Treating Fibromyalgia, Chronic Fatigue and Chronic Pain with Low Dose Naltrexone (LDN)

LDN pain relief

You may have heard of naltrexone as a medication to help people recover from drug dependence. It blocks receptors in the brain for the most addictive drugs, known as opioids. Naltrexone helps to reduce cravings and lowers the risk of relapse, without a negative impact on mood. Naltrexone is safe to use because it is not habit forming.

So what does this drug have to do with fatigue or fibromyalgia relief?

Very low doses of naltrexone have been found to be very helpful to people who are struggling to cope with chronic pain and fatigue, and fibromyalgia.

Low dose naltrexone, or LDN, enables many to find pain relief for symptoms without unwanted side effects. It requires a physician’s prescription. Typically it comes in tablet form that patients usually take at bedtime.

How LDN Works

LDN has been found to impact the production of endorphins, the body’s natural feel-good hormones. Doctors believe that this medication blocks the brain’s receptors for endorphins, and this stimulates the body to compensate and make more of them.

Endorphins are one of the body’s natural and most powerful anti-depressants and pain relievers. The brain and other parts of the nervous system naturally produce endorphins. Endorphins may boost the immune system, and are known to trigger positive moods and reduce the perception of pain.

Some medical professionals believe that fibromyalgia symptoms are linked to problems with the body’s stress response system controlled by the HPA axis. This part of the brain regulates the body’s response to stress and sensation of pain. The HPA axis is the complex interaction between the hypothalamus, pituitary gland and the adrenal glands.

The HPA axis also produces endorphins. When this area is not functioning properly, many medical professionals believe it throws the body’s hormone chemistry out of balance, and impairs the body’s pain regulation systems.

There is some controversy about how much the HPA axis and endorphins impact fibromyalgia pain. But evidence has made it clear that LDN helps many people who suffer fibromyalgia pain to find lasting relief.

Results of Treatments with LDN

In my practice, I see patients make remarkable improvement with LDN. Instead of having to rely on strong painkillers with undesirable side effects, patients find that low doses of naltrexone allow them to reduce or eliminate their use of other drugs. While a small amount of pain may still exist, it is mild when compared to the excruciating levels that people with fibromyalgia can suffer without effective treatment.

LDN allows many patients to sleep better, manage lower levels of pain much more easily, and feel more positive about life.

LDN therapy for fibromyalgia or chronic fatigue is not a simple cure. It is part of a treatment plan that you and your doctor create together. Treatment plans vary for each individual, and may include other changes that keep your symptoms in check.

At the Optimal Wellness Center, we find the best results combine therapies including acupuncture, hormone balancing treatments, and healthy life habits such as getting enough sleep, exercise, and choosing nutritious foods and supplements wisely.

If you are in the Ridgewood, New Jersey area , and want to see if LDN could work for you, speak to Dr. Keller at 201-485-7930 or request an appointment online.

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Could A Leaky Gut Be The Cause Of Your Symptoms?

Could A Leaky Gut Be The Cause Of Your Symptoms?

Do you suffer from? Fatigue? IBS? Rashes? Or Joint Pain?

A “Leaky Gut” can cause of a wide variety of symptoms and diseases.
Including the following:

Chronic Fatigue Syndrome
Food Sensitivities
Diarrhea, constipation, gas, bloating or IBS
Rashes, hives, eczema, psoriasis or acne
Allergies, asthma
Joint pains, arthritis
Autoimmune disease, Celiac, Rheumatoid Arthritis, Chron’s disease

Leaky gut syndrome happens when the lining of your intestines are damaged by inflammation. Foods including gluten, highly processed foods, medications, stress, intestinal infections and an imbalance of your intestinal bacterial flora are some of the potential causes of a leaky gut.

When the intestinal lining is damaged, inflammation develops resulting in small holes in the intestinal lining causing increased intestinal permeability. The problem comes from small food particles, and toxins that can now “leak” into your blood stream through these holes. Once these substances enter your body they can trigger an inflammatory immune response, resulting in a wide variety of symptoms and diseases.

How to treat a leaky gut? As long as the intestinal lining is damaged food and toxins will continue to enter your blood stream and continue the inflammatory process.
The way to stop this vicious cycle is to heal your intestinal lining.

At Optimal Wellness we use the 5R Restoration Program

Remove offending substances from the diet, while adding targeted nutritional support to help remove unwanted compounds from the body.

Replace digestive enzymes if needed. Digestive factors and enzymes facilitate the breakdown of food. An insuffiency of these enzymes prevents optimal digestion and absorption of nutrients.

Reinoculate the GI tract with a good probiotic (good bacteria) to rebalance your intestinal flora. This balance is import to your overall health including supporting your immune system, GI health, digestion and intestinal barrier function.

Regenerate the GI mucosa through diet and lifestyle changes, enhanced by nutritional support. If needed we may recommend medical food to help repair and maintain intestinal integrity
Retain the health of your GI tract with nutritional support along with healthy eating, adequate sleep, regular exercise, and stress management.

Are you tired of being tired? Could you have Chronic Fatigue?

Chronic fatigue syndrome (CFS) is overwhelming fatigue that is not explained by a known medical condition.

CFS gets worse with too much activity and is not relieved by rest. The cause of CFS in unknown, however there are many theories. In some cases it may be caused by viral illnesses including Epstein Barr, HHV-6, and parvo.

There is also evidence to suggest it can develop after a bacterial infection like Lyme or prolonged respiratory infections.. There may be impairment of the immune system or hormonal imbalances of the hypothalamus, pituitary gland, or adrenal glands. Other theories include excessive stress, from any source including, physical, emotional, chronic diseases, or infections. Most likely it is a combination of genetic and environmental factors, and that multiple triggers alone or in a combination can cause the onset of chronic fatigue.

How is Chronic Fatigued Syndrome Diagnosed?

There is no single test to confirm CFS.  To make the diagnosis of CFS underlying medical conditions need to be ruled out.  A comprehensive work up should be done and include a comprehensive history, physical and appropriate laboratory tests. Some of the more common causes of fatigue including anemia, diabetes or an underactive thyroid can be easily ruled out with simple blood tests.  Additional diagnostic tests should be done based on an individuals symptoms and physical findings.


The diagnosis of CFS is based on the following criteria. Severe persistent or relapsing fatigue lasting six months or more, in which the fatigue is not caused by a known disease, and is not relieved by rest. The fatigue also causes a significant (50%) reduction in a person’s activity level. In addition, to diagnose CFS four out of the following eight symptoms needs to be present.

  • Not feeling refreshed after sleep
  • Impaired memory/concentration
  • Muscle pain
  • Joint pain, involves one joint to another without swelling or redness
  • Headaches
  • Sore throat
  • Tender cervical/ axillary lymph nodes
  • Extreme exhaustion lasting more than 24 hours after physical exercise

What are the risk factors for developing CFS?

Risk factors for developing CFS include age, female gender, genetics, high stress occupations and or lifestyle.

CFS occurs more commonly in people in there 40s and 50s.  Anyone can develop CFS, but it is more common in women, this may be that women are more likely to seek treatment for fatigue.  There appears to be a genetic link as well. People with a first degree relative with CFS have an increased risk of developing CFS.  Those with high stress lifestyles are also more susceptible to developing CFS.

Associated Conditions

Some people with CFS also fit the criteria for FMS (a chronic pain syndrome). People with CFS who do not get help are at risk of developing anxiety, depression, social isolation, lifestyle changes (reduce activity level), and increased work absences.

Treatment for Chronic Fatigue

The treatment for Chronic Fatigue Syndrome must be individualized; a comprehensive holistic approach can help the body return to a healthy state. There is no magic pill that will make your symptoms disappear. It will take time for your body to recover. It is best to find a Practioner who has experience in treating CFS.  The first step your doctor should do is to confirm the diagnosis, making sure there is not another cause for your fatigue. After your diagnosis is confirmed they need to help you develop an individualized treatment and wellness plan. Your wellness plan is not limited to but should include the following:

  • Stress management plan– tools and ways to reduce and manage stress. Excessive production of stress hormones can cause fatigue and make it difficult to recover.
  • Nutritional plan– you are what you eat you need to follow a whole food diet, avoid processed foods and artificial sweeteners, and chemical additives. It is best to work with a practitioner who can help you develop a healthy eating plan.  A diet rich in nutrients   can help heal your body.
  • Vitamins/ Supplements- Appropriate vitamins and supplements if indicated.
  • Medications– Appropriate medications when indicated.
  • Sleep Hygiene Program– a program to help you get enough restorative sleep, so your body can heal.
  • Exercise program– individual exercise program tailored to your energy level.
  • Psychological support: Appropriate support in dealing with emotional issues, making sure to address automatic negative thoughts.  Negative thinking can further fatigue your body.  A referral to a good mental health professionals can help you when indicated.
  • Additional Treatments: Additional treatments to consider in your wellness plan include, Cognitive Behavioral Therapy, Acupuncture, Massage, Physical therapy, and Chiropractic therapy.
  • Support: on going support, working with a doctor who is there to support your recovery. It will take time to recover but with the right treatment and wellness plan you will get better.

Trouble Sleeping? Tips for Better Sleep Hygiene

Many people have poor sleep habits.  We stay up too late and get up to early.  We interrupt our sleep with drugs, chemicals and work, and we over stimulate ourselves with late-night activities such as television.

It is important to have good sleep hygiene. Sleep hygiene refers to measures you can take to ensure good quality nighttime sleep. One of the most important things you can do is to maintain a regular sleep and wake pattern.

Good Sleep Hygiene Practices

Good sleep hygiene practices include:

  1. Avoid napping during the day if you can.  If you must take a nap, try to keep it short, (20 minutes or less).
  2. Avoid caffeine 4-6 hours before bedtime.  This includes caffeinated beverages such as coffee, tea and many sodas, as well as chocolate.
  3. Avoid alcohol 4-6 hours before bedtime.  Initially alcohol has a sedation effect but a few hours later it can have a stimulant effect.
  4. Avoid heavy, spicy, or sugary foods 4-6 hours before bedtime.
  5. Exercise regularly, but not right before bed.  Regular exercise, particularly in the afternoon, can help deepen sleep.  Strenuous exercise within the 2 hours before bedtime, however, can decrease your ability to fall asleep.
  6. Maintain a regular sleep and wake pattern.  The body functions best on a regular schedule.  You need a minimum of 7 hours per night for your body to function at its best.
  7. Associate your bed with sleep. It is not a good idea to use your bed to watch TV or use other electronics. Turn off all electronics and hour before bed. Use of these devises stimulate your brain and make it difficult to sleep.
  8. Make sure your sleep environment is pleasant and relaxing.
  9. Use comfortable bedding.
  10. Find a comfortable temperature setting for sleeping and keep the room well ventilated.  If your bedroom is too cold or too hot, it can keep you awake.  A cool (not cold) bedroom is often the most conducive to sleep.
  11. Block out all distracting noise, and eliminate as much light as possible.
  12. Make sure your bedroom is dark. Remove all computers; cell phones, and turn bright light alarm clocks away from you.

Establish a Regular Relaxing Bedtime Routine

  1. Establish a pre-sleep ritual.  Pre-sleep rituals, such as a warm bath or a few minutes of reading, can help you sleep.
  2. If you have trouble sleeping you can try a light snack before bed.  Warm milk and foods high in the amino acid tryptophan, such as bananas, may help you to sleep.
  3. Avoid emotionally upsetting conversations before bed.
  4. Don’t make to do lists in your head. Write down what you need to accomplish the next day, and then forget about it once you go to bed. Tell yourself “its on your list, you do not need to worry about it.”
  5. Practice relaxation techniques before bed.  Relaxation techniques such as yoga, deep breathing and others may help relieve anxiety and reduce muscle tension.

Getting Up in the Middle of the Night?

Most people wake up one or two times a night for various reasons.  If you find that you get up in the middle of night and cannot get back to sleep try meditation, visualizing or progression relaxing. Do not perform challenging or engaging activity such as office work, housework, etc.  Do not watch television. Try one of these relaxation techniques:

Relaxation Techniques

  1. Try to concentrate on your breathing. Count 1 on the inhale and 1 exhale, 2 inhale and 2 exhale, 3 inhale and 3 exhale, 4 inhale and 4 exhale then go back to 1 inhale and 1 exhale. Keep repeating until you fall asleep.
  2. You can try visualizing, imagining you are in a calm relaxing environment like walking on the beach or sitting in a garden.

Try progressive muscle relaxation. Starting at your toes and progressing up towards your head. Relax each muscle group while concentrating on your breathing

Feeling Tired? Wish You had More Energy? 10 Tips to Fight Fatigue

Fatigue has many possible causes.  Some fatigue comes from habits that cause our lack of energy – and we may not even realize it.  Here are 10 tips to help you have more energy by looking at some easy choices you can make every day.

10 Tips to Fight Fatigue

1. Make sure you are getting enough sleep. I know this one is obvious but many people do not get enough sleep. Try to get at least 7 to 8 hours of sleep each night.

2. Make sure you’re drinking enough fluids. Being even slightly dehydrated can cause fatigue. Try to drink 6 to 8 8oz glasses of fluid each day.

3. Eat a whole food diet. Avoid processed foods and foods high in sugar (white bread, crackers, chips, cookies, and cakes).  Eating these types of foods can leave you feeling tired.   When you eat simple carbs found in processed foods, your blood sugar spikes than quickly drops down leaving you feeling weak and tired. Eating whole foods, fruits, vegetables, legumes, nuts and lean proteins keeps your blood sugar at a steady state avoiding extreme highs and lows.

4. Don’t skip meals. Eat a balanced breakfast including protein, whole grains and fruit.  Have a small snack between breakfast and lunch, another small snack between lunch and dinner. This will keep your blood sugar steady and prevent your blood sugar from dropping too low and leaving you feeling fatigued.

5. Sip on green tea. The caffeine will give you a burst of energy and it is full of antioxidants

6. Make sure you get enough exercise every day. Aim for a minimum of 30 minutes of cardiovascular exercise at least 5 days a week and resistance exercise at least two days a week. Make it part of your day, find activities you enjoy.  Try something new.

7. Reduce your response to stress. Our lives are full of stress, which can zap your energy. Try meditation, yoga, deep breathing exercises or acupuncture. These are proven methods to help calm the body and mind and give you more energy.

8. Think positive.  Do something you enjoy everyday. Having something to look forward to can help boost your energy level.

9. Take a walk outside.  The sunlight stimulates the brain to release chemicals that elevate your mood and gives you more energy. Don’t forget your sunblock!

10. Listen to music.  Just as listening to soft music can help you relax and even fall asleep, listening to upbeat or lively music can energize you.

Still tired?

You may have a medical condition causing your fatigue.   There are many causes of fatigue.  Anemia, under active thyroid, Lyme disease, chronic sinusitis, allergies, sleep disorders, restless leg syndrome, fibromyalgia, chronic fatigue syndrome, undiagnosed heart disease and depression are just a few medical conditions that can cause fatigue.  If you have persistent fatigue see your doctor for an evaluation.

Disclaimer: The information contained in this site is for educational purposes only, and should not be used as a substitute for personal care by a licensed physician.