Benefits & Uses of Low-Dose Naltrexone

Low-dose Naltrexone (LDN) has shown promising efficacy in reducing the severity of symptoms in conditions like Crohn’s disease, multiple sclerosis, complex regional pain syndrome, fibromyalgia, lupus, and other autoimmune conditions (Younger et al., 2014). When appropriate, SageMED practitioners have commonly prescribed LDN as part of the treatment plan for patient’s with autoimmune conditions, and have witnessed the significant positive impact LDN can have on patient’s quality of life.

About The Research

The ability of LDN to reduce the severity of symptoms in the above conditions is thought to be unique to low dosages of naltrexone, as the name implies. Studies of LDN show pain relieving and anti-inflammatory properties, but this is not found with high doses of naltrexone (Younger et al, 2014). LDN is typically prescribed at a custom-compounded strength of 4.5mg and taken daily, although the dosage can be a few milligrams above or below 4.5. This is particularly interesting as it relates to fibromyalgia, as fibromyalgia typically fails to respond to common anti-inflammatory drugs (Younger et al., 2014). In the first pilot study of the usage of the ability of LDN to reduce fibromyalgia pain, researchers conducted a single-blind crossover trial of 12 participants over 14 weeks (Younger & Mackey, 2009). Participants took a placebo or 4.5mg of LDN nightly. The entire cohort of participants demonstrated a reduction in fibromyalgia symptoms, with an over 30% reduction compared to the placebo (Younger & Mackey, 2009).

LDN is thought to operate as an anti-inflammatory agent in the central nervous system through what’s called microglial cells. Microglial cells are the immune cells of the central nervous system, and play a key role in inflammation throughout the brain and body (Wake et al., 2012). Research is ongoing, however LDN may be one of the first glial cell modulators to be used to manage chronic pain disorders. LDN exhibits an analgesic effect, which means it provides pain relief to patients who take it (Younger et al., 2014). Unlike many other medications used to manage autoimmune conditions, the potential side-effects of LDN are generally very mild and short-lived. The most common symptoms are vivid dreams and short-term insomnia. Usage of LDN is considered experimental, however established studies have demonstrated both the efficacy and safety of LDN.

References

Li, Z., You, Y., Griffin, N., Feng, J., & Shan, F. (2018). Low-dose naltrexone (LDN): A promising treatment in immune-related diseases and cancer therapy. International Immunopharmacology, 61. https://doi.org/10.1016/j.intimp.2018.05.020

Wake, H., Moorhouse, A. J., & Nabekura, J. (2011). Functions of microglia in the central nervous system – beyond the immune response. Neuron Glia Biology, 7(1). https://doi.org/10.1017/s1740925x12000063

Younger, J., & Mackey, S. (2009). Fibromyalgia symptoms are reduced by low-dose naltrexone: A pilot study. Pain Medicine, 10(4). https://doi.org/10.1111/j.1526-4637.2009.00613.x

Younger, J., Parkitny, L., & McLain, D. (2014). The use of low-dose naltrexone (LDN) as a novel anti-inflammatory treatment for chronic pain. Clinical Rheumatology, 33(4). https://doi.org/10.1007/s10067-014-2517-2