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Does Low Dose Naltrexone (LDN) reduce inflammation?

minkeygirl

But I Look So Good.
Messages
4,678
Location
Left Coast
@Dufresne Naltrexone 50 mgs tends to be pretty expensive. I've seen that brand but can't remember where. (I'll look for you to see if I have the link. I just found a different brand for that was $150 for #28 50 mgs. I'm pretty sure the Revia, which is the name brand is about the same.

I've found several different generics if you're interested in that. One was #10 for $19.95 plus $25 for shipping. Brands are Intas or Sun Pharmacy
 
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melamine

Senior Member
Messages
341
Location
Upstate NY
nomad said:
I would be very keen to try this if its possible to get a private prescription for it. Anyone ?

nomad: I may be able to help you re: high grade compounded Rx naltrexone if you contact me privately.
 

bertiedog

Senior Member
Messages
1,738
Location
South East England, UK
Does LDN tend to improve fatigue levels?
LDN has been a really big help for me especially with regard to fatigue and a sense of well being. I think it has also helped my sleep. I have always taken it after breakfast and not in the evenings because I don't tolerate any medication in the evenings because of adrenal insufficiency which is treated with a replacement dose of Prednisolone of 6 mg.

I only tolerate 1 mg of LDN and have been on it for 5 months but get nasty side effects of feeling very giddy if I take more. I got mine from Dicksons Glasgow and it costs me £18 for 2 months supply with a £35 consultation fee from an online clinic which seems to have to be paid twice yearly.

I did come off it for 3 weeks but the fatigue was really bad but I soon improved once I restarted it.

Pam
 

melamine

Senior Member
Messages
341
Location
Upstate NY
LDN has been a really big help for me especially with regard to fatigue and a sense of well being. I think it has also helped my sleep. I have always taken it after breakfast and not in the evenings because I don't tolerate any medication in the evenings because of adrenal insufficiency which is treated with a replacement dose of Prednisolone of 6 mg.

I only tolerate 1 mg of LDN and have been on it for 5 months but get nasty side effects of feeling very giddy if I take more. I got mine from Dicksons Glasgow and it costs me £18 for 2 months supply with a £35 consultation fee from an online clinic which seems to have to be paid twice yearly.

I did come off it for 3 weeks but the fatigue was really bad but I soon improved once I restarted it.

Pam
Interesting that you only tolerate 1mg. I am getting excitotoxic symptoms and greatly exacerbated fatigue on 1.5mg, and am ready to give it up after two attempts lasting 3-4 days. While I would consider trying a lower dose/different protocol, I am dealing with a dangerous symptom that is not just uncomfortable and inconvenient, but a familiar signal that irreversible nerve damage will soon follow. And because of that, it makes me wonder if a long term trial would be useful even if I found an apparently tolerable dose. There is little to no information to be found on neurotoxic reactions to LDN.
 

Dufresne

almost there...
Messages
1,039
Location
Laurentians, Quebec
@Dufresne Naltrexone 50 mgs tends to be pretty expensive. I've seen that brand but can't remember where. (I'll look for you to see if I have the link. I just found a different brand for that was $150 for #28 50 mgs. I'm pretty sure the Revia, which is the name brand is about the same.

I've found several different generics if you're interested in that. One was #10 for $19.95 plus $25 for shipping. Brands are Intas or Sun Pharmacy

Revia worked really well for me, while Naltima was a nightmare. Just walking around the house was causing me PEM and depression after using the generic. Normally I can walk a few miles at a brisk pace.

I've a script for 3mg LDN, but I want to make sure I'm getting Revia. It's also nice to tinker with the dose to get it just right and I don't want to have to break open tablets that are costing me four times the cost of the drug. What can I say, I'm frugal.
 

maddietod

Senior Member
Messages
2,859
I've tried crushing the tablets and starting at 0.5 doses twice, and failed to increase that dose. I blamed the pills and am now trying a compounded version. I started at 0.1 and increased every 3-4 days until I got a reaction.

At 0.4 I got increased energy and pronounced allergic symptoms (sinus and swollen glands). I'm staying at 0.4 for now.
 

Hip

Senior Member
Messages
17,824
Naltrexone Therapy Response Determined By rs1799971 SNP

I just noticed on the 23andme website, under the drug responses section, there is a webpage detailing your predicted response to naltrexone therapy, in the treatment of alcohol dependence.

See here: Naltrexone Treatment Response - 23andMe.

The rs1799971 SNP in the OPRM1 gene apparently helps determine your response to naltrexone. OPRM1 is the gene for the mu1 opioid receptor.

According to 23andme, if you have the GG genotype for rs1799971, you have "substantially higher odds of good clinical outcome in response to naltrexone therapy." Whereas if you have the AA genotype, you have "typical odds of good clinical outcome in response to naltrexone therapy." And the AG genotype is somewhere in between.

So GG seems to be the most favorable, and AA the least favorable. The G allele is also associated with stronger cravings for alcohol.


I am wondering whether this rs1799971 SNP may play a role in determining which ME/CFS patients benefit from low-dose naltrexone (LDN), or get strong start-up side effects from LDN. It might be worth setting up a poll on this; but I thought I'd begin some pre-poll discussion here before organizing such a questionnaire.

I have the least favorable AA genotype, and I seem to get no benefit from LDN (and few side effects either), in spite of trying LDN numerous times over the years.

Anyone else care to give their rs1799971 results, and their response to LDN? You can see your genotype for rs1799971 on the the right hand side of the webpage link given above (and you can also see your rs1799971 genotype on this page).



Note that LDN may not work unless you also take vitamin D3.
 
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Sushi

Moderation Resource Albuquerque
Messages
19,935
Location
Albuquerque
That is very interesting @Hip. I wonder whether low dose response correlates with high dose response? It seems that with some drugs this may not be so. I also wish I had 23andme results to check so I could take your poll. I respond very well to LDN.
 

Indigophoton

Senior Member
Messages
127
Location
UK
I am wondering whether this rs1799971 SNP may play a role in determining which ME/CFS patients benefit from low-dose naltrexone (LDN), or get strong start-up side effects from LDN. It might be worth setting up a poll on this; but I thought I'd begin some pre-poll discussion here before organizing such a questionnaire.

Just a thought - it's possible that the benefits of LDN in ME are down to its antagonism of the Toll-like receptor 4's found on microglia, which modulate the body's response to inflammation. The opiod activity may not be the key.

For myself, I am finding LDN helpful, but I haven't noticed any opiate effects, good or bad. I don't have 23andme data to compare.
 

Misfit Toy

Senior Member
Messages
4,178
Location
USA
I'm on an LDN group on FB. So many people on there have Crohn's disease, rheumatoid arthritis, lupus, MS, Sjogren's syndrome, and other autoimmune inflammatory diseases. Many of them are doing great on LDN and their inflammation has decreased. They are back to living and off of prednisone.

I feel too apprehensive to take it right now with all the reactions I've had to everything this year. I tried it back in 2008 and could not sleep and my fibromyalgia became so out of control. I'm hoping my body will settle down and I'll be able to try more things.
 

bertiedog

Senior Member
Messages
1,738
Location
South East England, UK
Just to add my 23andme SNPs showed AA and I stopped LDN around Christmas last year because I was still getting a nasty reaction to just 1mg on some days (dizzy and spacey feeling). I was no different on stopping it.

Pam
 

Hip

Senior Member
Messages
17,824
Just a thought - it's possible that the benefits of LDN in ME are down to its antagonism of the Toll-like receptor 4's found on microglia, which modulate the body's response to inflammation. The opiod activity may not be the key.

That is certainly possible. LDN may work for ME/CFS because it:
blocks TLR-4 on microglia
increases levels of met-enkephalin (opioid growth factor) and its receptor
• blocks the mu-opioid, delta-opioid and kappa-opioid receptors for a short while (thought to up-regulate endorphins)
• has an effect the nociceptin system
• may reduce peroxynitrite and may thereby increase astrocyte glutamate transport



It might be an interesting experiment for ME/CFS patients who do well on LDN to try taking hyaluronic acid supplements instead. Hyaluronic acid also reduces microglial activation by a TLR-4 receptor mechanism. 1 If similar benefits to LDN were obtained with hyaluronic acid, that would perhaps suggest that TLR-4 is involved in mediating LDN's benefits in ME/CFS.

Ibudilast (a Japanese drug) also inhibits TLR-4. 1

A comprehensive list of microglia activation inhibitors is given in this post.



Note that LDN may not work unless you also take vitamin D3.
 
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Dufresne

almost there...
Messages
1,039
Location
Laurentians, Quebec
Thanks for the info, Hip. I've the AG genotype and respond favourably to LDN, without side-effects. I also do extremely well on opioids, as I've reported on the forum. And I have a family history of alcoholism.
 

Vojta

Senior Member
Messages
167
Location
Czech Republic
My second try with LDN failed again. I started with 0,5mg before sleep. It causes insomnia which I don't have normally (I sleep 2-3h less) and dysphoria. It makes me outspaced and very irritated all next day. On third night I took only 0,2mg and I feel like shit anyway again. Now I remember why I quit my first attempt. It may lower my pain though but because of side effects it's not worth to me. I wonder if naltrexone is occupying receptors for too long or my body doesn't produce more endorphins because of some metabolism thing. I also don't tolerate tramadol at all which makes me very sick too.
 

maryb

iherb code TAK122
Messages
3,602
Location
UK
I'm an AA so I'll probably not bother trying LDN, I've been looking at it for a while but this has decided me results with patients seem so variable:(
 

flitza

Senior Member
Messages
145
That is certainly possible. LDN may work for ME/CFS because it:
blocks TLR-4 on microglia
increases levels of met-enkephalin (opioid growth factor) and its receptor
• blocks the mu-opioid, delta-opioid and kappa-opioid receptors for a short while (thought to up-regulate endorphins)
• has an effect the nociceptin system
• may reduce peroxynitrite and may thereby increase astrocyte glutamate transport



It might be an interesting experiment for ME/CFS patients who do well on LDN to try taking hyaluronic acid supplements instead. Hyaluronic acid also reduces microglial activation by a TLR-4 receptor mechanism. 1 If similar benefits to LDN were obtained with hyaluronic acid, that would perhaps suggest that TLR-4 is involved in mediating LDN's benefits in ME/CFS.

Ibudilast (a Japanese drug) also inhibits TLR-4. 1

A comprehensive list of microglia activation inhibitors is given in this post.
A very good idea, Hip. Did anyone check it out?
 

Hip

Senior Member
Messages
17,824
A very good idea, Hip. Did anyone check it out?

I tried hyaluronic acid myself, at doses of 400 mg, but did not noticed much. However, I am a non-responder to low-dose naltrexone, so I am probably not the best patient to test hyaluronic acid.