AHSTA Chats with Elaine Moore

AHSTA Members Chat with Elaine Moore
About Low-Dose Naltrexone (LDN)
May 5, 2008

EXCERPT

What do you think the timeframe is for seeing an effect or change in antibodies while taking LDN?

Elaine Moore: Since thyroid antibodies persist in your circulation for several months, you wouldn't see a decline before then. And even as your immune system starts healing, thyroid antibody production would slow down gradually. Other factors also matter, including exposure to allergens, vaccines, and other environmental triggers.

Do you think 6 months is a good time span or longer if you are still symptomatic? Go by symptoms and labs?

Elaine Moore: I'd go by symptoms and labs. But if you're not seeing any noticeable changes after months and you have any side effects I'd probably stop. LDN often needs some tinkering with the dose. But once you've got it right, most people see improvement of some sort within months.

I had a question about tracking antibodies if I go on LDN.

Elaine Moore: You'd still want to follow the guidelines of not having TSI more often than 6 months, although since you have TED, it would be better to have a test for total TSH receptor antibodies (TRAb), or the thyroid binding inhibitory immunoglobulin (TBII) test, than the TSI.

Is there a correlation between the LDN dose to the number of endorphins produced? Does 3 mg produce more endorphins than a 1.5 mg dose?

Elaine Moore: It's my understanding that the higher the dose the more endorphins… Varying doses shouldn't hurt anything. In fact, I vary my dose. But with a stable dose, you'd be more likely to report what effects you have with the dose.

I want to stay on LDN as I seem to get one autoimmune disease after another….

Elaine Moore: The general idea is that people with certain disorders, especially autoimmune disorders, have low endorphin levels. No one knows if this is a cause or effect. But it could be that low endorphins predispose us to certain conditions. We can't really become addicted to LDN but we can notice that we feel better when we're taking it. Other ways to increase endorphins like chocolate, sex, and acupuncture aren't exactly addicting but we know we feel better afterwards….

Can we say yet whether there is a relationship between LDN and thyroid hormone? Or is that still an unknown?

Elaine Moore: I haven't seen anything concrete with LDN and thyroid hormone. I think it would depend on the person's condition. Probably, with normal people there's no difference. For someone with a nodule secreting thyroid hormone, a reduction in nodule size would lower Free thyroid hormone. For someone with TSI and no blocking antibodies, LDN would probably lower levels of Free thyroid hormone. But without studies, there's no real way to say.

I was surprised when a compounder of LDN told me that they do not think it matters what time of the day to take LDN as long as it's taken at the same time of day.

Elaine Moore: LDN causes a temporary blockade of the opiate receptor. After the blockade ends endorphin production increases regardless of the time of day that you take in. According to the folks at Dr. Bihari's office, he originally thought that the blockade of the opiate receptor might cause effects due to endorphin deprivation. It doesn't since endorphins are still in the blood circulation. However, this was his initial reason for recommending that LDN be taken at night.

Should one take LDN until antibodies are significantly diminished to nonexistent? What is the protocol for length of time? And is there a rebound effect with cessation of LDN?

Elaine Moore: Many people with autoimmune thyroid disease show evidence of thyroid antibodies even after they achieve remission. Elderly people also often have thyroid antibodies and normal thyroid function. You may not see levels fall to <0.2 (what normal people without thyroid disease usually run) but you should see a significant decline in your levels. Without studies on autoimmune thyroid disease and LDN, there's no way to know for sure… until the survey starts showing results.