RHR: Low-Dose Naltrexone (LDN) as a Treatment for Autoimmune Disease
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RHR: Low-Dose Naltrexone (LDN) as a Treatment for Autoimmune Disease

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Find out how low-dose naltrexone works, what kind of conditions it’s been studied in, and how you might find a doctor that you can work with to take it.

Revolution Health Radio podcast, Chris Kresser

What conditions is low-dose naltrexone effective for? There are actually two ways to answer this question. The first is what the scientific literature shows, and then the second is what clinical and anecdotal experience of clinicians that are working with LDN shows.

In this episode, we cover:

3:36  How LDN works
10:50  The effectiveness of LDN
17:25  Finding a doctor to work with

Play

Steve Wright: Good morning, good afternoon, and good evening. You are listening to the Revolution Health Radio Show. I’m your host, Steve Wright, co-author at SCDlifestyle.com. This episode of the RHR podcast is brought to you by 14Four.me. This is a 14-day healthy lifestyle reset program. Chris has put together a really simple, step-by-step, hand-holding program for those of you who are still struggling with sleep issues, weight issues, gut issues — actually basically any health issues — because the 14Four.me program addresses your food, your sleep, your movement, and your stress, all foundational principles for living a long, healthy life and overcoming any sort of chronic conditions you’re still dealing with. If you’re having problems implementing these in your life, please check out 14Four.me. It might be the program for you.

With me is integrative medical practitioner, healthy skeptic, and New York Times bestselling author, Chris Kresser. Chris, how are you doing?

Chris Kresser: Pretty well. How are you, Steve?

Steve Wright: I’m catching up on some sleep, but I’m doing well.

Chris Kresser: All right. Yeah, I heard you’ve been out partying hard at Garth Brooks concerts!

Steve Wright: I can’t say I haven’t been. It’s been good to put on the Stetson, the cowboy boots, and sing some Friends in Low Places.

Chris Kresser: That’s pretty awesome. I have to remember you’re Midwest born and raised, right?

Steve Wright: Yeah, yeah, coming from the rural backwoods of Michigan. Not really that backwoods, but —

Chris Kresser: That’s great.

Steve Wright: — I got the country gene.

Chris Kresser: Good times, good times.

Steve Wright: Yes.

Chris Kresser: All right, so we have a great question this week. It was actually hard for me to believe that I had never covered it. I’ve talked about it on so many different podcasts and in blog articles and stuff, but I realized when we got this question that I had never actually covered this topic in one distinct podcast, so here we go.

Question from Larry: Hi, Chris. My name is Larry Leibowitz. I’m an integrative/functional family physician in Connecticut. I’ve become an avid listener to your podcast, and I find a lot of the material to be extremely useful and very helpful for my practice. As you can imagine, I see a lot of patients with chronic inflammatory conditions. Many of them are autoimmune in nature, and recently I’ve been considering the use of low-dose naltrexone with my patients. I’d be very interested in hearing about your experiences with the medication, some of the successes and/or failures, and in which cases you find it to be the most useful. Thanks. Take care.

Chris Kresser: All right. Yeah, like I said, it’s something we’ve talked about here and there, and it can be really useful for people with autoimmune conditions. I think a lot of folks have heard of it by now, but I want to just take the chance to give a little bit of background, explain how LDN, low-dose naltrexone, works, what kind of conditions it’s been studied in and might be effective for, and we’ll talk about some pros and cons and things to keep in mind if you take it and how you might find a doctor that you can work with to take it.

How LDN Works

As the name implies, low-dose naltrexone is a low dose of a medication called naltrexone that was originally approved back in the ’80s at a higher dose, 50 mg, for the purpose of helping opiate and heroin addicts to get off those drugs, and it works by blocking the reception of opioid hormones. So if you were on a 50 mg dose, you could take any kind of opiate drug and not get high. But the problem was that in addition to not getting high when taking these opiates, people who were taking 50 mg of naltrexone didn’t feel any pleasure at all because the opioid receptors in our brain mediate our experience of pleasure. So at the full dose, naltrexone really reduced that experience of pleasure and, therefore, wasn’t a very sustainable or effective drug.

But around that time in the mid ’80s there was a doctor in New York named Dr. Bihari who was interested in treating cancer and AIDS, which was just becoming something that people were starting to focus on more at that point, of course, and he discovered that a low dose between 3 mg and 4.5 mg of naltrexone had beneficial effects on the immune system. And since then, LDN has been used for autoimmune disease, cancer, and other conditions that involve immune dysregulation. This is important to understand if you’re going to talk to your doctor about LDN because a lot of doctors might be familiar with naltrexone that was used for this purpose and might raise their eyebrows or not be familiar with the fact that a lower dose is used for a completely different purpose. The higher dose is about blocking opioid receptors and detox and getting people off drugs, whereas the low dose is being used now for balancing and regulating the immune system, so it’s important to make that distinction.

Without getting too geeky here, I want to tell you a little bit about how LDN works because it’s interesting, and it, of course, helps to understand how it might benefit you if you have an immune-related condition. And this is ongoing. There are new papers published about the mechanisms of LDN each year, and we’re still learning about this, but so far, there are two main mechanisms that have been identified. One is that, as I said, it regulates the immune system, and it does this primarily by promoting T regulatory cell function. The T regulatory cells, or Tregs, they keep the immune system in balance, and they turn inflammation on and off, depending on what’s needed, and they prevent the immune system from getting stuck in patients with overactive immune systems, like people with allergies or asthma or autoimmune conditions. The way this works is LDN, as I mentioned, it temporarily blockades the opioid receptors in the brain, and when the receptors are blocked, the body thinks more opioids are needed, and so it produces more, and by the time more opioids are produced, LDN is out of the system, the receptors are unblocked and receive those, and that leads to essentially a net increase in opioid production.

So if you’re wondering now, like, what does this have to do with the immune system, we now know that people with autoimmune disease often have low levels of these opioids and that white blood cells, which, of course, are what are driving the immune response, have receptors for these opioids, which, of course, suggests that they play a really important role in the immune system.

So that’s number one, this immune-regulating, balancing mechanism.

Steve Wright: Does the increase in opioids actually then cause a corresponding increase in Treg cells? Is that the point you were making there?

Chris Kresser: Yeah, exactly. And then the Treg cells are the ones that — I mean, they’ve been referred to as the police force of the immune system. I’m not sure that’s the best analogy these days, given what’s been happening, but the idea is that they balance and regulate the immune system and keep both sides in check.

Another more recently discovered mechanism is that LDN reduces inflammation in the central nervous system, and the significance of this is that inflammation in the central nervous system is thought to play a role in a number of different conditions that LDN has been shown to be effective for, like fibromyalgia and chronic pain and depression. In addition to blocking the opioid receptors, LDN blocks something called toll-like receptor 4 that’s found on white blood cells that are called microglia, and the microglia are central nervous system immune cells that produce inflammation, pain sensitivity, fatigue, sleeplessness, mood disorders, and cognitive problems. When those microglia are chronically activated, as they are fibromyalgia and other pain disorders, it results in neurotoxicity and then this whole wide cascade of symptoms that are associated with all these conditions, and LDN essentially blocks that cascade by blocking the receptors on those microglial cells. This probably explains why in some of the studies so far LDN has been shown to reduce something called erythrocyte sedimentation rate, or ESR, which is an inflammatory marker that’s elevated in conditions like fibromyalgia.

Again, to recap, there are two basic mechanisms: balancing and regulating the immune system and then reducing central nervous system inflammation. There probably are other mechanisms, but those are the ones that have been the most clearly defined so far.

Steve Wright: Chris, is there any way for people to test their opiate levels to know if they might be low and LDN would be an ideal —

Chris Kresser: Not that I’m aware of. There are some tests that can look at various kinds of immune cells and the balance between those immune cells, but they’re not widely available and they’re a little bit difficult to interpret, so it’s not something that I think is that useful for the average person or ready for primetime. I think with LDN the best way to determine if you’ll benefit from it is whether you have the conditions that it’s shown to be useful for or any other kind of immune-related condition and then just doing a therapeutic trial, but we’ll talk a little bit more about that in a second.

The Effectiveness of LDN

OK, so what conditions is LDN effective for? There are actually two ways to answer this question. The first is what the scientific literature shows, and then the second is what clinical and anecdotal experience of clinicians that are working with LDN shows. There’s definitely research out there on LDN, but it’s still somewhat limited, and I think clinical and anecdotal experience is further ahead in terms of the breadth of conditions that LDN is being used for and the experience of how effective it can be for those conditions. The studies are also still usually relatively small sample size, not always randomized, not always double-blinded. Part of the reason for this is they’re probably not that well-funded because low-dose naltrexone is off patent, and that means that drug companies don’t stand to make a killing on selling LDN, and it’s unlikely that a whole lot of money is going to be put into it for that reason.

Having said that, the results so far of the studies on LDN have been really encouraging, and they’ve been primarily on cancer, multiple sclerosis, Crohn’s disease, fibromyalgia, and autism. It’s especially effective for Crohn’s with over a 70% remission rate and even complete mucosal healing as evidenced by colonoscopy in some cases. If you know about Crohn’s disease and how nasty it can be and how difficult to treat and how poor the success rates are of the typical treatments, that’s a pretty remarkable statistic, over 70% remission rate with mucosal healing, especially when you consider the fact that there were not documented side effects of LDN in that study compared to placebo.

So that’s what’s in the scientific literature, but anecdotally clinicians are using it for a whole wide range of conditions involving inflammation and immune dysregulation, autoimmune diseases like Hashimoto’s and Graves’, rheumatoid arthritis, lupus, psoriasis, chronic fatigue syndrome, neurodegenerative disorders like Parkinson’s and Alzheimer’s. It’s being extensively used for infertility. There’s a clinic in the United Kingdom that is basically almost entirely focused on using LDN for fertility to treat patients who are struggling with that. And the reason it’s effective for such a broad range of conditions is because of the mechanism of action. As I said, it regulates and balances the immune system and reduces inflammation, and of course, we know that inflammation and immune dysregulation are at the root of many diseases and certainly at the root of autoimmune conditions. Even though there aren’t any studies of LDN on Hashimoto’s, for example, it makes sense that it would work for Hashimoto’s if it’s working for multiple sclerosis and Crohn’s disease because the underlying mechanism of all those conditions is immune dysregulation, autoimmunity. That’s why a lot of clinicians out there feel justified and safe in using LDN for conditions that it hasn’t directly been studied on because, A, the mechanism makes sense and, B, it’s safe and well tolerated and doesn’t have any significant complications or risks or even side effects in many of these studies.

One of the advantages of LDN as a therapy is that it’s low cost. It’s off patent, as I said, which means typically you can get it for about 40 bucks a month, 35 or 40 bucks a month from a compounding pharmacy.

The side effects are pretty minimal, in that in some of the double-blind, placebo-controlled trials, as I said, there was no difference in side effect between placebo and the treatment group, but I will say that in our experience, what we’ve seen in our clinic and other clinicians I know that work with it, there are some side effects that are fairly common, which are temporary sleep disturbance when a patient first starts taking it or vivid dreams and a mild headache, but these usually pass pretty quickly and can often be mitigated by starting with a lower dose, so if 3 mg or 4.5 mg is the ultimate dose that they end up on, starting at, like, 1 mg or 1.25 mg or something and then building up more slowly.

LDN does not have any known abuse potential. It’s not an addictive medication. One of my hesitations or criticisms of a lot of drugs is that they just primarily work by suppressing symptoms and they don’t necessarily improve the function of the body, but LDN is a little different in that respect, in that it works by improving the function, it increases the production of T regulatory cells, which then have that immune-balancing effect and, I think, makes it a little bit safer to use over the long term. Now, of course, if you can achieve results and address your autoimmune condition without using a medication, even one as safe as LDN, then that’s great, but my rubric for a treatment, you know, whether a treatment makes sense, has always been whatever is the most effective and causes the least amount of harm. In many cases, that’s not a drug, but LDN is actually one medication that I think passes that test.

One of the disadvantages of LDN is that there’s still not standardized dose, and really the patient and the prescribing physician just kind of have to figure it out through trial and error. From our experience, we’ve seen most people end up around 2.5 mg to 3 mg; 4.5 mg tends to be too much for people. I’ve seen some patients settle on as little as 1.25 mg or 1.5 mg, but anywhere in the 1 mg or 1.25 mg to 4.5 mg range could be the optimal dose for a given person.

We still need more research. I mentioned that the research we have already is somewhat limited, so we need more research.

Finding a Doctor to Work With

It’s not always easy to get a prescription. A lot of primary care doctors aren’t familiar with it. It’s not covered by insurance. It’s completely off label, but fortunately it’s pretty cheap. Even if people are paying out of pocket, it’s only about 35 or 40 bucks a month.

And although all the studies we have so far show that it’s safe, we don’t have any hard data on really long-term safety, you know, people who have been taking LDN for 10 years or something like that. Of course, that’s true for a lot of drugs, but I’m just pointing that out.

So if you’re interested in LDN, keep in mind it has to be prescribed by a physician, or in some states, a naturopath can prescribe it. You can print out some studies from PubMed. You can go into PubMed.org and search for “low-dose naltrexone,” and there are a bunch of studies that will pop out. You can print those out and take them to your doctor to discuss. There’s a website called LDNinfo.org that has kind of a clearinghouse of information on LDN that you can go to. There’s a Yahoo group about LDN that you can join and talk to folks there and try to find a practitioner in your area.

What I don’t recommend is ordering it from overseas pharmacies. You never know what you’re getting that way, and there have been a lot of studies showing that drugs that come from those pharmacies are not often what they claim to be, and that’s just flat out dangerous and not very smart. Hopefully that goes without saying, but I’m just mentioning it anyway.

And particularly with LDN, it should be obtained from a reputable compounding pharmacy that has some experience in compounding LDN. I mean, there are certain pharmacies that know which binders and fillers make the most sense with it and seem to be the best tolerated, and they just a lot more experience working with patients that are taking it, and it’s a good idea to refer your physician to one of those. Skip’s Pharmacy in Florida is the one that comes to mind that’s been doing it for the longest period of time, so you can look them up on the web. There’s also a list of recommended pharmacies on the LDNinfo.org site that you can make your doctor aware of.

Let’s see. Anything else come to mind? What have you got, Steve?

Steve Wright: I got a question. Have you seen in your patient population that, for instance, say someone settles on 3 mg, do they ever need to change that? Does the effect wear down over time, or do life circumstances sometimes mean that you could get more sensitive or less sensitive to it?

Chris Kresser: Great question. My sort of take is usually, like, let’s use any treatment, whether it’s a supplement or medication for a therapeutic purpose, to reach a therapeutic goal, and once we reach that goal, I’m always interested in seeing if we get people off of stuff, maybe once the immune system comes back into balance and the patient is symptom free. Like we’ve talked about before, the concept of tolerance. You’re an engineer, Steve. You’ve told me about it. It’s easier to maintain something within tolerance, that’s already where it should be, than it is to get it back there in the first place. A patient may want to stop taking LDN or titrate off of it after a while to just test to see if they can maintain the improvement that they’ve gained from it.

On the other hand, if somebody has a condition like Graves’ disease where there’s a real risk of going into a hyperthyroid storm and stroking out and that’s been historically an issue for them and LDN is just completely managing it without any other medication, if you’re going to weigh that against taking PTU or methimazole or pretty toxic medications that often needed for Graves’ or even more invasive, like a surgery to remove the thyroid or to radioactively ablate the thyroid gland, and you’re weighing those against just staying on LDN, of course, you have to talk to your doctor about these questions, but my take on that would be if it were me as a patient, I would rather take LDN on an ongoing basis than to face any of those outcomes. So it just depends on the person.

And the dose can fluctuate, depending, of course, on the background level of immune dysregulation. If maybe someone is gluten intolerant and they don’t know it and they’re eating gluten and they’re taking LDN and they need the full 4.5 mg dose because they kind of have their foot on the accelerator and the brake at the same time, but then they take gluten out of their diet and maybe 4.5 mg is unnecessary or even starts causing some side effects, so that’s possible.

Steve Wright: One more question.

Chris Kresser: Yeah.

Steve Wright: In previous shows and potentially in writing — I’m not sure where I remember you mentioning this — but you’ve said to commit to a timeframe for LDN because not everybody shows symptom reduction or lab test reduction at a specific point in time after starting taking it, so what are your current thoughts on that?

Chris Kresser: Yeah, it’s the same. I mean, it’s really interesting. Some people, like, the next day after they start they feel like a different person, and then other people, it can take three months for them to really feel a significant difference. We don’t really understand why that is yet. And interestingly enough, it doesn’t necessarily correspond to how sick they are or how long they’ve been sick. I’ve seen it where people have been really kind of in bad shape and they respond immediately and other people whose condition was a lot more benign or mild and they didn’t have an immediate response. I don’t know about that, but I do know that it’s common. So I would say probably give it three months before you let it go if you’re going to try it.

A couple other things to consider are that because LDN blocks the opioid receptors, some pain narcotic drugs like Percocet or morphine or tramadol, LDN can decrease their effectiveness so that typically they shouldn’t be taken together. And patients with Graves’ or Hashimoto’s that are taking thyroid meds should be careful because one thing we’ve seen happen is if someone takes LDN and their thyroid function improves, then the dose of medication they were on that was maintaining equilibrium before all of a sudden becomes too high, and that person can go into kind of like a hyperthyroid episode or start feeling heat or not sleeping well or all those typical symptoms. Your doctor should mention this to you when they prescribe it, but that’s something to be aware of and to talk about with your doctor if you’re on a thyroid medication, to be ready to reduce the dose if your thyroid function starts to improve.

A question that often comes up is, OK, are there some natural alternatives to LDN that achieve the same purpose of reducing central nervous system inflammation and promoting T regulatory cell function? Definitely, there are things that achieve both of those goals. In some cases, especially when you put them together, they can do just as good of a job as LDN, but in other cases I’ve seen LDN just be more effective even when someone’s done all these other things. But for Treg cell function, vitamin D is a powerful T regulatory cell promoter, as is glutathione, so those should definitely be in the repertoire. Maintaining adequate levels of selenium and zinc and iodine is important for immune function. Probiotics, especially bacillus species like soil-based organisms, promote Treg cell function. Butyrate, which is a short-chain fatty acid that’s produced by beneficial bacteria in the colon, improves Treg cell function, so prebiotics can actually do that indirectly. Vitamin A is important for immune balance, so cod liver oil. And then for inflammation, we have things like curcumin and boswellia — those are COX inhibitors, selective kinase response modulators, fish oil or EPA and DHA from cold-water fish, of course, and then diet obviously. Whether we’re talking about just a general, overall anti-inflammatory paleo-ish type of diet or whether you’re taking the next step and doing an autoimmune protocol type of diet, those can be important as well.

Steve Wright: Awesome. Well, it sounds like a pretty good round-out there. It seems like if people wanted to try those things, I’ve seen a lot of people try those things and not get success and then get on LDN and through LDN and some of those supplements together, like, really have a brand-new life.

Chris Kresser: Yeah, it can be pretty dramatic. And of course, I don’t want to create any false hope or unrealistic expectations for people, but for some it has definitely been life changing. I have patients who had been on those thyrotoxic drugs for 20 years or more, 25 years. One patient comes to mind who had Graves’ and had been on PTU for 20 years and was able to get off PTU completely and all other medications and just take LDN and feel better than she ever had felt during that period and maintain completely normal thyroid numbers, so it can be pretty dramatic. I have to say, though, that we have had patients who have taken it and experienced nothing at all. So it’s not a miracle, of course. No treatment is, but it helps a lot of people, and it does it pretty affordably and without causing a lot of side effects or complications or risks, and that’s a pretty good combination.

Steve Wright: Yeah, definitely. Awesome.

Chris Kresser: All right.

Steve Wright: Well, if listeners would like their question answered, make sure to go to ChrisKresser.com/PodcastQuestion to submit your questions. Chris and his team are always taking those in and trying to pull the most relevant topics that haven’t already been covered, so if you have submitted questions and you’re wondering, why, guys, haven’t we talked about my question, make sure you listen to the rest of our episodes because there’s quite a treasure trove of information that we’ve covered over, what, like, four or five years now?

Chris Kresser: Yeah, four or five years, somewhere in there. I should know, but something like that. Yeah.

Steve Wright: Awesome. And in between episodes, if you’re not following Chris on social media, this is where you can get updates on the latest articles he’s reading, different things that he’s pulled from around the web, so go to Facebook.com/ChrisKresserLAc and Twitter.com/ChrisKresser. Thanks for listening.

Chris Kresser: All right. Thanks, everyone. Talk to you next time.

191 Comments

Join the conversation

  1. I have relapsing polychondritis and hashimoto’s am looking for a doctor in Phoenix, Arizona who prescribes LDN. I have been on a rigid autoimmune diet for a couple years which has helped, but I am still experiencing too many flares that are affecting my eyes. Can you recommend a doctor here? Thanks in advance.

    • Dr Petar Novakovic in Chandler AZ does. He is m y PC and I am just starting on it again. Tell him I sent you. I think he also has an office in Cave Creek if that is closer to you.

  2. I am wanting to start LDN for arthritic psoriasis and disc degenerative disease. I have had pain management mostly natural, over 30 years. My problem has been finding a doctor that could be willing to write a script, and then, it means monitoring the dose. I have been grain free, LCHF for over 5 years, and just started NatureThroid, luckily without antibodies. It seems the latest flare of psoriasis started up with the introduction of hypothyroid med, I cannot tolerate much more psoriasis pain without something, hopefully natural first.

  3. Is low-Dose Naltrexone available in Canada? I’m in Mexico until end of March and got the LDN from a doctor here in Puerto Vallarta. I take it for mainly Fibromyalgia and Graves’ disease which I was diagnosed with several years ago but did not continue with any medication.

  4. Thanks, very informative. I have had nerve problems in legs and butt. Relating to circulation both sitting and standing or turning in bed.. It is ongoing. That has been going on for over a yr. I take a capsule containing b vitamins and alphoic acid that seems to tone down a bit more tolerable.
    The last six weeks , lymph has leaked from both big toes, ears and neck, sleep is really erratic. This is an itching, burning at site and nerves. Anti histamine lessens itching, but nothing else. Started the paleo diet yesterday. Have an appointment with a new Dr. This week. Hope she is familiar with LDN. If she tests me and all confirms auto immune.

  5. Ive been on LDN for two months I have one last dose increase next week, I will be at 4.5mg then. I have no more IBS no more Autoimmune flare ups, no pain with Fibro, brain fog etc…… I am a 60 year old woman who has suffered with pain for over 15 years. I am now active happy and pain free. Ohh yeah I was poisoned last February with a prescription of Ciproflaxin to kill an over growth of Citrobacter Fundi I had horrible neuropathy pain of the feet and tendons I couldn’t walk with out help from my husband; LDN took all the pain away.

  6. I have been caught in a cycle of terrible daily migraines. My doc had me start ldn 7 mg to hopefully help relieve them. I’ve been on it a month and not sure I’m seeing much difference. Does anyone have any experience with ldn and migraine? (It works great for my sister @4.5 mg but she also has a mild form of MS)

    • I was started off with 5 mg then worked up 5 mg until I hit 4.5 mg. the small increases are due to the one side effect of sleeplessness which I found taking LDN late at night
      (10 pm and 12 am) helped tremendously.

  7. I have cluster migraines every year for extended periods of time. This is day 30 with the same painful, nauseating headache. My doc has started me on 7mg of LDN, I started taking it 4 days ago. I don’t think I’ve seen any dramatic changes yet. Does anyone here have any experience with LDN and migraines? (He started me on 7mg because he has a patient that is doing fantastic with it at that dose for migraine)

  8. Hi Chris I need help I have fibromyalgia for the last. 23 years and with last 3 years feeling worse.I am seeing a doctor next week who prescribes ldn for fibromyalgia.
    I also have another few issues which I am treating low b12 and low vitamin d and possible thyroid issue.would you mind looking at recent blood results. A fellow sufferer on a health website mentioned I need to add T3 to my system as I should be well with the ranges i am in.will Ldn help this issue or do i need to add T3.Thank you for all the amazing work you do helping where other doctors do not. I live in Ireland so ranges are in European format
    Regards Linda
    >> CRP 2.10 <3.0 mg/L

    Ferritin 76.9 20 – 150 ug/L

    Thyroid Function

    Free T4 L 11.34 12 – 22 pmol/L

    Free T3 6.02 3.1 – 6.8 pmol/L

    TSH 2.19 0.27 – 4.20 IU/L

    Reverse T3* 16.0 10 – 24 ug/L

    T4 Total 80.7 64.5 – 142.0 nmol/L

    Immunology

    Anti-Thyroidperoxidase abs 10.9 <34 kIU/L

    Anti-Thyroglobulin Abs 20.8 <115 kU/L

    Vitamins

    Vitamin D (25 OH) L 44 Deficient 175

    Vitamin B12 L 185 Deficient 725

    Serum Folate 12.27 10.4 – 42.4 nmol/L

    • I am on 3mg after working up to 4.5mg and it being to much! I feel great at 3mg. I used to be on T3 but as soon as I got my t4 levels sorted and got all grains out of my diet including the maize starch in my thyroid tablets I did not need any T3 (ironically that contained maize starch too so it definitely felt like I had the foot on the gas and brakes at the same time. Doing my genetics has also been a big piece of the puzzle as I do have homozygous snp’s on the MTHFR gene and it turns out I was deficient in a few of the B vitamins because I had low stomach acid (perhaps vicious circle due to low thyroid) but also turns out I tested positive for Pyroluria which cleaves my body of B6 and Zinc. After working to support my gene SNP’s and being on LDN now for over 6 months I am feeling fantastic with unbelievable brain and memory function. I am just about to get my Thyroid labs repeated as I am feeling a bit hyperactive and think I may need to reduce my thyroxine despite only being on 25mg any way. I take liquid thyroxine as it contains no grains as fillers ( I believe the fillers kept my sick for years until i finally figured out that even tiny traces of maize start caused an autoimmune reaction in me). I think you can get Tyrosint in the US which is also grain free. Hope this helps

  9. Hello, sorry to be joining this conversation so late. I am 44 years old I have Ehlers Danlos Syndrome, Fibro, Chronic Fatigue, Degen disc disease , Narcolepsy, Spondylitis all over, and a host of other things. Most of these were not diagnosed until after I was 40. Even with Nucynta and Percocet in my daily pain regimine I am still dealing with Chronic and Severe acute pain every minute of everyday. So I haven’t given up I found a doc 2 hours from my home a Rhuemetologist who came highly recommend by a Naturopath. He has found Spondyloarthritis and fungus/mold disease very high in my body. So this doc just prescribed me Naltrexone 0.125 and a couple anti fungal things for the “mold disease” … I saw my primary care doc who I have been seeing for over 20 years yesterday and he said you can’t take that it will put you in withdrawal from your other meds. So I’m not sure what to do. After reading all your posts I feel like I am on such a low dose that maybe it would be ok…but I’m afraid now to start any of this as I can’t be in even a small amount more pain than I am already…it’s horribly debilitating and I am pretty much home bound so yea. I was a high school guidance advisor for almost 20 years before I was unable to work any longer due to all this. I have had a cervical and lumbar surgery, my shoulders and knees have multiple bone spurs and tears in them so I can (if I choose to accept) have more orthopedic surgeries any time. I am sero-negative for most autoimmune things though this doc believes I have Sjogrens most likely and SpA… Anyhow my question is can I take .0125 Naltrexone and my 200mg Nucynta, and 7.5/325 Oxycodone/Acetaminophen (Generic Percocet)?

    • Hi Lisa,

      Your PCP gave you accurate and verifiable information: Naltrexone will induce opioid withdrawal and you will also experience whatever pain the Nucynta and Percocet have been mitigating.

      The discomfort of withdrawal will be proportionate to the dosage and duration of your use of the opioids in question. If you’ve ever missed a day or two of your pain meds, you probably have some idea of what that feels like. There are alternative therapies of pain management which do not involve addictive meds. If you’re so inclined, *Full Catastrophe Living (Revised Edition): Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness* by Jon Kabat-Zinn is my recommendation. I suspect that both your naturopath and rheumetologist are familiar with this work.

      Once you’ve safely withdrawn from the opioids you may choose, with medical supervision, to “field test” the low-dose naltrexone. There is no way to predict which, if any, of your specific medical issues will be ameliorated by the LDN. (As a side note, if you haven’t already eliminated from your diet foods from the nightshade family you may want to discuss this with your docs.)

      I hope this has been helpful and that you find peace of mind and body.

    • your pain med wont work if you take LDN. give up your pain med’s for awhile LDN saved me from a life of pain.
      Nothing like it.

    • LDN in ultra low doses .5 mg to 1 mg have been shown to actually enhance Opioids so they work better but take them 6 hours apart from each other.

  10. Hi,
    Can someone direct help about whether to pursue LDN first before considering hypothyroid med’s.?

  11. What I’d like to know is: Is LDN good to take “preventatively”? My blood results show I’m quite positive (and increasing over time) for Sjorgen’s syndrome, but I have little to no symptoms. Doesn’t mean I won’t GET symptoms one day, though.

    So, should I wait to see if that ever happens (symptoms), or is LDN safe enough to begin taking proactively, just for good immune-regulatory health?

    Thank you!

    • Take the LDN.. as it Optimized your Immunity. However, you do not have to take it every day to benefit, if you are healthy. You could take it 3-5 days a week if you wanted.

      I’ve been on it 5 years and it immediately stopped severe hives I had for 8 years, plus I have not had any colds.

      • David K,
        Have you maintained a steady dosage or gone up and down at times. And if so what dosages have you had the best luck with?

      • David K – I also have hives.
        What type of hives were you diagnosed with before you started taking low dose LDN?
        How long before you saw your hives go away and have you every tried to not take LDN and then have your hives come back? Thank you!

  12. Hi

    I have Secondary Progressive Multiple Sclerosis and have been using LDN over 12 years with great success, I’m also the founder of the LDN Research Trust. Here is my story should anyone wants to hear how LDN saved me.

    I was so sick and life wasn’t worth living at this point I was told nothing could be done for me!

  13. I was diagnosed 26 years ago with CFS and recently with Fibromyalgia. I have spent unknown amounts of money on just trying to cope with everyday life over years of pain, cognitive problems and devastating weakness.
    I finally gave up trying every new therapy that was supposed to help my condition. Only by accident did I find out about LDN, through a conversation my sister had with an associate, who’s friend was taking LDN for fibromyalfia.
    It took 2 months to find a doctor who would prescribe LDN. My GP knew nothing about it. I called a compounding pharmacist who deals with LDN and miraculously I was informed that they knew of only a couple of doctors in Toronto, Canada who prescribed it. Well one of them turned out to be my Arthritic specialist. She prescribed it immediately and started me out with drops so that I could control my dosage to start with. CFS and Fibromyalgia sufferers have many sensitive reactions to so many meds that every new med is a challenge.
    I even let it sit in my refrigerator for a week before I started it because I was afraid I might go into a downward spiral again.
    I started at the lowest possible dose because I felt if i was going to have a reaction I would know immediately.
    From all that I have read such a low dose would have no effect. HOWEVER every one is different in their reactions.
    I started at .25ml and over the last three weeks I have upped it to .35ml. YES this low a dose has had an effect.
    My energy has improved at least 50% and the weakness and pain is improving daily. For me this is unbelievable. I can finally walk without shuffling through the pain. The biggest effect is, with the brain fog-It has cleared drastically.
    My goal is to get up to 1mg daily by the new year. I am taking it very slow and with great caution, because after 26 years of this devastating condition, I am finding the effects of LDN amazing and almost (dare I say it) miraculous.
    WHY do so few doctors know about this? So much suffering could be alleviated.
    I will keep updating on my progress with LDN.
    If I have to take it for Life, then I will.

    • awesome isnt it? I too am on LDN and amazingly I feel cured but know I will probably always have to take it to keep from sliding back into hell and pain.

  14. I too have been wondering about LDN and pregnancy. I called and left a message for the podcast months ago as well. Hoping to hear soon if it’s safe as I am taking it now and just found out I’m pregnant.

  15. I have been recently diagnosed with chronic as well as acute Lyme disease by a functional medicine Dr. She started me on Doxycyclene 100mg twice a day and Naltrexone 4.5mg at bedtime. She said I should see a specialist in Indianapolis but there is a 6 month wait. I have probably had these symptoms for 15 – 20 years. I was recently bit by a tick 3 months ago. Should I wait to see the Dr. In Indy that could be 6 months away or do you know of a Lyme literate Dr. in Indiana or Illinois that deals with chronic Lyme. I didn’t see much on this site on Lyme and Naltrexone. Is there anything more I should be doing? I am also on a Pobiotic (100,000 live cfu 2x’s a day) , 10,000 D3, CoQ10, Lipoic Acid.

    • Hi Dionn,

      I was also recently diagnosed with Lyme from my alternative health practitioner. To find a regular, lyme literate doctor, I found this link.
      http://ilads.org/ilads_media/physician-referral/

      If you go there and fill out the online form, they will email you 3 lyme literate doctors in your area. They take a few days to respond.

      Once I had my list, I had to do a Google search to find the doctors, as their phone numbers had changed. Sometimes they had joined a new office, too.
      I then recommend researching them to see if they will be a good fit for you. Of the 3 recos that I received, one just had reviews that he was a “nice guy”, but no mention of lyme treatment. Another, the doctor was treating lyme patients, but about half the reviews were really negative– strong complaints about the bureaucracy of the office and fees. I went with the 3rd doctor. He had a 4 month wait, also. But, the above URL might help, and at least you can keep taking the antibiotics until you see someone.

      Here is who I went with (in the northern suburbs of Chicago):
      Dr. Keith Berndtson
      Park Ridge, IL
      847 232-9800
      http://parkridgemultimed.com/

      Good luck!!!

      • Heather & Dionn,
        If you have Lyme you may want to check this device out :. http://www.spooky2.com. It is a Rife machine that is affordable [software is FREE] and has detailed protocols for Lyme + hundreds of other things. They are legally sold as frequency generators & kill pathogens without drugs. Also makes colloidal silver & has many other features. I am not affiliated; but am very happy with mine [ about $400 with shipping compared to 4-8K for most Rife products]. I have CFS/FM/MCS for 25 years & gastritis for 12. I am using this machine, LDN and Kratom at age 63 to get my life back.

  16. Hi there,
    Has anyone ever been prescribed LDN for high levels of bio toxins, most likely mold related? I also have lymes and hashimoto’s which is controlled with a low dose of WP thyroid. My doctor is considering having me take LDN and I just wanted to know if anyone out there has had any success in using LDN to combat high levels of biotoxins? Any input would be appreciated!
    Thanks,
    Erin

    • I have been told I have a mold related disease. I was so brain fogged at the time. I am getting a bit better. I did start ldn 2 weeks ago and am beginning to sleep better.