Lyme Disease & Low Dose Naltrexone (LDN)

Our accreditations place us in the top 1% of compounding pharmacies

Table of Contents

New Advancements in Compounding for Lyme Disease

Expert Insight into Utilizing LDN for Lyme Disease

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


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


Most people with Lyme disease never felt the tick bite, and many do not see a rash. While you may not feel the bite, you may feel the symptoms. Some of the first symptoms may include a flu-like condition, 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. We’re not saying don’t enjoy the great outdoors, just learn how to prevent a tick bite and learn more about tick-borne diseases as a precaution. There are 427,000 new cases of Lyme disease in the U.S. every year. Don’t be one of them. Learn more about Lyme disease here.

*Source: Global Lyme Alliance

Shop Vitamins & Supplements for Pain & Inflammation

Low Dose Naltrexone & Lyme Disease

Over the years research has shown that LDN may be beneficial for patients with autoimmune disorders such as Crohn’s disease and Multiple Sclerosis. We are also working with physicians to incorporate LDN into protocols the utilize to treat Lyme Disease. It has been postulated that immune dysfunction could be a key to treating Chronic Lyme Disease.

Organisms transmitted by the tick may cause a shift in our immune systems (TH1-TH2 shift) causing a decrease in our ability to fight the infection and an increase in inflammation.

*Photo Source: Global Lyme Alliance

How LDN Works

Low Dose Naltrexone (LDN) at doses in the typical range of 1.5mg to 6.5mg can modulate the immune system and reset abnormal TH1/TH2 balance and promote healing. Also, we know many Lyme patients suffer chronic joint pain and inflammation. New research has pointed to class of receptors, Toll-Like Receptors (TLR) that can cause the release of inflammatory cytokines causing inflammation and pain which are a hallmark symptom of lyme disease. We now know that LDN as an antagonist of the Toll-Like Receptor can thereby decrease pain, inflammation and neuropathy that many patients with lyme disease suffer from.

Open label study by Dr Horowitz of 1000+ patients with lyme disease showed that approximately 75% of the patients experienced less fatigue, myalgia and arthralgia when their naltrexone dose was titrated to on average 4.5mg 1

Expert Titration Significance

Some patients when they initially start LDN therapy may suffer from insomnia, vivid dreams, headache and stomach upset. Our experience at Town & Country Compounding has been that if we start the dose low and slowly raise it we can minimize many of these side effects. Additionally if you raise the dose too quickly, you can pass the dose of LDN that may be beneficial for the individual patient and overshoot the dose of LDN that would have been best for that patient.

So here at Town & Country Compounding we have developed a patient specific LDN titration kit that many of the physicians we work with utilize to titrate the LDN therapy. The patient begins their titration with an LDN dose of 0.5mg and we go up weekly by 0.5mg dose to a typical dose of between 3.5 to 4.5mg. However that is not to say that we do not have patients on a dose as high as 9mg. This emphasizes the importance of working within the physician-patient-pharmacy triad to get to the appropriate dose for each individual patient.


John Herr, PCCA Advisory Council, Owner of T&C Compounding Pharmacy

Low Dose Naltrexone (LDN) Expert: John Herr, RPh

Expert Pharmacist John Herr, RPh has worked with researchers, physicians, and patients worldwide to become an expert in proper titrations & dosage of Low Dose Naltrexone (LDN).

He has observed its multiple benefits for chronic pain & various autoimmune conditions.

The LDN Book, written by Linda Elsegood is available at our Pharmacy in Ridgewood, New Jersey. You can also purchase it online via Amazon.

Reasonable Costs

The good news is once we have assisted you with finding your dose in the future, that dose can be compounded into a single capsule – typically taken at bedtime, where the cost to the patient for a 90 day supply is less than a dollar a day.

Of course the treating lyme disease is multifaceted and you should be working with both a lyme literate physician as well as a lyme literate pharmacy to help guide you through the different therapies utilized. Here at Town & Country Compounding we are an integrative pharmacy and take the time to counsel our patients on all aspects of their healthcare

methylene blue capsules prescription rx near me new jersey new york
Methylene Blue Compounded Capsules

Methylene Blue is compounded by a PCAB accredited pharmacy. This compounded medication requires a prescription.

Get the Help You Need to Improve Your Quality of Life

If you have a condition that involves Lyme Disease, pain, opioid dependence, or something else listed in our previous blogs about LDN, please call us and we’ll work with you and your doctor to find the appropriate solution.


  1. Alexander W. (2012). 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.
Town & Country Compounding Pharmacy is located at
Town & Country Compounding Pharmacy is located at 535 East Crescent Ave Ramsey, NJ 07446

Town & Country Compounding provides the most advanced formulations based on the most recent research and peer-reviewed guidelines.

We work with patients and their medical providers to customize solutions that are right for their individual needs when commercially-made medications are not showing results.

Medication is not one-size-fits-all. 

You might also be interested in

Call or Text: 201-447-2020

Subscribe to our newsletter