What is Naltrexone?
Naltrexone is an opioid antagonist, meaning it blocks the opioid receptors in your brain. These receptors are meant to respond to endorphins—your body’s natural “feel good” chemicals. Opioids (including the ones used in prescription pain medications such as Percocet, Dilaudid, Lortab, Vicodin as well as drugs such as heroin) attach to these same receptors and produce a similar result. They block pain, slow breathing, and lead to a generally calming and anti-depressant effect. As an opioid blocker, Naltrexone prevents opioids from attaching to your receptors and producing this result.
Doctors began prescribing Naltrexone in the 80’s for opioid addiction because, taken at doses of 50mg to 100mg, it completely prevents patients from experiencing the high of opioid drugs. It is often used while a patient is in recovery to keep them from relapsing.
You may have heard of Naltrexone’s sister medication, Naloxone, which was in the news at the time of Prince’s death. Naloxone could have potentially saved his life had he received it in time. The drug works by actively stripping opioids from receptors, effectively stopping an overdose from opioids in its tracks. While working as an emergency room physician in Baltimore, I routinely used this drug to save the lives of patients who had overdosed on drugs.
Naltrexone is an opioid antagonist, meaning it blocks the opioid receptors in your brain. These receptors are meant to respond to endorphins—your body’s natural “feel good” chemicals. Opioids (including the ones used in prescription pain medications such as Percocet, Dilaudid, Lortab, Vicodin as well as drugs such as heroin) attach to these same receptors and produce a similar result. They block pain, slow breathing, and lead to a generally calming and anti-depressant effect. As an opioid blocker, Naltrexone prevents opioids from attaching to your receptors and producing this result.
Doctors began prescribing Naltrexone in the 80’s for opioid addiction because, taken at doses of 50mg to 100mg, it completely prevents patients from experiencing the high of opioid drugs. It is often used while a patient is in recovery to keep them from relapsing.
You may have heard of Naltrexone’s sister medication, Naloxone, which was in the news at the time of Prince’s death. Naloxone could have potentially saved his life had he received it in time. The drug works by actively stripping opioids from receptors, effectively stopping an overdose from opioids in its tracks. While working as an emergency room physician in Baltimore, I routinely used this drug to save the lives of patients who had overdosed on drugs.
LDN as a Treatment for Autoimmunity
While Naltrexone is primarily for opioid addiction, a doctor in New York, Dr. Bernard Bihari, discovered that when it was taken at a much lower dose, LDM exhibited beneficial results for patients with autoimmunity, cancer, and HIV or AIDS. Hence the name Low-dose Naltrexone (LDN).
These low doses actually increase the level of endorphins in your body. They partially block your opioid receptors when your endorphin levels are typically highest (around 3AM to 4AM). This signals your brain that your levels are low, so it ramps up the production of endorphins and increases your overall levels.
The effects may be beneficial for autoimmune patients due to the fact that endorphins play a role in immune system modulation. Autoimmune patients typically have lower levels of endorphins than people without autoimmunity.
No one knows exactly how endorphins help modulate the immune system or why they are decreased in autoimmune patients, yet studies have shown anti-inflammatory benefits and a decrease in Crohns’, Multiple Sclerosis, and fibromyalgia symptoms in patients who were treated with LDN. There are also many anecdotal success stories from patients and physicians who have seen great results using Low-dose Naltrexone as an autoimmune treatment.
LDN can be used for any autoimmune disease, although it has typically been found most effective for painful conditions. Patients and physicians have seen success with LDN in almost every autoimmune disease, including:
- Hashimoto’s
- Rheumatoid Arthritis
- Lupus
- Crohn’s
- Ulcerative Colitis
- Multiple Sclerosis
- Fibromyalgia
- Chronic Fatigue Syndrome
- Celiac
- Psoriasis
- Sjogren’s
- Autism
- Scleroderma
How to Take Low-Dose Naltrexone
The therapeutic dose of low-dose Naltrexone for autoimmune conditions is typically somewhere between 1.5mg – 4.5mg. There are two main protocols used when starting someone on LDN—a slower, more gentle protocol starting at 1 mg, and a faster protocol starting at 1.5mg. I typically used the faster protocol in my clinic. I started patients on a dose of 1.5 mg for two weeks, increased the dose to 3 mg, and after another two weeks we increased the dose to 4.5 mg.
It is best if you take LDN at 9pm. Taking it at this time allows the medication to be most potent at 4am, right when your endorphin levels should be highest. The LDN will then partially block your opioid receptors all at one time and then release. The surge in endorphins will subsequently modulate your immune system.
LDN is not yet approved by the FDA for autoimmune diseases, so it is not commercially available. For that reason, you will need to have a compounding pharmacy fill your prescription. It is best to work with a compounding pharmacy who is familiar with making LDN to ensure that they are not compounding a slow release formula. Additionally, you do not want them to add calcium carbonate as a filler (which can slow the absorption of the medication).