| Low dose naltrexone has recently garnered | | | | emphysema) |
| attention as a possible treatment for autoimmune | | | | - endometriosis |
| diseases, neurological conditions, cancer and some | | | | - fibromyalgia |
| other illnesses. Naltrexone is an opiate antagonist, | | | | - chronic fatigue syndrome/myalgic |
| which means that it blocks opioid receptors in the | | | | encephalomyelitis (CFS/ME) |
| brain and thus eliminates the feeling of pleasure | | | | - irritated bowel syndrome (IBS) |
| caused by e.g. drinking alcohol, because our | | | | LDN may possibly also work for e.g. myasthenia |
| endogenous opioids (endorphins) cannot bind to | | | | gravis, antiphospholipid syndrome/Hughes |
| the receptors. But when used in very small doses | | | | syndrome, narcolepsy (a possibly autoimmune |
| (less than 1/10 of the normal dose) naltrexone | | | | condition), interstitial cystitis, chronic Lyme disease |
| can be used to stimulate the release of | | | | post Lyme syndrome, acne, rosacea, chronic |
| endorphins. | | | | urticaria, dementia, obsessive-compulsive disorder |
| History | | | | (OCD), cluster headaches, schizophrenia and |
| Low dose naltrexone was pioneered by the | | | | post-traumatic stress disorder (PTSD). It has |
| neurologist Bernard Bihari in the early 1980s, when | | | | been reported to be helpful in insomnia and |
| he was studying medications used for drug and | | | | migraine prevention. |
| alcohol withdrawal. He noticed that very small | | | | Mode of action |
| doses of naltrexone (initially 3 mg) taken at | | | | Endorphins are often associated with the pleasant |
| bedtime only blocked the opioid receptors | | | | feeling we get from e.g. exercise, but they are |
| transiently, which stimulated the body to produce | | | | more than just that. Beta endorphin and met |
| more of its endogenous opioids and produced no | | | | enkephalin, another opioid peptide produced by the |
| significant side effects. | | | | body have profound effects on the immune |
| Bihari tried LDN as a treatment for HIV/AIDS and | | | | system. Numerous animal studies have |
| multiple sclerosis, two conditions that have been | | | | demonstrated that met enkephalin acts as an |
| shown to be associated with low levels of beta | | | | anti-cancer agent. Beta endorphin levels have |
| endorphin, one of the most important endogenous | | | | shown to be low in HIV/AIDS, many autoimmune |
| opioids. In some of his AIDS patients the blood | | | | conditions and e.g. migraine. |
| levels of beta endorphin as much as tripled when | | | | Autoimmune illnesses have been traditionally seen |
| using low dose naltrexone. | | | | as manifestations of an overactive immune |
| Patients also experienced marked clinical | | | | system and are usually treated with |
| improvement. The MS symptoms (especially | | | | immunosuppressants, but more and more data is |
| fatigue) were relieved and the illness progression | | | | emerging that suggests that autoimmune |
| seemed to halt. Most patients never experienced | | | | conditions may in fact be forms of |
| a single MS attack after the initiation of low dose | | | | immunedeficiency, explaining why LDN, an |
| naltrexone. Patients infected with HIV had their | | | | immunostimulant, works for them. |
| viral counts drop radically and their CD4 counts | | | | Clinical effects |
| subsequently went up. As a result the rates | | | | In most autoimmune diseases the disease |
| opportunistic infections and AIDS related | | | | progression halts. Symptoms, such as fatigue, |
| malignancies decreased. | | | | pain, muscle weakness and cognitive problems are |
| Later development | | | | often alleviated, as well. In degenerative conditions |
| Encouraged by his success Bihari and other | | | | like ALS and Alzheimer's the illness progression is |
| doctors began trying LDN for other conditions, | | | | slowed down. The lipodystrophy caused by |
| such as other autoimmune illnesses and cancer, | | | | antiretroviral (HIV) drugs usually improves |
| often with great results. The support from the | | | | significantly. |
| patient community has been overwhelming. | | | | Bihari reports that a halt in cancer growth occurs |
| Patients with MS have collected money for clinical | | | | in about 50% of the cancer patients he treats. |
| trials and there have even been three | | | | Some of these patients show objective signs of |
| conferences on LDN and the fourth one is | | | | tumor shrinkage. Some patients who have been |
| scheduled for October 2008. | | | | deemed terminal with little time left are still alive |
| A study published in the American Journal of | | | | and doing well years later, such as one with |
| Gastroenterology found that 89% of patients | | | | pancreatic cancer (one of the deadliest cancers) |
| with Crohn's disease were improved on LDN and | | | | whose case was published in Integrative Cancer |
| 67% achieved a full remission. There are clinical | | | | Therapies. |
| trials currently running for multiple sclerosis, | | | | According to Bihari LDN works best for the |
| Crohn's disease, autism, fibromyalgia, pancreatic | | | | following cancers: multiple myeloma, Hodgkin's |
| cancer and squamous cell carcinoma of the head | | | | disease, breast cancer, cancers of the |
| and neck (head and neck cancer). A large HIV | | | | gastrointestinal tract (including the pancreas) and |
| AIDS study is also running in Mali, West Africa. | | | | non-small cell lung cancer. That isn't to say that |
| Illnesses that can be treated with LDN | | | | cancer patients should ditch their existing |
| LDN has been successfully used to treat the | | | | treatments, but LDN can be combined with |
| following conditions: | | | | chemotherapy and radiotherapy. Some patients |
| Autoimmune diseases | | | | only undergo surgery or are considered not to |
| - multiple sclerosis | | | | benefit from conventional treatment, so they |
| - systemic lupus erythematosus (SLE/LED) | | | | would be good candidates for LDN. |
| - rheumatoid arthritis | | | | How it is used |
| - ankylosing spondylitis | | | | LDN is taken every night between 9 PM and 3 |
| - pemphigoid | | | | AM, as the body produces most of its endorphins |
| - sarcoidosis | | | | during the early morning hours. There are usually |
| - scleroderma | | | | no side effects. Some people experience |
| - Crohn's disease | | | | problems with sleeping during the first week. |
| - ulcerative colitis | | | | Nausea, feeling "high", gas and bloating and hunger |
| - celiac disease | | | | pangs may occur in the beginning and usually go |
| - psoriasis and psoriatic arthritis | | | | away in a few days. In patients with MS spasticity |
| - Wegener's granulomatosis | | | | may transiently worsen. It may take anywhere |
| - transverse myelitis | | | | between a day and a few months to notice |
| Cancers | | | | improvement. |
| - bladder cancer | | | | LDN can safely be taken with all other |
| - breast cancer | | | | medications, foods or supplements, but because it |
| - carcinoid tumor | | | | is an opiate antagonist it cannot be combined with |
| - colorectal cancer | | | | any narcotic painkillers (opiates), including tramadol, |
| - glioblastoma | | | | and taking it with immunosuppressive drugs (like |
| - liver cancer | | | | corticosteroids) may cause the drugs to "cancel |
| - non-small cell lung cancer (NSLC) | | | | out" each other's effects, as LDN is an |
| - chronic lymphocytic leukemia | | | | immunostimulant. The only contraindication is a |
| - lymphoma (both Hodgkin's and non-Hodgkin's) | | | | past organ transplant, because taking an |
| - melanoma | | | | immunostimulant might lead to graft rejection. |
| - multiple myeloma | | | | Any doctor can prescribe LDN as an "ex |
| - neuroblastoma | | | | tempore" prescription, to be filled by a |
| - ovarian cancer | | | | compounding pharmacy. Some people use foreign |
| - pancreatic cancer | | | | pharmacies, as it is legal in most countries to |
| - prostate cancer | | | | order medications from abroad with a valid |
| - renal cell carcinoma | | | | prescription. LDN may be formulated as capsules |
| - throat cancer | | | | or liquid, but the liquid has to be refrigerated and is |
| - uterine cancer | | | | less convenient when traveling. It is recommended |
| Other illnesses | | | | that calcium carbonate is not used as a filler for |
| - HIV/AIDS | | | | tablets. |
| - hepatitis C | | | | The recommended dose is 4.5 mg, but some |
| - amyotrophic lateral sclerosis (ALS)/primary | | | | people, especially those who are very slim and |
| lateral sclerosis (PLS) | | | | those with severe MS, only take 3 mg. Often |
| - autism | | | | prescriptions are written for 1.5 mg capsules so |
| - Alzheimer's disease | | | | that the patient can try taking either two or |
| - Parkinson's disease | | | | three at once. LDN is also relatively inexpensive, |
| - Behcet's disease | | | | usually costing between $15 and $40 a month. |
| - chronic obstructive pulmonary disease (COPD, | | | | |