Low Dose Naltrexone
One of my favorite tools when helping patients deal with autoimmune type conditions is low dose naltrexone. Because the dose is so much lower than standard dosing you will need a compounding pharmacy. It is a prescription as well so you will also need someone that can prescribe medications. It can be an amazing tool.
LDN History
1980s: Naltrexone approved as a treatment for opiate addiction. Acts as an antagonist starting at 50 mg.
1990s: Discovered that at lower doses, Naltrexone acted as a short-term antagonist (4-6 hours) and then had a 'rebound' effect of increasing the production of endogenous opioids such as endorphins and enkephalins.
Mechanism of Action
LDN blocks Opioid Growth Factor (OGF) receptors for a few hours
LDN displaces endorphins from opioid receptors
Cells sense opioid deficiency which leads to a rebound effect via a positive feedback mechanism
Endorphin production increases
Receptors increases/receptor sensitivity increases
Increased endorphin activity results in improved modulation of the immune system.
Other Likely Mechanisms of Action:
Increases endogenous opiates
Inhibits pro-inflammatory cytokines
Blocks opiate receptors in the GI tract
Regulates T-reg cells like IL-10 and TGF
What Are the Side Effects?
Most people tolerate LDN very well but for those that do experience side effects they usually are vivid dreams, mild headache, Nausea/Gl disturbance.
Often the side effects are short lived.
How Long Should LDN Be Used?
LDN can be taken long term
it may take several months for the positive effect to occur.
Sometimes, we can use it for just a set period of time to help with symptoms.
When used for Hashimoto's patients, LDN should be part of other key pieces of treatment. Including, anti-inflammatory diet, addressing infections, food sensitives, gut health.
Conditions LDN is Used For
Ulcerative Colitis
Crohn's Disease
Fibromyalgia
Rheumatoid Arthritis
Cancer
Psoriasis
Autism
Lupus
Osteoarthritis
Eczema
Long Covid
Multiple Sclerosis
Endometriosis
Complex Regional Pain Syndrome
Chronic inflammatory pruritus
Polycystic Ovarian Syndrome
Amyotrophic Lateral Sclerosis
Hashimoto's Thyroiditis
LDN Response Time
1-2 weeks for mood
3 wks for pain
3 mo. for digestive
6 mo. for skin & gyn
1 year autoimmune
What is the Dosing?
1.5mg at bedtime x 5, then 3mg at bedtime x 5, then 4.5mg thereafter
This is the typical dosing for most people, though some conditions may require a different max dose.
Morning is for mood
Evening is for disease state
Oral Dosing Examples:
Fibromyalgia 1mg in morning
3mg at bedtime
Autoimmune: 4.5 mg bedtime
Chronic pain: 4.5 mg twice/day
Hashimoto's: 3mg bedtime
Endometriosis: up to 9mg/day
Source: https://ldnresearchtrust.org