Introduction to Low Dose Naltrexone (LDN)

Welcome, first a couple ADMINISTRATIVE NOTES:
1 The groups are closed so you can’t tag anyone that is not a member.

2) Reminder: When typing your dose please add a zero to the left of the decimal if appropriate. So for example 0.5mg rather than .5mg. This will help to avoid the typo that seems to often come up of people typing .05mg when they mean 0.5mg. .Also I suspect that especially on phones the decimal may be easy to miss so people sometimes read 5mg rather than .5mg.

Just a reminder that we are not medical professionals in this group so we are not qualified to diagnose or prescribe. We ask that when posting members concentrate on their own dosage and experience rather than instructing others as to what they should do. Any gentle suggestions along the lines of troubleshooting should be seen as fellow patients brainstorming and sharing experiences. Any guidance from staff is generally based on established advice from research, group experience or LDN Research Trust which is the major source for LDN information world wide. Before making changes in your medications or routines it will be important to do your own research and go over your thoughts with your doctor. Your treatment routine may need to be adjusted for individual factors and conditions which are beyond the scope of what we can learn about a person from a brief encounter on social media.

For a basic understanding of how LDN works please watch the video that follows after reading this quote:
Here's one doctor's way of explaining LDN.
From Dr. David Gluck, MD: "LDN is absolutely unique. And that's part of its problem, in that it's a brand new paradigm, a new way of thinking of treatment. Instead of the medication actually doing the work, LDN goes into the body and essentially tricks the body by forcing it to double and triple its output of endorphins and metenkephalin, also known as opioid growth factor (OGF). Those endorphins and metenkephalin, in turn, cause the immune system to [balance itself]. A nice way to think about LDN is that it is not like any other medication whatsoever. It is a way to strengthen (in the sense of regulate/modulate/normalize) the immune system."

Intro video........… https://www.youtube.com/watch?v=z0p0ykSzy9o

For a historical understanding the following has been generally accepted for many years and is the most common analysis found for searching for information online:

From Dr. Tom Gilhooy: "The drug naltrexone has two parts; it’s [left] handed element interacts with opiate receptors and causes a rebound increase in endorphin production. This increase in the specific endorphin known as metenkephalin has been shown to have immune-modulating activity and in an elegant study by Dr Zagon, the action of a hormone, also known as opiate growth factor (OGF), was found to be a key factor in controlling tumor growth (7).

The [right] handed element of LDN reduces cellular inflammation by another mechanism; it reduces the production of the signaling molecule NF Kappa B in the cells. This signaling molecule results in an increase in the production of inflammatory proteins known as cytokines. Reducing cytokines is thought by many to be the dominant effect of LDN. Until we have more research on the subject the debate about how LDN works will continue, but it does appear that it may have two anti-inflammatory mechanisms which can have a beneficial effect on cancer. "

Corrected information from researcher Dr. Jared Younger in response to my question:

Brian Haviland: “Dr. Younger, in your 2014 article you say that the LDN we take is ONLY the levo form and that the dextro is jettisoned in manufacture. Do you still think this? My understanding has always been that LDN has both forms as per:

From Dr. Tom Gilhooy: ‘The drug naltrexone has two parts; it’s [left] handed element interacts with opiate receptors and causes a rebound increase in endorphin production. This increase in the specific endorphin known as metenkephalin has been shown to have immune-modulating activity and in an elegant study by Dr Zagon, the action of a hormone, also known as opiate growth factor (OGF), was found to be a key factor in controlling tumor growth (7).

@youngerlab

4 months ago

“Thanks for bringing up that issue! There has been a ton of misinformation on "regular" prescription naltrexone, even among experts. If you look it up on Google, it will tell you that naltrexone is a racemic mixture of l- and d- forms. Any many, if not most, papers do the same. They are all wrong. If you pull up the CoA for manufactured naltrexone, you will see it has a -192 degree optical rotation. All commercial naltrexone is levo only. Levo hits both opioid and TLR4 receptors (among other things), while dextro only hits the TLR4 receptor. I don't know how to fix the misinformation online because now AI is pulling its info from incorrect sources. So it is almost impossible to get to the right source unless someone already knows what they are doing (e.g., accessing the manufacturer CoA's). - Jarred Younger

Posted in the comments under this video from him:
How I am going to fight brain inflammation…https://www.youtube.com/watch?v=KpsK6RmqLNI

Regarding dextro as + and levo as -https://chemistry.stackexchange.com/questions/16914/what-do-the-stereochemical-labels-d-and-%E2%88%92-mean-in-tartaric-acid

So there are two mechanisms at work and one may be more important than the other for a given person or both may be helping. We often talk about the blocking period which is about 4 hours when the person is on the right dose. After that endorphins increase. But the blocking period does not apply to the anti-inflammatory aspect. This can happen quickly for example within 30 min of dosing. Inflammation can have both pain and mood effects.

Many who have a principle issue of pain may find that they get relief shortly after dosing and they may do better towards the higher end of LDN doses -- sometimes above 4.5mg. See the Guides:
https://www.ldnresearchtrust.org/sites/default/files/2013%20Sept%20Newsletter.pdf

Dextronaltrexone for Chronic Pain and Fatigue…

https://www.youtube.com/watch?v=K2SYjG6jM5k

Some links with more detailed explanations of how LDN works:

Mechanistic Insights Into LDN Troches: How Buccal Delivery Enhances Anti-Inflammatory and Neuroprotective Signaling… https://www.gethealthspan.com/research/article/ldn-troche-delivery-research-review

https://ldnresearchtrust.org/how-naltrexone-works

http://ldnnow.com/48501/90412.html

https://sa1s3.patientpop.com/assets/docs/255331.pdf

Low Dose Naltrexone 2024— LDN Guides:

https://ldnresearchtrust.org/2024_LDN_Guides

A well done review article follows (two corrections – dosing at bedtime is no longer required – go with what works. And ULDN dosing starts at 0.001 to 0.01mg – higher doses may cause withdrawal) --

6 Potential Low Dose Naltrexone (LDN) Uses for Pain & More…. https://selfhacked.com/blog/top-22-scientific-health-benefits-low-dose-naltrexone/#comment-52012

Another well-done overview - The Multidimensional Benefits of Low-Dose Naltrexone ... https://www.gethealthspan.com/research/article/multidimensional-benefits-low-dose-naltrexone

The Uses of Low-Dose Naltrexone in Clinical Practice….
https://www.naturalmedicinejournal.com/journal/2018-04/uses-low-dose-naltrexone-clinical-practice
The use of low-dose naltrexone (LDN) as a novel anti-inflammatory treatment for chronic pain… https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3962576/

What’s the proper diagnosis? Autoimmune disease or endorphin deficiency?…

https://anneangelone.com/endorphins-autoimmune-disease/
To research your individual condition:

LDNRT videos...... Here are about 1600 videos of patients talking about LDN and their condition. To see the ones about your condition use the SMALL magnifying

glass above the blue rectangles to search https://vimeo.com/channels/ldnresearchtrust/videos

Diseases treated with LDN.................. https://www.ldnresearchtrust.org/conditions

Clinical Trials/Studies.......................

https://www.lowdosenaltrexone.org/ldn_trials.html

https://www.ldnresearchtrust.org/Clinical-trials-studies

https://ldnnow.com/47401/index.html

https://www.clinicaltrials.gov/ct2/results?cond=&term=Low+Dose+Naltrexone&cntry=&state=&city=&dist=

Documentary which talks about LDN in general and then features a fibromyalgia patient and a young boy with autism................. https://vimeo.com/131314110

"The Game Changer" LDN and Cancer.… https://vimeo.com/168562089

“Bullseye” LDN and Lyme Disease… https://vimeo.com/268938843

Norwegian LDN Documentary, English subtitles (may need to “rewind”)….

https://www.youtube.com/watch?v=rBd2gv8UGU0

You will find the above and other documentaries and info at this site (scroll down). You can also sign up for a newsletter… https://ldnresearchtrust.org/ldn-documentaries

LDN and Thyroid Disorders Kent Holtorf, M.D (Fibro mentioned also)….. https://ldnresearchtrust.org/dr-kent-holtorf%E2%80%99s-presentation-thyroid-disorders-2016-ldn-conference

LDN RT Radio Interviews.....

https://www.mixcloud.com/LDNRT/

Survey from Walgreens….

https://www.patientslikeme.com/treatment/low-dose-naltrexone-ldn#overview

Low-dose naltrexone (LDN): Tricking the body to heal itself... https://www.sciencedaily.com/releases/2011/09/110902133047.htm

You can see an image derived from the above survey at the end of this document.

Q: What’s the difference between Naltrexone and opiates? Is Naltrexone addictive?
A: The key is that opiate *agonists* like morphine go into the receptors in the same way that our natural internal painkillers do. The word Endorphin derives from Endogenous (Internally Created) Morphine. Opiates artificially dull pain and create pleasure to the point of euphoria. As they do this they damage our natural production of these chemicals and create addiction. They also have negative effects on the immune system.

LDN is an opiate *antagonist* so it blocks the receptor and prevents both external and internal stimulation of the receptors. Picture a piece of tape over a keyhole vs. the opiate or Endorphin "key".

At the low dose typically used the blocking effect wears off in a few hours, and the system responds with an increased production of Endorphins and Endorphin receptors. This has a balancing effect on the immune system.
Here are some collected “Success Stories”. It often seems that people are more likely to post when they are having problems so these reports were nice to hear.

Success Stories from the LDN Chronic group on Facebook (group is now on MeWe as LDN International and Reddit https://www.reddit.com/r/LowDoseNaltrexone/ )

- not sorted by condition, but document can be searched for mentions...https://docs.google.com/document/d/1ruk5xYyOs5QnI04j5Ai2v1e5v9ioLfld-xuepb7EHT4/edit?usp=sharing

Also be sure to check the groups for documents on Pain, Side Effects and Dosing, specific conditions, and many other topics.

I would suggest getting sucrose, rice flour, magnesium glycinate or ginger as a filler for capsules as it seems to cause the fewest problems. You may want to get 0.5mg capsules the first time and use them to build your dose. Some prefer a liquid version to start with because it will be even easier to adjust the dose – but check the ingredients. Added ingredients may not be any problem for you, but sometimes it's hard to know if someone is reacting to the LDN or something mixed with it. So for liquid you may want to get the version made with pure Naltrexone powder (NOT crushed tablets) and distilled water with nothing else. This will eliminate any possible filler reaction. Check with your pharmacist about the life in the fridge. Since this version doesn't have preservatives it may only be good for 30 days (but check). If you want to have preservatives for safety and longer life of the product perhaps ask if you can have an alternative to sodium benzoate with ascorbic acid. My impression over time is that it is impossible to know your "right dose" -- it will have to be determined by experience but it is likely to be between 0.5mg and 4.5mg. It seems that it is easier to start low and build than to start high and have to drop back. 0.5 and 1.5mg doses are popular starting points. You will find a lot of info in the Files. Some may do better at even lower or higher doses than normal.

Ask in the group for additional help in finding a doctor or compounding pharmacy.

Additional sites for info and research:

LDN International group on MeWe… https://mewe.com/group/68184bdfb6f32649cc96d0f6

Low Dose Naltrexone (LDN) And Hashimoto...
............https://www.facebook.com/groups/LDN4Hashi/

Low Dose Naltrexone and Rheumatoid Arthritis ...

https://www.facebook.com/groups/196150270793074/

Autoimmune Diseases, Cancer & Low Dose Naltrexone (LDN) [FB group re: Sjogren’s and other]….

https://www.facebook.com/groups/sjogrensandLDN/?hc_location=ufi
https://ldnnow.com/

https://www.facebook.com/groups/LDNRT/

https://www.ldnscience.org/

https://www.lowdosenaltrexone.org/
And a great site for Adrenal and Thyroid help:
Adrenal Fatigue and Thyroid Care… https://www.facebook.com/groups/AdrenalFatigueandThyroidCare/

For More Information:

Brian Haviland - LDN International

https://www.reddit.com/r/LowDoseNaltrexone/

Following is one capture from the Walgreen’s survey: