Low dose naltrexone (LDN) has been used as a treatment for autoimmune diseases, neurological illnesses, cancer and HIV/AIDS since the 1980s. At least seven conferences have been held on LDN, the most recent in Birmingham, UK, on the 23rd of October 2010.
The conference was meant for both doctors and patients. It was also filmed for an upcoming TV documentary on LDN. Sadly, three scheduled speakers had to cancel, including LDN prescriber Dr. Andrew McCall and John Donnelly who was going to speak about LDN for cancer both missed their flights.
Several themes emerged: dosing and scheduling of LDN; the difficulty of getting studies published in medical journals; the importance of diet and nutrition and the biological mechanisms of how LDN works (especially non-opioid mechanisms of regulating the immune system.)
One general theme seemed to be how even after hundreds of studies into the mode of action there is still a lot that needs to be figured out about LDN, both in regard to its mechanisms of action, but also the practical side, and many common "truths" about LDN may be nothing but myths or generalizations.
Tom Gilhooly on Low Dose Naltrexone
After the conference was opened by Linda Elsegood of LDN Research Trust, Dr. Tom Gilhooly of the Essential Health Clinic in Glasgow presented an overview of low dose naltrexone therapy. He recounted the history back to Bernard Bihari's experiments and Ian Zagon's studies in the 1980s and noted that Bihari did try to get his HIV/AIDS result published, but was not able to.
Gilhooly talked about the way LDN appears to reduce peroxynitrite (ONOO), which has been implicated in multiple sclerosis and CFS/ME. Nitrotyrosine in the cerebrospinal fluid is a biomarker for peroxynitrite and correlates with clinical deterioration. Lumbar puncture is not a very nice procedure however, so they are trying to develop a blood test.
Gilhooly also brought up again the stereoisomerism of the naltrexone molecule discussed in the Glasgow LDN conference in April. D-naltrexone is an opioid antagonist while L-naltrexone blocks TLR-4 (toll-like receptor 4). Some scientists are going to be studying L-naltrexone and its effects in isolation.
Gilhooly Revokes LDN Myths
Gilhooly noted that while 4.5 mg is often touted as the "optimum" dose for LDN, the best dose depends on the individual and may vary from 0.5 to as much as 25 mg. It should be started with a low dose and slowly brought up as high as tolerated. Side effects may be due to a too high dose and on the other hand, inefficacy due to a too low dose.
Gilhooly considers the claim that LDN needs to be taken at bedtime to be a myth as well, and believes that LDN can be combined with opioid painkillers, as long as they are taken at a separate time of the day.
Gilhooly stressed the importance of diet, saying it would be "madness" not to consider it. He warned against saturated fat (often avoided in MS; he said it activates TLR-4 so essentially works the opposite of LDN) and excess omega-6 fatty acids.
Gilhooly also brought up the use of LDN for lesser used conditions, such as alopecia (autoimmune diseases causing hair loss) and hayfever.
See Also
Third part of the report
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