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

To Caldiana13
Amen to that.
June

Hi, I have been taking LDN for several years for Fibromyalgia. I had a lot of side effects ( conjunctivitis, nausea) I really did not think it was going to help me then the clouds parted and my pain was greatly diminished!. Stick with it for at least a month even if you have side effects-it worked for me-hope it will help you too .

lpool39xops, I’m glad to hear it ended up helping you a lot. From what I’ve read, it can take some people 9 - 12 months on the highest dose of 4.5 or 5 mg before feeling noticeably better.
June

I have been on LDN for 4 years. It has helped, it hasn't brought me back to the Wonder Women I was before Covid. But I have alot of symptoms other than chronic fatigue.

Went I had to request a refill from my PCP, I found out how much it helps when I had to do without until he understood how to prescribe to Mayo pharmacy.

I hope you find some relief. Just remember, nothing is a miracle drug that will make you feel like you did before Covid. You may need to find relief to your other symptoms for that.

Took 4.5 mg x 2 years. In my experience, it did not shift the PEM. Somehow I felt more blood flow to my brain; a positive feeling. Currently I'm on a medication holiday because of increased neuropathic pain that was new for me. It seems that sort of pain is less off the drug. Waiting to see neurologist for perhaps lower dose or higher? Best wishes. I think it helps many people.

@earthangel ,
Thanks for the encouragement that LDN has helped. I’m sorry you are dealing with many Long Covid issues and hope something is soon found that helps. I have been lucky that PEM is my only real issue, except a tiredly specific kind of brain fog that only deals with calendar issues and comes and goes.

Thanks for the encouragement that it has helped you somewhat . I’m sorry you are dealing with so many difficult issues and ai hope something is found soon that helps. I am grateful and lucky that PEM is my only issue besides a weirdly specific sort of brain fog that comes and goes and is limited to calendar issues.

@mayo4g
Thanks for the positive report on LDN. I hope you get help with the neuropathic pain. When my late husband began feeling severe neuropathic pain, a doctor at Memorial Sloan Kettering cancer hospital prescribed Methadone, which eliminated the pain within a week or so, I think.

Two different physicians recommended LDN for me because I had retained a contrast dye in my system from a procedure in 2017, had many issues from that, and finally started chelation in 2022 once I found someone who specialized in that. Near the end of my chelations in 2024, I still had some issues; a shortness of breath, brain fog, tiring easily upon taking my normal walks, serious muscle and joint pains, etc.

I did not get covid vaccines because I was told my immune system was already compromised from the contrast dye, but I did get covid one time. Many of the covid residual issues crossed over with some that I was already having from the contrast dye.

I decided to start the LDN; they started me at 1.5 mg and went up each month by a half and I am at 3.0 right now. I stopped taking the LDN for a while because I was going to have a colonoscopy, and then started back.
The filler they used was lactose, and I decided to take it at bedtime; my experience has been really good.
The first thing I noticed was how well I felt upon waking after the first night. In a few days, I noticed my shortness of breath was no longer there, and soon following, muscle and joint aches and pains went away; and then I noticed that my sinus' seemed to be clear and I was not stuffy anymore. Things started getting better; most probably helped because LDN is an amazing anti-inflammatory for inflammation, throughout your body.

I continue to take it and went back to look at some of my blood work, just for curiousity to see if I could see anything; and I did. From July 2024, through July 2025, my creatine, eGFR, and glucose numbers had gotten either higher or lower than they should have been. At the end of July 2025, I started taking the LDN, and when I did blood work in early Sept, those sets of numbers had since gone back to the good place that they were before. in July 2024. My research said that LDN is healing to the immune system, I believe that to be true, now.

Also read that the fillers the compounding pharmacist uses when compounding your LDN prescription, matters; some fillers interfere with the efficiency of the medication, I read. The LDN has helped me immensely.

Lesligirl02, I’m so glad to hear about your dramatic improvement on LDN. 5 days ago I started at 2.5 mg after slowly going up every 2 weeks from a start at .5 mg. I don’t see any change yet but remain hopeful.