Low Dose Naltrexone (LDN): A Gentle, Powerful Ally for Numerous Conditions—Pain, Inflammation, IBS, Autoimmune Support, Weight Loss, and Beyond

At my menopause-focused clinic, I’m always on the lookout for gentle, effective options that help women feel better. One treatment I’m newly offering is Low Dose Naltrexone (LDN)—a medication that’s gaining attention for its wide-ranging benefits, especially in chronic inflammatory and autoimmune conditions.

What Is Low Dose Naltrexone (LDN)?

Naltrexone is a medication traditionally used in much higher doses (25–100 mg or more) to treat opioid and alcohol dependence. LDN refers to the off-label use of naltrexone in very small doses, typically between 0.5 and 9 mg. At these lower doses, it behaves very differently—supporting the body’s ability to modulate inflammation, regulate the immune system, and increase natural endorphins.

It’s important to note that this is not an FDA-approved use for naltrexone, but it has been used off-label for many years with a strong safety profile and growing support from physicians, pharmacists, and patients alike.

How LDN Works: A Multifaceted Approach

LDN affects several key systems in the body:

• Endorphin release: LDN boosts the body’s endorphin production, which is often suppressed in people with chronic inflammatory or autoimmune disorders.

• Opioid receptor modulation: It temporarily blocks opioid receptors, triggering a rebound effect that enhances the body’s own pain and mood regulation systems.

• Dopamine pathways: LDN may influence dopamine signaling, supporting mood, focus, and motivation.

• Inflammatory response: It helps down-regulate overactive inflammatory pathways and immune overreactions.

• Immune system balance: Unlike biologics that suppress the immune system, LDN helps the immune system self-regulate—calming it when it’s overactive while keeping it functional.

  
  

Who Might Benefit from LDN?

LDN has shown promise in:

• Rheumatoid arthritis

• Hashimoto’s thyroiditis

• Crohn’s disease

• Multiple sclerosis

• Fibromyalgia

• Chronic fatigue syndrome

• IBS

• Endometriosis

• Long COVID

• Menopausal joint pain, brain fog, and inflammation

• Patients unable to use hormone therapy due to hormone-sensitive cancers

• Restless leg syndrome

• Patients struggling with weight loss

  
  

I’ve recently started offering LDN in my practice. One patient is a woman whose arthritis didn’t improve with estradiol and another has chronic back pain that hasn’t responded to traditional treatments. I anticipate many more patients with the above conditions (and others) will trial this medication with me in the future. I’m also especially excited about using it for menopausal patients who cannot take hormones due to active or recent hormone-sensitive cancers. For these women, options are limited—and LDN might offer relief without affecting hormone levels.

What Patients Are Saying

According to Stephanie at Pure Scripts Pharmacy in Bloomington, MN, who has extensive experience compounding LDN:

“About 85% of patients say LDN is a life changer.”

It’s an encouraging statistic for those who feel like they’ve tried everything.

Unexpected Benefits

One interesting effect seen is relief from restless leg syndrome (RLS). Patients who started LDN for pain or inflammation sometimes report that their RLS improves, which is wonderful for such a frustrating and hard-to-treat condition.

Some patients also experience improved control over emotional eating and cravings. Because LDN affects the brain’s reward system, it may help reduce addictive behaviors—including food addiction—and support weight loss indirectly.

Alcohol and Opioid Considerations

LDN may make alcohol less enjoyable for some. While you can drink on LDN, some people find they no longer crave alcohol or feel slightly hungover even after a small amount. It often changes your relationship with drinking.

LDN should not be taken with opioid medications, as it may block their effect or cause withdrawal. If you're on opioids, LDN isn't safe to use without careful medical supervision.

Dosing: Start Low, Go Slow

LDN is extremely patient-dependent. Some patients feel best at 1.5 mg; others need 4.5 mg or more. We usually start at 0.5 mg and increase gradually. Most patients tolerate it well, but side effects like vivid dreams, mild nausea, or sleep issues can occur early on.

The key to success is a personalized, slow titration based on your body’s response. I work closely with a knowledgeable compounding pharmacist to guide each patient safely.

Cost and Accessibility

One of the best parts? LDN is affordable. Most patients pay around $30–60 per month from a compounding pharmacy, making it an accessible option for long-term care.

A Physician's Reflection

I recently attended a 90-minute presentation on LDN and left feeling like I had just added a brand new tool to my menopause care toolkit. I could have inserted the words "menopause" and "estrogen" throughout much of the talk—which only reinforced my belief that menopause is, for many, an inflammatory condition.

Estrogen receptors throughout the body are left "empty" during menopause. Some estrogen receptors even multiply to try and catch any remaining circulating estrogen. This hormone drop causes widespread discomfort and dysfunction in areas like joints, brain (leading to hot flashes and mood disruption), skin, pelvic region, bladder, and gut to name a few. LDN may help by calming the inflammation that results from this estrogen withdrawal.

Final Thoughts

I’m new to using LDN, but the experiences of colleagues and pharmacists like Stephanie at Pure Scripts—have me excited and optimistic. For patients who are struggling with inflammation, pain, or hormone-free menopause care, this may be a valuable and affordable tool worth exploring.

If you're curious about whether LDN might help you, let's talk. This is exactly the kind of personalized care I love providing.