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Low dose naltrexone

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Low dose naltrexone (LDN), where naltrexone is used in doses approximately one-tenth those used for drug/alcohol rehabilitation purposes, is being used as an "off-label" treatment for certain immunologically-related disorders. The use of LDN for such diseases as cancer was first proposed by Ian Zagon, PhD, and LDN's broader clinical effects in humans were proposed by Bernard Bihari, MD[citation needed].

In Milan, Italy, a sixth month trial with a low dose of the opiate antagonist Naltrexone (LDN) was carried out in 40 patients with primary progressive multiple sclerosis (PPMS). It reported that neurological disability progressed in only one patient, and that a significant reduction of spasticity was measured at the end of the trial. It also reported that BE concentration increased during the trial, but that no association was found between OPRM1 variants and improvement of spasticity. There were two "major adverse events" and five dropouts from the trial, resulting in an extremely small sample group. The two adverse events were not connected with LDN or MS. Multiple Sclerosis. 2008 Sep;14(8):1076-83. A pilot trial of low-dose naltrexone in primary progressive multiple sclerosis. http://msj.sagepub.com/cgi/content/abstract/14/8/1076

Low-dose naltrexone (LDN) may be useful in treating fibromyalgia, according to research by Jarred Younger, Ph.D., and Sean Mackey, M.D., of the Stanford University School of Medicine in Palo Alto, Calif. The authors of the report write: "We conclude that LDN is a drug that should be researched more thoroughly for the treatment of fibromyalgia, and perhaps more generally for conditions associated with elevated erythrocyte sedimentation rate." The American Fibromyalgia Syndrome Association provided financial support for the study. http://snapl.stanford.edu/research/ldn.html

The results of an open-label pilot study at Pennsylvania State University College of Medicine were reported to an international gastroenterology conference in Los Angeles in May 2006. The trial examined the safety and efficacy of LDN in a group of patients with Crohn's disease. Dr. Jill Smith, Professor of Gastroenterology at Pennsylvania State University's College of Medicine concluded that "LDN therapy appears effective and safe in subjects with active Crohn’s disease."[1] Smith and her colleagues have since received a NIH grant and are proceeding with a definitive Phase II placebo-controlled clinical trial.

There is some in vitro data that may suggest the potential benefits of LDN therapy[citation needed]. Many anecdotal accounts and case reports have also been cited in favor of LDN therapy Those Who Suffer Much Know Much, July 2009 is the first book to contain LDN patient testimony in detail, as case studies. It contains 47 low dose naltrexone patient case studies , researched over many years and produced by Cris Kerr of Case Health as a community service. Some of the many conditions for which LDN has been reported as beneficial include multiple sclerosis (in particular, the primary progressive variant[2]), Crohn's disease, HIV/AIDS, chronic fatigue syndrome, irritable bowel syndrome, psoriasis, fibromyalgia, ALS, autism in children, depersonalization disorder, and cancer. Several clinical trials have been planned and a few are currently taking place.

Various low doses of Naltrexone have also been used as part of the "NaProTECHNOLOGY" fertility treatment, a commercially trademarked and heavily marketed product aimed at religious adherents who may have moral objections to common birth control and fertility treatments. [1][2]

Contents

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[edit] Pharmacology

It has been theorized that LDN works in multiple modalities. Without formal studies, there is no formal conclusion as of yet, but the generally accepted theory posited originally by Dr. Bihari is as follows:

Beta-endorphins are important regulators of the immune system. Naltrexone, which is a pure antagonist to opiates, causes an artificial blockade of the endorphin/opioid receptors in the brain. However, unlike the normal (~50 mg) dose of naltrexone used to treat drug addiction, which maintains this blockade continuously for 24 hours (preventing any derived pleasure from taking the forbidden drugs), low dose naltrexone (~3 mg to 4.5 mg) blocks the endorphin receptors for only a couple of hours. During that time, endorphins fail to attach to the receptors and the body compensates by creating more endorphins. (Note that Dr. Bihari prescribes LDN to be taken at bedtime to take advantage of the body's pre-dawn boost in endorphin production.) Once the low dose naltrexone dose has been metabolized, the body is left with a "normal" amount of endorphins as compared to healthy controls, which consequently "normalizes" the immune function. The link between endorphins and immune system regulation is a good candidate for more research.

Since 2005, at least 3 separate scientific reports have described an underlying immunodeficiency as being characteristic of four different autoimmune diseases, including multiple sclerosis, rheumatoid arthritis, Crohn's disease and chronic fatigue syndrome.[3][4][5] In addition, recent scientific research has demonstrated abnormally low beta-endorphins in all forms of multiple sclerosis.[6]

In April 2006 an LDN conference was held at the National Cancer Institute. Several lecturers were present discussing the use of LDN in Crohn's disease, multiple sclerosis, general autoimmune disease, and cancer. One participant, Burton M. Berkson MD PhD of Las Cruces, New Mexico discussed his experience treating metastatic pancreatic cancer and B cell lymphoma with LDN at bedtime.

{Berkson, BM, Rubin D, and Berkson AJ (2006) "Long term survival of a 46 year old man with pancreatic cancer and liver metastases and treated with intravenous alpha lipoic acid and low dose naltrexone." Integrative Cancer Therapies 5:1,83-89. PMID: 16484716}{Berkson, BM, Rubin D, and Berkson AJ (2007) "Reversal of signs and symptoms of a B-cell lymphoma in a patient using only low-dose naltrexone."Integrative Cancer Therapies" Sep;6(3):293-6. PMID: 17761642} His images showing the reduction and elimination of tumours and metastaces are impressive.

[edit] Alleged Controversy

Some Doctors are reluctant to prescribe LDN for multiple sclerosis patients, as LDN boosts the immune system.[citation needed] More accurately, LDN is believed to restore normality to the immune system, which leads to correct immune system behavior. However, the large number (over 50,000) of people using it for MS without experiencing worsening of their condition suggests that the prevailing model is flawed. This is one of the most significant points of controversy in this debate.

It is a fact that some doctors prescribe LDN to MS patients via a telephone conversation, without even seeing the patients or their medical records. This practice has evolved out of desperation to get LDN. However, in trials, Naltrexone has been proven safe even for pregnant mothers. While it is strongly recommended to consult a doctor directly and one that requires you to provide medical records, there are now more and more doctors who will prescribe LDN.

Some who use LDN can experience vivid, memorable dreams for the first week or so and a very few with multiple sclerosis can also suffer increased stiffness in the beginning of use.[citation needed]

[edit] Conferences

The most recent LDN Conference was held on 19 October 2009 at the National Institutes of Health, near Washington D.C. [3]

Last year's Annual LDN Conference was held on 11 October 2008 at USC Health Sciences Campus, Los Angeles, California, USA.

The first European LDN Conference was held on 25 April 2009 at The Western Infirmary, Glasgow, Scotland, UK. The next is on 23-24 April 2010.

Bold text==References==

  1. ^ *Smith JP, Stock H, Bingaman S, Mauger D, Rogosnitzky M, Zagon IS (April 2007). "Low-dose naltrexone therapy improves active Crohn's disease.". Am J Gastroenterol 102 (4): 820–8. doi:10.1111/j.1572-0241.2007.01045.x. PMID 17222320.
  2. ^ Gironi M, Martinelli-Boneschi F, Sacerdote P, Solaro C, Zaffaroni M, Cavarretta R, Moiola L, Bucello S, Radaelli M, Pilato V, Rodegher M, Cursi M, Franchi S, Martinelli V, Nemni R, Comi G, Martino G (2008). "A pilot trial of low-dose naltrexone in primary progressive multiple sclerosis.". Multiple Sclerosis 14 (8): 1076–83. doi:10.1177/1352458508095828. PMID 18728058.
  3. ^ *Thewissen M, Linsen L, Somers V, Geusens P, Raus J, Stinissen P (June 2005). "Premature immunosenescence in rheumatoid arthritis and multiple sclerosis patients.". Ann N Y Acad Sci 1051: 255–62. doi:10.1196/annals.1361.066. PMID 16126966.
  4. ^ *Marks DJ, Harbord MW, MacAllister R, Rahman FZ, Young J, Al-Lazikani B, Lees W, Novelli M, Bloom S, Segal AW (25 February 2006). "Defective acute inflammation in Crohn's disease: a clinical investigation.". Lancet 367 (9511): 668–78. doi:10.1016/S0140-6736(06)68265-2. PMID 16503465.
  5. ^ *Vernon SD, Reeves WC (April 2006). "The challenge of integrating disparate high-content data: epidemiological, clinical and laboratory data collected during an in-hospital study of chronic fatigue syndrome.". Pharmacogenomics 7 (3): 345–54. doi:10.2217/14622416.7.3.345. PMID 16610945.
  6. ^ *Gironi M, Furlan R, Rovaris M, Comi G, Filippi M, Panerai AE, Sacerdote P (2003). "Beta endorphin concentrations in PBMC of patients with different clinical phenotypes of multiple sclerosis.". J Neurol Neurosurg Psychiatry 74 (4): 495–7. doi:10.1136/jnnp.74.4.495. PMID 12640071.

[edit] Further reading

  • Berkson, BM, Rubin D, and Berkson AJ (2006) "Long term survival of a 46 year old man with pancreatic cancer and liver metastases and treated with intravenous alpha lipoic acid and low dose naltrexone." Integrative Cancer Therapies 5:1,83-89. PMID: 16484716
  • Berkson, BM, Rubin D, and Berkson AJ (2007) "Reversal of signs and symptoms of a B-cell lymphoma in a patient using only low-dose naltrexone."Integrative Cancer Therapies" Sep;6(3):293-6. PMID: 17761642
  • Those Who Suffer Much Know Much, July 2009 is a free book containing 47 low dose naltrexone health success stories presented as case studies, produced by Cris Kerr of Case Health as a community service.
  • Wouk, Joseph (2009) "Google LDN ! : How an overlooked Drug Relieves Cancer, AIDS,MS, and Immune System Disorders for a Dollar a Day" Foreword by Bernard Bihari, M.D.
  • Moore, Elaine A. Author, Dr. Yash P. Agrawal (Foreword), Samantha Wilkinson (Collaborator)(2008) "The Promise Of Low Dose Naltrexone Therapy: Potential Benefits in Cancer, Autoimmune, Neurological and Infectious Disorders"
  • Bradley, Mary Boyle (2009) Up the Creek with a Paddle: Beat MS and All Autoimmune Disorders with Low Dose Naltrexone (LDN)

[edit] External links

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