At what point would you decide Low Dose Naltrexone (LDN) isn't helping?

LDN Specialist Pharmacist Stephen Dickson
Pharmacist Stephen Dickson

At what point would you decide Low Dose Naltrexone (LDN) isn't helping?

I’ve been on LDN at 4.5 mg since 2019. In the first year I felt improvement, but since then, my fibromyalgia pain has just gotten worse. I've been scared to stop LDN in case I get even worse. At what point would you decide LDN isn't helping and should I just stop taking it?

There's nothing to say that you can't stop LDN straight away, and as long as it's within two weeks, you can restart it at the dose you previously got to. Stop LDN and see if your symptoms get dramatically worse quickly within two weeks. If they do, you can start back at the dose that you were on before.

It might be that you're taking slightly too much LDN. You could find that dropping your dose down to 3 mg or 3.5 mg might give you some of the benefit again. You might be reaching the ceiling of what the anti-inflammatory effect can do at the dose you're on. So, you might want to come down to 3 or 3.5 mg and see what happens. I think an answer your question, I would stop it and see if the symptoms get dramatically worse. If they do and you still have a supply, you can restart it again and then mess with the dose a bit and see if you can find a sweet spot, either lower or a little bit higher than where you are.

That gives you the best benefit because, you know, it has worked for you before, because in the first year, you did get a result. So it could be that since you started in the first year, the opiate receptors have reduced or have internalized, and you just don't need as much anymore to get that benefit.