5 years into Long COVID and my PEM has improved after 3 months titrating up on Low Dose Naltrexone. It does give me insane insomnia if I take it later than noon and I do have more vivid dreams but not nightmares. I can now walk 2/3 to a mile every day weather allows. I still tire by early afternoon (I usually get up at 7-8 am) and lie down for a while but no longer have to sleep. I am hopeful the LDN will continue to help me have even more energy.

Here is what researchers believe LDN does:

1. LDN increases the secretion of naturally occurring Endorphins (“feel good, runner’s high”). Endorphins relieve pain, give a happy feeling and reduce inflammation.
2. LDN increases the release of Opioid Growth Factor which works powerfully to reduce inflammation, auto-immune responses and tumor cell growth.
3. LDN reduces inflammatory immune cell signaling (Toll like Receptor-4). When these immune “look out cells” get excited, they signal the immune system to get overly busy, which can cause or worsen auto-immune and inflammatory responses. These “look out cells” are located all over the body, including the gut and the brain.
4. LDN calms glial cells in the nervous system. Glial cells make up over 70% of the immune system and can either protect nerve pathways or cause inflammation of nerves. We want our glial cells to remain in a calm and protective mode!
5. LDN increases dopamine levels. Dopamine is a neurotransmitter that makes us feel happy and rewarded, gives us energy and helps our brain solve problems. When dopamine is low, we feel depressed.