LDN and Lyme Disease - San Antonio Integrative Functional Medicine.

Using Low-Dose Naltrexone (LDN) to Treat Lyme Disease: An Emerging Therapeutic Approach

LDN and Lyme Disease - Book Cover LDN Therapy LDN + Other Tools for Healing by Dr. Kim

Lyme disease, a tick-borne illness caused by the bacterium Borrelia burgdorferi, affects thousands annually, often leading to persistent symptoms such as fatigue, joint pain, and neurological issues even after standard antibiotic treatment.

Low-dose naltrexone (LDN)—an off-label application of the opioid antagonist naltrexone at reduced dosages—has gained attention for its potential to modulate immune responses and alleviate chronic inflammation. While evidence remains primarily anecdotal and drawn from small-scale studies, LDN shows promise as an adjunctive therapy for symptom relief.

Understanding Lyme Disease

Lyme disease is primarily transmitted through the bite of infected black-legged ticks.

Early symptoms may include:

• Erythema migrans rash (bull’s-eye rash)

• Fever

• Headache

• Fatigue

If untreated, it can progress to more severe stages, causing arthritis, neurological complications, and even cardiac involvement.

Diagnosis relies on both clinical presentation and serological testing, though challenges remain due to variable immune responses and possible co-infections (e.g., Bartonella, Babesia).

Standard treatment typically involves antibiotics such as doxycycline. However, some patients develop post-treatment Lyme disease syndrome (PTLDS)—a condition marked by lingering symptoms attributed to immune dysregulation and persistent inflammation.

What is Low-Dose Naltrexone?

Naltrexone is FDA-approved at 50 mg doses for opioid and alcohol dependence. At low doses (0.001 mg–4.5 mg), however, its effects differ:

• Transiently blocks opioid receptors, prompting a rebound increase in endorphins.

• Reduces pro-inflammatory cytokines while promoting anti-inflammatory pathways.

• Supports immune regulation without narcotic effects.

LDN is generally well-tolerated and considered safe for long-term use in chronic conditions.

How LDN May Help Lyme Patients

Chronic Lyme symptoms often involve immune dysfunction, including:

• Elevated inflammatory cytokines (IL-6, TNF-alpha, TGF-beta)

• Autoimmune-like responses triggered by bacterial remnants

LDN mechanisms include:

• Inhibiting toll-like receptors (TLRs) → reduces inflammation cascades

• Upregulating endorphins & opioid growth factor receptors → neuroprotection, mood stabilization, tissue repair

• Enhancing immune surveillance → potential benefits against lingering infections

Many experts suggest LDN is best used alongside antibiotics to control symptoms, rather than as a direct antimicrobial cure.

Evidence from Studies and Clinical Observations

While large-scale randomized controlled trials are lacking, smaller studies and clinical reports provide encouraging data:

• Inflammatory conditions overlap: Research in fibromyalgia and multiple sclerosis shows LDN reduces fatigue, pain, and inflammation—symptoms common to chronic Lyme. (PubMed Central)

• Patient-reported outcomes: Observational data suggest up to 75% of Lyme patients on LDN report improved fatigue, muscle pain, and joint stiffness.

• Immunomodulation: Studies indexed on Google Scholar highlight LDN’s ability to downregulate TH17 cells and reduce autoimmune activity.

• Borrelia persister activity: Preliminary lab research hints at possible action against persister forms of Borrelia burgdorferi.

The LDN Research Trust has compiled patient reports, prescriber insights, and conference presentations showing symptom relief, particularly in pain, brain fog, and energy.

Patient Testimonials and Expert Insights

• Patient reports: Enhanced sleep, better energy, and reduced pain after starting LDN.

• Cory Tichauer, ND: Highlights LDN’s role in restoring immune balance and protecting neurological function in PTLDS.

• Richard Horowitz, MD: Advocates for incorporating LDN into comprehensive protocols for persistent Lyme symptoms.

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Dosage, Side Effects, and Considerations

• Typical protocol: Start at 0.001 mg nightly, titrate up to 4.5 mg over several weeks.

• Formulation: Available via compounding pharmacies (standard tablets are only 50 mg).

• Side effects (usually mild & temporary): vivid dreams, insomnia, headache, GI upset.

• Contraindication: Should not be used with opioid medications.

• Medical guidance: Always consult a provider experienced with LDN, especially if liver issues are present.

For dosing guidance, search PubMed or Google Scholar.

Conclusion

Low-dose naltrexone represents a low-risk, affordable adjunctive therapy for managing chronic Lyme symptoms through immune regulation and inflammation reduction. While early clinical evidence and patient experiences are promising, larger controlled studies are still needed.

Patients considering LDN should work with knowledgeable practitioners to integrate it into a holistic Lyme treatment plan.

For additional resources, visit the LDN Research Trust Lyme Disease Page.

Dr. Yoon Hang Kim, MD is a board-certified physician specializing in integrative and functional medicine, dedicated to uncovering root causes and providing personalized healing for chronic and complex conditions. He is a recognized expert in Low Dose Naltrexone (LDN) therapy and offers telemedicine services across multiple states—including Quincy, IL and throughout Illinois, San Antonio and all of Texas, Missouri, Florida, and Atlanta as well as the rest of Georgia.

www.directintegrativecare.com

References

• Low Dose Naltrexone (LDN) for Lyme Disease – Dr. Todd Maderis

• Cheryl’s Lyme Disease & LDN Journey – LDN Research Trust

• Could Low-Dose Naltrexone Help Lyme Patients? – RawlsMD

• The use of Low-Dose Naltrexone as a Novel Anti-Inflammatory Treatment for Chronic Pain – PubMed

• Cory Tichauer, ND – LDN & Lyme Disease (2017 Conference)

• Unorthodox Alternative Therapies Marketed to Treat Lyme Disease – PubMed

• The LDN Book: How a Little-Known Generic Drug Could Revolutionize Treatment – Ed. Linda Elsegood (2016)

• The LDN Book, Volume Two: The Latest Research – Ed. Linda Elsegood (2020)

Got it 👍 I’ll create German, Dutch, and Italian versions of your blog article.I’ll keep the structure consistent (headings, subheadings, references) while using natural, localized medical terminology.

🇩🇪 Deutsche Version

Verwendung von Low-Dose Naltrexon (LDN) bei Lyme-Borreliose: Ein aufstrebender therapeutischer Ansatz

Die Lyme-Borreliose, eine durch Zecken übertragene Infektionskrankheit, die vom Bakterium Borrelia burgdorferi verursacht wird, betrifft jedes Jahr Tausende von Menschen. Auch nach einer Standard-Antibiotikatherapie leiden viele Betroffene weiterhin unter Symptomen wie Müdigkeit, Gelenkschmerzen und neurologischen Problemen.

Low-Dose Naltrexon (LDN) – eine niedrig dosierte, nicht zugelassene Anwendung des Opioid-Antagonisten Naltrexon – hat in den letzten Jahren Aufmerksamkeit erlangt. Es wirkt immunmodulierend und entzündungshemmend und könnte somit ein vielversprechender ergänzender Therapieansatz zur Symptomlinderung bei chronischer Lyme-Borreliose sein.

👉 Mehr Informationen bei der LDN Research Trust (Deutsch verfügbar)

Was ist Low-Dose Naltrexon?

• Ursprünglich von der FDA in 50 mg Dosen zur Behandlung von Alkohol- und Opiatabhängigkeit zugelassen.

• In niedrigen Dosen (1,5–4,5 mg) blockiert es vorübergehend Opioid-Rezeptoren → fördert die körpereigene Endorphin-Produktion.

• Wirkt entzündungshemmend, reguliert das Immunsystem und stabilisiert die Stimmung.

• Gut verträglich und für die Langzeitanwendung geeignet.

Evidenz und klinische Beobachtungen

• Studien: LDN reduziert chronische Entzündung und Schmerzen bei Erkrankungen wie Fibromyalgie und MS – Erkrankungen, die ähnliche Symptome wie chronische Borreliose zeigen.

• Patientenberichte: Verbesserte Energie, weniger Schmerzen, besserer Schlaf.

• Ärztliche Erfahrungen: Experten wie Dr. Richard Horowitz und Dr. Cory Tichauer empfehlen LDN als Teil ganzheitlicher Behandlungsstrategien.

Anwendung und Dosierung

• Start: 1,5 mg abends, langsame Steigerung auf bis zu 4,5 mg.

• Nebenwirkungen: Lebhafte Träume, Schlafstörungen, Kopfschmerzen, leichte Magen-Darm-Beschwerden.

• Wichtig: Keine gleichzeitige Einnahme von Opioid-Schmerzmitteln.

Fazit

LDN ist kostengünstig, risikoarm und potenziell wirksam zur Symptomlinderung bei chronischer Lyme-Borreliose.Mehr Forschung ist nötig, doch frühe Ergebnisse und Patientenerfahrungen sind vielversprechend.

👉 Weitere Informationen finden Sie auf der LDN Research Trust Webseite.

🇳🇱 Nederlandse Versie

Low-Dose Naltrexon (LDN) bij de ziekte van Lyme: Een veelbelovende nieuwe benadering

De ziekte van Lyme, veroorzaakt door de bacterie Borrelia burgdorferi en overgebracht door tekenbeten, treft jaarlijks duizenden mensen. Zelfs na antibioticabehandeling houden veel patiënten last van klachten zoals vermoeidheid, gewrichtspijn en cognitieve problemen.

Low-Dose Naltrexon (LDN) – een lage dosis van de opioidantagonist naltrexon – trekt steeds meer aandacht vanwege het vermogen om het immuunsysteem te moduleren en ontstekingen te verminderen.

Wat is LDN?

• Oorspronkelijk in 50 mg goedgekeurd voor alcohol- en opioïdenverslaving.

• In lage doseringen (1,5–4,5 mg) heeft het een ander werkingsmechanisme:

  • Stimuleert endorfineproductie.

  • Vermindert ontstekingsbevorderende cytokines.

  • Bevordert herstelprocessen.

LDN en de ziekte van Lyme

• Chronische klachten bij Lyme hangen vaak samen met immuunontregeling.

• LDN kan bijdragen door:

  • Ontstekingsreacties te remmen (via TLR-blokkade).

  • Endorfines te verhogen → verbetering van stemming en pijncontrole.

  • Immuunrespons te stabiliseren tegen blijvende infectiecomponenten.

Bewijs en ervaringen

• Klinisch bewijs: Studies bij MS en fibromyalgie laten verbetering zien in pijn en vermoeidheid.

• Observaties bij Lyme-patiënten: Minder spier- en gewrichtspijn, meer energie.

• Artsen: Integratieve geneeskundespecialisten adviseren LDN als aanvullende therapie.

Dosering en bijwerkingen

• Start meestal op 1,5 mg per dag, langzaam verhogen tot 4,5 mg.

• Bijwerkingen (meestal tijdelijk): levendige dromen, slapeloosheid, hoofdpijn, maagklachten.

• Niet combineren met opioïden.

Conclusie

LDN biedt een veelbelovende, veilige en betaalbare optie voor patiënten met chronische Lyme-klachten. Hoewel meer grootschalig onderzoek nodig is, ondersteunen vroege resultaten en ervaringen het gebruik als aanvullende therapie.

👉 Zie de LDN Research Trust pagina voor meer informatie.

🇮🇹 Versione Italiana

Uso del Low-Dose Naltrexone (LDN) nella Malattia di Lyme: Un approccio terapeutico emergente

La malattia di Lyme, causata dal batterio Borrelia burgdorferi e trasmessa dalle zecche, colpisce ogni anno migliaia di persone. Anche dopo la terapia antibiotica standard, molti pazienti continuano a soffrire di affaticamento, dolori articolari e problemi neurologici.

Il Low-Dose Naltrexone (LDN), una versione a basso dosaggio dell’antagonista degli oppioidi naltrexone, sta emergendo come possibile opzione per modulare il sistema immunitario e ridurre l’infiammazione cronica.

Cos’è il Low-Dose Naltrexone?

• Approvato originariamente in dosi da 50 mg per dipendenza da oppiacei e alcol.

• In dosi ridotte (1,5–4,5 mg) agisce in modo diverso:

  • Stimola la produzione di endorfine.

  • Riduce citochine pro-infiammatorie.

  • Supporta i processi riparativi.

Meccanismi nel contesto della Lyme

• La malattia cronica di Lyme è spesso associata a squilibri immunitari.

• LDN può agire:

  • Inibendo i recettori TLR → riduzione delle cascate infiammatorie.

  • Aumentando endorfine e recettori della crescita oppioide → neuroprotezione e miglioramento dell’umore.

  • Modulando l’immunità contro persistenze batteriche.

Evidenze e osservazioni cliniche

• Studi preliminari: LDN migliora sintomi in patologie simili (fibromialgia, sclerosi multipla).

• Dati osservazionali: Molti pazienti con Lyme riportano riduzione di stanchezza, dolori muscolari e articolari.

• Esperti: Medici integrativi come il Dr. Richard Horowitz raccomandano LDN come parte di protocolli combinati.

Dosaggio e tollerabilità

• Dose iniziale: 1,5 mg la sera, fino a un massimo di 4,5 mg.

• Disponibile tramite farmacie galeniche (compounding).

• Effetti collaterali: sogni vividi, insonnia, cefalea, disturbi gastrointestinali (solitamente transitori).

• Controindicato con oppioidi.

Conclusione

Il LDN rappresenta una terapia complementare sicura ed economica per gestire i sintomi cronici della malattia di Lyme.Servono studi clinici più ampi, ma i dati preliminari e le testimonianze dei pazienti sono incoraggianti.

👉 Ulteriori informazioni disponibili sul sito LDN Research Trust.