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Low Dose Naltrexone: An Effective Treatment for Chronic Pain and Fatigue


By Jessica Kelner, D.O. - May 8, 2019

Low-dose naltrexone (LDN) is often confused with naltrexone, which is a pharmaceutical medication that is typically used in higher doses of 50 mg or more to treat conditions such as alcohol and narcotic medication addiction as well as other opiate abuse. Naltrexone is an opiod antagonist. This means it is meant to bind to opioid receptors in the body and traditionally would block medications or drugs that bind to the receptor. 

Low-dose
 naltrexone (LDN) is a much lower dose than the traditional naltrexone dose.  LDN is  compounded by a reliable pharmacist specifically for each patient to make the doses very low. The dose of LDN starts between 1.0 to 4.5 mg of naltrexone/dose.  The lower dose of naltrexone helps the body combat chronic illness states.

LDN works by reducing inflammation in the brain caused by over-active microglia. Microglia are a type of glial cell of the Central Nervous System (CNS) (brain and spinal cord) and an important line of defense. When there is an assault on the CNS, the microglia are activated and release inflammatory substances (called cytokines) to destroy the foreign invaders. When the assault is over, the microglia go back to their normal resting state. However, when they react too often from repeated injury, infection, toxins, traumas, or emotional blows, they can  remain hyperactive, keeping the brain in a chronic state of inflammation.  

LDN also causes an adaptive increase in endorphin and enkephalin production (chemicals in the body that make you feel less pain). Endorphin and Enkephalin molecules work on opioid receptors to produce analgesia (pain relief).  The increase in endorphins also helps to normalizes immune response.  Additionally, it increases Met (5) aka Opioid Growth Factor which regulates cell division in normal and abnormal cells.  This may be why LDN is helpful in cancer. 

The inflammatory cytokines created by an assault to the CNS can increase pain sensitivity and fatigue and trigger other inflammation cascades in the body. Although doctors and scientists can't say what specifically causes fibromyalgia, it’s suspected that chronic glial cell activation is involved. This may explain why a 2010 study of LDN treatment in women with fibromyalgia found a 30% reduction in symptom severity. An even stronger response in symptom reduction has been found in studies on patients with Crohn’s Disease; Up to 80% saw significant improvement.

The effect that LDN has on chronic pain caused by autoimmune conditions like psoriatic arthritis works similarly, suppressing glial cells and therefore reducing inflammation. In addition, as mentioned before, there’s some evidence that LDN retains some of its regular dosing activity and blocks opioid receptors, which causes the body to release more endorphins, thus reducing pain.

Research on LDN suggests that it’s able to suppress the inflammatory response of the microglia.  Some of the inflammatory conditions that have shown to benefit from LDN include fibromyalgiamultiple sclerosisCrohn’s diseasecomplex regional pain syndrome and cancer.
Other conditions LDN may treat are: Autoimmune conditions such as: Multiple Sclerosis, Hashimoto’s Thyroiditis, Rheumatoid Arthritis, Lupus, Celiac, Ulcerative Colitis, Crohn's,  as well as IBS/IBD, Eczema, Psoriasis, and Chronic Fatigue. 

Because low-dose naltrexone blocks opioid receptors,  you cannot continue taking narcotic pain medication with LDN.  Otherwise, LDN has virtually no side effects and is well tolerated by most patients. Most people notice an increase in dreaming and some people notice a bit of sleep disruption during the initial few days of treatment but this improves over time.

You can read more about low-dose naltrexone for auto-immune disorders, and other illnesses at www.lowdosenaltrexone.org.

If you have questions about Low Dose Naltrexone or would like to know if this is the right treatment for you, please contact FORM Medical today 720-370-9559.