Naltrxone vs Azathioprine

Hello- I take low dose naltrexone (LDN), but I’m not familiar with the other medications you mentioned. I have seronegative spondyloarthropathy (an autoimmune inflammatory arthritis), central sensitivity syndrome, fibromyalgia, and POTS, among others conditions.

Initially I started the LDN to see if if would help with fatigue and pain sensitivity and GI symptoms. I can’t say it’s helping with pain, but it does help with fatigue.

That said, based on my experience, I wouldn’t expect for it to replace a different medication for a serious condition. For example, I still take my Humira and wouldn’t expect it to replace that. I use it in a more targeted way to help fill in the gaps for what the other medications don’t do.

Based on what I’ve read about LDN, it’s thought to help fatigue by increasing endorphins in the body. And you can get some other benefits like pain relief and improved GI symptoms from that, possibility. It may act as an anti-inflammatory, something important for us. And it may regulate glial cells, which when overactive can contribute to pain. There’s still uncertainty about those things though. Anecdotally, I read and hear more about its effect on fatigue, and that’s also been my experience too.

I’m sorry I can’t help with the other medications, but hopefully someone else will have some experience to share. I can relate to it being tough to decide to take a medication, especially those with serious side effects.

Thank you for your insight. I appreciate it!

I second what Emo said. And very well put it was, too. As a LDN user with multiple autoimmune conditions I have found that it does help with some types of pain, it helps normalize sleep, helps intestinal inflamation and helps the immune system get back in rhythm with itself. All very helpful. But I wouldn't expect it to take th place of specific drugs that are given for specific conditions. The only time I have had it take the place of a drup was I was taking Budesinide ( a steroid given by mouth for the small intestine) and the LDN healed it so thoroughly that I didn't neet it any more. And the pain it helped was caused by Sjogren's and was intractable to NSAIDs. I certainly didn't want to try anything stronger. But the LDN made it go away in less than 2 days. So it isn't for every one but it has certainly helped me.

Your doc is wrong. I took LDN when my ulcerative colitis went out of control, and it helped me get back into remission.

I’ve taken both AZA and LDN (but never together), for UCTD. The AZA caused my liver enzymes to skyrocket (transaminitis), so that was a short-lived trial! I was on LDN for several months. It seems to have helped a lot with my photosensitive rash—haven’t had any since starting LDN! Unfortunately and paradoxically, I determined it was the LDN that was contributing to my severe insomnia. I no longer take the LDN, and am sleeping much better with 100 mg magnesium glycinate at bedtime. 😴

HI thisnthat,

I have read that vivid dreams and insomnia can be caused by LDN. Reducing the dose and taking it in the morning can help with those side effects-- is what I read.

Glad you are sleeping better.

About starting azathioprine:

I have been on azathioprine for 16 months or so. It has been effective for my
joint swelling from autoimmune arthritis.

Before my rheumatologist doc started me on it, she ordered some kind of blood work to test for a genetic marker connected to in/tolerance of azathioprine. I was ok to take it.

Also, she tested my liver function frequently at the start of the medication. At month one and then month 3, if I recall correctly. Now I am back to routine testing.

Also, she started me on it slowly. I think it was one pill a day for the first month, then the blood test, then 2 pills a day and the blood test.

My doc is very, very cautious-- belt-and-suspenders kind of person. Maybe not all doctors follow this protocol.

About Low-Dose Naltrexone:

I've been researching LDN. I haven't started it yet. My doctor has agreed to prescribe it to me.

The article (link below) is pretty scientific. I go to the "conclusion" sections first! If I don't, then my brain gets too tired from trying to understand all of the statistical and scientific explanations that comprise the bulk of the article.
https://pubmed.ncbi.nlm.nih.gov/30917675/
Once you get into "pub med" here, then you can search it for more articles on LDN. Be sure to look at the publication dates. While some of the articles are older, it doesn't mean they are wrong. Naltrexone has been around for a long, long time. I think the first studies for its use in autoimmune-related disease was in the 1980s.

Since companies canNOT make money from its use (because it's an old and cheap medicine with an expired patent), there's no money to do the expensive, double-blind drug trials that would help answer our questions about it...But that's a topic for another thread.

Hope it works out for you! And for me, too!

Hi kak1601,

My rheumatologist is keeping me on azathioprine AND adding the low-dose naltrexone.

I also take Tremfya. I am allergic to NSAIDS, so that kind of limits my pain-relief options. I've been through a bunch of other meds over the years: dmards, tnfis, biologics, too.

When you are on LDN, you cannot take any medication with an opioid in it, like tramadol, or some cough medications, or some anti-diarrhearals (sorry about spelling).

I posted some more messages in this thread, but I'm not sure in which order they appear. Sorry for any confusion. 🙂

I was going to say the same thing as @annewoodmayo ... I take LDN in the morning and I stopped having issues with insomnia. Except, no reason to bring it back if the magnesium glycinate helps you 🙂 I take that too.