Bioidentical Hormones 101 
The Book, by Jeffrey Dach MD

55. Low Dose Naltrexone

Chapter 55. Low Dose Naltrexone LDN - The Latest Medical Scandal and Outrage

The Greatest Medical Discovery of the Century

No doubt, future medical history books will look back at the 20th century and conclude that the great medical discovery was the opiate receptor system in the brain, the brain’s own production of these compounds called, endorphins, or endogenous opioids.  The widespread medicinal use of the morphine class of opioid narcotics for pain relief is due to the fact that opioid receptors already exist in the brain and nervous system. The opioid drugs flood these receptors, blocking pain and sedating the nervous system.(1)  Another key discovery was made quietly without fanfare by a humble New York internist, Bernard Bihari in the 1970’s. (2-3)  While working with drug addicts, he noted a beneficial effect from temporary blockade of opioid receptors, which produced a rebound increase in endogenous opioid production.   The opioid blocking drug he used is called Naltrexone, an FDA approved drug developed by the government as part of its “War Against Drugs” campaign.(1-3)

This largely ignored and inexpensive off-patent drug called LDN has been used with great success over the past 20 years by various renegade physicians to cure or induce remissions in a host of seemingly unrelated diseases such as Multiple Sclerosis (4-6), Crohn's Disease (7), Systemic Lupus, Rheumatoid Arthritis, Pancreatic Cancer and Lymphoma.  LDN has also been found useful in Autism, and halts progression to opportunistic infection in AIDS patients.(1)

Criticism from Mainstream Medicine

Paradoxically, LDN's ability to benefit so many seemingly unrelated medical conditions has been the greatest criticism from conventional mainstream medicine.  If it sounds too good to be true, it probably is.  However, since LDN is an FDA approved drug, off label use is allowed.   LDN has virtually no adverse side effects, and based on my own short clinical experience prescribing LDN for Multiple Sclerosis (4-6), Crohn's Disease(7) and Ulcerative Colitis(38), I can report that although it does not work for all patients, it is amazingly effective in many.  Even though it may sound too good to be true, in the case of LDN, I can assure you that, yes, it is all true.

Domination by Pharmaceutical Industry

The medical system's domination by the Pharmaceutical industry is clearly apparent by the scandalous and outrageous manner in which LDN has been ignored.  Mainstream neurologists refuse to prescribe LDN for multiple sclerosis, instead using prednisone, and other useless medications.  Mainstream gastroenterologists refuse to prescribe LDN for Crohn's and Ulcerative colitis, instead using prednisone, methotrexate and newer drugs like Remicade to inhibit the immune system, all with horrendous adverse side effects.  Conventional oncologist refuse to prescribe LDN for cancer patients, preferring the more traditional chemotherapy, radiation and surgery, modalities which have changed very little over the past 60 years and although effective for a few selected cancers, largely ineffective for the vast majority of cancers and their relentless spread as metastatic disease.

A Mass Movement Driven by People, Not Pharmaceutical Corporations

An amazing thing is happening. In spite of lack of research funding by Big Pharma, a mass people power movement on the internet is creating a tidal wave of interest in LDN.  A flood of anecdotal reports of LDN remission and cures have been posted in the internet, and in some cases published in the medical literature. (37)  A series of LDN conferences have been organized, and have been highly successful.  The 2008 LDN Conference speaker presentations may be viewed on You-Tube videos on the internet.(8-15)  Jill Smith MD at Penn State University Hospital published a successful clinical trial of LDN for Crohn's disease in the American Journal of Gastroenterology.(7)  This has blazed the trail for a whole series of new clinical trials.  An army of dedicated volunteers are working selflessly to promote new clinical trials, to get the word out about LDN and to make a reality the eventual acceptance by mainstream medicine.

October 2008 Conference at USC Medical Center

LDN for Cancer -Dr Burton Berkson

At the October 2008 LDN conference at the USC Medical Center, Burton Berkson MD PhD presented his clinical experience with LDN which can be viewed on a You Tube video presentation.(8-15)  Dr Berkson presents cases of successful remission from pancreatic cancer and B Cell lymphoma with LDN. Berkson also reported dramatic responses in cases of autoimmune diseases such as Rheumatoid Arthritis, Systemic Lupus and Dermatomyositis, as well as multiple sclerosis and inflammatory bowel disease. (8-15)

Lymphoma and LDN

One case report involves a lymphoma patient who experienced dramatic regression with LDN.  This report by Berkson describes the treatment of a 61-year old man with biopsy-proven Lymphoma. His initial physical examination and PET/CT scan showed multiple large, metabolically active, pathologic lymph nodes that demonstrated complete resolution within 6 months of commencing therapy with Low Dose Naltrexone, taken as a capsule before sleep every night. The Pet Scans before and after LDN treatment showing regression of lymphoma can be viewed on a You Tube video.(11-15)

Pancreatic Cancer and LDN

Another case report involves pancreatic cancer which responded favorably to LDN.  A 46-year-old man who was diagnosed with metastatic pancreatic cancer in October 2002.  He was initially treated with a standard chemotherapy regimen by the local oncologist.  However, after a single chemotherapy treatment, the patient experienced severe bone marrow suppression with low platelet and WBC counts,  and could not tolerate any further chemotherapy.  In addition, in spite of the chemotherapy, the cancer progressed.   The patient then presented to Dr. Berkson, who promptly started treatment with intravenous Alpha Lipoic Acid (ALA), Low Dose Naltrexone (LDN), and a healthy lifestyle program.  The Pancreatic cancer with metastases to the liver was followed with serial CAT and PET scans, and he has remained stable.(11-15)  It is interesting to note that the cancer progressed rapidly when the ALA-LDN therapy was halted; however, the cancer stabilized quickly when treatment resumed.  Serial Cat scans show no progression of hepatic metastatic lesions over three years. 

How does LDN restrict pancreatic cancer? 

A phase I clinical trial by Smith and Zagon using Opiate Growth Factor in advanced pancreatic cancer patients showed that OGF can be safely administered to patients with advanced pancreatic cancer.  Basic science research by Dr. Zagon using molecular biology tools has answered this question.(16-34)   Zagon found that Opioid Growth Factor and receptor inhibit growth of pancreatic cancer cells by influencing cellular replication during the G0/G1 phase of mitosis.  Zagon found that this inhibition of cell replication in human pancreatic cancer involves a well known pathway in molecular biology, the p21-CKI pathway.  This inhibition of cell replication can be obtained with Opioid Growth Factor itself, or with LDN. (16-34)

The Definitive Book on LDN

I recommend for you a book on LDN, “The Promise of Low Dose Naltrexone Therapy: Potential Benefits in Cancer, Autoimmune, Neurological and Infectious Disorders, by Elaine Moore and SammyJo Wilkinson. (1)  The drug, Naltrexone, was developed in the 1960's as part of the government’s War on Drugs, as a narcotics blocker intended as a treatment for narcotics addiction.  However, narcotics addicts avoided it because of the narcotics withdrawal induced by the drug.  However, over the years, Naltrexone found a niche for treatment and prevention of alcoholism.  The usual tablet dosage is 50 mg, although some practitioners use a monthly injection for alcoholics. The book covers the use in LDN in the following disease categories (1):

Low Dose Naltrexone Use in Disease Categories(1)

Autoimmune Diseases
Multiple Sclerosis
Neurodegenerative Disorders
Autism Spectrum Disorders
LDN in Wound Healing and Infections
The Immune System and LDN in HIV/AIDS


As of this date, this is the first and only book of its kind on LDN, and as such represents a milestone in the effort to bring LDN into mainstream use.  Written by Elaine Moore, a high level science writer with a portfolio of previous accomplishments, her LDN book is perhaps somewhat technical and may be difficult for the untrained non-professional to follow.  It delves into the sophisticated jargon of the medical research world.  However, in addition to the esoteric technical sections of the book, there are also chapters devoted to the lay reader interested in learning how LDN can help them on a practical level.  A listing of dispensing practitioners was included.  The book is highly recommended for other health care practitioners who wish to get quickly up to speed in this new area of medicine which is destined to become the medical paradigm of the 21st century, casting a giant shadow over the rest of mainstream medicine.

LDN requires a prescription and is available at a few specialty compounding pharmacies.(35-36)   For references and links, see my web site:

References for Chapter 55. Low Dose Naltrexone

(1) The Promise Of Low Dose Naltrexone Therapy: Potential Benefits in Cancer, Autoimmune, Neurological and Infectious Disorders by Elaine A. Moore, McFarland (December 1, 2008)

(2) Curriculum Vitae, BERNARD BIHARI, M.D. 29 West 15th Street New York, N.Y. 10011, (212) 929-4196 retired as of March 2007. Sadly, Dr. Bihari passed away on May 16, 2010.

(3) Video of Dr. Bihari Released on the First Anniversary of His Death (May 16, 2011) Transcript of Dr. Bihari Video. Also see:

(4) Ann Neurol. 2010 Aug;68(2):145-50.Pilot trial of low-dose naltrexone and quality of life in multiple sclerosis.Cree BA, Kornyeyeva E, Goodin DS.

(5) Mult Scler. 2008 Sep;14(8):1076-83. A pilot trial of low-dose naltrexone in primary progressive multiple sclerosis. Gironi M et al.

(6) Low-dose naltrexone as a treatment for multiple sclerosis by Tom Gilhooly, British Journal of Neuroscience Nursing, Vol. 5, Iss. 11, 13 Nov 2009, pp 494

Low-dose naltrexone therapy improves active Crohn's disease.Smith JP, Stock H, Bingaman S, Mauger D, Rogosnitzky M, Zagon IS. Am J Gastroenterol. 2007 Apr;102(4):820-8. Department of Medicine, Pennsylvania State University College of Medicine, Hershey, Pennsylvania 17033, USA.

 (8) 4th Annual LDN Conference 2008 You Tube Videos of Presentations //

(9) 4th Annual LDN COnference. LDN 2008 Sunny Sedlock O’Malley Interview
corrdinator of 2008 meeting discusses how her fathers Multiple Myeloma went into remission with LDN

(10) //
3rd LDN Conference Doctor Interviews 2007. Dr David Gluck gives overview of conference. 2007 3rd.

(11) //
October 11 2008 USC Medical Center . LDN 2008 Dr Burt Berkson Best of part 1.  Here are three videos of the meeting presentation by Dr Burt Berkson, a clinician using LDN, at the Oct 2008 LDN conference at USC Medical Center, in which he presents cases of successful remission from pancreatic cancer and B Cell lymphoma with LDN. He also notes most dramatic responses in cases of autoimmune diseases such as Rheumatoid Arthrisis, Systemic Lupus and Dermatomyosis, as well as multiple sclerosis and inflammatory bowel disease. 

(12) //
LDN 08 Dr Burt Berkson Part 2

(13) //
LDN 2008 Dr Burt Berkson Part 3. Burt Berkson's publications of case reports of success with LDN for pancreatic cancer and B cell lymphoma:

Reversal of Signs and Symptoms of a B-Cell Lymphoma in a Patient Using Only Low-Dose Naltrexone. Integr Cancer Ther 2007; 6; 293. Burton M. Berkson, MD, Daniel M. Rubin, ND, FABNO, and Arthur J. Berkson, MD. 

The Long-term Survival of a Patient With Pancreatic Cancer With Metastases to the Liver After Treatment With the Intravenous Alpha-Lipoic Acid/Low-Dose Naltrexone Protocol by Burton M. Berkson, Daniel M. Rubin, and Arthur J. Berkson. INTEGRATIVE CANCER THERAPIES 5(1); 2006 pp. 83-89

Cancer Lett. 1983 Nov;21(1):89-94. Opioid antagonists inhibit the growth of metastatic murine neuroblastoma.Zagon IS, McLaughlin PJ.

Life Sci. 1983 Dec 12;33(24):2449-54.  Naltrexone modulates growth in infant rats.Zagon IS, McLaughlin PJ.

Brain Res. 1999 Dec 4;849(1-2):147-54. Cloning, sequencing, expression and function of a cDNA encoding a receptor for the opioid growth factor, [Met(5)]enkephalin.  Zagon IS et al.

Opioid growth factor regulates the cell cycle of human neoplasias.Zagon IS, Roesener CD, Verderame MF, Ohlsson-Wilhelm BM, Levin RJ, McLaughlin PJ.

(20) Cancer Lett. 1996 Mar 29;101(2):159-64.
Inhibition of human colon cancer by intermittent opioid receptor blockade with naltrexone.Hytrek SD, McLaughlin PJ, Lang CM, Zagon IS.

Cancer Lett. 1997 Jan 30;112(2):167-75. Opioid growth factor (OGF) inhibits human pancreatic cancer transplanted into nude mice.Zagon IS, Hytrek SD, Smith JP, McLaughlin PJ.

Science. 1983 Aug 12;221(4611):671-3. Naltrexone modulates tumor response in mice with neuroblastoma.Zagon IS, McLaughlin PJ.

Matthew, PM, Froelich CJ, Sibbitt WL, Jr., Bankhurst AD, Enhancement of natural cytotoxicity by beta-endorphin, J Immunol 130, pp.1658-1662, Apr 1983.

Zagon IS, McLaughlin PJ, Naltrexone modulates tumor response in mice with neuroblastoma, Science 221, pp.671-3, Aug 12, 1983.

Hytrek SD, McLaughlin PJ, Lang CM, Zagon IS, Inhibition of human colon cancer by intermittent opioid receptor blockade with naltrexone, Cancer Lett 101(2), pp. 159-64, Mar 29, 1996.

Zagon IS, Hytrek SD, Lang CM, Smith JP, McGarrity TJ, Wu Y, McLaughlin PJ, Opioid growth factor ([Met5]enkephalin) prevents the incidence and retards the growth of human colon cancer, Am J Physiol 271(3 Pt 2), pp.R780-R786, Sep 1996

Zagon IS, McLaughlin PJ, Duration of opiate receptor blockade determines tumorigenic response in mice with neuroblastoma: a role for endogenous opioid systems in cancer, Life Sci 35, pp. 409-416, 1984.

Zagon IS, McLaughlin PJ, Opioid antagonist modulation of murine neuroblastoma: A profile of cell proliferation and opioid peptides and receptors, Brain Res 480, pp. 16-28, 1989.

(29) The OGF-OGFr axis utilizes the p21 pathway to restrict progression of human pancreatic cancer. Fan Cheng1 , Patricia J McLaughlin1 , Michael F Verderame2  and Ian S Zagon . Molecular Cancer 2008, 7:5

Mol Biol Cell. 2009 January 1; 20(1): 319–327. The OGF–OGFr Axis Utilizes the p16INK4a and p21WAF1/CIP1 Pathways to Restrict Normal Cell Proliferation.  Fan Cheng,* Patricia J. McLaughlin,* Michael F. Verderame,† and Ian S. Zagon

(31) Int J Oncol. 2008 Oct;33(4):751-7. Prevention and delay in progression of human squamous cell carcinoma of the head and neck in nude mice by stable overexpression of the opioid growth factor receptor.  McLaughlin PJ, Kreiner S, Morgan CR, Zagon IS.

(32) Int J Oncol. 2008 Aug;33(2):317-23. Prevention and delay in progression of human pancreatic cancer by stable overexpression of the opioid growth factor receptor.  Zagon IS et al.

 (33)  Anticancer Drugs. 2004 Mar;15(3):203-9. Treatment of advanced pancreatic cancer with opioid growth factor: phase I. Smith JP, Zagon IS et al.

 (34) Am J Physiol. 1996 Sep;271(3 Pt 2):R780-6. Opioid growth factor ([Met5]enkephalin) prevents the incidence and retards the growth of human colon cancer. Zagon IS , Smith JP wt al. Sources for LDN

The Compounder Pharmacy 340 Marshall Ave Unit 100 ~ Aurora, IL 60506-2956
Phone: 630-859-0333 Fax: 630-859-0114

Skip's Pharmacy LDN PAGE 21000 Boca Rio Rd Suite A-29 Boca Raton, Florida 33433
561-218-0111 800-553-7429 Fax: 561-218-8873

(37)  LDNINFO Web site for low dose naltrexone information.

(38) One patient's UC Ulcerative Colitis success story, Nick's success story by Ronald Hoffman MD

Author: Jeffrey Dach MD

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