Naltrexone is an old medication with a new use. At its regular dose of 50 to 100 mg, it treats opioid and alcohol addiction. At a much smaller dose of 0.5 to 4.5 mg, it does something different.
That small dose is called Low Dose Naltrexone, or LDN. It has become a well-established option for autoimmune conditions, chronic pain, and inflammation, either on its own or alongside other treatment.
How LDN Works
At a low dose, naltrexone briefly blocks your opioid receptors. Your body responds by making more of its own endorphins. Endorphins are your natural painkillers, and they also help regulate the immune system.
LDN also calms specific immune cells in the nervous system called microglia. When those cells stay switched on, they drive pain and inflammation. Quieting them is likely why LDN helps conditions that other anti-inflammatory drugs do not touch.
What LDN May Help
- Autoimmune conditions. Its anti-inflammatory effect may help reduce inflammation in autoimmune disease.
- Chronic pain. Especially fibromyalgia, low back pain, chronic nerve pain, and diabetic neuropathy.
- Sleep and energy. Many patients report better sleep quality and more energy when they take it consistently.
- Mood. More endorphins can lift mood and may help with symptoms of depression and anxiety.
LDN is not a cure for any of these. For the people it helps, it lowers the volume on symptoms enough to make daily life easier.
Why the Safety Profile Stands Out
LDN has a favorable safety profile. This matters most for autoimmune disease, where many standard treatments work by suppressing the immune system. That helps the disease but leaves you more open to infection.
LDN does not suppress immune function the way those treatments do. For many patients that is the deciding factor.
It is also inexpensive. Naltrexone has been off patent for years, though the low doses must be compounded by a pharmacy because they are not sold commercially.
How It Is Taken
LDN is a capsule taken once a day. Most people take it at bedtime, since the endorphin rebound happens over the following hours.
We start low, usually at 0.5 to 1.5 mg, and increase slowly over several weeks toward a dose that works for you. Going slowly reduces side effects and helps us find the smallest effective dose.
Not everyone lands at the same dose. Some people do best at 1.5 mg. Others need 4.5 mg. A few do better taking it in the morning. We adjust based on how you respond.
Side Effects
Side effects are usually mild and often fade after the first few weeks. The most common are vivid dreams and trouble sleeping in the first week or two. Some people notice headache or mild stomach upset early on.
If sleep is disrupted, moving the dose to the morning often solves it.
One important point: LDN blocks opioid medications. If you take an opioid pain medication, LDN is not safe for you. Tell us about every medication you take before starting.
How Long Before It Works
LDN is not fast. Some people notice a change in a few weeks. For others it takes two to three months at the right dose.
The benefits also tend to hold. Many patients report no loss of effectiveness over time, which is not true of every medication used for chronic pain.
We usually give it a fair trial of about three months before deciding whether it is working for you.
Is LDN Right for You?
LDN is worth discussing if you have an autoimmune condition, long-standing pain that has not responded well, or inflammation that is not well controlled. It is often used alongside your other treatment rather than instead of it.
Common Questions
Will it make me drowsy? No. LDN is not a sedative and does not cause daytime grogginess.
Is it addictive? No. Naltrexone blocks opioid receptors rather than stimulating them, so there is nothing to become dependent on.
Can I take it with my other medications? Usually yes, with the important exception of opioid pain medications. Always give us your full list.
What if I need surgery? Tell your surgical team you take LDN. It typically needs to be stopped a few days beforehand so pain control works normally.
Why It Must Be Compounded
Naltrexone is manufactured as a 50 mg tablet. The doses used in LDN are a fraction of that, so a compounding pharmacy prepares capsules at your specific dose.
We work with pharmacies we trust for consistency, because with a medication dosed in fractions of a milligram, accuracy matters.
We prescribe LDN by telehealth across Washington and Idaho from our clinic in Spokane. Book a free 15-minute call and we will talk about whether it fits your situation.