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Low-dose Naltrexone

History of Low-dose Naltrexone (LDN):

Naltrexone has historically been used at higher doses (50-300 mg) to treat alcohol and opioid addictions. Low dose naltrexone (LDN) was discovered back in 1980 at the Pennsylvania State University by Dr. Zagon and Dr. Mclaughlin where they found Naltrexone to have different effects at lower doses (3-4.5 mg). It was not used clinically until 1985 where Dr. Bihari used low dose naltrexone for a patient with multiple sclerosis (MS). Dr Bihari later used low dose naltrexone in over 2000 MS patients. In 2003 the first study emerged proving it’s effectiveness with crohn’s disease, also at Penn State Univeristy. As a result of it’s ability to stabilize the immune system (versus suppressing it like a steroid), LDN has now been used in patients with various autoimmune disorders all over the world.

Effects of LDN:

  • Adaptive increase in endorphin and enkephalin production produces analgesia, promotes healing, decreases inflammation, normalizes the immune response, and promotes well-being and satisfaction.  
    • Used for many autoimmune conditions (rheumatoid arthritis, Crohn’s disease, ulcerative colitis, eczema, etc.) and certain infections (e.g. Borrelia burgdorferi).  
  • Increases Met (5) Opioid Growth Factor regulates cell division and growth.  
    • Implications in cancer treatment.
  • Works on various Toll-like receptors which can affect the nervous system and CNS immune cells.
    • Can have an impact on neurological conditions such as multiple sclerosis, Parkinson’s disease, etc.
  • Metabolized through the liver and excreted through the kidneys (need to make sure the liver and kidney function are ok – this should be monitored at least annually).

Possible Side Effects:

  • Vivid dreams and possibly sleep disturbance.  If sleep disturbance is severe, can switch to taking it in the morning.
  • Nausea – usually dissipates over the first couple of weeks.  If this happens, try taking with food.
  • Constipation – usually dissipates over the first couple of week
  • “Die-off” effect or temporary worsening of symptoms (usually first 1-3 weeks)
  • Dry Mouth
  • Headache


  • Cannot take while on opioids/narcotics/pain medications (even Tramadol and Codeine).
  • Most effective when combined with an autoimmune diet (no gluten, no dairy, increased fresh and fermented vegetables, low-moderate amounts of high-quality protein, etc.)
  • Most patients see benefit between 3-6 months of use, some sooner but some can take up to a year to see results.  **Stick with it!
  • Do not use if on anti-rejection medication (e.g. for organ transplantation)
  • Do not use if you are pregnant or breastfeeding.
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