For an adult cancer patient who has “no evidence of disease” and wants to use LDN as recurrence prevention, I generally set a target dose of 2mg – 4.5mg.
I start at 2mg and gradually increase to 3mg then 4mg then 4.5mg as tolerated. I use bedtime dosing as long as sleep is ok prior to starting LDN. The dose is increased to tolerance (watch for insomnia or vivid dreams). If side effects occur, hold the dose and wait to see if they will go away, or reduce slightly. Side effects such as insomnia or intense dreams are an indication that the LDN is effective at boosting the patient’s endorphin levels, so that is a sign that you have reached a therapeutic dose.
If the patient has pre-existing insomnia, I would add a natural sleep aid that is also anti-cancer, like melatonin 20 – 60mg at bedtime, or HonoPure 1 – 3 capsules at bedtime. The other option is to use morning LDN dosing. In that case, I typically start at 3mg daily and after 1 – 2 weeks try increasing to 4.5mg. It would be unusual to get side effects with morning dosing of LDN.
It is important to note that LDN cannot be used for anyone taking a long-acting opiate pill or any other continuously dosed opiate (like morphine infusion or methadone or fentanyl patch). In this case, LDN would put the patient into acute opiate withdrawal.
We have had excellent results using circulating tumour cell counts to monitor the success or failure of therapy for cancer patients who are “NED”. The CTC test called Maintrac (available in Germany) has been very reliable in our experience. It can be used for all cancer types except leukaemia and lymphoma. I highly recommend running a Maintrac test every 3-6 months to monitor for early signs of recurrence (it provides an early warning before tumours form).