What began as a treatment for opioid addiction, naltrexone is becoming a common treatment option for many conditions when prescribed at a very low dose. Used in this way, it can be a safe and cost-effective treatment option.
What is naltrexone?
Naltrexone belongs to a class of medications called opioid antagonists. In the 1980s, the FDA approved naltrexone to treat opioid addiction at 50 to 100 mg daily. Naltrexone works for this indication because it strongly binds to the opioid receptors in the body – called mu receptors – and blocks opioid medications from binding at that same spot. It is also used at this dose to decrease alcohol intake by reducing the urge to drink.
What is Low-Dose Naltrexone (LDN)?
LDN is naltrexone dosed much lower than the standard 50 mg – usually between 0.5 mg and 4.5 mg every day. Drug companies do not manufacture this dosage level, so it is not available at retail pharmacies. A compounding pharmacy must prepare LDN. We commonly dispense capsules, but other dosage forms like creams and oral solutions are available too.
How does LDN work?
Research has shown that LDN has additional benefits when taken at doses below “standard” dosing. LDN has anti-inflammatory effects by binding to and blocking toll-like receptors (TLR) throughout the body. By blocking TLRs, LDN prevents the release of proinflammatory cytokines, substance P, and nitric oxide. Leading to a reduction in the proinflammatory cascade.
LDN also partially, and temporarily blocks opioid receptors. This blockade triggers the body to increase the production of its natural endorphins, such as Met-enkephalin, aka opioid growth factor. These endorphins produce natural analgesia, as well as modulate the body’s immune system.
How is LDN used?
The following is a small number of conditions that LDN can treat. This list is constantly growing as research continues to add new benefits.
- Alzheimer’s
- Anxiety
- Arthritis
- Cancers
- Chronic Fatigue Syndrome
- Depression
- Dermatologic (skin) conditions
- Diabetic Neuropathy
- Endometriosis
- Fibromyalgia
- Hepatitis C
- Herpes Zoster (Shingles)
- HIV/AIDS
- Hypothyroidism
- Inflammatory Bowel Disease
- Lyme Disease
- Multiple Sclerosis
- Pain
- Parkinson’s Disease
- Polycystic Ovary Syndrome
(PCOS) - Type 1 Diabetes
- Vitiligo
This is not an exhaustive list. Your doctor may prescribe LDN for one of many other conditions.
Common Dosing
Most people take 4.5 mg of LDN daily. Your specific dose might end up being higher or lower, depending on your body’s unique response. If LDN is an option for you, your doctor will probably start you on a very low dose (like 0.5 mg – 1.5mg) and increase the dose slowly over a few weeks. It’s best to take note of how your body responds to the medication during these weeks.
Side Effects
LDN is very well-tolerated, and most people do not experience side effects. Patients who do have adverse reactions to LDN may experience:
- insomnia
- vivid dreaming
- GI upset
These effects often subside after a few weeks as your body gets used to taking LDN. Contact your doctor if they do not go away.
It is crucial to tell your doctor or pharmacist if you are taking an opioid medication before starting LDN. Commonly prescribed opioids include oxycodone, hydrocodone, hydromorphone, or morphine. Taking even a small dose of naltrexone can block the opioid medication from working in the body. You could experience increased pain or other symptoms associated with abruptly stopping chronic pain medication. Alternatively, very low doses in the range of 1 – 10 micrograms (0.001 – 0.0010 mg) may be prescribed for patients on chronic opiate pain medications.
LDN at Coastal Pharmacy & Wellness
Everyone responds differently to LDN therapy. We can compound your LDN dose to meet your unique treatment needs. We compound capsules with pure naltrexone powder certified by USP and one inactive ingredient. Our most standard and inert filler is microcrystalline cellulose powder. However, we can substitute with stevia, lactose, or sucrose based on your preference. We can also compound LDN in various dosage forms, like oral drops or topical creams. We will work closely with you and your doctor to ensure that your LDN treatment is right for your goals. We even have a certified LDN specialist on staff to address your in-depth questions and complex needs.
Where can I find more information?
LDN Research Trust: https://ldnresearchtrust.org
The LDN Research Trust is a nonprofit organization based in the United Kingdom that compiles literature, research, and data directly related to the use of LDN. The most up-to-date information can be found here, as well as answers to commonly asked questions.
Questions?
Call us during regular business hours at (207) 899-0886 or email [email protected]. We’d love to chat with you about your options.