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Low dose naltrexone
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==Evidence== [[File:LDN-Fibro2014.jpg|alt=Data shows a graph with 10% worse after treatment, 57% improved or much improved, and 12% very much improved. Darker colors are the most improved sections.|thumb|350x350px|Low Dose Naltrexone results for 29 patients with [[Fibromyalgia]]. Fibromyalgia participants’ (N = 29) self-reported improvement in symptoms after daily LDN treatment. Source: Clin Rheumatol 2014; 33(4):452-459. Fig 1.<ref name="Younger2014" /> [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3962576/figure/Fig1/ PMC3962576] ]] [[Jarred Younger]] published a small study that concluded "...low-dose naltrexone may be an effective, highly tolerable, and inexpensive treatment for fibromyalgia".<ref name="Younger2009" /><ref name="Mackey2009" /> A second study concluded that "specific and clinically beneficial impact on fibromyalgia pain".<ref name="Younger2013" /><ref>{{Cite web|url=https://med.stanford.edu/pain/snapl/completed-research/naltrexone2.html | title = Low Dose Naltrexone for Fibromyalgia|website=Systems Neuroscience and Pain Lab {{!}} Stanford Medicine|language=en|access-date=2018-10-04 | date = |last = | first = | authorlink = |archive-url=|archive-date=|url-status=}}</ref> A 2014 review by Stanford researchers suggests that "LDN may operate as a novel anti-inflammatory agent in the [[central nervous system]], via action on [[microglia]]l cells. These effects may be unique to low dosages of naltrexone and appear to be entirely independent from naltrexone's better-known activity on [[opioid]] receptors. As a daily oral therapy, LDN is inexpensive and well-tolerated."<ref name="Younger2014" /> [[File:LDN-Fibro-ESR.jpg|thumb|420x420px|Relationship between ESR, a marker inflammation, and LDN treatment in 29 patients with [[Fibromyalgia]]. ]] The [[FDA]] approved naltrexone HCL in 1984 to treat opioid addiction. Low-dose naltrexone is typically given at about 1/10th the typical dose of naltrexone. By blocking opioid receptors, naltrexone can increase pain, but at very low doses naltrexone has both pain-reducing ([[analgesic]]) and anti-inflammatory properties. In 2012 [[Solve ME/CFS Initiative]] contracted [[Biovista]] to use drug models to identify existing drugs that may be worth investigating for treatment. The results suggested Naltrexone was worth considering.<ref>{{Cite web|url=http://solvecfs.org/biovista-work-released | title = Biovista work released|last = Solve ME/CFS Initiative | first = | authorlink = Solve ME/CFS Initiative | date = |website=|archive-url=|archive-date=|access-date=|url-status=live}}</ref> Jarred Younger's research suggests that people with an [[Erythrocyte sedimentation rate|Erythrocyte Sedimentation Rate]] (ESR) over 40 millimeters an hour, tend to be strong responders to LDN, and that there may be other predictive factors for success.<ref name="Younger20160329sh" />
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