low-dose naltrexone (LDN)

Low-dose Naltrexone, better known as LDN, is a recent addition to the repertoire of autoimmune patients. The claim is that it “can normalize the immune system”. There is an extensive page of information found here which catalogs the list of diseases for which it has been useful.

I wanted to know exactly how it works, but it turns out that the best we can do is know “how it is BELIEVED to work”.

In general, in people with diseases that are partially or largely triggered by a deficiency of endorphins (including cancer and autoimmune diseases), or are accelerated by a deficiency of endorphins (such as HIV/AIDS), restoration of the body’s normal production of endorphins is the major therapeutic action of LDN.

I didn’t find the literature very satisfying from a scientific standpoint, and I found the description’s given by those that had taken it even less so. “A significant improvement in mental health quality of life” was identified as the result of this study. They “felt better”. I’m all for feeling better, but what does that mean? Can’t we come up with something more concrete than that? Given the dose was so low at 1.5-4.5mg (therapeutic dose of Naltrexone is typically 50mg), I decided to try it.

The low dose requires that the drug be specially made or “compounded” by a pharmacy. My functional medicine doc called the Rx into Belmar Pharmacy, and I received my low-dose Naltrexone within days. The first thing I noticed within several days is that I just “felt” better. Here we go with the nebulous descriptions and unscientific nature of our findings. I disliked the fact that I couldn’t come up with better wording, but I believed I now understood WHY low-dose Naltrexone users had described it the way they did. The next thing I noticed is I found myself walking across the expanse of a room without even thinking about my balance. There are side effects: vivid/disturbing dreams, insomnia, headaches. I experienced all of them, of course. My functional medicine MD suggested I take my dose in the AM rather than the PM to get around the dreams and insomnia issues. She said it made no matter when I took it even though the info page specifically says it needs to be taken in the evening such that opiate receptors are blocked at a very specific time (instead of all of the time which is the case with the therapeutic dose used for heroin addicts). I switched when I took LDN. It alleviated the side effects, and the benefits were not diminished. I did continue to have headaches off and on, but not enough to stop LDN.

I went up to 3mg after a month to see if we could find my particular therapeutic dose. I noticed that my legs seem to cramp more after about a week. I had also taken note of the below information before taking LDN:

People who have multiple sclerosis that has led to muscle spasms are advised to begin LDN treatment with just 3mg daily and to maintain that dosage.

This information from the LDN info page. I wanted to know why increased doses caused spasticity, but I’ve yet to find an answer. I continued with the 3mg to see if the tightness in my legs persisted. Soon my partner noticed that my appetite had seriously declined. I googled “LDN & appetite” and found that LDN is also used for weight loss. Whoops. This is definitely not sustainable. Eating close to nothing is not healthy. This side effect was not mentioned in any literature I had read. I guess I had thought I wasn’t eating as usual because my headaches had increased. Headaches often cause nausea for me, and nausea doesn’t promote normal food consumption. I stopped taking LDN to regain my appetite.

For whatever reason, I tend to react very strongly to medications/supplements. I plan to return to my 1.5mg LDN dose as soon as I have fully recovered from my recent experiences.

NOTE: As of February 12, 2015, I have returned to the 1.5mg daily dose. 🙂

extra credit:

A “Must-See” Video of Dr. Bernard Bihari, LDN Pioneer and Champion. Click here

Transcript of Dr. Bihari video.

13 thoughts on “low-dose naltrexone (LDN)

  1. hey! thanks for the post. are u still on LDN? can u detail the progress u have made since february 2015? i’m about to begin using it for my autoimmune thyroid condition, and i’m very curious about how it works for people longer-term.

    • Hello Rebekah,
      I am continuing to steadily improve although I have had a few setbacks due to a death in the family and my stress level. This is life. I still have no problems with RA, and MS issues less of a problem than a pesky SI (sacroiliac) joint at the moment.
      There is no doubt that I feel better when on LDN, and my legs behave better when I am on LDN–less cramped, easier to go up stairs 2 at a time. I recently went on vacation for 12 days and forgot to take it while I was away to spite the fact that I brought it with me. :-/
      I could definitely tell the difference by the time I returned home and wasn’t preoccupied with international travel.
      Please let me know if I may answer any other questions.
      Best of luck,

  2. I have been taking 4.5 mg at bedtime for my hashimotos hypothyroidism. I was found to not have any of the autoimmune diseases that most people who have had it as long as I have. I am in the 3percent to be safe from those awful diseases such as RA and lupus. I think it is because I have taken LDN for years. I was surprised to hear it helped with weight control/lose. I am 25 pounds overweight????

    • I certainly would not approve of the use of LDN for weight control although I realize it is sometimes used “off-label” for that purpose. I’m glad you have not progressed into other autoimmune diseases other than Hashimotos’s. I’ve never heard of LDN in doses higher than 3mg per day.
      Kind regards,

  3. Oh, one more thing. It does need to be taken at bedtime because between …I think it is around 10:00-3:00 am is when the body heals itself. IT NEEDS TO BE TAKEN AT BEDTIME!!!

    • LDN does not need to be taken at bedtime in order to see benefits. I know people who take it in the morning to avoid side effects like intense, vivid nightmares. I take LDN at dinnertime.
      Be well,

  4. Hi! I’ve been taking LDN, 4.5 mg for about seven months now. I have ankylosing spondylitis and it has helped me be able to function and walk. I feel like it’s a gift from God. I have lost significant weight, which is why am at this for him 🙂 I highly recommend a bedtime dosing, because they said you’re not supposed to take it with meals and it’s just because of the endorphin release and the timing for one’s body. I did not have nightmares and have had very few side effects, maybe a headache occasionally.

    • Everyone reacts differently. I’m glad it’s working for you, but it is not necessary to take LDN at night. Best of luck!

  5. Thank you for this article. I have been on LDN for the past 2 months and my weight has plummeted and not in a good way. There’s barely 128 lbs of me to begin with and now I’m down to 116. Yikes! I am reluctant to stop as it has helped with the fibro symptoms so much. Back to the doctor and the drawing board of frustration.

  6. I have had chronic fatigue, fibromyalgia, hypothyroidism, restless leg syndrome, high blood pressure, and clinical depression for over 25 years. I am so to tired of taking lots of medication and still not feeling well!
    Do you think low dose naltrexone would be good for me? Who do I need to see to get it prescribed for me. I am looking for a great doctor in the Birmingham, Alabama.

  7. Hello. I am taking ldn for undifferentiated connective tissue disease. I have overwhelming fatigue, joint pain, muscle pain, and brain fog. When I started the ldn about three months ago at 1.5mg, I immediately noticed improvement in my brain fog and my energy level/fatigue. Over the course of the three months, I have increased to 4.5mg. Honestly, I do not notice the initial “good” feeling that I had when I took it at 1.5mg. I feel like it interferes with my sleep somewhat, as well. Do you think that maybe my body just does better at 1.5mg? Or do you think I should give it up to a year before I decide that 4.5mg isn’t the correct dosage for me? I would love your input. Thanks.

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