Can LDN be used in Pregnancy

We have a caller who would like to know about LDN in pregnancy. It looks like they are currently on a 4.5 milligram dose and trying to conceive. It looks like she's a fairly busy individual. She lists a few medications that she's currently taking, specifically levothyroxine, bupropion, vibrid and allegra, plus vitamins, and the question is whether or not she could stop some of those medications and only took LDN, if that would help in pregnancy. She a little bit further down specifically says that she has already asked a pharmacist and a gynecologist, but they weren't very sure of the answers.

So how I would approach this is, I think it's very important to really understand the breadth of a low functioning thyroid condition. I think it's important to not just look at TSH, but also look at some of the other lab parameters, and that's going to give us a lot of information, especially if you're trying to conceive. So we need to look at the free T3 and free T4. We need to look at TPO, which is one of the antibodies, and perhaps thyroglobulin as well. And I also like to look at a reverse T3, which indicates how stressful a situation is, because that cortisol can actually allow for that active molecule, which is liothyronine, to be kind of flipped around and then it becomes inactive. So that's really important, to understand all the pieces of the puzzle. What we find not only in case study but also in scientific papers is that low dose naltrexone is incredibly helpful in a low functioning thyroid situation.

When we start low-dose naltrexone, we still need to monitor what's actually happening with the thyroid labs, because they can significantly change, even as quickly as four to six weeks after starting LDN. And why that's important is because we don't want someone who is currently on therapy to all of a sudden become hyperthyroid or even have too much medication, particularly when you're trying to conceive, because there is a very narrow window where you have enough medication and yet not too much medication to be able to not only maintain your own metabolism. But certainly then, allow for conception, and then also maintain a good viable pregnancy.

We know that Dr Phillip Boyle has done a lot of research, and he's spoken on the use of low-dose naltrexone in pregnancy with tremendous success. We know that there's very few side effects, very few drug interactions, and we know that low-dose naltrexone does help with allergic issues as well, so if that's the reason why she's particularly taking Allegra, which is an antihistamine, if there are some other issues going on LDN could potentially be helpful as well. Specifically with depression. So I think that that hopefully answers the majority of the question, and if not please let us know and we'll answer a little bit more.

Answered by Pharmacist Michelle Moser LDN Specialist