• Dr Sajad Zalzala

The Benefits of Low Dose Naltrexone (LDN)

What you should know about LDN:

  • Low Dose Naltrexone (LDN) works with endorphin and immune systems to reduce overall oxidative stress

  • LDN relates to doses of 10mg per day or less

  • LDN is shown to reduce chronic inflammation, autoimmunity, obesity, fatigue, and chronic pain

  • LDN is a safe and effective treatment for over 40 years

My Experience with LDN


I first learned about Low Dose Naltrexone (LDN) when I attended an integrative medicine conference as a medical student. I was naturally intrigued when I heard about the effects LDN has on autoimmunity and chronic inflammation. Individuals diagnosed with a disease falling under these two broad conditions often do not receive much relief from conventional therapies—and the conventional therapies typically come with detrimental side effects.


After much research and investigation, I decided that Low Dose Naltrexone was something that would highly benefit a large number of individuals who were seeking answers to their health issues. During my residency training, I was able to convince one of my supervising physicians to allow me to try LDN on a patient—and there began my obsession with it.


As time went on, I began prescribing LDN in my very own brick and mortar clinic. There was still more I felt I could do to help patients. So, I decided to create a service that was available nationwide to provide easy access to patients wanting LDN. In 2016, I launched LDN Direct. Since then, I have prescribed LDN to over 1,000 patients. The vast majority of these patients experience symptom relief to some degree, and, furthermore, a good number of them have claimed life-changing experiences with LDN.


LDN and Lyme Disease


As the service became widespread and consultations quickly increased, I began to notice patterns in the ways in which individuals reacted to LDN. For example, individuals dealing with Lyme or related infections tended to need to start at a much lower dose—sometimes even a micro-dose of Naltrexone—in order to avoid uncomfortable side effects. I hypothesize that these patients’ immune systems have been devastated by these infections and need to be brought back in balance very gently and slowly.


Others who tend to fall into this category are those experiencing chronic migraines, and patients who are sensitive to multiple medications or foods. More recently, I have seen an uptick in MCAS (Mast Cell Activation Syndrome) consultations; these patients also tend to require a lower initial dose and slower titration schedule.


LDN and Thyroid Diseases


While there is some school of thought that individuals with a Hashimoto’s diagnosis need to start at a lower than normal dose of 0.5 mg, I have actually found that these particular patients tend to require a higher maintenance dose than others in order to keep symptoms at bay and regulate the immune response. If they begin at a low dose, it winds up taking them quite some time to find relief; some may throw in the towel before they get the relief they seek. I prefer to start these individuals at a “regular” starting dose of 1.5mg daily, and educate them on the potential to titrate back a bit if they experience long lasting side effects. Hashimoto’s—and thyroid disorders in general—seem to be particularly susceptible to the effects of Low Dose Naltrexone.


We ask any patients taking thyroid medication to have a full thyroid panel checked by their physician every 6-8 weeks while titrating up to their maintenance dose or sooner if they experience symptoms of hyperthyroid. I have seen many thyroid patients need to reduce their dose after starting LDN, and I even find that it lowers auto-antibodies.


LDN and Elher’s Danlos Syndrome (EDS)


A formerly uncommon diagnosis that I have started to see is Elher’s Danlos syndrome (EDS). This is a condition that conventional therapies have almost no treatment for—yet the increase in diagnosis is quite staggering. Over the last year, we have seen close to 50 patients with this diagnosis. LDN seems to be one of the few treatments that yields results for them. Several have actually emailed in excitement about the difference they feel after only a few weeks of taking LDN. The majority of these patients seem to have an “acquired” form of EDS, rather than the classic purely genetic variety we learn about in medical school. I suspect the acquired form of EDS has an immune dysfunction component that LDN is helping to resolve.


LDN and Fibromyalgia/Chronic Fatigue Syndrome


The most common success stories with LDN are Fibromyalgia (FMS) and Chronic Fatigue Syndrome (CFS). Again, these patients tend to fall through the cracks when it comes to conventional therapy, and many individuals do not respond well to the common medications prescribed. Fatigue and phantom pain are the most commonly reported symptoms in patients with FMS and CFS diagnoses, and, in fact, these two diagnoses commonly go hand-in-hand. While neither is technically considered an autoimmune disease, they have many commonalities with other autoimmune diagnoses. Even for those patients who do not have an actual diagnosis, but have similar symptoms that are clearly based on a dysfunctional immune system and chronic inflammation, LDN has shown to be successful to some degree, time and again—with some patients experiencing near-complete resolution of symptoms.


LDN and Longevity


Considering how LDN works in the body to balance the immune system and reduce inflammation, it poses the question: Does it also help to increase longevity?


My answer is Yes! The mechanism by which Low Dose Naltrexone works is by boosting the body’s natural production of endorphins (read more about that process here). Considering that endorphins are a key constituent in the production of SuperOxide Dismutase, and SuperOxide Dismutase is the body’s most prominent way of decreasing oxidative stress—the most common cause of aging—it bears considering that utilizing Naltrexone at a low dose could be a wonderful long-term preventative to early aging.


Still not convinced? Click here to learn more.


Until next time!


Dr. Z


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