Naltrexone

I love Naltrexone as well. I started at 1 mg and have worked up as high as 4.5 mg but 3.5 mg seems to be my sweet spot. I have to take it in the morning as it does give me insomnia. It does give me a burst of energy about 2 hours after I take it and it almost completely takes away the pain from the COVID constant chronic inflammation. I still have to pace myself or I will run out of energy and be down for a few days...but I feel better than I have in 5 years.

What exactly does this med address?

Hi Diverdown.
I think you made a typo and forgot a decimal in your "25mg" dosage, as that's actually a full dosage for treating opiate dependence!
(Just to prevent confusion in future readers).

No, I am taking 25 mg. This is not considered a low dose. I tried the low dose 4.5 mg but it has to be compounded as the only dose available without compounding is 50 mg. So I break the 50 mg in half. This is a dose used to treat OUD, you are correct. We are just trying it to see if it helps and it seems to help.

It binds to the opiate receptors in the brain, theoretically tricking the brain into producing more. It is used for people with opiate addiction and alcoholism, higher doses 25, 50, 100 mg and so on. I am using 25 mg as I have tried the low dose which has to be made specifically for lower doses as the pharmaceutical companies do not make lower doses than 50 mg. I hope that makes sense.

I see, but what does it do….stop pain, enhance mood, provide energy, etc.?

Naltrexone was originally used to treat both opioid and alcohol use disorders at a dose around 50 mg or more. For people at this high dose, it binds the opioid receptors and prevents them from feeling high if they use their drug of choice.

Lower doses, from .01 mg to 4.5 mg, has been found to help people with Long COVID, chronic fatigue/pain, fibromyalgia, Crohn’s and other dysfunctional immune system disorders. At this small dose, it blocks the opioid receptor for about 1.5 hours and then provides analgesic and anti-inflammatory benefits. When it unblocks the receptor, I get more energy from the increase in endorphins and it greatly decreases the inflammation that gives me so much pain. You would not benefit from this medication if you routinely have to take an opioid for pain relief as the opioid will not work properly.

There is a very cheap option other than compounding. That is make up your own oral solution and drink it. My doctors gave me this option. My dose is 3.5 mg. I take a 50mg Naltrexone tablet and put it in a jar with 50ml water measured out with a graduated cylinder. Once the tablet dissolves I have a 1 mg to 1 ml solution and can use a syringe to drink a 3.5ml dose. At my 3.5 dose the 50ml solution will last for about two weeks in the fridge. Because insurance will cover the 50mg Naltrexone tablets my annual cost is under ten dollars! Compared to about $1,200 from the compounding pharmacy which insurance would not cover.

I have been taking LDN since Dec 2024. It definitely has been a help for my PEM (Post Exertional Malaise) and shortness of breath. Weirdly, and I don't understand, I still get shortness of breath when bending and reaching but can walk distances and play golf again. I do still have days of extreme fatigue - probably overdoing it. I take 4.5 mg in the morning but have very weird dreams every night, a side effect. I think the dreams effect my sleep quality. Also, I used to enjoy a glass of wine and having one now results in an increased effect of the alcohol and night sweats. If anyone can explain these reactions, I'd appreciate it.

I buy a 3 months supply of compounded LDN for $100 or $400/year. Shop around for compounded pharmacies with cheaper prices than $1,200/year. I have found the $100/3 months in MI and in FL.

My doc prescribed it for my fatigue and brain fog. I did not do well but I only tried it for 3 days. May give it a shot again. He started me very low. 0.5mg. Made me very tired. Plan was/is gradual increase to 4.5mg.