Debbie Judd on the Wonders of Low-Dose Naltrexone
As a practicing Certified Functional Medicine nurse practitioner who uses low-dose naltrexone (LDN) as a key therapy, she attests that LDN is the most successful and important medication she prescribes.
Why is LDN so important in your functional medicine practice? Functional medicine focuses on chronic, complex health issues. To find a medication that can revolutionize treatment for autoimmune diseases such as Hashimoto’s thyroiditis, multiple sclerosis, rheumatoid arthritis and Crohn’s disease, along with fibromyalgia/chronic fatigue, cancer, depression, asthma and allergies is extraordinary. It’s a drug that can revolutionize medicine. However, many practitioners are still unaware of LDN mainly because it isn’t used in their medical specialty.
What is the history of its use? Naltrexone is already being used as an FDA-approved medication to treat opiate (narcotic) and drug abuse addictions. Developed in the 1970’s, it is an opiate antagonist drug that blocks the physiological activity of other drugs as well as endorphins, hormones and neurotransmitters. Research and years of clinical experience demonstrate that used at much lower doses it is helpful in treating many immune system disorders. It is available as a compounded medication, only through a compounding pharmacy, as low-dose naltrexone. Most commonly, doses range anywhere from 0.5 milligrams (mg) to 4.5 mg per capsule.
How does this medication, that claims to be so helpful with so many disease conditions, work? Many diseases are expressions of a malfunctioning immune system, a system that is regulated by endorphins and immune receptors. Endorphins are chemicals produced naturally by our body during times of emotional stress, strenuous exercise and pain. They can be considered “immunomodulators” balancing the immune systems response to pain and stress. These endorphins have a primary action on opiate receptors. When taking LDN, opiate receptors are temporarily blocked, “tricking” the body to produce more endorphins to compensate for a seemingly low production. This works to strengthen the immune system, not suppressing it as many drugs do. In the case of some forms of cancer, cell growth can also be suppressed by a sub-type of endorphins. This leads to a reduction of inflammation in the body and potentially down-regulating oncogenes, a gene that has the potential to cause cancer.
What are the down sides of this medication? There aren’t many. Starting patients on doses between 0.5 mg and 1.5 mg significantly lowers the potential for any adverse effect from LDN. The dose is typically increased by 1 mg every 1 to 3 weeks which allows the prescriber an opportunity to evaluate the patients’ response. The max dose is 4.5 mg but not everyone achieves this dose, which is fine. Patients do very well long term on a lower dose, say 3.0 mg. LDN is typically taken at bedtime but newer research reports taking it in the morning is as effective and often can abate any adverse effect that lasts longer than a couple of weeks.
The most reported side effects in the initial phase of treatment are insomnia, vivid dreams and nightmares. In my experience, this only happens if the starting dose is too high. Occasional reports of transitory stomach cramps, loose stools and headache may occur but typically pass with time or the change to a morning dose. The only medication that cannot be taken with LDN is an opiate pain medication because LDN will make the medication ineffective.
Debbie Judd, ARNP, FAARFM, ABAAHP, is co-owner of the Metabolic Institute in Spokane, Washington. For more information, contact 509-822-2974 or visit TheMetabolic-Institute.com.
For more information on LDN, contact Sixth Avenue Medical Pharmacy at 509-455-9345 or visit SixthAvenuePharmacy.com.