Low Dose Naltrexone (LDN) Therapy
Accumulating evidence suggests that Low Dose Naltrexone (LDN; 3.0-4.5 mg orally, taken once daily at bedtime) can promote health supporting immune-modulation which may reduce various cancer-causing and inflammatory autoimmune processes. LDN may also play a role in healing and repair of tissues, as well as promoting stress resilience, social bonding, and emotional well-being; and helping with psychiatric problems such as autism and depression.
LDN and Lyme Disease
Chronic Lyme disease is often the result of not only infections with borrelial organisms (the most well-known culprit) but also multiple co-infections with other bacteria and parasites. These multiple co-infections may suppress the immune system or may cause a nonspecific stimulation of the immune system, leading to inflammation, pain, and immune dysfunction.
At the 2012 Integrative Healthcare Symposium, Richard Horowitz, MD, of Hudson Valley Healing Arts Center, Hyde Park, N.Y., and President of the International Lyme and Associated Diseases Educational Foundation, noted, “Usually, the sickest patients require a combined approach using pharmaceuticals and nutraceuticals.” Dr. Horowitz notes that low-dose naltrexone (LDN) has helped patients with Crohn’s disease, multiple sclerosis, and fibromyalgia. In his open-label study of 500 patients with Lyme disease and Multiple Chronic Infectious Disease Syndrome (MCIDS), approximately 75% of patients experienced less fatigue, and less muscle and joint pain when the naltrexone dose was titrated to 4.5 mg at bedtime, using compounded LDN.
Dr. Horowitz concluded that treating the three forms of Borrelia, as well as co-infections, hormonal abnormalities, heavy metals, neurotoxins, sleep disorders, psychiatric problems, and nutritional deficiencies is the best way for patients to regain their health and to decrease pain. Supplementation with alpha-lipoic acid (ALA), glutathione, resveratrol, and curcumin have been found to relieve pain, fatigue, and “brain fog”.
Often, initial tests for Lyme disease are negative, even in infected individuals. “Most conventional practitioners don’t believe that Lyme disease exists in chronic form, because they think the blood tests are reliable when they come up negative. But ELISA (Enzyme-Linked Immunosorbent Assay) is unreliable; you need a Western blot looking at the Lyme-specific bands from a good lab,” Dr. Horowitz said.
Low-dose naltrexone (LDN) has been found to be a well-tolerated and inexpensive treatment to reduce daily pain in patients with fibromyalgia, according to the results of a placebo-controlled, double-blind trial, reported at the American Academy of Pain Medicine’s 28th Annual Meeting. In the study sponsored by the American Fibromyalgia Syndrome Association, researchers from Stanford University evaluated 30 women with fibromyalgia (average age, 43 years) who completed baseline measurements and12 weeks of LDN treatment (4.5 mg each day), 4 weeks of placebo, and 4 weeks of follow up. At the end of the trial, patients reported a 43% reduction in pain during the LDN treatment when compared to the placebo treatment. The only major side effects reported more frequently during the LDN phase of treatment were vivid dreams (37% in LDN vs. 13% in placebo) and headache (16% in LDN vs. 3% in placebo).
It is doubtful that large scale studies will ever be done to investigate potential indications for the much lower dose of naltrexone (LDN) as described above “because there’s no profit motive to fund research on an inexpensive drug with an expired patent.” Low Dose Naltrexone (LDN, in doses such as 4.5 mg) is not commercially available; however, it is a prescription medication that can be compounded by our pharmacy. Although sleep disturbances are rare, some patients using LDN have reported vivid dreams. To minimize this risk, therapy can be started with a lower dose (1.5 mg) and increased slowly over two months.
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