Low-Dose Naltrexone (LDN) A — Dr. Rawls’ Ratings
Efficacy: 4 stars
Safety: 4 stars
Cost: 2 out of 5 dollar signs
Ways to Administer: oral dose once or twice daily
Bottom Line: About half of the people who try low-dose naltrexone experience benefits from it, but the risk associated with trying it is very low. It’s primarily supportive, but increased endorphins do support immune system functions.


Naltrexone is a drug designed to block opioid receptors in the body. Opioid receptors decrease the pain response when activated by endorphins in the body. Opioid drugs reduce pain by mimicking endorphins to activate opioid receptors. The limitation of prolonged use of opioid drugs (narcotics) is habituation and dependence.

Naltrexone was created back in the 70s to help addicts get off heroin. At a standard dose of 50 mg, the drug blocks all opioid receptors in the body. In other words, it blocks all the effects of heroin. In theory, an addict would find heroin useless and stop using it, but it never took off as a popular drug.

Interestingly, someone noticed that low-dose naltrexone (LDN) in 1.5-4.5 mg doses had a different effect: When it’s administered once daily, or sometimes twice daily, an intermittent blockage of opioid receptors causes a surge in natural endorphin production. With daily use, elevated endorphin secretion is sustained, along with pain relief and enhanced feelings of well-being.


Use of LDN in autoimmune disease, chronic pain and inflammation, and a range of health conditions, including fibromyalgia and chronic Lyme disease, is well supported by research documented at lowdosenaltrexone.org.

In my clinical experience, only about half of people benefit from LDN. Of those, some gain significant benefits, but most experience only mild improvements. The other half of people have little or no response, and some experience significant side effects. If a benefit is achieved, it’s okay to stay on LDN long-term. Note that CBD oil also provides similar benefits and works more consistently, and the two can be used together.


Use of naltrexone at a low dose is generally safe and has a low incidence of severe side effects. It has no narcotic effects and carries zero potential for dependence and habituation.

Naltrexone requires a prescription from a healthcare provider and is usually obtained from a compounding pharmacy. To use low-dose naltrexone, you must be off all narcotics for at least a week.


The cost to fill LDN tends to vary between different compounding pharmacies and the strength of the prescription, but a monthly prescription could cost between $200 to $300.

Dr. Bill Rawls Treatment Guide

Dr. Bill Rawls’ Treatment Guide

Want to see more Lyme disease treatment ratings? See What Dr. Rawls has to say about popular treatments and therapies in his Lyme Disease Treatment Guide.

Dr. Rawls is a physician who overcame Lyme disease through natural herbal therapy. You can learn more about Lyme disease in Dr. Rawls’ new best selling book, Unlocking Lyme.
You can also learn about Dr. Rawls’ personal journey in overcoming Lyme disease and fibromyalgia in his popular blog post, My Chronic Lyme Journey.