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Endorphines, Naltrexone & Autoimmune Disorders

Whilst researching the immune systems balance of Th1 and Th2 cells I stumbled on a comment by a webpage visitor that Low Dose Naltrexone (LDN) therapy helped to balance Th1 and Th2 production. A quick search yielded something fascinating that I had never ever heard of before.. apparently LDN therapy can have a significant improvement on the health of a wide range of autoimmune disorders such as:
  • Crohn's Disease (CD)
  • Multiple Sclerosis (MS)
  • Lupus
  • Ankylosing Spondylitis (AS)
  • Ulcerative Colitis (UC)
  • Rheumatoid Arthritis (RA)

  1. The body produces the active endorphines that are modulating the immune activity during the night (apparently even if you do shift work it is still produced at night) (2).
  2. Under Low Dose Naltrexone (LDN) therapy for autoimmune disorders, a dosage of 3mg to 4.5mg (for adults) at sometime between the hours of 9pm and 3am. This increases the production of endorphin and enkephalin - which in turn is observed to modify immune system regulation.
  3. Random thought - if this crucial night time window (2am to 4am, see ref 2)  is so important in regulating our immune system then perhaps some aspects of modern society are messing with the bodies daily rhythms, eg: excess light at night, and too little light during the day time. This may help to explain differences in autoimmune disorders according to latitude (the further away from the equator the greater the occurrence of immune disorders such as MS)

  1. Low-dose naltrexone therapy improves active Crohn's disease (ref 2)
      Endogenous opioids and opioid antagonists have been shown to play a role in healing and repair of tissues. In an open-labeled pilot prospective trial, the safety and efficacy of low-dose naltrexone (LDN), an opioid antagonist, were tested in patients with active Crohn's disease.
      Eligible subjects with histologically and endoscopically confirmed active Crohn's disease activity index (CDAI) score of 220-450 were enrolled in a study using 4.5 mg naltrexone/day. Infliximab was not allowed for a minimum of 8 wk prior to study initiation. Other therapy for Crohn's disease that was at a stable dose for 4 wk prior to enrollment was continued at the same doses. Patients completed the inflammatory bowel disease questionnaire (IBDQ) and the short-form (SF-36) quality of life surveys and CDAI scores were assessed pretreatment, every 4 wk on therapy and 4 wk after completion of the study drug. Drug was administered by mouth each evening for a 12-wk period.
      Seventeen patients with a mean CDAI score of 356 +/- 27 were enrolled. CDAI scores decreased significantly (P= 0.01) with LDN, and remained lower than baseline 4 wk after completing therapy. Eighty-nine percent of patients exhibited a response to therapy and 67% achieved a remission (P < 0.001). Improvement was recorded in both quality of life surveys with LDN compared with baseline. No laboratory abnormalities were noted. The most common side effect was sleep disturbances, occurring in seven patients.
      LDN therapy appears effective and safe in subjects with active Crohn's disease. Further studies are needed to explore the use of this compound.
    1. Bihari et al found that a low oral dose of the opioid antagonist naltrexone, when taken at bedtime, led to a doubling or tripling of low levels of circulating beta-endorphin.7 Bihari has since treated some 100 people with autoimmune disorders. None of them has progressed further while the patient continued taking low dose naltrexone each night at bedtime.
  1. Yahoo support group for those interested in LDN
  2. LDN Database - people with a wide range of health problems have given their feedback
  3. Various videos
  4. Video - How to use LDN
  5. Video - How LDN therapy works

  1. Smith JP, Stock H, Bingaman S, Mauger D, Rogosnitzky M, Zagon IS. (2007)
    Low-dose naltrexone therapy improves active Crohn's disease
    Am J Gastroenterol. 2007 Apr;102(4):820-8. Epub 2007 Jan 11.
  2. LDN and Autoimmune Disease