I am 35 and was diagnosed with MS three years ago. I just heard about low-dose naltrexone therapy, and it sounds promising, but I would like to know more about it. How can it work for so many different conditions, and do you think it might be right for me

Low-dose naltrexone (LDN) is just an off-label use of the FDA-approved drug naltrexone. Any physician can write the prescription for you. Rather than the original 50 mg daily of naltrexone for those addicted to narcotics or alcohol, LDN is used at doses between 1.5 and 4.5 mg and is generally taken at bedtime.

LDN works by blocking the body’s opioid/narcotic receptors for just a few hours rather than the all-day blockade caused by the standard 50 mg dosage. The opoid/narcotic receptors are the same receptors used by the body’s endorphins. The body responds to this temporary blockade by greatly increasing its endorphin production, and those higher levels last all day—far after the blockade by LDN has ended. Endorphins are the major normalizer/upregulator of one’s immune system.

This is of critical importance to anyone who has an autoimmune disease. Published studies have demonstrated that all autoimmune disorders tested thus far are marked by weak, dysfunctional immune systems (in contrast to the common belief that they are probably too strong). This makes good sense, because the first commandment of the immune system is “Thou shalt not attack self!” Only a dysfunctional immune system attacks self.

When the LDN normalizes one’s immune system, it halts the further progression of any autoimmune disease. When one takes LDN, one is regaining a normalized immune system, and it is the immune system that has such a positive effect on such a wide variety of conditions.

We have already noted positive benefits from LDN in those with HIV, any autoimmune disorder, many cancers, Parkinson’s disease, motor neuron diseases like ALS, COPD, and in childhood autism.

LDN has been especially popular for a great number of people who suffer from MS because it is beneficial in a high percentage of patients and it is the antithesis to the spectrum of “approved” anti-MS medications, which are questionably effective, often painful and problematic to use, sometimes dangerous, and always expensive. In contrast,

LDN is almost always effective, easy to use, nontoxic, easily affordable, and has virtually no significant side effects.

Because naltrexone has been a generic drug for many years, no large pharmaceutical company will invest a dime in the large research costs needed to gain FDA approval of these special new off-label uses of the medication. No one makes any significant money from sales of LDN! Nonetheless, there have been many small studies of LDN performed at outstanding medical centers, all showing it to be safe and effective. Check my website for detailed information on the research (ldninfo.org/ldn_trials.htm).

There have been two very promising studies regarding MS. The first comes out of a group of hospitals in Milan, Italy. In this study, 40 patients with primary progressive MS (PPMS) were treated with LDN over a period of six months, and only one patient showed any sign of disease progression! (This is especially significant because there is no recognized treatment for PPMS.)

The other study—performed by UCSF, one of the best neurology departments in the U.S.—was very brief, but showed that within eight weeks of LDN treatment there were already statistically positive improvements.

I am aware of only two substantial contraindications to LDN’s use. The first is that the potential user must not be dependent on daily narcotic-containing pain medications. Remember that naltrexone is a pure opioid antagonist, so even one little capsule of LDN taken by such a person might well lead to a prompt and dangerous withdrawal reaction. The other contraindication is based on a supposition: we believe that anyone who has had an organ transplant, and thus must take daily immunosuppressant medications, ought not start using LDN, as it reliably strengthens one’s immune system.

Use of LDN is generally compatible with all other treatments or medications, with these few caveats:

• Use of any narcotic-containing pain medication during the same few hours (about five hours) of LDN’s activity is unwise because LDN will block that drug’s effect.

• Use of immunosuppressant medications for any length of time will act to counter LDN’s benefits, most of which are based on its ability to normalize the immune system.

Because LDN is a prescription drug that is made by compounding pharmacies, and because there can be a rather high rate of error in compounding, I strongly recommend using only those pharmacies recognized for their expertise in compounding effective supplies of LDN. On my website’s home page (ldninfo.org), is a list of pharmacies in the U.S., Canada, and the U.K., that are highly recommended for LDN because they have proven themselves over many years. They all ship it to you promptly and are inexpensive.

In summary, if you have MS and you don’t have either of the improbable contraindications that I’ve noted above, then by all means get started on LDN as soon as you can.

David Gluck, MD, is a board-certified specialist in both internal medicine and preventive medicine. Dr. Gluck has served as medical director for JCPenney and MetLife, and is now semi-retired, living and working in New York City.