ME/CFS patient makes major improvement on full-dose naltrexone (50 mg daily), rather than low-dose naltrexone

[Hip]

This Reddit thread details a patient with ME/CFS for 24 years who made massive improvements from taking full-dose naltrexone at 50 mg daily (rather than the usual low-dose naltrexone of 4 mg daily that ME/CFS patients normally try).

His ME/CFS started 6 months after a motorcycle accident (though an MRI scan showed no brain injury). He was completely bedbound for the first 4 years of his illness.

He said before he took naltrexone, he was unable to type a single coherent sentence, due to severe brain fog.

But the next day after taking 50 mg of naltrexone, he found himself able to perform complex computer software coding for hours on end.

 

[Hip]

Someone on that Reddit thread pointed out that the LDN Research Trust (a UK registered Charity) advises that after a traumatic brain injury (TBI), full doses of naltrexone (50 mg or more) may be necessary to stabilise the brain initially, before later transitioning to low-dose naltrexone:

Higher, standard doses of 50mg or more may be required for TBI (Traumatic Brain Injury) patients until they are stabilized before transitioning to chronic daily low doses of naltrexone.

Source: LDN 2024 Patient Guide

 

[jasperZA]

Any ideas on the mechanism?
I read somewhere thst normal dose Naltrexone behaves very differently from LDN, but I'm not sure.

 

[Hip]

Any ideas on the mechanism?

Low-dose naltrexone block the TLR-4 receptor on microglia, inhibiting microglial activation, and so reducing brain inflammation. Perhaps full-dose naltrexone has a stronger anti-inflammatory effect?

 

[jasperZA]

In that case, on could hypothetically try slowly increasing the dose to see if it improves anything.

 

[dr. Arf]

Just for reference / background info: 50 mg naltrexone patient is physically mild:

> “My problems are mostly mental, although perhaps because that is what's the most important to me (coding). For the last 10 years, I always try to do 10,000 steps a day but it's very rough some seasons”