What is the efficacy of low-dose Naltrexone (opioid receptor antagonist) for treating Chronic Fatigue Syndrome (Myalgic Encephalomyelitis)?

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Last updated: February 27, 2025View editorial policy

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From the Guidelines

Low-dose naltrexone (LDN) is a potentially effective treatment for Chronic Fatigue Syndrome (Myalgic Encephalomyelitis), with substantial anecdotal reports of success within the patient community, as noted in a 2023 study published in Nature Reviews Microbiology 1. The efficacy of LDN for treating Chronic Fatigue Syndrome is supported by its ability to modulate immune function, reduce inflammation, and increase endorphin production.

  • The typical dosage of LDN ranges from 1.5 to 4.5 mg taken once daily at bedtime, with most patients starting at 1.5 mg and gradually increasing by 0.5-1.5 mg every 1-2 weeks until reaching an effective dose.
  • Treatment duration is usually long-term, with benefits potentially taking 2-3 months to become noticeable.
  • Common side effects of LDN include vivid dreams, headaches, and initial sleep disturbances, which often resolve within the first few weeks.
  • It is essential to discuss LDN treatment with a healthcare provider familiar with its use, as it may not be suitable for everyone, particularly those taking opioid medications or with certain liver conditions.
  • LDN may also have benefits in addressing underlying mechanisms of chronic fatigue, such as modulating microglial cell activity in the brain, as suggested by its use in treating pain, fatigue, and neurological symptoms in ME/CFS and other literature 1.

From the Research

Efficacy of Low-Dose Naltrexone for Chronic Fatigue Syndrome

  • There are limited studies on the efficacy of low-dose naltrexone (LDN) for treating Chronic Fatigue Syndrome (Myalgic Encephalomyelitis) 2.
  • A case report series suggests that LDN may be beneficial for some patients with Chronic Fatigue Syndrome, with treatment doses ranging from 4 to 12 mg 2.
  • However, there are no clinical trials on the use of LDN for Chronic Fatigue Syndrome, and more research is needed to determine its efficacy 2.

Related Conditions and Low-Dose Naltrexone

  • Low-dose naltrexone has been used to treat other chronic pain and inflammatory conditions, such as fibromyalgia, Crohn's disease, and multiple sclerosis 3, 4, 5.
  • Studies suggest that LDN may have subjective benefits for these conditions, including improved quality of life and reduced pain 3, 5.
  • However, more research is needed to determine the efficacy of LDN for these conditions, and to identify the optimal dosing range 3, 4.

Recent Studies on Low-Dose Naltrexone

  • A recent pilot study found that treatment with LDN and NAD+ supplementation may improve fatigue symptoms and quality of life in patients with persistent fatigue after COVID-19 6.
  • The study suggests that LDN may be a safe and potentially beneficial treatment for some patients with chronic fatigue symptoms, but larger randomized controlled trials are needed to confirm these findings 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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