The use of Low Dose Naltrexone (LDN) for Herpes Viruses

Herpes infection with humans is a common complaint. This article gives a general overview of HSV-1 and HSV-2 plus the various treatment options available and a general overview of the other six forms of Human Herpes Virus that can affect people's lives so badly.

There are two common types of herpes simplex viruses: HSV-1 causes cold sores around the mouth, with fever, fatigue and visible blisters

HSV-2 is genital herpes that causes sores and blisters, affecting the genital and buttocks regions. This form of herpes is commonly sexually transmitted.

According to the World Health Organisation, an estimated 500 million people worldwide have HSV-2 infection. 1

Once contracted HSV-1 and HSV-2 can remain dormant or reactivate - sometimes several times a year.


Both oral herpes infections and genital herpes infections are mostly asymptomatic but can cause symptoms of painful blisters or ulcers at the site of infection, ranging from mild to severe.

The more severe outbreaks can include:

  • Itching or pain - tenderness may develop in the facial area or groin area, depending on the infection type.
  • Tiny white blisters or small red bumps - these often appear days to weeks after the first infection.
  • Ulcers - these develop once the blisters and bumps break down. Pain can increase, sometimes significantly, in the affected areas.
  • Scabs - these develop as the infection begins to heal up.
  • Flu-like symptoms, fever, fatigue, swollen lymph glands, headaches and sore muscles often also occur if the infection takes hold.


The appearance of the different herpes simplex virus forms is usually easy to diagnose when an outbreak occurs.  Sometimes a physician may need to take swab tests for laboratory analysis to make a definite diagnosis.


HSV-1 is transmitted by oral-to-oral contact to cause oral herpes infection, via contact with the HSV-1 virus in sores, saliva, and surfaces in or around the mouth. However, HSV-1 can also be transmitted to the genital area through oral-genital contact to cause genital herpes.

HSV-2 is transmitted during sex, through contact with genital surfaces, skin, sores or fluids of someone infected with the virus. HSV-2 is transmitted from skin in the genital or anal area that looks normal and can be transmitted in the absence of symptoms.

HSV-2 and Pregnancy

In rare circumstances, HSV-2 infection can be transmitted from a mother to her infant during delivery to cause neonatal herpes. Therefore a woman who has been in contact with herpes previously should discuss the various birthing options available if she is considering pregnancy. An obstetrician may advise a cesarean section depending on the Mother's medical history.


There is no cure presently for herpes simplex. Vaccines against herpes simplex virus 2, and cytomegalovirus (HHV-5), are undergoing extensive evaluations in field trials but could take years to complete. There is no standard treatment for Epstein-Barr virus (HHV-4) or human herpesvirus 6, 7 or 8 infections.

Antiviral medications are the mainstay of treatment for recurrent sufferers of herpes – Zovirax, Valtrex, Acyclovir, Famciclovir, and Valacyclovir are the most effective medications available for people infected with active herpes viruses. These can help to reduce the severity and frequency of symptoms, but cannot cure the infection.

A person suffering from recurrent bouts of herpes often become experts in predicting another attack and know that having a backup antiviral treatment is sensible.

Low Dose Naltrexone (LDN) and Recurrent Herpes

Naltrexone is a drug known as an opiate antagonist and licensed for use in treating opiate and alcohol dependence at doses of between 50 mg and 300 mg daily.  At these doses, the opioid receptors are blocked for an extended period, thus suppressing the cravings for opiates or alcohol.

The first clinician to record immunological effects of Low Dose Naltrexone (LDN) was Dr Bernard Bihari in 1985. His primary line of research at that time was with HIV/AIDS. He was trying to improve the survival rate of seriously immune-compromised patients.

Dr Bihari knew from previous research that endorphins were significantly involved in regulating the immune system, it was an ingenious step to try treatment with LDN.  On finding that giving LDN daily to his patients improved their outcomes dramatically, it inspired a plethora of research on the importance of endorphins and opiate antagonists to regulate the immune system. 

Dr Bihari believed that low doses of Naltrexone should help treat any chronic infection, including Genital Herpes (HSV-2), preventing recurring flares. Dr Bihari patented the use of LDN specifying that "This invention relates to the treatment of certain chronic diseases; namely, chronic infections caused by herpes virus, both herpes simplex viruses and Epstein-Barr virus, and multiple sclerosis." (Patent US5356900A) 2  

Dr Andrew McCall

Over the years, we have treated many patients with LDN with usually a good success rate.

The vast majority of people who come to our clinic with this condition have usually suffered several attacks and have already tried conventional antiviral medications. 

A large percentage of sufferers appear to get recurrent or chronic episodes of intense fatigue, as well as the myriad other symptoms of HSV-2.

Our medical team always advise patients to attend their usual physicians for review and active treatment. 

Our prescriptions of LDN are complementary and supplementary way, as a second line form of therapy. On reviewing our treated patients, most get some form of benefit, and some get a significant and positive response.

Case Study from Dr Bihari's Patent

Genital Herpes 

A 50-year-old woman has had genital herpes for 13 years, experiencing a severe painful attack with several lesions for the 4-5 days preceding each menstrual period during most of that time. She commenced on low dose naltrexone, 1.75 mg per day at bedtime. Her attacks immediately stopped. Ten months later, the dosage was increased to 2.75 mg per day also taken at bedtime. In the entire period of naltrexone treatment covering many months, she has had only two attacks each occurring 2-3 weeks after she ran out of naltrexone and temporarily interrupted the treatment. 3

Monique's Story click ***here***

Herpesviruses in General

Of the more than 100 known herpesviruses, eight routinely infect only humans: herpes simplex virus 1 & 2, Varicella-zoster virus (HHV3), Epstein-Barr virus (HHV4), Cytomegalovirus (HHV5), Roseola (HHV6 & 7) and Kaposi's sarcoma (HHV8). 4   

It is of interest that many autoimmune diseases have HHV-6 as a possible trigger, research links HHV-6 A to numerous neurological conditions. Some of these links are supported by considerable evidence, while other ties are less specific. 5 

These are a few of the diseases possibly linked to HHV-6:

Hashimoto's Thyroiditis – "Overall, our study indicates that HHV-6 infection might be an important factor in Hashimoto's Thyroiditis development". 6

Sjogren's Syndrome – "According to current experience, six out of 11 patients with Sjogren's Syndrome had serological evidence for active HHV-6 infection". 7

Multiple Sclerosis – "There is sufficient and compelling evidence that HHV-6 may be involved, albeit to an unknown extent, in the disease pathogenesis of a subset of Multiple Sclerosis cases". 8

Chronic Fatigue Syndrome – "It is plausible that active infection with HHV-6 may trigger and perpetuate Chronic Fatigue Syndrome in a subset of patients".  9

Myalgic Encephalomyelitis - "Herpesvirus 6 (HHV-6) is frequently associated with several human diseases including ME/CFS". 10

Sarcoidosis – "Serologic studies showed IgG antibody titers against HHV-6 in up to 41% of patients with sarcoidosis". 11 

At this point nobody can say for certain that HHV-6 directly causes or contributes to any of these conditions but links exist nonetheless and research is ongoing. 
Low Dose Naltrexone is prescribed as an often-successful treatment or complimentary treatment for all of the above, Epstein-Barr Virus (HHV4) 12 and many other autoimmune diseases. 13