Could 4.5 milligrams of Low Dose Naltrexone (LDN) be Pro-Flammatory?

Could 4.5 milligrams of Low Dose Naltrexone (LDN) be Pro-Flammatory?

Could 4.5 milligrams of LDN be pro-flammatory in some people? I would imagine it could be but if you go back and look at the original research that Dr Bihari did, he didn't see immunomodulatory effects from LDN until you got to about three milligrams.  You could see anti-inflammatory effects at lower doses.You could go lower and see decreased inflammation. You see other effects from smaller doses but typically that is not going to cause inflammation. 

Some people have SNPs  in their receptors.  For example you can have all kinds of SNPs; genetic snips and one of them is they're going to get a paradoxical effect from Naltrexone.  It's rare but I've seen a couple of cases.  I had a patient and as soon as you stop the Naltrexone the inflammation goes away.  It was a couple weeks in onset.  It didn't happen right away but it happened a couple weeks into therapy.  

I've seen it with topical Naltrexone as well.  It may not be just oral Low Dose Naltrexone.  It might be more  common in the topical. The patients I've seen were using topical.  The two patients that I have direct knowledge of were using it topically but I would imagine if it could happen topically it could happen orally.   I don't know for sure.  Maybe someone else has more experience with this than I do.