Do I have to get to 4.5 mg of Low Dose Naltrexone (LDN)? 

LDN Specialist Pharmacist Michelle Moser
Pharmacist, Michelle Moser 

Do I have to get to 4.5 mg of Low Dose Naltrexone (LDN)? 

I slowly titrated up to 3 mg and been on this dose for 10 months. I wanted to try increasing my dose to 4.5 mg but still I have pain. I tried increasing to 3.5 once and I had a terrible stomach cramps that day. That was about a month ago. Is it worth trying to increase again or should I stay at 3mg? I am taking this for Adhesive Arachidontitis and inflammatory conditions of the spine. 

Okay. So as I just said sometimes with pain we need to start even lower and perhaps even 3mg is too high. Perhaps we need to split that up and do this twice a day. The stomach cramps that you felt when you increased to 3 .5mg tells me a couple different things. Number one 3 .5 is too high and number two it means that there is definitely a GI disturbance that is binding to the low dose naltrexone and causing some other issues. Obviously some symptoms that you're not comfortable with. 

You could talk to your provider about splitting the dose and taking that twice a day or you can simply stop for a short period of time and restart all over at the bottom and slowly increase again and some people find that that works really well for them. 

Again, it's all about the dose that's best for you. It's not about getting to 4.5mg About 50% of the patient population that we serve is about 4.5 almost everybody else is around 3 or less. We have some people that we use liquids with we literally compound Low Dose Naltrexone in a liquid form and give them an oral syringe so that they can most accurately dose that and allow, the physician literally allows them to titrate up their dose as long as they keep track of their symptoms. We provide them with a symptom chart so that they could rate their symptoms and how things are going. 

And then there's a follow -up program by which the patients are giving us feedback and then we're giving feedback back to the provider so that we're, you know, keeping everybody in the loop, which is really important when it comes to Low Dose Naltrexone. Those doses absolutely need to be individualized. It's not about what everybody else is doing on Facebook.