LDN in Houston, for autoimmune and inflammatory conditions.
Low-dose naltrexone for chronic inflammation, autoimmune conditions, fibromyalgia, and long COVID — a useful tool for the right patient, with realistic expectations.
An off-label medication with a genuinely interesting evidence base for chronic inflammation.
Low-dose naltrexone (LDN) is naltrexone — an FDA-approved medication for opioid and alcohol use disorder — prescribed at roughly one-tenth its usual dose. At the lower dose, naltrexone produces a completely different clinical effect: it appears to modulate the immune system and reduce inflammation through pathways involving glial cells, opioid receptor signaling, and inflammatory cytokines.
LDN has been used off-label for more than 30 years for a growing list of inflammatory and autoimmune conditions. The evidence base ranges from strong (fibromyalgia, certain autoimmune conditions) to emerging (long COVID, chronic fatigue, neurological symptoms post-viral). It’s not a miracle drug. It is, for the right patient, a remarkably useful tool — well-tolerated, affordable, and effective in ways that more aggressive immune-modulating treatments often aren’t.
We prescribe LDN for specific clinical indications where the evidence supports it and where alternative treatments haven’t worked or aren’t appropriate. The medication itself is well-characterized; the off-label nature requires a clinician who understands when to use it and when not to.
The conditions where LDN genuinely helps.
LDN is most useful for specific patterns of chronic inflammation, autoimmune dysregulation, and post-viral syndromes. Here’s where the evidence and clinical experience converge.
Autoimmune & inflammatory conditions
Hashimoto’s, lupus, multiple sclerosis, inflammatory bowel disease, and other autoimmune conditions often respond to LDN. The mechanism appears to involve modulation of regulatory T-cells and reduction of inflammatory cytokines. LDN is often added to existing autoimmune management rather than replacing other treatments. Coordination with the patient’s rheumatologist or specialist is important.
Evidence: Strong in fibromyalgia; growing in other autoimmune conditionsPost-viral fatigue & long COVID
One of the most active areas of LDN use in recent years. Patients with persistent fatigue, brain fog, and inflammatory symptoms following COVID-19 or other viral illnesses have shown meaningful response to LDN in clinical settings. The evidence base is still emerging — the formal trial data is thinner than the practitioner experience suggests — but the patient-reported outcomes have been notable.
Evidence: Emerging · Real-world experience strong · See our immune serviceFibromyalgia & chronic pain
This is where LDN has the strongest formal trial evidence. Multiple randomized studies show meaningful pain reduction in fibromyalgia patients on LDN compared to placebo. The mechanism appears to involve glial cell modulation in the central nervous system. For patients with chronic pain that hasn’t responded to other approaches, LDN is often worth trying.
Evidence: Strongest for fibromyalgia · RCT data availableLDN works best when paired with addressing the underlying drivers.
LDN is a useful tool, but it works as part of a broader approach to inflammation and immune function. The patients who do best are those who address the root drivers alongside the medication.
The medication helps the immune system. The foundations decide what it has to work with.
Chronic inflammation rarely has a single cause. LDN addresses one piece; the broader picture matters for sustained results.
- Sleep quality — chronic poor sleep is one of the strongest drivers of inflammation
- Nutritional foundations — adequate protein, omega-3 status, micronutrient sufficiency
- Stress management — sustained cortisol elevation drives systemic inflammation
- Gut health — coordinated through our immune and gut service
- Concurrent peptide protocols — BPC-157 and TB-500 are sometimes layered for specific tissue concerns
From consultation to first prescription, in real medicine.
LDN requires careful initial dosing and patient education. It’s well-tolerated when prescribed correctly; less so when started too high or without adequate context.
Initial consultation
In person at our Houston clinic. We discuss your specific condition, what you’ve tried, current medications (LDN can’t be combined with opioid medications), and your goals. We’re honest about whether LDN is the right tool for your situation or whether something else makes more sense.
Focused workup
Lab work appropriate to your specific concern — thyroid panel, inflammatory markers (CRP, ESR), comprehensive metabolic panel, autoimmune markers where indicated, and other testing based on the suspected underlying condition. The workup tells us what else needs attention alongside LDN.
Protocol design
Compounded LDN, typically starting at 1.5 mg once daily and titrating up to 4.5 mg over 4 to 6 weeks. Most patients tolerate this gradual increase well. The compound is taken at bedtime in most protocols (timing matters because of how it affects sleep architecture during the initial weeks).
First prescription
Compounded LDN shipped from licensed compounding pharmacy. Detailed dosing schedule for the gradual titration. Clear expectations: most patients notice nothing for the first 2 to 4 weeks, with meaningful benefit emerging between 8 and 12 weeks.
Reassessment
Honest review at 12 weeks. If response is meaningful, continue. If response is partial, we may adjust dose or consider adjunctive approaches. If response is absent after 3 to 6 months at adequate dose, we have an honest conversation about discontinuing — LDN isn’t right for everyone, and we don’t keep prescribing what isn’t working.
Ready to start the conversation?
A 45-minute consultation with one of our Houston physicians. We’ll review your specific situation, discuss whether LDN fits your clinical picture, and design a protocol that pairs the medication with addressing the underlying drivers.
What LDN can — and can’t — do.
LDN is genuinely useful for the right patient. It’s also slower-acting and more variable in response than most prescription medications. Setting expectations matters.
What LDN can do
- Reduce chronic pain in fibromyalgia and related conditions, with strong RCT evidence
- Improve symptoms in autoimmune and inflammatory conditions for many patients
- Help patients with long COVID and post-viral fatigue based on emerging evidence and clinical experience
- Be very well-tolerated — most patients experience few or no side effects
- Be affordable — compounded LDN is typically $30 to $80 per month
- Combine safely with most other medications (with the critical exception of opioids)
What LDN can’t do
- Be combined with opioid pain medications — absolute contraindication
- Replace primary autoimmune therapy when more aggressive treatment is required
- Produce fast results — most patients need 8 to 12 weeks before noticing benefit
- Work for every patient — about 30 to 40% of patients don’t get meaningful response
- Avoid initial side effects entirely — vivid dreams and sleep disturbance during the first 1-2 weeks are common but usually resolve
- Be appropriate for patients on opioids (including some pain medications, certain cough suppressants, anti-diarrheal medications)
This page describes a compounded peptide or off-label medication. The compound is not FDA-approved for the proposed indications. Available human clinical evidence is limited. Information on this page is provided for educational purposes; clinical decisions are made individually during physician consultation. See our full disclaimers for additional context.
Before you book.
How much does treatment cost?
Compounded LDN typically runs $30 to $80 per month, which makes it one of the more affordable specialty medications available. Our clinical service fees cover physician oversight, lab review, and structured monitoring separately. We’ll discuss specifics during consultation.
Is LDN FDA-approved?
Naltrexone is FDA-approved at 50 mg for opioid and alcohol use disorder. LDN at 1.5–4.5 mg is prescribed off-label for inflammatory and autoimmune conditions. Off-label prescribing is a standard part of medical practice when there’s clinical evidence supporting the use. The medication itself is FDA-approved and well-characterized; we’re using it at a different dose for a different indication, which is supported by decades of clinical experience and an expanding evidence base.
What are the side effects?
LDN is unusually well-tolerated for a prescription medication. The most common initial side effects are vivid or unusual dreams and sleep disturbance during the first 1 to 2 weeks, which typically resolve as the body adjusts. Some patients experience mild headache or GI upset in the first few days. Serious side effects are rare. The biggest practical concern is the contraindication with opioids — LDN blocks opioid receptors, so concurrent opioid use is unsafe.
Can I take LDN with my other medications?
Generally yes, with one critical exception: opioid medications (including some pain medications, certain cough suppressants like codeine, and anti-diarrheal medications like loperamide at higher doses) are absolute contraindications. LDN can be safely combined with most autoimmune medications, antidepressants, and other commonly prescribed drugs. We review your full medication list during consultation and prescribe accordingly.
How long does it take to work?
Most patients notice nothing for the first 2 to 4 weeks. Meaningful benefit typically emerges between weeks 8 and 12 of consistent use at therapeutic dose. The mechanism appears to involve gradual modulation of inflammatory pathways rather than immediate symptom suppression. Patients expecting fast results often get frustrated — setting realistic expectations upfront matters.
Does it actually work for long COVID?
The formal clinical trial evidence is still emerging — long COVID itself is a relatively new condition, and rigorous LDN trials are ongoing. The practitioner experience and patient-reported outcomes have been notable: many patients with persistent fatigue, brain fog, and post-viral symptoms have described meaningful improvement on LDN. We discuss this honestly during consultation — the evidence isn’t yet at the level of the fibromyalgia data, but the signal is real and the side effect profile is favorable enough that a trial is reasonable for many patients.
What if I’m a non-responder?
About 30 to 40% of patients don’t experience meaningful benefit from LDN. If you’ve been at a therapeutic dose (typically 4.5 mg daily) for 12 weeks without noticeable improvement, we have an honest conversation about whether to continue. Sometimes the answer is adjusting the dose or trying a different timing; sometimes the answer is acknowledging LDN isn’t the right tool for your situation and exploring other approaches. We don’t keep prescribing if it’s not working.
Start with a conversation, not a prescription.
A 45-minute consultation with one of our Houston physicians. We’ll review your specific condition, discuss whether LDN fits, and design a protocol that takes the whole picture into account.