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LDN: Asked & Answered
January 27, 2026
Watch on-demand! Belmar Pharma Solutions’ first Preferred Provider webinar of 2026: “LDN: Asked & Answered” This webinar brings together five Belmar […]
Low Dose Naltrexone (LDN)
Low dose naltrexone (LDN) is a low dose of naltrexone that is thought to briefly block opioid receptors to boost natural endorphins and support immune balance.
Common dosage forms
Capsule
Cream
Fast SL
Gel
Oral Tablet
Suspension
Troche
What is Low Dose Naltrexone?
Low dose naltrexone (LDN) uses a much smaller amount of naltrexone, about 1–5 mg instead of the standard 50–100 mg, that may create short‑term opioid receptor blockade that boosts natural endorphins and helps regulate immune activity.
These endorphins may support stress response, mood, and pain signaling, and they may also influence immune balance, which is why low dose naltrexone benefits may include improved sleep, reduced chronic pain, better mobility, and clearer thinking.
LDN is explored in autoimmune and inflammatory conditions, including interest in low dose naltrexone for Hashimoto’s thyroiditis, as endorphin and immune modulation may help calm overactive immune patterns.
LDN is typically well tolerated, with low dose naltrexone side effects such as vivid dreams or headaches usually being mild and temporary.
Because it is not commercially available at these strengths, low dose naltrexone is prepared through compounding pharmacies in forms like oral tablets and capsules, topical creams, or sublingual tablets.
Who May Benefit from Low Dose Naltrexone Therapy?
Autoimmune Conditions
Patients with autoimmune disorders—such as Hashimoto’s thyroiditis, multiple sclerosis, Crohn’s disease, lupus, rheumatoid arthritis, and psoriasis—may benefit from LDN because it can boost endorphins and help regulate an overactive immune response.
Chronic Pain or Inflammatory Conditions
LDN is an immune modulator and an anti-inflammatory agent. LDN may be helpful for those experiencing chronic pain like fibromyalgia or autoimmune related inflammatory flare‑ups because it can reduce pain sensitivity and support appropriate inflammatory signaling. By strengthening immune system performance and upregulating endorphins, LDN can improve quality of life for patients plagued with flares and fatigue.
Fatigue, Mood or Sleep Concern
Those with depression, anxiety, chronic fatigue, or sleep problems may benefit from LDN, as higher endorphin levels may support mood, energy, and restorative sleep.
Weight Management
LDN may ignite brain areas involved in appetite regulation. It can affect food cravings, metabolism, and energy.
Immune Support
LDN may support those with weakened or dysregulated immune function by helping balance immune activity, which is why it’s being explored for conditions like long‑term fatigue, certain infections, and neuroinflammatory concerns.
Access clinical studies on Low Dose Naltrexone
- Ekelem C, Juhasz M, Khera P, Mesinkovska NA. Utility of Naltrexone Treatment for Chronic Inflammatory Dermatologic Conditions: A Systematic Review. JAMA Dermatol, 2018.
- Mischoulon D, Hylek L, Yeung A, et al. Randomized, proof-of-concept trial of low dose naltrexone for patients with breakthrough symptoms of major depressive disorder on antidepressants. Journal of Affective Disorders, 2017; 208:6-14
- Raknes G, Småbrekke L. Low dose naltrexone: Effects on medication in rheumatoid and seropositive arthritis. A nationwide register-based controlled quasi-experimental before-after study. PLoS One. 2019 Feb 14;14(2):e0212460.
- Dara P, Farooqui Z, Mwale F, Choe C, van Wijnen AJ, Im HJ. Opiate Antagonists for Chronic Pain: A Review on the Benefits of Low-Dose Naltrexone in Arthritis versus Non-Arthritic Diseases. Biomedicines. 2023 Jun 2;11(6):1620.
- Zielsdorf S, Graves’ Disease (2019 Conference, Low Dose Naltrexone)
- Turel AP, Oh KH, Zagon IS, McLaughlin PJ. Low Dose Naltrexone for Treatment of Multiple Sclerosis: A Retrospective Chart Review of Safety and Tolerability. J Clin Psychopharmacol, 2015; 35(5):609-611.
- Ludwig MD, Turel AP, Zagon IS, Mc Laughlin PJ. Long-term treatment with low dose naltrexone maintains stable health in patients with multiple sclerosis. Mult Scler J Exp Transl Clin, 2016; 2:2055217316672242
- Ludwig MD, Zagon IS, McLaughlin PJ. Featured Article: Serum [Met5]-enkephalin levels are reduced in multiple sclerosis and restored by low-dose naltrexone. Exp Biol Med (Maywood), 2017; 242(15):1524-1533
- Zapata N, Georgiadi E, Cantrell C, Rilinger RG, Levine MA, Wilson R. Low-Dose Naltrexone for Managing Pain and Autonomic Symptoms in Patients With Dysautonomia. Cureus. 2025 Jun 22;17(6):e86538.
- Stallkamp Tidd SJ, Cantrell C, Greene BD, Wilson R. Low-Dose Naltrexone Use in Postural Orthostatic Tachycardia Syndrome: A Case Series. Cureus. 2023 Aug 13;15(8):e43426.
- Weinstock LB, Brook JB, Myers TL, Goodman B. Successful treatment of postural orthostatic tachycardia and mast cell activation syndromes using naltrexone, immunoglobulin and antibiotic treatment. BMJ Case Rep. 2018 Jan 11;2018:bcr2017221405. doi: 10.1136/bcr-2017-221405. PMID: 29326369; PMCID: PMC5778345.
- Zagon IS, McLaughlin PJ. Intermittent blockade of OGFr and treatment of autoimmune disorders. Exp Biol Med (Maywood),2018
- Li Z, You Y, Griffin N, Feng J, Shan F. Low-dose naltrexone (LDN): A promising treatment in immune-related diseases and cancer therapy. Int Immunopharmacol,2018;61:178-184.
- Atanaskova Mesinkovska N. Emerging Unconventional Therapies for Alopecia Areata. J Investig Dermatol Symp Proc, 2018;19(1):S32-S33.
- Patten DK, Schultz BG, Berlau DJ. The Safety and Efficacy of Low-Dose Naltrexone in the Management of Chronic Pain and Inflammation in Multiple Sclerosis, Fibromyalgia, Crohn’s Disease, and Other Chronic Pain Disorders. Pharmacotherapy,2018;38(3):382-389
- Rupp A, Young E, Chadwick AL. Low-dose naltrexone’s utility for non-cancer centralized pain conditions: a scoping review. Pain Med. 2023 Nov 2;24(11):1270-1281.
- Toljan K, Vrooman B. Low-Dose Naltrexone (LDN)-Review of Therapeutic Utilization. Med Sci (Basel), 2018;6(4)
Access package inserts for Low Dose Naltrexone
Commonly Asked Questions
When taking low dose naltrexone, it may be recommended to avoid opioid pain medications because LDN briefly blocks opioid receptors and can interfere with how those drugs work. Those with liver or kidney disease, bleeding disorders, or individuals using immunosuppressive therapy may also need to discuss LDN use with their trusted prescriber.
Taking low dose naltrexone at night may be beneficial because its short receptor blockade occurs during sleep, allowing the natural rise in endorphins to happen the next morning. This timing may help support immune regulation and overall daytime well‑being, based on how LDN briefly interacts with opioid and immune receptors.
Belmar Pharmacy has been compounding low dose naltrexone (LDN) since 1985, and with a prescription from a medical provider, will ship to all 50 states, Washington, DC, Guam and Puerto Rico.
In Hashimoto’s Thyroiditis, the body’s own specialized white blood cells attack the thyroid gland, which can result in underproduction of thyroid hormone. LDN’s therapeutic targets are immune activity—by aiming to calm the overactive immune response, LDN may improve thyroid function and autoimmune-related symptoms. However, it is not a replacement for thyroid hormone therapy like levothyroxine sodium (T4) or liothyronine sodium (T3).
Low dose naltrexone (LDN) can benefit Hashimoto’s thyroiditis patients by addressing the autoimmune component of the disease. As an immune modulator and an anti-inflammatory agent, LDN can upregulate endorphins and decrease inflammation. Its unique mechanism of action has been shown to limit autoimmune flares and fatigue, impacting patients’ overall quality of life.
Contact us and we can provide the information and pricing you need about LDN and other compounded medications. If you have immediate questions and would like to speak to a Solutions Engineer, someone is available to help you Monday through Friday during business hours.
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