What to do when LDN doesn't seem to be working???
Dudley's Low Dose Naltrexone Sites has some fantastic responses for this problem.
"The following is an edited and augmented version of a message posted some years ago by a former member of the main Yahoo LDN group at http://tinyurl.com/main-ldn-group
It refers mainly to people suffering with multiple sclerosis, but could also apply to most other conditions in which LDN is being used as a treatment:
I think it is important to remind everyone that we do notice overall about 15% of people taking LDN for MS do not seem to get any help from it. We have also noticed that many people experience worsening of symptoms, re-visiting old symptoms or even having new problems for a short period of time and then they usually get better and go on to experience the benefits of LDN. It is scary when you take a medicine hoping to get better and you are feeling worse. But since this happens enough that we are used to seeing it and seeing people get through it with good results, we try and encourage those taking LDN to ride through it. Understandably, not everyone can tolerate worsening symptoms and they must keep asking themselves if this medication is making them worse or if they are part of that 15% that just won't get better on it.
Other options that might help while going through a difficult period of time with increasing symptoms include the following:
1. LDN needs to metabolise quickly, which is why it should always be compounded/formulated as fast release. Sometimes this is overlooked.
(a) To aid fast metabolisation, take LDN on an empty stomach at bedtime, preferably 4 hours, but at least 2 hours after eating.
(b) Phone your compounding pharmacy to check if your LDN was formulated as fast release. The Naltrexone component in your capsule is miniscule (most of the content is filler). Some fillers used by compounding pharmacies can slow down the release of the Naltrexone.
Be advised that compounding pharmacies can vary the fillers they use to suit you, but they should always be fast release. Some pharmacies aren't familiar with compounding LDN and can make innocent mistakes:
2. We also have seen some that have not been doing better with LDN test for Lyme disease. We recommend testing with a Lyme literate doctor (LLD). Unfortunately, some of the general tests for Lyme may not catch or diagnose it accurately. Many consider the most accurate test to be the Igenex version.
3. We have also seen a number of cases where people were not feeling better with LDN and then they get checked for Candida (overgrowth of yeast in your body - many times stemming from use of antibiotics). If they find they have a high concentration of Candida and they go through the process of getting it under control, LDN tends to work much better for them. Click here for information about Lufenuron, a very effective method of treating a systemic infection. If the overgrowth is limited to the gastrointestinal tract.
4. Keeping stress in check. Time and time again we find that exacerbations come up in times of extreme stress. This even happens to those that are doing well with LDN. We cannot emphasize enough the importance of finding ways to reduce stress in your life.
5. On a number of occasions we have noticed that when people have large scale infections that they may have an increase in symptoms. This may be due to the body using all of its resources towards fighting off the infection, or it might be a result of using antibiotics to fight the infection.
6. For the reduction in side effects we typically recommend starting LDN at a very low dosage and building your way up to 3 or 4.5. Most people that try this start at 1.5mg, and gradually go up to 3 or 4.5 until they feel at their best.
People who have multiple chemical sensitivities are advised to start LDN at a dose of .5 mg at bedtime, and increase it by .5 mg every two weeks. Some authorities also suggest a starting dose of .5 mg for Hashimotos, Chronic Fatigue Syndrome, and fibromyalgia, increased by .5mg each week until 4.5mg is reached.
7. Doctors running clinical trials have discovered that low vitamin D levels can hinder the effectiveness of LDN. Many people are deficient in vitamin D. It might be a good idea to get your vitamin D level checked and, if need be, supplement your diet with at least 5000-10,000 IUs of vitamin D3 per day.
8. Mold toxins can cause as well as mimic many health problems and undermine your success with LDN.
9. Another important consideration are the harmful effects of electromagnetic field (EMF) radiation given off by cell phones, cell phone towers, smart meters, etc. For more information, visit
10. Be patient! Some people get results overnight. However, it can take weeks, months, or even a year or more to experience the maximum therapeutic benefit of LDN.
Over the past couple of years we have been saving chats regarding problems associated with the many illnesses and/or problems that are helped by or associated with LDN use. Many times we try and forward on the solutions found by other chatters from this site. If you have questions or problems please write regarding the problems to the chat site and we will send you what we can find that has been saved. Some of these problems and solutions found include: stiffness, sleep, fatigue, etc. We also have been forwarding messages regarding other supplements that have helped others with certain ailments like pain, depression, eye problems etc.
Dr. Jaquelyn McCandless was a physician who treated hundreds of autistic children with LDN. These are some of her edited comments regarding problems that she observed in her practice:
Seldom is LDN a stand-alone treatment, but accompanies other strategies a person's body needs, especially a healthy diet. No sugar, dairy, or gluten. It takes some people longer to respond to LDN, and they may be colonized with pathogenic yeast and bacteria that could be slowing response. These setbacks usually do not last long unless something like a candida yeast infection is stubborn without specific treatment. Try to hang in for awhile longer.
LDN has been noted to aggravate yeast infections and other latent pathogens, viruses, etc., as the immune system is making early adjustments. It is good to have natural yeast remedies on board when LDN is started (grapefruit seed extract, Candex, lauricidin, hi-potency probiotics, etc.) to help offset this possibility. (And of course a good dietary regime that does not encourage gut inflammation which is usually the predecessor to pathogen invasion.)
There is a phenomenon that happens to some people that as the immune system is shifting (usually from T2 to T1) right after starting LDN, the immune system drops and people get an infection, cold, flu, cold sore, etc., which is usually short-lived. Candida tends to overgrow or a virus will flare up. These infections are usually short-lived unless something like candida and gut bacteria needs treatment. If you are having adverse symptoms caused by LDN, would you be willing to stop all casein (milk products) and gluten (wheat, rye, barley, and oats) for a week and see if you feel better? A study done several years ago showed that 30% of us have some degree of celiac disease (intolerance/allergy to wheat) even though the clinical symptoms may not be obvious enough to alert most people to that. When anyone in that 30% of persons stops eating wheat, they feel a lot better. The LDN may be acting like the opioid antagonist it is and causing a withdrawal reaction from taking away your fix, even if only for a few hours. Many people who eat wheat and drink milk do not even know what "feeling good" is like until they remove these foods from their diet.
Anytime someone has a negative reaction to LDN, the first question I would ask is, "What is the diet like?" If I had a disease such as ALS or MS or other autoimmune disease, I would be more than willing to see if my dietary exogenous opioids could be causing the negative reaction to a drug that is helping most of these people get off all their other drugs without progression of their disease. The reason this is a worthwhile trial is that this intolerance is affecting their general health and immunity in a negative way. Unfortunately, sometimes it takes up to 6 months to get gluten out of the system, so it is not so easy to test. Food is so emotionally entrenched in most people's notions of love and inner security, you would be amazed at what people will endure to eat the foods to which they are addicted! I have a huge respect for the power of addiction to foods and the difficulty in making radical changes from the diet we are accustomed to. Usually it takes an evaluation in the context of a serious illness for people to even consider changing, and even then many will not.
In line with the importance of diet when taking LDN, I strongly suggest that you avoid dairy and gluten genetically modified food, sugar , fried food, Some people have found it also helps to avoid nightshades, e.g., tomatoes, potatoes, peppers, and eggplant."