I have been prescribing Low Dose Naltrexone (LDN) in my practice for some time and continue to see many of my patients benefit from using it. LDN has an anti inflammatory effect that can help with many conditions including:
- Autoimmune Diseases
- Ulcerative Colitis
- Chronic pain
- Irritable Bowel Syndrome
Naltrexone is most commonly used to block opiate receptors to help prevent drug and alcohol relapses for people struggling with addiction. However, in very small doses, Naltrexone (or Low Dose Naltrexone/ LDN) can be used to modulate the immune system to aid in decreasing inflammation, pain and more. I have been frequently impressed with the compounded, low dose form of this medication for its efficacy and affordability in many of the health challenges my patients face.
LDN works to signal the immune system to reduce inflammation and reset the balance of inflammatory cells and signaling. By binding to opioid receptors, LDN affects endorphins which in turn have a cascading effect in decreasing inflammatory signaling. LDN works on both the Central & Peripheral Nervous Systems; calming the Central Nervous System and reducing inflammatory cellular signaling molecules (IL6, IL12, TNF alpha) & decreasing gut inflammation in the Peripheral Nervous System.
Although rare, there can be some side effects from LDN. The main side effects from this drug are insomnia or vivid dreams. If it is used improperly and in high doses by patients taking opioid medications, it can result in a serious withdrawal reaction (e.g., sweats, chills, anxiety, vomiting, and body pains).
Occasionally, during the first week’s use of LDN some of my patients have reported difficulty sleeping. This rarely persists longer than the first week. I usually start my patients on a very low dose of 1.5 mg and titrate up to 4.5mg, adjusting the dose as needed.
While there are many promising studies showing the benefits of LDN for autoimmune and inflammatory ailments- LDN is not yet approved by the FDA for autoimmune diseases. Thus, it is not available in commercial pharmacies. It is however available via compounding pharmacies.
In the sliding-scale approach of Integrative Medicine, in which “the greater risk there is of harm then the greater need there is for evidence”, I believe the risk/benefit ratio points to a reasonable trial of LDN in many circumstances as the risks are low and benefits can be high. Research is evolving and accumulating in favor of LDN’s benefits as a novel anti-inflammatory agent.
As part of my LIVEIT approach, LDN can be a tool I may consider with my patients to vitalize. In combination with looking at the full picture, including the greater context of why a person might need to use this intervention and triggers and mediators of the immune process- LDN is a valuable tool I use with my patients.
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