There is a lot of talk in the MS community about a treatment known as “LDN,” or “low dose naltrexone.”  Much of the talk is confusing and controversial.  On one hand, there are people who claim that LDN is remarkably effective for treating MS symptoms and slowing down the disease course.  On the other hand, there are those who state that LDN should not be used by anyone with MS.  What is the truth?

The Basics of LDN
Before considering the evidence related to LDN, it is important to know some basic information.  The “LD” of LDN refers to the use of “low dose” treatment, while the “N” refers to naltrexone, an oral medication that is approved by the Food and Drug Administration (FDA) for the treatment of alcohol and opiate addiction.  The typical dose of naltrexone is 50 milligrams daily.  With “low dose” treatment, daily doses of 1.5-4.5 milligrams are used.  LDN is claimed to be effective for MS as well as multiple other diseases, including cancer, AIDS, rheumatoid arthritis, and Crohn’s disease.

The reason why LDN could be beneficial for MS and other diseases is not clear.  It has been claimed that LDN produces changes in the immune system that decrease disease activity in MS.  It has also been proposed that LDN decreases the harmful effects of two classes of chemicals in the nervous system, “free radicals” and “excitotoxins.”

LDN and MS
At this time, the clinical evidence about LDN is limited but growing rapidly.  In MS, there are many anecdotal reports of people with MS experiencing benefits while taking LDN.  There are also anecdotal reports that LDN is usually well tolerated but that it may worsen muscle stiffness.  Many of these anecdotal experiences with LDN may be found on the Internet. 

To determine whether LDN has beneficial (or harmful) effects in MS, several studies are underway.  One of these studies is being done at the University of California at San Francisco.  This study is examining whether LDN has an effect on quality of life and multiple MS symptoms.

LDN and Other Diseases
In other diseases, small clinical trials have been published.  One of these studies found that LDN produced improvement in Crohn’s disease, an immune disease of the intestines.  Another study reported that LDN increased the number of pain-free days in those with another gastrointestinal condition known as irritable bowel syndrome.

What to do Now?
What can one do with the current information about LDN?  As noted, the information is limited--it is not known whether LDN is beneficial, is harmful, or has no effect on those with MS.  With limited information, it is reasonable to wait until more rigorous information becomes available before using this therapy.  If LDN use is being considered, one should discuss LDN with their health provider.  In addition, if LDN is used, it should be recognized that the safety and effectiveness information is limited and that LDN should not be used instead of conventional disease medications (such as interferons (Avonex, Betaseron, Rebif) and glatiramer acetate (Copaxone)).

A very important consideration in the LDN area is that research is needed.  As noted, there is a current study that is being done at the University of California at San Francisco.  Formal studies are the only way to determine whether LDN—or any other new therapies—are truly helpful or harmful to those with MS.  For LDN, human and animal studies need to be done to determine whether LDN produces immune changes and clinical benefits.

Post your experiences or thoughts about LDN in the comment area below.