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We had a severe storm on Tuesday, which damaged our Telecommunications at the Clinic. The result was many of you could not get through by phone, and those that did found the line was very poor. This meant I have had to reschedule my cancelled telephone consults. I apologize for this but it was out of my control.

I finish work tomorrow, and will be back in the middle of January. This has been a very busy week, on thing or another, so I have been slow on answering emails, due to the amount of them I am receiving at present. I will get around to them, but some patience and understanding is required. Very few doctors allow patients to email them and provide assistance in that way. Over the holiday period, i will be available by email for any urgent problems that may arise.

I have been using LDN (see below) for the last 5 years, and found it generally to be safe and effective in many medical conditions, as many of you have found.

Low-Dose Naltrexone: An Inexpensive Medicine for Many Ills?

Miriam E. Tucker

March 11, 2020

Low-dose naltrexone (LDN) could represent a low-cost and safe alternative treatment for several chronic neurologic, rheumatologic, psychiatric, and gastrointestinal inflammatory conditions, recent findings suggest.  

The opioid antagonist naltrexone is currently approved in 50 mg tablet doses for the treatment of opioid and alcohol dependence. But at much lower doses — typically 1.5 mg to 12 mg — it appears to operate uniquely as an anti-inflammatory agent in the central nervous system, via action on microglial cells. The low-dose version is not currently approved by the US Food and Drug Administration, so to be used it must be prescribed off-label and specially compounded.

Given that it’s off-patent and costs only about $25 to $65 a month (at US compounding pharmacies), there’s little financial incentive for pharmaceutical companies to conduct large randomized clinical trials of LDN.

However, accumulating data from a variety of sources suggest that it’s relieving pain and other symptoms of several different chronic inflammatory conditions, with few side effects other than mild and transient nausea, insomnia, headache, and vivid dreams.

One recent three-patient series published in BMJ Case Reports is the latest to describe successful use of LDN in relieving not just pain, but also fatigue, cognitive impairment, and post-exertional malaise in patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), a debilitating neuroimmune condition for which there are no currently approved treatments.

Another case series published in November reports similar benefits in ME/CFS, and clinicians who specialize in the illness have endorsed its use based on their cumulative anecdotal experience.

Indirect evidence for LDN’s benefits comes from a unique series of articles published in the last few years from Norway, reporting the impact of a surge in LDN prescribing in that country in 2013 following the airing of a television documentary about LDN.

According to Norway’s nationwide prescribing database, about 15,297 patients, or 0.3% of the country’s population, was prescribed LDN by physicians following the airing of the documentary. Over the next year, there were dramatic drops in prescriptions for high-cost drugs used in the treatment of rheumatoid and seropositive arthritis, inflammatory bowel disease, epilepsy, psychotic conditions, and depression.

Jarred W. Younger, PhD, who has studied LDN in fibromyalgia and is seeking funding to study it in ME/CFS, told Medscape Medical News, “We really need clinical trials to show what it works for [ME/CFS] and how to use it properly.”

“A lot of clinicians are trying it without enough guidance,” added Younger, who is director of the Neuroinflammation, Pain and Fatigue Lab at the University of Alabama, Birmingham