Is Evening Dosing of Low Dose Naltrexone (LDN) Most Effective?

Is Evening Dosing of Low Dose Naltrexone (LDN) Most Effective?

A patient is wondering if they should change the timing of their LDN dose. The patient reports:  I have used LDN for Mast Cell Activation Syndrome and it has helped my POTS symptoms and improved my quality of life.  I have settled on 4.5 milligrams, nine drops sublingualy at 11 am but I am trying to move it to the evening time.  I have split the dose to two milligrams in the AM and 2.5 milligrams at 6 PM. Will it affect its effectiveness if I move the rest to 6 PM so I find I am more awake and can't sleep.  Will this improve over time?  

Dr. Lebsock replied: my first question is if everything's going well you don't actually need to move it from 11 AM. You could just leave it at 11 AM. Historically everyone thought that evening dosing was the ideal time because that's when endorphins were thought to be made but now research shows people take it in the morning or people who take it in the evening all have very similar results. I don't think you have to move it. It's really what's best in your schedule.

Sometimes if people do have nightmares I tell them to take it in the morning and then they don't have nightmares.  It depends on the patient.  If you're wanting to move it you can and see how it goes.  If 6 PM is better in your schedule that is fine.  But, if you are more awake and can’t sleep then keep it at the morning dose, especially if you are doing well. .