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This video by Dr. Sarah Zielsdorf, MD, MS explores the off-label use of Low-Dose Naltrexone (LDN) in fertility treatment, particularly for recurrent miscarriage. Dr. Phil Boyle, a NaPro Fertility Physician, discusses how LDN modulates the immune system by stimulating endorphin production, potentially addressing endorphin deficiencies linked to infertility. The discussion also covers safety considerations during pregnancy and recommended dosing strategies.
Dr. Sarah Zielsdorf, MD, MS:
Low Dose Naltrexone has been used um for um several decades off label for recurrent miscarriage and inf and conditions that can cause infertility. I want to highlight the work of um LDN research trust member and adviser Dr. Phil Bole and he is a napro fertility physician and family medicine phys physician out of Gway Ireland. He and his predecessors have really uh been the the um catalyst for us using LDN for this patient population. So Nrexone was shown up to 100 milligrams as safe in pregnancy for use by women with opioid dependence. This was Dr. Hilders out of Kraton University Omaha, Nebraska in the United States. Now using high levels of Nrexone at 100 milligrams is very different um for the immune system. That's full blockade of the opioid receptor. We do not want to do this um in cases where we're working for um reducing inflammation. Here we're going to be using off label dosing from 04 0.5 in general to 4 1/2 milligs for infertility. um though sometimes we go even lower or even a little bit higher if needed. LDN modulates the immune system by stimulating endogenous endorphin production which we know is lower in cases of endometriosis. Dr. Bole believes that these patients infertility is caused by an endorphin deficiency.
In 2006, it was found that miscarriages and premature delivery were more likely when they stopped LDN during pregnancy. So therefore, I either start LDN prior to pregnancy or post pregnancy to prevent autoimmune flares postpartum. I do not initiate or terminate LDN use during pregnancy. I repeat, please do not initiate or terminate LDN during pregnancy. The starting dose is 0.5 to 1 and 1.5 mg. You're going to titrate to a maximum dose of 4 1.5 milligram nightly. And again, you don't have to go to 4 and 1/2 mig if someone does not tolerate going up some LDN is better than no LDN. In general, we think that we are getting maximum immune system modulation at about 4 1/.5 millig. This off label dosing use uses principles of immune modulation as described by doctors Bernard Bhari and Ian Zyon. You can use it in the daytime in the morning if it causes vivid dreams or insomnia. It is recommended to stop LDN at 37 weeks of pregnancy, but there's no harm in continuing until delivery. We do this in the case of surgery or other medical interventions that may may be needed.
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