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Experiences with LDN

Explore the potential benefits of Low Dose Naltrexone (LDN) in treating a range of conditions, including Sarcoidosis. Learn about the experiences of over 1200 individuals with various disorders like Crohn's disease, Fibromyalgia, and Ulcerative Colitis. Discover how LDN may regulate T-cell and B-cell growth, decrease inflammation, and improve GI motility as a possible treatment for Sarcoidosis. Get insights into case studies showcasing positive responses to LDN therapy in Sarcoidosis patients.

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Experiences with LDN

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  1. New Use for LDN: SarcoidosisLeonard Weinstock, MDAssociate Professor of Clinical MedicineWashington University School of MedicinePresident, Specialists in Gastroenterology

  2. Experiences with LDN • “Conditions where LDN could be of benefit” • 176 diseases, syndromes, and disorders • Limited number of publications www.ldnresearchtrust.org

  3. My LDN Experience: (N>1200) • Alopecia areata • Chronic fatigue synd. • Complex regional pain * • Constipation * • Crohn’s disease * • Dercum’s disease • Eczema • Fibromyalgia * • AIDS * • Interstitial cystitis • Irritable bowel syndrome * • Multiple sclerosis * • Prostatitis (Type III) • Restless legs syndrome • Sarcoidosis • Small intestinal bacterial overgrowth • Ulcerative colitis *

  4. Sarcoidosis • Granulomatous disorder with T-cells • & macrophages in multiple organs • CD3+ cells, CD4+ cells w/ HLA-DR antigen, & high CD4/CD8 ratio in bronchus • CD4+ CD29+ memory T-cells increased Iida K et al. Thorax 1997;52:431-7.

  5. Sarcoidosis • Special T-cell interactions in pulmonary and liver sarcoidosis • Activated memory T-cells with CD11a Iida K et al. Thorax 1997;52:431-7.

  6. Sarcoidosis: Pathogenesis • Genetic susceptibility with functional polymorphisms • Exposure to antigens leading to activation of macrophages • Attainment of T-cell immunity against antigens mediated by antigen processing and presentation by macrophage Zissel

  7. Sarcoidosis: Standard Rx • Initial therapy: prednisone (often 2 yr) with variable initial dose, taper, & duration • Steroid-sparing Rx: • Methotrexate • Azathioprine • Leflunomide • Mycophenolate • Infliximab Baughman; Chapelon-Abric.

  8. Sarcoidosis vs. Crohn’s disease • Similar pathology • Unregulated T-cell activity • Non-caseating granulomas

  9. Sarcoidosis Rx: Role for LDN • Regulate T-cell growth • Regulate B-cell growth • Decrease inflammation • Decrease permeability • Stabilize Toll-like receptors • Decrease microglia activation • Decrease cytokine release • Shift from TH2 to TH1 • Improve GI motility

  10. Sarcoid Case 1 Rash Fatigue Adenopathy Liver/Spleen

  11. Case 1 • AH 73 y.o. AAF – supraglotic resection in 2001 d/t sarcoidosis. Sx weak voice, painful rash, fatigue, and parotitis • Rash prevention • by minocycline • Hx MTX neuropathy • Referred abnl CT • LDN – prescribed

  12. Progress 2015 February - LDN 1 mg/day March - less dyspnea, fatigue, able to stop minocycline w/o rash March – LDN increased 12 days to 4.5 mg May – Dec - less DOE, more energy July & Dec – CT’s showed reduction in the size of the splenic lesions and liver lesions

  13. 12/2014 11/2011 Before LDN

  14. 12/12 - 10 mo LDN 7/15 - 5 mo LDN

  15. 12/15 – 10 mo LDN 12/14

  16. Sarcoid Case 2 Pulmonary Fatigue

  17. Case 2: PFB 64 y.o. AAF • 26 yr pulmonary sarcoidosis • 2 yr home O2 (24 hr/d; 2 L) • Dyspnea (rest/activity) and dry cough • 7/15 - Prednisone 20 mg • Last used 16 yr ago • 8/15 - LDN

  18. Case 2: PFB 64 y.o. AAF • 9/15 – 1 mo LDN • No change • 10/15 - 2 mo LDN • Less fatigue • Less dyspnea • O2prn for vigorous activity • Prednisone taper started

  19. Sarcoid Case 3 Pulmonary

  20. Case 3: PLB 63 y.o. WM • Abnl CXR 17 yr ago – Bx: granulomas • Hx osteopenia • 2 yrs dyspnea with activity • 8/20/15 - LDN • 4.5 mg (titrated up from 1.5 over 2 wks)

  21. Case 3: PLB 63 y.o. WM • 1 mo after LDN – unchanged • 2 mo after LDN – less short of breath • 3 mo after LDN – asthma from allergens

  22. Sarcoidosis Rx: Role for LDN Experience needed – enroll AA pts • Pulmonary response w treadmill testing • Anti-inflammatory markers

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