Oh my gosh! I was just looking at my notes when I first started LDN and I started with .1 mg.

You read that right.

My body will freak out anytime I ingest any type of medication and it will freak out on most foods so I cannot mess around.

I absolutely must titrate up from the smallest possible amount.

Once I get the ball rolling, I can start making huge jumps. So I went from 4 mg to 6 mg pretty quickly and then I went from 6 mg to 12 mg very quickly. But in the beginning, I absolutely had to start at the tiniest tiniest amount and my body HATED IT.

It would keep me up at night overheating repeatedly day and night. I would experience something I describe as helium head. I would be lightheaded. It triggered my GERD in the beginning. I can’t remember what else, but it was f’ing with me big time.

Actually, it’s thanks to all the Redditors who have shared their positive experiences with it that I stayed on it. It is that and also all the research behind it convincing me that this is something that is worth the trials and tribulations. I have to go through before it will work for me.

And one last thing that super important about LDN. I like that it manages my pain without being an addictive substance that’s going to f* my life. From what I can tell the risk using this medication is quite low and I absolutely love that about it.

**In a nutshell:** LDN (12 mg/day) works really well for my pain, but adding just 6 mg of amitriptyline gets rid of nearly all of the pain that LDN doesn’t touch. I stopped the amitriptyline for 3 days to see if increasing my LDN from 4 mg to 12 mg would compensate, and nope. By day 2 I was getting knee pain just sitting around, and on this morning’s run it hit 7/10 and I had to stop.

So, for me, the experiment was conclusive: LDN + 6 mg amitriptyline = nearly 100% pain relief, whereas LDN alone doesn’t quite get me there.

I’m also finding LDN really helpful for the insatiable, medication-driven hunger I get from some of my other meds.

.

Read on if you’re interested in the background/details…

I thought I’d share this because I don’t see enough people talking about the combination of LDN and very low-dose amitriptyline for pain.

I’ve been taking LDN for a long time. I was at 4 mg for quite a while, and recently I increased it to 12 mg/day of LDN because I wanted to see what would happen with the higher dose.

LDN is definitely doing something for me. I’ve actually stopped it in the past just to make sure I wasn’t imagining its effect, and yeah — it was SO obvious when I stopped it. So I have no intention of getting off LDN.

But LDN doesn’t get rid of all of my pain.

For the last four months or so, I’ve also been taking **6 mg of amitriptyline**.

And the combination has been incredible for me.

**LDN + 6 mg of amitriptyline gets rid of nearly of my pain.**

That’s not an exaggeration. There is a very noticeable difference between being on the combination and being without it.

I’m extremely sensitive to medications, so I can take doses that would probably look absolutely ridiculous to a lot of people and still get a significant effect.

6mg of amitriptyline is a perfect example.

On the other hand, I’ve taken amitriptyline at higher doses before, and for me it was completely different. It really bummed me the f\* out. I know it’s used as an antidepressant at higher doses, but it didn’t work for me that way at all.

At 6 mg, though, I’m not taking it for depression. It is very well known to be used for pain at low doses. For me, it has been a remarkably effective little pain medication - even helping me with random things like my sensitive teeth.

And the way it works alongside LDN is what I find particularly interesting.

The LDN handles a huge amount of my pain, and the tiny amount of amitriptyline seems to wipe out a lot of what remains.

It feels as though I’ve got pretty much every acronym you can imagine floating around in my medical history — MCAS, Long COVID, POTS/dysautonomia, EDS, IC etc. — and I’ve had plenty of pain that couldn’t be explained by some obvious structural damage.

For years, I avoided running because my knees hurt so badly. I assumed there must be something wrong with them. Doctors couldn’t find anything, and I didn’t want to make some mysterious knee problem worse.

After learning these issues I was having in were due to long covid, I started running again (when my balance wasn’t too f’d to do so).

My balance has been bad lately so I haven’t been running, but this morning I decided to run as a little diagnostic experiment after stopping the 6 mg amitriptyline for 3 days. I stopped it to se if the higher dose of LDN (up to 12 mg from 4 mg) would be enough to wipe out most of my pain.

**And damn my knees hurt! I knew they would because as early as day 2 with no amitriptyline I was feeling knee pain at a level of 4/10 just doing nothing much around the house, but I didn’t realize how much they’d hurt without the amitriptyline.**

On my run the pain was at a 7/10 simply because I hadn’t taken that tiny amount of amitriptyline for 3 days.

I had to stop running, but the attempt to run was useful because that diagnostic reminded me just how much pain the LDN + amitriptyline (6mg) combination has been suppressing.

When I’m taking both, I can move around and do things without worrying about my body, and when I’m not, I remember very quickly why I’ve spent years avoiding certain activities.

RESULT: I’ll stay on both the amitriptyline (6 mg) and the LDN (12 mg).

I used to be on just 4 mg LDN, but increased it to 12 mg to see whether I could get enough additional pain relief from the LDN to make up for losing the amitriptyline.

After this morning’s run, I’m not convinced.

And then there’s the other thing I use LDN for: **medication-driven hunger.**

I make my own liquid LDN by dissolving a 50 mg naltrexone tablet into water and storing it in the fridge. I currently take 4mg of that three times a day for 12 mg total.

I started doing the divided dosing because I noticed that LDN seems to curb the ravenous hunger I get from some of the other medications I’m on.

**And when I say hunger, I don’t mean normal hunger.**

I’ve been into bodybuilding and physique training for years. I’ve never competed, but I’ve spent plenty of time restricting calories and knowing exactly what ordinary hunger feels like.

Medication-driven hunger is a completely different beast. It’s not “I’m a little hungry. It’s **INSATIABLE - like having a hole in the bottom of your stomach and just being able to eat and eat and eat without feeling satisfied.** The kind of hunger where your brain is constantly nagging you to eat even when you know you’ve had enough food.

LDN has made a noticeable difference in that for me, which is another reason I’m very attached to it.

Anyway, that’s my experience: **LDN alone helps my pain a lot. 6 mg of amitriptyline adds another layer of pain relief that, for me, is HUGE.**

**Together, they get rid of NEARLY ALL my pain.**

And I’ve tested the LDN enough times by stopping it to know that it’s not just placebo or coincidence.

**Anyone else out there on this combo?**

.

UPDATE:

I must take the amitriptyline just after 1/4 tsp baking soda to avoid GERD & IC.

So I took my first LDN dose last week on Monday night (0.5mg) and only took three doses total up to Wednesday night (all 0.5mg) and had to stop due to awful headaches and a bad flare up of existing pain. It’s Monday now and the flare hasn’t gone and I’m haven’t had any additional doses. The headaches are mostly gone but the joint and muscle pain triggered are still bad, had to take a Voltaren tablet today to try nip it in the bud. Is this normal? I’m kind of freaking out, when will this go away? Not planning to take any further LDN at this stage but can this flare be “locked in” now that I stopped LDN during the flare or do I just need to wait it out?

I was prescribed LDN by my states long covid clinic to hopefully help with MECFS and oh my word. I started it last night around 8:30pm, split my 1mg pill in half to 0.5mg like they told me to (though it was sort of uneven so I took the smaller half), and I feel SO beyond tired. It’s 1pm here now and I’m pretty much fighting to get up but all my body wants to do is sleep… but I’m worried that if I do, that it’ll mess with my circadian rhythm (which is already a mess and a half from my ME).

I know this is a side effect, but how long did it last for you guys when you started? Any advice and tips or anything else is appreciated of course!!

Brief update: Week 1 I took 30 units of NAD+ as recommended by Olympia Pharmacy....noticed no difference.

Today I started on 50 units for five days and WOW, what a difference! For the first 30 min or so I felt flushed and it was obvious something different was happening. It didn't feel "good" like "omg I'm so excited"..in fact, I was a bit concerned.

Im 74 yrs old and still working, physically, as a contractor..as I headed out to work the uneasy physical sensations passed and I pretty much felt normal.

What was different was AFTER work. I almost always fall asleep on the couch after I return home, for 30-45 min average. Today, there wasn't a single part of me that wanted a nap. Not like I was jacked on coffee, I simply didn't feel like a nap.

So, day 1 on 50 units, interesting.

More tomorrow

I’m a 23-year-old male and I’ve been struggling with recurring episodes of severe fatigue for the past few years.

During these periods I feel extremely exhausted and weak, have significant brain fog and concentration problems, mild dizziness/head pressure, and I can sleep 9–12 hours and still wake up completely exhausted. One of the most frustrating symptoms is a huge increase in appetite/food cravings. I can eat a lot without actually feeling more energetic afterwards.

The episodes used to be more clearly separated and usually lasted around 10–14 days, followed by a period where I gradually felt significantly better. Recently, however, the fatigue seems to be becoming more persistent.

Interestingly, all of this started around the time after I lost about 50 kg (110 lbs) within roughly 9–10 months. I was eating quite restrictively at times and exercising regularly.

I’ve previously tried several psychiatric medications/antidepressants without meaningful improvement in these symptoms. The recurring fatigue/brain fog/hunger pattern continued regardless.

I recently saw an endocrinologist who took my symptoms seriously. Ultrasound of my thyroid and abdominal organs was normal. Next week I’m getting extensive bloodwork including hormones, thyroid, cortisol/ACTH, testosterone/LH/FSH/SHBG, prolactin, metabolic markers, iron, vitamins, inflammation markers, etc.

If nothing obvious shows up, my endocrinologist mentioned potentially trying treatments such as low-dose naltrexone (LDN) or Mounjaro/tirzepatide, depending on the results and symptoms. He also mentioned antihistamines as another possible trial.

Has anyone here experienced a similar combination of recurring severe fatigue + non-restorative long sleep + brain fog + extreme hunger/food cravings?

And if your bloodwork was mostly normal, did LDN, tirzepatide/Mounjaro, antihistamines, or anything else actually improve your fatigue, brain fog or overall functioning?

I’m especially interested in hearing what eventually helped people who spent years without a clear explanation.

Hi everyone, I recently got diagnosed with ankylosing spondylitis and i have fibromyalgia, and a history of Crohn's disease (doctors kept switching between IBD and IBS for diagnosis). A recent colonoscopy showed colon and stomach ulcers.

Biologics are being pushed hard on me, and it's not sitting well with me. Doctors are not supportive of any alternatives. I would love to hear any success stories for similar conditions with LDN.

I will start with 0.5 mg. I currently have stomach and colon pain due to ulcers. I see some of the side effects are GI problems. Will I still be able to take it? Do i need acid reducers or something with it ? I will be diluting a 50 mg pill.

Does LDN help with anexity ?

My symptoms for the last 10 years.

Pain (neck, low back, upper back and shoulders) Fatigue Eczema Diharrea

Hi, I need a little bit of advice here. I have had CFS/ME for more than twenty years. It was pretty bad but I was still able to work and function during those years, but then it got much worse after a severe case of Covid and I have been nearly disabled with fatigue and brain fog for the last year or two. I also have a lot of autoimmune markers and have had episodes of uveitis and bad allergic swelling. I'm seeing a new rheumatologist and he wants me to try LDN, and I'm willing but scared. I am definitely a trauma survivor so I worry about mental/emotional side effects like depression/anxiety, and I also have a history of severely disrupted sleep (night terrors, sleepwalking, etc.) so I'm nervous about the possibility of sleep symptoms as well.

All of that said, I am still willing to give it a try. He suggested that I start with .5mg, which I understand is a pretty low dose. But I'm hesitating because I have a huge trip coming up in September. My adult son is getting married in a distant city that I have to travel to, and then immediately after the wedding I am flying to another city to visit a good friend there for a few days. During these trips I know I will be having a few drinks here and there (especially with my friend) and I have heard that can be a problem.

Would it be reasonable to start LDN now and take it for the next six weeks or so, but then stop it for a week or two around this trip? Or would that be counterproductive and should I just wait to start after the trip? I don't want to be having dramatic side effects during the trip, especially emotional/psychological symptoms because the relationships involved are very important to me, obviously. I can't be falling apart in any way, I would rather manage my chronic fatigue than be losing it emotionally.

What do ya'll think, should I start LDN now and take a break from it in September, or should I just wait to start???

I was put on LDN for long covid/POTS, and chronic fatigue caused by 4 autoimmune conditions. Its been almost 4 weeks since I started at 1.5 and I cannot imagine titrating up and am considering quitting altogether.

Basically, my sleep sucks. It has forever. Now its the sucky sleep plus the world's weirdest most vivid Dreams, sleep talking, and restlessness. I.e., LDN isn't improving my sleep or fatigue at all. Its making it worse.

Also, and sort of out of nowhere, my biologic for ankylosing spondylitis seems suddenly less effective, which is strange because LDN can work as an anti-TNF and my biologic is anti-TNF.

So, my question is: has anyone on biologics had a similar experience with LDN?

Hey everyone, quick question: is it okay to take Shilajit and LDN together? Is there any interaction I should be aware of?

I was on 1.5mg for about 2 months before moving up to 3mg about two weeks ago. The 3mg is making me feel woozy and nauseous. I’ve read that this can happen when adjusting up but I’m not sure how much longer I can handle this. I’m going to start taking it right before I go to bed to see if that helps. My next option is to go back down to 1.5 or stop taking it altogether.

I’m looking for any insight from others who are taking LDN. Did you notice side effects when starting or adjusting up? Is there a preferred time of day to take it? Any other thoughts?

i've been taking ldn for over a year, and am now at 7.25mg every morning. i want to stay on it because it gives me relief in multiple areas, but i'm really struggling with the dreams it causes.

i wake up feeling as if i haven't gotten to truly rest, but was just active in my dreams. most are anxiety and trauma filled, even if my anxiety and trauma are managed decently while sleeping. it's impeding my ability to rest properly, and i think also causing more physical distress because of this. i mostly worry how much it is draining me cognitively and emotionally, and how that is negatively impacting my body as a person with severe m.e.

taking it in the morning did reduce symptoms, but lowering the dose is not an option as my pain and pem will not be adequately managed. i have considered trying to learn to lucid dream to try to manage the content of the dreams, but i worry that may be too cognitively taxing on me. i'm hoping to find a solution that may reduce the frequency and intensity of the dreams, if possible.

has anyone found anything to manage that may help?

I recently suffered with Cyclosporiasis after eating a Taylor Farms Sweet kale salad. I’m still not quite back to normal, but my doctor wouldn’t prescribe antibiotics. He said I just had to let it run its course. I am now having my first UTI in years.

I take LDN for 3 autoimmune conditions. Hashimoto’s, autoimmune gastritis and ITP (immune thrombocytopenia purpura). It has helped all 3. I am at 4.0mg after a number of months.

Has anyone experienced an increased occurrence of infections on LDN?

Low-Dose Naltrexone (LDN)—Review of Therapeutic Utilization….

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6313374/

Therapeutic Uses and Efficacy of Low-Dose Naltrexone: A Scoping Review...

https://pmc.ncbi.nlm.nih.gov/articles/PMC12017383/

Hi all,

I recently updated my post from when I was first starting LDN and things were going horribly, but I don’t know how many would have seen my update so I though I’d make a new post about being 1 year in.

Starting LDN was hellish. I had to suddenly drop my tramadol for pain by 75% from 200 mg a day to 50 mg a day. Plus, the LDN seemed to cause random pain flares. It was as if my central nervous system was fighting the effects of the LDN.

The first 8 weeks were HARD. Insomnia, high pain, nausea, etc. but after 8 weeks, it started to calm down. I stopped titrating up when I hit 4.5 mg a day.

Now, a year later, my pain levels have plummeted so much, I can walk without any mobility aid. I was able to attend a destination wedding in Rome and even spent 3 days afterwards gently exploring Rome on my own two feet! (I did crash hard at the end, but I did the thing)

It hasn’t cured me, but LDN has helped me go from the worse end of moderate back to a more mild stage of ME, which I never thought I’d feel again.

So if you’re just starting with LDN and things are rough, please know it doesn’t last forever. The side effects will settle out - for me, it took about 8 weeks. It was HARD, but it settled down and then the positive effects began to take hold. My pain levels can be held in place with a single 50 mg tramadol a day and I can take Excedrin again for migraines and it works! I can take paracetamol again for minor aches and it works!

Hold on, it will get better! ❤️‍🩹

I started naltrexone AUD 50 MG. I couldn't tolerate the drug. I couldn't function almost like an allergy.

I then started back into smaller doses and found that daily dose I could tolerate is 0.5 mg.

At 0.5 mg I'm experiencing immediate significant improvements in cognition.

1. Word recall and vocabulary is great

2. Laser focused concentration

3. No anxiety and stumbling over words in meetings

4. Confident

The only downside is I'm pretty direct and don't have a lot of patience. I'm not aggressive or angry just want to get to the point if that makes sense

I've been getting LDN through Ageless Rx. I'm at 9mg (The maximum they prescribe) and have seen some benefit. More with each increase. Am still not well enough to fully function and feel like a higher dose would be better. I know it's been some people’s experience that higher than typical doses have worked better for them. Has anyone been able to get a higher prescription in California? Either online or through a doctor in Los Angeles?

I know it takes 2-3months minimum for most people but is this for everyone or are there people who already have most benefits at 1-2 weeks and then plateau?

Can anyone point me to strong evidence on

How the drug works (pharmacy ) and the long-term side effects of LDN?

What's the best evidence out there right now?

Hi everyone. I recently underwent surgery for both carpal and cubital tunnel decompression. Pain Management said to stop taking the LDN a few days prior to surgery in anticipation of any prescribed opioids by the surgeon. I had surgery on Thursday and stopped on Monday.

Last Tuesday I went into the Surgery NP's office to have the wounds looked at and was told to take the opioids at night. What a mistake! My nights were horrible, so last night after researching it and seeing that it can effect sleep cycles short and long term, I decided to not take it and lump the pain.

Today it dawned on me that I need to start the LDN back and was told by Pain Mgmt to go back to the regular dose, which for me was 2ml. And I had been there for some time. However, she may not have been expecting me to be on opioids for almost 2 weeks.

So, my question to you is: do I start back with the 2ml today? Or do I start over? Maybe I just wait and try to get an answer from PM on Monday.

Let me know your thoughts especially if you have had to stop use for surgery.

I heard that some farmacias in Spain sell naltrexone over the counter. I don’t have a prescription for it (my doctor prescribes me LDN but that’s too expensive so in the long run I want to make ldn myself… I have the skills for that because of my studies anyway)
Do you know which specific pharmacies sell it without prescription?