Many people who come in to see me want to avoid pharmaceutical treatments or at least not start taking another one. Because of this they are often surprised and at times apprehensive when I recommend a medication. One of the most common medications that I prescribe is low dose naltrexone. I also get a lot of questions about this medication from people who have heard about it and are wondering if it is right for them. I hope this article answers your question. If you have more, please let me know in the comment section below.
What is Naltrexone?
Most people have heard of naltrexone in the context of opioid addiction. This is because at a standard dose (50mg) it blocks opioid receptors, and is FDA approved to treat opioid and alcohol addiction. At lower doses (1.5-4.5 mg) it has a different action in the body. It blocks the opioid receptors only temporarily, which the causes your body to compensate by producing endorphins and enkephalins. These are both neurotransmitters that can reduce pain, decrease inflammation (including neurological inflammation) and promote tissue repair. Endorphins are also known as the “feel good” neurotransmitters. Because low dose naltrexone causes an increase in these chemicals, taking LDN can lead to a decrease in anxiety and depression.
What is Low Dose Naltrexone Used For?
In my practice I use LDN in patient where inflammation is playing a significant role in their condition. I use it for autoimmune diseases such as rheumatoid arthritis, hashimotos, crohn’s, ulcerative colitis, lupus, sjogrens, multiple sclerosis, etc… I also use it for fibromyalgia, chronic fatigue syndrome, long Covid, cancer and other conditions.
Is Low Dose Naltrexone Safe?
The safety profile of Low Dose Naltrexone is very good. Generally the side effects are mild and do go away after you have been on the medication for a little while. They can include vivid dreams with insomnia and GI upset. LDN has very few medication interactions. The main contraindication is if you rely on opioid medications (such as oxycodone) for breakthrough pain. Because LDN causes a transient blockage of the opioid receptors, these medications will not work as effectively if you are taking LDN.
Is Low Dose Naltrexone Expensive?
Using naltrexone at low doses for the conditions mentioned above is an off-label use of this medication i.e. it has not yet been FDA approved for these uses. Because of this LDN is often not covered by insurance. However, it is a relatively inexpensive medication, and costs less than many nutritional supplements (prices vary from pharmacy to pharmacy but it is usually less than $20 per month).
Should You Take Low Dose Naltrexone?
LDN can be a great addition to your treatment regimen if you are someone struggling with an autoimmune condition, chronic pain, fibromyalgia, long Covid, cancer, or other condition where your immune system is dysregulated. That being said, not all medication is right for everyone. Talk with a doctor who is knowledgable about low dose naltrexone to see if it would be a good choice for you.
If you’d like more information on low dose naltrexone, the LDN Research Trust has some great resources.
