Autoimmunity, Pain, and More – 5 Conditions Low Dose Naltrexone Can Help Treat

Low Dose Naltrexone Benefits

Naltrexone is a prescription medication primarily known for curbing opioid withdrawals and cravings. Naltrexone also reduces alcohol cravings and limits effects if taken beforehand. However, we are finding that Naltrexone has many other conditions it helps treat, including autoimmune disease.

Naltrexone reduces the effects of opioids and alcohol because it’s an opioid antagonist. This means that it blocks the opioid receptors in your brain and prevents these drugs from having an effect on you. Your opioid receptors play an important role in pain perception and mood.

When you take Naltrexone, it attaches to and blocks these opioid receptors. This effect was found to be helpful to drug addicts and alcoholics, preventing them from relapsing because they had lower cravings and it reduced the enjoyment of the drug while they were on Naltrexone.

In these circumstances, Naltrexone is usually being used at higher doses of 50 to 100 mg. What doctors have discovered in the past few decades is that Naltrexone in lower doses, between 1 and 4 mg, helps regulate the immune system.  Specifically, Dr. Bernard Bihari noticed the low dose naltrexone (LDN)  benefits in HIV/AIDS patients in the mid-1980s.

What Dr. Behari set the stage for was the discovery of novel treatment approaches of many other conditions. He found that low dose Naltrexone was protective of the immune system through normalizing its function and significantly bringing down inflammation. Other researchers and doctors went on to use low dose Naltrexone in other conditions where inflammation and immune system dysfunction were underlying causes – primarily autoimmune disease.

5 Conditions Low Dose Naltrexone Treats

Low dose Naltrexone has been found to be extremely beneficial in a number of unexpected conditions, including:

1. Pain conditions
2. Fibromyalgia
3. Hashimoto’s Thyroiditis
4. Rheumatoid arthritis
5. Inflammatory bowel diseases

Let’s take a closer look.

Low Dose Naltrexone Alleviates Pain and Inflammation

Low dose Naltrexone has been shown to act as an anti-inflammatory agent in the central nervous system, through the microglial cells – in both opioid and non-opioid receptors. It’s through these pathways that low dose Naltrexone is believed to be effective in reducing pain and inflammation in a number of autoimmune diseases.

The microglia are cells located in the central nervous system and are considered part of  immune system cells. These cells often become activated by triggers, which causes inflammation throughout the body. Low dose Naltrexone has an antagonistic effect on these cells, which calms the overreaction of the immune system down. Thus, reducing inflammation and pain throughout the body.

This is one of the best effects I’ve seen in my practice first hand – LDN has worked wonders in my chronic pain patients.

Low Dose Naltrexone for Fibromyalgia

Doctors have been thrown off by fibromyalgia for a long time. This is because fibromyalgia looks like an inflammatory condition and yet it doesn’t respond to many traditional anti-inflammatory treatments and therapies.

What we’ve come to find is that there are low dose Naltrexone benefits associated with fibromyalgia in reducing pain and other symptoms. This is because LDN reduces inflammation differently than many of these other conventional treatments.  And there are theories about fibromyalgia really being more of an autoimmune condition, which would make sense as to why LDN would help for it.

One study found LDN reduced symptoms in fibromyalgia patients by up to 30%. For a frustrating and painful condition like fibromyalgia, this is extremely good news!

Low Dose Naltrexone Benefits for Hashimoto’s Thyroiditis

Low dose Naltrexone reduces inflammatory cytokines, which is a major contributor of autoimmune disease. Chronic inflammation can cause immune system dysregulation until it attacks healthy tissue throughout the body – which leads to autoimmunity. In the case of Hashimoto’s, the immune system is attacking the thyroid gland. Through immunoregulation, low dose Naltrexone has shown to be effective in Hashimoto’s Thyroiditis patients.

Dr. Izabella Wentz, who went through Hashimoto’s herself and now regularly treats this condition, took a survey of over 2,000 of her Hashimoto’s readers and asked what their most helpful interventions were. Only a surprising 38% had actually tried low dose Naltrexone but those who did saw significant improvement in:

• Thyroid antibodies
• Mood
• Energy
• Pain

Low Dose Naltrexone for Rheumatoid Arthritis

Due to its anti-inflammatory effect, low dose Naltrexone has been shown to improve rheumatoid arthritis. Additionally, low dose Naltrexone has immunomodulatory effects which could help reduce the underlying cause of the rheumatoid arthritis autoimmunity.

Currently, most of the evidence supporting low dose Naltrexone in rheumatoid arthritis patients is anecdotal. Though there are clinical studies underway reported to be completed in June of 2019. This study is looking at low dose Naltrexone,osteoarthritis, and inflammatory arthritis.

I am excited to see what comes back!

Low Dose Naltrexone for Inflammatory Bowel Disease

Studies have found a low dose Naltrexone is also effective in both Crohn’s disease and ulcerative colitis, which are the two forms of inflammatory bowel disease. Again, just like so many of the other studies when it comes to low dose Naltrexone, there is minimal research available at this point in time.

However, our preliminary findings seem to be hopeful and even inspiring.

The beneficial results that are being seen, paired with the fact that low dose Naltrexone is extremely safe and has minimal side effects, makes this treatment worth looking into for anyone with inflammatory bowel disease.

In fact, one study found that Naltrexone was safe even among children with Crohn’s disease due to its low toxicity. This study found that low dose Naltrexone safely reduced disease activity of inflammatory bowel disease in these children.

Should I Take Low Dose Naltrexone?

An added benefit of low dose Naltrexone is that it has practically no side effects, making it an extremely safe option for anyone with the conditions above to try. Talk to your doctor about low dose Naltrexone for pain, inflammation, autoimmune disease, and more.

It’s generally reported that people taking low dose Naltrexone for autoimmune disease typically take between 1.5 mg to 4.5 mg. It’s better to start low and gradually increase over the span of a few weeks.

You should know that low dose Naltrexone has not yet been approved for treatment of autoimmune diseases by the FDA, though there are many inspiring stories from both physicians and patients. In my practice, I regularly use low dose Naltrexone and have seen significant improvements in many conditions.

2020 Update

In this article I wrote about the benefits of LDN for pain conditions, fibromyalgia, Hashimoto’s thyroiditis, rheumatoid arthritis and inflammatory bowel disease.  There are also many other conditions that LDN has been found to be helpful for including:

• Cardiac, Endocrine, Pulmonary, Renal, Dermatological, Eye, Neurological, Vascular Autoimmune Conditions
• Certain Cancers
• Chronic Fatigue Syndrome
• Chronic Infections (such as hepatitis C and EBV)
• Hematologic/Bone Marrow Disorders
• Neurological Conditions
• Psychological Disorders (including anxiety, depression, and PTSD)
• Restless Leg Syndrome
• Sleep Disorder
• Women’s Health

Types of LD

LDN is a medication that needs to be made in a compounding pharmacy, as it does not come in the dosing needed for low dose naltrexone therapy at a regular pharmacy. It is available in tablets, capsules, liquid, sublingual, topical, and eye drops. 

How To Get LDN

It is important to get an LDN prescription from a licensed prescriber.  There are many reasons for this, including making sure it is actually LDN that you are ingesting. In addition, if you are on certain medications including thyroid and blood sugar controlling medications your doses may needed to be adjusted during LDN therapy.  

How To Start Taking LDN

For the lowest side effect profile, I recommend starting LDN at 0.5mg for one week, then increasing to 1mg for one week, then 2 mg for one week, then 3mg for one week, then stay at 4-4.5mg.  Typically more clinical benefit is not seen above 4.5mg, although there may be a few outliers that may do well on slightly higher doses.  

LDN Safety

In a 2019 placebo controlled trial publishes in BMC Medicine showed no difference in adverse events between the LDN groups at any dose between 3 and 250mg and the placebo group.   LDN is typically prescribed in doses of 0.5mg to 4.5mg, thus overall significant side effects are uncommon and/or short lived. 

LDN Side Effects

The most common reported side effect from LDN is vivid dreams.  This side effect usually goes away within a couple of weeks of starting it and can also be mitigated by changing the dosing to the morning/daytime versus before bed.  This strategy works for insomnia also. Very infrequently patients may have nausea or other GI symptoms, in which case the sublingual drops will be best to bypass the GI tract. 

Find a trusted functional or integrative medicine provider who is familiar with LDN if you are interested in learning if it can help your specific condition.  If you are in the Phoenix/Scottsdale/Paradise Valley area reach out to us at Arizona Wellness Medicine here or call our office at 602-892-4727.

Resources:

http://todayspractitioner.com/wp-content/uploads/2013/10/Bernard-Bihari-MD-Low-dose-Naltrexone-for-Normalizing-Immune-System-Function-athm_19_2_bihari_56_65.pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3962576/
https://www.ncbi.nlm.nih.gov/pubmed/19453963
https://clinicaltrials.gov/ct2/show/NCT03008590
https://www.ldnscience.org/research/low-dose-naltrexone-in-therapy-resistant-ibd-a-case-series
https://www.ncbi.nlm.nih.gov/pubmed/23188075

This article was originally published on April 28, 2018

This article was updated on September 24, 2020