Recently I wrote an article entitled “Low Dose Naltrexone and Thyroid Autoimmunity”. In the article I discussed how more and more medical doctors are prescribing low dose naltrexone (LDN) for autoimmune conditions such as Graves’ Disease and Hashimoto’s Thyroiditis. I also discussed some of the risks associated with this medication.
While in most cases the benefits of LDN outweigh the risks, it’s still not something I usually recommend initially to my patients. And the main reason for this is because it’s not addressing the cause of the problem, and quite frankly, most people don’t need to take it. However, there are some cases when I will recommend LDN to my patients. One of these situations is when someone has severe symptoms that aren’t being managed through conventional or natural treatment methods. Let’s look at a few situations when LDN might be a good option:
Scenario #1: Someone with hyperthyroidism or Graves’ Disease who isn’t able to effectively manage their symptoms with herbs such as bugleweed and motherwort, and isn’t able to take antithyroid medication due to side effects they experience.
Scenario #2: Someone with hypothyroidism or Hashimoto’s Thyroiditis who is still very symptomatic despite taking thyroid hormone medication and following a natural treatment approach.
Of course there are other situations when LDN might be worth giving a try, but these are two common scenarios. In any case, besides not doing anything to address the cause of the problem, another downside of LDN is that it doesn’t work in everyone who takes it. I personally have seen mixed results for those patients with Graves’ Disease and Hashimoto’s Thyroiditis who have taken LDN. I’ve seen some autoimmune thyroid patients significantly lower their thyroid antibodies when taking LDN, but there are also people who took LDN and didn’t show any improvement.
When LDN doesn’t work there can be a few different reasons why this is the case. One reason is due to low or depressed vitamin D levels. Another reason can be due to having a Candida overgrowth. Both of these are common problems, and ideally should be addressed before someone takes LDN. However, there are some people who have taken LDN and didn’t receive good results, even with healthy vitamin D levels, and without an overgrowth of Candida.
The main purpose of this blog post is get the feedback of others with Graves’ Disease and Hashimoto’s Thyroiditis who took LDN. If you took LDN and if it benefited you please let me know! If you took LDN and didn’t notice any positive changes please let me know! And if you took LDN and had any negative side effects please let me know! Thank you so much for sharing your experience with others.
Hello, I have had Graves’ disease 25 yeas. I have been on and off carbimizole all this time. I have tried every alternative medication and therapy out there. Sometimes with some good effect but nothing seems to work long term. I started on ldn 2 months ago and have completely come off carbimizole. My doctor said that he couldn’t prescribe ldn even though he wanted me to come off carbimizole as it’s so harmful long term. I’m in the uk and the ldn is still not available via the NHS. I’m now feeling very good and mostly well. I have not had a blood test recently but I’m confident my Graves has been supressed. Naturally I would prefer to get to the root of the problem but I’ve so far spent thousands over the years and money is now not great so ldn is a great alternative to staying on toxic carbimizole.
Best wishes
And thank you for your great website
dear Collette, Sheila here,, I have been on 3 mg LDN for over 9 years. Most non MS users can start low with 1.5 mg and increase to what works for you up to 4.5 mg. I take high dose Biotin (300.mg) and took B complex for health several years. It has lately been discovered that taking Biotin even in low doses can throw off TSH and T$ lab test results. Your doctor probably only knows about Naltrexone for its 50 mg per dose use to keep overdosers alive while detoxing from drugs and alcohol. (Staying off any Biotin for 7 days will result in accurate lab results.) In GB there is an organization “THE LDN TRUST’ run by Linda Ellersbee. She/they have written the LDN Book. You might try to educate your doctor to the up to date uses and of course yourself. The only known ‘side effect’ is very active dreaming during sleep if you take it before bed time as suggested. But it is just as effective taken upon rising (I take it in lactose capsule) sublingually.) It acts by suppressing endorphins for 2 hours producing a rebound endorphin surge thereafter. Just like running 3 miles without doing so. good luck reaching Linda she is quite the lady. There will be an LDN conference in Portland, Oregon this autumn where medical professionals and users will meet to share and learn from their LDN experiences. Just go to the LDN TRUST site for information.
My then doc (retired now:-( tried me on LDN a few years ago. He started me right off at the top recommended dose of 4.5 mg/day which I felt was too high having read some of the literature about it but I didn’t say anything as I was just so grateful that a doc was willing to prescribe it for me! I have FMS/CFS, Hashimoto’s, and likely leaky gut and goodness knows what else. Anyhoo, I felt that LDN really helped my immune system ’cause normally (for me) I would be sick with some kind of upper respiratory illness like cold or flu very very frequently but I didn’t get sick once whilst taking the LDN. Sadly for me though, it only seemed to work for a short time, about 4-5 months if I am recalling correctly, and then I seemed to go back to how I was before I took LDN – sick a large part of the time, so, I stopped taking it. I read that if LDN didn’t work, then you likely have some kind of untreated infection going on like chronic lyme, systemic candida or parasites, or adrenal fatigue…all of which I’ve long suspected may be problems for me but I can’t afford to get properly tested and treated.
Mare, I’ve been on Dr. Amy Myer’s diet plan and targeted supplements for candida overgrowth (just based on the fact that they said you probably have it if you have autoimmune/Hashi’s, etc.). I have severe osteoarthritis and will be having a knee replacement in a few weeks and have already had a hip replacement. Anyway, within a week and a half of being on her program, I was able to lessen the pain meds I’ve been on for years (a Hydrocodone, Meloxicam and Tramadol per day). When I finished her protocols, I began Dr. Coker’s program to address gut, liver and cellular health – you can do it with or without the supplements. Both programs are around $300, give or take. But the amount of supplements on Dr. Coker’s program run about $1,000, which I am doing. What I want to share is that now I’m off over 90% of the pain meds!!! I still have a fair amount of pain (made even worse by my significantly deteriorated knee), but it’s less than when I was on the pain meds. Also, I’m getting my energy back. I’ve been sedentary for about 8 years and I used to be very active. But I haven’t had the mental energy, either, to even WANT to tackle much of anything. Now, I’m starting to! I’ve also lost over 40 lbs. (using their AIP protocol diets, but eating less and doing some intermittent fasting) and that is tantamount to a miracle because my orthopedic doc told me I wouldn’t be able to lose weight because of the arthritis. But I’ve done it going against 3 factors – Hashi’s, severe osteoarthritis and menopause. I hope that you can somehow find a way to at least do some research and get on an AIP diet. I’ve struggled with weight issues my entire life and I still have a long way to go, but this way of eating is, while very restricted, is also very satiating. One can do it as a long term lifestyle whereas most diets are unsustainable. I wish you well and hope you can find a way to pursue getting your health back in the way you desire. Blessings for your health and your future, Mare! By the way, Isabella Wentz and Amy Myers both have wonderful and informative books out on thyroid issues. Those would be a good place to start if you haven’t already. I’m sure there are probably many other out there as well.
I took it for 4 months for Grave’s Disease. During that time, I experienced no benefits and instead had some bothersome symptoms: my arms and legs were very tight and almost nothing helped that problem until I stopped the LDN. I also had mild nausea at night in bed.
I have Hashimoto’s and was diagnosed in 2012. I only suffer from mild symptoms, on and off sweating and occasional fatigue. I have tried the natural protocol, cut gluten, dairy, grains etc. without any results other than that selenium reduced my antibodies. My main goal is to put myself into remission and I had read good things about LDN. I was on it for over a year, I started at 1 mcg and slowly increased to 4.5 mcg. I saw no benefit at all in my labs and upon increasing to 4.5 mcg my joints started aching and I was afraid I was developing rheumatoid arthritis too! I discontinued LDN and the joint pain stopped.
I’ve had Graves (partial thyroidectomy) and Sjogrens for over 20 years and now Hashimoto’s for a few years. I take Naturethroid and various supplements. I started LDN just over a year ago and for me it’s a lifesaver. I never want to be without it! It gives me more energy, it stops the body aches and pains and lifts and stabilises my mood. I think it’s wonderful and have not had any adverse effects from it. Also I’ve been able to reduce my NDT dose. I recently tried taking the LDN every other day and then at another time reduced my dose from 4.5mg to 3mg, because I read that some people get a better result from these regimes. But both times my pains came back and I didn’t feel so good, so I’ve gone back to my 4.5mg daily, which works really well for me.
I have been struggling with Hashimotos for many years. I have completely changed my lifestyle and eating habits to accommodate, elimination diet, gut healing, removed root canaled teeth, and quit my toxic job. Although I have had tremendous improvement with energy and fatigue, I still suffer from chronic pain and inflammation. I believe it to be fibromyalgia symptoms. I take natural thyroid and have worked with functional medicine doctors. I had researched LDN and thought I would give it a try although I don’t believe in taking synthetic prescriptions unless absolutely necessary.
I started LDN gradually increasing. The pain disappeared the first night! It was a miracle so it was worth the insomnia I suffered with the first coupe weeks.Eventually the insomnia went away. Unfortunately the LDN only worked for 6-7 week. The pain came back and now I have been researching CBD and looking into some detox therapy with Dr Pompa or someone similar. Any suggestions would be greatly appreciated!
Beth
I attend a fibro support group where info shared among us has been very helpful. I went to Mass General to be tested by Dr. Oaklander for small fiber neuropathy which was also positive. Dr. Oaklanders associate, Dr. Cheung, was willing to prescribe the LDN. Also have hasimoto’s and dry eye, along with all the usual symptoms of fibro, pain brain fog unregulated body temp exercise intolerance etc daily headaches etc. For me, for years, my body was in overdrive, zero quality sleep ever, and always anxious. Functioning every day, week, month, and year in a gray out. I am on gabapentin 400, nortripilene 60, armour thyroid, hydrocloroquine, and LDN. I’ve been on the same dosages for two years and haven’t had the need to increase any of them. The LDN began very low, increasing to 4.5 very slowly. For me, it’s made a world of difference. None of the other medications helped me to sleep (also tried trazadone and other meds not effective), and like a car that reved up, the LDN kicked down the overdrive and anxiety. The bed, supposed to be a source of peace and restoration, was my mortal enemy, every single night. I dreaded ever lying down. Now I am sleeping. The quality of sleep is so greatly improved. For me, LDN is literally a wonder drug because it addressed serious issues left unaddressed by the other meds. Whether a benefit of LDN, or derived from sleeping, my brain fog has cleared up alot too. It has to be started very very slowly and gradually.
I’ve been on LDN for about 3 years. I’ve been dealing with autoimmune symptoms for about 35 years, but was only diagnosed with Hashi’s about 17 years ago. By the time I began taking LDN, I had been dealing with muscle knots and pain for a number of years and had to give up my career as a professional flutist. The LDN has not resolved this problem for me, but it has definitely lessened the pain and helped to return my muscle fibers to a more normal state. I am now pursuing NAET acupuncture treatments which are slowly clearing allergies and intolerances from my body. I am still on the LDN, but I predict this acupuncture is going to help me more than anything else has in the decades I’ve been struggling with this.
I have had Graves’ Disease for 12 months. My first doctor put me on methimazole right away which stopped all my symptoms except for exopthalmus and itchy legs. She also put me on a beta blocker. Then I started going to a functional medicine doctor who has been working with me to try to detect and treat the underlying cause of the Graves’, while still staying on methimazole to manage symptoms. At first we tried dietary changes, and I was able to get off beta-blockers and lower my methimazole. But from there I stalled. He had mentioned the possibility of LDN previously, and I figured if it might help me improve my numbers and get off methimazole, it was worth a try. So he had me start taking it along with the methimazole. This was about three months ago.
Well, overnight, the itching on my legs decreased 95%! So that was awesome! And it never affected my sleep, nor have I had any other side effects. But, according to my blood tests, it hasn’t helped improve my numbers, and I have not been able to lower my methimazole further yet. Also my exopthalmus is the same. My doctor said for some people it can take a long time to help, even a year. I’m grateful my legs don’t itch, but it doesn’t seem to be doing much else yet. We found out recently from a GI map test that I have blastocystis hominis, so we’re trying to address that, and we’ll see what happens. The test said I don’t have candida overgrowth, and we already got my vitamin D up months ago, so I don’t think those things could be interfering with the effectiveness of LDN.
I have myasthenia gravis, but I’ve been reading your site to help me understand the Hashimoto’s that my three sisters and five nieces are experiencing. I’ve picked up a number of good points of treatment that I have added into my own MG therapy. I started LDN .5 mg in April and I have been increasing the dose by .5 mg every two weeks. I currently take 2.5 mg at bedtime, I’ve been able to reduce my prednisone from 60 mg a day in July to 9.5 mg a day. I had read that prednisone and LDN would cancel each other out, so I waited until I got down to 12.5 a day of prednisone before starting LDN. I’ve since learned that the two do not cancel each other. The second day on LDN .5 mg I saw incredible reduction in the IBS symptoms that I have had for more than 40 years. My vitamin D last year was at 24, and my last reading in March it was 72. I estimate almost 3,000,000 IUs of D3 to raise my level. No gluten, and the autoimmune paleo diet helped with the IBS symptoms, but I still had IBS symptoms until I did a twelve week biofilm protocol attacking candida and Epstein-Barr virus, both of which I felt were the underlying triggers for my enteritis. Once the candida and EBV were under control, I started LDN, and it was amazing. I’ve only experienced very interesting dreams since beginning LDN.
I’ve been taking LDN for about 6 months for Hashi’s. The only Hashi’s symptom I still had was brain fog (which may or may not be caused by the Hashi’s as I have other issues like adrenal fatigue, severe hypoglycemia, and insomnia). The LDN has not helped the brain fog at all and I’m not sure if it’s doing anything for thyroid antibodies either (antibodies were around 60 when I tested about 6-8 months before starting LDN and about the same 4 months after starting it, but I was also 6 months post-partum which is supposed to be when antibodies tend to be the highest so I don’t know yet if the LDN will do lower antibodies long-term). It is helping me wean off the hydrocortisone that I’ve been on for adrenal fatigue for 3 years. Prior to starting LDN I’d tried to wean off the HC several times and had only been able to cut back a tiny bit. Since starting LDN I’ve been able to wean off 2.5-5 mgs with every LDN dose increase. I’m at 3.5 mgs LDN now and down to 5 mgs of HC a day (down from 27.5 mgs initially).
The only side effect I’ve had has been some insomnia the first night of a dose increase. I do have slightly high iron and ferritin levels now when they’ve tended to be low in the past, so maybe the LDN is affecting those somehow. I started at 1 mg and increase by .5 mg about every 3-4 weeks.
Even though I have been diagnosed with Hypothyroidism (I take low dose meds 25 mag) I have now developed another more annoying disease TED Thyroid Eye Disease. My left inferior rectus muscle of the eye is 5 times the size of the rest of them ~ Neuro Ophthalmologist had an MRI done. I am intermittent double vision at night. Doc is monitoring the progression of the disease as it could cause blindness if optic nerve is compressed. I am VA and MA licensed optician so Totally understand this visual drama. I am using 4 diopters prism to offset the double vision at night.
I am also using a thyroid supplementation on my own ~ iodine, B12 and selenium plus turmeric ….
What can I use to naturally help this situation??? It’s an autoimmune disease and will run it’s course but anything else I can do to naturally help?
Lu, I recommend that you research the effects of iodine on autoimmune thyroid disease, and consider stopping that. From personal experience, and from medical studies, ingesting increased amounts of iodine can cause or aggravate autoimmune thyroid disease in susceptible people. See, for example, http://apps.elsevier.es/watermark/ctl_servlet?_f=10&pident_articulo=90210881&pident_usuario=0&pcontactid=&pident_revista=412&ty=2&accion=L&origen=zonadelectura&web=www.elsevier.es&lan=en&fichero=412v60n05a90210881pdf001.pdf
which says “Euthyroid patients with some prior episode of postpartum thyroiditis, type 2 amiodarone-induced thyrotoxicosis, or interferon-induced thyroid dysfunction are more susceptible to develop hyperthyroidism due to excess iodine intake (up to 20%), as are patients with multinodular thyroid, autonomous nodules, or diffuse goiter. 3,4 In the latter, the prevalence ranges from 3.5% to 21% depending on iodine exposure. Iodine intake may set the course in patients with Graves-Basedow disease, because a slight increase in dietary iodine results in a greater frequency of hyperthyroidism and a decreased efficacy of antithyroid treatment. 5”
Here’s another article affirming the link between increased iodine and thyroid autoimmune disease: https://synapse.koreamed.org/DOIx.php?id=10.3803/EnM.2014.29.3.240 Effects of Increased Iodine Intake on Thyroid Disorders — “Another Austrian multi-center retrospective study including more than 400,000 participants was conducted in 19 regions in 1998 and showed that the incidence of clinical hyperthyroidism and subclinical hyperthyroidism increased by 36% and 64%, respectively, following an increase of iodine in salt from 10 to 20 mg/kg [10]… Another 494-case study was performed by Solomon et al. [14] investigating relationships between iodine intake and remission rate of Graves disease during a 20-year period. They found remission rates of Graves disease were 60% to 80% in 1963, decreased to 13% to 20% in 1973 and then increased again to 50.6% in 1987. The change of Graves disease remission rates was associated with iodine in the diet during the same period [14]. However, in two follow-up studies conducted by our group in China, the prevalence and cumulative incidence of Graves disease were found to be not related to iodine intake, which had no effect on the outcomes of patients with Graves disease following drug treatment [15,16]… There is increasing evidence that the occurrence of thyroiditis is related to iodine supplementation. When mice of an autoimmunity-prone strain were first fed an iodine-deficient diet followed by an iodine-excessive diet, they developed ultrastructural thyroid epithelial cell damage in a dose-dependent manner suggestive of autoimmune disease. The incidence of thyroiditis as well as the degree of lymphocytic infiltration in the thyroid increased gradually, dose-dependently [24]… [Conclusions:] The majority of excessive iodine exposure cases does not generally result in apparent clinically fatal consequences but could be harmful. More than adequate or excessive iodine levels are unsafe and may lead to hypothyroidism and autoimmune thyroiditis, especially for susceptible populations with recurring thyroid disease, the elderly, fetuses, and neonates.”
Dr. Izabella Wentz has also written about the risks of iodine on her blog:. https://thyroidpharmacist.com/articles/iodine-hashimotos/ She says selenium can help prevent the damage to thyroid tissue from excess iodine. I’m not sure if taking it after the damage has been done can help. Dr. Wentz recommends 200 mcg of selenium daily. However, this article says excess selenium can also trigger or exacerbate autoimmunity, so it might be best to see what your selenium levels are first. https://wellnessmama.com/13234/iodine-bad-for-thyroid/
There are definitely things you can do to find out the root cause of your autoimmunity, and heal yourself. You do not need to just wait for the thyroid disease to “run its course,” and I personally think you need to be proactive if you want to regain your health. I had severe TED with my Graves’ and Hashimoto’s, and my eyes are almost completely back to normal now. But it took a lot of reading and research, dietary changes, reducing stress, various testing, and then treatment for the Blastocystis hominis parasite I learned I had, before I began restoring my health. Dr. Osansky’s book was a helpful source of information, and if you feel overwhelmed about where to start or don’t want to “do it yourself,” I see he also offers consultations. Best of luck to you!