Low Dose Naltrexone and Fertility

Hi everyone – Happy Fertile Friday! I’ve been looking into some other alternative treatments for infertility, and I have come across some information about the benefit of Low Dose Naltrexone and fertility, so I thought I’d share it with you!

I have used Low Dose Naltrexone (LDN) in my practice a lot with my Lyme patients. I didn’t know that it was being used for fertility, but thinking through the mechanism of it’s action, it does make sense. I’m going to start taking it and see what happens. There are very few side effects and very little down side to trying it.

Low Dose Naltrexone (LDN) is used in many illnesses and syndromes, among them Lyme disease, fibromyalgia, chronic fatigue syndrome, multiple sclerosis, autism, rheumatoid arthritis, HIV and cancer. Since it works to balance the immune system, any condition that involves immune dysregulation may benefit from LDN. It is particularly useful for auto-immune conditions, and since auto-immunity is a potential cause of infertility, it makes sense that it could have great benefit here. It can also be helpful for depression because of it’s effect of boosting endorphins.

What is LDN?

LDN is an immune modulator, which means it helps to balance and strengthen the immune system without over-stimulating it. That is why it is safely used in auto-immune conditions such as rheumatoid arthritis, Hashimoto’s thyroiditis and Crohn’s disease – it neither stimulates nor suppresses immune function, but serves to balance and regulate it.

How does it work?

Naltrexone in higher doses (50-300mg) was approved by the FDA in 1984 for helping heroin addicts, as it blocked the effect of such drugs. It did this by binding with opioid receptors in the brain.

In lower doses (1.5-4.5mg), it still causes a very mild blockage of those opioid receptors. The body’s response to this binding is to compensate by increasing production of endorphins and enkephalins (our natural opioids).

The benefits in chronic illness are less pain, improved sleep, more energy and accelerated recovery. In infertility, the goal would be to stop any process in the body where the immune system is attacking it’s own tissues, which could hinder the fertility process. There is an increasing body of research that infertility may be due to auto-immunity, including the immune system’s overreaction to one’s own hormones. Hashimoto’s thyroiditis definitely falls into the category of an auto-immune issue that can impair one’s ability to get (and stay) pregnant.

Are there any side effects or contraindications?

LDN has very few side effects. Some people report some difficulty sleeping in the first week or so, which typically resolves spontaneously. I have found that starting with lowest possible dose and working up incrementally offsets this considerably. The dosage range is 1.5mg to 4.5mg taken once daily between 9pm and 11pm.

There are a few cautions – for example, a patient with Hashimoto’s thyroiditis with low thyroid function will need to monitor their thyroid medication carefully, as when the thyroid starts functioning better after the LDN, the regular dose of medication may become too much.

LDN should not be taken by those on narcotic pain medications, immune suppressants such as prednisone, or by transplant recipients.

Where is it available?

LDN is a prescription medication, and is available from several compounding pharmacies. The important things to be aware of is not to get a sustained release form, and that it not contain calcium carbonate as a filler. Both those things could reduce its efficacy.

Given that I’m generally healthy and not chronically ill, it’s hard to say whether LDN is necessarily going to have any benefit for me, but hey, for $40 a month and no side effects, I’m happy to give it a 3-6 month trial! I do think it would be important to consider for anyone struggling with infertility when there is a known auto-immune issue going on.

Read more about Low Dose Naltrexone here!