Low dose naltrexone (LDN) is a treatment that is being studied for a variety of chronic conditions that affect inflammatory processes in the body. One chronic condition that LDN is being used to treat is rheumatoid arthritis, which affects more than 1.3 million Americans. While the clinical research for this particular application is preliminary, patients are already finding that regular treatment with LDN improves their rheumatoid arthritis symptoms. Patient reports and initial clinical trials have demonstrated that low dose naltrexone is a promising treatment with few side effects.
What is Low Dose Naltrexone for Rheumatoid Arthritis?
The FDA-approved drug naltrexone is used for treating opiate addiction at a dose of 50mg or higher. Low dose naltrexone is the same drug, except it is taken at doses of 0.5mg-4.5mg. At these low doses, there are few side effects and treatment is well tolerated by most patients. At a dose of about 1/10th of that which is used for managing addiction, naltrexone exhibits beneficial effects on the immune system and increases endorphin production.
LDN is inexpensive as far as treatments for rheumatoid arthritis go and most patients can afford the monthly cost. It requires a prescription and can only be obtained from a compounding pharmacy as the lower dosages of naltrexone are not commercially available. The most common directions for LDN are to take it once per day before bedtime. It is important that the capsules are not slow-release as this will alter how the drug works to increase endorphin production.
The symptoms of rheumatoid arthritis that can be improved with low dose naltrexone include joint pain, joint swelling, fatigue, stiffness, and more. At the LDNscience.org website there is a great personal account of a woman with rheumatoid arthritis who takes LDN regularly. She has seen a reduction in pain and inflammation as well as increased energy and a reduction in flare-ups of her arthritis.
Why is Naltrexone FDA Approved but Not LDN?
The effectiveness of naltrexone at lower dosages was first documented in 1985 by Dr. Bernard Bihari, who treated patients with many types of chronic conditions and cancer. Since naltrexone is now available as a generic drug, there is not much financial incentive for a pharmaceutical company to go through the complicated process of getting FDA approval for the lower dose. Since 50mg naltrexone is already approved by the FDA, the majority of doctors feel confident in prescribing the much lower 0.5mg-4.5mg dose to treat their patients.
While there are several drugs that are approved for treating rheumatoid arthritis, most of them have undesirable side effects. Low dose naltrexone is unique among rheumatoid arthritis treatments in that it is non-toxic and has few side effects. No adverse effects or withdrawal symptoms have been reported in the few clinical trials that have been conducted. Most studies report that LDN is rated slightly more tolerable than placebo. Additionally, there is no abuse potential as the drug does not produce any addictive effects.
Can You Make Dosages of LDN for Rheumatoid Arthritis at Home?
Although there are resources online that demonstrate how to make daily dosages of LDN out of a full 50mg naltrexone capsule, this method is not recommended. There can be a high day-to-day variability in dosages by dividing it at home. Having LDN compounded by a pharmacy ensures that the accurate dose is obtained for consistent results. Consistency is important to maintain the effectiveness of the medication and for compliance with treatment. For example, if a patient accidently gets lower doses than usual for a few days they may think that the LDN is no longer working and discontinue treatment. This will prevent a patient from benefiting from the symptom relief LDN can provide and make them feel that their treatment is ineffective.
Research on LDN for Rheumatoid Arthritis
On the blog Cure Together, information was compiled from a survey of rheumatoid arthritis patients who visited the blog. This information was made into a chart that shows the popularity of a treatment relative to its effectiveness. LDN was shown to have low popularity but high effectiveness as reported by patients. Although not many rheumatoid arthritis patients have tried low dose naltrexone, the ones that have tried it find that their symptoms are improved without experiencing any significant side effects.
A clinical trial involving 60 patients is currently underway that will compare LDN to placebo in treating rheumatoid arthritis, osteoarthritis, and psoriatic arthritis. The treatments will continue and data will be collected until March 2019. Until the results of these small clinical trials are published, healthcare practitioners will continue to prescribe LDN for rheumatoid arthritis due to consistent positive feedback from their patients.