Since the publication of my 2009 book on the use of low dose naltrexone (LDN) in autoimmune diseases, there have been a limited number of new research studies on its use along with a wealth of anecdotal information, especially in the United Kingdom where there is a grass roots movement to have LDN approved by the National Health Service.
In the United States, LDN is still considered an investigational drug and has not been approved as a therapy for any specific conditions. A handful of new studies conducted during the last 8 years indicate that LDN has been found to reduce symptom severity in various conditions including fibomyalgia, Crohn's disease, multiple sclerosis, and complex regional pain syndrome. Because of its ability to balance the immune system, LDN is also used by many patients with autoimmune thyroid disorders and certain cancers.
Jared Younger and his team at Stanford have conducted several trials using LDN in patients with fibromyalgia where it has been found to reduce symptom severity in the majority of patients. Fibromyalgia is a chronic condition causing musculoskeletal pain, profound fatigue, cognitive disruption, and sleep difficulty. Although this disorder does not respond to common anti-inflammatory medications and is not considered a classic inflammatory condition, inflammatory processes are suspected of contributing to the disease process and symptoms.
Book: The Promise of Low Dose Naltrexone
Younger explains that LDN may represent one of the first glial cell modulators used for the management of chronic pain. Glial cells are immune system cells that reside in the central nervous system. This theory is supported with other studies using dextro-naltrexone, which is a stereoisomer of naltrexone with glial cell activity but no effect on the opioid receptors targeted by naltrexone.
Because naltrexone is a generic drug, there is no financial incentive for pharmaceutical companies to study its use in low doses. Research conducted to date has been in university settings. Findings indicate that LDN is safe and well-tolerated although there is not a specific dose that works for everyone. The usual dose is still listed as 4.5 mg daily although for some patients a lower dose appears to work better. Studies also suggest that LDN offers promise for chronic pain conditions involving inflammatory processes.
Crohn's disease remains the condition with the most scientific support for LDN efficiency. Crohn's disease is an inflammatory bowel disease that affects the gastrointestinal tract and often exhibits systemic effects. Researchers at Penn State University have been studying the use of LDN in both adults and pediatric patients with Crohn's disease for nearly 20 year. The response rate of LDN in Crohn's disease may be even higher than that seen in fibromyalgia, with over 80 percent of patients showing significant improvement.
Patients with Graves' disease continue to report that used with anti-thyroid drugs, LDN enhances healing and evokes remission sooner than is typically seen with the use of anti-thyroid drugs alone. LDN is also reported to enhance healing in patients with Graves' ophthalmopathy (thyroid eye disease). Patients with Hashimoto's thyroiditis have reported reduced titers of thyroglobulin antibodies and the need for reduced doses of thyroid replacement hormone.
Younger J, Parkitny L, and D McLain. 2014. "The use of low-dose naltrexone (LDN) as a novel anti-inflammatory treatment for chronic pain." Clinical Rheumatology; 33(4):451-9.
The Promise of Low Dose Naltrexone Therapy
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