Low Dose Naltrexone

LDN is an affordable, non-toxic, and safe medication that has the potential to assist in regulating an impaired immune system.

Low Dose Naltrexone (LDN) may alleviate pain and combat inflammation, serving as a potential remedy for symptoms of various conditions such as cancers, autoimmune diseases, chronic pain, and mental health issues, among others. The field of treatment is dynamic, continually advancing with the frequent introduction of novel conditions and treatment methodologies.

LDN functions as a competitive opioid receptor antagonist. At the typical dosage, naltrexone inhibits the impacts of both natural opioids, found in endorphins, and pharmaceutical opioids. It's crucial to recognize that LDN is a pure antagonist, dispelling misconceptions as some may mistakenly perceive it as a controlled substance, narcotic, or opioid.

LDN operates as a pure inhibitor without inducing narcotic effects. Its chemical structure closely resembles naturally occurring endorphins, specifically met-enkephalin, also known as OGF or Opioid Growth Factor. This chemical structure allows LDN to serve as an antagonist at the OGF receptors, which are present on a wide range of cells throughout the body. When referring to low-dose naltrexone, it implies doses that are a fraction (typically one-tenth or less) of the standard dose of Naltrexone. Most research studies have employed a dosage of 4.5mg per day, and clinical practice encompasses doses ranging from 0.001mg to 16mg.

The binding of Low Dose Naltrexone to endorphin receptors lasts approximately 1 to 1.5 hours, with the blockade persisting for about 4 to 6 hours. LDN's effects include analgesia and anti-inflammatory properties, and it notably stimulates the production of the body's endorphins.

Research on LDN effects initiated in the 1980s through the work of Dr. Ian Zagon and Dr. Patricia McLachlan at Penn State. Dr. Bernard Bihari in New York pioneered the clinical use of LDN, initially applying it to treat HIV in the mid-1980s. While weaning patients off Naltrexone for opioid addictions, he observed positive side effects on various conditions and symptoms. As a Harvard-trained neurology specialist overseeing the New York State health department, Dr. Bihari incorporated LDN into clinical practice based on ongoing research findings.

Endorphins, the innate peptides generated in numerous cells, play a crucial role in regulating cell growth, including the activity of immune cells. Individuals with autoimmune conditions often exhibit diminished levels of endorphins. Met-enkephalin, also known as opioid growth factor (OGF), serves as a significant immunomodulator. Opioid receptors are distributed in the central and peripheral nervous systems, the gastrointestinal tract, and on lymphocytes.

Through the utilization of LDN, a temporary blockade is induced, leading to a rebound effect that results in heightened endorphin levels, including OGF, and an increased production of OGF receptors.

Conditions where the use of LDN may be beneficial in reducing symptoms

  • Complex Regional Pain Syndrome/RSD

    Diabetic Neuropathy

    Migraines

    Peripheral neuropathy

    Temporomandibular joint disorder

    • Autoimmune hepatitis

    • Autoimmune enteropathy

    • Autoimmune pancreatitis

    • Celiac disease

    • Churg-Strauss syndrome

    • Crohn’s disease

    • Eosinophilic gastroenteritis

    • Gastritis

    • Gastrointestinal pemphigoid

    • Gastroparesis

    • Gluten sensitivity

    • Gut dysbiosis

    • Inflammatory bowel disease (IBD)

    • Irritable bowel syndrome (IBS)

    • Lupoid hepatitis

    • Nonalcoholic steatohepatitis (NASH)

    • Mesenteric Panniculitis

    • POEMS syndrome

    • Polyarteritis nodosa

    • Primary biliary cirrhosis

    • Primary sclerosing cholangitis

    • Pyoderma gangrenosum

    • Small intestinal bacterial overgrowth (SIBO)

    • Schnitzler syndrome

    • Ulcerative colitis (UC)

    • Adult Still's disease

    • Ankylosing spondylitis

    • Anti-synthetase syndrome

    • Arthritis

    • Chronic fatigue syndrome (CFS)

    • Chronic recurrent multifocal osteomyelitis (CRMO)

    • Complement component 2 deficiency – increase risk of lupus

    • CREST syndrome

    • Ehlers-Danlos Syndrome (EDS)

    • Enthesitis-related arthritis

    • Eosinophilic fasciitis

    • Fibrodysplasia ossificans progressive

    • Fibromyalgia

    • Inclusion body myositis (IBM)

    • Juvenile arthritis

    • Juvenile idiopathic arthritis

    • Juvenile rheumatoid arthritis – Still’s disease

    • Lupus erythematosus

    • Majeed syndrome

    • Mixed connective tissue disease (MCTD)

    • Morphea myositis

    • Myalgic Encephalopathy (ME)

    • Palindromic rheumatism (PR)

    • Polymyalgia rheumatica

    • Polymyositis

    • Psoriatic arthritis

    • Reactive Arthritis

    • Reiter's syndrome

    • Relapsing polychondritis

    • Retroperitoneal fibrosis

    • Rheumatic fever

    • Rheumatoid arthritis

    • Sarcoidosis

    • Schnitzler syndrome

    • Scleroderma

    • Seropositive arthritis

    • Sjögren's syndrome

    • Spondylitis

    • Spondyloarthropathy

    • Undifferentiated connective tissue disease (UCTD)

    • Undifferentiated spondyloarthropathy

    • Alcohol use disorder

    • Anxiety

    • Autism

    • Depersonalization/Derealization Disorder

    • Depression

    • Dissociative Disorder

    • Dissociative identity disorder

    • General Anxiety Disorder (GAD)

    • Hypervigilance

    • Obsessive Compulsive Disorder (OCD)

    • Opioid withdrawal

    • Panic Disorder

    • Phobias

    • Post-Traumatic Stress Disorder (PTSD)

    • Postpartum Depression

    • Premenstrual Dysphoric Disorder (PMDD)

    • Social Phobia

    • Stress

    • Substance abuse disorders

    • Trichotillomania

    • Alopecia areata

    • Alopecia universalis

    • Amyopathic Dermatomyositis

    • Anti-synthetase syndrome

    • Atopic allergy

    • Atopic dermatitis

    • Autoimmune progesterone dermatitis

    • Autoimmune urticaria

    • Bechet’s syndrome

    • Benign mucosal pemphigoid

    • Blau syndrome

    • Bullous pemphigoid

    • Cicatricial pemphigoid

    • Cutaneous leukocytoclastic angiitis

    • Darier Disease

    • Dego's disease (thrombotic vasculopathy)

    • Dercum's disease (adiposis dolorosa)

    • Dermatitis herpetiformis

    • Dermatomyositis

    • Diffuse cutaneous systemic sclerosis

    • Discoid lupus erythematosus

    • Eczema

    • Epidermolysis bullosa acquisita

    • Erythema nodosum

    • Erythmodermic psoriasis

    • Essential mixed cryoglobulinemia

    • Familial cold autoinflammatory syndrome (FCAS)

    • Frontal Fibrosing Alopecia (FFA)

    • Hailey-Hailey Disease

    • Herpes gestationis/pemphigoid gestationis (PG)

    • Hidradenitis Suppurativa (HS) (Acne Inversa)

    • Kawasaki disease

    • Lichen planus

    • Lichen sclerosus

    • Linear IgA disease (LAD)

    • Majeed syndrome

    • Morphea Mucha-Habermann disease, PLEVA (pityriasis lichenoides et varioliformisacuta)

    • Myositis

    • Neonatal lupus

    • Parry Romberg syndrome

    • Pemphigus vulgaris

    • POEMS syndrome

    • Progesterone dermatitis

    • Psoriasis

    • Pyoderma gangrenosum

    • Schnitzler syndrome

    • Schulman disease

    • Subacute cutaneous lupus erythematosus (SCLE)

    • Sweet's syndrome

    • ​Topical Steroid Withdrawal (TSW) 

    • Vitiligo

    • Vogt-Koyanagi-Harada Disease

    • Addison's disease

    • Autoimmune polyendocrine syndrome

    • Cushing's syndrome

    • Diabetes mellitus type 1

    • Eosinophilic esophagitis (EoE)

    • Glycogen storage disorder (GSD VII)

    • Graves' disease

    • Hashimoto's thyroiditis

    • Hypoglycaemia

    • Hypopituitary or Secondary adrenal insufficiency

    • Hypothalamic Dysfunction

    • Hypothyroidism

    • Juvenile diabetes (Type 1 diabetes)

    • Ord’s thyroiditis

    • Pituitary dysfunction

    • POEMS syndrome

    • Polyglandular syndromes type I, II, III

    • Schmidt syndrome

    • Thyroid eye disease (TED)

    • Thyroiditis

    • Amyloidosis

    • Autoimmune angioedema

    • Common Variable Immunodeficiency

    • Epstein Barr Virus

    • IgG4-related sclerosing disease

    • Juvenile myositis (JM)

    • Mast cell activation syndrome (MCAS)

    • Mold toxicity

    • Pernicious anemia (PA)

    • Vitiligo

    • Autoimmune oophoritis

    • Endometriosis

    • Healthy pregnancy – new concepts

    • Herpes gestationis/pemphigoid gestationis (PG)

    • Infertility

    • PMS (premenstrual syndrome)

    • Polycystic Ovary Syndrome (PCOS)

    • Pregnancy

    • Premenstrual syndrome (PMS)

    • Progesterone dermatitis

    • Recurrent vaginitis

    • Reduced ovarian reserve (Low AMH)

    • Vaginitis

    • Vulvodynia

    • Painful periods (Dysmenorrhea)

    • Anti-GBM/Anti-TBM Nephritis

    • Autoimmune orchitis

    • Autoimmune renal neuropathy

    • Berger's disease - IgA nephropathy

    • Glomerulonephritis

    • Goodpasture's syndrome

    • IgA nephropathy

    • Interstitial cystitis (IC)

    • Microscopic polyangiitis (MPA)

    • POEMS syndrome

    • Sperm & testicular autoimmunity

    • Anti-synthetase syndrome

    • Asthma Churg-Strauss syndrome

    • Emphysema

    • Fibrosing alveolitis

    • Granulomatosis with Polyangiitis (formerly Wegener’s Granulomatosis)

    • Goodpasture's syndrome

    • Idiopathic pulmonary fibrosis

    • POEMS syndrome

    • Sarcoidosis

    • Pediatric Disorders: Addison’s disease

    • Autism

    • Celiac disease

    • Congenital heart block

    • Crohn’s disease

    • Juvenile arthritis

    • Juvenile dermatomyositis

    • Juvenile diabetes (Type 1 diabetes)

    • Juvenile idiopathic rheumatoid arthritis

    • Juvenile myositis (JM)

    • Lupus

    • Multiple sclerosis (MS)

    • Neonatal Lupus

    • Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections

    • Scleroderma

    • Type 1 diabetes

    • Ulcerative colitis (UC)

    • Autoimmune retinopathy

    • Autoimmune uveitis

    • Blau syndrome

    • Cogan's syndrome

    • Devic’s disease (neuromyelitis optica)

    • Ligneous conjunctivitis

    • Miller-Fisher syndrome

    • Mooren’s ulcer

    • Neuromyelitis optica

    • Ocular cicatricial pemphigoid

    • Optic neuritis

    • Opsoclonus myoclonus syndrome

    • Pars planitis (peripheral uveitis)

    • Scleritis

    • Susac's syndrome

    • Sympathetic ophthalmia (SO)

    • Thyroid eye disease (TED)

    • Tolosa-Hunt syndrome (THS)

    • Uveitis

    • Vogt-Koyanagi-Harada Disease

    • Adenoid Cystic Carcinoma

    • Bladder Cancer

    • Breast Cancer

    • Carcinoid Colon & Rectal Cancer

    • Cholangiocarcinoma

    • Colon Cancer

    • Esophageal carcinoma

    • Glioblastoma

    • Glioma

    • Hepatoblastoma

    • Leukemia

    • Liver cancer

    • Lung cancer (Non-small cell)

    • Lymphocytic leukemia (chronic)

    • Lymphoma (Hodgkin's and Non-Hodgkin's)

    • Malignant melanoma

    • Mesothelioma

    • Multiple myeloma

    • Neuroblastoma

    • Ovarian cancer

    • Pancreatic cancer

    • Parotid carcinoma

    • Prostate cancer (untreated)

    • Renal cell carcinoma

    • Throat cancer

    • Uterine cancer

Standard dosing instructions*

*These highlights are based on default dosing. Actual dosing might differ significantly.

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

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.

You will receive an automated email from jade@ rootcausesclinic.com upon booking with our LDN Direct Titration Guide to help you find your optimal dose and manage side effects.

Testimonials

LDN has made functioning better. My joint pain is gone, my butterfly rash is gone, I have more energy, more stamina, I can think clearer, and I sleep better. I went from needing half a day to recover from a shower to working a full time job and fully functioning as a single mother. Life altering doesn’t begin to cover it.”

Michelle, Ohio


“LDN’s been my biggest help with MCAD since beginning treatment. It’s the first change that’s allowed me to get foods/supplements back and has significantly expanded my diet, which was previously limited to only a few ingredients. I think it’s also helped with recovery time after exposure to triggers and my gastroparesis, which hasn’t had as many significant episodes since beginning LDN.”

Chelsea, Arizona


“I am taking it for RA, thyroid disease and general inflammation. I am so happy with my results! My pain is gone. Even my lifelong depression is GONE!”

Nick, Washington

“I was diagnosed with fibromyalgia several years ago, and was interested in trying LDN for management of pain. I have not tried any other medications other than ibuprofen and Meloxicam, which were not very helpful. As directed, I titrated the dose of LDN starting with daily 1.5 mg, increasing every 2 weeks. After experimenting with dividing the dose morning and night, I found the best relief from pain and fatigue was with 6 mg twice per day.”

Helen, Georgia