Low-Dose Naltrexone (LDN) Reduces Fibromyalgia Pain

Low-dose naltrexone (LDN) is a fibromyalgia pain treatment that reduces neuro-inflammation. Learn how LDN works, what the studies show, and some clinical pearls of wisdom. Although LDN typically does not combine well with opioids it can work in certain scenarios that I describe here. • Low-Dose Naltrexone (L...
LDNresearchtrust.org is a great resource and you can find study references below.
About me: I graduated from Tufts University School of Medicine and am board-certified in internal medicine. After developing fibromyalgia in medical school I was able to find integrative treatments that helped me feel much better. I share my complete treatment approach in my book The FibroManual amzn.to/3Uql7wg
In my videos I hope to inspire everyone dealing with #fibromyalgia to remember they are #fibrofierce!
Sign for my email newsletter for all things #drginevra and #fibro at www.drginevra....
References:
Younger J et al. The use of low-dose naltrexone (LDN) as a novel anti-inflammatory treatment for chronic pain. Clin Rheumatol 2014 Apr;33(4):451-9.
Younger J et al. Low-dose naltrexone for the treatment of fibromyalgia: findings of a small, randomized, double-blind, placebo-controlled, counterbalanced, crossover trial assessing daily pain levels. Arthritis Rheum 2013 Feb;65(2):529-38

[@persnickety369]

YES! BUT, the compounded pill form of LDN wasn't effective for me. My doctor had it compounded to be taken sublingually (as a troche) and it's been a GODSEND! This need for it sublingually might be related to me having both variations of the MTHFR gene mutation. I take it every night, melts under my tongue. If i miss a night, boy do i feel it the next day! The only side effect for me is that it makes me a little sleepy which is great at bedtime. Anyway, just wanted to share this siblingual (under the tongue) hack if the pill doesn't help. It can take a month to start feeling it to help. After month two, you'll know!

[@anjacarolinachristensen9103]

In Denmark, LDN is also made in liquid form and a lot of patients get the 50 mg pill prescribed and make a solution they dose with a syringe and keep in the fridge. Maybe other countries can do the same?

[@thefibroshow]

Interesting! Thank you so much for sharing.

[@thefibroshow]

I am not aware of any liquid form of naltrexone available in the US. But anyone interested should look on www.ldnresearchtrust.org, a great resource!

[@Twang-Train]

Can you take with lyrica?

[@mandogrogurescuedogs]

Yes! I take a low-dose 5 mg and it definitely helps bring down my pain level and makes my quality of life much better. When I first started taking it, I went from taking three Aleve’s’s per 24 hours down to taking just one or two.

[@75pdubs]

How many aleve do you take now?

[@user-hc5zi5pn6w]

@@75pdubs ya ur statement is not complete. u first started with 3 then went to 1-2 after few days now?

[@75pdubs]

@@user-hc5zi5pn6w wrong person

[@marianahiga2790]

I just started taking it! I’ll be back to let you know how it worked for me

[@traceyadixon]

Any feedback?

[@marianahiga2790]

@@traceyadixon it helped me to sleep but I had terrible headaches and had to stop :( (I was taking only 1.5)

[@moduqueRN]

This is very helpful. Unfortunately, my rheumatologist said she’s never heard of this medication. So frustrating. I live in Chicago area. Do you see patients in the clinic setting?

[@LedgerAndLace]

Hila Handler M.D. is in Chicago and specializes in LDN. I won't put a link or website, but you should be able to find her with a google search.

[@CorbinDollas]

@@LedgerAndLaceDo you know who I could see in Seattle?

[@raloufen4292]

Dr Handler is in WI according to Google

[@sueanneduerson9241]

Started 1.5 mg for three weeks. Up to 3 mg for past week. Dr prescribed it for Hashimoto’s. I have definitely seen so many positive changes! I have eczema and it is GONE! I have had chronic allergies for years. Tested several times through the years but always told I was not allergic to anything. I probably should own stock in KLEENEX 😂. LDN has stopped all of my allergy symptoms. I feel more awake every morning! Less aches and pains. Just AMAZING! I’m 73 and I am so grateful my functional med Dr recommended LDN.

[@jean6460]

Fabulous summary! Thank you so much!! I’m just starting LDN and am hoping it decreases my anxiety!

[@thefibroshow]

I am glad my summary helped!

[@janetphillips2875]

I want something that kills it, gets rid of it

[@Truerealism747]

Take a look at TMS Dr schubiner it hasn't cured me yet but all hoping found out I have Asperger's hypomobility why I have fybromyalgia

[@thefibroshow]

I hope we will have that type of fibromyalgia treatment in the future!

[@quake2u]

🤣

[@faithf5846]

LDN is helping me at least for the last couple weeks. I can only take 1 mg because of the sleep disturbance. I've taken LDN in the past for facet syndrome and had to stop because I was getting sleep disturbance in a little jittery. So far ok

[@Nelz4]

Sadly LDN didn’t work for me 😢 my whole body got swollen and ended up in ER. Was so hopeful that it would help me.

[@Truerealism747]

Wonder why it did this hormones? been in ldn 8 months though hasn't helped pain helped fatigue and ibs

[@Nelz4]

@@Truerealism747 interesting you should say this. For me I think fibromyalgia was brought on by imbalanced hormones and gut issues. I see a huge difference when I focus on healing these 2 areas.

[@thefibroshow]

Yes, it definitely doesn't work for everyone.

[@charlietodd8195]

Has anyone here for it from the NHS in England??

[@Lionessliving]

No but I will ve pishing for it if it works for me. Only started yesterday. Private script from Glasgow pharmacy

[@CorbinDollas]

I’m disabled with terrible quality of life from FM. What kind of doctor can prescribe patients naltrexone?? Please help.

[@thefibroshow]

Any doctor can prescribe LDN- great resource to find a prescriber at www.ldnresearchtrust.org

[@literarypotatogoblin]

I asked my doctor about this and she refused to consider it.

[@thefibroshow]

That is so frustrating!

[@lorismith5369]

Find another doctor. Be an advocate for yourself. Best wishes!

[@karrilucas1]

@literarypotatogoblin Because there is no money in prescribing it.

[@GreatDebate1]

I have the same issues but I'm searching for another alternative. I found a way to get the prescription but challenges finding someone that can help me transition off pain meds to start it.

[@mikeshay4866]

​@@karrilucas1but there is in 1000s of other drugs they prescribe ??

[@anjacarolinachristensen9103]

Here in Denmark, the doctors consider Naltrexone to be low dose up until 25 mg, I wonder why there's such a difference? I would love to know more about LDN, specifically about doing what they here in DK call Alternative Regime (AR - in English it would probably be named twice a day dosing), meaning that you up your intake of LDN to two times a day - morning and evening with 12 hours apart - for about 14 days, as a "booster" I guess. I haven't found much information about that, but having tried it, I know it can work wonders. As a note for others reading this, AR is not recommended for cancer and thyroid patients.

[@thefibroshow]

Very interesting! Twice daily dosing is definitely becoming more common.

[@klclark525]

I'm so glad you are talking about this! It has really helped me. After reading information in the LDN book 1&2, and a talk with the founder of LDN Research Trust, I have ended up (after a year) at my best dose 4.5 mg on waking and again around 2pm.

[@melissanreynolds]

Interesting, how did you decide on the time of your second dose? I've taken 4mg at bedtime for six years and tried 4.5 recently but that dose doesn't suit me! Considering a second dose but unsure when!

[@thefibroshow]

Wonderful!

[@CorbinDollas]

Glad to hear this! What kind of doctor can perscribe LDN. I desperatelyyy need help with my FM.

[@amandawilder8896]

@@CorbinDollas my pain mgmt physician prescribed it to me

[@michaels999]

⁠functional medicine doctors or you can order it online with a consultation

[@raloufen4292]

ER Drs don't know the difference between the 50MG and 5.00MG. How can I help them

[@timwright4676]

Dear Dr Ginevra, Is LDN also effective against Polymyalgia Rheumatica?

[@user-hc5zi5pn6w]

isnt fibromyalgia caused by trigger points? u get rid of trigger points with myofascial release right?

[@GG-sk3tw]

Unfortunately it is not that simple for people who suffer from chronic pain.

[@Anvanho]

Thank you! Very informative video. Just started Naltrexone tonight (for myalgia). Hoping some improvement in overall pain can start showing up sooner than later. I dissolve a 50mg tablet into 50ml of water, then extract 1ml in a syringe, take that. Not even sure how much that is then I take (?) but we'll see.

[@thefibroshow]

Yes some patients resort to doing it that way, but definitely not the recommended way to do it for many reasons. The biggest one is its hard to know what actual dosage you are getting.

[@jamilafay]

Can you still take low does opioid with it durning flare ups?

[@thefibroshow]

It depends on several factors I cover in another video kzbin.info/www/bejne/qHybo61nbt6GhpI

[@emilycampbell5798]

I’m 4 days in but super sleepy (like extreme sleepiness) I’ve had a few other side effects, nausea and little headache. I wanna work through this!! Any suggestions

[@thefibroshow]

If my patients are struggling to tolerate I usually have them take a break for a few days and then try again with lower LDN dosage

[@highvalueecomm7023]

I'm around 7 weeks on LDN now taking 4.5mg dose bedtime and got a terrible flare up what could cause it?LDN?bad weather?it shouldn't be so bad but it is😢somebody??

[@thefibroshow]

LDN doesn't work for everyone, not sure if that is what is happening for you or not. Fibro flares can be so unpredictable!

[@bulkingtonwiltshire6605]

If someone is on biologics for RA could they use lnd?

[@thefibroshow]

There is no known contraindication, but definitely talk with your rheumatologist before starting LDN

[@dianapaloma3102]

Thank you so much . I’m excited to try. My doctor says it can help with depression too. 🙏❤️

[@bonchauvin5744]

I’m going to try LDN for burning mouth…..my life is horrendous because of the pain..

[@Ann-ws2dj]

I’m in extreme pain today. My doctor gave me LDN It’s very expensive. I did get it but was afraid to take it because I was afraid of the side effects. I’m doing neurofeedback right now with my Chiropractor. Any thoughts on this. If I did decide to try it, do you have to wean off it.

[@Truerealism747]

Sided effects for few days

[@PureExistence1]

@@Truerealism747 what side effects did you have?

[@thefibroshow]

Typically not a medication that you need to wean off, but great question to ask your doctor that prescribed LDN!

[@elyssaberger5901]

I have a regular SED rate but funny enough I’m basically a tad high CRP at around 10

[@GreatDebate1]

Do you know or can you support someone trying to transition to LDN thar is on opiods currently?

[@jm-5678]

I’ve only been able to handle 1.5 mg doses of LDN, due to intense stomach pain at 3 mg. (I’ve tried a couple of trials of this dosage and I’m now sure I can’t handle it.) Would it be beneficial to take 1.5 mg twice a day? I have noticed a reduction in pain, so I want to get the most benefit from it that I can. I may check with my pharmacy to see if they do sublingual, but I don’t think they do.

[@thefibroshow]

I think twice daily options for LDN can be really helpful for some folks.

[@bearynice2u]

Is there an alternative for 4.5 low dose naltrexone? No pharmacys close enough that will compound it= my insurance and Medicare won't pay for it so all have to come out of pocket! Which I can't afford. Please Help

[@thefibroshow]

I suggest talking to your doctor and seeing if you might be able to take 1/4 of a 50mg tab as a substitute.

[@lovelymeidiland7803]

I read under another KZbin video that people with gut infections or gut microbiome issues might not respond well to LDN and need to get that checked out first. Did you hear about that? My doctors are inexperienced with LDN. I need to know before starting to take LDN. Thanks in advance 🌸

[@thefibroshow]

I have heard that as well, but in my clinical experience have not seen it to be an issue. Www.Ldnresearchtrust.org is a great place to find knowledgeable LDN practitioners.

[@mumbagirl]

I am on 9 mg twice a day. My pain doctor, Dr. Ong in Vancouver Bc says she has patients on even higher doses. I am also on Duloxetine. It is expensive but fortunately my extended health insurance covers most of the cost. I am not pain free and currently have a terrible flare but usually I am not too bad. Thanks for sharing. On a side note, I also have have DISH diseaese

[@thefibroshow]

I have heard of higher doses being used, but in my patients the benefit seemed to 'cap' at around 12mg. Above that didn't seem to make much difference. But definitely sounds like you have a great doctor who is willing to experiment to find what works!

[@everising4999]

Which cbd? Too many choices. It can’t have sugar in it and if it’s in oil dropper bottle I feel sick. Help

[@thefibroshow]

CBD oil gelcaps might be an option to explore.

[@HayleyBuckley-z2u]

My daughter suffers from Fibromyalgia and is only getting worse, but her doctors has helped her at all, can you tell me is this Medication available in the UK , she is only in her 30s with two children and Desperately Need help x

[@thefibroshow]

It is available in the UK, you can find a prescriber at www.ldnresearchtrust.org

[@margaretball8835]

Is there a possibility it would work for neuropathy?

[@thefibroshow]

yes!!

[@kimberleemonroe2255]

I was prescribed this snd will be starting . I’m just wondering if you still are in practice as far as a clinic? I’m looking for somewhere that discus likes in all of this. My doctor had really done great at managing it but would like to get more individualized care. Thank you😊

[@thefibroshow]

Glad you have found a good doctor to help you. I closed my clinic last year to focus more on teaching patients and other doctors how to treat fibromyalgia more effectively. On my website www.drginevra.com I have some resources to find other providers with fibromyalgia expertise.

[@nanas.grotto3091]

how do you feel about suboxone vs naltrexone

[@thefibroshow]

Everyone’s situation is different but I think suboxone can be a great option for pain management in some patients. I prefer to try LDN first since it more directly addresses the source of pain. I talk more about suboxone and LDN in my book The FibroManual if you want to learn more.

[@nicholasquirino5818]

will this help with bad abdnominal pain and gut dybsiosis?

[@thefibroshow]

I know LDN has shown benefit in Crohn’s disease and other GI conditions, you can find more information at www.LDNresearchtrust.org

[@TK-MSPsych2010]

I see you said 4.5 mg or less is the right dose for fobro. What does it happen or what is a benefit and side effects if I take 5mg? I have Kaiser insurance and they give me only 5mg. Started in Feb 2023. I take it in the morning now as i couldn't sleep. It reduces my pain from 10 to 7 on average , but around 4pm i start feeling it at extreme level again. I wonder if I can take it 2nd time at 4pm? My pharmacist recommended to buy out of pocket 3mg and take late afternoon. What is your thoughts? Thank you.

[@thefibroshow]

I can't give specific medical advice, but taking LDN twice daily is effective for some patients

[@elyssaberger5901]

I have Kaiser. I’m about to start it and I’m going to get lower dose at a compounding pharmacy. It’s $1/pill so $30 a month. Not that expensive

[@60n24yeah]

Can I take this while on Tramadol?

[@thefibroshow]

In certain cases opioids can be taken with LDN, learn more in this video kzbin.info/www/bejne/qHybo61nbt6GhpIsi=JHmE5BIBTYwnyJz4

[@vitalijusmacas1629]

👍

[@kfossi1986]

How long has this been on the market and studies on long term use?

[@thefibroshow]

It’s been on the market in the US since 1984 (in its full dose form), best resource to learn more about long term safety studies is at www.ldnresearchtrust.org