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Patients living with severe chronic pain have limited options. Opioids have been shunned. You can read about how the “War on Opioids Punishes Desperate Pain Patients” at this link. Doctors have substituted drugs such as gabapentin (Neurontin) and pregabalin (Lyrica). Are these medications being overprescribed? Learn about the downsides of such drugs at this link. Then there is tramadol (Ultram). It is often promoted as nonaddicting, but side effects and withdrawal can be challenging. Low dose naltrexone (LDN) may offer an interesting alternative for some people in pain. Will it work for painful osteoarthritis?
People in Pain Are Trapped!
People who suffer with severe chronic pain often face a difficult dilemma. Opioids aren’t considered appropriate for long-term use. Physicians and pharmacists may be chastised by their professional organizations if they repeatedly prescribe or dispense such drugs.
NSAIDs like diclofenac, ibuprofen, meloxicam or naproxen can lead to dangerous side effects including bleeding stomach ulcers, high blood pressure and heart attacks. As a result, finding a way to manage chronic pain can be quite a challenge.
What Is Low Dose Naltrexone (LDN)?
There are two powerful opioid antagonists: 1) naloxone (Narcan) given as an injection or nasal spray in the case of narcotic overdose and 2) naltrexone administered orally in the treatment of alcohol dependence and to block opioid activity in the brain. There is a growing interest in low dose naltrexone (LDN) for the treatment of pain. Doses range from 1 to 4.5 mg instead of the standard 50 to 100 mg dose.
A Very Old Drug!
Naltrexone was developed in the 1960s. The FDA approved it under the brand name Trexan in 1984 to treat people with opioid use disorder. This drug is currently prescribed for people with alcohol use disorder at a dose of 50 mg. Most physicians have never heard of low dose naltrexone (LDN) because the FDA has never approved this drug for pain.
A reader found LDL helpful against serious pain:
“Thank you for writing about low dose naltrexone. I have spinal stenosis and osteoarthritis. Because I suffered a major stomach bleed while on meloxicam, I cannot use NSAIDs.
“I have tried several common remedies without much success. Grape juice and Certo relieved the joint pain but it caused a major stomachache. So did tart cherry juice.
“My primary care physician looked at me like I’d pulled a gun on him when I asked for low-dose naltrexone (LDN). My pain doctor had a more subdued reaction but still wouldn’t prescribe it.
“A compounding pharmacy suggested a naturopath. My first clue to how good this stuff is was when I slept through the night for the first time in months. All this time, I’d thought it was my bladder waking me up three to four times a night. Instead, it was aches and pains all along.
“When I work in my yard, I’d limited myself to two-hour shifts before. Now I can go up to five hours. I used to think twice before bending over to pick something up, but now it’s routine. Low-dose naltrexone probably won’t work for everyone but for me it is truly an enormous help.
“There’s a lot of misinformation out there. I switched primary care providers over this and my new one warned me that naltrexone is an opioid.”
A. It is discouraging to learn that a physician called naltrexone an opioid. It is just the opposite. Naltrexone is an opioid antagonist similar to naloxone (Narcan).
That means it blocks the action of opioid-type narcotics. When people overdose on drugs like heroin, morphine or fentanyl, naloxone quickly kicks these compounds off receptors in the brain. People awaken from a coma and start breathing again.
Low Dose Naltrexone (LDN) for Osteoarthritis?
We recently heard from another reader who cannot take NSAIDs for pain.
Q. I have painful osteoarthritis throughout my body. Because I am on the blood thinner Pradaxa for life, I am not able to take aspirin or NSAIDS for the pain.
I have been taking low dose naltrexone (LDN) for a couple of years. I didn’t realize quite how well it relieved my pain until I went on vacation and forgot to bring it along. I couldn’t wait to get home and get back to my LDN!
My doctor doesn’t really like to prescribe it, but she does because my former doctor, her colleague, did. I’m grateful.
A. The FDA has not approved the use of low-dose naltrexone (1.5 to 4.5 mg), but many practitioners prescribe it for a variety of painful conditions. These include fibromyalgia, multiple sclerosis, inflammatory bowel disorders and diabetic neuropathy (Journal of Pain Research, June 14, 2023).
Researchers have not studied low-dose naltrexone for osteoarthritis, although some believe it might be helpful (Biomedicines, June, 2023). One intriguing study suggests that LDN might also help people with symptoms of long COVID (Clinical Therapeutics, March, 2024). Most clinicians will want to see well-conducted randomized clinical trials before prescribing LDN for either long COVID or arthritis, however.
Why Won’t Doctors Consider LDN For Pain?
Another reader wanted to know why doctors won’t consider prescribing low dose naltrexone:
Q. I suffer from arthritis pain in my joints and muscle pain due to old injuries as an athlete. This limits my ability to exercise. I have hypothyroidism, so I have difficulty losing weight and managing my blood pressure as a result of the ongoing pain as well as the NSAIDs I take for it.
I have read about low dose naltrexone (LDN) and have discussed it with my primary care provider. He insists I should stick to aspirin and NSAIDs. Given the reported safety and effectiveness of LDN, why don’t doctors prescribe it? This is particularly irksome since there is so much concern about opiates.
The answer is that most MDs never learned about low dose naltrexone in medical school.
The FDA has never approved LDN for treating pain or inflammation. And because naltrexone is no longer under patent, no drug company is likely to spend money to see if it could be repurposed for other conditions. There is some reason to believe that at low doses it helps regulate the immune system.
Auto-Immune Disorders Are Hard to Treat:
There is mounting evidence that LDN may offer unique benefits against a number of auto-immune conditions as well as chronic pain. Norwegian researchers compared before and after results among patients receiving low-dose naltrexone and found that those on the drug needed fewer NSAIDs and other arthritis prescriptions (PLoS One, Feb. 14, 2019).
They conclude:
“Randomised clinical trials should be performed to investigate whether LDN has a place in the treatment of rheumatic disease, either as an alternative or as an add-on to established pharmacotherapy. The expired patent on naltrexone makes commercial studies unlikely, but the low cost and LDNs outstanding safety profile make it an attractive candidate for both patients and those who pay for health services.”
Remember, we are talking about doses of 1 to 4.5 mg. The doses that the FDA has approved and doctors prescribe to treat alcoholism or opioid use disorder are up to 100 times that.
Is There Any Science?
Some doctors do prescribe naltrexone to ease the pain and inflammation associated with conditions such as fibromyalgia, chronic pain syndrome, MS and Crohn’s disease (Current Pain and Headache Reports, Aug. 26, 2020).
There are reports that the drug can help treat a range of other health problems with minimal side effects (Clinical Rheumatology, online, Feb. 15, 2014). We do need large, well-controlled clinical trials of low dose naltrexone (LDN) to confirm its benefit/risk profile though!
Most people tolerate LDN well, although some report nausea, nightmares or vivid dreams. Taking it in the morning may reduce sleep disturbances.
Here is another report from a reader.
Chronic Pain Relief:
Q. I have dealt with body pain for many years. Like the proverbial frog in boiling water, my pain increased gradually over the years and I just dealt with it. I wasn’t using meds because I seem to have so many side effects from them.
This summer my doctor put me on low dose naltrexone (LDN). It is not an opioid.
Medical oversight is essential for people switching from opioids to LDN. Not all doctors know about low dose naltrexone, so it is essential to find a doctor who is experienced in prescribing this medicine.
LDN has definitely helped me with my pain. I can even think and do activities. I have not noticed any side effects.
The studies of LDN are very interesting and there is potential that it might be used for more than just pain.
New Uses for Low Dose Naltrexone (LDN)
Low dose naltrexone (LDN) is being investigated for its ability to relieve the pain of fibromyalgia (Current Rheumatology Reviews, March 21, 2017). People are also considering it as a possible treatment for Crohn’s disease, multiple sclerosis, chronic fatigue syndrome and ALS aka Lou Gehrig’s disease (NIPH Systematic Reviews, April 2015).
While you are right that the studies are interesting, a lot more research is needed to determine which conditions might respond well to LDN. It appears that this treatment is nontoxic as well as affordable (Multiple Sclerosis Journal–Experimental, Translational and Clinical, Sep. 29, 2016).
How Does Low Dose Naltrexone (LDN) Work?
There are several proposed mechanisms of action for this drug. The leading hypothesis is that LDN blocks opioid receptors. The body then compensates by manufacturing its own natural (endogenous) opioids. LDN may also have anti-inflammatory activity. Both naloxone and naltrexone appear to protect nerve cells and may have direct pain-relieving activity of their own.
Low Dose Naltrexone (LDN) Downsides:
The FDA has approved a 50 mg pill of naltrexone. To our knowledge, there are no low dose naltrexone (LDN) pills available in drug stores. As a result, they must be specially prepared by a compounding pharmacy.
If a patient tries to split up a 50 mg tablet into tiny chunks it is likely the dose will be completely off. That would lead to inconsistent dosing.
Although low dose naltrexone (LDN) is being prescribed by some physicians, long-term safety studies for chronic pain patients have not been carried out. The drug seems relatively safe, though. Vivid dreams are one of the most common reactions. Some people may find this an acceptable trade off rather than a disturbing complication.
One way to reduce this complication might be to take the drug in the morning rather than the evening. The prescriber should do some checking about the appropriate strategy for phasing in the medication and the best time of day to take it.
Low Dose Naltrexone (LDN) Upsides:
The drug should be relatively inexpensive compared to most other treatments for chronic pain. Normal dose naltrexone (50 mg tablets) cost under $40 for a months supply. A compounding pharmacy should not charge an outrageous amount for making low dose naltrexone.
LDN is being studied for a range of health conditions.
Norwegian researchers reported in April, 2015, the following:
“Naltrexone in much lower doses than 50 mg has been used in Norway for the treatment of a variety of diseases, such as multiple sclerosis (MS), Crohn’s disease, fibromyalgia, cancer, inflammatory bowel disease, chronic fatigue syndrome, and amyotrophic lateral sclerosis.”
The authors note, however, that the research to date has been of very low quality and they could not determine “whether the use of naltrexone in low doses is effective or safe.”
The People’s Pharmacy Perspective:
Much more research needs to be done on low dose naltrexone (LDN) (1 to 4.5 mg) before many clinicians will consider this approach. It is unlikely that any pharmaceutical company will spend the money to prove safety and efficacy for chronic pain. That means the FDA is not likely to approve it for anything other than alcohol abuse or to block narcotic drugs. That’s a shame, because in doses of 1 to 4.5 mg it seems safer than many of our current pain meds.
There is even a little bit of data to suggest that LDN might be helpful for some patients with long COVID (Brain, Behavior, & Immunity- Health, Oct. 2022):
“LDN is safe in patients with PCS [Post COVID-19 Syndrome] and may improve well-being and reduce symptomatology in this cohort. Randomised control trials are needed to further explore this.”
We found this article of interest as well (Pain Management, Sept. 2022):
“Cases reported significantly greater pain reduction (-37.8%) than controls (-4.3%). Whole sample multivariate modeling predicts 33% pain reduction with LDN, with number needed to treat (for 50% pain reduction) of 3.2. Patients with neuropathic pain appeared to benefit even more than those with ‘nociceptive’/inflammatory pain. Conclusion: LDN is effective in a variety of chronic pain states, likely mediated by TLR-4 antagonism.”
A “number needed to treat” (NNT) of under 10 is considered very impressive. In the above study the NNT was 3.2. That means that one out of three patients got benefit.
By comparison, the NNT for statin-type cholesterol-lowering medicines in the primary prevention of heart attacks and strokes is 140, according to Dr. John Abramson and colleagues (BMJ, Oct. 22, 2013). Physicians consider statins absolutely crucial medicines to prevent heart attacks even with a high NNT.
You can learn more about the “official” use of naltrexone at this link:
Naltrexone Cuts Urge to Drink
If you have had experience with low dose naltrexone for pain, please share your story in the comment section below.
Beth
This article from The People’s Pharmacy has saved me. I asked my Urologist to prescribe Naltrexone, but was told “no way.” I then asked my GP and was told yes, but he was confused. I pleaded and was successful. From the first dose of 1.5mg I found improvement for my diagnosis of IC (Interstitial cystitis, bladder pain syndrome, a chronic condition. The pain is severe). My compounding pharmacy cost is $33 for 30 pills. I called around to 7 other compounding pharmacies and mine was cheapest.
I now take 4.5mg my 2nd month of taking LDN. My severe cramping pain is gone. I was afraid to leave my house but am now no longer housebound. I can drive without panic (traffic jam) or not knowing where they may hide or deny the use of their precious restrooms. I couldn’t sleep longer than 15 minutes without having an awful bladder cramp throwing me out of bed like a calf cramp if you have ever had one of those. Not fun. I have no side effects in these 2 months. Hoping for continued relief. Good luck to you all.
Julue
I took LDN for a number of years to treat my fibromyalgia, Hashimoto’s, and significant post-exertional malaise (PEM) related to likely ME/CFS, which is also a common symptom of Long Covid. [I think I had Long Covid 10 years before it was cool] LDN changed my life by modulating my immune system! No more getting a cold every time I walked past a toddler in the grocery store (so to speak), my brain fog was reduced, and my inflammation was reduced. Oh, and no more constant fibromyalgia pain.
It’s a “goldilocks” drug – everyone’s dose is different, so titrating up slowly is critical. I moved up monthly at 0.5mg steps and ended at 3.5mg.
The one cost that I experienced was, eventually I had taken it too long, and ended up with serotonin syndrome (SS). Eventually the SS went away, but it took awhile. If my doctor had been half as educated about LDN as I was, we might have caught the SS sooner.
Lastly, there is plenty of research being done by the LDN Research Foundation, and a number of universities. But not any large Phase 3 trials, because there no profit to be made, and phase 3 trials cost a ton of money.
Brooke
My Dr was very receptive to my taking LDN for Fibro. I’ve been taking it for over 10 yrs at the 4.5 mg dose. I take it in the am,the earlier the better. I have it compounded by a compounding pharmacy in Colorado. I brought my Dr lots of printed out info from reputable sources.
Marie
I was surprised when I asked my doctor for pain medication. She was horrified and said “don’t
ever ask”. I’ve taken Hydrocodone when I had knee replacement. I need a new knee after ten years. I have back pain that’s very unpleasant. Just because some people become addicted doesn’t mean the rest of us should suffer. Thanks for the article on Naltrexone.
Jennifer
I have taken LDN for about 6 years. After 25 years of multiple myalgias, weird symptoms and getting sick often, I was diagnosed with Ehlers Danlos and it was suggested that I try LDN to calm my overreactive body. It’s been wonderful! I didn’t instantly feel different but, give it time and it should help. If you have a chronic condition then there are probably other things that you’ll need to always work on (like changing your diet, limiting certain activities etc) but LDN can certainly be an encouraging boost!
Jeanne
I wish it worked for me. I’ve tried it 4 different times, in two different forms, from two different doctors and three pharmacies.
The latest trial started a year ago at an ultra low dose (0.25mg) and was amazing for two days. Then when I titrated to 0.35mg after 2 weeks, horrible depression took over. I tried going up, going down…same thing. After that, no matter what dose I tried, it brought on depression.
Kathleen
Over 25-30 years ago I read about the doctor that was using this for ms. It was also being used to help opiod addicts detox. Of course it was impossible to find a doctor that would prescribe it for those purposes. Now it
‘s the IT drug.
MICHELE
I have been taking LDN for osteoarthritis for about a year. I believe it is helpful and have not had any side effects. It is easily available on line from AgelessRX.com.
Albert
I too suffer with chronic back pain, tried injections, and Dalit Tramadol still suffer with poor sleep and daily constant pain. No way will I get surgery, would like help. LDN , doubt my Dr would prescribe now will ask my pain clinic.
Julie
Thankfully, I don’t need anything for pain relief right now, but I am taking this article to my doctor this morning when I go for my annual exam. It sounds like the potential for helping so many people is very significant.
Maggie
I got Long Vax three days after my last Covid booster.
(Fifth Covid shot). For eight months I lived in a chair.
Brushing my teeth was an effort. and I did little else.
I was finally over that when after four years of caution
because of Covid, I attended a longtime friend’s birthday
party, forgetting that some would be flying in for it.
Half the people there came down with Covid, but mine never went away. I had hardly any symptoms until it
morphed into Long Covid. Again, for almost a year, I could do nothing but sit in a chair under heating pads and electric blankets, in pain, and in deep brain fog. Finally, several months ago, my doctor suggested we try a very low dose of Naltrexone. At 4.0, it had to be compounded. After
just a few days, I was out of my chair and back to life.
The only side effect that I noticed short term was irritability.
I stopped for a couple of weeks, but started slipping backwards so started taking it again. It will be a
process to see where it takes me from here, but at this point
for me it’s a miracle drug.
Joan
My husband has a rare autoimmune disease called RS3PE which made his hands swell up to the point where he could not use them. The rheumatologist prescribed steroids which allowed him to use his hands again. However, the side effects of the steroids were not good. We read your article about low dose naltrexone and asked his ND about the drug. There is a compounding pharmacy about 40 miles away where the pharmacist is very knowledgeable about LDN. The ND sent a prescription, and my husband has been taking 0.3ml nightly since 10/22. He has had no adverse side effects from the LDN and the RS3PE is under control. He was able to get off steroids completely.
Bob
Is this drug being studied as a possible help to sufferers of Long Covid – and if not, why not??? Many (if not all) of the symptoms it seems to successfully address are present in those suffering with Long Covid.
Janice
I have been taking LDN (4.5 mg) for the past 9 months, prescribed by my Mayo Clinic neurologist for erythromelalgia (“burning feet syndrome”). I have suffered with this condition for 17+ years, and LDN is the first medication – I’ve tried more than a dozen – that has ever helped. With LDN, the worst pain I feel in my feet is a 6-7 on the pain scale. Before LDN, my worst pain was a 9-10. This is a HUGE improvement and has brought me back from the brink of despair. The only noticeable side effect are very vivid dreams (I take LDN at night), but it’s not a big deal and doesn’t really affect the quality of my sleep.
My neurologist believes my erythromelalgia is a symptom of an underlying autoimmune disease, possibly Sjögren’s, and therefore my situation could be another example of LDN helping with autoimmune conditions.
Georgeann
Please note a very unpleasant side effect of LDN. After a few years of enjoying its positive treatment of my MS brain fog I developed very serious and extremely uncomfortable diarrhea eventually diagnosed as IBS. Stopping the drug calmed the IBS massively to a more manageable degree. I believe, as the GI doc said, LDN aggravated the IBS but it did not actually cause it. So now I have to put up with MS brain fog and and an at least manageable level of IBS attacks. Such is life in the MS sphere.
Belinda
My doctor prescribed LDN a few years ago for the pain of fibromyalgia. Within a couple of days I started having migraines. I thought that perhaps it would get better with time, but after two weeks I was in constant severe pain. After consulting with the doctor, I stopped taking LDN and felt better after a couple more days. I’m so glad that this works for many people, but just beware that it isn’t for everyone.
Amy
I started LDN in 2015 for autoimmune issues. While I wasn’t having much pain (I had been on Dr. Brown’s antibiotic protocol for 5 years with great success http://www.roadback.org/faqs ) LDN brought me into remission according to lab values. Unfortunately I stopped taking it as I thought it had stopped working for me. This was when I hit menopause and everything went haywire in my body. I restarted LDN in 2020. In late 2019 I developed MdDS or disembarkement syndrome where I feel the emotion of being on a boat. Similar to stepping off a cruise ship, although it is nonstop. The LDN has helped this motion tremendously.
There are online communities about LDN. Unfortunately, medical records don’t allow for the listing of LDN and it is reported as Naltrexone. I always get an odd look from a new doctor.
Go to the Facebook group, Low dose Naltrexone (LDN) for chronic illness & infections
https://www.facebook.com/groups/108424385861883 is a helpful group for LDN. There is a ton of resources in the file tab. Even how to compound your own by dissolving 50mg naltrexone in 50ml of water. Now 1ml equals 1mg. Makes for easy dosing. But do replace this solution every 7 to 10 days as it loses effectiveness. And store in the refrigerator.
If you can’t find a doctor to prescribe it, check with a pharmacy and ask for the names of local doctors who do prescribe LDN. It can make a world of difference. And it is cheap. I ask for a 90-day supply of one a day 50mg tablets. That lasts for more than a year for about $30.
Brooke
I read about a Dr checking the effectiveness of LDN on AIDS patients. He was based at the University of PA.. In Hershey.I printed out the info Took it to my Dr. I wanted to take it for my fibromyalgia. He agreed to prescribe it, even tracked down a compounding pharmacy.It works for me.No side effects & costs about $25 bucks a month.my hometown compounder retired so I found one in CO.There’s a fair amount of info out there. Google is your friend!
Lesley
My husband has MS and has been on low dose naltrexone 4.5 mg for over 20 years. He sleeps very well and has never had pain. His neurologist writes the prescription and we get it from a good compounding pharmacy in Florida.
TR
I was put on daily dose of 4.5 Mg of LDN by my GYN for severe fatigue (started at 1.5mg and increased from there) I also have spinal stenosis, bulging discs and osteoarthritis throughout my body, in addition to a lupus like auto immune disease. LDN has helped tremendously with fatigue and as a bonus my pain. I still take Diclofenac and Gabapentin which I was taking before starting LDN. The nightmares are a small price to pay for less pain and fatigue during the day. They have actually diminished in frequency over the first year, but boy they can be vivid! My rheumatologist has taken over prescribing my LDN since I have had such success with it. I have wondered if a higher dose would work better for me since I’ve read of ppl taking up to 10mg. The compounded rx costs me approximately $70 for a 90 day supply.
Pamela
Used LDN for severe pelvic nerve pain and it provided good relief. Had read about it and discussed with a compounding pharmacist who was supportive and then went and approached Doctor. Because nothing including 5 nerve blocks and all the other drugs he approved. Compounding pharmacists are awesome!
Patricia
As the 50 mg tablets are inexpensive, but compounding smaller doses can be quite expensive, I found that I can dissolve 1/2 tablet (25 mg) in 25 ml of filtered water, using a graduated cylinder to measure the water level. I then use a plastic syringe to measure 1.5 ml and squirt that into my mouth. I keep the solution in a dark bottle in the refrigerator and make sure to thoroughly clean it after having used up the 25 ml, before dissolving another 1/2 tablet.
Joan
I have painful osteoarthritis throughout my body. Because I am on Pradaxa, a blood thinner for life, I am not able to take aspirin or NASIDS for my pain. I have been taking low dose naltrexone (LDN) for a couple of years. I didn’t realize quite how much it was relieving my pain until I went on vacation and forgot to bring it along. I couldn’t wait to get home and get back to my LDN! My doctor doesn’t really like to prescribe it, but does because my former doctor, her colleague, did. I’m grateful.
Gary
LowDoseNaltrexone.org
The LDN Book by Linda Elsegood, volume 1 & 2
These references are excellent sources of information about low dose naltrexone (1-4.5 mg/day) and (vol 2) ultra low dose (0.1 mg/day) naltrexone (for chronic pain treatment).
As a family physician, practicing in Woodbury, MN; I have seen LDN improve and prevent viral infections, cancer, chronic urticaria and many autoimmune conditions. It is well tolerated, particularly if taken in the morning, if sleep is disturbed. Symptom improvement typically takes 2-3 months, but can occur quicker. Symptoms will recur if the LDN is discontinued.
In 2021, LDN 1.5 mg, 3.0 mg and 4.5 mg tablets were manufactured, just not widely available, yet.
More of my colleagues, are willing to prescribe this treatment as of late, but sadly, the vast majority remain reluctant.
The majority of my patients receiving this treatment, have experienced life changing improvement.
Pamela
A compounding pharmacy is NOT necessary to use LDN. My doctor just prescribes the 50 mg pills, and we put them in water and the titrate how much is needed. I am on a 4.5 dose. I have been doing this for years, and it works beautifully. Please tell people this so they don’t think they need to pay extra at another pharmacy just to access this cheap, PERFECT painkiller. You can even just order it online.
Karen
I was diagnosed with Hashimoto’s July, 2017. My doctor prescribed LDN 4.5mg to help lower my Thyroid Peroxidase antibodies. It has helped tremendously! My anitbodies went from 2900 down to 129 (Normal is 0-34). I am sure that diet and exercise has helped as well. Feeling better everyday! :)
Brooke
I’ve been taking LDN for 6 yrs at least. Read about the work done by a Dr at the U of Pa& printed out all the info.Took it to my Dr. He even found a compounder here in town. I soon quit that compounder as he raised the price monthly. Found a compounder inGolden Colorado & they charge $20. A month & that includes shipping.I take it for fibro. It definitely helps.
Deborah
I have Hasimoto’s thryoiditis. I cannot take higher doses of Levothyroxine because of my history of paroxysmal atrial fribrillation, so my thryroid antibodies (TPO) have always remained more than double the high range. For years I have experienced the feeling of depletion that goes with this autoimmune response to my thyroid. However, after three months on LDN my TPO came down to within six points of normal range, which is a quantifiable difference, and I continue on a dose of 3 mg because I feel so much better. Can’t put my finger on a quantifiable difference in how I feel; can only describe it as a feeling of relief, lightness, and well-being. I switched to taking it in the morning.
GODISLOVE
I have had fibromalgia for 24 years, and it is a very hard disease to treat. I also have daily headaches with the fibromyalgia and occasional migraines and IBS. I was diagnosed 3 years ago with Hashimoto’s. I have taken everything for Fibromyalgia but the following work the best for me: Magnesium 2 200 mg tablets a day, Vitamin D3, Omega 3, B Complex, Probiotic, Vitamin C, Melatonin 5 mg for sleep, Flexeril for muscle pain, extra strength tylenol (ONLY AS NEEDED) and low dose of Naltrexone, 1 mg, 3 times a day and Voltarin prescription pain cream. Eating a high protein and low sugar diet AND staying away from caffeine helps me the most, diet-wise.
It’s important to keep moving as much as possible and keep your weight down. People truly do not understand both of these diseases if they do not have them. You have pain, soreness, stiffness, mental fog, trouble sleeping, severe fatigue and barometric pressure can flare up the pain. Long soaks in epsom salt help tremendously along with heat packs, and a massage tends to help tremendously. No two people are alike that have Fibromyalgia or Hashimoto’s – so it is not a one-size-fits-all treatment. I hope that some of these suggestions help others. God bless you – I understand!!
MICHAEL
KATY TEXAS
4/9/2018
V.a. 58 year old tbi, autoimmune passiviley trying to kill me for 40 years. Va with much fighting proved sarcadosis, inflamatory disease of some kind, ostiarthitis. Ie hard to type here. Headaches i lost a deacade of life with what some believe the worst headaches every recorded. Constant chronic pain, fybromalgia, reactions to meds. Headaches hormone, cluster constant, migraine and nerve. Resulting in tbi at the point of death. 3 years i gave va life or death altematum. Ldn or die trying. Started high kicked like a mule worked at 4.5-5. Its like a gumball you put a penny in you get a penny gumball a quarter a bigger. The va does not have this so here are 50mg pills you figure it out. It has stopped most all headaches, no side affects, stopped autoimmune attacks in which i hit the floor 18 times in 3 years. Slowed inflamation on location such as arthritis in back and fingers. It works electronicly in the body. The bodies nervous system opperates to a degree like an electrical circuit. This modifies that so that it does not over impact the neuro response. So in my case the headaches were my target it worked because of the blood brain barrier. I surmised that since opoids did work years ago for the pain this had to do a similar and that was correct. Since it works in the nervous system i figured it would work for my onset parkensons symptoms. Likely tbi but the same and it did. Where as the va are dip shits and like to cancel my meds its one reason i hit the floor. Cascade system failure causes the autoimmune to go from passively trying to kill me to activily. This stop the active but it cant fix the stupid. Sugar levels put strain onheart and neuropothy it cant fix the actual physical nature but the correct levels of those meds keep it down so the ldn keeps the auto immune in check. Ie ldn can control the systems but you still need the other meds to keep the system in balence. Bp gi diabetic meds hold things good then this will work for pain headaches and auto immune. The va and i quote neuro to mental health. Go ahead give it to him he cant hurt himself with it. Thats probably true to a point maybe. When they played with my meds testosterone and diabetic a real time occurance happend and i had to add prednizone and increase ldn. Cleaned my clock. Worked i also tried lower doses did not work. So as i said physical medication and factual issues do apply. As to what would happen with much larger dose i would not try. But i suspect only a person who needs this would be impacted by it. Ie if you have no issues your body would ignore it. My results started the same day i took it. As per take it at night after sleep meds i take zanex for sleep and before you get in bed sleepy. I already have a hangover type in am this is a minor less than it was and you will wake up like a bullet. I wake up 9 am pretty much on the dot. Wide awake. Like a wide awake drunk to some degree. Been on it 3 months.
Bailey c
Texas
I’ve been on 3mg for three weeks now and have not seen a BIT of improvement or pain relief. Should I continue to be patient or ask for a higher dose? My pain is greatly affecting my job and I’ve had to demote due to not being able to perform everyday. Can anyone offer advice? I have fibromyalgia, lupus, degenerative disc disease and RA (and of course the depression and anxiety all of the above caused) and the only thing that seemed to work (sort of) was Plaquenil but that drug scares me. Any info is appreciated.
Rosary
United Kingdom
Hi Baily C
How are you feeling? Did you have any improvements with the LDN?
Linda
Ennis, Montana
I have been on LDN for 6 months. I have Sjogren’s, small fiber Neuropathy, autonomic insufficiency, raynauds, osteoarthritis in most joints. This drug has me feeling better than I have felt in years. I like to think of it as prednisone lite, with none of the side effects. I no longer take prednisone, azothiaprine or Plaquenil! Diet has also helped some. Gluten free, very little soy, no coffee or alcohol, little dairy and sugar. I am so pleased with LDN I want to tell everybody that hurts to try it!
I should mention, the first week on LDN I actually felt worse. The next 4-5 weeks I felt pretty normal for me. But then it was like a switch came on! Suddenly my pain was gone! Sure I still have arthritis, but feel so much better! Give it time, so worth it!
worried wife.
Australia.
Hi, my husband began using LDN about eight weeks ago, along with Ketamine, and Tapentadol.
He has an extremely complex case of Peripheral Neuropathy, sensory in his feet. So anything he touches feels like tacks in his feet. This condition has been crippling him emotionally for a long time, but moreso the past five years. At the moment, he is extremely unwell from feeling nauseous and cannot hold food or drink down. We are not sure what the cause is, but LDN is the only new drug he has been taking, and for three weeks now has been feeling really like crap. His full dose of LDN was reached almost one month ago after a buildup for 27 days.
He was in hospital overnight, came home feeling a lot better after receiving 6lts of fluids due to being dehydrated from not being to hold anything down. Felt fine when we left the hospital. Came home, had his 4.5mg dose of LDN, as they didn’t have it at the hospital, and within an hour was feeling dreadful again.
We are thinking maybe this medication is causing the problem. Has anyone else had the same symptoms? What did you do to alleviate them? The pain in his feet is no better.. so we don’t know whether to continue on or just wean off the LDN.
Coco
South Africa
What dose are you on? Glad for you that it’s working. I have been on 2.5 mg for the last 3 week. Don’t feel any difference yet. I really struggle to have a good night’s rest since I started. I am supposed to go up to 4 mg, but worry that I will sleep even less.
Sarah N.
NY
Amy on 11/17 posted about 50 mg in 50 ml of water. I use 2 pills (=100 mg) dissolved in 100 ml (3.5 oz) of filtered water, & take 1-4.5 ml, in free syringes from pharmacy (given for children’s liquid meds). 100 ml is a month’s supply. The liquid form is stable: see “Formulation and stability of naltrexone oral liquid for rapid withdrawal from methadone,” by Fawcett JP1, Morgan NC, Woods DJ., in Ann Pharmacother. 1997 Nov;31(11):1291-5. “Abstract: Objective: To assess the stability of naltrexone oral liquid prepared from tablets and powder … Conclusions: Naltrexone 1 mg/mL oral liquids prepared from tablets or powder are stable when stored in the dark for 60 days at 4 degrees C and for 30 days at 25 degrees C. …”
Viewed at https://www.ncbi.nlm.nih.gov/pubmed/9391680 PMID: 9391680 DOI: 10.1177/106002809703101102
Evan K.
FL
I gave been on Ldn for about a year. I am so grateful to the man who brought it to my attention at a support group for fibro.
About a year ago I produced a song called “Ldn” to show my appreciation. Ldn has helped so much.
Here’s the link to the song :
https://youtu.be/SPEZNpucwqI
Dani
Franklin, TN
I use LDN daily with my chronic pain, autoimmune, RA, LUPUS, Hashimoto’s patients! I personally us it at 3.0 mg for my Lupus and my hand pain (along with food elimination) is gone! My patients love LDN and many tell me they feel better than they have in years on LDN. I generally use anywhere from 1.5-4.5 mg. It’s a shame to me that big pharma doesn’t get on board and realize that our bodies are designed to heal themselves! We simply have to give it what it needs. Keep up the good work! I share your podcasts weekly with my Facebook community!!
Dani Williamson MSN, FNP
Integrative Family Medicine
http://www.danwilliamson.com
Coco
South Africa
This is so encouraging. I have Hashimoto’s and had painful burning in my feet for 3 years, and now lately also the palms of my hands and wrists have burning sensation all day. I have been on 2.5 mg for the last 3 week. Don’t feel any difference yet. I really struggle to have a good night’s rest since I started. I am supposed to go up to 4 mg, but worry that I will sleep even less. Will this pass? Thanks C
Cynthia
murrells inlet, sc
Dan Williamson, MSN,FNP, would you consider a telephone consult to prescribe LDN? I have asked my FNP, family physician and a Rheumatologist. None of them have heard of or will consider the benefits on LDN for osteoarthritis of neck and back. I cannot locate any one in the Myrtle Beach, SC area who will prescribe this combo. Thank you,
Cindy S
Steve
East Coast
I tried LDN for fibromyalgia and very carefully titrated the dose. It does not work for everyone, despite many online cheerleaders. When I hit 2.5 mg, it upregulated my fibro pain to intolerable, the opposite of helping. I also experienced several terrifying nightmares. It’s a real medication so don’t underestimate it because it 1/10 strength of naloxone.
Melissa
Durham, NC
Below is a letter I wrote to my rheumatologist in November 2015. She had diagnosed me with mild-moderate rheumatoid arthritis (RA) in November 2012 (age 57). I am grateful to have to opportunity to thank you both as one of your programs helped me find LDN. I continue to be free of RA symptoms and consider myself cured.
Dear Dr. xx,
I write to let you know how I am doing in hopes that my story might be of interest to you and that others might benefit from my experience.
Since I saw you last in spring of 2013 I have managed to heal my RA completely – meaning I have no RA symptoms at all – no swelling, no pain, and no loss of ROM (range of motion) – nothing. In fact I feel better than I have in years.
As you may recall I presented to your office in a lot of pain in November 2012. After your workup, including x-rays, labs and a clinical exam you diagnosed me with mild-moderate RA. You were patient with me as I struggled to accept the bad news. I delayed starting methotrexate in hopes that my thyroid medication would help my symptoms but by early January 2013 I agreed to begin methotrexate at 10 mg/week.
You may also remember that I very much wanted to find an alternative treatment approach. I shared an article from the New York Times Magazine (The Boy with a Thorn in His Joints) that was similar to my story and similar to the approach I wanted to take. The article described a 3 year old boy with RA whose mother found that the source of his problem was intestinal permeability. She treated him with dietary restrictions (no gluten, dairy, and nightshade vegetables), Chinese 4 Marvels Powder as well as methotrexate for a time.
After reading that article I decided to find a doctor who might be familiar with 4 Marvels Powder and who would also be able to help me heal my leaky gut. I found Dr. XXXX. She started me on supplements including probiotics, IP6, D3, methyl B12, curamin, L-glutamine and fish oil.
A few weeks after my first appointment with Dr. xxxx I happened to catch an episode of The People’s Pharmacy. The guest was Paul Ewald, PhD. He was discussing his research on infectious causation of some autoimmune disorders and some cancers. As my RA onset was sudden and followed a flu shot and antibiotic treatment for a sinus infection I had wondered if the sinus infection and/or the antibiotics could be at least part of the cause of my RA in conjunction with my leaky gut. This led me to the web to search for medications that might address “RA caused by infections.”
I found articles about Low Dose Naltrexone (LDN). I was familiar with Naltrexone from my work on an HIV prevention clinical trial for injecting drug users that included treatment with Suboxone (buprenorphine/naloxone). Both Naltrexone and Naloxone are opiate antagonists.
As you probably know Naltrexone is an older FDA-approved drug for treating opiate addiction at 50 mg daily. I started LDN at 1mg per day in June of 2013. With Dr. xxxx’s help I tapered off the methotrexate and tapered up the LDN over 6 weeks until I was off methotrexate and taking 4.5 mg of LDN daily.
I continued on 4.5 mg of LDN daily from June 2013 until May of this year. I hesitated to stop it but I needed a screening colonoscopy and was advised to stop LDN 10 days prior to my procedure. My RA symptoms never returned and I have not returned to LDN.
Dr. xxxx has followed me closely and my labs have shown no liver or kidney issues at all. I also had a repeat set of x-rays in January 2014 (no methotrexate for 6 months and LDN for 6 months) that showed no progression of arthritis. My symptoms had certainly improved on the methotrexate and I will never know if that caused my remission (or cure as I like to say) but I do know that I have been off methotrexate for well over 2 years and now off LDN for over 6 months and I have no symptoms.
In fact I am well enough to be accepted into the Peace Corps. I leave in January 2016 for 2 years in South Africa. A diagnosis of RA is usually cause enough to be denied according to their literature. I am sure that because I have been symptom-free for so long and now medication-free as well that they feel I am healthy enough to serve.
I hope my experience will be of interest to you and that you will explore intestinal permeability (leaky gut) and Low Dose Naltrexone. RA is such a disabling disorder and while I know my experience may not be typical I also know I am not the only person who has found that diet change and healing intestinal problems can significantly reduce RA symptoms.
Kind Regards
Gloria
Is this low dose the one you are familiar with?
HappyHiker
Pacific Northwest
I have been using 4.5 mg nightly for 1 month. It is dramatically improving my rare idiopathic dystonia my neurologist thinks is neuroinflammatory in nature. LDN acts to reduce neuroinflammation. I can walk and type and work again with no appreciable side effects.
I am over the moon happy to return to gentle hiking in my favorite mountains. There is a desperate need for more research and so very many people who could benefit. And yes, my first rx of LDN was very expensive but now I just found a more reasonable compounding pharmacy from a friend.
Good book on LDN is by Elaine Moore and Samantha Wilkinson, available on Amazon. I believe that neuroimmunology will be the most exciting area to break open our understanding and treatment of diseases in neurology, psychiatry, and rheumatology, just to name a few.
We need to press for real NIH and NIMH research into neuroimmunology across diseases and across medical disciplines. I am a living experiment benefiting from LDN thanks to an unusually smart and open minded neurologist.
Thanks, People’s Pharmacy, for spreading the good news about LDN!
Shannon
GA
I use naltrexone off patent too for trichotillomania [hair pulling]. It has been a godsend and helped me more than I ever thought possible. (I’ve struggled with the disorder for almost 40 years).
Susanne
Charlotte, NC
LDN made a major change in my life! I can function much better during the day; my pain levels and ability to focus have improved greatly, and I can enjoy life again. My fibromyalgia and other autoimmune symptoms have definitely abated. The only side effects for me are insomnia and vivid dreams, which I will GLADLY exchange for what I suffered before LDN. These symptoms did taper off after several weeks.
I found that my rheumatologist was most unwilling to prescribe it and wasn’t willing to even investigate it; he wanted to prescribe plaquenil and other drugs with side effects. However, my primary care doctor was willing to prescribe it after I asked him about it.
I am so thankful for this drug! I take 5mg every evening. I tried taking it in the morning to try to help my insomnia, but it seems to work better when I take it at night. My insomnia is much better than it was than when I first started taking it, in any event.
Nora
Hillsborough, NC
Susanne,
I was wondering if it would be possible to connect with you. I have had TTM since I was 9 (30 now) and my mom is the poster above with the letter to her doctor and peace corps admission. I would love to talk more as I am considering trying LDN myself.
Dave
Virginia
Could the pills be safely divided by using a water titration method? I used this method to taper off Klonopin. Buy a 100 mL graduated cylinder, mortar and pestle, and a syringe (like used for giving kids medicine). Pulverize a pill using the mortar and pestle, then dissolve it in 100mL of warm water. If you started with a 50mg pill, you’d just take 10 ml of the solution.
Amy
NC
LDN is widely used in the rheumatic community. Instructions are online on how to make a solution of 50 ml water with a 50mg tablet. Then you have 1 mg per ml for accurate dosing as compounding is pricey. LDN modulates the immune system. There is much info on it in the book, Honest Medicine. It even helped with my dreaded seasonal allergies with no side effects for me.