Healthy Hormones

Low Dose Naltrexone for Hashimoto’s and Weight Loss

Research has shown the benefit of using low dose naltrexone for Hashimoto's thyroiditis and other autoimmune conditions.

If you have an autoimmune condition such as Hashimoto's thyroiditis, reducing the inflammation in your body is crucial to help you feel better and lower your antibody levels.

If you don't lower the inflammation, it will be next to impossible to lose weight or feel as good as you can.

Lose dose naltrexone has been shown to substantially lower inflammation.  It also helps to raise endorphin levels which makes you feel better overall.

There is also a lot of anecdotal evidence that LDN can help some people lose weight.

In this article, I will discuss LDN and what some of the research is showing about it.  I will explain how it can be used to potentially lower antibody levels, help with chronic pain, and maybe even help people with Hashimoto's to lose weight.

Let's get started...


What is LDN?

LDN is short for low dose naltrexone.

Naltrexone was developed in the 1980s to treat patients with opioid withdrawal.  It is a sister drug to the well-know Narcan (naloxone).

It is an opioid antagonist, which means it blocks opioid receptors in the brain.

When taken in doses of 50-100mg, it completely saturates the opioid receptors which prevents the person from experiencing the "high" that they normally would get from taking opioid (narcotic) medications.

It is therefore used by people in drug or alcohol rehab to help them stay off of their drug of abuse.

Dr. Bernard Bihari performed research in which he discovered that naltrexone in low doses helped reduce symptoms and inflammatory markers in patients with autoimmunity, cancer, and HIV.

How does LDN work?

Endorphins are our "feel good" chemicals.  They are associated with feelings of pleasure, sexuality/sensually, euphoria and pain relief. Essentially, endorphins make us feel good and give us a sense of well-being. 

Endorphins are what cause the "runners high" when we exercise.

Low levels of endorphins are associated with the opposite effects: physical and emotional pain (including chronic pain found in disorders such as fibromyalgia), and addiction.

Low doses of naltrexone (from here on I will refer to it as LDN) appears to increase the level of endorphins in the brain by only partially blocking the opioid receptors when the endorphin levels are at their highest (3-4am).

This signals to the body that the levels are low, so it temporarily increases endorphin production.

Endorphins appear to modulate the immune system.  Therefore, raising the endorphin levels (like LDN does), impacts the immune system in a positive way.  

LDN has also been shown to decrease inflammation in chronic pain conditions, which is why the people that have the most success using LDN typically have chronic pain as one of their main symptoms.

Low Dose Naltrexone for Autoimmune Conditions

People with autoimmune conditions typically have lower levels of endorphins than people without autoimmunity.

So it makes sense that if LDN raises endorphin levels, it would help someone with an autoimmune condition feel better.

Also, autoimmune conditions are associated with an increased level of inflammation.  So the anti-inflammatory effects of LDN would obviously also help lower the overall inflammation in the body.

In addition to the benefits listed above some studies have shown that the use of LDN can help to improve the immune system and reduce auto antibodies in some autoimmune conditions.

The majority of research regarding LDN that I found dealt with how it can impact multiple sclerosis (MS), Crohn's disease, and fibromyalgia.  However, it has also been used to in many other conditions.

Now let's see what impact LDN has on thyroid disease (particularly Hashimoto's).

Low Dose Naltrexone for Hashimoto's

To learn more about Hashimoto's thyroiditis, read my article here.

I discuss natural treatments for Hashimoto's in this article.

LDN appears to improve Hashimoto's (and all hypothyroidism for that matter) by:

Much of the evidence of LDN impacting Hashimoto's is anecdotal, meaning doctors and patients give their personal experiences using it.  To this point, the number of research studies are small and sporadic.

However, a quick Google search will take you to websites such as that will show you much of the research and patient testimonials about LDN.

I myself have had several patients that reported feeling much better when taking LDN.  Some even showed a reduction in their antibody levels.

Does LDN Help with Weight Loss?

The answer is yes in some studies, no in others.

LDN should never be prescribed for the sole purpose of weight loss, but some patients have had some significant weight loss while taking it.

It appears that LDN helps with weight loss by affecting the following:

  • Reduces Insulin Resistance - Insulin resistance is a common cause of weight gain, so it makes sense that reducing it will result in weight loss.
  • Increases Growth Hormone - Growth hormone increases lean muscle mass and increases fat burning, both of which help with weight loss.
  • Modulates Appetite - LDN may help to normalize the appetite in people with a damaged metabolism which helps to match their appetite with the amount of energy they burn.
  • Decreases Inflammation - High levels of inflammation cause several hormonal changes including insulin resistance, leptin resistance, poor T4 to T3 conversion, high estrogen and low testosterone.  All of these lead to weight gain.
  • Improves Sleep - Lack of sleep has been shown to increase inflammation and weight gain.  Studies show that LDN improves sleep in patients with sleep apnea and chronic pain syndromes

Naltrexone can be found in a currently marketed drug for weight loss - Contrave.  However, the doses in this pharmaceutical drug are higher than the ones I recommend in this article.

How to Take LDN

LDN is a prescription medication, so it must be prescribed by a medical professional - doctor, nurse practitioner, or physician assistant.

The vast majority of doctors have little to no experience writing it.  You may have to do your own research to find a doctor that is knowledgeable about LDN and willing to prescribe it for you.

Naltrexone is not available in most retail pharmacies in the low doses we are discussing in this article.  You will have to purchase it from a compounding pharmacy.

Insurance will not cover it.  Fortunately, it is usually less than $50 per month, so it is still affordable.

How to Dose LDN -

I have had the most success with LDN by starting on a low dose then stepping up the dose every 2 weeks until we get to the target dose.

My typical prescription looks like this:

Take 1.5mg daily at bedtime for 2 weeks, then 3.0mg daily at bedtime for 2 weeks, then 4.5mg at bedtime thereafter.

Side Effects of LDN -

LDN has virtually no side effects, which makes it a great medication to try in people with autoimmune conditions, especially those with chronic pain.

Rarely, patients may complain of vivid dreams or muscle spasms when taking the 4.5mg dose.  If that happens, reducing to 3mg usually resolves the problem.  

The patient can try to go back up to 4.5mg a few weeks later if the 3mg is not adequate to resolve their symptoms.

Remember, LDN partially blocks opioid receptors.  So if you are taking a opioid (narcotic) medication regularly, it could block the effects of your pain medication.

Therefore, if you are on regular narcotic pain medications, you should NOT take LDN at least until you reduce or stop your pain medications.  At the very least, you will want to take your pain medications at a different time to try to prevent the interaction.

If you take your pain medication at the same time (or close to it) as you take LDN, it could block the effect of the narcotic medication on the opioid receptors which would in effect reverse its action.

This could result in a sudden increase in your pain level.  While it is not life-threatening, you could experience a lot of pain until the LDN wore off and you were able to take more pain medication.

If you are interested in trying LDN, it is critical that you give your doctor a complete list of all of your current medications.  This will help him or her to know if you can safely try LDN.

If you have Hashimoto's and you decide to try LDN,. it is important that you watch your thyroid levels closely.  LDN may decrease your thyroid antibody levels which could cause your thyroid hormone level to increase and cause symptoms of hyperthyroidism.

That would be a great thing ultimately, but it could be potentially dangerous at first.  You may therefore need to lower your thyroid medication dose.  


Low dose naltrexone is a seldom used, yet potentially helpful medication in people with Hashimoto's and other autoimmune conditions.

Studies show that it can lower inflammation in autoimmune conditions.  It also raises endorphin levels in the brain which makes the person feel better.

It is especially helpful in people who suffer from chronic pain, although it should not be taken at the same time as an opioid pain medication because it can block the effect of the pain medicine.

If you are interested in trying it, you will need to find a medical provider with experience in prescribing it.  It will need to be purchased from a compounding pharmacy and insurance will not cover it.

Now it's your turn...

Have you ever tried LDN?

If so, what was your experience with it?

Leave your comments below.

About the Author Dr. Jeff Whelchel

Dr. Whelchel is a family physician who specializes in functional medicine, especially hormone optimization. He has over 20 years experience in private practice managing patients with various medical issues. His passion is helping patients reach their full potential of wellness and quality of life. He grew up in the Texas Panhandle where he currently lives. He is married and has 3 awesome children.

Leave a Comment:

Carrie Mashburn says November 13, 2017

LDN has been a LIFESAVER for me and my journey with Hashimotos! I feel better than I have in years! I have less pain and more energy! My general wellbeing is soooo much better! LDN along with a gluten and dairy free diet has changed everything!!!I am so thankful for you Dr Whelchel!

    Dr. Jeff Whelchel says November 13, 2017

    Thank you for the kind words, Carrie. I have had good success in the majority of patients who have taken LDN. I’m so glad that you are feeling better.

Kim stavenhagen says January 10, 2018

Dr Whelchel, please say that I can take this medication.

    Dr. Jeff Whelchel says January 11, 2018

    Hi Kim. Yes, we can try you on it. Please contact the office and we will get it sent in.

Leslye Langen says January 11, 2018

Dr. Whelchel.
I think I would benefit from LDN. I have not been diagnosed with Hashimoto’s, but would like to be tested. Can you help with that or do I need to go see someone locally? Thanks so much!

    Dr. Jeff Whelchel says January 11, 2018

    Hi Leslye. It’s great to hear from you.

    Most doctors are unfortunately not very comfortable with diagnosing or managing Hashimoto’s. I would be happy to help you. I would suggest joining my online hormone consulting practice. You can read more by going here: Take care!

Leslye Langen says January 18, 2018

Hello! I’m going to get blood work before having my BioTe pellets inserted. If I’m wanting to show the results in order to screen for Hashimoto’s, what all does the blood work need to include?
Thank you!

    Dr. Jeff Whelchel says January 18, 2018

    Hi Leslye. A complete thyroid panel would include TSH, free T4, free T3, reverse T3, TPO antibodies and thyroglobulin antibodies. I also like to monitor the ferritin level because it is commonly low in thyroid patients. If you need more help from me, you might consider joining my online consulting membership.

    It was great to hear from you.

Bobby Saint says February 22, 2018

Honestly, this is the first tie I’ve ever come across Low Dose Naltrexone. Now, I know that it is one effective way of treating inflammation and raising endorphin levels which can make someone feel much better in general. I wonder if this is available nationwide and if it can be purchased over the counter though. I’ll definitely read more about LDN and its benefits for additional learning. Thanks.

    Dr. Jeff Whelchel says February 24, 2018

    Hi Bobby. LDN requires a prescription from a medical provider in order to purchase it. Chances are your regular doctor may be unfamiliar with it, so you may need to do some research to find a doctor in your area that is comfortable prescribing it.

Kerry says April 25, 2018

I just found out that I have Hashimoto’s my LDN will be in this week but I am that person who does not like to take meds so I’m really nervous. I also found out that I have entered menopause and I have to take meds for that as well…sigh I have been so tired lately like every day around 2 or 3 pm I am falling asleep at my desk I hope that the LDN will help me gain my energy back. I work out daily (except for Sunday) and I have started to struggle with having the energy although I push though because working out is my favorite thing to do. I also wanted to ask can I take the LDN during the day or does it have to be taken at night. I don’t want to have crazy dreams that keep me up because I get up at 4 am. Does this medication cause hair loss I’m worried about that as well I just read that it can but I don’t know if that was for higher doses. I’m going to look into the AIP diet too. Thank you for your help.

    Dr. Jeff Whelchel says April 26, 2018

    Hi Kerry. I have found that LDN is typically very well tolerated. People can occasionally have vivid dreams on the 4.5mg dose, but even then it is relatively rare. You may want to take 3mg for awhile and see how you do. Many folks get a good response at that dose with no side effects. It works best when taken at bedtime.

    I would also suggest getting your cortisol levels checked since you are having mid afternoon crashes and the fact that exercise exhausts you.

    Hair loss can be from many causes – adrenal issues, thyroid issues, low ferritin, etc. I have not personally had any patients that developed hair loss from LDN.

Sherri Chambliss says May 28, 2018

Dr Welchle what is your opinion on this product for meal replacement? And these another called Organifi Green Juice and Protein. Can I use these products? Also what about me taking LDN?

    Dr. Jeff Whelchel says June 3, 2018

    Hi Sherri. I’m not familiar with that drink but from its website it looks okay to me.

    LDN would be a great choice for you. Call my office or send a portal message and we can get you prescribed some.

Donna Czerwinski says June 6, 2018

If you’re currently taking np thyroid 90 mg – 120 mg and you wanted to start the low dose of NDN, what dosage of np thyroid would you change to?

    Dr. Jeff Whelchel says June 9, 2018

    Hi Donna. Normally, you don’t need to adjust your thyroid dose when you start LDN.

Maria Keller says July 25, 2018

I feel so lucky to have found your articles now I just have to find a dr to listen to me!

    Dr. Jeff Whelchel says July 25, 2018

    Hi Maria. Thank you for the kind words.

    I don’t know where you live, but starting in January I will be opening my online membership practice to all states. The only legal requirement would be to meet you face-to-face one time per year. If you were willing to travel to Amarillo, Texas, to see me, we could do that. Think about it. Click on “Get Help From Dr. Whelchel” at the top of my website if you want more information.

Ann G. Arens says January 10, 2019

I have 2 doctors. An Orthopaedic MD and a PA. I have been diagnosed by both with
severe Hashimoto’s. First my PA after extensive blood work up, put me on Naltraxone 1.5 mg. After more work up by my MD, he upped my dose
to 3 mg. and today at age 76 yrs. I feel the best I can remember in my entire life.
Many years and many MD’s in the past saying I had Fibryalgia and prescribing Ambien, Lyrica etc. I have finally found what I’ve needed my whole life.
Thank you for your research and the difference folks like you have made in my long time suffering. Happy in Texas soon to be 77 yrs.

    Dr. Jeff Whelchel says May 11, 2019

    Good for you Ann! I’m so glad you are getting relief! Sounds like you have some good medical providers. Best of luck.

Marty Ungs says February 20, 2019

I am in Des Moines, Iowa. Any practitioners here that you know of that will prescribe low dose naltrexone? Thanks!

    Dr. Jeff Whelchel says May 11, 2019

    Hi Marty. I don’t know any providers in your area. I would suggest contacting one of your local compounding pharmacies and asking them for a list of providers that prescribe LDN.

Susan V Zorn says March 1, 2019

Thank you for explaining how low dose naltroxene helps Hashimotos patients. I am looking for a doctor that us familiar with the benefits of LDN. Wish me well.

    Dr. Jeff Whelchel says May 11, 2019

    Thank you, Susan. I would call a local compounding pharmacy and ask them for a list of providers that prescribe LDN. That would be a great starting point. Best of luck to you.

Randee Ruiz says April 17, 2019

I have been on 4.5 LDN since December. I haven’t had any side effect except that my libido in gone. Should I lower my dose? My antibodies have not changed at all yet.

    Dr. Jeff Whelchel says May 11, 2019

    Hi Randee. I’m sorry that you have not had a great response to LDN. You could try reducing the dose to see if your libido improved, although that is not a common side effect. I would have the discussion with the physician who prescribed your LDN. Good luck!

tim petty says April 20, 2019

can ldn be taken with methotrexate if not taking it the day i take methotrexate with the idea of weaning off mtx

    Dr. Jeff Whelchel says May 11, 2019

    I don’t know of any interaction between methotrexate and LDN. I would check with your pharmacist to be sure.

Louise says October 23, 2020

Would Contrave have the same effect? Does it have to be low dose? I found someone who will prescribe Contrave but not LDN

    Dr. Jeff Whelchel says November 11, 2020

    Yes, contrave as naltrexone in it. It is a much higher dose and includes buproprion, but it should have similar benefits if the side effects are tolerable.

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