Ten years ago April marks the anniversary of the first time I wrote about low-dose naltrexone (LDN). I described it as an orphan drug, meaning that its patent had long ago expired, that it was generic, and that it was not owned by any one company. For these reasons and because they’d never recoup their investment, no Big Pharma company was interested in pursuing the costly clinical trials that might have proven LDN’s usefulness.
Full-strength naltrexone (in a 50-mg capsule) was approved by the FDA for patients addicted to opioid medications, and with the opioid crisis still with us, it is for this that full-strength naltrexone is prescribed.
But an interesting phenomenon was observed among some patients taking full-strength naltrexone for opioid addiction. Those who also had Crohn’s disease or multiple sclerosis reported an improvement in symptoms. Many, in fact, were able to reduce their doses of conventional medications to treat those conditions, and some went off their meds completely.
(A similar phenomenon occurred among patients taking beta blockers for cardiac arrhythmias who noticed their migraines were occurring less frequently. Three years and many clinical trials later, beta blockers got FDA approval for migraine prevention. Since the beta blockers were still protected by patents, the clinical trials were paid for by Big Pharma.)
There was one interesting sidelight: when the naltrexone was given in lower doses (as low as 1/10th or even 1/20th of the usual dose), it actually worked better for the Crohn’s and MS. Hence, low-dose naltrexone, which you’ll see everywhere as LDN.
LDN use dramatically increases
For LDN you need to seek out a compounding pharmacist. Here the pharmacist is making up the capsules individually for your needs precisely as prescribed by your physician.
It’s not necessarily easy to find a physician-prescriber for LDN. Many doctors, especially those employed in the mega-groups like Northwestern or Advocate, have agreed to limit prescribing to FDA-approved drugs. Just to be clear: LDN is not FDA-approved for anything and will not work for opioid addiction. A person struggling with opioid addiction will always be prescribed full-strength (50 mg) naltrexone.
Ten years ago, at the time of my original article, I asked gastroenterologists and neurologists if they’d heard about LDN. Yes, their patients mentioned it. Did they prescribe it? No.
A decade later, reflecting on the significant increase in the number of conditions helped by LDN, we can add allergists, dermatologists, rheumatologists, psychiatrists, pain management specialists, endocrinologists, cancer specialists, kidney specialists, pulmonologists (lung), and infectious disease specialists.
This link opens to the non-profit LDN Research Trust and lists the conditions for which LDN has been prescribed.
Is LDN 100% effective for this startling catalog of human (and pet) ailments? Of course not. If this were the case, health care would grind to a halt and everyone would be taking LDN for everything.
The list is meant to show that trying two to three months of LDN might be an important addition to your current chronic condition treatment regimen.
How does LDN actually work?
Low-dose naltrexone, on the other hand, is incapable of blocking opioids. However, it is well recognized as an excellent choice for chronic pain management. LDN is totally non-addicting and has minimal side effects (vivid dreams are among the most commonly mentioned).
How LDN works for chronic pain gives physicians some idea of how it works for other conditions.
First, understand that you’re actually taking a mixture of two forms of LDN in every capsule, a levo form, where the molecule is twisted to the left, and a dextro form, twisted to the right. These are called isomers.
The levo form acts to block the opioid receptors. In the process, it also raises the brain’s level of neurotransmitters, especially dopamine, one of the so-called happy molecules, which explains its recent increase by psychiatrists for treating resistant depression. Raising endorphins also reduces inflammation and in turn reduces pain and improves the overall sense of well-being.
The dextro form of LDN is more useful for autoimmune conditions, because of its effect on cytokine-modulated immune cells. “Cytokine” is a very general term for a type of protein released by white cells that either lessens or increases inflammation. A balance of both pro- and anti-inflammatory cytokines is ideal. An excess of inflammatory cytokines spells trouble. Here’s one study showing how LDN reduced the cytokine inflammation (and pain) of fibromyalgia. And here is another study that was started last year when it was recognized that Covid-19’s attack on the body was one massive cytokine storm.
Chronic conditions and LDN
If you have just about any chronic condition, it’s worth learning if LDN can be a useful adjunct to your treatment. A quick way to do this is to type the name of your condition (or symptom if you don’t have an official diagnosis) into your search bar along with either “low-dose naltrexone” or “LDN.” Just now I did this with psoriasis and came up with several quality research articles, among them this one. Get the drift?
You can ask your primary care doc or specialist for an LDN prescription, but don’t count on an enthusiastic response. Expect instead a lecture about “off-label drugs” and “unproven drugs,” ending with “just take what I tell you to take.”
If you’d like to pursue a course of LDN, schedule a WholeHealth Chicago appointment, either in person or via telemed, with practitioners Caley Scott, Wendy Ploegstra, Parisa Samsami, Rachel Gates, Katie McManigal, or me.
All of us at WholeHealth Chicago are familiar with the benefits of LDN and can connect you with one of our MDs or nurse practitioners who can send your prescription to a compounding pharmacy. Compounders are preparing thousands of prescriptions for LDN around the US and worldwide, so if you have a favorite, we’ll be happy to send it there.
David Edelberg, MD
6 thoughts on “What is Low-Dose Naltrexone (LDN) and Can It Help Me?”
I was put on the antiarrhythmic drug Amiodarone a month prior to a planned heart ablation to stop A-fib. Two days after starting the drug I started having crying spells for no reason and lost my appetite and had to struggle to eat anything. That was 22 months ago and the crying has turned into anxiety and depression which I never had experienced before and it hits me at regular intervals throughout the day. I went from weighing 125 lbs when they started the Amiodarone and I went down to 99 lbs in 3 months with a messed up gut and SIBO. I struggle to eat, can’t gain back weight, am fatigued and all trials with antidepressants make things worse. Lorazepam is the only med that works and I take 1 mg/day to dampen the continued anxiety. I know that Amiodarone messed up my mind and gut by it’s effect on the Vagus Nerve and am looking for methods to heal the damage – acupuncture provides relief but only last a day. I just received my prescription of 1.5 mg of LDN from a compounding pharmacy and will see if this treatment will provide relief. In Addition to the Lorazepam, I am taking Ashwaganda and Chinese herbs qui pi tang and tian wang bu xin wan . Is there a potential interaction between these supplements and LDN? Can LDN help?
It’s possible that LDN might help – the best step to take here is to schedule an in-person or telemedicine visit with one of our functional medicine providers. Please give our Patient Services staff a call and they can set an appointment for you at your convenience. They can be reached at 773-296-6700.
We look forward to seeing you, Moira!
I’m 82 yrs young with a history of over 15 yrs on Lipitor & now over 1 yr. on Crestor! 3 yrs ago I had 2 TIA’S while in Europe. I was then told I had 2 blood thhinners. Socialized Med droped one. Now on Pradaxa & Crestor. Want to get off Crestor. I’m Obese at home due to Covid 19! HELP!
Hi Thomas –
Our nurse practitioner Rachel Gates can help with this! Please consider scheduling a telemedicine visit with her by calling 773-296-6700. Rachel has a background in cardiology and can see you from the comfort of your home to go over your history and discuss options.
Not long ago I was given lLDN . It was a horrible experience . Instead of doing as the article suggest , it threw my body into full blown detox from my prescribed opioids . My heart rate was over 130 and my blood pressure was extremely elevated . From one dose . My husband had to call poison control and they said it was absurd to be prescribed this while on opioids because it is what they use when someone is over dosing on opioids . From personal experience I wouldn’t suggest that anyone who is prescribed opioids should try this .
Years ago, I gave my dog, suffering with nasal cancer, low dose naltrexone. I had to beg my vet for a prescription, and I had to get it at a compounding pharmacy. Her diagnosis of 90 days was extended to 2.5 years, and we were so grateful to have our sweet girl with us that much longer. I’m sure LDN and other supplements I gave her, including Chinese herbs, prolonged her life.
Barbara J Dalton