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Low-Dose Naltrexone Promising for Autoimmune Therapy

Dec 30, 2021 ● By David J. Zeiger
A hand holding a pill

Naltrexone was originally approved by U.S. Food and Drug Administration in 1985 at dosages from 50 to 100 milligrams for treatment of alcohol and opioid addiction. Its two forms comprise “dextro”, which blocks toll-like receptors decreasing cytokines and inhibiting inflammation, and “levo”, which blocks opioid receptors that release endorphins and decrease pain by upregulating the immune system and potentially decreasing cancer genes from activating.

Bernard Bihari, M.D., later discovered the clinical effects on the immune system of low-dose naltrexone (LDN) in humans. In his clinical trial of patients with HIV/AIDS at SUNY Downstate Medical Center, in New York, he saw its effectiveness of low dose naltrexone in protecting the battered immune systems of those infected.

LDN appears to operate uniquely as an anti-inflammatory and immune system modulator agent by binding to opioid Mu receptor in or on immune cells in the central nervous system via action on microglial cells and tumor cells. Thus LDN may be a promising agent in the therapy for cancer and many immune-related diseases.

Dosing forms can be in liquid, capsule, creams, tablets, suppositories or eye drops made by a compounding pharmacist. This prescription medication is not addicting, but should be used with caution in patients currently taking opioids, including Tramadol. It works by blocking opioid receptors throughout the body for three to four to five hours. To avoid drug interactions, opioid pain prescriptions should be discontinued or reduced approximately one week before starting this medication.

People with organ transplants or using immunosuppressive drugs may want to avoid LDN. Those with Hashimoto’s thyroiditis should use this medication with caution and on the advice of their treating physician, as they may have to adjust their thyroid supplement often in the early stage of treatment.

LDN could represent a low-cost, safe alternative and complementary treatment for several chronic neurologic, rheumatologic, psychiatric and gastrointestinal inflammatory conditions, as recent findings suggest.

David J. Zeiger, DO, ABOIM (with specialty board certification in integrative medicine) is the medical director of HealthWorks IMC. For more information, visit LDN is available at Mark Drugs, 1020 N. Milwaukee Ave., Deerfield. Call 847-419-9898 or see