Can Low Dose Naltrexone (LDN) stop working over time?

Dr Pamela Smith
Dr Pamela Smith
Center for precision Medicine

Can LDN stop working over time?

First of all, you can develop a tolerance to low dose naltrexone (LDN) so that you require a larger dose. This is problematic, since most physicians, pharmacists, and researchers believe that the upper limit of dosing for LDN is 6 mg. Certainly anything above 8 mg is no longer low dose. One of the ways to help with tolerance is to actually back down on the dose of LDN instead of going up. There are also four things that can affect LDN tolerance.

One is stress. Do a salivary test to look at cortisol and treat according to lab results.

The second is the thyroid. Remeasure the entire thyroid panel, all of it, and if the patient has developed hypothyroidism or and/or an autoimmune process of the thyroid then this can also affect tolerance.

The third is GI health. Do a gut health test and fix the gut and this will also help the development of tolerance.

Lastly, make sure the patient does not intake gluten or dairy products.

In addition, as one is healthier, they commonly need less medication and not more. But this does mean that the neurotransmitter function would also need to be normal, as would the patient's sex hormones. A neurotransmitter test would be suggested in this patient, along with a saliva test for measuring the sex hormones.

The answer to the question will 99% of the time be answered in the tests I have just described.

Answered by Pamela Smith, MD, MPH, MS
LDN Specialist