Naltrexone was a drug approved in the 1980s to treat opioid addiction and alcoholism. Later, it was discovered that very low doses of this medication can help patients with many other conditions.
Low Dose Naltrexone (LDN) is only available through compounding pharmacies like Peninsula Compounding Pharmacy.
How Does Low Dose Naltrexone Work?
Low Dose Naltrexone works by temporarily binding and blocking a mechanism called the MU receptor, which is linked to pain. Blocking the receptor tells our bodies that we aren’t producing enough endorphins (our natural pain relievers). This helps our body to then release these endorphins.
This is important because endorphins are hormones produced by the patient’s body to relieve stress and pain. Endorphins also help regulate the immune system, calming it down in autoimmune disorders, and revving it up when needed.
LDN may be used to manage:
- Autoimmune conditions (like Hashimotos, MS, Crohns, etc)
- Pain conditions (like: Chronic regional pain, nerve pain, fibromyalgia, neuropathic pain, etc)
- Mental health conditions (like anxiety, depression, PTSD, etc
- Women’s health conditions (like vulvodynia)
- Lyme Disease
- Weight loss
The Research and Application of Low Dose Naltrexone
Clinical Practice
Bolton M, Hodkinson A, Boda S, et al. Serious adverse events reported in placebo randomised controlled trials of oral naltrexone: a systematic review and meta-analysis. BMC Med, 2019;17(1):10.
Schwaiger T. The Uses of Low-Dose Naltrexone in Clinical Practice; Potential benefits for a wide range of conditions. Natural Medicine Journal, 2018; 10(4).
Zagon IS, McLaughlin PJ. Intermittent blockade of OGFr and treatment of autoimmune disorders. Exp Biol Med (Maywood),2018:1535370218817746. doi: 10.1177/1535370218817746.
Toljan K, Vrooman B. Low-Dose Naltrexone (LDN)-Review of Therapeutic Utilization. Med Sci (Basel), 2018;6(4).Li Z, You Y, Griffin N, Feng J, Shan F. Low-dose naltrexone (LDN): A promising treatment in immune-related diseases and cancer therapy. Int Immunopharmacol,2018;61:178-184.
Patten DK, Schultz BG, Berlau DJ. The Safety and Efficacy of Low-Dose Naltrexone in the Management of Chronic Pain and Inflammation in Multiple Sclerosis, Fibromyalgia, Crohn’s Disease, and Other Chronic Pain Disorders. Pharmacotherapy,2018;38(3):382-389.
Brown N, Panksepp J. Low-dose naltrexone for disease prevention and quality of life. Med Hypotheses, 2009; 72(3):333-337
Multiple Sclerosis
Ludwig MD, Zagon IS, McLaughlin PJ. Featured Article: Serum [Met5]-enkephalin levels are reduced in multiple sclerosis and restored by low-dose naltrexone. Exp Biol Med (Maywood), 2017; 242(15):1524-1533.
Ludwig MD, Turel AP, Zagon IS, Mc Laughlin PJ. Long-term treatment with low dose naltrexone maintains stable health in patients with multiple sclerosis. Mult Scler J Exp Transl Clin, 2016; 2:2055217316672242.
Turel AP, Oh KH, Zagon IS, McLaughlin PJ. Low Dose Naltrexone for Treatment of Multiple Sclerosis: A Retrospective Chart Review of Safety and Tolerability. J Clin Psychopharmacol, 2015; 35(5):609-611.
Rahn KA, McLaughlin PJ, Zagon IS. Prevention and diminished expression of experimental autoimmune encephalomyelitis by low-dose naltrexone (LDN) or opioid growth factor (OGF) for an extended period: Therapeutic implications for multiple sclerosis. Brain Res, 2011; 1381:243-53.
Frech T, Novak K, Revelo M, et al. Low-Dose Naltrexone for Pruritus in Systemic Sclerosis. International Journal of Rheumatology, 2011; 2011:1-5.
Cree BA, Kornyeyeva E, Goodin DS. Pilot trial of low-dose naltrexone and quality of life in multiple sclerosis. Ann Neurol, 2010; 68(2):145-150.
Zagon IS, Rahn KA, Turel AP, McLaughlin PJ. Endogenous opioids regulate expression of experimental autoimmune encephalomyelitis: a new paradigm for the treatment of multiple sclerosis. Exp Biol Med (Maywood), 2009 ; 234(11):1383-1392.
Gironi M, Martinelli-Boneschi F, Sacerdote P, et al. A pilot trial of low-dose naltrexone in primary progressive multiple sclerosis. Multiple Sclerosis, 2008; 14(8):1076-1083.
Chrone’s Disease and Inflammatory Bowel Disease
Smith J, Stock H, Bingaman S, et al. Low-Dose Naltrexone Therapy Improves Active Crohn’s Disease. The American Journal of Gastroenterology, 2007; 102(4):820-828.
Lie MRKL, van der Giessen J, Fuhler GM, et al. Low dose Naltrexone for induction of remission in inflammatory bowel disease patients. J Transl Med, 2018; 16(1):55.
Raknes G, Simonsen P, Smabrekke L. The Effect of Low Dose Naltrexone on Medication in Inflammatory Bowl Disease: A Quasi Experimental before-and-after Prescription Database Study. Journal of Chrohn’s and Colitis, 2018; 12(6):677–686
Roginsky G, Alexoff A, Ehrenpreis ED. Initial Findings of an Open-Label Trial of Low-Dose Naltrexone for Symptomatic Mesenteric Panniculitis. J Clin Gastroenterol, 2015; 49(9):794-795.
Segal D, John K, Macdonald J, Nilesh C. Low Dose Naltrexone for Induction of Remission in Crohn’s Disease. Cochrane Database of Systematic Reviews, 2014; (2):CD010410.
Smith JP, Field D, Bingaman SI, Evans R, Mauger DT. Safety and tolerability of low-dose naltrexone therapy in children with moderate to severe Crohn’s disease: a pilot study. J Clin Gastroenterol, 2013; 47(4):339-345.
Smith J, Bingaman S, Ruggiero F, et al. Therapy with the Opioid Antagonist Naltrexone Promotes Mucosal Healing in Active Crohn’s Disease: A Randomized Placebo-Controlled Trial. Dig Dis Sci, 2011; 56(7):2088-2097.
Shannon A, Alkhouri N, Mayacy S, Kaplan B, Mahajan L. Low-dose naltrexone for treatment of duodenal Crohn’s disease in a pediatric patient. Inflamm Bowel Dis, 2010 Sep;16(9):1457.
Autism
Woeller, K. Autism – The Benefits of Low Dose Naltrexone. Biomedical Autism Intervention. website. http://drkurtwoeller.blogspot.com/2009/01/autism-benefits-of-low-dose-naltrexone.html. January 09, 2009. Accessed January 24, 2019.
Sandman C. The Opiate Hypothesis in Autism and Self-Injury. Journal of Child and Adolescent Psychopharmacology, 1990; 1(3):237-248.
Bouvard M, Leboyer M, Launay J, et al. Low-dose naltrexone effects on plasma chemistries and clinical symptoms in autism: a double-blind, placebo-controlled study. Psychiatry Research, 1995; 58(3):191-201.
Ing B, Au D, Poland R. Low-Dose Naltrexone Inhibits Pemoline-Induced Self-Biting Behavior in Prepubertal Rats. Journal of Child and Adolescent Psychopharmacology, 1993; 3(2):71-79.
Campbell M, Overall J, Small A, et al. Naltrexone in Autistic Children: An Acute Open Dose Range Tolerance Trial. Journal of the American Academy of Child & Adolescent Psychiatry, 1989; 28(2):200-2006.
Diabetes Mellitus
McLaughlin PJ, Cain JD, Titunick MB, Sassani JW, Zagon IS. Topical Naltrexone Is a Safe and Effective Alternative to Standard Treatment of Diabetic Wounds. Adv Wound Care (New Rochelle), 2017; 6(9):279-288.Sassani JW, Mc Laughlin PJ, Zagon IS. The Yin and Yang of the Opioid Growth Regulatory System: Focus on Diabetes-The Lorenz E. Zimmerman Tribute Lecture. J Diabetes Res, 2016; 2016:9703729.Hota D, Srinivasan A, Dutta P, Bhansali A, Chakrabarti A. Off-Label, Low-Dose Naltrexone for Refractory Painful Diabetic Neuropathy. Pain Med, 2016; 17(4):790-791.McLaughlin PJ, Sassani JW, Klocek MS, Zagon IS. Diabetic keratopathy and treatment by modulation of the opioid growth factor (OGF)-OGF receptor (OGFr) axis with naltrexone: a review. Brain Res Bull, 2010; 81(2-3):236-47.
Fibromyalgia
Metyas S, Chen CL, Yeter K, Solyman J, Arkfeld DG. Low Dose Naltrexone in the Treatment of Fibromyalgia. Curr Rheumatol Rev, 2018;14(2):177-180.
Cote B, Ross B, Fortner J, Rao D. The Use and Utility of Low-dose Naltrexone Capsules for Patients with Fibromyalgia. Int J Pharm Compd, 2018; 22(3):252-256.
Parkitny L, Younger J. Reduced Pro-Inflammatory Cytokines after Eight Weeks of Low-Dose Naltrexone for Fibromyalgia. Biomedicines,2017; 5(2).
Ramanathan S, Panksepp J, Johnson B. Is fibromyalgia an endocrine/endorphin deficit disorder? Is low dose naltrexone a new treatment option? Psychosomatics,2012; 53(6):591-594.
Younger J, Mackey S. Fibromyalgia Symptoms Are Reduced by Low-Dose Naltrexone: A Pilot Study. Pain Med, 2009; 10(4):663-672.
Younger J, Noor N, McCue R, Mackey S. Low-dose naltrexone for the treatment of fibromyalgia: findings of a small, randomized, double-blind, placebo-controlled, counterbalanced, crossover trial assessing daily pain levels. Arthritis Rheum, 2013; 65(2):529-538.
Cancer
Miskoff JA, Chaudhri M. Low Dose Naltrexone and Lung Cancer: A Case Report and Discussion. Cureus, 2018; 10(7):e2924.
Donahue RN, McLaughlin PJ, Zagon IS. Low-dose naltrexone targets the opioid growth factor-opioid growth factor receptor pathway to inhibit cell proliferation: mechanistic evidence from a tissue culture model. Exp Biol Med (Maywood), 2011; 236(9):1036-1050.
Khan A. Long-term remission of adenoid cystic tongue carcinoma with low dose naltrexone and vitamin D3–a case report. Oral Health Dent Manag, 2014; 13(3):721-4.
Liu WM, Scott KA, Dennis JL, et al. Naltrexone at low doses upregulates a unique gene expression not seen with normal doses: Implications for its use in cancer therapy. Int J Oncol, 2016; 49(2):793-802.
Meng J, Meng Y, Plotnikoff NP, et al. Low dose naltrexone (LDN) enhances maturation of bone marrow dendritic cells (BMDCs). Int Immunopharmacol, 2013; 17(4):1084-1089.
Donahue R, McLaughlin P, Zagon I. Low-dose naltrexone suppresses ovarian cancer and exhibits enhanced inhibition in combination with cisplatin. Experimental Biology and Medicine, 2011; 236(7):883-895.
HIV/AIDS
Yi Z, Guo S, Hu X, et al. Functional modulation on macrophage by low dose naltrexone (LDN). IntImmunopharmacol, 2016; 39:397-402.
Abdel T, Oumar T, Sounkalo D, et al. Impact of low dose naltrexone (LDN) on antiretroviral therapy (ART) treated HIV+ adults in Mali: A single blind randomized clinical trial. Journal of AIDS and HIV Research, 2011; 3(10):189-198.
Pain
Bostick, K, McCarter A, Nykamp D. The Use of Low-Dose Naltrexone for Chronic Pain. The Senior Care Pharmacist, 2019; 34(1):43-46.
Oaks Z, Faraone SV, Johnson B. Clinical Utility of the Cold Pressor Test: Evaluation of Pain Patients and Treatment of Opioid-Induced Hyperalgesia and Fibromyalgia with Low Dose Naltrexone. Discov Med, 2018; 26(144).
Pineda-Farias JB, Caram-Salas NL, Salinas-Abarca AB, Ocampo J, Granados-Soto V. Ultra-Low Doses of Naltrexone Enhance the Antiallodynic Effect of Pregabalin or Gabapentin in Neuropathic Rats. Drug Dev Res, 2017; 78(8):371-380.
Weinstock LB, Myers TL, Walters AS, et al.Identification and Treatment of New Inflammatory Triggers for Complex Regional Pain Syndrome: Small Intestinal Bacterial Overgrowth and Obstructive Sleep Apnea. A A Case Rep, 2016; 6(9):272-276.
Hota D, Srinivasan A, Dutta P, Bhansali A, Chakrabarti A. Off-Label, Low-Dose Naltrexone for Refractory Painful Diabetic Neuropathy. Pain Med, 2016; 17(4):790-791.
Sturn KM, Collin M. Low-Dose Naltrexone: A New Therapy Option for Complex Regional Pain Syndrome Type I Patients. Int J Pharm Compd, 2016; 20(3):197-201.
Raffaeli W, Indovina P. Low-dose naltrexone to prevent intolerable morphine adverse events: a forgotten remedy for a neglected, global clinical need. Pain Med, 2015; 16(6):1239-1242.
Ghai B, Bansal D, Hota D, Shah CS. Off-label, low-dose naltrexone for refractory chronic low back pain. Pain Med, 2014; 15(5):883-884.
Younger J, Parkitny L, McLain D. The use of low-dose naltrexone (LDN) as a novel anti- inflammatory treatment for chronic pain. Clin Rheumatol, 2014; 33(4):451-459.
Chopra P, Cooper M. Treatment of Complex Regional Pain Syndrome (CRPS) Using Low Dose Naltrexone (LDN). Journal of Neuroimmune Pharmacology, 2013; 8(3):470-476.
Mood Disorders
Mischoulon D, Hylek L, Yeung A, et al. Randomized, proof-of-concept trial of low dose naltrexone for patients with breakthrough symptoms of major depressive disorder on antidepressants. Journal of Affective Disorders, 2017; 208:6-14.
Pape W, Wöller W. Low dose naltrexone in the treatment of dissociative symptoms. Nervenarzt, 2015; 86(3):346-351.