John Herr, RPh, pharmacist and owner of Town & Country Compounding in Ridgewood, NJ, would like to discuss the potential utilization of Low Dose Naltrexone (LDN) for patients with Lyme disease.

About Lyme Disease

Prevention

Increased tick activity combined with unreliable diagnostics and limited options makes diligent tick prevention for the entire family, including pets, extremely important. The risk of a potentially debilitating tick bite is too great. Get prevention tips here.

Symptoms

Most people with Lyme disease never felt the tick bite, and many do not see a rash. Some early symptoms may include flu-like illness with fever, chills, headache, stiff neck, achiness, and fatigue. Learn more about symptoms here.

We Are All at Risk

Everyone is at risk for Lyme disease, especially if you enjoy outdoor activities. Learn how to prevent tick bites and understand tick-borne diseases as a precaution. There are approximately 427,000 new cases of Lyme disease in the U.S. every year. Learn more about Lyme disease here.

*Source: Global Lyme Alliance — globallymealliance.org

Low Dose Naltrexone & Lyme Disease

Research has shown that LDN may be beneficial for autoimmune disorders such as Crohn’s disease and Multiple Sclerosis. We are also working with physicians to incorporate LDN into protocols used to treat Lyme Disease.

Organisms transmitted by the tick may cause a shift in immune response (TH1–TH2 shift), decreasing our ability to fight infection while increasing inflammation.

*Photo Source: Global Lyme Alliance

How LDN Works

Low Dose Naltrexone (LDN) at doses typically ranging from 1.5mg to 6.5mg may help modulate the immune system, reset abnormal TH1/TH2 balance, and promote healing.

New research highlights Toll-Like Receptors (TLR) as drivers of inflammatory cytokines, contributing to inflammation and pain—hallmark symptoms of Lyme disease. LDN may act as an antagonist to these receptors, reducing pain, inflammation, and neuropathy.

Open label study by Dr. Horowitz of 1000+ Lyme patients showed ~75% experienced less fatigue, myalgia, and arthralgia when titrated to an average dose of 4.5mg.

Expert Titration Significance

Some patients starting LDN may experience insomnia, vivid dreams, headaches, or stomach upset. Our experience has shown that beginning with a low dose and slowly raising it can minimize side effects.

Town & Country Compounding has developed a patient-specific LDN titration kit, starting at 0.5mg and increasing weekly by 0.5mg up to a typical range of 3.5–4.5mg. This emphasizes the importance of the physician–patient–pharmacy triad.

Reasonable Costs

Once we help you find your optimal dose, it can be compounded into a single capsule (typically taken at bedtime). The cost for a 90-day supply is often less than a dollar a day.

Treating Lyme disease is multifaceted. Patients should work with a Lyme-literate physician and a Lyme-literate pharmacy. At Town & Country Compounding, we are an integrative pharmacy and take time to counsel patients on all aspects of care.

Get the Help You Need to Improve Your Quality of Life

If you have a condition involving Lyme disease, pain, opioid dependence, or another issue discussed in our blogs, please call us and we’ll work with you and your doctor to find the appropriate solution.

References

1. Alexander W. (2012). Integrative healthcare symposium: treating the pain of Lyme disease and adopting lifestyle change as therapy. P & T: a peer-reviewed journal for formulary management, 37(4), 247–249.