Low Dose Naltrexone Weight Loss: A Guide

Written by Elizabeth Brown

Low-dose naltrexone (LDN) has become an increasingly popular treatment for various autoimmune diseases and chronic health conditions. Though generally well-tolerated, it's important to know what to avoid when taking low-dose naltrexone to prevent potential side effects or interactions. This article will outline low-dose naltrexone weight loss, how naltrexone works, and what side effects to look out for when beginning treatment.

Why Take Low-Dose Naltrexone At Night? Find Truth!

what to avoid when taking low dose naltrexone

Naltrexone can disrupt sleep cycles if taken at certain times. Doctors often recommend taking low-dose naltrexone (LDN) at bedtime to minimize side effects and improve efficacy. The delayed peak after evening ingestion allows LDN to reduce inflammatory cytokines during critical overnight repair phases. Learn how low-dose naltrexone can help with weight loss goals. Research shows LDN may support metabolism and hormone regulation to aid in fat reduction.

low dose naltrexone benefits

  • Modulates the immune system - LDN can help regulate the production of cytokines and reduce inflammation in conditions like autoimmune diseases.
  • Chronic pain relief - By reducing inflammation, LDN may provide pain relief for those suffering from conditions like fibromyalgia.
  • Improved mood disorders - Some research shows LDN can help lift mood in cases of depression and anxiety.
  • Anti-cancer effects - Early research indicates LDN may help slow cancer cell growth for certain cancers like ovarian and pancreatic.
  • Reduced side effects of opioids - For those taking opioids for pain, LDN may potentiate the effects and help reduce tolerance build-up.
  • Treating Crohn’s disease - Some studies have found LDN provides symptomatic relief and improved quality of life for Crohn’s patients.
  • Neuroprotective qualities - LDN may help protect neurons and reduce neurodegeneration in diseases like multiple sclerosis and Parkinson’s.
  • Increase energy and mental clarity - Some patients report significant boosts in energy levels, cognitive abilities, and overall sense of well-being.

Low-Dose Naltrexone Uses

Naltrexone is an opioid antagonist medication primarily used in the treatment of alcohol and opioid dependence. It works by blocking the effects of opioids, including alcohol, and reduces cravings for these substances. Naltrexone is also used in low doses (typically 1.5-4.5mg daily) as an off-label treatment for various autoimmune and inflammatory conditions, such as fibromyalgia, Crohn's disease, and multiple sclerosis. The low dose is believed to have an immune-boosting effect that reduces inflammation.

Naltrexone Mechanism of Action

As an opioid antagonist, naltrexone works by temporarily blocking opioid receptors which are involved in pain signaling and inflammation. Though the mechanism isn't fully understood, it’s believed that the rebound effect after the medication leaves the body gives an immune-boosting effect that reduces inflammation.

This makes low-dose naltrexone a promising therapy for conditions like fibromyalgia, Crohn’s disease, multiple sclerosis, and more. Typical dosing starts at 1.5-4.5mg daily, with effects taking several weeks to fully develop. During this time, it’s essential to know what to avoid when taking low-dose naltrexone.

Several types of substances and medications should be avoided when beginning low-dose naltrexone (LDN) treatment. Awareness of these naltrexone interactions is key to maximizing benefits and minimizing side effects.

How Long Does It Take Low-Dose Naltrexone To Work?

Most experts recommend giving LDN at least 8-12 weeks at the optimal dose to properly evaluate its efficacy. The mechanism of raising endorphin levels takes time to develop fully. Patience during this ramp-up period is key. If no benefits are seen after 3-4 months, the medication may not be effective for that particular case. However, the majority of responders report noticeable improvements within 2-3 months of consistent low-dose naltrexone therapy. Low-dose naltrexone (LDN) can aid weight loss through appetite suppression and anti-inflammatory effects when taken correctly under medical supervision.

What to Avoid When Taking Naltrexone?

What to Avoid When Taking Naltrexone

One of the most notable medication classes to avoid is opioid-based pain medications. This includes commonly prescribed options like oxycodone, hydrocodone, codeine, morphine, fentanyl, and tramadol. The mechanism of LDN relies on temporarily blocking opioid receptors and then allowing natural endorphins to increase after this effect wears off.

If you have concurrent opioids in your system, the LDN is not able to function properly and patients may experience worsening pain as a result. Luckily, for those with chronic pain, many report decreases in pain levels after being on LDN long enough for it to achieve optimal therapeutic effect.

In addition to classic opioid medications, it’s also vital to avoid taking LDN within 1-2 hours of any opiate derivatives. This includes seemingly innocuous compounds like the anti-diarrheal medication loperamide (Imodium AD).

Additionally, some cough suppressants can interact so read medication labels carefully before taking anything new while on LDN. Even codeine-containing foods like poppy seeds should be avoided to prevent blocking naltrexone’s effects. Having an awareness of these substances is imperative for anyone beginning low-dose naltrexone treatment.

Some additional medications reported to potentially interact with LDN include:

  • Sedatives like benzodiazepines or hypnotics: May cause additive drowsiness/sedation
  • Anti-seizure drugs: Naltrexone may reduce absorption leading to lower anti-seizure drug levels
  • Buprenorphine: Can precipitate opioid withdrawal when combined
  • Naltrexone implant/injections: Don’t take oral LDN simultaneously with another form of naltrexone

Any medication metabolized by the liver may also be affected since naltrexone is metabolized by the same liver pathway. Though rare, this includes things like heart medications, antifungals, antibiotics, and more. While not always problematic, it’s ideal to monitor medication levels if adding LDN to an existing drug regimen. Discussing potential interactions with the prescribing doctor and pharmacist can help catch issues early.

Foods to Avoid While Taking Gabapentin

Gabapentin is an anti-seizure medication often prescribed with naltrexone. It is used to treat neuropathic pain, seizures, and restless leg syndrome. While there are no specific dietary restrictions for gabapentin, it is generally recommended to avoid alcohol, as it can increase the risk of side effects such as drowsiness and dizziness. Additionally, it is advisable to consume gabapentin with food to reduce the risk of stomach upset. Some patients may also experience an increased appetite while taking gabapentin, so it is important to monitor calorie intake and maintain a balanced diet.

Low Dose Naltrexone Side Effects

Aside from medication interactions, LDN can produce side effects that are important to look out for. The most common include trouble sleeping, vivid dreams, headaches, anxiety, and nausea. For many patients, these dissipate within the first week or two as the body adjusts. However, others experience digestive upset even after adjusting to LDN. This may require avoiding certain trigger foods to manage.

Some nutritionists speculate that LDN may indirectly exacerbate existing food sensitivities. This means those with conditions like IBS, leaky gut, food allergies or autoimmune disease may need to tweak their diets more carefully. However, research in this realm remains limited regarding definitive dietary restrictions.

how long does naltrexone stay in your system?

Naltrexone typically stays in your system for one to two days, though it can take a week or more for the effects on opioid receptors to fully wear off. Factors like dosage, frequency of use, body mass, age, liver and kidney health, and genetics can influence how quickly naltrexone is metabolized and excreted.

low dose naltrexone weight loss

low dose naltrexone weight loss  benefits

Low-dose naltrexone (LDN) at around 4.5mg per day has shown promise for encouraging weight loss in some small studies. It is thought to act on opioid receptors and inflammation pathways to help regulate appetite and boost metabolism. More research is still needed, but LDN could potentially aid weight loss by reducing food cravings and stabilizing blood sugar and hunger signals when combined with diet and lifestyle changes.

Key messages

Low-dose naltrexone is an emerging therapy for the treatment of autoimmune and inflammatory conditions, though its mechanism of action requires avoiding opioids for proper effect. Learning what to avoid when taking low-dose naltrexone prepares patients to maximize therapeutic benefits while minimizing adverse reactions. Key substances to avoid include opiate-based pain medications, anti-diarrheal with opium derivatives, cough medicines with opioid effects, and even foods containing poppy seeds in some cases.

Certain medication classes like sedatives, anti-seizure drugs, and those metabolized by the liver may also require adjustments or more careful monitoring when adding LDN. Digestive upset, headaches, insomnia, and vivid dreams are potential short-term side effects but often resolve within 1-2 weeks of treatment initiation. However, food sensitivities may be exacerbated by LDN long-term for some patients based on anecdotal reports. An anti-inflammatory, whole-food diet can help counter this effect.

Being informed on what to avoid when taking low-dose naltrexone empowers patients to be active partners in their treatment plans. From monitoring medication interactions to identifying dietary triggers of symptoms, patients have an important role to play in optimizing their LDN protocol. With proper preparation regarding substances and medications to avoid, LDN can safely help induce remission in various inflammatory and autoimmune conditions.

Could this emerging therapy provide you with lasting relief from chronic symptoms? If you have taken LDN before, what was your experience with it?

Final Note

Being aware of substances that can interact with naltrexone’s unique mechanism of action is vital when starting LDN. Opioid pain medications pose the highest chance of interaction and should strictly be avoided. Looking out for side effects is also essential, as Digestive upset, headaches, vivid dreams, and sleep disruption seem most prevalent initially.

Adjusting the timing of the dose to the afternoon instead of bedtime can sometimes help in that regard. With the right preparation regarding what to avoid when taking low-dose naltrexone, many patients report excellent benefits that improve quality of life in chronic disease. Being an informed patient by knowing potential medication interactions, side effects, and individual food reactions sets the stage for optimal therapeutic response.


  • National Institute Of Health(2021) Safety and efficacy of naltrexone for weight loss in adult patients – a systematic review Available online at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8314402/
  • Guerdjikova AI, Walsh B, Shan K, Halseth AE, Dunayevich E, McElroy SL. Concurrent improvement in both binge eating and depressive symptoms with naltrexone/bupropion therapy in overweight or obese subjects with major depressive disorder in an open-label, uncontrolled study. Adv Ther. 2017;34:2307–15. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5656719/

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Elizabeth Brown is a registered and licensed dietitian with over 10 years of experience helping clients successfully achieve their weight loss and nutrition goals. She received her Master of Science in Nutrition from the University of Washington and completed her dietetic internship at Harborview Medical Center. Elizabeth specializes in bariatric patient care, working closely with bariatric surgery teams to provide pre- and post-operative nutrition counseling. She has supported hundreds of patients in preparing for weight loss surgery, adopting the required dietary changes, and making lifestyle adjustments for long-term success. She stays up-to-date on the latest research and best practices in bariatric surgery aftercare through her membership in the Obesity Society (TOS) and the Obesity Action Coalition (OAC). She is an avid speaker and educator, presenting regularly at local and national conferences on topics related to post-bariatric nutrition and weight maintenance.

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