Low Dose Naltrexone | The Ultimate Resource

LDN is a specialty medication meaning it’s custom-prepared by compounding pharmacies or “specials pharmacies” using the approved drug - naltrexone - but in a specially formulated way. Unlike medications in which ingredients and production processes are standardized, the formulation and quality of LDN will depend on the pharmacy that produces it.

LDNscience has compiled helpful guidance that explains the difference between LDN formulations and what you should look out for. Knowledge is power, and will enable you to make good LDN decisions.

The Different LDN Formulations

Capsules

Benefits: Easy to swallow

Drawbacks: Cannot be cut

Storage: Room Temperature

Cautions: Avoid fillers/excipients that slow down release
Avoid lactose for people with lactose sensitivity

Tablets

Benefits: Ease of swallowing
Sometimes are scored so can be divided into smaller doses

Drawbacks: More excipients (fillers) than capsules

Storage: Room Temperature

Cautions: Avoid fillers/excipients that slow down release
Avoid lactose for people with lactose sensitivity

Liquid / Drops

Benefits: Fastest absorption
Can be mixed into liquids. Allows very small dose modifications

Drawbacks: Short stability for some formulations
Can have a bitter taste if placed directly in mouth

Storage: Refrigerated or room temperature - follow the pharmacy’s storage instructions

Cautions: Pay attention to short expiration dates

Important Other types of naltrexone formulations are available for other purposes. While these can have medical benefits, these formulations should not be confused with the regular well-studied “low dose” naltrexone (LDN).

Slow-release or Extended-release: Such formulations should be avoided because they prevent the necessary rebound effect that makes low dose naltrexone effective.
Cream: Since creams are absorbed slowly through the skin, they don’t provide the typical “rebound effect” necessary for low dose naltrexone to work.

Know about Fillers

A filler is an inactive ingredient that is mixed with naltrexone in order to ensure uniform filling and dosing. Certain fillers may physically bind with the LDN which prevents its necessary rapid absorption. Here is what you should know:

Cellulose or plant-fiber fillers are more likely to bind with the LDN and slow its absorption. They are best avoided.
Protein-based fillers (amino acids such as glycine) do not slow down LDN absorption.
Simple-sugar fillers such as sucrose, dextrose, or lactose do not slow down LDN absorption.
Lactose should be avoided by individuals with lactose intolerance, gastrointestinal issues, irritable bowel syndrome (IBS), inflammatory bowel disease (IBD, such as Crohn’s and Colitis), and leaky gut syndrome.
Propylene glycol (also known as methylethylene glycol), and glycerine are suitable for use in liquid LDN formulations.

Choose the Best Pharmacy For You

To find the right compounding pharmacy to prepare your LDN, a great start is to look at LDNscience’s free global compounding pharmacy directory. It is an excellent resource to find a pharmacy closest to you that is familiar with LDN preparation. You can discuss with them (in addition to your LDN prescriber) what formulation and fillers would be best for you. By following these steps, you can ensure that your LDN experience is as optimal as can be.

The year of 2019 saw a great surge in LDN activity!

Take a look at some of the LDN milestones:

Publications

A record high in published LDN articles, books, and posters was achieved.

LDN publications in 2019 focused on using LDN for: skin conditions - HHD, alopecia, Darier’s, atopic dermatitis, psoriasis; chronic pain - neuropathic corneal pain, fibromyalgia, Ehler’s Danlos; psychiatric conditions, rheumatologic conditions - RA, Sjogren’s; as well as explorations in chronic fatigue syndrome and cancer.

Academic Institutions

More academic institutions published on LDN in 2019 than in any previous year.

LDN research has truly gone international. Countries from all over the world represented LDN scientific publications, including: Eastern & Western Europe: Finland, Germany, Norway, Poland, Spain, UK; North America: Canada, USA (academic centers across 16 different states!) South America: Brazil; Middle East: Egypt, Iran, Saudi Arabia; East Asia: China, Japan; South Asia: India Oceania: New Zealand

Authors

There was more than a 45% increase in the number of LDN-related authors compared to previous years.

Among the increase in 2019’s authors were some "LDN frequent fliers" who’ve published more than one article on LDN, including Drs. Dieckmann and Hamrah of Tufts University, Norwegian researchers Drs. Raknes and Småbrekke, and Dr. Jfri of McGill University. We look forward to seeing what LDN progress is made by all of these authors in 2020.

Conditions

We reached a new high of 65 different conditions explored with LDN therapy that were published in the scientific literature.

Among the 1sts in 2019 were the first large scale study of LDN use related to rheumatoid arthritis, the first case report of LDN therapy for Sjogren's syndrome, and the first articles published on LDN therapy for chronic fatigue syndrome, erythrodermic psoriasis, and amyopathic dermatomyositis.

Behind the scenes of all this important LDN activity, LDNscience plays a significant role as #1 source of accessible scientific information and practical guidance about LDN.

We always keep the LDN community up to date by reporting the latest scientific developments, conducting exclusive interviews with experts and patients, disseminating LDN user stories, answering questions, and making LDN treatment more available by providing free, easy access to prescribers and pharmacies.

With your support, we can make 2020 a year of unprecedented growth in LDN research and help bring LDN’s healing potential to more people in need than ever before.

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More than ever before, we now know that untreated or under-treated pain damages the body’s immune and neurological systems in the long term. The consequences can be devastating.

How can this be avoided? There are effective treatments for pain...but some can result in side effects (abuse, addiction, overdose) that are worse than the original pain itself.

LDN’s excellent safety profile makes it different. However, how effective is it for pain?

The body of published reports of LDN successfully treating different kinds of pain (especially pain that has not responded to other treatments) continues to grow.

Here are a few different kinds of pain that have been reported to respond to LDN:

inflammatory soft tissue pain - when organs, muscles or tissues are damaged and inflamed
nerve pain - when nerves are damaged
chronic pain - when it lasts for a long period of time

Using LDN to heal inflammatory pain

In numerous publications in medical journals, prominent institutions such as Penn State University, the Cleveland Clinic, and Vanderbilt University have reported that LDN relieves some of the troubling abdominal pain that accompanies inflammatory bowel disorders (such as ulcerative colitis and Crohn’s).

When Dr. Leonard Weinstock, Associate Professor of Clinical Medicine and Surgery at Washington University School of Medicine, did research on LDN for psoriatic arthritis (painful joint inflammation associated with the skin disease) he found that giving LDN to patients resulted in up to a 60% improvement. “That’s something that you can take home and ask your doctor about,” he remarked to us.

For rheumatoid arthritis and ankylosing spondylitis (arthritis affecting the spine), Dr. Guttorm Raknes and his colleagues published the first study about LDN. In his video interview with LDNscience, he discusses how taking LDN long-term resulted in less use of opioids AND other painkillers. This suggests that LDN provided enough pain relief that more medication was unnecessary. Patients themselves describe this effect here: Kayleen’s story of taking LDN for her rheumatoid arthritis and several other patients’ reports of successful treatment of RA with LDN.

Patients themselves write to LDNscience to report the life-changing effects of taking LDN for painful ulcerative colitis and Crohn’s disease.

Several other patients using LDN to treat osteoarthritis volunteered to be interviewed about their experience. Alan told us, “I feel decades younger now,” while Deb shared that, “Once I actually started taking LDN, my pain was so relieved...I haven't needed the ‘heavy duty stuff’ anymore.” Watch and read how LDN changed Alan’s experience of osteoarthritis, and how one dose of LDN made a major impact on Deb’s 25 year history of osteoarthritis pain.

Using LDN to alleviate nerve pain

Nerve pain, also called neuropathic pain, is notoriously difficult to treat. In fact, in their article about treating cornea nerve pain, Tufts University and University of Arkansas clinicians describe such patients “extremely challenging to manage,” because it’s hard to relieve their pain. That’s why it’s particularly noteworthy that they recommend such patients take low dose naltrexone. Similarly, other universities have published reports about how LDN alleviated severe nerve pain from a burn injury for one patient, and LDN relieved 95% of the severe diabetic nerve pain of another. LDN worked where other treatments has failed, without any significant side effects.

Using LDN to relieve chronic pain

There are more than a dozen different publications about LDN for chronic pain, including chronic back pain (that many of us know so well!).

In LDNscience’s interview with Dr. Mark Schukhman, a Chicago psychiatrist/researcher, he explains that using LDN to treat opioid addicts (many of whom started taking opioids because they suffer from chronic pain) enables them to decrease or cease taking opioids, and more easily recover from “prolonged post-opioid use problems” that include highly elevated pain levels. Addiction specialists around the country are starting to use LDN for this purpose.

What about the experience of people using LDN for chronic pain? Here are a couple of highlights from our full-length patient interviews:

Kim used to be a “gym rat” until she became disabled from painful arthritis, fibromyalgia, and other conditions. Wanting to get off opioids, she found out about LDN but wasn’t ready to try it. That is...until her dog got sick and LDN worked so beautifully for her dog that Kim decided to try it herself! Her life changed because of that decision. Click here to see Kim’s story of chronic pain, dogs, and LDN.

Laura Dysart would come home from work each day, and go straight to the couch with a heating pad and Perocet to cope with the chronic bladder/pelvic pain of interstitial cystitis (IC). After 7 doctors, 2 surgeries, and many ineffective treatments, her doctor finally suggested LDN. Within days of starting, her symptoms started improving. Watch and read Laura’s LDN story to see how her life dramatically turned around thanks to LDN.

Don’t see your specific pain condition mentioned here? You may very well find it in the LDN user stories and interviews on LDNscience.

Using LDN to treat pain syndromes

In any discussion about pain, one seat at the table has to be for disorders in which pain is the core symptom. Think Fibromyalgia. Think Complex Regional Pain Syndrome (CRPS). LDN has had surprising success in these disorders where other treatments have failed. There are more than a dozen different clinical trials/medical reports about LDN for fibromyalgia as well as about LDN use for CRPS (the before and after pictures are striking!).

In interviews with LDNscience, experts from Stanford University, the University of Alabama at Birmingham, and SUNY Upstate Medical University discuss the use of LDN to treat fibromyalgia.

Since Dr. Jarred Younger’s original interview with LDNscience, he has published the first clinical trials of LDN for fibromyalgia in 2009, followed by 3 others in 2013, 2015, and 2017. Dr. Younger reports that patient satisfaction with LDN has been very high, and that most individuals he’s evaluated reported no side effects at all, which adds to patient satisfaction. Dr. Younger and his colleagues think that LDN may act as an atypical anti-inflammatory medication and this should be studied further.

Dr. Brian Johnson, of SUNY Upstate Medical University, shared the fascinating connection between the kind of pain that addicts feel when trying to stop taking opioids and the daily chronic pain of fibromyalgia patients. In Associate Professor Johnson’s interview with LDNscience, he describes how LDN alleviates hyperalgesia (elevated pain) similarly in both conditions because they may both be the result of endorphin deficiency.

There are also dozens of patient interviews and user stories about LDN for fibromyalgia and other pain syndromes.

If you or a loved one suffer from pain, especially pain that has not responded well to other treatments, consider discussing LDN with a physician to see if it’s an option for you. If you need help finding a clinician familiar with LDN, you can make use of LDNscience’s prescriber directory.

An estimated 85 million people suffer from skin disease in the U.S. alone! In fact, 1 in 4 Americans have been treated for a skin disease and 50% of the US population over age 65 has not one but two skin diseases.

Doctors are increasingly using LDN and reporting its success in relieving difficult-to-treat skin conditions. As of November 2019, more than 26 reports have been published in the scientific literature about using LDN to treat skin conditions. Below you will find highlights from those reports.

Two skin conditions that have been the subject of many publications are:

Hailey-Hailey Disease (HHD)

Over a dozen(!) reports have been published about using LDN for Hailey-Hailey Disease, also called “benign familial pemphigus.” HHD is a genetic condition that causes painful blisters and skin erosions, infection, and medical complications that severely impact quality of life. Physicians have reported cases of HHD responding well to LDN even when resistance developed to other treatments.

Psoriasis (including subtypes Erythrodermic, Guttate, Vulgaris)

Physicians have published a number of reports on treating psoriasis with LDN. A new study will be published soon by Dr. Leonard Weinstock, affiliated with Washington University School of Medicine, so make sure to subscribe to our updates and be first to know. Our 2019 interview with Dr. Weinstock about LDN's potential as a treatment for psoriasis and psoriatic arthritis gives a preview of coming attractions from his upcoming article.

Of all the articles published about using LDN for treating skin disorders, the following themes tend to run through them all:

The skin disease was resistant to "conventional therapies." Disease symptoms (pain, itching, etc.) were still not adequately controlled.
Side effects from other treatments were intolerable.
LDN was used by itself or added to patients’ other medications.
LDN caused the skin condition to go into remission and reduced painful, uncomfortable symptoms.
LDN significantly improved quality of life.

Here are some highlights from the published reports about the following conditions:

Amyopathic Dermatomyositis (ADM): "LDN has emerged as an alternative treatment option for patients owing to its efficacy and limited toxicity as seen in the treatment of several autoimmune dermatologic conditions including our case of ADM."

Alopecia: "...LDN would be a possible alternative to be added to the therapeutic arsenal owing to its anti-inflammatory properties, analgesic potential, low cost, and few adverse effects described."

Darier Disease (DD): "...patients with a mild to moderate form of the disease did show a good response."

Dermatitis Herpetiformis (DH): "The patient’s skin lesions were present for 2 years and went into complete remission within 3 months of taking low dose naltrexone."

Dermatomyositis (DM): "The first patient experienced improvement of his skin lesions, arthralgia, and muscle pain. The second patient experienced relief from her recalcitrant pruritus. Despite tapering the other immunosuppressants, her skin disease did not recur..."

Lichen Planopilaris (LPP): "This is the first case series demonstrating the beneficial effects of low-dose naltrexone for patients with LPP. This medication was well-tolerated by the patients and is cost-effective."

An Important Perspective: The Patient’s View

What about the patients' point of view on using LDN for skin diseases? Here are some altruistic LDN users who generously shared their experiences of using LDN for their dermatologic conditions:

Lichen Sclerosis: "After 11 months of LDN, my skin condition has healed 99%. To me, that is nothing short of a miracle!" - Ruth Eisenberg

Psoriasis/Psoriatic Arthritis
"I was diagnosed with Psoriatic Arthritis in 2012...Since taking LDN my life has improved drastically for the better. My joint pain reduced hugely after just 3 days. I sleep much better, and I also find it helps with fatigue and anxiety problems. Low Dose Naltrexone has given me my life back...." - Sarah Berry
"I have been 100% painless, I have lots of energy and I sleep well...My life has completely changed and I'm eternally grateful. I don't use any other drugs than LDN." - Anette Møberg

Eczema (Dermatitis): "It was a miracle and a lifesaver!" - Tom Jacobs

Pyoderma Gangrenosum: "We saw improvement straight away. The pain went away and I was able to reduce the steroids. When I came off the steroids completely, I went red all over...but the LDN cured that in three days. My thighs have improved greatly and the rest of me is completely clear. I feel happy and full of energy." - Michele Romano

If you or a loved one has a skin disorder, discuss LDN treatment with your healthcare practitioner. If you need help finding an LDN prescriber, LDNscience’s highly popular Prescriber Directory is a useful resource to find an LDN prescriber near you.

Veterinarians and astute caretakers can sometimes detect the signs and symptoms of pain. Pets may move slowly, have difficulty changing position, refuse to walk, not eat well, pant excessively, or vocalize (yelping, whimpering, meowing) more than usual. They may seem listless and sleep a lot.

Pet pain is distressing, especially when the cause of the pain is untreatable, or available treatments may cause significant side effects.

Can LDN help pet pain? Here is what we know so far.

Clinical Trials

While many small animal studies exploring LDN’s effects have been conducted, there has been only one published clinical trial using LDN for pets. It explored the effect of adding LDN to the chemotherapy of dogs with mammary (breast) cancer. The researchers measured LDN’s effect not only on the dogs’ immune systems and survival rates, but also on their quality of life. To measure their quality of life, their owners did a periodic assessment of pain, among other aspects of their animal’s well-being.

The researchers found that the dogs given LDN maintained a higher quality of life (and survived longer) compared to the other dogs.

The researchers reported, "The results of this study support that quality of life is directly related to the beneficial effects of LDN, being important in the evolution of treatment and consequent survival."

Pet Owner Experiences

LDNscience has received numerous stories from “pet parents” about the helpful and, at times, remarkable outcomes experienced after giving their pets LDN.

Here are some excerpts about their experiences:

After LDN worked so nicely for Alan Koshak's osteoarthritis pain and Cindy's Sjogren's and Burning Mouth Syndrome pain, they considered giving it to Maggie, their bulldog. Maggie suffered from severe arthritis and torn a ligament. She had a hard time getting up from a sitting position, couldn't move quickly, and had a bad limp. Their veterinarian told the Koshaks that Maggie would always limp and be in pain. After researching LDN for pets, they decided to give it a try. The results were immediate and dramatic; LDN significantly changed Maggie’s quality of life for the better. See more about this story here: "She's Like A Puppy Again!" Maggie's Recovery from Arthritis & a Torn ACL

Yeti was about to be euthanized due to pancreatic cancer. The abdominal pain, weakness, lethargy, and loss of appetite made Yeti a shadow of her former self. But Yeti's family didn't want to give up just yet- they had seen benefit from taking LDN themselves and decided to see if it would help their cat. From the first dose of LDN, Yeti's behavior changed significantly, indicating a much improved quality of life. After a year on LDN, the latest visit to the veterinarian revealed an even bigger change...the pancreatic tumor had disappeared. More about Yeti's success story can be found here: LDN Family Success Story: Alleviating Fran's Dementia and Yeti the Cat's Pancreatic Cancer

Because LDN had worked so well for the Koshak's and their bulldog Maggie, they mentioned it to their son Dustin, whose dog Rocky was suffering from an aggressive, fast growing facial tumor. Rocky would yelp when he opened his mouth to eat or yawn due to the pain. The veterinarian said the tumor was inoperable and predicted Rocky had about 6 weeks to live. Dustin decided to give Rocky LDN. Once on LDN, the tumors started to shrink, and Rocky was able to eat, yawn, and open his mouth without any pain. Dustin thinks LDN significantly improved the length and quality of Rocky’s life. Read more of the story here: "LDN Really Is For The Dogs!": Rocky's Cancerous Tumors Disappear

Dolly, a rescued poodle, started having nosebleeds, which led to a diagnosis of sinus cancer and a prognosis of 3-6 months to live. Sadly, she showed signs of being in pain and started to withdraw. In light of Steve's own positive experience using LDN, he decided to treat Dolly with it. Dolly seemed to feel much better after starting LDN: her nosebleeds stopped and she appeared pain-free. She became frisky again, just like a puppy, even though she was a “senior citizen” at 12 years old. Read more about Dolly's experience here: Dolly The Rescue Poodle's LDN Story: Beating The Odds Against Sinus Cancer

Kim's service dog Hayliegh had liver cancer and a leg problem. Kim had to give pain and anxiety medication to her dog to try to help her be more comfortable. But she still was unwell, and the veterinarian didn't have much else to offer. Since Kim had found relief herself using LDN, she decided to give it to her dog...what was there to lose? The response was quick. After starting LDN, Hayliegh wasn’t panting anymore, was sleeping better, and moving much more. Hayliegh lived symptom-free for a year and a half after being diagnosed with liver disease, while on LDN. At each follow-up visit, her veterinarians were surprised to see Hayliegh still around and doing so well. They would ask, “How?” and Kim would say,"LDN!". Read more about Kim and her service dogs here: LDN Restored Quality of Life for Kim's Life of Fibromyalgia & Arthritis (as well as her Service Dogs!)

If your pet is suffering from pain, consider discussing it with your veterinarian. If you need help finding a veterinary LDN prescriber or way to buy LDN, you may also find LDNscience’s veterinarian directory and compounding pharmacy directory useful.