Low-Dose Naltrexone

NaltrexoneAt Johnson Compounding and Wellness we pride ourselves on being experts on low-dose naltrexone.  Our staff of 10 pharmacists is here to help educate you on the uses and potential benefits of LDN.  We are proud members of the LDN  Research Trust and have presented worldwide on the uses of LDN. 

What is Low-Dose Naltrexone (LDN) and Why is it Important?

was approved by the FDA in 1984 in a 50mg dose for the purpose of helping heroin or opium addicts, by blocking the effect of such drugs. In technical terms, it is an opioid antagonist. By blocking opioid receptors, naltrexone also blocks the reception of the opioid hormones (endorphins) that our brain and adrenal glands produce – beta-endorphin and metenkephalin. Many body tissues have receptors for the endorphins, including virtually every cell of the body’s immune system.

In 1985, Dr. Bernard Bihari discovered the effects of a much smaller dose of naltrexone (approximately 3mg once a day) on the body’s immune system. He found that this low dose, taken at bedtime, was able to enhance a patient’s response to infection by HIV, the virus that causes AIDS. Subsequently, Dr. Bihari found that patients in his practice with cancer (such as lymphoma or pancreatic cancer) could benefit from LDN. In addition, people who had autoimmune disease (such as lupus) often showed prompt control of disease activity while taking LDN.

How Does LDN work?

According to Dr. Bihari’s information, the brief blockade of opioid (endorphin) receptors that is caused by taking LDN at bedtime each night is believed to produce a prolonged up-regulation of vital elements of the immune system by causing an increase in endorphin production. Normal volunteers who have taken LDN in this fashion have been found to have much higher levels of beta-endorphins circulating in their blood in the following days. It is believed that the endorphins act to increase natural killer cells and other healthy immune defenses against cancer

What Diseases Has LDN Been Useful For?

Some diseases for which LDN has been used:

  • ALS (Lou Gehrig’s disease)
  • Alzheimer’s disease
  • Ankylosing spondylitis
  • Anti-aging
  • Autism
  • Celiac disease
  • Chronic fatigue syndrome
  • Crohn’s disease
  • Endometriosis
  • Fibromyalgia
  • Glioblastoma
  • Inflammatory bowel disease
  • Lupus
  • Multiple sclerosis (MS)
  • Parkinson’s disease
  • Post Traumatic Stress Disorder (PTSD)
  • Psoriasis
  • Rheumatoid arthritis
  • Sarcoidosis
  • Scleroderma
  • Ulcerative colitis
  • Practically ANY CONDITION that may in any way be associated with inflammation

Are there any side effects or cautionary warnings?

> Side effects:

LDN has virtually no side effects. Occasionally, during the first week’s use of LDN, patients may complain of some difficulty sleeping. This rarely persists after the first week. Should it do so, dosage can be reduced from 4.5mg to 3mg nightly.

> Cautionary warnings:

  1. Because LDN blocks opioid receptors throughout the body for three or four hours, people using medicine that is an opioid agonist, i.e. narcotic medication — such as Ultram (tramadol), morphine, Percocet, Duragesic patch or codeine-containing medication — should not take LDN until such medicine is completely out of one’s system. Patients who have become dependant on daily use of narcotic-containing pain medication may require 10 days to 2 weeks of slowly weaning off of such drugs entirely (while first substituting full doses of non-narcotic pain medications) before being able to begin LDN safely.
  2. Those patients who are taking thyroid hormone replacement for a diagnosis of Hashimoto’s thyroiditis with hypothyroidism ought to begin LDN at the lowest range (1.5mg for an adult). Be aware that LDN may lead to a prompt decrease in the autoimmune disorder, which then may require a rapid reduction in the dose of thyroid hormone replacement in order to avoid symptoms of hyperthyroidism.
  3. Full-dose naltrexone (50mg) carries a cautionary warning against its use in those with liver disease. This warning was placed because of adverse liver effects that were found in experiments involving 300mg daily. The 50mg dose does not apparently produce impairment of liver function nor, of course, do the much smaller 3mg and 4.5mg doses.
  4. People who have received organ transplants and who therefore are taking immunosuppressive medication on a permanent basis are cautioned against the use of LDN because it may act to counter the effect of those medications.

Information on warnings from lowdosenaltrexone.org

When will the low-dose use of naltrexone become FDA approved? The FDA approved naltrexone at the 50mg dosage in 1984. LDN (the 3mg dosage) has not yet been submitted for approval because it is highly unlikely that any drug company would spend the money to obtain approval for the special use of a drug whose patent has expired. Be assured, the compounded form of naltrexone (LDN) is made with FDA approved chemicals.

All physicians understand that appropriate off-label use of an already FDA-approved medication such as naltrexone is perfectly ethical and legal. Naltrexone itself has already passed toxicity studies.

How do I know I am getting the correct strength of LDN?

Our pharmacy sends out our low-dose Naltrexone to ensure the patient is getting the amount of drug that the Doctor ordered. We send our drug out for private testing in order to ensure the highest quality preparation.

What types of fillers are available for LDN?

We offer many different types of filler for the provider to choose from depending on what they believe will work best for the patient.

Acidophilus, Avicel, Loxoral, and capsule blend

Dosage options for Low-Dose Naltrexone?


At Johnson Compounding and Wellness we regularly compound prescription for low-dose naltrexone.  Most commonly we see prescriptions for 1.5mg, 3mg, and 4.5mg but can easily compound more specific concentrations as well.

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Healthcare Providers can fax prescriptions to 781-899-1172

Patients or Healthcare Providers can call to speak with one of our pharmacists 781-893-3870