Friday, September 9, 2011

Getting Started

After reading extensively on Low Dose Naltrexone (LDN), I decided that I definitely wanted to try it.  I've suffered with Hashimoto's Thyroiditis (an autoimmune disorder) for over 15 years and I'm fed up with the medical care I've been given.  All my doctors (and I've tried many) do is test my TSH and adjust my medication (Synthroid or Armour Thyroid) accordingly.  They don't take my symptoms into consideration at all and I haven't felt good in over 15 years.  I'm ready to try something, anything, for the chance at feeling like myself again.  LDN has almost no side effects and has the potential to improve my immune system, so that it stops attacking my thyroid, which would relieve my symptoms of low thyroid function (swelling, slow metabolism, fatigue, weight gain, extremely dry skin and brittle hair/nails, high cholesterol, etc.)

Since the use of LDN for autoimmune treatment has not yet been approved by the Federal Drug Administration, most doctors will not consider it.  Let me explain that Naltrexone HAS been approved by the FDA in larger dosages to treat other conditions, not related to the immune system.  It's most common strength is 50 mg.  However, it's use in treating immune disorders only requires a dose of 4.5 mg.  Since it is not in widespread use at this strength, drug companies do not make it in a pill at this dosage, so one has to either have it made at a compounding pharmacy or get the 50 mg pill, crush it and mix it with water to dose it in a dropper.  Since I knew that my doctor would not listen to me about the use of LDN, I chose to purchase it myself, crush the pills and mix with distilled water, which I could then dose in a child's medicine dropper.

I bought the drug, Naltexone, in the 50 mg dose, from River Pharmacy, headquartered in Canada.  These drugs actually come from India, but they are the same thing we buy in the United States.  I bought a pill crusher from a local pharmacy, as well as a graduated 50 ml cylinder and 4 oz. amber glass bottle from U.S. Plastic.  I already had a 5 ml medicine dropper.  Prior to receiving my medication, I ordered a thyroid test panel from My Med Lab, so that I could get a baseline to compare future results to, after taking LDN for a few weeks.  When the medication arrived, I crushed one 50 mg pill, mixed it with 50 ml of distilled water (it's important to use distilled) and poored it into my 4 oz amber glass bottle (it's also important to use amber glass, which keeps the medicine from losing its effectiveness over time).  I then dosed out the medication in ml using the medicine dropper.  By doing so, I am able to get X mg by doing X ml (i.e. 4 mg = 4 ml).  It's also important to shake the bottle before each dosage, so that the medicine is equally distributed in the fluid.

At first, it is recommended that one take 3.5 ml in the evening, before bed (say 10 p.m.), as the drug must be in your system for a few hours prior to 3 a.m., when most people are in the state of sleep that helps it to work (when endorphins, etc. are made).  Starting at 3.5 ml helps to reduce the one side effect noted with LDN, insomnia.  I had no trouble getting to sleep with LDN, but did wake up often during the first couple of nights that I took it.  After staying on 3.5 ml for a few days, I moved up to 4 ml for a few days and then went to 4.5 ml, which is the optimum dosage of LDN.

Slight sleep disturbance for the first couple of days is the only side effect that I have experienced and I've been taking it for about two weeks.  I've seen a slight decrease in weight and maybe a bit more energy.  I have not adjusted my thyroid medication, but I will decrease it if I start to see any hyperthyroid symptoms (racing heart rate, rapid weight loss, insomnia, etc.)  When I ordered Naltrexone through the River Pharmacy, I also ordered Synthroid in 25 mcg, so that I could tweak my thyroid medication as needed during this test of LDN.  I also plan to use My Med Lab to order periodic test of  my thyroid function and will judge my results accordingly.

One thing I'd like to note is that this may not be for everyone.  I have done extensive research on my thyroid condition over the years and feel confident that I know more about it than most doctors.  I have taken ownership of treating my condition and will no longer throw up my hands and just trust that the doctor knows what's best.  I'd recommend that, if you trust your doctor, you should talk to him or her about LDN or seek out a doctor that would be open to prescribing it, such as a doctor of integrated medicine.  I feel comfortable doing this on my own, but you may not and that's okay.  Finding a doctor that will prescribe it, getting it at a compounding pharmacy and having your doc order lab work is another alternative that one might prefer.  This is just my choice and the record of my experience using this method.

If you have questions or comments, feel free to post them and I'll respond accordingly.

Friday, September 2, 2011

How Does LDN Work?

Once again, from http://www.lowdosenaltrexone.org/:

Up to the present time, the question of "What controls the immune system?" has not been present in the curricula of medical colleges and the issue has not formed a part of the received wisdom of practicing physicians. Nonetheless, a body of research over the past two decades has pointed repeatedly to one's own endorphin secretions (our internal opioids) as playing the central role in the beneficial orchestration of the immune system, and recognition of the facts is growing.

Witness these statements from a review article of medical progress in the November 13, 2003 issue of the prestigious New England Journal of Medicine: "Opioid-Induced Immune Modulation: .... Preclinical evidence indicates overwhelmingly that opioids alter the development, differentiation, and function of immune cells, and that both innate and adaptive systems are affected.1,2 Bone marrow progenitor cells, macrophages, natural killer cells, immature thymocytes and T cells, and B cells are all involved. The relatively recent identification of opioid-related receptors on immune cells makes it even more likely that opioids have direct effects on the immune system.3"

The brief blockade of opioid receptors between 2 a.m. and 4 a.m. 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 and enkephalin 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. Animal research by I. Zagon, PhD, and his colleagues has shown a marked increase in metenkephalin levels as well. [Note: Additional information for Dr. Zagon can be found at the end of this page.]

Bihari says that his patients with HIV/AIDS who regularly took LDN before the availability of HAART were generally spared any deterioration of their important helper T cells (CD4+).

In human cancer, research by Zagon over many years has demonstrated inhibition of a number of different human tumors in laboratory studies by using endorphins and low dose naltrexone. It is suggested that the increased endorphin and enkephalin levels, induced by LDN, work directly on the tumors' opioid receptors — and, perhaps, induce cancer cell death (apoptosis). In addition, it is believed that they act to increase natural killer cells and other healthy immune defenses against cancer.

In general, in people with diseases that are partially or largely triggered by a deficiency of endorphins (including cancer and autoimmune diseases), or are accelerated by a deficiency of endorphins (such as HIV/AIDS), restoration of the body's normal production of endorphins is the major therapeutic action of LDN.