Treatment of ME/CFS and Long COVID with Low-Dose Naltrexone

 

In addition to autoimmune diseases, there is also interest in the use of low-dose naltrexone (LDN) in the treatment of chronic fatigue syndrome (ME/CFS) and Long COVID. Although the exact cause of ME/CFS and Long COVID is not yet fully understood, it is thought that immune dysregulation and inflammation play a role in the development and persistence of these conditions.

In a study of three cases of ME/CFS Bolton described subjective improvements after starting LDN [1]

Long Covid, also known as post-COVID syndrome, or Post-Acute Sequelae of SARS-Cov-2 (PASC) refers to the persistent symptoms that occur after an acute Covid-19 infection. Research into the treatment of Long COVID is still in its early stages, but there are indications that LDN may have beneficial effects.

A recent pre-post intervention study [2] investigated the safety and efficacy of low-dose naltrexone (LDN) in a cohort of patients with prolonged COVID-19 symptoms. The study included 52 participants. The participants used 1 mg LDN for one month and 2 mg LDN for another month. Of 36 participants, the before and after questionnaires were known. After using LDN, patients reported a significant improvement in 7 of the eight symptoms, such as fatigue, brain fog, and other long-term COVID-19 symptoms. In addition, minimal side effects were observed, indicating that the patients generally well tolerated LDN.

In a retrospective study of 59 patients with PASC treated with LDN, Bonilla et al. reported a reduction in clinical symptoms and improved functioning [3].

In our ME/CFS patients, 69% of the patients responded positively to LDN. The average score of the patients who responded was 2.5 on a scale of 1-3.

These findings suggest that LDN may be an effective and safe treatment option for patients with Long COVID. It can reduce symptoms and improve overall quality of life.

Although this study yielded promising results, further research is needed to determine the optimal dosage and duration of LDN treatment. More extensive randomized controlled studies are also needed to investigate the efficacy and safety of LDN further in this specific context.

Conclusion

The use of low-dose naltrexone (LDN) shows promising results in the treatment of autoimmune diseases, ME/CFS, and Long Covid. Due to its immunomodulatory effects, LDN can relieve symptoms and improve the quality of life for patients with these conditions. However, further research is needed to determine the optimal dosages and treatment strategies for LDN in ME/CFS and Long Covid.

References:

  1. Bolton MJ, Chapman BP, Van Marwijk H: Low-dose naltrexone as a treatment for chronic fatigue syndrome. BMJ Case Rep 2020, 13(1).
  2. O’Kelly B, Vidal L, McHugh T, Woo J, Avramovic G, Lambert JS: Safety and efficacy of low dose naltrexone in a long covid cohort; an interventional pre-post study. Brain Behav Immun Health 2022, 24:100485.
  3. Bonilla H, Tian L, Marconi VC, Shafer R, McComsey GA, Miglis M, Yang P, Bonilla A, Eggert L, Geng LN: Low-dose naltrexone use for the management of post-acute sequelae of COVID-19. Int Immunopharmacol 2023, 124(Pt B):110966.