Low-Dose Naltrexone (LDN) and MS
Naltrexone, in a low dose, can boost the immune system â€” potentially helping those with central nervous system disorders like multiple sclerosis.
By Ronald Hoffman, MD, and Skip Lenz, Pharm D FASCP
“LDN may well be the most important therapeutic breakthrough in over fi fty years,” says David Gluck, MD, editor of www.ldninfo.org, a Web site detailing the uses of low-dose Naltrexone (LDN). “It provides a new method of medical treatment by mobilizing the natural defenses of one’s own immune system.”
Naltrexone was approved by the FDA in 1984 in a 50 mg dose for the purpose of helping heroin or opium addicts, by blocking the effect of such drugs. By blocking opioid receptors, Naltrexone also blocks the reception of the opioid hormones that the brain and adrenal glands produce: beta-endorphin and metenkephalin. Many body tissues have receptors for these endorphins and enkephalins, including virtually every cell of the body’s immune system.
In 1985, Bernard Bihari, MD, a physician with a clinical practice in New York City, discovered the effects of a much smaller dose of Naltrexone (approximately 3 mg once a day) on the body’s immune system.
A small dose of the drug taken nightly at bedtime can double or even triple the endorphin levels in the body all of the next day, restoring levels to normal. Since endorphin levels are low in people with MS, immune function is poorly orchestrated with significant impairment of the normal immune supervisory function of CD4 cells. In the absence of normal orchestration of immune function, some of the immune system cells “forget” their genetically determined ability to distinguish between the body’s 100,000 unique chemical structures (called “self”) and the chemical structures of bacteria, fungi, parasites, and cancer cells (called “nonself”). With this loss of immunologic memory, some cells begin to attack some of the body’s unique chemical structures. In the case of people with MS, the tissue attacked by immune cells (particularly macrophages) is primarily the myelin that insulates nerve fibers. These attacks result in scars in the brain and spinal cord called plaques. Low Dose Naltrexone (LDN) in such patients seems to work by restoring endorphin levels to normal, thereby allowing the immune system to resume its normal supervision and orchestration.
In general, in people with diseases that are partially or largely triggered by a deficiency of endorphins (including autoimmune diseases) restoration of the body’s production of normal levels of endorphins could be one of the major therapeutic targets of LDN.
In Dr. Bihari’s practice, within the group of patients who presented with an autoimmune disease, none have failed to respond to LDN; all have experienced a halt in progression of their illness. In many patients there was a marked remission in signs and symptoms of the disease. The greatest number of patients within the autoimmune group are people with multiple sclerosis, of whom there were some 400 in Dr. Bihari’s practice. Less than 1% of these patients has ever experienced a fresh attack of MS while they maintained their regular LDN nightly therapy.
Up to the present time, the question of “What controls the immune system?” has not been present in the curricula of medical colleges and the issue has not formed a part of the received wisdom of practicing physicians. Nonetheless, a body of research over the past two decades has pointed repeatedly to one’s own endorphin secretions (our internal opioids) as playing the central role in the beneficial orchestration of the immune system, and recognition of the facts is growing.
Dr. Bihari’s experience and that of others who have prescribed LDN over the last 20 years is considered “anecdotal evidence” because there had been no real medical trials done of LDN. Today, there are three medical trials being performed on LDN and its effects on MS. One is being conducted in Milan, Italy; one in San Francisco, California; and one in Akron, Ohio. We will report more about those trials in next month’s Action.
If you are interested in finding out more about LDN, please visit www.ldninfo.org. This site provided most of the information being reported to you here.
Ronald Hoffman, MD, is founder and Medical Director of the Hoffman Center in New York City, author of numerous books and articles for the public and for health professionals, and host of the nationally syndicated radio program Health Talk. Skip Lenz, Pharm D FASCP, is a pharmacist in Boca Raton, Florida.