How Does Low Dose Naltrexone (LDN) help CRPS?
CRPS patients, Chronic Regional Pain Syndrome patients. This was a really cool discussion, and I can't get too technical on this because you're asking an insanely fun question to me. Your microglia are highly activated. You have the central sensitization. This is really simple, Very short course on this. There's a number of drivers in your body that are all inflammatory mediated, in fact, all pain systems, all pain, either acute or long term, is inflammatory mediated at some point, acute things. You can feel this. You bang your finger and you get swelling and tenderness. That is actually an inflammatory response. Then you have a central compartment. So your CNS sensitization, your microglue gets super activated, and they are on fire. And what they're doing is they're lowering the threshold of activation for your nerves inside your brain. So their sensitization is really, really heightened, which means that any incoming response is received and perceived as pain. And it's just like, boom, bells go off. And this is a central sensitization aspect of chronic regional pain sensitization or pain sensitivity. And what that means is a touch feels like a punch or worse. And so that is completely unhinged and not normal.
How does LDN help? It's working on the TLR4 system. And what it's doing is it's down-regulating that microglial activation and inflammatory component inside your CNS. So up in your upper CNS, and that's how it's down regulating that activation and downregulating that hypersensitization. So all of a sudden, we start to see that sort of abatement of incoming information. It's slowed down. It's not so heightened. It's not like that hurts. It's more like, whoa, that's bad to, whoa. Okay, that's just touch. And so, over time, and this is actually an example that Linda may point to Chronic Regional Pain Syndrome patients. Three months minimum, usually six months out to two years. And boy, their lives are just completely different. Like, woo. Usually, they're on high dose opioids when we get them, and so we titrate them up to that 1 mg, hold them there for at least three months, and then we start knocking down a lot of their pain management medication. And then we can ramp up their Naltrexone as they come off their pain management narcotics. But it's brilliant. It is one of my favorite uses of Naltrexone, honestly, because we're life-changing for those patients. So, very, very cool.