Did you know Low Dose Naltrexone can be used for PCOS & Endometriosis?

Low Dose Naltrexone (LDN) is used for autoimmune diseases & patients have good success with it.  Many women with PCOS & Endometriosis also have autoimmune disorders; and thus LDN is emerging as an option for treatment of these health and other women’s health issues.

 

What Is Naltrexone?¹

Naltrexone is type drug called an “opiate antagonist”, meaning it blocks opioid receptors. Opioid receptors are related to pain, pleasure and endorphins.

In 1985 Naltrexone was approved in some countries to be used to treat opiate or alcohol dependency. Standard dose to combat dependency is between 50 to 300mg a daily.  At ultra low doses, medical providers are using Naltrexone as off-label treatment for many chronic illness and autoimmune related ailments.

What is Low Dose Naltrexone?¹

Low Dose Naltrexone (LDN) is the term used for any dose of Naltrexone under 10mg a day. Studies have shown that when Naltrexone is used at a low dose, it blocks opioid receptors only for a couple of hours. During this brief time, a “rebound effect” occurs in which there is an increased production and utilization of endorphins and opioid receptors.

After a couple of hours, the LDN is broken down and the newly made endorphins can interact with the opioid receptors.  The endorphins help manage pain and help regulate cell growth and immunity.

For the most part, the rebound effect lasts about a day, which is why the LDN is taken once a day (every 24hrs).  Furthermore, the rebound effect has only been shown to be effective at low doses of naltrexone. A rebound effect will not occur at higher doses because it leads to a continuous blockade of the opioid receptors versus a short period of time.

What Female Conditions Does LDN Help?

• PMS symptoms
• Persistent fatigue
• Sleep issues, disturbance, insomnia
• Low mood, depression
• Anxiety
• Underactive thyroid

Naltrexone helps women with PCOS ovulate and possibly conceive – Naltrexone has been shown to improve overall function in women with PCOS who are trying to get pregnant that are resistant to courses of clomiphene citrate².  One study looked at 30 infertile females with PCOS.  All subjects were obese, hyperandrogenic and hyperinsulinemic.  16 patients had no periods and 14 had irregular/infrequent periods.  All 30 women received naltrexone (50 mg daily) for 6 months.  Patients who did not ovulate after 12 weeks of naltrexone monotherapy, also received clomiphene citrate (CC).  The outcome was the following²:

• 3 ovulated during naltrexone monotherapy
• There were no conceptions during naltrexone monotherapy
• 19 of the remaining 27 ovulated during naltrexone + CC therapy.
• 9 of 27 women (33.3%) conceived during naltrexone + CC
• There was one missed abortion at 9 weeks, one preterm delivery at 34 weeks and seven term live births. Naltrexone therapy was also led to by significant reductions in BMI, fasting serum insulin, luteinizing hormone (LH), LH/follicle-stimulating hormone ratio and testosterone.

In another study, it was found that women with PCOS that were given LDN had the following success³:

• Lost weight
• Insulin resistance decreased
• Blood levels of free testosterone, dehydroepiandrosterone sulfate, cortisol, and androstenedione decreased significantly.
• Periods improved in 80% of the women
• The fasting glucose-to-insulin ratio improved in those with insulin resistance

LDN helps women with endometriosis – Endometriosis is related to imbalances in your hormones but one aspect that is often ignored is that it is also related to the immune system and inflammation. Endometriosis has been shown to have similarities with various other autoimmune diseases by also presenting with elevation in inflammatory markers, cell-mediated abnormalities, anti-bodies against itself and elevation of other blood markers⁴.

LDN is also used for chronic diseases including

• Multiple sclerosis
• Lyme disease
• Chronic pain
• Autoimmune arthritis
• Inflammatory bowel disease
• Psoriasis
• Cancer – pancreatic, renal, colorectal, uterine, hepatic, lung, breast, ovarian etc

How Is LDN Dosed?^1,5

LDN is started at a super ultra low dose anywhere between 0.5mg to 1.5mg at night-time. If you are doing well, without side effects then your dose is very slowly increased. Dose adjustment occurs over 4 to 8 weeks until you feel stable.

Most people will have symptom controlled at a daily dose of anywhere between 3mg to 5mg.

What Are the Side Effects I May Experience When Starting LDN?

Side effects are temporary and for some subside within the first 2 weeks. For others, it takes about 3 to 4 weeks for side effects to go away. Common side effects include:

• Sleep disturbance
• Vivid dreams
• Headache
• Dry mouth

On the rare occasion, you may experience nausea, constipation and/or diarrhea.  If this is the case and the symptoms are not improving, your medication will be switched to sublingual drops (drops you put under the tongue).  Sublingual drops avoid the stomach and pass directly into the blood stream when placed under the tongue.

Who Should Not Use LDN?

If you’re using codeine or morphine you should not be taking LDN.  Both codeine and morphine are opioids and if you mix Naltrexone with either of these medications, one may become very sick with persistent vomiting.

What About Alcohol?

If you’re planning on going out and having a few glasses of wine or some pints of beer, you should skip your dose of LDN for the day and resume the following day.  Naltrexone can increase the hangover feeling you get as it can easily interact with alcohol consumed.

If you have questions about LDN, I invite you to reach out to me or speak to your healthcare provider for support.  I offer services all across Ontario.  So definitely reach out!

The information provided is for informative purposes and is not intended to substitute professional medical advice, diagnosis or treatment from your medical provider.

Sincerely,

Arv

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References

(1) Brown N, Panksepp J. Low-dose naltrexone for disease prevention and quality of life. Med Hypotheses. 2009;72(3):333-7. Duleba AJ. Medical management of metabolic dysfunction in PCOS. Steroids. 2012;77(4):306-311.

(2) Ahmed MI, Duleba AJ, El shahat O et al. (2008). Naltrexone treatment in clomiphene resistant women with polycystic ovary syndrome. Hum Reprod, 23(11), 2564-9.

(3) Fruzzetti F, Bersi C, Parrini D, Ricci C, Genazzani AR. Effect of long-term naltrexone treatment on endocrine profile, clinical features, and insulin sensitivity in obese women with polycystic ovary syndrome. Fertil Steril. 2002;77(5):936-44.

(4) Eisenberg, VH, Zolit, M, Soriano, D. (2012) Is there an association between autoimmunity and enodmetriosis? Autoimmunity Reviews, 11(11), 806-14.

(5) https://www.ldnscience.org/

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