Hashimoto Thyroiditis and Low Dose Naltrexone (LDN) by Paula Johnson

Hashimoto’s thyroiditis is caused by the immune system attacking the thyroid gland which can then become inflamed and become damaged.  As the damage progresses the thyroid becomes increasingly unable to produce enough thyroid hormone.  Symptoms can vary among different individuals but can include tiredness, weight gain, thinning or loss of hair, painful and stiff muscles, PMS, intolerance to cold weather and dry skin.  It often causes a lump in the throat called a goitre, this makes the throat feel full and uncomfortable. 

A large number of studies show that LDN can reduce abnormal inflammation and cytokine production and effectively normalise immune abnormalities in many autoimmune diseases.

Clinical trials looking specifically at LDN and Hashimoto’s are virtually non-existent, the likely explanation for this is that the drug companies don’t have a lot to gain from funding this type of research as LDN is an old generic drug and it’s relatively cheap.  What we do have are an abundance of clinical data from doctors willing to prescribe it and patients eager to share their experiences. 

How is LDN thought to work for Hashimoto’s patients?

LDN has anti-inflammatory properties and increased endorphin function which helps modulate the immune system.  By decreasing inflammatory cytokine concentration, reducing interleukin activity, and lowering IFN-a and TGF-a (inflammatory markers), it is thought that LDN can improve thyroid function effects both in the pituitary gland and in the body’s peripheral cells. These physiological mechanisms have been shown to further improve T4 conversion into active T3. Moreover, LDN has been shown to inhibit cells that cause the autoimmune process.1

Case Study by Dr Harpal Bains

A 32-year-old female presented with dull skin and slow movement; she was clearly joyless.  There was a history of Hashimoto’s in her family.  The lady was diagnosed with Hashimoto’s when she was 25 and so had been suffering for 7 years. She was also diagnosed with polycystic ovarian syndrome. At the age of 30, she was diagnosed with uterine fibroids. Her symptoms were weight gain, constipation, hair loss, poor temperature regulation, very heavy but regular periods. The fatigue was making it difficult for her to maintain her job.  Decreased ability to handle stress and anxiety and mood swings and poor quality of sleep.  Her medication at that time was Levothyroxine, Ulipristal acetate (a progesterone receptor modulator with a partial progesterone antagonist effect) and Metformin. This lady reported an initial benefit from conventional treatments but then hit a plateau when she felt that things could be better. She was taking Selenium, Vitamin D, Vitamin E supplements and a multivitamin with Gamma-Linolenic Acid. This lady was well-read and came to Dr Bains with a request for LDN. Dr Bains found that her diet was lacking in many nutrients and she suspected that this lady had a leaky gut and food intolerances, which Dr Bains addressed. Tests revealed that her fasting insulin was too high despite the metformin, very low progesterone, free testosterone was quite low, TSH seemed very suppressed, Free T4 was quite high, T3 moderate but antibodies quite high. Dr Bains advised on dietary changes, removing the foods that this lady was sensitive to, she prescribed LDN, pregnenolone, a short course of melatonin, adrenal supplements and fish oil, Levothyroxine was left on with a view to reviewing within three months. 

Three months later the patient returned to see Dr Bains. Her diet was much improved, all allergens removed, and she had increased her dose of LDN slowly and had got to 4.5mg and was feeling much better. She had not been sick once in the previous three months, as usually, she would get a lot of colds. Her fibroid had shrunk by 2cm (from 7cm to 5cm), she felt less tired, had fewer body aches and had started to feel more energetic.  She admitted that she’d tried missing LDN a few times and each time the next day her tiredness and pains came back.  Her stress levels were lower and her sleep quality had much improved.

Over 9 months this lady’s quality of life improved significantly.  Dr Bains concludes “Overall positive results in a short period of time. LDN fits in with the complete management of her issues. LDN in this patient probably contributed not only to modulating her immunity in regards to Hashimoto’s but also helped her leaky gut and general immunity. Leaky gut was possibly the bigger issue here causing added adrenal strain which secondarily impacted on her thryroid.2

Case study by Yoon Hang Kim, MD MPH, Director of Integrative Medicine, The University of Kansas Health System.

Dr Kim’s patient was a woman in her 40s with low TSH (hyperthyroid) with hypothyroid symptoms. These are the most difficult clinical scenarios.  This lady’s test results show an improvement in her symptoms over an 8-month period after starting LDN:



Free T3

Free T4


Symptoms status


0.01 – Low






0.02 – Low




Much improved


0.32 – Low




No Hypothyroid


0.70 - normal




No Hypothyroid


After 8-months of LDN treatment, the patients TSH became normalised. The above response is best explained by LDN’s ability to reduce inflammation in the central nervous system.  LDN targets microglia in the central nervous system and spinal cord to reduce inflammation.

Dr Kim states that: “Although people are told that hypothyroidism cannot be reversed, in my clinical experience with LDN, I have seen many patients whose hypothyroidism has been fully reversed or their conventional thyroid medication dose has been reduced.”3

Case Study by Dr Laurie Marzell, ND, N.C.M.P

A 60-year-old female who was hypothyroid.  This lady gained 20lb over 3-years.  She was insulin insensitive without overt diabetes and had the following additional conditions:  Allergies, history of parathyroidism (surgically treated), intermittent abdominal pain, diverticula and strong family history of pancreatic cancer. The patient was taking the following medications: femring and divigel, metformin, l-thyroxine and omeprazole. Her symptoms were: difficulty with feelings of constriction in her throat and tenderness in her thyroid when this occurred, she had great difficulty with fatigue. The exhaustion finally prompted the patient to seek more medical help.

Dr Marzell started the patient on 1mg of LDN and the patient reported crying spells and her estrogen was increased.  Four days into LDN treatment the patient reported feeling better with more energy and better sleep. When the patient increased her dose to 2mg she had some anxiety. She was advised that this happened sometimes and so she persevered and it resolved within a few days.  Her energy increased, there was less depression and there was less pressure in her throat – she stated that her thyroid felt normal.  The patient continued on 2mg of LDN. At a two month review, the patient stated that she had had a few episodes of thyroid swelling but all were much less than she had had previously.  She noted that her moods were better.4

Dr Sarah J Zielsdorf, MD

“I have had autoimmune thyroid disease (Hashimoto’s hypothyroidism) for over 20 years. Its complications, including liver disease and infertility, nearly took my life. I began to heal and was able to have two children. I had had a severe autoimmune flare postpartum when my doctor first introduced me to LDN in 2014, which enabled me to continue to work and saved my life.  LDN has prevented further severe flares, greatly decreased my inflammation and chronic pain, and has been the only medication to give me complete remission of all other symptoms of my chronic autoimmune condition.  I am now not only an LDN user but an LDN researcher, clinician and prescriber.”5

Kali Johnson – Patient

“I have been struggling with Hashimoto’s Thyroiditis and Epstein-Barr and MTHFR gene mutation for over 15 years. I discovered LDN and asked my doctor to prescribe it.  She said she didn’t know enough about it and would do some research and then see what she thought about it.  I waited and pleaded and finally went to a naturopath practitioner and he was happy to let me try it.  I am currently on 4.5mg and I haven’t gotten sick at all this flu season! I am a busy hairstylist so I am always around sick people.  I know a lot of people who have been sick with either influenza A, strep throat, pink eye or stomach flu.  I have been completely healthy and my energy levels finally feel normal.  There are no side effects that I’ve noticed so that’s great as well.”6 

 Pam Skaggs – Patient

Pam had been diagnosed with Sjogren’s, Inflammatory Myositis and Hashimoto’s. Before she was diagnosed with the first two conditions she had begun to develop neuropathy in her hands, feet and face which was very painful.  Unfortunately, Pam was allergic to all pain medications.  In her search for answers she saw a functional medicine doctor in 2015 who prescribed LDN for her Hashimoto’s.  From the first day she took LDN she has not had neuropathy symptoms at all.  She was able to lower her thyroid medication and also lost 8lb of fluid after only 5 days on LDN.  Her joint pain also resolved.  She now takes 4.5mg of LDN daily though she felt the first benefits at a dose of 1.5mg. Pam says “I am so thankful that I found this medication”.7

These are only a few of the success stories in Linda Elsegood’s eBook, The LDN eBook, published by the LDN Research Trust to celebrate the Trust’s 15th Anniversary.

Low Dose Naltrexone treats many autoimmune diseases, there is a list of conditions on the LDN Research Trust Website https://ldnresearchtrust.org/conditions.

LDN doesn’t just manage the symptoms of autoimmune disease, it reduces inflammation thus putting the disease into remission – this is a far better choice than cytotoxic drugs prescribed in conventional medicine.  It doesn’t work for everybody but it does work for most people, especially when combined with a good healthy diet with food intolerances removed, and exercise which for most people with autoimmune disease becomes easier once the fire of inflammation is reduced or eradicated. 

Naltrexone and Low Dose Naltrexone are prescription-only drugs and should never be purchased online without a prescription as these products have bypassed safety and efficacy testing, they could be harmless or deadly there is no way of telling. We always recommend a patient obtaining LDN from a respected LDN prescriber and expert LDN pharmacist. Check out the lists of Prescribers and Pharmacists www.ldnresearchtrust.org.


1 Harbour Compounding Pharmacy, The Interplay between Low Dose Naltrexone and Hashimoto’s Thyroiditis, (July 2019), https://www.harborcompounding.com/the-interplay-between-low-dose-naltrexone-and-hashimotos-thyroiditis

2 Dr Harpal Bains – “Managing Hashimotos: Are We Asking the Right Questions in Hypothyroidism?”, from LDN Research Trust 2018 conference, https://ldnresearchtrust.org/dr-harpal-bains-managing-hashimotos-are-we-asking-right-questions-hypothyroidism-ldn-low-dose

3 Yoon Hang Kim, MD, MPH, Case report: woman in 40’s with low TSH (Hypoerthyroid) with Hypothyroid symptoms, https://ldnstudy.wordpress.com/page/2/

4 Dr Laurie Marzell, N.D., N.C.M.P. LDN Cases #1-6, Case #4, LDN Video Interviews and Presentations, https://ldnresearchtrust.org/ldn-videos?field_type_of_video_target_id=551

5 Elsegood, Linda, The LDN Ebook, The LDN Research Trust, available on Amazon.

6 Elsegood, Linda, The LDN Ebook, The LDN Research Trust, available on Amazon.

7 Elsegood, Linda, The LDN Ebook, The LDN Research Trust, available on Amazon.