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Low Dose Naltrexone (LDN)

What Is Low Dose Naltrexone (LDN)?

Naltrexone is an FDA (Food and Drug Administration) approved medication used to treat alcoholism and opioid addiction. It is a mu-opioid receptor antagonist, which means it blocks one or more opioid receptors in our nervous system. This prevents the body from experiencing the “high” and sedative effects of drugs such as heroin or other opioids. Naltrexone looks to reduce the effects of withdrawal symptoms and reduces the user’s craving for opioids.

While naltrexone can help treat opioid and alcohol addiction, low doses of naltrexone have also been shown to have positive effects. While working in addiction clinics, Bernard Bihari, MD, discovered how lower doses (4.5 mg) of naltrexone can have benefits. This is just under 1/10th of the standard dosage (50mg) used to treat addiction. As we know, naltrexone blocks opioid receptors by binding to them. By intermittently blocking receptors with low doses of naltrexone, the receptor sites began to restore and even increase the production of endorphins. By training the body to utilize its own natural endorphins, the body is able to naturally relieve pain, enhance sense of well-being, and regulate the immune system. Before starting low dose naltrexone (LDN), the patient must first have a full review of the current medication and supplements they are taking. Modifications may need to be made.

LDN Compounded Forms

Capsules

Compounded in appropriate doses for titration and maintenance.

Liquid

Allows for slow titration to optimal dose.  

Sublingual Drops

For patients with swallowing difficulties or GI side effects from the liquid.

Topical Cream

Can be helpful when administering to children.

Side Effects of Low Dose Naltrexone

Most patients are able to tolerate LDN pretty well. Side effects are usually short term and do not stick around for too long. Some common side effects may include:

  • Sleep disturbances/vivid dreams
  • Gastrointestinal upset, nausea
  • Mild headache
  • Mild agitation

In order to avoid side effects, doses will need to be carefully titrated over time. Commercially, naltrexone is available in 50 mg tablets. A compounding pharmacy is necessary to provide custom dosage amounts. Compounding pharmacists have specialized training and will work with medical professionals to provide guidance for dosing protocols for various conditions.

How Does LDN Help Mental Health?

Preliminary studies have shown LDN to have positive effects on various mental health conditions. Though more studies are necessary, the early findings regarding LDN and mental health are promising. Here are a few conditions LDN may help with.

LDN for Depression

LDN is proposed to function as a dopaminergic drug. This means it is able to stimulate the body into releasing the neurotransmitter dopamine and create a more positive mental feeling. In a study following 12 subjects with depression, LDN was able to reduce their scores on various depression measuring scales.

LDN for Complex Posttraumatic Stress Disorder

LDN’s ability to block opioid receptors may lead to reducing dissociative symptoms in patients with PTSD. In a study with 15 patients, “11 reported immediate positive effects, while 7 described a lasting helpful effect.” This was after being treated with 2-6 mg of naltrexone per day. This helped reduce dissociative episodes in the patient.

LDN for Borderline Personality Disorder

People with borderline personality disorder (BPD) may struggle to function in society due to their self-image and difficulty managing emotions and behaviors. In a 2021 study, “naltrexone was associated with improvement in BPD in a dose-dependent manner.” LDN has been shown to regulate the body’s opioid system, which can lead to reduced BPD symptoms.

Does LDN Help with Pain?

Pain symptoms can be debilitating to patients. For those who have experienced bodily injuries due to accidents or illness, they may need additional help to manage their pain. Opioids are often used to reduce extreme pain, but this has the potential of leading to addiction. LDN is a nonopioid alternative that actually blocks mu-opioid receptors in the body. This keeps the patient from developing an addiction.

LDN for Chronic Pain

Glial cells help hold nerve cells in place and aid their everyday functions. When irritated, glial cells can trigger inflammation. Neurons are exposed to this inflammation and can be damaged or destroyed. LDN works as an inhibitor to glial cells. By deactivating glial cells, LDN acts as an anti-inflammatory agent and reduce pain.

Does LDN Help with Autoimmune Conditions?

Autoimmune disorders, such as Crohn’s disease and multiple sclerosis, can lead the body to hurt itself. When the immune system is triggered, the antibodies it sends may begin to attack and damage its own tissue, rather than fighting off disease.  There are clinical reports stating that LDN was able to reduce fatigue and improve overall health with few side effects.

LDN for Crohn’s disease

The endogenous opioid system plays in role in inflammatory bowel diseases such as Crohn’s disease. By inhibiting opioid receptors, LDN can have a positive effect on symptoms of this disease. Additionally, LDN may also pose anti-inflammatory benefits for symptoms in the bowel.

LDN for Dermatology

Opioid receptors can be found on the skin. They play a role in cell proliferation, migration, and adhesion. As a mu-opioid antagonist, LDN may be able to have an effect on the skin. A 2019 study shows that “naltrexone affects inflammation, cell adhesion, and keratinocyte proliferation and migration.” This could give LDN a place in dermatology treatment regimens. Though more research is needed, current data suggest that naltrexone can be a part of treatment plans for inflammatory and acantholytic skin diseases that are not responding to other treatments.

LDN for Polycystic Ovary Syndrome (PCOS)

PCOS occurs due to “metabolic derangements including insulin resistance, dyslipidemia, systemic inflammation, and endothelial dysfunction.” Increased levels of insulin are associated with PCOS in women. Naltrexone is able to reduce appetite and modulate the release of insulin. This may help with symptoms deriving from PCOS.

Is LDN Right for You?

LDN has many uses including for pain, mental health, and autoimmune diseases. Commercially offered naltrexone is available in 50 mg doses. To get lower doses of naltrexone, you’ll require a compounding pharmacy. ClearSpring Pharmacy is a local community pharmacy with the capability to compound the exact dosages of naltrexone needed. We can help navigate the proper use of naltrexone to meet your specific needs. Call our Littleton or Denver location today. Or simply fill out our contact form, and we will get back to you with a prompt response!

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