Jun 30, 2024
- Linda Elsegood (founder of LDN Research Trust) became interested in low-dose naltrexone (LDN) 20 years ago after experiencing severe health issues herself. She was bedridden, couldn’t recall words or form sentences, had muscle twitches, pins and needles, restless legs, and was unable to do anything. Her quality of life was only 1 out of 10. Remarkably, within three weeks of starting LDN, she regained her ability to think clearly, function normally, and felt like herself again.
Our Take: We’ve been prescribing LDN since 2017 for various medical conditions, including rheumatoid arthritis, Sjogren’s syndrome, lupus, psoriasis, interstitial cystitis, fibromyalgia, chronic fatigue, obesity, Hashimoto’s thyroiditis, and more recently, long COVID. Many of our patients experience remarkable, life-changing improvements.
- LDN usually acts as a prokinetic agent, which means it helps your bowel move better by increasing bowel activity. It works on the gut’s migratory motor complex to improve bowel movement. However, some people may experience constipation, which might be due to the cellulose filler in the medication. If this happens, a compounding pharmacist can switch the filler to magnesium or ginger, change the form to a liquid, or lower the dosage.
Our Experience: The most common side effect we’ve encountered is vivid dreams. This usually subsides if LDN is taken in the morning instead of at night. Additionally, some sensitive patients benefit from a liquid form that allows for very gradual dosage increases.
3. How LDN (Low-Dose Naltrexone) Works:
LDN is anti-inflammatory and modulates the immune system. It blocks the opioid receptor for 4 to 6 hours, and when it releases, there is a short burst of endorphins and an opioid-derived growth factor (met-enkephalin). LDN is also a TLR4 antagonist (Toll-Like Receptor 4 antagonist). By blocking TLR4, it reduces cytokine release and calms the overactive immune response. It doesn’t over-activate the immune system but instead moderates and soothes it.
Understanding TLRs:
- Gates Triggered by Danger Signals: TLRs act like gates triggered by danger signals from inflamed or dying cells, or pathogens like bacteria or viruses. In people prone to autoimmune diseases, these TLRs can become overactive and cause chronic inflammation, especially in the central nervous system and gut. Once activated, it’s difficult to turn them off.
- Calming Overstimulation: Dr. Zielsdorf (on the expert panel) coined the term “pan-specific TLR attenuator” to describe LDN. This means LDN doesn’t shut the receptors down but calms their overstimulation. This is important for conditions like long COVID and autoimmune diseases, where TLRs are often over-activated.
LDN also works on aberrant T cells and monocytes, contributing to its immune-modulating effects.
- Long COVID and Symptom Recognition: Many patients with long COVID did not have severe symptoms when they initially had COVID, so some people with long COVID do not realize they actually had the virus.
- LDN for Weight Loss: LDN, taken 1 to 3 times a day in doses up to 8 mg daily, is beneficial for weight loss.
- Starting and Adjusting LDN Dosage: Patients commonly start LDN at 1.5 mg daily. When the dosage is increased, symptoms may improve or worsen. If a patient feels worse, the dosage should be decreased to the level where they felt better.
By Drs. Adam and Renanit Barron
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