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Low-Dose Naltrexone

One of the more contentious but promising new potential therapies for MS is low dose naltrexone. Naltrexone is a drug which reverses the effects of opiates like morphine or heroin. It is used in clinical practice in people trying to rid themselves of addiction to opiates. How it works in MS and other immune-mediated diseases, if it does, is the subject of some conjecture. But there seems to be overwhelming anecdotal evidence that it prevents relapses and also reduces disease progression.1 It has been suggested that it acts by reducing cell death in oligodendrocytes. There is considerable evidence available of its apparent benefit in individual cases published in a number of sites on the internet, but to date, there are no results from randomised controlled trials, although several are in progress. The drug does seem to be very promising though. An important aspect of this treatment is that it is relatively free of side-effects, unlike many of the other heavily promoted immune modulating therapies on the market. In addition, because it is a generic drug that cannot now be patented, it is very cheap, far cheaper than other currently available drugs. This may also explain why it hasn’t been studied much to date.

There are however a number of LDN treatment trials underway at present. A large RCT of 40 patients taking LDN for Crohn’s Disease is underway at Penn State University after a pilot study showed that two thirds of 17 patients taking the medication went into remission.2 Low-dose naltrexone MS research is underway as well, with an Italian study enrolling 40 patients with primary progressive MS. The study will be reporting results shortly. A further LDN MS treatment RCT has finished enrolment at University of California, with 80 patients with relapsing-remitting MS randomised. The researchers found significant improvements for LDN over placebo in several mental health quality of life measures3. This appears to be the beginning of formal research into LDN in MS, and further trials are eagerly awaited by the research community. The website gives periodic updates on progress. There is also a gateway website where you will find many links to worldwide information, resources and events:

Cris Kerr of Case Health, Queensland, Australia, has been advocating the use of patient testimony in the use of LDN for MS for many years, and publishes these testimonies under the title 'Those who suffer much know much'.  The following are two of the testimonies that can be found in her publication.  To see more of these testimonials please visit our News Archives here and our What's New section here where we keep the editions as they get published.

Case Testimonials

Maurey, USA
I was diagnosed with MS in July ’07. Looking back before my major episode, I had strong symptoms that I denied for 5 years or so. In July 2007 I couldn’t climb steps, I dragged my legs to get around, had no central vision in one eye, cried for no reason, had slurred speech and couldn’t find the words for my thoughts, and I was so dizzy I walked into walls.

I started LDN in August ’07, right after receiving my diagnosis. The first month I took 3mg, and I’ve been taking 4.5mg ever since. The greatest improvement in my symptoms occurred in the first 30 days. Improvement is slower now, so I keep a diary and check in with myself every 3 months. I haven’t been disappointed yet. Once in a while if my legs feel stiff I drop back to 3 mg for a day. I follow most diet and supplement recommendations related to my condition. I also have high cholesterol but my new diet has reduced my bad cholesterol by 20 points and increased my good by 7 – a nice side benefit. I have 80% of my leg function back, no more dizzy spells, and no more speech problems. I have some loss of color vision in one eye, but I can see. My MS taps me on the shoulder every now and then, but I no longer think about it 24×7. I continue to work on my balance and leg strength with various activities.

At my 6-month check up with the same neurologist, he gave me a lecture on LDN not being FDA approved and strongly recommended Rebif to slow the progression. I asked him how he could possibly recommend expensive painful injections when I’m doing so well on LDN.

My LDN was prescribed by my GP who said “Why not? It makes perfect sense, won’t hurt you, and the CRAB drugs are limited in their ffectiveness.”
My Neuro report came in the mail. He must have done some thinking after our visit. It reads, “The patient has done quite well since I saw her in July. She has had no attacks of multiple sclerosis. She takes low dose Naltrexone. She gets that medication through her primary care provider. She is aware that there is no evidence that this is helpful in multiple sclerosis. She is not interested in going on Interferon medication at this time and I do not think that it is necessary at this point either. It may turn out that she has benign multiple sclerosis.” I say, that if it is benign, it’s only because of LDN, diet and exercise. I do believe attitude plays a big role. I’m putting a son through college and have 5 horses that must be fed and cared for. I cannot be disabled and will find the way. That’s my story and I’m sticking to it.

UPDATE: July, 2008 – 1 Year on LDN
Certainly! I’ve read through the specifics section, and all remains the same. Still doing very well on LDN – no further progression or attacks, no medical information to report. Still following the same routine, LDN, supplements and exercise. No episodes, no progression, slow but steady improvement in leg strength and balance. Tolerating the heat of summer much better than last year.

UPDATE: July 2009 – 2yrs on LDN
Still firmly committed to LDN. No exacerbations – one very tired day after extreme exercise in high heat. In general, I’m able to handle heat much better than a year ago. Frustrated by a plateau in improvement, I’ve been seeing an acupuncturist/Chinese herbalist who is doing FCT testing and therapy for Lyme, Babesia and mercury poisoning. I believe it has sparked some improvement.

I’ll see my neurologist on July 31 for my first repeat MRI.
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Audrey, UK
There’s not much to my story really. I am in my late thirties now, but I’ve had MS since I was young (when I had diplopia for a few weeks). I also had burning sensations in my legs. In my early 20s I had a lumbar puncture and MRI. As it was during the late 1980s, the doctors thought it better not to tell me, even though they wrote in my medical notes that they ‘suspected’ MS.

Throughout my twenties I had relapses, but I wasn’t diagnosed until I ended up in tears in front of a compassionate GP. He sent me for another MRI, and then the two MRI’s were compared. MS was confirmed. Throughout my thirties my relapses got progressively worse and despite following a healthy diet I got to the point where I couldn’t see, couldn’t stand up, and was falling over – mainly because of balance problems. I had fatigue that prevented me walking very far. I couldn’t even peel a carrot, and was generally feeling suicidal and hopeless. During this time, I never tried any other drug.

I seemed to be on a steep decline. I had five relapses with no intermission and no short breather. The last went on for six months. I wasn’t sure what was happening but my MS was really progressing. If I went for a walk it was like the plug was pulled out after a short distance. My energy was zapped. I could barely walk. Very, very little energy to do anything or go anywhere. I would awaken as if I had done a marathon the day before. My right hand would keep me awake at night from nerve damage – it had been numb for six years.

One of my relapses just six months prior to LDN left me unable to drive, with difficulty walking, talking, eating and preparing food. I had terrible fatigue. No energy and no ability to make something to eat – with no one to help, including my husband. I found it difficult to go to the toilet to empty my bladder. I dropped whatever I touched literally. My balance became bad and I would constantly fall over. I would go into remission, only to have another relapse straight away. I had double vision and needed an eye patch. I sprained my ankle 5 times because I couldn’t see. I had problems with cognition, no clarity of thought – often called ‘brain fog’ by others with MS.

Then I had a bladder infection and I had to take antibiotics and both my legs went numb and stiff with spasticity. Then I found out about LDN. My neuro and two local GPs would not prescribe LDN, but fortunately, a Harley Street GP came through for me. At the time of starting LDN, I had spasticity in my legs and general fatigue. Within a matter of days I felt like a new woman. It was as though I had been given my life back. The spasticity left, and the fatigue lifted.

I noticed a difference within a few days. I began three days before I had an appointment with my MS nurse. I actually walked to the hospital – something I definitely couldn’t have achieved before starting. It must have been 1 mile at least. My mood was much happier and I noticed a difference from the word go. I found myself dancing to the radio and realised my fatigue had disappeared.

I saw my GP and he noticed my walking was much better. The previous time I saw him I was walking with a stick. Today my right hand (which suffered from nerve damage and numbness) feels markedly better.This is one of my diary notes: ‘I have been taking LDN for a month and already I have virtually no symptoms including previous bladder retention. My energy is amazing. I am sleeping the whole night through. Yesterday I got up in the morning, walked the dog, and went for a 1km swim. I went for a strenuous bike ride, walked the dog, made lunch, tidied the house, walked the dog again, went shopping, picked up my husband from the station, walked the dog yet again, and still had enough energy to make something to eat. I find if I plan, I can still spend the day somewhere like St Albans or Windsor and still find energy to drive home, walk the dog and socialize. The most noticeable difference is the reduction in numbness, pins and needles, bladder retention, sleeping the night through, energy levels and probably more. All in the first month.’

Taking LDN has helped me get back on my feet and build up my strength sufficiently to stop my rapid decline. On the way to my second appointment with the GP who originally prescribed my LDN, I got off the train at Marlebone and ran all the way to Harley Street. I remember running down the platform at the station and beating everyone to the barriers. I thought that was pretty good considering I’d spent six months incapable of much at all not that long ago.

I originally paid for the LDN myself, but later went to my own GP and asked if she would prescribe LDN. She said; “Wow you look fantastic’, and prescribed it for me. Two male GP’s at the same local practice had previously turned me down. I’ve now been on LDN since March 2007, 16 months. Despite a short exacerbation, which wasn’t as severe as previous relapses, I’m still active and full of life. I have a border collie who is extremely active and keeps me busy.

More than anything LDN has given me hope.

Update – January 2009
I’ve had diplopia for as long as I can remember. When I look to the far left, right, up or down. If I do exercise it gets a bit worse. I saw my optician recently and he thinks I had it as a child, just didn’t notice. I haven’t had a relapse and it’s been like this the whole time I’ve been on LDN. I am trying to be careful with diet and lifestyle but Christmas is a difficult time of year. I’ve just had a birthday celebration and I was as good as gold. I ate pigeon and venison. I had an Elissa test and it revealed I had a problem with most proteins. The only proteins I eat at home are hemp seeds and quinoa.

The constipation problem disappeared soon after starting on the Best Bet Diet (BBD), and I got rid of my nightmare problem by taking my LDN a bit earlier at 10.00pm instead of 11.30pm. I have just joined a gym for three months so I hope to make the most of it. I don’t think my border collie is going to be too pleased!!

Update – July 2009
To update my case I never did go to the gym and I didn’t continue with the BBD. My Elissa test told me to exclude everything I was eating but to give up so many foods would be impossible. I now eat everything, gluten, dairy and the odd glass of wine. My health has been good and I didn’t have a cold all winter until May. I don’t feel like I have MS. I am even attempting to have a baby, something I never thought I’d hear myself say. I’m closer to the end than the beginning of my child bearing years so it’s a bit late, but I am putting my trust in the LDN.
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  1. Agrawal YP. Low dose naltrexone therapy in multiple sclerosis. Med Hypotheses 2005; 64:721-724
  2. Smith JP, Stock H, Bingaman S, et al. Low-dose naltrexone therapy improves active Crohn’s disease. Am J Gastroenterol 2007; 102:820-828
  3. Bruce A.C. Cree, Elena Kornyeyeva, and Douglas S. Goodin. Annals of Neurology