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More Than a Magic Bullet: Low Dose Naltrexone


Low dose naltrexone (LDN) is a hot topic among patients with multiple sclerosis (MS), cancer, neurological conditions, HIV infection, herpes, autism, and autoimmune diseases. With good reason. Clinical trials and anecdotal studies show that LDN can stop disease progression, reduce symptoms and help the body heal itself. And if that isn't enough, LDN is inexpensive and it's FDA approved. There's just one catch. Naltrexone hasn't yet been FDA approved for conditions other than opiate abuse, alcohol abuse and self-injurious behaviors. It can be prescribed off-label for other conditions but in this manner, LDN is kept out of the public eye.

Naltrexone is an opiate antagonist developed in the early 1980s in response to the need for an effective treatment for opiate addiction. Its safety and effectiveness at doses ranging from 50 to 300 mg daily were confirmed in clinical trials. In 1984, the FDA approved naltrexone as a treatment for opiate abuse, and several years later it was approved as a treatment for alcohol abuse. In the protocol known as low dose naltrexone, naltrexone is used in doses ranging between 1.5 and 10 mg daily.

During the development phase of naltrexone, Dr. Ian Zagon and his team at Pennsylvania State University began researching naltrexone and other opiate antagonists. Dr. Zagon was particularly interested in the reasons for the low birth weight in children born to heroin addicts. His studies led to the discovery that opiate antagonists such as naltrexone and naloxone caused increased production of endorphins. He discovered that besides making us feel better, endorphins are neutrotransmitters that regulate immune function and cell growth. Most importantly, he found that low doses of naltrexone blocked the opiate receptor intermittently and caused a dramatic increase in endorphins. Increased production of one particular endorphin, met-5-enkephalin, Dr. Zagon found, inhibited cell proliferation, reducing inflammation in autoimmune and neurological disorders and stopping cell growth in tumors.

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Dr. Zagon published his findings around the same time naltrexone was introduced in clinical trials for drug abuse. Dr. Bernard Bihari in New York City took an immediate interest in Dr. Zagon's reports of the immune system effects of naltrexone. The reports of low dose naltrexone confirmed what he was seeing in drug addicts recently diagnosed with HIV infection. Individuals infected with HIV using naltrexone weren't progressing to AIDS as quickly. Seeing the potential for low dose naltrexone, Dr. Bihari began prescribing low doses of naltrexone to patients with multiple sclerosis and other immune-mediated illnesses who weren't responding to other therapies. Dr. Bihari's childhood friend, Dr. David Gluck started up a website www.lowdosenaltrexone.org/ where he shared news of LDN's success. Dr. Bihari began publishing reports of his findings to AIDS conferences and he organized the first LDN conference in New York City in the fall of 2005. In 2007, the National Institutes of Health showed their interest by hosting a conference on the unexplored potential of opiate antagonists..

It didn't take long for patients searching online, especially MS patients, to begin using low dose naltrexone. Worldwide, patients began demanding LDN and sought out physicians who would prescribe it. Sammy Jo Wilkinson and other patients with MS, who experienced dramatic improvement, began fundraisers and collected enough money to partially fund the first clinical trial of low dose naltrexone in humans at the University of California San Francisco in 2008. A similar trial in Italy proved LDN's potential in MS. Clinical trials of LDN in Crohn's disease and pancreatic cancer have shown early promising results at Pennsylvania State University. Dr. Zagon at Penn State has been studying LDN for more than 30 years and is pleased to see people worldwide benefiting from his efforts.

However, because naltrexone has been a generic drug for more than a decade, pharmaceutical companies aren't interested in funding clinical trials for a drug they can't patent. Clinical trials, such as the trials of LDN in fibromyalgia and Gulf War Syndrome Dr. Jarred Younger is conducting at Stanford University, are being funded by grants and private donors. Dr. Zagon relies on small grants and private donations for his ongoing research on LDN in MS and cancer. In the meantime, most patients who could benefit from LDN don't know it exists. And without glossy ads in medical journals from pharmaceutical companies, most doctors remain uninformed.

Elaine Moore and Samantha Wilkinson, The Promise of Low Dose Naltrexone Therapy: Potential Benefits in Cancer, Autoimmune, Neurological and Infectious Disorders, Jefferson, NC: McFarland and Company, Incorporated, 2008.



I have been LDN for over 4 years at this point. Was first scripted by a MS only MD because he believed no harm in me trying it. He did not realize that I stopped using the injectables( Avonex) when I started it. I had no problems with the injections or the cost of the medication which seems to be a concern for some people. I'll be hitting 5 years this summer as I reach my 40th birthday. I moved to a new state and continued with my script thru phone consultation with a GP . I spoke with new MS Dr and he would not prescribe LDN for me. This past Nov had a new MRI and MS specialist said to me (same one who 3 years before said No) "You might be making me a believer out of the LDN" and gave me a script. I have had two flairs while being on LDN . One burning in back side (confirmted by MRI) and other lose of taste. Both incidents followed stressfull situations combined with poor heating habits. IS it working overall ,I think so. I feel better than before. As with every medication it works for some. If it worked for all it would be a cure which it is not. But I am staying on until something better comes along. Kim Z
After Remicade stopped working for me, I joined Dr. Jill Smith's Penn State Hershey Medical Center Crohn's LDN clinical study and am amazed at how well it works for me. My out-of-pocket costs went from $426 every eight weeks to small change for LDN. Millions of people will benefit when LDN is approved by the FDA. Medicare costs will drop when the Government no longer has to pay for expensive infusions of medications for inflammatory diseases. Lastly, this medicine which can replace medicines with strong black-box warnings has fewer side effects than aspirin!
my daughter's doctor just prescribed LDN for her but at a dose of 25mg per day, I thought the recommended dose was 4.5mg Do you have any idea why he would give her so much. I told me that he has done his research and this is ok for her. She is only 115 lbs. Do you have any thoughts. Thank you.
I know this is very late, but the Doctor was wrong. Hope you got it straightened out:)
This is a great article.I have used naltrexone to treat Crohn's disease with good success.The work and trials taking place at Penn State are very exciting. Anyone with an auto immune disease may want to consider LDN therapy.There appear to be few if any side effects.
Try a gluten-free diet for a minimum of 6-8 weeks before deciding on drugs. It may help some people. It has helped me, decreasing pain in some areas of the body, and totally eliminating pain in other areas. Pressure points/areas are less tender. Not PERFECT, but better. Perhaps this drug, naltrexone, in combination with a gluten-free diet, may help someone out there suffering from pain all over the body.
I started LDN just over 1 month ago, having been diagnosed with MS over 20 years ago. So far I am not just happy with the changes I am experiencing, but frankly nothing less than amazed. The most significant changes to this point are some which have been noted in testimonials that can be read on-line, such as a lessening of the fatigue is very real. However, the most striking difference I have noticed was a change in a numbness that has been with me even before my diagnosis. Both of my hands have been numb and accompanied with an electrical shock sensation running down each arm to the ends of the fingers. This sensation was most intense when I held my chin down to my chest. Now I have very little of either the numbness or shock feeling that I had grown accustomed to feeling. So far, so good to experience the sensation of touch once more. I am on the second phase now and just glad this is happening, But if these changes are the extent of what I will notice, it will have been worth the cost to feel a coin in my pocket again.
I've been on LDN (3 mg.) for a little over two months. I will be starting 4.5 mg in two weeks. I am happy to report that my walking is better. While I use a wheelchair most of the time, when I use my walker, my right leg is not dragging as it was before. Sometimes it wouldn't even move at all. I stopped taking tysabri three months ago, to my doctor's chagrin. I'm relieved he was willing to give me scipts for LDN. Looking forward to further improvement. -Louise S.
Could you share the name of your MD that prescribes your LDN? Willing to travel if necessary. Thank you so much.
LDN can work on all autoimmune diseases. Don't trust your doctor to bring it to your attention...He or she won't because there is no drug representative pushing it because it is an off patent drug. And if your in the US get it soon before the Gestapo-like Obama health care system goes into effect.
My son is one of the "lucky" ones. He is currently enrolled in the LDN drug trial for kids with Crohn's at Penn State with Dr Jill Smith. He is now the healthiest he has been in 4 years since the disease struck... It really does work.
As a patient advocate for LDN for some years now (and a user) I now that LDN is NOT safe in dosis up to 10 mg. To have the effect you want for low dosis, modulating the immune system and healthy cells, you need a dose somewhere between 1 and 4 mg. Above 4 mg, Naltrexone has other effects. The optimal dose is different for everyone. If mild side effectsdo not disappaer after a week or two, the dose is probably to high for that individual.