Stephen Dickson: So this is a patient asking about using LDN to treat constipation or slow motility, and asking what doses work well, and what time do you tend to do as they. So I have to say that I personally have no experience at all of using LDN to treat constipation. It is something which we just have not come across in the last 15-17 years. In theory, I guess if it was caused by taking opiates, then yes. But if anybody else wants to take that and they'd be more than welcome
Dr Sam Lebsock: I will say that I found that LDN is kind of a pro-kinetic agent, so it can cause some diarrhea. Some patients do report that as a symptom initially. So I have seen that.
Michelle Moser: And to also then roll into the next question, which is: what are the main side effects you find when working with LDN? It's interesting, and not to confuse this point at all but LDN, can also bind to the opiate receptors in the gut, which can actually slow the gut, right, so sometimes you might have a little bit of constipation. But I think the most widely reported side effect is vivid dreams, and that can be minimized. It may not be negated, but it could definitely be minimized by really slowing that taper. And generally that goes away in a few days. But I will say that for some people, that's very dramatic, that can be literally the difference between being able to work or not being able to work, or even care for their family. So whether we're dealing with sleep disturbances, sometimes a little bit of a headache, some people classify that as a migraine, but we usually just say headache, and then maybe a little bit of GI issues those are pretty much… There's always going to be these one-offs, right? There's always going to be some other things. But I will say, the majority of the time when we're following up with patients around two weeks, four weeks, six weeks, etc, the side effects that they're talking about aren't necessarily specifically because of LDN. It's more of understanding there are underlying issues that we're using LDN to treat. So whether somebody has Epstein-Barr - well if you have a bloom - for example, there was a wonderful naturopath from Arizona that spoke on how sometimes you feel worse before you get better. Well, people classify that as a side effect. Well that isn't because of low-dose naltrexone. That's because of the underlying disease. So it's really about understanding that, and then keeping in touch with your medical professionals so that they can help hold your hand and walk you through that so that you don't inadvertently bail out on LDN before it's really reached its full potential.
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