The Texas Guide to LDN Benefits and Risks: What You Need to Know

Low dose naltrexone (LDN) refers to the very low dose of the opioid antagonist (blocking) drug called naltrexone.  Initially developed to treat opioid addiction, naltrexone was later found to have significant beneficial effects on immune system modulation at much lower doses. 

Diseases that involve immune system dysregulation are the primary types of conditions that may benefit from adjunctive treatment with LDN.  Ongoing research is uncovering other mechanisms and effects that may broaden its use with time.

LDN briefly blocks opioid receptors, which triggers a rebound effect, leading to increased production and release of endorphins and enkephalins, natural substances that have pain-relieving and anti-inflammatory properties.

May help regulate the balance between pro-inflammatory and anti-inflammatory cytokines, potentially reducing inflammation and promoting healthy immune regulation.

May inhibit the activation of microglia, the immune cells in the central nervous system and thereby dampen neuroinflammation and provide neuroprotection.

May affect the levels of neurotransmitters such as serotonin and dopamine in the brain, potentially influencing mood, pain perception, and other physiological processes.

Naltrexone is FDA approved for use in opioid and alcohol addiction/dependency disorders.  Low dose naltrexone (LDN) is legally prescribed "off label" though technically it has not been "approved" for use in low dose by the FDA.

Most insurance plans do not cover LDN though if you have a HSA card you may be able to use it to pay for your prescription.  Contact your HSA plan to verify.

Excellent quality LDN should only be obtained from a compounding pharmacy experienced in its special preparation.  I can provide recommendations of several compounding pharmacies or if you have one already in mind, I can send the prescription there.  All prescriptions will be sent electronically to the compounding pharmacy of your choice.  Paper prescriptions are not provided.

Patients taking opiate based pain killers should not take LDN.  Likewise patients taking multiple medications and/or herbal products should consult with a qualified physician or pharmacist prior to considering adding LDN to their regimen. 

In my experience "side effects" are actually uncommon, but when they do occur, they typically are of the "common" type.

Common:

• Sleep disturbances
• Mild headache
• Mild agitation
• Nausea/GI effects 
• Hyperthyroidism in Hashimoto’s patients

Uncommon:
• Flu-like symptoms
• Rash
• Herxheimer reactions
• Dizziness
• Increased fatigue or spasticity (in Parkinson’s cases)

Side effects are usually only present in the initial phase of dosing and can be easily managed with the help of your physician.

The typical dose of Low Dose Naltrexone (LDN) varies depending on the condition being treated and individual factors.  In general a dosage range of 0.5 to 4.5 milligrams (mg) per day is common. Further adjustment of dose is based on the individual's response and tolerance.

In most cases the answer is yes assuming no opiate containing medications are being taken.  However, other immune system modifying medications likewise might interact.  It is critical that you tell your physician or other prescribing provider about all the medications and/or supplements and/or herbs you are taking so as to avoid potential conflict.

LDN has been found to be a useful adjunct for several chronic pain conditions including but not limited to:  Fibromyalgia, Complex Regional Pain Syndrome/RSD, Diabetic Neuropathy, Migraines, Peripheral neuropathy, and Temporomandibular joint disorder.

Positive effects in certain autoimmune conditions such as multiple sclerosis (MS), rheumatoid arthritis (RA), Crohn's disease, and Hashimoto's thyroiditis have been documented.  As experience is rapidly evolving, it becomes even more important to consult with a qualified physician to determine if the autoimmune condition you are experiencing has been found to be helped by LDN.

Yes they can, however in my opinion they should be managed by a physician experienced in not only prescribing LDN but experienced in managing its use in children.

Even though I am trained in family medicine which certainly includes pediatric care, most of my personal practice experience has been in managing adult disease. For this reason, this practice will only accept patients 18 years of age or older.