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.