulating (3-5mL) influence is appropriate. The more controlling of a dose, the higher the risk of side effects.
Other things to consider are 1) high doses will also contain more alcohol. 2) higher doses can become more expensive for the patient. 3) Timing of the dosing is also important. Some plants for adrenal support are best taken morning and around 3pm. If these plants are taken too late in the evening, they may be enlivening and increase sleep latency, especially in sensitive patients. So sometimes it is helpful to dose 4mL in the morning and 3mL in the afternoon.
In my practice, when dealing with a patient new to tinctures, I often have them start at half the target dose for 3-7 days just so they can get the feel for it. I typically have a follow up with them at the 4-6 week mark and that is when I have a better idea of how to adjust the dosing. This is part of the art of medicine.
Regarding Paxlovid, your observations are correct: it seems to be prescribed with relative impunity and little consideration to drug/plant interactions. When a patient comes to me already on it, I don’t necessary stop all other herbs and supplements, and it seems like my patients more commonly want stop then Paxlovid before stopping plants due to GI side effects. The reality is that other prescriptions medicines have a higher likelihood at interacting negatively with Paxlovid than the plants, and I have yet to see another physician stop a prescription medication that a patient is already on just so they can take Paxlovid. For me, the question isn’t whether so much as whether a plant should be stopped but whether Plaxovid was safe/appropriate to start in the first place. What I pay closest attention to is GFR/renal function. I avoid plants that may inadvertently worsen GFR though over-aggressive volumetric dieresis (favoring pre renal azotemia). For example, while I love Juniperus communis and Buchu, I would probably stop these if a patient was instant on taking Paxlovid (and I would resume after they stopped). However, less aggressive renal draining plants would probably be fine or even helpful to continue. If in question or if the patient is fragile, you can always stop or decrease the plant prescription. Keep in mind that the half-life of Paxlovid is approximately 6 hours, so wait 4 half-lives (24 hours) since last dose before resuming other medications.
One of the many strengths of using the biology of functions is both in making a rational decision on what prescription medication would be worth considering starting and also in being able to assess whether a prescription medication is doing what it is intending to do. Specifically related to SSRIs, SNRIs and other antidepressants, if (for example) a patient is on Duloxetine (SNRI’s) and is still depressed and the peripheral serotonin index is markedly elevated and immediate adaptation indexes are elevated, I would conclude that the Duloxetine is probably not a great fit for that patient and not doing what it is supposed to do. On the other hand, if the peripheral serotonin is low, I would advise against starting an SSRI or SNRI even if depressed. If the peripheral serotonin is normal(ish) and the prolactin index is normal or a little high, bupropion may be good medication to use. My personal practice is to try to use prescription antidepressants for 6 months or less duration (if possible) at their lowest effective dose while simultaneously using other natural treatments to balance the underlying physiology. I also have various weaning protocols for bringing patients off of prescribed antidepressants (the longer they have been on them, the slower the protocol, and the shorter the half life of the medication the slower the wean, and when patients are close to stopping the antidepressant I check in with the patient very frequently until stabilized). Aside from a careful history, the way I determine the how a plant may be influencing the actions of a prescription medication is by repeating the biology of functions. However, if a particular physiology is fairly “installed” you may have clinical improvement before seeing significant changes for the better in the BoF (similar to the observation that a patient may clinically improve from pneumonia before you see significant improvements in chest radiography).
Regarding Crocus sativus, I personally use this plant with exceptionally high frequency even when people are on prescribed antidepressants (I do avoid Crocus when relaunching ACTH would be undesirable, like hematologic malignancies). I have no qualms about combining Crocus sativus with prescription medications, although I typically use a low dose (10mL per 240mL bottle) initially, most frequently combined with Agrimonia eupatoria at 60mL/240mL bottle, and will increase the amount of Crocus sativus if needed depending on what I am seeing with repeat biology of functions. In this doses, the plant will not “override” the prescription medication as they are more “influencing” as opposed to the more controlling actions of prescriptions. If I start Crocus at a higher dose than that (which I sometimes do), I frequently (and expect to) see a temporary increase in the cortisol index, and sometimes the peripheral serotonin index (which both usually start to normalize with a longer duration on Crocus sativus). I will tolerate these temporary changes in the BoF if the patient is doing better clinically. I rarely use St. John’s wort, but only because other physicians get alarmed when they see this plant and I have other plants to use that other physicians don’t know anything about and therefore don’t get alarmed.
Hello,
Broadly speaking, the position of Endobiogeny regarding ALS is similar to the approach to all diseases: to try to understand the “why” of disease, not just the “how.” Often, the problem isn’t just with one system (i.e. nervous system) but in how all the systems are connected and interact with one another. There are specialists who provide a great deal of information in their system of expertise, but there aside from Endobiogeny, there is not a specialty that has expertise in “the in-between” systems (how the nervous system, immune system, endocrine system influence one another). Endobiogeny does this using mathematics. Take ALS as an example: At the highest level there is the “effect” of the disease (the symptoms). A level below that is the “mechanism” of disease” (the driver of symptoms). Most medical approaches focus on these two levels. But a level below that is the body’s “response” to an aggression (does the patient have an insufficient response to a trigger or an exaggerated response?). A level below that is the actual “aggressor” or disease trigger (which in the case of ALS could be environmental exposures such as Cyanobacteria blooms, genetics, etc). At the lowest/deepest level of inquiry is the true “cause” of disease (very different from the mechanism of disease which frequently gets confused for cause of disease). According to the theory of Endobiogeny, the cause is the physiologic imbalance in timing, duration, efficiency, and speed of communication between systems. The approach to therapy is to embrace “standard of care” but add a therapeutic strategy intended to address the physiologic imbalances with consideration to all levels of pathophysiology: cause, trigger, response, mechanism and effect.
