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Low Dose Naltrexone and Thyroid Autoimmunity

Published February 27 2017

Low dose naltrexone (LDN) is being prescribed for autoimmune conditions by a greater number of medical doctors these days.  And so it’s not surprising that many people with Graves’ Disease and Hashimoto’s Thyroiditis have asked me if they can benefit from taking LDN.  While LDN is something for some people with autoimmune thyroid conditions to consider taking, there are some drawbacks of taking this medication, which I will discuss in this article.

But what exactly is low dose naltrexone?   Naltrexone is an FDA-approved medication, although it was approved to help with heroin and opium addicts by blocking opioid receptors.  In 1985 Dr. Bernard Bihari experimented with lower doses of naltrexone, and realized that it can modulate the immune system.  Soon thereafter it was found that LDN can benefit many people with autoimmune conditions, although it can also help with certain types of cancers, as well as some other chronic health conditions.

Low Dose Naltrexone and the Research

Unfortunately there isn’t a lot of research regarding the benefits of low dose naltrexone.  One study showed that LDN might act as an anti-inflammatory agent in the central nervous system, and can help with chronic pain disorders (1) [1].  Another study showed that LDN can benefit those dealing with the pain associated with fibromyalgia (2) [2].  Another study concluded that it can be helpful for some people with gastrointestinal disorders (3) [3].  A small study suggests that LDN might help some people with active Crohn’s disease (4) [4].

You’ll notice that there aren’t studies I listed which show that low dose naltrexone can benefit those with autoimmune thyroid conditions such as Graves’ Disease and Hashimoto’s Thyroiditis.  But this doesn’t mean that LDN can’t help people with these conditions, as there also aren’t any studies which show that LDN is ineffective for thyroid autoimmunity.  The lack of research doesn’t mean that LDN shouldn’t be considered in some cases, and I’ve worked with patients who have done well taking LDN.  And I know other healthcare professionals who have worked with autoimmune thyroid patients that also did well when taking LDN.

Low Dose Naltrexone vs. Thyroid Medication

When someone is dealing with hypothyroidism or Hashimoto’s, most medical doctors will recommend thyroid hormone medication.  Similarly, it’s common for endocrinologists to recommend antithyroid medication for those with hyperthyroidism and Graves’ Disease.  And while managing the symptoms while addressing the cause of the problem is important, it might make sense to have someone take low dose naltrexone instead of thyroid medication.  And the reason for this is because if LDN works, then the person might not need to take thyroid hormone medication or antithyroid medication.

But why is this important?  Well, a condition such as Hashimoto’s Thyroiditis involves the immune system damaging the thyroid gland, and taking thyroid hormone medication isn’t going to do anything to stop or slow down this destruction.  On the other hand, LDN has the potential to prevent further damage of the thyroid gland from occurring, which is why some people with Hashimoto’s are able to reduce the dosage of their thyroid hormone medication, and in some cases even stop taking it after starting LDN.

As for those patients with hyperthyroidism and Graves’ Disease, while many people do fine taking antithyroid medication such as Methimazole, this isn’t always the case.  And if someone can’t take antithyroid medication because it increases their liver enzymes, or if they have a sensitivity to one of the ingredients, then many endocrinologists will further pressure the patient to receive radioactive iodine or thyroid surgery.  But by modulating the immune system, LDN might help some people who can’t tolerate antithyroid medication to avoid radioactive iodine and thyroid surgery.

Are There Risks Associated With Taking Low Dose Naltrexone?

Although side effects are rare with LDN, there are a few things you need to know before taking this:

1. LDN doesn’t do anything to address the cause of the problem.  Although LDN can modulate the immune system, it doesn’t do anything to address the underlying cause of Graves’ Disease or Hashimoto’s Thyroiditis.  Of course one can choose to take LDN while trying to detect and remove the autoimmune trigger, and I’ve worked with some patients who chose to do this.

2. LDN doesn’t always work.  Although I can’t say that I’ve had a lot of patients who have taken LDN, I’ve worked with enough to see that LDN sometimes is effective, while at other times it doesn’t seem to help at all.  This is a big reason why in most cases LDN wouldn’t be a good first option for someone with hyperthyroidism or Graves’ Disease, as if someone is experiencing moderate to severe cardiac symptoms then it’s important to get these symptoms under control quickly.  On the other hand, as I mentioned earlier, LDN should be considered in those with hyperthyroidism who don’t do well when taking antithyroid medication such as Methimazole or PTU.

3. LDN can affect sleep.  Initially it is common for LDN to interfere with sleep.  However, this seems to be more common in those people who start with a higher dosage (i.e. 4.5mg), and so if this occurs you would want to lower the dosage.  Or better yet, start with a lower dosage of LDN and then gradually increase it if necessary.

Getting Your Body Ready For Low Dose Naltrexone

In the past, Shannon Garrett wrote a guest blog post [5] on my website that focused on LDN.   Shannon was diagnosed with Hashimoto’s Thyroiditis, and LDN has helped her a great deal.  In the blog post she mentioned that it took nine months to get her body in a healthier state before she even started LDN.  So before taking LDN she recommends to correct nutrient deficiencies, improve the health of your adrenals, and to do things to heal your gut and eradicate infections.

How To Find A Doctor Who Will Prescribe Low Dose Naltrexone

How can you find a medical doctor who would be willing to prescribe LDN?  In the opening paragraph I mentioned how more and more medical doctors are prescribing LDN, but the truth is that many medical doctors still aren’t open to prescribing LDN.  One of the main reasons for this is because most medical doctors aren’t aware of the benefits of LDN with regards to autoimmunity.  With that being said, you can contact some of the local pharmacists and see if they can refer you to a medical doctor who prescribes LDN.  After all, the pharmacists are the ones who fill the prescriptions, and so they should know if any local medical doctors prescribe LDN.  Also visit the website http://www.lowdosenaltrexone.org/ [6].

In summary, low dose naltrexone (LDN) can benefit some people with Graves’ Disease and Hashimoto’s Thyroiditis.  It does this by modulating the immune system.  In fact, in some cases LDN can be used as a substitute for thyroid hormone or antithyroid medication.  Just keep in mind that LDN doesn’t do anything to address the cause of the problem, and it doesn’t always work in those with autoimmune thyroid conditions.  One reason why it might not work is because you might need to correct certain imbalances first.  Finding a medical doctor who prescribes LDN can be a challenge, although you can contact some local pharmacists to help with your search.