Low dose naltrexone

2020-06-18T14:25:51Z

Jmalterre:/* Articles */ added LDN for Fibromyalgia and Chron's Disease

'''Low Dose Naltrexone''' (LDN) refers to very small doses of the generic drug, '''naltrexone''', normally used to treat drug dependence. When taken at much smaller doses it may allay [[Nervous system|neurologica]]<nowiki/>l symptoms. Although prescriptions of LDN are becoming more popular, any use other than for treating drug dependence is considered off-label. Some patients report that LDN helps reduce their symptoms of [[ME/CFS]], [[multiple sclerosis]] (MS), [[fibromyalgia]] (FMS) and [[autoimmune disease]]. Although its mechanism of action is unclear, some have speculated that it may act as an anti-inflammatory.<ref name="Younger2014" />

== VLDN and ULDN ==
'''Very Low Dose Naltrexone''' (VLDN) and '''Ultra-Low Dose Naltrexone''' (ULDN) have recently been used in limited trials, both VLDN and ULDN involve doses of naltrexone significantly below 1mg.<ref>{{Cite journal|last=Toljan|first=Karlo|author-link=Karlo Toljan|last2=Vrooman|first2=Bruce|author-link2=Bruce Vrooman|author-link3=|author-link4=|author-link5=|date=Sep 21, 2018|title=Low-Dose Naltrexone (LDN)—Review of Therapeutic Utilization|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6313374/|journal=Medical Sciences|volume=6|issue=4|pages=|doi=10.3390/medsci6040082|issn=2076-3271|pmc=|pmid=30248938|quote=|via=}}</ref>

==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. [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|language=en|access-date=2018-10-04}}</ref>

A 2014 review by Stanford researchers suggests that "LDN may operate as a novel qjanti-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|last2=|first2=|authorlink2=|date=|website=|archive-url=|archive-date=|dead-url=|access-date=}}</ref>

There is an [https://www.facebook.com/groups/GotEndorphins/ online patient community] where patients with various diseases discuss their experiences taking Low-dose Naltrexone.

Jarred Younger's research suggests that people with an [[Erythrocyte sedimentation rate|ESR]] (Erythrocyte Sedimentation Rate) 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" />

==Articles==
* 2016, [https://selfhacked.com/2016/06/20/top-22-scientific-health-benefits-low-dose-naltrexone/ Top 15 Scientific Health Benefits of Low Dose Naltrexone]
*[http://www.cortjohnson.org/blog/2016/02/04/low-dose-naltrexone-combo-chronic-fatigue/ 2016, Low Dose Naltrexone Drug Combination Proposed for Chronic Fatigue Syndrome], ''Health Rising'', by [[Cort Johnson]]
*2016, [https://cfsremission.wordpress.com/2016/03/19/review-of-low-dose-naltrexone/ Low dose naltrexone: side effects and efficacy in gastrointestinal disorders] by [[CFS Remission]]
*Opioid blocking and alcohol - [http://www.well.com/user/woa/revia/reviafaq.htm FAQ About Naltrexone Treatment for Alcoholism - 10.]
*2018 [https://www.cfspharmacy.pharmacy/blog/post/low-dose-naltrexone-for-fibromyalgia Low Dose Naltrexone for Fibromyalgia]
*2018 [https://www.cfspharmacy.pharmacy/blog/post/low-dose-naltrexone-therapy-for-crohn-s-disease Low Dose Naltrexone Therapy for Crohn’s Disease]
*2019, [https://www.npr.org/sections/health-shots/2019/09/23/741783834/in-tiny-doses-an-addiction-medication-moonlights-as-a-treatment-for-chronic-pain In Tiny Doses, An Addiction Medication Moonlights As A Treatment For Chronic Pain], ''NPR, All Things Considered'' by Alex Smith
*2019 [https://www.healthrising.org/treating-chronic-fatigue-syndrome/drugs/low-dose-naltrexone-ldn-fibromyalgia-chronic-fatigue-syndrom/ Low Dose Naltrexone Resource Center for Fibromylgia and ME/CFS]

==Clinical use==
Naltrexone is a prescription drug in many countries.<ref>{{Cite journal|date=2018-12-24|title=Naltrexone|url=https://en.wikipedia.org/w/index.php?title=Naltrexone&oldid=875181184|journal=Wikipedia|language=en}}</ref> Compounding chemists or compounding pharmacists can mix naltrexone with a powder filler or dilute in into a liquid to create the lower dose.

=== Fast-release fillers only ===
"Pharmacies should be instructed NOT to provide LDN in an "SR" or slow-release or timed-release form. Unless the low dose of naltrexone is in an unaltered form, which permits it to reach a prompt "spike" in the blood stream, its therapeutic effects may be inhibited."<ref>{{Cite web|url=http://www.lowdosenaltrexone.org/index.htm#How_can_I_obtain_LDN|title=The Low Dose Naltrexone Homepage|website=www.lowdosenaltrexone.org|access-date=2019-01-21}}</ref> Calcium Carbonate filler should NOT be used. "Avicel, lactose (if lactose intolerance is not a problem), or sucrose fillers as useful fast-release fillers."<ref>{{Cite web|url=http://www.lowdosenaltrexone.org/index.htm#How_can_I_obtain_LDN|title=The Low Dose Naltrexone Homepage|website=www.lowdosenaltrexone.org|access-date=2019-01-21}}</ref>

===Do not take with opioids===
In general, Low Dose Naltrexone (LDN) should not be taken concurrently with opioid-containing drugs (opioid receptors in brain are blocked by LDN), immunosuppressive drugs, or immunomodulator drugs.<ref>[https://yourverity.wordpress.com/2009/07/07/drugs-to-avoid-when-taking-low-dose-naltrexone/ Drugs To Avoid When Taking Low Dose Naltrexone]</ref> LDN blocks the effect of opioid drugs.<ref name=":0">{{Cite web|url=https://www.ldnresearchtrust.org/content/low-dose-naltrexone-and-chronic-pain-pradeep-chopra-md|title=Low Dose Naltrexone and chronic pain - Pradeep Chopra, MD {{!}} LDN Research Trust - Low Dose Naltrexone|website=www.ldnresearchtrust.org|access-date=2019-01-31}}</ref> Some opioid drugs are [[codeine]], [[tramadol]], [[oxycodone]], [[vicodin]], [[hydrocodone]], [[fentanyl]] and [[morphine]].

==== Australia ====
''Compounding Pharmacies'' are able to fill these prescriptions, and post if needed.

==== UK ====
[http://www.dicksonchemist.co.uk/LowDoseNaltrexone/Default.aspx Dickson Chemist] in Glasgow dispenses Low Dose Naltrexone in various forms, with a valid prescription. They will usually put patients in contact with private doctors who will consider writing a prescription.

====US====
Neighborhood ''Compounding Pharmacies'' are able to fill these prescriptions and mail if needed. Your prescribing doctor can help you locate a compounding pharmacy in your area/state or you can look online.<ref>[http://www.wikihow.com/Find-a-Compounding-Pharmacy Finding a Compounding Pharmacy - WIKI How]</ref>

== Clinical trials ==
A large number of clinical trials have been completed for LDN recently, although none have looked at the effect of LDN on symptoms of [[myalgic encephalomyelitis]]/[[chronic fatigue syndrome]]. Research has been carried out on patients with MS, [[Chronic Regional Pain Syndrome]], FMS, [[Irritable bowel syndrome|Irritable Bowel Syndrome]] (IBS), Ulcerative Colitis, Skin Disorders and a range of other illnesses.<ref>{{Cite web|url=https://www.ldnresearchtrust.org/ldn-clinical-trials|title=Clinical Trials {{!}} LDN Research Trust - Low Dose Naltrexone|website=www.ldnresearchtrust.org|access-date=2019-01-21}}</ref>

==When, How To Take ==
Dr Whitaker states that the ideal dose is different for each person. Some doctors recommend starting at 1mg.<ref>{{Cite web|url=http://www.ldnnow.com/48591/90512.html|title=LDN Dosing|last=LDN Now|first=|authorlink=LDN Now|last2=|first2=|authorlink2=|date=|website=|archive-url=|archive-date=|dead-url=|access-date=2018-02-01}}</ref> Common dosages are 1.5mg, 3mg, 4.5mg.<ref>{{Cite web|url=https://www.amymyersmd.com/2017/05/low-dose-naltrexone/|title=Amy Myers MD|last=www.well-donedesign.com|date=2017-05-02|website=Amy Myers MD|language=en-US|access-date=2019-02-02}}</ref><ref name=":1">{{Cite web|url=https://www.drwhitaker.com/what-is-low-dose-naltrexone|title=What is Low-Dose Naltrexone?|last=Dr Whitaker|first=|authorlink=|last2=|first2=|authorlink2=|date=|website=www.drwhitaker.com|language=en|archive-url=|archive-date=|dead-url=|access-date=2019-01-21}}</ref><ref name=":0" /> When beginning use of LDN, the drug must be stepped up over 6-8+ weeks as it may keep you awake; discuss how best to do this with your doctor and pharmacist.<ref name=":1" /><ref>{{Cite web|url=https://collierdrug.com/low-dose-naltrexone-ldn/|title=Low Dose Naltrexone (LDN) – Collier Drug Store|last=|first=|authorlink=|last2=|first2=|authorlink2=|date=|website=collierdrug.com|at=What dose of Low Dose Naltrexone (LDN) is best?|archive-url=|archive-date=|dead-url=|access-date=2019-02-02}}</ref><ref name=":0" />

LDN is usually taken at bedtime. Some people take LDN in the morning to minimize [[Sleep dysfunction|sleep disturbance]], [[insomnia]], and vivid dreams.<ref name=":0" />

== Talks and webinars==
*2012, [https://www.youtube.com/watch?v=z0p0ykSzy9o LDNscience® Presents - How LDN (Low Dose Naltrexone) Works]<ref>{{Cite web|url=https://www.youtube.com/watch?v=z0p0ykSzy9o|title=LDNscience® Presents - How LDN (Low Dose Naltrexone) Works|last=|first=|authorlink=|last2=|first2=|authorlink2=|date=Dec 20, 2012|website=YouTube|publisher=LDNscience|archive-url=|archive-date=|dead-url=|access-date=}}</ref>
<embedvideo service="youtube" dimensions="400" alignment="center" container="frame" description="''LDNscience® Presents - How LDN (Low Dose Naltrexone) Works'' By LDNscience">https://www.youtube.com/watch?v=z0p0ykSzy9o</embedvideo>

*2015, [https://www.youtube.com/watch?v=8a-ULCaarCQ Functional Medicine & LDN (low-dose naltrexone) with Drs Carnahan and Vasquez]<ref>{{Cite web|url=https://www.youtube.com/watch?v=8a-ULCaarCQ|title=Functional Medicine & LDN (low-dose naltrexone) with Drs Carnahan and Vasquez|last=Carnahan|first=Jill|authorlink=|last2=Vasquez|first2=Alex|authorlink2=|date=Nov 30, 2015|website=YouTube|publisher=Alex Vasquez|archive-url=|archive-date=|dead-url=|access-date=}}</ref>
<embedvideo service="youtube" dimensions="400" alignment="center" container="frame" description="''Functional Medicine & LDN (low-dose naltrexone) with Drs Carnahan and Vasquez '' By Alex Vasquez">https://www.youtube.com/watch?v=8a-ULCaarCQ</embedvideo>

*2015, [https://www.youtube.com/watch?v=Qnr51yU9ih8 Is Low Dose Naltrexone (LDN) for you?]<ref>{{Cite web|url=https://www.youtube.com/watch?v=Qnr51yU9ih8|title=1:05 / 7:05 Is Low Dose Naltrexone (LDN) for you?|last=|first=|authorlink=|last2=|first2=|authorlink2=|date=Oct 11, 2015|website=YouTube|archive-url=|archive-date=|dead-url=|access-date=}}</ref>
<embedvideo service="youtube" dimensions="400" alignment="center" container="frame" description="''Is Low Dose Naltrexone (LDN) for you?'' By Integrative Health Solutions">https://www.youtube.com/watch?v=Qnr51yU9ih8</embedvideo>

==Notable studies==
* 2009, Fibromyalgia Symptoms Are Reduced by Low-Dose Naltrexone: A Pilot Study<ref>{{Cite journal|last=Younger|first=Jarred|author-link=Jarred Younger|last2=Mackey|first2=Sean|author-link2=|last3=|first3=|author-link3=|last4=|first4=|author-link4=|last5=|first5=|author-link5=|last6=|first6=|author-link6=|last7=|first7=|last8=|first8=|date=May 2009|title=Fibromyalgia Symptoms Are Reduced by Low-Dose Naltrexone: A Pilot Study|url=https://academic.oup.com/painmedicine/article-lookup/doi/10.1111/j.1526-4637.2009.00613.x|journal=Pain Medicine|language=en|volume=10|issue=4|pages=663–672|doi=10.1111/j.1526-4637.2009.00613.x|issn=1526-2375|pmc=2891387|pmid=19453963|access-date=|quote=|via=}}</ref> - [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2891387/ (Full text)]
* 2013, Low-dose naltrexone for the treatment of fibromyalgia: findings of a small, randomized, double-blind, placebo-controlled, counterbalanced, crossover trial assessing daily pain levels<ref name="Younger2013" /> - [https://onlinelibrary.wiley.com/doi/full/10.1002/art.37734 (Full text)]
* 2014, The use of low-dose naltrexone (LDN) as a novel anti-inflammatory treatment for chronic pain<ref name="Younger2014" /> - [http://link.springer.com/article/10.1007%2Fs10067-014-2517-2 (Full text)]
*2018, Double-blinded placebo-controlled cross-over pilot trial of naltrexone to treat [[Gulf War Illness]]<ref name="Brewer, 2018" /> - [https://www.tandfonline.com/doi/full/10.1080/21641846.2018.1477034 (Abstract)]

* 2018, Low-Dose Naltrexone (LDN)—Review of Therapeutic Utilization<ref>{{Cite journal|last=Toljan|first=Karlo|last2=Vrooman|first2=Bruce|date=2018-09-21|title=Low-Dose Naltrexone (LDN)—Review of Therapeutic Utilization|url=http://www.mdpi.com/2076-3271/6/4/82|journal=Medical Sciences|language=en|volume=6|issue=4|pages=82|doi=10.3390/medsci6040082|issn=2076-3271|pmc=PMC6313374|pmid=30248938}}</ref> - [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6313374/#!po=19.1057 (Full text)]

* 2019, Low-dose naltrexone in the treatment of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)<ref>{{Cite journal|last=Polo|first=Olli|author-link=Olli Polo|last2=Pesonen|first2=Pia|author-link2=|last3=Tuominen|first3=Essi|author-link3=|last4=|first4=|author-link4=|last5=|first5=|author-link5=|last6=|first6=|author-link6=|last7=|first7=|last8=|first8=|date=2019-11-19|title=Low-dose naltrexone in the treatment of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)|url=https://www.tandfonline.com/doi/full/10.1080/21641846.2019.1692770|journal=Fatigue: Biomedicine, Health & Behavior|language=en|volume=|issue=|pages=1–11|doi=10.1080/21641846.2019.1692770|issn=2164-1846|pmc=|pmid=|access-date=|quote=|via=}}</ref> - [https://www.tandfonline.com/doi/abs/10.1080/21641846.2019.1692770?journalCode=rftg20 (Abstract)]
* 2020, Low-dose naltrexone as a treatment for chronic fatigue syndrome<ref>{{Cite journal|last=Bolton|first=Monica Jane|author-link=|last2=Chapman|first2=Bryan Paul|author-link2=|last3=Van Marwijk|first3=Harm|author-link3=|last4=|first4=|author-link4=|last5=|first5=|author-link5=|last6=|first6=|author-link6=|last7=|first7=|last8=|first8=|date=Jan 2020|title=Low-dose naltrexone as a treatment for chronic fatigue syndrome|url=http://casereports.bmj.com/lookup/doi/10.1136/bcr-2019-232502|journal=BMJ Case Reports|language=en|volume=13|issue=1|pages=e232502|doi=10.1136/bcr-2019-232502|issn=1757-790X|pmc=PMC6954765|pmid=31911410|access-date=|quote=|via=}}</ref> - [https://casereports.bmj.com/content/bmjcr/13/1/e232502.full.pdf (Full text)]

==See also==
*[[Brain#Microglia|Microglia]]
*[[The LDN Book]]
*[[Oxymatrine]]
==Learn more==
*[https://www.ldnresearchtrust.org LDN Research Trust]<ref>{{Cite web|url=https://www.ldnresearchtrust.org/|title=LDN Research Trust - Low Dose Naltrexone {{!}}|website=www.ldnresearchtrust.org|access-date=2019-02-02}}</ref>
**[https://www.ldnresearchtrust.org/content/low-dose-naltrexone-and-chronic-pain-pradeep-chopra-md Low Dose Naltrexone and chronic pain]<ref name=":0" />
*[https://en.wikipedia.org/wiki/Naltrexone Wikipedia - Naltrexone]
*[https://en.wikipedia.org/wiki/Naltrexone#Low-dose_naltrexone Wikipedia - Low dose Naltrexone]
*[https://www.ldnscience.org/ MedInsight Research Institute Homepage]<ref>{{Cite web|url=https://www.ldnscience.org/|title=Low Dose Naltrexone {{!}} The Ultimate Resource {{!}} LDNscience|website=www.ldnscience.org|language=en-gb|access-date=2019-02-02}}</ref>
*2015, [https://www.ncbi.nlm.nih.gov/books/NBK390569/ The Use of Naltrexone in Low Doses Beyond the Approved Indication]<ref>{{Cite book|url=https://www.ncbi.nlm.nih.gov/books/NBK390569/|title=The Use of Naltrexone in Low Doses Beyond the Approved Indication|last=Ringerike|first=Tove|last2=Pike|first2=Eva|last3=Nevjar|first3=Janicke|last4=Klemp|first4=Marianne|publisher=NIPH|year=2015|isbn=|editor-link=|location=|pages=|chapter=|quote=|editor-last2=|editor-link2=}}</ref>
*2016, [http://www.rheumatologyadvisor.com/fibromyalgia/using-low-dose-naltrexone-in-fibromyalgia/article/478182/ Low-Dose Naltrexone as Adjunctive Pharmacotherapy for Fibromyalgia]<ref>{{Cite web|url=https://www.rheumatologyadvisor.com/fibromyalgia/using-low-dose-naltrexone-in-fibromyalgia/article/478182/|title=Low-Dose Naltrexone as Adjunctive Pharmacotherapy for Fibromyalgia|last=Arlotta|first=CJ|authorlink=|last2=|first2=|authorlink2=|date=2016-02-21|website=Rheumatology Advisor|language=en|archive-url=|archive-date=|dead-url=|access-date=2019-02-02}}</ref>
*[https://books.google.co.uk/books?id=CQ2oCwAAQBAJ&lpg=PR9&lr&pg=PA69#v=onepage&q&f=true Chronic fatigue syndrome and Fibromyalgia]<ref>{{Cite book|url=https://www.amazon.com/LDN-Book-Little-Known-Naltrexone-Revolutionize/dp/1603586644|title=The LDN Book: How a Little-Known Generic Drug — Low Dose Naltrexone — Could Revolutionize Treatment for Autoimmune Diseases, Cancer, Autism, Depression, and More|last=Elsegood|first=Lisa|date=2016-02-15|publisher=Chelsea Green Publishing|year=|isbn=9781603586658|editor-last=|editor-first=|editor-link=|location=|pages=|language=en|chapter=|quote=|author-link=|editor-last2=|editor-link2=}}</ref> - [[The LDN Book]]
*[https://www.facebook.com/groups/GotEndorphins/ Facebook patient community] where patients with various diseases discuss their experiences taking Low-dose Naltrexone.

==References==
<references>
<ref name="Brewer, 2018">{{Citation
| last1 = Brewer | first1 = Kori L. | authorlink1 =
| last2 = Mainhart | first2 = Allison | authorlink2 =
| last3 = Meggs | first3 = William J. | authorlink3 =
| title = Double-blinded placebo-controlled cross-over pilot trial of naltrexone to treat Gulf War Illness
| journal = Fatigue: Biomedicine, Health & Behavior | volume = | issue = | page =
| date = 2018
| pmid =
| doi = 10.1080/21641846.2018.1477034
}}
</ref>
<ref name="Younger2009">{{citation
| last1 = Younger | first1 = Jarred | authorlink1 = Jarred Younger
| last2 = Mackey | first2 = Sean | authorlink2 = Sean Mackey
| title = Fibromyalgia Symptoms Are Reduced by Low-Dose Naltrexone: A Pilot Study
| journal = Pain Med | volume = 10 | issue = 4 | page = 663–672
| date = 22 Apr 2009
| pmid = 2891387 | doi = 10.1111/j.1526-4637.2009.00613.x
| url = http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2891387/
}}</ref>
<ref name="Younger2013">{{citation
| last1 = Younger | first1 = Jarred | authorlink1 = Jarred Younger
| last2 = Noor | first2 = Noorulain | authorlink2 = Noorulain Noor
| last3 = McCue | first3 = Rebecca | authorlink3 = Rebecca McCue
| last4 = Mackey | first4 = Sean | authorlink4 = Sean Mackey
| title = Low-dose naltrexone for the treatment of fibromyalgia: findings of a small, randomized, double-blind, placebo-controlled, counterbalanced, crossover trial assessing daily pain levels
| journal = Arthritis Rheum | volume = 65 | issue = 2 | page = 529-38
| date = Jan 28, 2013
| pmid = 23359310 | doi = 10.1002/art.37734
| url = http://onlinelibrary.wiley.com/enhanced/doi/10.1002/art.37734/
}}</ref>
<ref name="Mackey2009">{{citation
| last1 = Mackey | first1 = Sean | authorlink1 = Sean Mackey
| title = An Update on Fibromyalgia - from Sean Mackey, Chief, Division of Pain Management, Stanford University
| journal = Research Channel (USA)
| date = 1 May 2009
| url = https://www.youtube.com/watch?v=jtc2JARVpPw
}}</ref>
<ref name="Younger2014">{{citation
| last1 = Younger | first1 = Jarred | authorlink1 = Jarred Younger
| last2 = Parkitny | first2 = Luke | authorlink2 = Luke Parkitny
| last3 = McLain | first3 = David | authorlink3 = David McLain
| title = The use of low-dose naltrexone (LDN) as a novel anti-inflammatory treatment for chronic pain
| journal = Clin Rheumatol | volume = 2014 Apr | issue = 33(4) | page = 451-9
| date = 15 Feb 2014
| pmid = 24526250 | doi = 10.1007/s10067-014-2517-2
| url = http://link.springer.com/article/10.1007%2Fs10067-014-2517-2
}}</ref>
<ref name="Younger20160329sh">{{citation
| last1 = Younger | first1 = Jarred | authorlink1 = Jarred Younger
| last2 = Cohen | first2 = Joseph M | authorlink2 = Joseph Cohen
| title = Dr. Jarred Younger: Cutting Edge Research on CFS, Neuroinflammation, Pain, and Fatigue
| type = video interview with transcript
| journal = Self Hacked Blog
| date = 29 Mar 2016
| url = http://selfhacked.com/2016/03/29/dr-jared-younger-cutting-edge-research-on-cfs-neuroinflammation-pain-and-fatigue/#Leptin_and_Chronic_Fatigue_Syndrome
}}</ref>
</references>

[[Category:Potential treatments]]
[[Category:Anti-inflammatories]]

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Low dose naltrexone