Analysis & Summary

Host: Dr. Yoon-Hang Kim

Duration: Approximately 55 minutes (10:28 AM – 11:22 AM CST)

Format: Facebook Live Q&A with real-time viewer comments

1. Session Overview

Dr. Yoon-Hang Kim hosted his regular Saturday morning live stream Q&A session for the LDN Support Group. The session ran approximately 55 minutes, significantly exceeding the planned 30–45 minute timeframe due to strong engagement (34 comments/questions). Dr. Kim addressed viewer-submitted questions in real time while sharing clinical experience, educational content, and community updates. Throughout the session, he consistently modeled Facebook-compliant language, framing clinical insights as personal experience and education rather than medical advice.

2. Key Topics Discussed

2.1 LDN Dosing Philosophy: Start Low, Go Slow

This was the dominant theme of the session. Dr. Kim repeatedly emphasized individualized, conservative dosing as the cornerstone of his approach:

• Standard starting dose in his practice: 0.1 mg (100 mcg), with some patients started as low as 1 mcg (0.001 mg)
• Ultra-low dose defined as: 1–10 mcg; he does not consider 0.5 mg (500 mcg) to be “low”
• Dosing tiers by patient complexity: Single concern = 0.1 mg start; two concerns = 0.01 mg; multiple conditions/MCAS = 1 mcg
• Titration guidance: Increase only when no side effects AND no desired effects are observed
• Neuropathic pain dosing: Higher ranges considered (4 mg, 6 mg, 9 mg), including twice-daily dosing
• Case example (self-disclosure): Dr. Kim shared his own experience starting at 6 mg for nerve pain, experiencing several days of side effects before tolerating it

2.2 MCAS (Mast Cell Activation Syndrome)

MCAS was extensively discussed as a central concept in Dr. Kim’s root cause framework:

• Conceptual framework: MCAS is a “state” or expression of immune derangement, not a standalone diagnosis. He uses the analogy of a “kidnapper” bringing the body to “the land of MCAS”
• Common triggers: Lyme disease, mold exposure, post-COVID, antibiotics, surgery
• Treatment approach: "Siege, not frontal assault"—gentle, incremental interventions including LDN (starting at 1 mcg), ketotifen (very low doses), chromolyn sodium, methylene blue, and ketosis
• Why it is difficult: Multiple symptoms make it easy to chase symptoms rather than address root causes; aggressive dosing can trigger flares
• Personal experience: Two family members had MCAS; took 10 years to achieve remission

2.3 LDN Mechanism of Action

Dr. Kim provided an educational overview of how LDN works:

• LDN interacts with multiple receptor types, not just mu-opioid receptors
• Key mechanism via TLR4 (Toll-Like Receptor 4) on microglia
• Microglia activation drives neuroinflammation and systemic immune dysregulation
• LDN inhibits microglial activation, making it anti-inflammatory with minimal side effects
• Three primary reasons Dr. Kim uses LDN: brain protection, neuroinflammation reduction, and systemic inflammation lowering

2.4 Side Effects & Troubleshooting

2.5 Additional Clinical Topics

• LDN + Ketogenic Diet: Synergistic effects due to the anti-inflammatory properties of ketosis. Dr. Kim shared personal experience of his autoimmune skin condition improving significantly after combining LDN with ketosis.
• LDN for Neurological Conditions: Used for dementia, post-stroke recovery, post-concussive disorder, and TBI. Combined with acupuncture neurology techniques.
• LDN Before Surgery: Recommended stopping 1–3 weeks prior; discuss with anesthesiologist.
• Remission Duration: Recommends staying on LDN for 5 years after remission. "For immune related issues we don’t say cure; we say in remission."
• Liquid vs. Tablet: Liquids preferred for sensitive patients (easier to dilute); cons include shorter shelf life and higher cost.
• FDA Status Clarification: Naltrexone is FDA-approved; LDN is an off-label use, which is standard medical practice.
• SHINE Program: Dr. Kim’s root cause framework: Sleep, Hormones, Infections, Nutrition, and autoimmunE.