Naltrexone is approved at 50mg for opioid and alcohol dependence. At a fraction of that dose, researchers have studied it off-label for a different set of conditions entirely: fibromyalgia pain, mood symptoms, multiple sclerosis, and Crohn’s disease.
BEST FOR
Adults with fibromyalgia-type pain, mood symptoms, or inflammatory gut conditions unresponsive to standard options
METHOD
Oral tablet, dosing form varies by provider
FREQUENCY
Once daily before bedtime
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At low doses, naltrexone briefly blocks opioid receptors, which appears to trigger a rebound rise in the body’s own endorphins and to quiet inflammatory signaling in the nervous system.
Randomized trials have tested low-dose naltrexone in fibromyalgia, major depressive disorder, multiple sclerosis, and Crohn’s disease, giving providers real trial data to weigh, even where results were mixed.
Naltrexone is not a controlled substance and carries none of the dependency risk of opioids, part of why providers are willing to try it off-label where other options haven’t worked.
LDN modulates Toll-like receptor 4 signaling, which is thought to reduce inflammatory activity in the nervous system, the basis for its use in inflammatory conditions like Crohn’s disease.
Naltrexone is an opioid receptor antagonist approved for treating opioid and alcohol dependence at 50mg. At low doses (1 to 5mg), it works through a different mechanism called transient opioid modulation.
A small nightly dose briefly blocks opioid receptors, prompting your body to upregulate endogenous opioids and receptor sensitivity. This rebound effect is the basis for its off-label use in fibromyalgia, mood, and inflammatory gut conditions.
Our board-certified providers review your health history, current medications, and the condition you’re managing to determine whether LDN is appropriate to discuss further.
If your provider determines LDN is appropriate, dosing and next steps are set individually rather than following a fixed protocol.
The endorphin rebound and immune-modulating effect build over several weeks rather than working immediately, which is why clinical trials measure outcomes at 8 to 12 weeks, not days.
Your provider orders follow-up labs and your Personal Health Coach checks in regularly. We reassess based on how your actual symptoms have responded.
Standard naltrexone (50mg) is a full opioid antagonist used for addiction treatment. Low dose naltrexone (1 to 5mg) creates a brief, transient receptor blockade that triggers your body to upregulate its own endorphins and opioid receptors. This rebound effect is the mechanism studied in fibromyalgia, mood, and inflammatory bowel conditions.
The evidence is mixed. A 2023 randomized controlled trial in the Lancet found LDN did not show statistically significant superiority over placebo for fibromyalgia pain, while a separate systematic review reached more favorable conclusions. Providers weigh both before recommending it.
The most common side effects during the first 1 to 2 weeks are vivid dreams, mild headache, and temporary sleep disruption. These typically resolve as your body adjusts. Our providers monitor your response at each check-in and adjust your dose if needed. Naltrexone itself is not a controlled substance, unlike the opioids it blocks.
This depends on your current medications. Some drugs interact with naltrexone, which is why our board-certified providers review your full medication list during your initial evaluation. LDN cannot be combined with any opioid medication, including opioid pain relievers, without risking withdrawal or blocking that medication’s effect.
The 50mg dose sustains opioid blockade to treat addiction. The low dose, roughly 1 to 5mg, is thought to work through a brief rebound effect on endorphins and immune signaling instead, which is why it’s studied for conditions like fibromyalgia and Crohn’s disease rather than dependency.
