Are there suggestions to help you find the right dose of Low Dose Naltrexone (LDN)?

LDN Specialist Pharmacist Michelle Moser
LDN Specicalist Pharmacist Michelle Moser

Are there suggestions to help you find the right dose of Low Dose Naltrexone (LDN)?

I started taking LDN for body-wide pain that developed after an inflammatory autoimmune and so MCAS (Mast Cell Activation Syndrome) reaction.  This person worked up to 4.5 milligrams and it has helped with the pain a lot for a couple of months.  Then the pain came back, and wondering if my dose of LDN might be too high.  The second part of that question is does it ever happen that the dose appears to work for a while and ends up being too high and then the third part is if it's to be reduced or scaled back do you do that slowly or just simply start to stop and start all over?  The answer to the first part is yes.  Often 4.5 milligrams is high for some people. 

Not everybody gets to 4.5.  Starting with a very low dose and slowly increasing that will help you find your happy dose is what I like to call it.  

Some people will use liquids because liquids are much easier to titrate, and what I mean by that is you can actually take a teeny teeny teeny bit more in just even more slowly hone in on exactly what your best dose is.  When we're dealing with an inflammatory and autoimmune or even an MCAS situation, some people stay with once-a-day dosing, whether it's in the morning or at night.  Some people will take it twice a day and those doses might be uneven. You might take a little bit of a dose in the morning in a different dose at night. And the reason for that is because sometimes we're able to kind of systematically deal with a variety of issues but the one expectation that we like to set up at the very beginning is that just because you get to 4.5 milligrams within let's say even 60 days that doesn't mean you're done.  In other words, the activity of Low-Dose Naltrexone may take four to six months to kick in fully. So although you're probably still in pain and probably still inflamed, please give it some time.  So that's one thing that this participant did not say is how long they're actually on that. 

But that is one thing that we are very careful to ensure that we're setting up the expectation right away.  That this is not an analgesic as in taking acetaminophen or ibuprofen or naproxen or anything like that.  They work on completely different pathways.  Now you can simply just roll your dose down to if you can remember when you felt you had better control.  You can go back to that dose or what several other providers have actually mentioned during the LDN Research Trust Conferences is that sometimes if you stop and you wash out for two to four weeks, in other words, you just don't take LDN for two to four weeks, your symptoms may return but then if you start all the way back down at the bottom again and then slowly increase your body might actually remember to have a better response next time.  It's a really interesting mechanism but we have seen that work, especially when we're dealing with extreme autoimmune and inflammatory issues.  People are super sensitive because you're so inflamed and so and then sometimes, too we add other medications to help with other parts of the inflammatory cascade like catataphin that can be added in the same capsule or a second capsule and or in a liquid form as well.  We can we can play around with that.  But that's the beauty of using a knowledgeable compounding pharmacy no matter where you are in the world because these questions are very easily asked and answered and you don't necessarily have to wait months or dig around on Facebook to try to find your answers, right?