ALBUQUERQUE, N.M — According to the Centers for Disease Control and Prevention, an estimated 20.4% of U.S. adults had chronic pain in 2019. Are you one of them? Living with chronic pain affects work and quality of life. It’s associated with poor mental health and opioid dependence. 

Are you looking for a nontraditional option that’s low on dose, risk, side effects, and cost? Low-dose naltrexone (LDN) is an off-label medication for chronic pain that’s inexpensive. According to studies, it has minimal side effects and has no potential for abuse or misuse. It poses a low risk and is viable as an option for chronic pain. Its therapeutic uses include other medical conditions, too.

This blog shares what you need to know about LDN and how it can benefit you:

• What is low-dose naltrexone?
• What is the mechanism of action of LDN?
• What is LDN’s other mechanism of action for chronic pain?
• What are the other potential benefits of LDN?
• How is naltrexone administered?
• Is low-dose naltrexone safe and tolerated by the body?
• What are the potential side effects of naltrexone?
• Can low-dose naltrexone cause depression?
• Where can you get a dose of LDN?

What is low-dose naltrexone (LDN)?

The FDA approved naltrexone HCL as an opioid receptor antagonist in 1984, to treat alcohol dependence and prevent drug dependence relapse.  Naltrexone medical practitioners use it after detox as an off-label use of the drug.  Studies show Naltrexone to have analgesic and neuroprotective effects. 

Low-dose naltrexone is a much lower dose than traditional naltrexone.  Naltrexone is 50mg whereas LDN is often started at 1.5mg and slowly increased to 4.5mg.  The weight loss drug, Contrave, contains 8mg of LDN.  So most patients on LDN are taking anywhere from 1mg to 10mg typically with the most common dose being 4.5mg.

What is the mechanism of action of Low-Dose Naltrexone?

Three actions of LDN as an anti-inflammatory therapy for chronic pain:

1. Low-Dose Naltrexone acts as opioid receptors to stimulate the release of (β)-endorphin, the “feel-good” hormones.  This action is associated with LDN’s ability to relieve pain. Its effect is short-lived. But LDN continues to stimulate your body to produce endorphins, even if it’s no longer in your body – up to one month.
   
   
2. Low-Dose Naltrexone reduces pro-inflammatory and increases anti-inflammatory cytokines. Studies show it reduces pain concerning inflammation. Cytokines are chemical messengers produced by the body. They are involved in inflammation and pain. 
   
   Cytokines either reduces or increases inflammation, which depends on the body’s ability to keep the balance. Proinflammatory cytokines allow inflammation and pain. The reverse is anti-inflammatory cytokines, which reduce chronic pain due to inflammation. 

3. Low-Dose Naltrexone regulates opioid growth factor (OGF) and receptors axis. OGF is involved in the growth of normal cells and some tumors or cancers. Researchers found out LDN’s ability to regulate OGF as a treatment for cancer.

What is LDN’s other mechanism of action for chronic pain? 

Low-Dose Naltrexone is a promising treatment for chronic pain that involves the inflammatory process through microglial cells. Many triggers can activate central nervous system immune cells called microglia. Once activated, it produces inflammatory factors that cause sickness behaviors. It includes pain, fatigue, mental disturbance, mood disorders, and sleep problems. Low-Dose Naltrexone acts as a glial cell modulator that can treat pain.

What are the other potential benefits of Low-Dose Naltrexone? 

Low-Dose Naltrexone has been used as an off-label drug in the management of chronic pain, autoimmune disorders, skin diseases, and various cancers:

• Fibromyalgia is a persistent pain disorder. It affects the muscles and bones accompanied by fatigue with problems in sleep, memory, and mood.
  
  Low-Dose Naltrexone may work as an inexpensive and highly tolerable drug for fibromyalgia. Participants in a study completed a cross-over trial of Low-Dose Naltrexone and placebo pills. Participants who took Low-Dose Naltrexone had a 30% reduction in symptoms of pain, including fatigue and stress. 

• Crohn’s disease is a type of irritable bowel disease that causes inflammation of the digestive tract. It leads to stomach pain, bouts of diarrhea, malnutrition, and weight loss. 
  
  Researchers gave Low-Dose Naltrexone to 19 people with Crohn’s disease and 28 people with ulcerative colitis.  Their study shows that 74.5% of people improved in contrast to 25.5% who experienced remission. Low-Dose Naltrexone was tolerated, with four reporting temporary vivid dreams as a side effect. The researchers concluded Low-Dose Naltrexone is a safe and potentially beneficial adjunct treatment for IBD.
  
  It’s also safe for short-term use in children who have Crohn’s disease.

• Multiple sclerosis is a life-long chronic condition that affects the spinal cord and brain. Researchers studied Low-Dose Naltrexone for MS with positive results. They found that LDN is safe and tolerable. It benefits the mental health as people reported reduced fatigue and improved quality of life. 
  
  
• Complex regional pain syndrome (CPRS) is prolonged and severe pain resulting from a leg or arm injury. LDN improved symptoms of CRPS, particularly in people who have involuntary muscle contraction. LDN also worked for a person suffering from long-term CPRS, sleep apnea, and small-intestine overgrowth. 
  

• Hailey-Hailey disease, a rare genetic skin condition, is seen as blisters or lesions on skin folds. Also called chronic benign familial pemphigus, it relapses and recurs. LDN proved useful to a person who was treatment-resistant to topical and oral steroids. Another study of three people showed that lesions flared up when the patient stopped taking LDN. But the lesions cleared when patients restarted LDN.
  
  
• Psoriasis: Psoriasis is an autoimmune skin disorder that causes flaky patches on the skin. A total of 13 people with psoriasis participated in a study. The researchers of the study gave them LDN of 4.5 mg. The participants then completed a self-assessment scale on the effect of LDN. The researchers noted a marked improvement on more than half of the participants.
  
  
• Cancer: Ovarian cancer is a leading cause of death among women within ten years from diagnosis. Researchers transplanted human ovarian cancer cells into mice. They treated the mice with OGF and LDN every day for 40 days. According to the researchers, OGF and LDN significantly decreased the number of tumor cells. They observed a reduction in the weight of the ovarian tumor, too. In another study, LDN suppressed ovarian cancer in combination with cisplatin, a chemotherapeutic drug.
  
  Researchers have also studied LDN as a potential therapy for lung cancer, pancreatic cancer, and colorectal cancer. Researchers have yet to conduct further studies to validate these claims.
  
  

• COVID-19: People with severe COVID-19 experience cytokine storm. It’s a hyperactive immune response, which causes harm to the body.  A 2020 study reveals that LDN is a potential antiviral therapeutic agent to fight COVID-19. 
  
  The results show that LDN lessens the lipopolysaccharide (LPS) induced cytokine storm. LPS causes sepsis and sets off an inflammatory response. Due to the promising finding, the researchers suggested further study on actual COVID-19 patients for confirmation. They added that LDN may be used as a lone or an adjunct therapy.
  
  If you think you may be suffering from any of these diseases, please talk to us about it at Well Life ABQ 505-585-2345.

How is low-dose naltrexone administered?

• Taken by mouth: Oral naltrexone is taken with food or after meals to lessen gastrointestinal upset. Sometimes, a healthcare professional prescribes an antacid for this. It’s packaged in various forms, such as capsules, liquid, sublingual drops, and tablets.
  
  
• Placed on the skin: LDN cream and topical lotions usually come in 0.5mg doses. It’s helpful for people who have difficulty swallowing or allergic to flavorings or colorings found in other forms. Another form is a transdermal patch. The body slowly absorbs LDN in the patch which is placed on the skin.
  
  
• Administered in the eye or nose: Eye drops are most commonly used for dry eyes. Intranasal sprays are also available.

Is Low-Dose Naltrexonene safe and tolerated by the body?

Studies have shown that LDN is safe and tolerable for people with auto-immune conditions, Crohn’s disease, fibromyalgia, multiple sclerosis, and many other conditions. Naltrexone has a long history of safe use, but there’s little known of its safety for long-term use. In a study, it’s more tolerated than placebo.

What are the potential side effects of Naltrexone?

Researchers claimed they had not observed severe adverse effects. Thirty-eight percent of the participants in their study reported vivid dreams. A few participants reported nightmares and headaches.

Potential side effects of LDN are RARE:

Participants in a study reported insomnia, diarrhea, and headache. Other side effects include anxiety, constipation, decreased appetite, dizziness, stomach pain, or vomiting. Seek immediate medical help if you experience blurred vision, confusion, or hallucination.

Seek immediate medical help if you experience signs of allergic reactions. It includes rashes or itching, swelling, and difficulty breathing.

Can Low-Dose Naltrexone cause Depression?

LDN does not cause depression. Rather, it helps people improve their mood. 

• Useful for depressive relapse: Another study further suggests LDN may be helpful for depressive relapse. A total of 12 people participated in the study. They were depressed and had relapsed despite being treated with dopaminergic antidepressants. The researchers then gave LDN for three weeks.  The results reveal increased dopamine due to increased endorphins. 
  
  
• May work for post-traumatic stress disorder (PTSD): Other than depression, LDN may also help treat people with PTSD. The researchers in a study gave LDN to people with severe PTSD and dissociative disorders. Eleven of the 15 participants reported positive effects, and seven said it had a lasting impact. The participants improved their perception of reality, body image, and self-regulation with nil side effects. 

Where can you get a dose of Low-Dose Naltrexone?

Naltrexone may be an off-label drug for chronic pain and other medical conditions. It still requires a prescription. LDN as a non-mainstream therapy for chronic pain and other medical conditions, may not be covered by insurance. For more details on LDN, call us at the Well Life ABQ at 505-585-2345.