(If you don’t want to read this whole post – just know that it wasn’t a good experience).
Maybe you’ve been there. Maybe you haven’t. You’ve been battling with whatever chronic, difficult, and frankly, BS symptom/condition for a while, a new symptom develops, and you feel pressure to try to handle things – right now.
Well, I’m no different from anyone else in that regard. When faced with something new, I’m willing to try just about anything.
Enter: LDN (or Low Dose Naltrexone for the uninitiated).
This drug has been touted as the new wonder drug – that it fixes everything from autoimmune disorders to female reproductive system issues. It’s proposed that it lowers autoimmune antibodies and decreases inflammation – improving fertility, chronic pain, fatigue, etc.
Now, Naltrexone itself is typically prescribed in ~50 mg dosages for people wanting to discontinue alcohol or opiate use. It essentially blocks the effects of opiates, including the ones that the body produces on its own, at the receptors. For people who are using opiates/alcohol, this causes immediate withdrawal.
But, LDN is at a much lower dose. Dosage varies – usually 1.5 mg-4.5 mg. It’s given about a half hour before bed. And they THINK that it affects the microglia, which are macrophages (scavengers of bad stuff like bacteria, viruses, etc.) in the central nervous system (CNS). Microglial cells, which are pretty much the immune system of the brain, produce pro-inflammatory chemicals and excitatory amino acids (like glutamate). More importantly, Microglial cells mediate damage to the brain. The more aggravated they are, the more pro-inflammatory chemicals they produce, the more damage to the brain and the spinal cord.
Ok, well, nothing wrong with my brain (well – no comment there from the peanut galleries of those that actually know me IRL), but what does this have to do with fixing my thyroid or lowering my antibodies? And more importantly, how is this going to help with my hormones? How is it going to fix THAT?
To give you some context behind me trying this – I was struggling with a couple of things – mainly my thyroid antibodies. Since being diagnosed with Hashimoto’s thyroiditis circa 2009, they’ve been up and down and up and down and I was having a devil of a time getting my thyroid hormones regulated. I’d had them fairly well balanced and teetering in the low normal range for T3, but those antibodies were still out of control. Mind you – my antibodies were hovering under 300 – which still isn’t all that bad for a Hashimoto’s patient (I’ve seen people in the thousands). After evaluating my diet (seriously anti-inflammatory with one exception: dairy), my functional medicine GP had absolutely no more ideas. She mentioned that she’d tried several patients on LDN and it had improved their antibodies. Given how much I despise pills, especially “quick fix” pills, I was extremely hesitant. But also, desperate. Because if you’ve done the rollercoaster of thyroid meds, you know that it’s no fun. Incidentally, I take Armour (which I would endorse as a patient wholeheartedly over Synthroid/Levothyroxine – but that’s another story).
So, I poured through as much research as I could find. I contacted physician practices all over the world trying to find more information about this LDN – why people thought it worked the way it did, what they thought it did, what the side effects were supposed to be, and what the side effects might be for me. I also read every journal article I could find. After all, anecdotal (personal experience) information is just that – personal. I couldn’t find ANY controlled studies – only reviews. I found physicians that use it with their patients and their experiences – still, no controlled studies. And I found dozens of personal accounts. Still. no controlled studies. In all of that research, I found everything from “no or minimal side effects” to “main side effect exhibited is vivid dreams”. And I never did find a mechanism of action for anything other than CNS inflammation. So I thought to myself – surely one of my patients at some point is going to ask me about this drug. And while I don’t dispense drugs or monitor them for that matter, if the side effects are as minimal as everyone says they are and the “good” so vast, why not?
So, I did.
I started on LDN somewhere around January of this year. Within a week I was having night terrors. I’ve always been a vivid dreamer, but this was something new. My thyroid went completely bonkers. My moods were off the chart. My gut was even more of a disaster. And did I mention that my reproductive hormones also went crazy? I’ve never experienced anything like this before in my life – and I’ve taken corticosteroids! In addition, I was monitoring my hsCRP (non-specific inflammatory marker) fairly closely, my T3/T4, and Thyroglobulin and Thyroperoxidase antibodies. Guess what? The CRP and antibodies doubled (and then some)! But, I thought they were supposed to go back down? This was going to fix everything, right? WRONG!!!!!!!
At the point that I realized I was seriously going off the deep end, I quit taking it. I’d just had blood drawn so was anxious to see if the insanity had been worth it. Of course, see above, I found out that it wasn’t. My doctor was flabbergasted, although relieved. I think the panicked emails and calls from me in my state at the time were more than she wanted to deal with. But also, I broke her paradigm that a drug would fix me. Wait. DUH! Isn’t that what we’ve figured out here? There are no curative pharmaceuticals (except maybe antibiotics – at a cost). You have to figure out WHY there’s a problem in the first place. Oh yeah, I AM a functional medicine practitioner. I remember now.
After months of trying to re-balance everything with supplements, serial bloodwork, and some hefty withdrawal, I resorted to my old friend lab testing. I decided to have my IgG foods re-tested (it had been years), just like I do with the vast majority of my patients. And lo and behold, guess what came up there? Dairy. My immune response to dairy was off the charts. I had to quit – and now. It’s no great surprise that the body develops inflammation and whichever is the weakest link becomes the problem. See above for my weakest links. Thyroid just happens to be one of them. IgG = inflammation = autoimmune attack. Gotta fix it!
I’ve happily harassed patients about stopping dairy on more than a number of occasions. It’s pro-inflammatory. It produces opioids in the gut and CNS (brain/spinal cord). It also disrupts the tight junctions leading to gut malabsorption and neurological dysfunction. But like everybody else, I’m a human who hates doing what’s best for me. (The proof was in the pudding and the ice cream and the cheese). It was time.
Less than 3 months after quitting dairy, I had my antibodies checked. They were half of their previously “normal for me” levels. HALF! While some things hadn’t regulated back yet (still messing with hormones), my T3/T4 were FINALLY in midline optimal range, my antibodies were below 50, and my energy was coming back.
Find the cause. Fix the problem.
Fortunately/Unfortunately, fixing these things takes work. It takes changes to re-balance and repair – to quiet the immune response and restore what’s supposed to be going on in the body. No quick fixes. But the results are phenomenal. I’m my own poster-child.
Need some help?
If you want more “objective” info on LDN: