Is 4.5 milligrams of Naltrexone always Immunomodulatory?

Is 4.5 milligram Naltrexone always immunomodulatory or might it ever be a suppressant or stimulant?  There is a lot of individuality to that question. You might see somebody, especially an autoimmune case or long COVID, where you taper them up and they might hit two milligrams is great for them and they hit three milligrams and it's too much. That's  a sign that for them that two milligrams is probably the sweet spot for where their body is right now.  

The body weight variation is something to consider  If you have a 70 kilogram person and you're treating somebody and they're a 50 kilogram person you know 4.5 may hit them very differently than than with a larger person.  There's all of that possibility.  Between 1 and 10 milligrams is a spectrum of modulation and then minor stimulation of modulation and then more suppression and modulation.

Over time I have found that the dose that you don't react badly to for the moment is the best dose and then we'll work on your case.  If we can ramp you up great or if we have to start higher and work you down also appropriate.