Frequently Asked Questions

General

 

What is Low-Dose Naltrexone (LDN)

Naltrexone is a medication that was approved in the 19080s by the FDA to treat drug and alcohol addiction. It works by blocking opioid receptors. It was found that at much lower doses than those used to treat addiction, it could have a positive effect on the immune system.

To read more about LDN, visit http://www.lowdosenaltrexone.org

 

What services do you offer on this site?

Currently we only offer video consultation with a doctor to evaluate prospective patients for a prescription for LDN

If you are looking for more comprehensive treatment, please check out our partner site, Root Causes Clinic (www.rootcausesclinic.com)

 

Who can access your services?

 

Must be 18 years and older (or 12 and older with a parent/guardian)

Video consultation is available to residents of States where our doctors are licensed.

NOW AVAILABLE:
ALL 50 States
District of Columbia (DC)

 
 

Where are you located?

Our office is physically located in Dearborn, MI.  However, this is irrelevant since everything is done electronically.

For the video consultation, the doctor is required to be licensed in your state, but can be really anywhere in the world otherwise.

 

Where are the consultations held?

We use doxy.me to perform the consultations.  Most patients use their computer or smartphone app for this part.  You must be located in one of the States listed above at the time of consultation to be eligible.

 

How much does it cost to do a consult?

Currently, the consult fee is $69 or $99 depending on who performs the consultation.  This may change based on a variety of factors.  This only includes a brief consult (15 minute) with the doctor to determine if a prescription for LDN is appropriate for you.  If you would like to get help beyond this, please Contact Us or visit or partner site, www.RootCausesClinic.com

Are the consultations covered by my insurance?

We do not bill any insurance, you are expected to pay at the time of booking an appointment.

We believe the consult fee (currently $69) is reasonable.  You might be able to get some of the cost of the consult reimbursed by your insurance by contact your insurance carrier and submitting what’s known a “superbillâ€.  If you have paid for a consultation and would like a superbill, please Contact Us.

How do I cancel or reschedule my consultation?

Use the email you were sent when you scheduled the initial appointment.  If you still have difficulties with this, please Contact Us.

If you have not yet made your initial appointment, please use the Book Now page for instructions.

Please pay attention to the cancellation policy when booking.

How do I get a refill?

Usually, you will receive a 3 months prescription with one refill (a 6 month supply total).  If you need additional refills after that, you will need to request a refills using the instruction in this link.

It depends. LDN is only available at a special type of pharmacy known as a “compounding pharmacyâ€. If you are not sure if yours is one, then its probably not.

We do not have any financial interest or affiliation with any pharmacy and do not have any preference.  However, there are a few compounding pharmacies that we see patients commonly use – we can share these options with you during the consultation.  You can also find an LDN-literate compounding pharmacy here:

Please your compounding pharmacy fax number ready for the consultation.

 
 
 

About Low-Dose Naltrexone (LDN)

 

What is LDN used for?

Naltrexone is currently only FDA approved for Alcoholism and Opioid Addiction.  However, like many medications, Naltrexone at low doses is used “off-label†for many conditions.

LDN has been reported to be possibly helpful with:

Fibromyalgia/Chronic Fatigue Syndrome
Autoimmune conditions (Colitis, Lupus, Rheumatoid Arthritis, etc…)
Cancers of many types
Infectious diseases (HIV, Lyme, etc…)
Anxiety/Depression/PTSD
Osteoarthritis

For a more comprehensive list, visit www.lowdosenaltrexone.org

 

Is LDN effective?

LDN can have amazing results for some patients.  Most studies we have seen show that 30-60% of patients will have a positive response.  We find the response rate a bit higher (60-80%) because we allow for dose adjustments and individualization.  In our experience, there is no way to determine ahead of time who will benefit and who will not.

Given that its relatively safe and inexpensive, we encourage any patient with any of the conditions listed above give it a try for 3-6 months.

 

Do you sell LDN?

No.  Our doctors prescribe LDN and send the prescription to a compounding pharmacy.  You will need to coordinate with the pharmacy to get the actual medication.

 

Can’t I just use a website where I can just buy LDN online?

Well… LDN is by prescription only.  Just like any prescription you can purchase online without a doctor’s prescription, but you are taking your chances.

 

Is LDN FDA approved?

Naltrexone is FDA approved for Alcohol and Opioid Drug Addiction, and also weight loss.  However, its use for autoimmune and other condtions are at much lower doses (1.5-9mg vs 50-100mg) and is considered an “off-label†use.  

Doctors very commonly use medications “off-label†and in fact it is thought most prescriptions are “off-labelâ€

 

How much does LDN cost?

It all depends on the pharmacy, but you can expect a one-month supply to run about $25-60.  Patients are encouraged to shop around for cost

 

Is LDN safe? Does it have a lot of side effects?

Naltrexone at 50-100mg dose is usually well tolerated.  LDN at 3-6mg is even more so and very few side effects have been reported.  About 20% of patients report sleep problems, probably the most commonly reported side effect and usually temporary and can be reduced by starting with a low dose and working up.  

Other less common side effects include mild nausea, headaches, feeling a “bit offâ€.

 

Is there anybody who cannot take LDN?

Really the only patients who cannot take LDN are those on opioid pain medications (morphone, oxycodone, fentanyl, etc…).  It will block the effects of these medications and might send somebody into an immediate withdrawal.

The purpose of the consultation is to determine the appropriateness of prescribing LDN.

 
 

Dosing instructions for Low Dose Naltrexone

Standard dosing:

Begin with 1.5 mg each evening, approximately 1 hour before bed. Stay at this dose for two weeks. Every two weeks, add a dose of 1.5 mg. Continue adding until you find the maintenance dose that is best suited to you.

Week 1 + 2: 1.5mg daily
Week 3 + 4: 3mg daily
Week 5 + 6: 4.5 mg daily
Etc.

If you are beginning at a lower dose, the titration schedule remains the same- you increase by your beginning dose every two weeks until you find your optimal dose.

Keeping a symptom journal will help you to find the best dose. On day one, write down your top 3-5 symptoms and rate them on a scale of 1-10. Twice a week while increasing the naltrexone, rate your symptoms. When you find 100% symptom relief OR plateau at symptom relief, you have found your maintenance dose.

If you experience side effects such as nausea, headache, gas, diarrhea, insomnia, heightened anxiety, or vivid dreams or nightmares, they should be mild to moderate and should self-regulate in 3-5 days. If they do don’t go away by day 5, this indicates the 1.5 mg dose is too high for you to start with, and you should halve your dose to 0.75mg. In this case you will titrate more slowly, increasing every two weeks by 0.75 mg. If the only side effects you experience are insomnia or vivid dreams or nightmares, you may switch to taking the LDN during the day rather than at night.

 

 

 
 
 
 
 
 

Ordering

 

What happens after I order a consultation?

Video consultations are booked through the Book Now page.  After booking a consultation, there are instructions how to access the video chat.

During the consultation, the doctor will determine the appropriateness of the request for LDN, will discuss dosing and side effects, and will fax a prescription to the pharmacy of your choice.

Follow-up consultations are the same cost and are usually required every 6 months – you can also visit the Refill page for details on refills

If there are any questions or concerns in between consultations, most of these can be handled through the pharmacy or by using the Contact Us

 

Your prescription will be faxed to the pharmacy of your choice within two business days of your consult. Some pharmacies take an additional two business days to contact patients.