Low-Dose Naltrexone, an Extraordinary Therapy

Low-Dose Naltrexone, an Extraordinary Therapy

Julian Whitaker, MD

Among conventional medicine’s most disappointing and disturbing flaws is its consistent refusal to seriously consider any and all safe and effective therapies that fall outside the mainstream. I want to tell you about one of these overlooked therapies, which shows great promise for cancer, autoimmune diseases, fibromyalgia, and a number of other disorders: low-dose naltrexone (LDN).

A Serendipitous Discovery

Naltrexone is a drug used to help addicts withdraw from heroin and other opiates. Bernard Bihari, MD, was treating heroin addicts in New York City when naltrexone first came on the market in 1984, and he began using it with his patients. It works by attaching to the opioid receptors in the brain that heroin and other opiates seek out—so when an addict uses heroin, it can’t bind to the receptors and produce a high. But naltrexone also blocks the binding of the body’s own endorphins, enkephalins, and other natural opiates that boost mood and sense of well-being. As a result, it makes people feel lousy, and no one stays on it.

At about the same time naltrexone was introduced, the AIDS epidemic struck. Because so many needle-sharing addicts were HIV-positive and there were so few effective treatments for AIDS, many of Dr. Bihari’s patients became ill and died. Looking for ways to help them, he tested their endorphin levels, and noting that the levels were critically depressed, he thought there might be some link between endorphins and immunity.

Although Dr. Bihari had dismissed the therapeutic value of naltrexone for heroin withdrawal, he recalled research suggesting that lower doses of the drug might stimulate endorphin release. So he began giving 1.75–4.5 mg (the dose for addicts is 50 mg) to his AIDS patients at bedtime. Their endorphin levels doubled or tripled, and more important, their immune systems bounced back and they got better.

A Shift of Focus

Dr. Bihari knew he was on to something, and his focus shifted away from addiction and toward immune function.

In 1985, he gave LDN to a friend with recurring non-Hodgkin’s lymphoma. To Dr. Bihari’s amazement, the tumors in her neck, chest, and abdomen shrank and disappeared! He also gave LDN to a friend of his daughter who had acute multiple sclerosis (MS), and for five years she had no symptoms. Then she ran out of LDN and within a month developed numbness and weakness. She got back on it, and her symptoms resolved. That was 16 years ago, and she has had no MS attacks since.

Today, more than two decades years after its discovery, LDN is making inroads. It’s not because a drug company is advertising it on TV or paying for research. Its patent ran out long ago, so there is no financial incentive. Nor are many doctors prescribing it, since no drug reps are spoon-feeding them info on it. But LDN’s popularity has steadily grown, driven by word of mouth from the many patients whom it’s helped.

LDN Normalizes the Immune Response

At first glance, it seems unlikely that a single drug, taken at less than one-tenth of the recommended dosage, would have such profound effects on so many seemingly unrelated conditions. It just doesn’t fit modern medicine’s “magic bullet” model of a different drug for every disease. But that’s the beauty of this therapy. Because it works with the body to help regulate the immune system and make it more efficient, it has widespread benefits.

When LDN is taken at bedtime, it attaches to opioid receptors. This action signals the body to produce large amounts of endorphins and enkephalins, which are powerful stimulators of the immune response. Once the short-lived blockade of LDN wears off, these opiates bind to receptors in bone marrow progenitor cells (stem cells), macrophages, natural killer cells, T and B cells, and other immune cells and influence their development, differentiation, and function. Recent research suggests that natural opiates also bind to receptors on cancer cells and inhibit their growth.

Solid Track Record in Cancer

Over the years, Dr. Bihari has treated patients with a variety of cancer types, including colon, prostate, melanoma, multiple myeloma, breast, ovary, uterine, brain, neuroblastoma, lung, Hodgkin’s disease, non-Hodgkin’s lymphoma, and chronic lymphocytic leukemia. He estimates that about 60 percent of cancer patients—for virtually all of whom conventional treatment had failed—receive benefits. He followed a group of patients between 1999 and 2004 and reported that 86 had a minimum tumor reduction of 75 percent and were headed toward remission. Another 125 had stabilized but hadn’t achieved that level of tumor shrinkage. Nine had tumor progression, and 84, most of whom were very ill to begin with, died.

Burton Berkson, MD, a friend of mine and an expert in alpha lipoic acid, has been using LDN at his clinic in Las Cruces, NM, for several years. In 2006, he published a case study in Integrative Cancer Therapies of a 46-year-old man diagnosed in October 2002 with pancreatic cancer and metastases to the liver. The prognosis for this type of cancer is dismal; average survival after diagnosis is just three to six months. This man had a single dose of chemo, which he tolerated very poorly, and he was told that further treatment would be “fruitless.”

So he went to see Dr. Berkson, who started him on 3–4.5 mg of naltrexone at bedtime, along with 300–600 mg of intravenous alpha lipoic acid twice a week and daily oral supplementation with lipoic acid, selenium, silymarin, and B-complex vitamins. Today, this gentleman is back at work, symptom free, and “without appreciable progression of his malignancy.”

An Answer for Autoimmune Disorders?

LDN’s track record in multiple sclerosis, lupus, rheumatoid arthritis, Crohn’s disease, and other autoimmune disorders appears to be even better.

A multi-center trial studying LDN for the treatment of MS is currently underway in Italy, and in a study published in the American Journal of Gastroenterology, patients with active Crohn’s disease were given 4.5 mg of naltrexone at bedtime for 12 weeks. Eighty-nine percent had symptom improvements, and 67 percent achieved remission.

People with these chronic conditions, which are caused by a dysfunctional immune system, often suffer horribly, so they know what works and what doesn’t. They are among the most passionate and vocal advocates of this therapy. If conventional medicine picks up on LDN at all, it will likely be for autoimmune conditions, as these patients educate their own doctors.

Fibromyalagia and Other Conditions

I believe that we’re just scratching the surface of the conditions that can be helped by LDN. Researchers from Stanford are conducting a study of its effects on pain, fatigue, and quality of sleep in patients with fibromyalgia. We’ve had some experience at the clinic with allergy relief.

I’m not suggesting that LDN is a cure-all, but I do recommend that you look into this safe, inexpensive ($25–30 a month) therapy. It may take some work convincing your doctor because this is an “off-label” use of an approved drug—but its long track record of benefits makes it worth the effort.


  • Visit lowdosenaltrexone.org to learn more about LDN, and peruse the Internet. You’ll find hundreds of thousands of links and many inspiring stories of patients it has helped.
  • Naltrexone requires a prescription and, at low doses, is available only from compounding pharmacies.
  • The therapeutic dose of LDN is 1.75–4.5 mg; 4.5 mg is the most common dose. It must be taken at bedtime. Do not use time-release or full-strength (50 mg) naltrexone. Try it for at least three months to evaluate effectiveness. LDN is safe and well tolerated, but should not be taken by patients on opioid narcotics.
  • If you can’t find a doctor willing to prescribe LDN, come to the Whitaker Wellness Institute. For more information, contact a Patient Services Representative at (866) 944-8253 or click here.


  • Berkson BM, et al. The long-term survival of a patient with pancreatic cancer with metastases to the liver after treatment with the intravenous alpha-lipoic acid/low-dose naltrexone protocol. Integr Cancer Ther. 2006;5(1):83–89.
  • Low Dose Naltrexone. [Low Dose Naltrexone Web site]. www.lowdosenaltrexone.org. Accessed January 29, 2007.
  • Smith JP, et al. Low-dose naltrexone therapy improves active Crohn’s disease. Am J Gastroenterol. 2007 Jan 11; [Epub ahead of print].

Modified from Health & Healing with permission from Healthy Directions, LLC. Copyright 2007. Photocopying, reproduction, or quotation strictly prohibited without written permission from the publisher. To subscribe to Health & Healingclick here.

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