Low Dose Naltrexone (LDN) Treatment for Autoimmune Disorders:

Low Thyroid / Hashimoto’s Disorder 




What is LDN?

You may be familiar with Naltrexone, which is an FDA-approved medication that has been used since the 1980s for opioid withdrawal. It is used at a higher, standard dose of 50 mg per day. However, low doses of this medication (hence, Low Dose Naltrexone or LDN), have been found to modulate the immune system and have shown promise in improving cases of autoimmune disease. These include Crohn’s, MS, and Lupus, Hashimoto’s, as well as other immune system-related conditions such as cancer and HIV/AIDS. 

LDN is truly an intriguing drug. It can be incredibly helpful for quite a few symptoms that are common for people with autoimmune disorders.

Doses of 1.5 – 4.5 mg per day are usually recommended and have been reported to enhance immune function by increasing the body’s production of endorphins, also known as endogenous endorphin production. This is important for autoimmunity because the increased endorphins help to modulate and regulate the immune system. LDN also reportedly works by reducing inflammation, promoting DNA synthesis, and slowing down motility in the GI tract, to facilitate healing.

The usual adult dosage is 4.5mg taken once daily at night. Because of the rhythms of the body’s production of master hormones, LDN is best taken between 9pm and 3am. Most patients take it at bedtime.

Notable exceptions:

  • People who have multiple sclerosis that has led to muscle spasms are advised to use only 3mg daily and to maintain that dosage.
  • For intial dosage of LDN in those patients who have Hashimoto’s thyroiditis with hypothyroidism and who are taking thyroid hormone replacement medication, please read cautionary warnings below.

The therapeutic dosage range for LDN is from 1.5mg to 4.5mg every night. Dosages below this range are likely to have no effect at all, and dosages above this range are likely to block endorphins for too long a period of time and interfere with its effectiveness.

To get a little more technical, LDN balances the immune system by increasing the amount of T-regulatory cytokines and modulating TGF-B, leading to a reduction of Th-17, the promoter of autoimmunity. This means that it turns off the cells that cause autoimmunity!

LDN has virtually no side effects. Occasionally, during the first week’s use of LDN, patients may complain of some difficulty sleeping. This rarely persists after the first week. Should it do so, dosage can be reduced from 4.5mg to 3mg nightly.

> Cautionary warnings:

  1. Because LDN blocks opioid receptors throughout the body for three or four hours, people using medicine that is an opioid agonist, i.e. narcotic medication — such as Ultram (tramadol), morphine, dextromethorphan, Percocet, Duragesic patch or codeine-containing medication — should not take LDN until such medicine is completely out of one’s system. Patients who have become dependant on daily use of narcotic-containing pain medication may require 10 days to 2 weeks of slowly weaning off of such drugs entirely (while first substituting full doses of non-narcotic pain medications) before being able to begin LDN safely.
  2. LDN users who are planning to have surgery performed generally discontinue taking LDN for one or two days prior to the scheduled procedure. They then are able to restart it promptly after surgery, when they no longer need to take narcotics regularly.
  3. Those patients who are taking thyroid hormone replacement for a diagnosis of Hashimoto’s thyroiditis with hypothyroidism ought to begin LDN at the lowest range (1.5mg for an adult). Be aware that LDN may lead to a prompt decrease in the autoimmune disorder, which then may require a rapid reduction in the dose of thyroid hormone replacement in order to avoid symptoms of hyperthyroidism.
  4. Full-dose naltrexone (50mg) carries a cautionary warning against its use in those with liver disease. This warning was placed because of adverse liver effects that were found in experiments involving 300mg daily. The 50mg dose does not apparently produce impairment of liver function nor, of course, do the much smaller 3mg and 4.5mg doses.
  5. People who have received organ transplants and who therefore are taking immunosuppressive medication on a permanent basis are cautioned against the use of LDN because it may act to counter the effect of those medications.