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

HealthTara Woodland