[EDIT: Since writing this article, I have started taking LDN to treat my Crohn’s. For all articles on this blog related to LDN, including my experiences with it, click here.]
First, some background information. Also, please note that I am not a doctor. All the information below was either relayed to me by an ND, or I found it on the internet. I do not claim that it is accurate, only that it is my understanding of the hows and whys of the use of low-dose naltrexone in the treatment of Crohn’s.
Endorphins make us high. We know this. Our body creates them when under stress, and it can provide a powerful cathartic effect. When our bodies produce endorphins, they are consumed by specific types of receptors within the nervous system. As it turns out, these same receptors are fooled by opiates. The reason heroin feels so good (so they tell me) is that it’s behaving in your body like a massive rush of endorphins. This has two effects: 1) it makes you euphoric, and 2) over time, your body ceases to produce its own endorphins. It’s this second issue that leads to addiction. Your body only produces the endorphins that it thinks it needs, and if your endocrine system thinks that you have a surplus, it will stop production altogether. Once the supply of endorphins (or opiates) is gone, it takes your body a while before it starts producing its own again. Thus, the withdrawal period. Naltrexone is a drug that has historically been used to help people kick addiction. It works by blocking the endorphin receptors. This results in 2 things: 1) Your body can no longer respond to endorphins (so you can’t get high), and 2) because your receptors are tricked into thinking that there are no available endorphins, your body begins to produce more.
As a treatment for addiction, naltrexone has been around for a long time and helped a lot of people. Recently, however, there have been some promising pilot studies (and LOADS of anecdotal evidence) showing that the use of low-dose naltrexone (LDN) can safely and reliably induce and maintain remission in both Crohn’s disease and multiple sclerosis. I don’t know much about MS, so that’s the last I’m going to mention it here. But in terms of treating Crohn’s, here’s how the thinking goes: We know that stress is a significant factor in Crohn’s flares. When people encounter stress, the body will typically produce endorphins to help manage and mitigate this stress. It’s theorized that one of the factors at play in Crohn’s patients is that they under-produce endorphins. This leads to greater stress in the body, which leads to more Crohn’s flares, which leads to greater stress in the body, which leads… you get the picture. The use of LDN is believed to stimulate the body to produce more endorphins, by the same mechanism that it helps heroin addicts kick the habit. The only real difference is a question of degree. Whereas heroin addicts need to completely restart the production of endorphins and therefore take very large doses of naltrexone, Crohn’s patients merely need to increase production. It’s thought that by taking a very low dose, the endorphin receptors are only blocked for a very short period of time. So, if one takes that low dose at a time when they would be producing their usually short supply of endorphin (say, right before bed), then the body creates more, essentially tricked into recognizing that the amount it usually creates is not sufficient. This increased endorphin production brings catharsis to the body, reducing stress, and thereby reducing the inflammation that was created in response to that stress.
Let’s be clear: This is NOT an FDA-approved use of naltrexone. While there have been some small, preliminary pilot studies researching the *safety* of taking LDN, there have been very little in the way of formal clinical trials. There is an organization evangelizing the use of LDN in the treatment of autoimmune diseases (http://www.lowdosenaltrexone.org/), but I find them difficult to take very seriously. They make LDN sound like some kind of miracle drug, and many of the claims they make sound, to me, to be contradictory. To my eyes, they do more damage than good to the cause, coming across more like snake oil salesmen.
Having said that, it doesn’t take much google-fu to find tons of people who claim to have benefited from the use of LDN in treating their Crohn’s. It’s unlikely that I would have even heard of it, had my ND not talked about it as a possible treatment. Of all the drug-based therapies I’ve read about, it is, by far, the one that scares me the least. It has very few side effects, it’s processed through the system very quickly (one LDN does generally sticks around for about 4 hours, and then is completely metabolized.), and unlike steroids or immune suppressants, it has not been shown to lead to any sort of post-use super flare.
Overall, I’m cautiously intrigued by LDN. Should my colonoscopy next month show that, even after two months of SCD, there is inflammation present in my gut, this is definitely a therapy at which I’ll be looking more closely. What about you? Do you use LDN? What’s been your experience? Have you chosen NOT to use LDN? Why? Leave a comment and let me know!