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LDN

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Naltrexone itself is a TGA approved medication (brand name Revia), which has been used since the 1970’s as an opiate antagonist for treating opiate drug and alcohol addiction. At regular dosing, to treat addiction, usually 50-150mg a day, it has shown to block the euphoric response to opiate drugs such as heroin, morphine and alcohol. Dr Jaquelyn McCandless (author of Children with Starving Brains), along with many other DAN! Doctors have tried Naltrexone as an opioid blocker in the hope it would offset the opioid effects of the large peptides in wheat and milk that are thought to affect most ASD patient adversely. However, unfortunately they did not find it to be useful for that purpose.

Opioids are in fact endorphins, which are known to operate as cytokines (the principal communication signalers of the immune system), and it has been shown that opioids can operate through opioid receptors on immune cells and produce immunomodulatory effects.

The most commonly used classification method in this regard, is referred to as the Th1/Th2 balance, with…

  • Th1 cells → promoting a cell-mediated immunity that directs Natural Killer T-cells and macrophages to attack abnormal cells and microorganisms at sites of infection inside the cells
  • Th2 cells → induce humoral immunity that results in the production of antibodies, which are used to neutralize foreign invaders and substances outside of the cells.

 

The inability to respond with a sufficient Th1 response can contribute to chronic infection and cancer; while an overactive Th2 response can result in allergies, various syndromes and play a major role in autoimmune disease, which many ASD patient have to some extent.

The discovery that ultra low doses of Naltrexone (approx one-tenth of the usual dosage), had the ability to boost the immune system was made by Dr Bernard Bihari, a New York physician studying the immune response in HIV/AIDS patients. He termed this new therapy Low-Dose Naltrexone (LDN) and has described the promising responses seen in those patients with AIDs, cancer, and with other autoimmune diseases such as Multiple Sclerosis (MS). LDN has demonstrated the ability to normalize the immune system by elevating the body’s endorphin levels and accomplishes these results with virtually no side effects or toxicity. Naltrexone is considered a very safe drug and has never been reported as being addictive.

Dr Jaquelyn McCandless, conducted an eight week informal study on 15 of her own ASD patients (May – June 2005), using 5mg of LDN in a transdermal cream, applied between 9 – 12pm each evening. Dr McCandless used a transdermal cream for the following reasons:

  1. It gave her the ability to adjust the dose easily, if required (some of the smaller children reported doing much better with doses as low as 0.5mg)
  2. Naltrexone is known to possess a very bitter taste, this was no longer a problem
  3. The cream could be applied to the child’s body while they slept.

The study also included several adults, one with Crohn’s Disease and one with Chronic Fatigue Syndrome (using an altered dose of 4.5mg nightly).

Dr McCandless asked the participants for a weekly report on: sleep, appetite, stools, relating, general activity, cognitaion, and language. The results showed that 8 of the 15 children had positive responses, with 5 of these 8 being “nothing short of phenomenal” according to their parents. The primary positive responses were in the area of mood, cognition, language, and relating. The two adults in the study (one with Crohn's and the other with Chronic Fatigue Syndrome), also had very positive responses. With the Crohn’s participant going on to say that she has not had any problems with her gut since taking the LDN (over one year of the writing of Dr McCandless).

Please note: Dr McCandless stated that 5 of the children had equivocal results, some good responses interspersed with complications with gut infections and treatments, so it was difficult to know just what was doing what, and the other 2 were unable to complete the study due to personal reasons.

Please keep in mind that every patient is different and LDN dose not have to work in all patients to be of benefit to some. LDN has so far shown to be an “effective, non-toxic and non-addicting… behavioral and immunomodulating intervention.”

LDN is a prescription only medication and must be compounded accurately for the tiny dosing required. It is available at Kingsway Compounding as a 6mg/ml transdermal cream in 3ml syringes.

Dosing Recommendations:

We recommend starting at a low dose, for example 1.25mg (equal to 0.2ml) and apply between 9 and 12pm (this is when the pituitary is alerted and the body attempts to overcome the opioid  block with an endorphin  elevation). Increase the dose gradually; by 0.1ml every second or third day, depending on patient response. Once happy with response maintain the dose ensuring patient is continuously monitored by their doctor.

Please feel free to contact us with any questions you have regarding Low Dose Naltrexone or anything else which I have discussed throughout the year.

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