Clinical trials and anecdotal reports suggest that low doses of the opiod antagonist naltrexone offer promise to patients with a variety of different autoimmune diseases.
Used in low doses, the pure opiod antagonist Naltrexone (LDN refers to low-dose Naltrexone), a mainstay for treating opiate and alcohol addiction since 1984, has been reported to provide significant benefits for patients with autoimmune diseases, HIV infection, various cancers, and neurodegenerative diseases. The use of LDN in treating patients with multiple sclerosis (MS) was first proposed in the mid-1980s by Dr. Bernard Bihari, a New York City neurologist. In his clinical practice, the Harvard educated Bihari found that a low dose of naltrexone (1.5 to 4.5 mg daily) taken at bedtime offered benefits to patients with MS and other autoimmune conditions including rheumatoid arthritis and systemic lupus erythematosus. Since, additional studies and anecdotal reports have confirmed Bihari's findings and demonstrated the effectiveness of naltrexone for Crohn's disease, Parkinson's disease and other conditions.
Naltrexone Dose
The usual dose of naltrexone used for opiate addiction is 50-300 mg daily and in autoimmune diseases the dose ranges from 1 to 10 mg daily and, according to recommendations, the dose should always be taken at night. Naltrexone is a very inexpensive medication, with a reported cost of less than 50 cents daily when low doses are used. Side effects are rarely seen when doses less than 300 mg daily are used and have been limited to rare reports of insomnia.
Naloxone
Naloxone, an opiate antagonist often used in emergency settings to treat opiate overdoses, has also been researched for its use in autoimmune disease. The drawback of naloxone is that it cannot be administered orally. However, studies regarding low dose naloxone show effects similar to those of naltrexone.
Clinical and Anecdotal Reports
The results of clinical trials on LDN to date have shown remarkable improvement in patients with Crohn’s disease and patients with MS. In the last decade there have also been numerous anecdotal reports of MS patients worldwide, particularly in the US and UK, experiencing relief from symptoms, a decline in disease progression, and remission from the use of low dose naltrexone. In addition, there are anecdotal reports of improvement in patients with chronic fatigue syndrome, autoimmune liver disease and rheumatoid arthritis.
Immune System Effects
Used as a low dose, Naltrexone is able to block the mu opiod receptor but does not affect the other opiod receptors. In blocking the mu opiod receptor, low dose Naltrexone re-establishes the normal balance between the mu and delta opiod receptors, which is necessary for immune competence. Naloxone has also been show to increase Th1 and decrease Th2 cytokine production, decrease IL-4 production, and increase IL-2 and interferon gamma levels. In many autoimmune diseases, for instance Graves’ disease, low Th1 levels are related to the proliferation of autoreactive T lymphocytes and the ability to produce autoantibodies.
The effects of naltrexone are also thought to be attributed to the removal of the regulatory effects on the immune system exerted by endogenous opiod peptides, which could activate Th2 and suppress Th1 cytokines. Naltrexone is reported to increase production of endogenous opiod peptides.
Biochemical Effects
Studies have suggested that naltrexone reduces apoptosis (cell death) of the myelin-producing oligodendrocytes. It accomplishes this by reducing inducible nitric oxide synthase activity, which cause a decrease in peroxynitrite formation, which, in turn, prevents the inhibition of glutamate transporters. Consequently, the excitatory neurotoxicity (cell destruction) of glutatmate on neurons and oligodendrocytes is prevented. Studies also show that naltrexone reduces inflammation in neurons.
Sacerdote P, Gaspani L, and Panerai, A, The opiod antagonist naloxone induces a shift from type 2 to type 1 cytokine pattern in normal and skin-grafted mice, Annuals of the New York Academy of Science, 2000; 917:755-763.
The copyright of the article Low Dose Naltrexone in Autoimmune Disease is owned by Elaine Moore. Permission to republish Low Dose Naltrexone in print or online must be granted by the author in writing.
I got diagnosed with MS in Sept. of 07' and took Avonex and Solumedrol --
both made me sick and tired. Plus, my mid section remained completely numb
as did my left side of my body. Finally, in Nov. of 07' I was able to get
an LDN prescription, and within 2 days of taking it, I could feel my
midsection again.
Sep 29, 2008 2:54 PM
Guest
:
My husband was finally diagnosed with MS in September 2007 - we went to
both an MS Society conference to learn about traditional treatments and
then a few weeks later to an Low Dose Naltrexone conference at Vanderbilt
University.
My husband began LDN, in November, 2007. The
challenge was finding a doctor to prescribe for this off label use.
In June, 2008 he had a new MRI - the Neurologist reported that he
had no new lesions and the old lesions appeared to be healing.
He has not had any side effects and is slowly recovering his balance and
capacity to exercise and work in the yard again. :)
Dec 16, 2008 7:23 PM
Guest
:
i have sjogren s and peripheral neuropathy my doctor has tried several
medications on me with no luck iam in limbo and in pain i live in melbourne
Australia i am looking for a doctor who is willing to give me LDN CAN
SOMEONE HELP! IS THERE ANYBODY OUT THERE!
Jan 4, 2009 8:51 PM
Guest
:
Hey for the Guy in melbourne goto this page
http://ldn.proboards3.com/index.cgi?action=display&board=links&thre
ad=721&page=1#3408 or find the email for this lady from her site
http://www.freewebs.com/crystalangel6267/index.htm
Jan 4, 2009 8:52 PM
Guest
:
Hey for the Guy in melbourne goto this page
http://ldn.proboards3.com/index.cgi?action=display&board=links&thre
ad=721&page=1#3408 or find the email for this lady from her site
http://www.freewebs.com/crystalangel6267/index.htm
Jan 14, 2009 2:03 PM
Elaine Moore :
Hi, There are no formal clinical trials of LDN in hyperthyroidism.
However, it's being used to treat patients with hyperthyroidism and,
anecdotally, patients seem to be doing well. LDN works by helping the
immune system heal and it helps the body heal itself. LDN also stops
disease progression and helps reduce thyroid antibody levels. I've heard
reports of LDN offering benefits in thyroid eye disease as well, but I
haven't seen the trial results. Best, Elaine
Jan 29, 2009 11:29 AM
Guest
:
It's really weird that so many doctors in US,which specialty is related to
autoimmune diseases (MS, RA, Chron's....) even didn't hear about LDN
telling me that there were NO studies no trials about it. So far I found
more than 45 studies and trials.( NO COMMENT !!) How come that it didn't
hit the market so far and become more popular? I am going to get my
medicine soon from overseas, for my RA, with doctor's blessing or without
it..and I'll let you know how does it work. I am sick and tired of
immunsuppressants and steroids.
Best, Valery Question for those who know:
Anybody heard of : Met-enkephalin
for MS, RA...?? Is it one of variations of morphine? It looks it has the
same endorphin stimulating effect.
Jan 29, 2009 11:41 AM
Elaine Moore :
Hi Valery, Metenkephalin or met{5}enkephalin is the primary endorphin
raised by low doses of naltrexone. It's also name as Opioid Growth Factor
or OGF and it available as a drug for investigational use. I discuss OGF
extensively in my book The Promise of Low Dose Naltrexone Therapy, which
was released in December (McFarland and Company, Inc publishers). Naltrexone is widely used in rheumatoid arthritis, usually at a lower
dose (1.5 mg daily) than what's used in MS. Although naltrexone was
FDA approved in 1984 for opioid abuse and later for alcoholism, it hasn't
been officially approved for other conditions with the exception of
conditions in which there is no other treatment such as self-injurious
conditions and certain cancers. Because naltrexone is now a generic drug,
pharmaceutical companies are unwilling to invest money for the studies
needed. To date, most studies have been privately funded or assisted with
small grants from the NIH. The goal of my book is to encourage more studies
and provide greater awareness of LDN. You might want to visit my website at
www.elaine-moore.com. Best,elaine
Jan 29, 2009 12:11 PM
Guest
:
Thank you, Elaine, that was fast! I just contacted some of the authors
of one European study about Metenkefalin in my country and can not wait to
talk to them since it looks like that somebody put that knowledge "in
use". Here's the study: (the main part is in eng.) http://bib.irb.hr/prikazi-rad?chset=UTF-8&lang=HR&rad=36329
Thanks a lot I will certainly read your book!
Valery
Jan 29, 2009 12:17 PM
Guest
:
Thank you, Elaine, that was fast! I just contacted some of the authors
of one European study about Metenkefalin in my country and can not wait to
talk to them since it looks like that somebody put that knowledge "in
use". Here's the study: (the main part is in eng.) http://bib.irb.hr/prikazi-rad?chset=UTF-8&lang=HR&rad=36329
Thanks a lot I will certainly read your book!
Valery
Jan 29, 2009 2:06 PM
Elaine Moore :
Hi Valery, Thanks for the link. It's very interesting to see
metenkephalin being used with corticosteroids. This makes perfect sense
since metenkephalins strengthen rather than stimulate the immune system.
Best, Elaine
Jan 29, 2009 2:15 PM
Guest
:
Thank you, Elaine, that was fast! I just contacted some of the authors
of one European study about Metenkefalin in my country and can not wait to
talk to them since it looks like that somebody put that knowledge "in
use". Here's the study: (the main part is in eng.) http://bib.irb.hr/prikazi-rad?chset=UTF-8&lang=HR&rad=36329
Thanks a lot I will certainly read your book!
Valery
Jan 29, 2009 3:30 PM
Guest
:
Thank you, Elaine, that was fast! I just contacted some of the authors
of one European study about Metenkefalin in my country and can not wait to
talk to them since it looks like that somebody put that knowledge "in
use". Here's the study: (the main part is in eng.) http://bib.irb.hr/prikazi-rad?chset=UTF-8&lang=HR&rad=36329
Thanks a lot I will certainly read your book!
Valery
Feb 2, 2009 10:47 AM
Guest
:
Dear Elaine,
I finally got my Naltrexone for RA from overseas
and I am ready to start it tonight, making my own solution 50 mg/50 ml. The
only problem I have is: I am still taking my Prednisone 10 and because of
it I need Lorazepam 1mg for sleep. The question is: Am I supposed to take
Lorazepam at badtime along with LDN ? I am afraid if I don't take
Lorazepam, I will not be able to sleep. Any other med schedule I can do? Please, help!
Thanks,
Valery
Feb 2, 2009 11:19 AM
Guest
:
Dear Elaine,
I finally got my Naltrexone for RA from overseas
and I am ready to start it tonight, making my own solution 50 mg/50 ml. The
only problem I have is: I am still taking my Prednisone 10 and because of
it I need Lorazepam 1mg for sleep. The question is: Am I supposed to take
Lorazepam at badtime along with LDN ? I am afraid if I don't take
Lorazepam, I will not be able to sleep. Any other med schedule I can do? Please, help!
Thanks,
Valery
Feb 2, 2009 12:50 PM
Elaine Moore :
Hi Valery, So 50 mg in 50 ml gives you a 1 mg/ml solution. For a 3 mg
dose, you'd take 3 ml. I know lots of people who take their LDN dose aroung
8 pm and then take their sleep meds about 15-30 min. before they go to bed.
That seems to work fine. Best, Elaine
Feb 2, 2009 12:53 PM
Guest
:
Thanks a lot Elaine, I'll try that.
Rgds,
Valery
Feb 5, 2009 3:20 PM
Guest
:
Dear Elaine, Just happened to come across LDN Whilst surfing for stuff
on hyperthyroidism. I have been suffering for Graves disease for about 11
years (am 28 now) and medicated with propylthiouracil for about 8 years
(Thycapzol gave me headaches). I am on very low levels but have relapsed
every time I tried without it. My doctors warned me of the risk of
Agranulocytosis, but I am hesitant about surgery or radioiodine as it is
still only treating the symptom, and in addition to that is non-reversible
and feels too intrusive. What are the side effects of LDN? Since it
has been used at much higher levels for drug patients, there must be some
record? I am still wanting to have kids, so I am wondering if it is too
risky to try LDN as it is an 'untested' drug... All the best, Marie
Feb 6, 2009 1:03 PM
Guest
:
I have MS and have been taking LDN since Nov 4, 2008. I can testify that
LDN works! My MS is finally in remission. LDN is my miracle and I feel
truly blessed! I have my life back. I had to call Skips Pharmacy in Florida
and ask them for a list of doctors who called in prescriptions to them from
California in order to find a doctor to prescribe it to me. They were a
great help. Go to their website. Skip is amazing...they are wonderful and I
trust them. They ship my meds all the way to California for me for $6. Here
is their website:http://www.skipspharmacy.com/ My step mom also started
taking LDN for her fibromyalgia. On day three of taking it her pain was
gone! Amazing!
Feb 7, 2009 10:02 AM
Elaine Moore :
Hi Marie, Agranulocytosis is most likely to develop when
inappropriately high doses of PTU are used. With a low maintenance dose,
agranulocytosis is unlikely. However, you might want to see if there are
any environmental triggers that are preventing remission, such as ingestion
of excess dietary iodine (in fast and processed foods, iodized salt),
aspartame in NutraSweet, exposure to cigarette smoke, stress without
adequate stress reduction techniques, low selenium levels (recommended 200
mcg daily), exposure to known or suspected allergens, etc.
Although there are no controlled studies of LDN in thyroid disease,
patients are seeing improvement using a low dose of 1.5 mg daily. It's
worth a try but you also want to look into environmental triggers to see
what might be preventing remission. Best, Elaine
Feb 7, 2009 10:44 AM
Elaine Moore :
Hi, Thanks for sharing your account of LDN. You might be interested in
reading my book, The Promise of Low Dose Naltrexone Therapy, which came out
in December. Best to you, Elaine
Feb 16, 2009 6:14 PM
Guest
:
Hi
First off I like your site, lots of information I don't
know if you are aware of the Database we are running at
www.ldn-database.carnebeach.com. We are trying to get as many people as
possible to enter their experience there so as to help others make up their
minds about LDN. Maybe you would put a link here somewhere Thanks John
Feb 16, 2009 7:13 PM
Elaine Moore :
Hi John, Thanks for the link to www.ldn-database.carnebeach.com. It's
a great resource for people interested in low dose naltrexone. I'll add a
link to my website as well. Best, Elaine
Feb 28, 2009 7:48 AM
Guest
:
Hi Elaine, I refer everyone to your site for your clear, concise
description of how LDN works. I take it for cancer. I am wondering if the
rhinocort that I just began to take for allergic rhinitis will interfere
with the efficacy?? It is a corticosteroid nasal spray. Jean
Feb 28, 2009 11:11 AM
Elaine Moore :
Hi Jean, Thanks for the referrals!!
I also use a nasal
corticosteroid, Beconase, with LDN and there's not any interference. The
nasal corticosteroids work primarily on the nasal tissue inhibiting the
nasal response on a respiratory level. Very little of the steroid is
absorbed into the blood circulation. Best, Elaine
Mar 1, 2009 3:23 PM
Guest
:
Elaine: I have a severe case of neurological lyme disease, with
co-infections including (but not limited to) babesia and bartonella, and am
unable to take antibiotics at this time due to gut issues, etc. I have a
myriad of symptoms (too many to list), some of which are similar to other
diseases treated by LDN (e.g., MS, CFS, Chron's, etc.). I am wondering if
you can provide any information regarding the efficacy of LDN for chronic
neurological lyme....Thank you, Elaine.
Mar 2, 2009 12:14 PM
Elaine Moore :
Hi, LDN works wonders in Lyme Disease. Combined with beta-lactam
antibiotics like penicillin or ceftriaxone, LDN is marvelous. We include
information on LDN in Lyme Disease in our book on LDN. We interviewed Dr.
Ken Singleton for the book. He recovered from Lyme Disease and wrote a book
on the subject and also includes info on Lyme Disease. Dr. Yash Agrawal,
who wrote our foreword, has also written letters to the Editor of I think
the NEJM regarding the success of LDN and these antibiotics in Lyme Disease
and explains why they work well together. Dr. Singleton has a website with
info on LDN in Lyme Disease too. Although you can't use antibiotics,
LDN alone would still offer benefits. LDN causes an increase in endorphins.
One particular endorphin, metenkephalin, has strong anti-viral properties
and also benefits bacterial infections. Best to you, Elaine
Mar 5, 2009 5:23 PM
Guest
:
I own a pharmacy that has just started dispensing LDN(4.5mg). We make
capsules and are looking to get more patients so we can one day give
testimony to its benefits. We have one patient on it and are waiting for
results. It's incredible to see a patient do well...reading about it is no
comparison. Smart Pharmacy smartpharmacy@bellsouth.net
Apr 5, 2009 4:38 PM
Guest
:
Looking to start on LDN for Progressive MS (not currently on any
medication). However, I am moving to South Carolina (Spartanburg
Area)....do you know of a doctor in that area to prescribe LDN...also, I
eat turmeric spice for relief of leg pain-do you know if turmneric will
interfere with LDN?
Thanks, Julie
Apr 5, 2009 9:01 PM
Elaine Moore :
Hi, I'm not familiar with doctors in your area, but you can find a
list of doctors who prescribe LDN on the ldner website at
http://www.ldners.org/resources.htm Best, Elaine
Apr 6, 2009 11:01 AM
Guest
:
Our pharmacy is often used as a resource for affordable Low Dose Naltrexone
and patients can order it without a prescription. The manufacturer we use
is Sun Pharma and we sell fast acting Naltrexone 50mg tablets. Customers
can then form a solution with a one to one ratio of 50mg tablet and 50ml of
distilled water and take 4.5 ml at a time. 30 tablets of 50mg can provide
LDN for 333 days for $129.64. You can see information on our web site at:
www.riverpharmacy.com or call our toll free in Canada at: 866-760-6337.
Apr 27, 2009 8:40 PM
Elaine Moore :
Hi, LDN is used for infertility in an effort to help the immune
system. Check with the team at Creighton about these studies. I don't think
there have been sufficient studies to show LDN's safety in pregnancy but
again I'd check with this team. I also edge on the side of safety and
recommend taking only medications that are absolutely necessary during
pregnancy and lactation. Best, Elaine
May 1, 2009 10:55 AM
Elaine Moore :
Hi, Some of LDN's greatest success stories are from people with MS.
You might refer your doctor to the clinical trials of LDN in MS conducted
by Italy's Dr. Maira Gironi. Dr. Bruce Cree has also conducted a clinical
trial at the University of California, San Diego. You can find more
information at www.ldners.org. Naltrexone isn't a narcotic. Nor is
it an addictive drug although in higher doses it's used to treat drug
addiction. It's safety has already been proven. Perhaps if your doctor had
more information he'd be more willing to prescribe it for you. Best,
Elaine
Jun 20, 2009 8:19 AM
Elaine Moore :
Hi, I know about 20 people who are using LDN for Graves' disease. It
seems to help lower thyroid antibody levels and help reduce symptoms in
people who have thyroid eye disease. According to Dr. Zagon, LDN should
offer benefits in all autoimmune diseases. Best, Elaine
