Thyroid problems affect millions of people in the United States and worldwide, but treatment options are limited.
Conventional treatments for thyroid disorders rely on surgery and drugs whose goal is to suppress production or deliver thyroid hormones, depending on the condition.
Men and women who deal with thyroid-related issues also use natural dietary supplements to support their health, but lately, the use of low dose Naltrexone has become frequent for this purpose.
Does low dose Naltrexone really work? We aimed to find out.
What is Naltrexone?
In order to understand potential low dose Naltrexone and thyroid relationship, it is important to discuss this drug first.
What is, actually, Naltrexone?
Well, Naltrexone is a type of medication that is primarily used to help alcohol abusers and narcotic dependents to beat their addiction.
In 1963 Naltrexone was synthesized for the first time and the process was performed by Z. Metossian at Endo Laboratories, a small pharmaceutical company from New York[i].
Two years later, in 1965, the new medication was characterized, and it was discovered that Naltrexone was orally active. Four years after the synthesis of Naltrexone, in 1967, Endo Laboratories patented the drug.
The drug, which is sold under names such as Revia, Vivitrol, is recommended together with counseling to men and women who have already stopped drinking or using narcotics.
Basically, the drug aims to aid their recovery process and prevent them from seeking alcohol or drugs again.
It is a common misconception that Naltrexone is a drug that cures addiction and all a person has to do is to get a prescription. The medication shouldn’t be used to treat people who are still engaging in heavy drinking sessions or use of street drugs[ii].
The drug works by blocking the effects of narcotics, particularly the feeling of “high” that makes a person want to use alcohol or drugs over and over again. Naltrexone has a high absorption rate; following the oral administration about 96% of the dose is absorbed by the gastrointestinal tract[iii].
What is low dose Naltrexone?
The term low dose Naltrexone (LDN) refers to the off-label use of this medication in smaller doses in order to address health problems that aren’t related to its initial purpose.
The LDN works to block the ζ-opioid factor (also known as opioid growth) and receptors pathways. In turn, the immune system and body’s natural defenses can become stronger.
When this particular pathway is blocked, your body tries to compensate by producing its natural opioids such as beta-endorphin and met-enkephalin.
Many tissues in the human body and all cells have receptors for these enkephalins and endorphins. What’s more, autoimmune diseases tend to be triggered by low blood levels of endorphins and this is exactly why LDN is used to address many conditions.
More precisely, LDN has the potential to correct deficiencies in the body’s natural opioids and, thereby, address its responses to sickness and disease. The drug promotes DNA synthesis and slows down the motility in the gastrointestinal tract to promote healing.
Besides increasing endogenous opioids level, LDN also inhibits pro-inflammatory cytokines and promotes nuclear opioid growth factor.
Low dose Naltrexone and thyroid autoimmunity
Hashimoto’s thyroiditis and Graves’ disease are autoimmune conditions that affect the butterfly-shaped gland. The first condition is one of the most frequent causes of hypothyroidism while the latter disease is associated with hyperthyroidism.
Bearing in mind that the use of LDN has become common among patients with autoimmune conditions, it is natural to wonder whether it could be helpful for thyroid autoimmunity too. As you’re already aware, the term autoimmunity refers to the instances when the body’s immune system starts attacking healthy cells and tissues, in this case, thyroid.
Since many doctors do recommend low dose Naltrexone to their patients, scientists have become intrigued by this drug. At this point, many studies are still in process and the available evidence on this subject is limited until new works are published.
There are no published studies about the impact of LDN on autoimmune thyroid conditions, but it doesn’t mean the drug is ineffective.
Current studies on autoimmunity and LDN show positive results, meaning the medication has the tremendous potential to act on autoimmune conditions, regardless of their kind or form.
For example, a team of scientists from the Stanford University discovered that LDN exhibits anti-inflammatory effects in the central nervous system through action on microglial cells.
Microglia are a type of neuroglia cells which are located throughout your brain and spinal cord. The study revealed these effects are unique to low dose Naltrexone and are entirely independent from the drug’s on opioid receptors. As a daily therapy, LDN is well-tolerated and affordable[iv].
The journal Arthritis and Rheumatism published a study which found that LDN has a specific and clinically beneficial influence on fibromyalgia pain. The intake of this drug also increased participants’ general satisfaction with life and improved mood[v].
These findings are particularly important if you take into consideration that fibromyalgia is associated with autoimmune thyroid conditions such as Hashimoto’s thyroiditis.
Evidence shows that prevalence of fibromyalgia among Hashimoto’s thyroiditis patients is 62%. In addition, studies reveal that consideration of the fibromyalgia component in the management of Hashimoto’s increases the likelihood of treatment success[vi].
Basically, fibromyalgia is a common occurrence in patients with Hashimoto’s thyroiditis and management of this condition is a practical approach toward successful treatment of this autoimmune condition. LDN proves to be effective for fibromyalgia management.
The low dose Naltrexone has a beneficial impact on gastrointestinal disorders, according to a study from the International Journal of Pharmaceutical Compounding[vii].
It’s useful to mention that research confirms the efficacy of LDN for patients with Crohn’s disease[viii].
What does it mean to individuals with thyroid conditions?
Similarly, to the above-mentioned fibromyalgia, autoimmune gastrointestinal diseases are widely prevalent among patients with autoimmune thyroid disease. In addition, these gastrointestinal issues can interfere in the treatment with thyroid hormone.
As a result, they cause an imbalance in thyroid hormones even though a patient adheres to the recommended therapy[ix].
Patients with autoimmune thyroid disorders can, thereby, benefit from LDN because it helps manage gastrointestinal disorders and improve the efficacy of the treatment.
Despite the fact no study has been published about the direct relationship between thyroid autoimmunity and LDN, current evidence indicates the drug could have a positive impact. Not only does LDN tackle autoimmunity, but it also proves to be effective in the management of conditions that are common in patients with autoimmune thyroid diseases such as Hashimoto’s thyroiditis.
Thyroid medication and LDN
The first line of treatment of thyroid-related disorders is the intake of medications that either suppress production of hormones (in hyperthyroidism) or to deliver a synthetic version of thyroid hormone that the gland doesn’t produce efficiently (in hypothyroidism).
Low dose Naltroxene could be a practical addition to the thyroid medication.
Let’s take Hashimoto’s thyroiditis, which causes hypothyroidism, as an example. In this case, the immune system damages a patient’s thyroid thus decreasing or stopping production of the hormones.
Although medications serve to supply those hormones, they are unable to halt the destruction of thyroid facilitated by the immune system itself. This is where LDN steps in; the drug can prevent further damage to the gland.
In turn, some patients get to reduce the dosage of medications they’re taking for Hashimoto’s.
Graves’ disease patients could also experience positive effects with low dose Naltrexone. Persons with this autoimmune condition have to take the drug whose purpose is to suppress the excessive production of thyroid hormones.
Some patients can’t take these drugs due to increased liver enzymes or because they are intolerant to some compound found in them. In these instances, doctors usually recommend surgery or radioactive iodine.
The LDN has the potential to modulate the immune system which helps patients avoid surgery and radioactive iodine[x].
How long does it take to see results?
With regular intake, patients with thyroid disorders may notice improvements in the lab test results including TSH, T3, T4, and TPO levels.
Improvements don’t just happen overnight, and they vary from one person to another. It would be impossible to pinpoint a single timeframe because every patient has a different metabolic rate.
When you start feeling better, the best thing to do is to maintain the dose for two to three months, but you should consult your doctor to see what he/she will recommend.
Do patients find it helpful?
The potential benefit of LDN for patients with thyroid disorders is one thing, but does it really help?
One survey found that 38% of patients reported spectacular results after they started taking LDN while 48% were able to decrease the level of thyroid antibodies.
Moreover, 40% of patients reported reductions in pain, 61% saw improvement in their mood, and 66% experienced energy boost[xi].
The above-mentioned figures only stress the importance of studies that would assess the impact of LDN on thyroid thoroughly. New, concrete evidence would improve patients’ quality of life and allow them to manage their condition successfully.
The standard dosage of LDN for adults is 4.5mg taken once a day. Due to the rhythm by which the body produces its hormones, it is ideal to take the drug between 9 pm and 3 am. Most patients take LDN before bedtime because it is most convenient for them.
The exact dose depends on a patient’s condition. For example, persons with Hashimoto’s, fibromyalgia, and multiple sclerosis are usually advised to take 1.5mg every night.
Depending on a patient, the dosage could be even lower. Generally speaking, patients with thyroid conditions are advised to start with the lowest dose possible. The point here is that you should consult your doctor regarding LDN for a thyroid condition and adhere to the dosage he or she recommends.
Are there any side effects?
It is of crucial importance to get a doctor’s prescription for LDN and make sure it is prepared by a reliable compounding pharmacy.
According to the LowDoseNaltrexone.org, the drug isn’t associated with severe side effects. During the first week of taking LDN, some patients may experience sleeping difficulties. This reaction rarely persists after the first week of LDN use.
Although liver toxicity is a common reaction in persons who take full dose Naltrexone, this side effect wasn’t recorded with LDN. Some patients might experience irritability and nausea.
Is LDN safe for pregnant women?
Low dose Naltrexone is safe during pregnancy.
That being said, if you’re pregnant or trying to conceive and want to start using LDN to manage your thyroid condition, make sure you consult your healthcare provider first.
Low dose Naltrexone is, basically, a lower dosage of a popular medication that assists in recovery from alcohol and narcotic use. LDN is a safe and effective treatment for many conditions and diseases.
Although evidence is limited with many studies still ongoing, current studies to show a great potential of LDN for management of thyroid disorders.
[i] Committee on Problems of Drug Dependence 1974, National Research Council US https://books.google.ba/books?id=pEYrAAAAYAAJ&pg=PA265&redir_esc=y#v=onepage&q&f=false
[ii] Naltrexone, MedlinePlus.com https://medlineplus.gov/druginfo/meds/a685041.html
[iii] Naltrexone, Drugs.com https://www.drugs.com/pro/naltrexone.html
[iv] Younger J, Parkitny L, McLain D. The use of low dose Naltrexone (LDN) as a novel anti-inflammatory treatment for chronic pain. Clinical Rheumatology 2014 Apr;33(4):451-9. Doi: 10.1007/s10067-014-2517-2 https://www.ncbi.nlm.nih.gov/pubmed/24526250
[v] Younger J, Noor N, McCue R, Mackey S. Low-dose Naltrexone for the treatment of fibromyalgia: findings of a small, randomized, double-blind, placebo-controlled, counterbalanced, crossover trial assessing daily pain levels. Arthritis and Rheumatism 2013 Feb;65(2):529-38. Doi: 10.1002/art.37734 https://www.ncbi.nlm.nih.gov/pubmed/23359310
[vi] Halioglu S, Ekinci B, Uzkeser H, et al. Fibromyalgia in patients with thyroid autoimmunity: prevalence and relationship with disease activitiy. Clinical Rheumatology 2017 Jul;36(7):1617-1621. Doi: 10.1007/s-017-3556-2 https://www.ncbi.nlm.nih.gov/pubmed/28176037
[vii] Ploesser J, Weinstock LB, Thomas E. Low Dose Naltrexone: side effects and efficacy in gastrointestinal disorders. International Journal of Pharmaceutical Compounding 2010 Mar-Apr;14(2):171-3 https://www.ncbi.nlm.nih.gov/pubmed/23965429
[viii] Plesner KB, Vægter HB, Handberg G. Low dose Naltrexone for treatment of pain. Ugeskr for Laeger 2015 Oct 9;177(43):V03150248 https://www.ncbi.nlm.nih.gov/pubmed/26509454
[ix] De Carvalho GA, Fighera TM. Effect of gastrointestinal disorders in autoimmune thyroid diseases. Translational Gastrointestinal Cancer 2015 Jan;4(1). Doi: 10.3978/j.issn.2224-4778.2014.07.03 http://tgc.amegroups.com/article/view/4364/5767
[x] Low dose Naltrexone and thyroid autoimmunity, NaturalEndocrineSolutions.com http://www.naturalendocrinesolutions.com/articles/low-dose-naltrexone-and-thyroid-autoimmunity/