The Clinical significance of low dose naltrexone in treating Multiple Sclerosis

The recommendation for the scientific research of LDN to treat multiple sclerosis (MS) was initially presented as a medical theory in 2005. Shortly after, an open-label multi-centered pilot trial including 40 patients evaluated the tolerability and safety of LDN in the initial progression of MS for six months. The medicine was well-tolerated by the patients, and a statistically notable reduction in spasticity was observed. β-endorphin levels in subjects’ peripheral blood mononuclear cells elevated simultaneously with administration of low dose naltrexone and proved the concept of one of the LDN’s mechanisms of action.

After some time, a retrospective study assessed 215 patients among which, 87% had relapsing-remitting MS and 10% with secondary progressive MS, who were given LDN. The average disease duration was ten years, and the LDN therapy was given for a median period of 804 days. Despite some hold of recall bias, 77% of subjects experienced no side effects at any point of LDN therapy. 6% reported insomnia, and 5% complained of having vivid dreams. 60% of subjects reported less weakness while using LDN, and just four persons mentioned it oppositely. More than half of the subjects confirmed an improvement in overall quality of life.

Moreover, two placebo-controlled randomized trials, seventeen-week long and eight-week long, determined the impact of LDN therapy on the quality of life of MS patients have been declared before in the study mentioned above. The seventeen-week-long study comprised 96 patients, and no analytical variation was observed between the groups. The eight-week-long trial was carried out on 60 patients, and researchers saw a considerable improvement in mental health elements of these patients and improved overall quality of life.

Preliminary investigations in autoimmune encephalomyelitis-induced mice, a standard MS model, manifested proof of opioid growth factor signaling as a prominent characteristic in the pathophysiology of Multiple Sclerosis. Before any other symptoms were observed, there was a decrease in the mice’s circulating opioid growth factors. After the administration, LDN restored the levels of opioid growth factors. Former in vitro experiments proved that LDN or opioid growth factor could suppress the proliferation of B and T cells, a mechanism that can benefit autoimmune states. An earlier investigation in the same mouse model also proved the advantages of opioid growth factor and low dose naltrexone in inhibiting the progression of the disease, modifying neurological defects, and considering postponing the onset of neurological dysfunction. Diminished levels of serum opioid growth factor were also seen in humans with MS, and LDN therapy reverted the discrepancy in these patients.

Such conclusions led researchers to recognize LDN’s therapeutic implications.

The opening research assessing Low Dose Naltrexone as an adjunct therapy in fibromyalgia was a single-blind, placebo-crossover study and included ten women undergoing the condition. After the initial couple weeks of placebo, LDN was given for eight weeks in a 4.5 mg dose with a subsequent two-week washout phase. After the trial was completed, six sufferers responded well and achieved a more than 30% reduction in the severity of the disease. The overall observed symptom reduction was 2.3% and 32.5% on placebo and LDN, respectively, in comparison to baseline. Secondary significant advantages were decreases in everyday pain, the peak of pain, tiredness, and stress.

The most recent research conducted on the same group of women assessed alterations in cytokine profile after treating them with LDN. It was a ten weeks long, single-blind investigation that included eight female patients in the final analysis of the data. The initial two weeks of the investigation were retained for baseline studies. In the remaining period of 8 weeks, LDN was given without a control group or placebo, even though the subjects were informed they could take the former medicine (placebo) at any time. Results have revealed a notable reduction in inflammatory cytokine levels.

On the basis of current information, further research-based data on LDN in treating fibromyalgia is needed.

Complex Regional Pain Syndrome (CRPS)

The term ” complex regional pain syndrome ” ( CRPS ) reflects characteristics of this Female sexual health condition, and an effective approach to treat it is still a clinical challenge.

In combination with standard pain management treatments, LDN has notably improved the symptoms of disease in three patients. Among three, the first two cases involved patients suffering from intractable CRPS for more than three years, with damaged multiple extremities seriously influencing body movements such as walking. Within a couple of months following the administration of LDN, both CRPS patients significantly decreased using ketamine for pain management, and their condition improved clinically. In addition to aiming for the reduction of CRPS symptoms, one patient quit using walking support. At the same time, the second one had an operation of the CRPS-affected dystonic foot, eventually achieving total remission. The latter case study is of particular concern because both trauma and surgical procedure are common factors involved in the etiology and growth of CRPS.

Another case report displayed a patient with multiple comorbidities, including Ehlers-Danlos syndrome, sleep apnea, small intestinal bacterial overgrowth, and CRPS. Following the eight years of unsuccessful combination therapies for pain management for CRPS, the patient was introduced to LDN. Along with concurrent medications treating other conditions, the patient gained remission on low dose naltrexone(LDN).

Reference Article link:

https://www.debwan.com/blogs/105648/Clinical-significance-of-low-dose-naltrexone-in-treating-Multiple-Sclerosis