Anyone had success with Low-Dose Naltrexone for PEM, Chronic Fatigue?

Yes, I've been on a very low dose for about a year and have found that my PEM is lessened when I am on it. I had to go off of it for a surgery and noticed a difference. It did take a while to work, a few months, and the initial side effects almost made me quit (nausea and dizziness), but in the end, it is worth it. I'm sure others can attest to this, but it doesn't work for everyone, and everyone has different side effects and tolerance levels. I hope it works for you!

@erinhastedt
Yes, LDN is one of those drugs that when it works it can be amazing.

It basically, does a reboot nightly of the immune system which helps reset all the normal parameters which have been messed with my virus action, age or even vaccine impact:
Low-Dose Naltrexone (LDN) improves Post-Exertional Malaise (PEM) and Chronic Fatigue symptoms through three primary pathways that "recalibrate" the body's response to stress and activity, the last link below tells how the below occurs:
1. LDN acts as a glial modulator to inhibit the release of inflammation markers.
2. Helps restore cellular energy
3. Boosts natural endorphins

Research articles:
https://pmc.ncbi.nlm.nih.gov/articles/PMC6954765/.
https://www.painspa.co.uk/low-dose-naltrexone-could-treat-long-covid-symptoms/.
Great paper on how LDN works in the body to help with Long Covid and auto-immune diseases:
https://meassociation.org.uk/wp-content/uploads/MEA-Summary-Review-Low-Dose-Naltrexone-LDN-in-MECFS-14.11.19.pdf

Yes, I've been on a very low dose for about a year and have found that my PEM is lessened when I am on it. I had to go off of it for a surgery and noticed a difference. It did take a while to work, a few months, and the initial side effects almost made me quit (nausea and dizziness), but in the end, it is worth it. I'm sure others can attest to this, but it doesn't work for everyone, and everyone has different side effects and tolerance levels. I hope it works for you!

@erinhastedt
Yes, LDN is one of those drugs that when it works it can be amazing.

It basically, does a reboot nightly of the immune system which helps reset all the normal parameters which have been messed with my virus action, age or even vaccine impact:
Low-Dose Naltrexone (LDN) improves Post-Exertional Malaise (PEM) and Chronic Fatigue symptoms through three primary pathways that "recalibrate" the body's response to stress and activity, the last link below tells how the below occurs:
1. LDN acts as a glial modulator to inhibit the release of inflammation markers.
2. Helps restore cellular energy
3. Boosts natural endorphins

Research articles:
https://pmc.ncbi.nlm.nih.gov/articles/PMC6954765/.
https://www.painspa.co.uk/low-dose-naltrexone-could-treat-long-covid-symptoms/.
Great paper on how LDN works in the body to help with Long Covid and auto-immune diseases:
https://meassociation.org.uk/wp-content/uploads/MEA-Summary-Review-Low-Dose-Naltrexone-LDN-in-MECFS-14.11.19.pdf

Anyone found it useful for muscular or nerve type pain?

@bajjerfan
Well that depends on what is causing the muscular or nerve type pain. LDN works to reset the immune system.

It is used for conditions like fibromyalgia, complex regional pain syndrome (CRPS), and diabetic neuropathy. It helps with this because it reduces neuro-inflammation and modulating immune cells in the central nervous system.
https://www.fibromyalgiafund.org/giving-ldn-your-best-shot/
It usually takes 3 months on the correct dose to see a difference from LDN, and it can take weeks or months to get to the correct dose because you must start low and titer up slowly. So this is a drug that will need patience. I tried it 3 or 4 times, but I just couldn't handle the side effects, but I am notorious for side effects.

@kathleen1314
My biggest question about LDN is, how long do you need to continue taking it? Does it eventually "reset" your system and allow you to discontinue use? Or are you on it forever? I haven't been able to get the answer from my DR. so am always curious what others think.

@erinhastedt
Well, what I see seems to be tied to the condition for whichyou are taking LDN and how it is tied to your general health situation. Usually, the patients that take LDN have a long term problem that their body just doesn't seem able to reset on its own and the body seems to not be able to hold the reset because of age, disease, inflammation etc . So this becomes a long term use of LDN.

The google search which I did says:
"Low Dose Naltrexone (LDN) is generally considered a long-term maintenance therapy rather than a one-time "reset" for the system. While it recalibrates the immune and neurological systems to promote balance, it does not typically provide a permanent cure for chronic or autoimmune conditions

Key Considerations for Duration
Maintenance vs. Reset: LDN works by temporarily blocking opioid receptors, which triggers a "rebound effect" of increased endorphin production. Because this effect is temporary (the medication clears the body in about 24 hours), daily dosing is usually required to maintain consistent immune modulation.

Discontinuing Use: Many patients report that symptoms—such as fatigue, pain, or inflammation—return within days or weeks of stopping the medication. For this reason, many continue treatment indefinitely as long as it remains beneficial.

Trial Period: Experts often recommend staying on LDN for at least 6 to 12 months to fully assess its impact, as maximum benefits for some conditions may not appear for 8 to 18 months.

"Drug Holidays": Some patients take short breaks (3–7 days) to manage potential tolerance or assess their baseline symptoms, though this should only be done under medical supervision.
https://ldnresearchtrust.org/there-time-you-should-quit-low-dose-naltrexone-ldn.
https://agelessrx.com/how-long-do-you-need-to-take-ldn/.