Many people are surprised to learn that a medication originally developed to help with addiction is now being used in much smaller doses to support the body’s ability to heal. This therapy is called Low Dose Naltrexone (LDN).
What is LDN?
Naltrexone blocks opioid receptors at full dose (50 mg) for addiction treatment. At very low doses (abiout 0.5–4.5 mg), it behaves differently—briefly blocking receptors so your body responds by increasing endorphins and dialing down inflammatory signaling from immune cells (microglia/TLR-4). That combo is why it can help with pain, immune overactivity, and mood.
What the research says (in plain English)
Fibromyalgia (chronic widespread pain).
Two Stanford crossover trials (small but well-designed) found that LDN reduced pain and improved overall symptoms more than placebo, with mild, short-lived side effects (often vivid dreams).
Crohn’s disease (inflammatory bowel disease)
An early open-label study showed symptom improvement, then a placebo-controlled trial found better clinical and inflammatory activity (including mucosal healing) with naltrexone vs placebo. These were small studies but encouraging.
Multiple Sclerosis (MS)
Small pilot trials suggest reduced spasticity and better mental health–related quality of life; LDN was safe and well-tolerated. Larger studies are still needed.
Painful Diabetic Neuropathy
A randomized, active-controlled crossover trial found LDN provided similar pain relief to amitriptyline with far fewer side effects—suggesting a reasonable non-sedating option for some patients. PubMed
Dermatology & Itch
In hard-to-treat skin conditions like hidradenitis suppurativa, reviews and guidance pieces describe LDN as an anti-inflammatory, itch-reducing option with a favorable safety profile. Earlier trials with standard-dose naltrexone also showed antipruritic benefit in severe itch (e.g., uremic/cholestatic), supporting the mechanism.
The Bottom line: Across conditions, the signal is symptom reduction with good tolerability in small RCTs and pilot studies—strong enough to consider in the right clinical context, but still calling for larger definitive trials.
Less-common & emerging uses (what we know so far)
1. Long COVID / Post-COVID Fatigue
Early reports (case series, observational) suggest LDN may improve fatigue, brain fog, sleep quality, and PEM in some patients. Reviews recommend it as an adjunct while we await randomized trials that are now underway.
2. POTS / Dysautonomia
A 2023 case series found a favorable safety profile; efficacy signals are uncertain. Randomized trials are enrolling to test effects on fatigue and quality of life.
3. Hidradenitis suppurativa & other inflammatory dermatoses (e.g., Hailey-Hailey, lichen planopilaris)
Case series and reviews report decreased pain/inflammation and itch; dermatology guidance lists LDN 1.5–4.5 mg daily as a reasonable off-label option when conventional therapy falls short.
4. Migraine (preventive/adjunct)
Very preliminary evidence (tiny trial combining LDN + acetaminophen, and case reports) hints at fewer migraine days in select patients; this is early-stage and not yet standard of care.
How it likely works (in human terms)
- Endorphin boost: brief receptor blockade → rebound in your natural pain-modulating endorphins.
- Immune calming: dampens microglial/TLR-4 activity → fewer inflammatory signals that drive pain, fatigue, and “sickness behaviors.”
Key takeaway
Low Dose Naltrexone is not a cure-all, but it offers something rare in medicine: a therapy that is safe, affordable, and versatile, with the potential to help where conventional treatments have left gaps.
The research, while still developing, consistently points toward meaningful benefits in conditions marked by pain, inflammation, and immune imbalance. Patients often describe improvements not just in their symptoms, but in their sense of resilience, energy, and quality of life.
What makes LDN unique is how it works—by nudging the body back toward its own natural state of balance, rather than forcing it in one direction. In this way, it reminds us that healing doesn’t always come from stronger drugs or more aggressive interventions, but sometimes from small, steady shifts that restore the body’s ability to regulate itself.
When combined with other foundations of health—nutritious food, restful sleep, regular movement, stress reduction, and meaningful connection—LDN can become a powerful ally in a person’s healing journey. It is not about replacing one ‘quick fix’ with another, but about offering a tool that supports the body’s own wisdom and capacity to heal.
If you’ve been searching for new options, LDN may be worth exploring with your provider. Sometimes, the smallest dose can spark the biggest change.