How Can Low Dose Naltrexone Be Used for Sjogren's Syndrome?

This video presented by rheumatologist Scott Zashin, MD presents a compelling case study of a 47-year-old female diagnosed with Sjogren's Syndrome. It details her journey with the condition, highlighting the impact of symptoms like fatigue and severe pain. The report focuses on the therapeutic potential of Low Dose Naltrexone (LDN) in managing inflammation and improving quality of life for SS patients.

A 47year-old female was diagnosed clinically with Shogrin syndrome six years ago by another rheumatologist based on her history of dry eyes and dry mouth. While her auto antibodies for this condition were negative, her sedimentation rate and C reactive protein had been persistently and significantly elevated. Both these tests measure inflammation. Past medical history included a diagnosis of fibromyalgia. She had a history of breast cancer that had been in remission for 20 years, a generalized seizure disorder and elevated liver test with a normal liver biopsy. Additional medical issues included neuropathy, anxiety, and depression, sleep apnea was excluded by overnight sleep study. At the time of her initial visit, she complained of fatigue, severe muscularkeeletal pain, as well as dryness of her eyes and mouth. Her daily medications included esatalopramgasis, moxyam, vitamin D3, magnesium, tramodol, polycarbine, and hydroxychlorin. Restasis is a medication that helps with inflammation in the eyes, increasing tear production. Loxyam is an anti-inflammatory. Tramodol narcotic pain medicine. Polyocarpine stimulates saliva and hydroxychloricquin, also known as plaquinil, helps with achiness and fatigue. Her exam demonstrated widespread trigger points affecting all four quadrants of her body. Her blood work was remarkable for a se rate of 37, normal less than 20, while her CRP was normal. Five years ago, she elected to try LDN and started at one and a half milligrams daily and increased to three milligrams after week one. Two weeks after starting LDN, she felt terrific and her sedimentation rate is now 25 and in a normal range. She was seen in followup four years ago and remained on 3 milligrams of LDN. She felt well but complained of neuropathic pain. Her S rate was now normal at 20. On her visit a year ago, she remained on three milligrams of LDN and continued to feel well without stiffness or pain. She noted previously it would take her all day to feel better. Over the past year, she did experience a flare of her condition and required steroids. Increasing her LDN at 4.5 milligrams has seemed to settle things down and she continues to do well. In addition to her clinical improvement from LDN, there were two things that were of interest. There was a significant decrease in an objective measure of inflammation as demonstrated by a lower set rate. On the other hand, there was not any significant improvement in the dryness that affected her eyes and mouth. This lack of improvement in dryness is something that I've seen with other patients.

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