A publication of the Kentucky Center for Public Service Journalism

Lyn Hacker: A fairly cheap way to treat inflammatory conditions, LDN is ‘plain Jane’ of pharmaceuticals

Inflammatory conditions – diabetes, rheumatoid arthritis, fibromyalgia, cancer and other such conditions – seem to be the bane of the 21st century. Pharmaceutical companies market to them with scores of newer and newer drugs with exotic price tags. But what if there was a fairly cheap drug that’s been around for a long time that has been making headway in these directions?

There is one.

It is LDN and it is the “plain Jane” of pharmaceuticals. It’s not well known. There are no TV ads for it, and there is very little interest in developing it by pharmaceutical companies. Nonetheless it is being used daily by thousands of satisfied and grateful patients.

LDN is Low Dose Naltrexone. It is an off-label use for an old drug named Naltrexone that was originally formulated to treat opiate addiction. LDN is a very small dose of Naltrexone, and is being used to treat cancer, multiple sclerosis, osteo- and rheumatoid arthritis, fibromyalgia, diabetes types 1 and 2, irritable bowel disorder, and a myriad of other such inflammatory conditions and pain disorders in both humans and animals.

LDN and full-dose Naltrexone both work on the premise that the human body produces its own opiates, called endorphins (beta-endorphins and met-enkephalins) which are part of the immune system. Within the body, all over the body, there are receptor sites for these endorphins. According to an article in Clinical Rheumatology, (02/15/14), “many body tissues have receptors for these endorphins and enkephalins, including every cell of the body’s immune system (italics mine). Cancer and autoimmune diseases are triggered by low blood levels of endorphins, contributing to the disease-associated immune deficiencies. Similarly, HIV/AIDS is accelerated by a deficiency of endorphins.”

Endorphins, as well as relieving pain and making a person feel good, also raise the body’s immune response, so they act as excellent natural anti-inflammatories. The most prevalent hypothesis to the way LDN works, advanced by Dr. Ian Zagon and colleagues, states that “inducing a small and transient opioid blockade will prompt the body to compensate by up-regulating both endogenous opioids and opioid receptors,” – or in layman’s terms, by blocking our natural opiate receptors for a short period of time, LDN tricks the body into making more endorphins and producing more opioid receptor sites. The resulting increase in endorphins and sites treats pain and raises the body’s immune response to inflammation.

Besides binding the opiate sites and increasing endorphin and opiate sites in the body, in studying LDN, they found opiate growth factor (OGF) became a key factor in controlling tumor growth. Subsequently a “left-handed” element of LDN reduces inflammation by reducing production of cytokines, inflammatory proteins, thus treating inflammation in a second way. According to the LDN Research Trust, “it does appear that it may have two anti-inflammatory mechanisms which can have a beneficial effect on cancer.”
Naltrexone was first developed around the late 1960s, and works by binding to the opiate sites in the body that naturally exist to bind with internally produced endorphins, so when one takes a narcotic or opiate, they can’t feel the affects. But it was not until President Nixon created the Special Action Office for Drug Abuse Prevention (SAODAP) in early ‘71, that the first director of the program, Dr. Jerome Taffe, took note of its importance in the fight against drug abuse. Taffe was determined to shift the emphasis of drug abuse treatment from prisons and hospitals to community based programs. Even so Naltrexone was not considered important to the pharmaceutical market and so it was determined that Federal funding would be necessary to bring it to market. That was accomplished the next year with the Drug Abuse Office and Treatment Act (DAOTA), which funded the research and development of the drug.

LDN was first developed therapeutically by Dr. Bernard Bihari in the mid 1980s. Bihari conducted a groundbreaking clinical trial with HIV/AIDS patients at Downstate Medical Center in New York (ldninfo.org). HIV/AIDS was then just emerging. Bihari discovered that low doses of Naltrexone, between 1.5 mg and 4.5 mg (vs. the standard 50 mg tablet), acted like the standard 50 mg, by blocking the opiate receptors in the body, but for shorter periods of time. That tricked the body into producing more endorphins and more receptor sites that lasted all day. Since endorphins are a major normalizer of immune systems, Bihari found this treatment protected “the battered immune systems” of AIDS patients. David Gluck, M.D., a Board-certified specialist in both Internal Medicine and Preventive Medicine, was a life-long friend and associate of Bihari, and took up the standard after Bihari’s death. He has been working to achieve recognition for Bihari’s discovery ever since.

According to Gluck, the major affect on the immune system that endorphins have is critical to understanding auto immune disorders. “Published studies have demonstrated that all autoimmune disorders thus far tested are marked by weak, dysfunctional immune systems (in contrast to the common belief that they are probably too strong). This makes good sense, because the first commandment of the immune system is ‘Thou shalt not attack self!’ Only a dysfunctional immune system attacks itself.” LDN normalizes immune systems, thereby halting further progression of disease. Normalizing the immune system has a positive effect on a wide variety of conditions. It essentially detoxifies the body. “We have already noted positive benefits from LDN in those with HIV, any autoimmune disorder, many cancers, Parkinson’s disease, motor neuron diseases (such as ALS), COPD, and in childhood autism,” he added. He feels LDN has been especially popular for a great number of people who suffer from MS because other modalities and drugs have many side effects and are very expensive.

The Experimental Biology and Medicine Society conducted research into LDN and found it targeted the Opiod Growth Factor (OGF) and Opiod Growth Factor receptor (OGFr) to the point of inhibiting cell growth. Professor Ian S. Zagon of Pennsylvania State University, also involved in the study, found that “OGF regulates the growth of cancer cells, and all cancer cells use the OGF-OGFr pathway in growth regulation.”

Frustrated because Naltrexone has been generic for so long, no large pharmaceutical company will invest in the huge research costs needed to gain FDA approval of these special new off-label doses of the medication, Gluck wrote in an article for the LDN Research Trust. “No one makes any significant money from sales of LDN,” he added. “Nonetheless there have been many small clinical studies of LDN performed at outstanding medical centers, all showing it to be safe and effective.” These studies are outlined on his website at www.ldninfo.org/ldn_trials.htm.

Gluck points out only two contraindications to using the drug – first, that the user must not be dependent on narcotics, because even one little capsule of LDN could lead to prompt and dangerous withdrawal reactions. Second, if one has had an organ transplant, and is on daily immunosuppressant medications, they shouldn’t take LDN as “the immune system balancing effects of LDN would work against the patient’s need for suppression of the system,” according to Brian Haviland, administrator of the LDN group on Facebook (https://www.facebook.com/groups/GotEndorphins/).

There is almost a kind of a cult-like atmosphere surrounding LDN, as not many people know about it, including a lot physicians and veterinarians. Regardless, it is being used with success both in human and non-human patients of those practitioners who are familiar with and prescribe it. People who use it are very interested in the drug, and spend a lot of time researching it, all of its uses, and the most recent studies on it. They share their knowledge, problems, comments and observations on message boards such as found on Facebook and Yahoo. Sometimes it becomes a real struggle for a patient to find a physician or a veterinarian who will work with them in using LDN for a troublesome condition that doesn’t seem to respond to other, more well-known drugs. There are files on these sites that help them locate practitioners who can help them, and nearby compounding pharmacies that can compound the drug for them. Calls for drug companies to begin producing the drug in the different low-dosages used are becoming more frequent. Still the drug companies don’t feel it warrants their attention and drug production won’t pay back the money they’d spend in research and development.

The only other alternative uses for Naltrexone at this time is its use in the new weight loss drug Contrave, in conjunction with the anti-depressant Bupropion (marketed under the trade names Wellbutrin and Zyban, also used for smoking cessation). In that drug, however, it is at a dose not considered to be low dose and is high enough, at 8 mg., so that it can’t be used by a person who is taking opiates, such as someone on long term pain control. Also Contrave’s doses of Naltrexone and Bupropion work up to higher doses and is sustained release, so it is very different in essence. LDN is considered to be a dose from less than 1 mg to 5 mg/day. Animals are dosed on their weight., ie, 0.03 mg/pound of of the weight of the animal.

It’s ironic that although Naltrexone prevents pain relief by opioids, in its LDN form, through treating inflammation, it does treat pain very well, especially chronic pain such as arthritic conditions. Maybe the most important advantage, considering the opiate crisis in our country, is it is not addictive. It does not get you high. It can produce some rather vivid dreams, otherwise side effects are rare.

Because it is not produced by pharmaceutical companies, it can only be taken by compounded doses, which must be produced in a compounding pharmacy, or as a tablet dissolved in a liquid. Because it is compounded, it is also not usually covered by most insurance. Compounded options are as a capsule, in a liquid to be taken by drop form, or in a transdermal cream that can be rubbed into a pet’s ear for convenience. It can also be taken by mixing ½ of a 50 mg tablet with 25 mls of distilled water and drawing a dose up via a dose syringe. That way is super cheap. Unless you are a recovering addict, most insurance doesn’t cover full dose Naltrexone, but the cost is usually around $30 cash for a 30 tablet/month prescription, and since one 50 mg tablet can be divided into more than 50 doses, one 30 tablet prescription can last well over a year. Care must be taken to keep this liquid form refrigerated once it has been mixed.

One of the main problems people report on the forum pages is their inability to find a physician who, first of all, is knowledgeable about LDN, and second, is willing to prescribe it and work with a patient.

One such group in Central Kentucky is the Joy Rich Clinic in Lexington. They work with the Lexington Compounding Pharmacy for the LDN doses, although there are at least three compounding pharmacies in the area.

The Joy Rich Clinic staff works closely with each patient, spending well over the usual five to ten minutes per patient in their exams. Their initial approach is to thoroughly explore the problem, gather a full history and test for applicable markers, plus the nutritional and hormonal status of the patient including thyroid and diabetes markers. Treatment follows from there. They are a complete Primary Care Center and so can treat multiple family members for every thing from Primary Care, Hormone Replacement, Nutrition (including testing for vitamin deficiences), Paleo, Weight Loss, Wellness, etc. They have a staffed lab on site and offer massage therapy besides. They are located at 2386 Professional Heights Plaza in Lexington.

Regarding LDN, finding the proper dose for each person takes a little adjustment, so the clinic monitors disease states in their lab following markers such as A1C for diabetes, thyroid panels, and inflammation markers like C-reactive protein (CRP) and estimated sedimentation rate (ESR). They have been very successful in treating some long term disabilities brought about by poor nutrition and inflammatory disease states.

Lyn Hacker is a Lexington native raised by Appalachian parents to be not only educated but proficient in the living arts – working very hard, playing music, growing gardens, orchard management and beekeeping. The UK graduate has been a newspaper staff writer and production manager, a photography lab manager, a Thoroughbred statistics manager, a Bluegrass singer and songwriter, a registered respiratory therapist, a farmer, a Standardbred horsewoman, and a beekeeper. She lives on a farm in Sadieville.

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  1. Diana Wells says:

    Excellent information to have. Well written

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