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Why should someone dose Low Dose Naltrexone (LDN) twice a day rather than once a day?
What is the advantage and how would I know if I should try twice a day dosing? Would the doses be equal in milligrams?
Some people have very complex issues. Let's go back to fibromyalgia. Fibromyalgia isn't necessarily always a single entity. It's a general description of a variety of symptoms usually centered around inflammation that they don't necessarily have a direct correlation as to the causative or the root cause of what's going on. In situations like that, we might use Low Dose Naltrexone twice a day because of more pain control versus taking care of the autoimmune issues. Usually when we're dealing with autoimmune, we're only dosing it once a day.
But we have found some individuals do better than on twice a day. Those doses are not necessarily equal. Sometimes they're very small at one end of the day and a little bit bigger at the other end of the day.
How do you know when you can try that? Well, for some people, especially with fibromyalgia, they're on once a day dosing. And it's just not cutting it. It's just not enough. So what we might do is, you know, let's say they were on 4 .5 milligrams at bedtime. Then what we might do is actually cut that down and give them half milligram in the morning that they could take a little bit in the morning and then reduce their bedtime dose. So we're still not going above four and a half, five, six milligrams, but we're splitting that up.
Dr. Norman Marcus uses for chronic pain 0 .1 milligram up to four times a day. But again, this is specific to his patients under his protocol. And again, because Low Dose Naltrexone doesn't have; this disease state equals this dosing routine, it literally is all about the individual.
And we try something for a period of time and if it's working great, fabulous. Do we adjust doses usually before someone finds their happy dose? We have adjusted that dose maybe nine to 12 times.