If you have autoimmune Hashimoto’s or Graves’ disease, your treatment almost always focuses on resolving the hypothyroidism or hyperthyroidism associated with these conditions. At the same time, you are usually told by physicians that there is nothing you can do to treat your underlying autoimmune disease.
Cutting-edge integrative health experts say that’s not true, and point to the innovative use of low-dose naltrexone — often referred to as LDN — as a treatment that can help some autoimmune disease patients.
What is low-dose naltrexone?
Naltrexone is approved by the Food and Drug Administration (FDA) to help combat opioid and other addictions and is typically prescribed at doses above 50 mg per day. One of naltrexone’s early adopters, the late Bernard Bihari, M.D., was the first to discover that very low doses of naltrexone — typically from 1.5 to 4.5 mg per day — had the ability to modulate the immune system, lower autoimmune antibodies, and could treat a variety of conditions, including cancer, HIV/AIDS, and a variety of autoimmune diseases, including multiple sclerosis, rheumatoid arthritis, Hashimoto’s thyroiditis, and Graves’ disease. The LDN Research Trust has a list of over 100 conditions LDN has successfully treated.
It's thought that LDN affects endorphin levels, shutting off cells that promote autoimmune responses, and stopping or stalling the inflammatory reactions and the destruction associated with autoimmune disease.
For several decades, LDN has been used by a small subset of physicians as a treatment for autoimmune diseases, including thyroid diseases. It’s important to note, however, that naltrexone has FDA-approval only at high doses for addictions. The use of the medication at low doses for autoimmune diseases, cancer, or HIV/AIDs is considered “off-label” use. The FDA gives physicians discretion to prescribe drugs “off-label” for other than their approved conditions.
Low doses of naltrexone are available only by prescription. Generic tablets are available, but in-the-know physicians favor specialized compounding into the appropriate lower doses. Many insurers and HMOs do not cover naltrexone except for addiction treatment. Even when compounded, however, naltrexone is inexpensive, and typically does not cost more than $50 per month, even out-of-pocket.
Taking LDN for autoimmune thyroid disease
If you are going to try LDN, it’s helpful to have a thyroid panel, including thyroid antibodies, thyroid stimulating hormone (TSH), free T4 and free T3 levels measured before you start, as a baseline for comparison.
Most experts recommend starting with a low dose of naltrexone, from .5 to 1.5 mg, taken at night, and slowly tapering up to a total of 3 to 4.5 mg per night. While LDN does not work for everyone with autoimmune thyroid disease, if it is going to work for you, you will typically notice improvements in symptoms, such as a reduction in fatigue, aches, and pains, within several months of starting treatment. You may also see reductions in thyroid antibody levels, and more optimal TSH levels, as well as improved free T4 and free T3 levels after treatment is started.
Thyroid patients are cautioned to have regular thyroid monitoring during LDN therapy, because normalization of your thyroid function may result in your needing less thyroid hormone replacement medication for hypothyroidism or less antithyroid medication for hyperthyroidism.
Side effects of LDN
LDN is considered very safe. The main side effects reported are sleep disturbances, vivid dreams, nausea, and irritability. These side effects frequently go away over time, or can be eliminated with a dosage decrease.
Keep in mind that if you are taking LDN, you need to stop before having any surgery that will require you to take opioid pain medication. Also, be sure to let any healthcare practitioners know that you are taking LDN.
Getting LDN from your doctor
Patient advocate and author of The Power of Honest Medicine, Julia Schopick, talked about the challenge in getting a doctor to prescribe LDN in an interview:
“Most conventional doctors do not know about Low Dose Naltrexone for autoimmune diseases, and those that have heard of LDN aren’t interested in learning more about how it can help their patients. Luckily, tens of thousands of patients have found it for themselves and are advocating for it all over the world. Thanks to LDN patient advocates, it is relatively easy for patients to find doctors who will prescribe it and compounding pharmacists who compound it correctly.”
Schopick, whose 2018 book highlights the successful use of LDN for autoimmune patients around the world, recommends connecting with LDN advocates for recommendations (see the resources list below). You can also consult the LDN Research Trust’s list of LDN prescribing doctors and LDN pharmacists for information.
Some people take LDN continuously for life, but others find that over time, you can taper off and discontinue the medication, without antibodies flaring, or a return to autoimmune thyroid disease. It appears that in some patients, the immune system “reboot” is permanent.
Some of the top resources for information on LDN, including for autoimmune thyroid disease, include:
In Julia Schopick’s book “Honest Medicine,” and at these sites, you can also read research studies and patient testimonials regarding health turnarounds and resolution of autoimmune diseases — including Hashimoto’s thyroiditis and Graves’ disease — as a result of LDN therapy.