LDN and multiple sclerosis

A practical, friendly deep dive into how low-dose naltrexone (LDN) could help people with MS—what it is, how it works, what the research says, and what real patients have experienced.

• LDN and multiple sclerosis: what’s the real story?
• How does LDN work, and is it safe for MS?
• What does the latest research say about benefits and side effects?
• Who might benefit, and what should you ask your pharmacist?
• Real-world tips, expert advice, and the latest science—explained simply.

Five key takeaways

• LDN (low-dose naltrexone) is a well-tolerated, affordable medicine being explored as a treatment for multiple sclerosis (MS), especially for symptom relief and quality of life [1],[ 2],[ 4].
• Research shows LDN may help reduce muscle spasticity, fatigue, and improve mental well-being for some people with MS, with minimal side effects [5],[ 6],[ 7],[ 8].
• LDN works by boosting natural endorphins and modulating immune responses—potentially calming the overactive immune system that drives MS. [11],[ 12],[ 13],[ 14].
• Studies suggest LDN is safe to use alongside standard MS treatments, without worsening disease or affecting key blood tests.[ 6],[ 9], [10], [15].
• While low-dose naltrexone isn’t a cure and more research is needed, it offers new hope for people with MS looking for extra support and symptom relief. [7], [8], [15].

Introduction: What is multiple sclerosis, and why is everyone talking about LDN?

Multiple sclerosis (MS) is a lifelong condition that affects the brain and spinal cord. It can cause a wide range of symptoms, from fatigue and muscle spasms to vision problems and changes in mood. MS is unpredictable, and everyone’s experience is different. For years, treatment focused on managing relapses and slowing progression, but there’s growing interest in therapies that can improve day-to-day quality of life [1], [2],[ 3].

Enter LDN—low-dose naltrexone. Originally used to treat opioid addiction at much higher doses, LDN is now being explored as a low-cost, low-risk option for people with MS. But what’s the evidence, and is it right for you? Let’s break it down [4], [5], [6].

What exactly is LDN, and how does it work?

LDN stands for “low-dose naltrexone.” At standard doses (50mg), naltrexone is used to help people stop drinking alcohol or using opioids. But at much lower doses (usually 3–4.5mg), it appears to have a different effect on the body—one that’s caught the attention of researchers and patients alike [4], [15],

The main theory is that LDN blocks opioid receptors for a few hours, causing the body to increase its own production of endorphins (natural painkillers and mood boosters). These endorphins may help regulate the immune system, which is overactive in MS. [11], [12], [13], [16].

In short: LDN may help calm the immune response and boost your body’s natural defences, without the strong side effects of many other MS drugs. [14], [15], [16].

The science: what does the research really say about LDN and multiple sclerosis?

Early days: from hypothesis to first trials

The idea of using LDN for MS was first proposed in 2005. Researchers suggested that a small dose of naltrexone could help manage MS symptoms by increasing endorphins and modulating the immune system [4].

A pilot trial soon followed, enrolling 40 people with primary progressive MS. Over six months, LDN was found to be well tolerated, and participants experienced a significant reduction in muscle spasticity—a common MS symptom. Even better, blood tests showed a boost in ?-endorphins, supporting the theory behind LDN’s action [5].

Larger studies and real-world experience

After this, a retrospective study looked at 215 patients with MS (mostly relapsing-remitting type) who used LDN for an average of over two years.

The results?

77% had no side effects, and only a small number reported insomnia or vivid dreams. Most people noticed less fatigue and an improved quality of life [6], [17].

Other studies, including randomised controlled trials, have found mixed results. One 17-week trial found no major difference in overall quality of life, but another 8-week study reported significant improvements in mental health for those taking LDN [7], [8].

A long-term follow-up found that people using LDN (sometimes alongside standard MS drugs) had stable disease for up to ten years, with no increase in relapses or new MRI findings. Blood tests for liver and kidney function remained normal [9], [10].

What about the immune system?

Experimental studies in mice (using a standard MS model) have shown that LDN can restore levels of a molecule called opioid growth factor, which appears to protect nerves and reduce harmful immune activity. LDN may also help shift the immune response from a damaging, inflammatory state to a more balanced, protective one [11], [12], [13], [14].

Is LDN safe for people with MS?

The short answer: yes, for most people, LDN is considered safe and well-tolerated. Across multiple studies, the most common side effects were mild and included insomnia or vivid dreams, which tended to improve over time. Serious side effects were rare [6],[ 7], [8], [15], [17].

Importantly, LDN has not been shown to make MS worse or interact negatively with standard MS treatments. Blood tests for liver, kidney, and blood cell health remained stable in all major studies [,9], [10], [15].

Of course, as with any medicine, it’s important to talk to your doctor or pharmacist before starting LDN—especially if you have other health conditions or take other medications. If you have any queries before starting LDN please contact us for a FREE LDN consultation.

How do you take LDN for MS? What should you expect?

Low-dose naltrexone is usually taken as a capsule, liquid or buccal film, once a day (typically at bedtime, but if it causes issues with sleeping, it can be taken during the day).

The starting dose is often 1.5mg or lower, for example, 0.5mg, and the dose is gradually increased by 0.5mg every week or every few days. The dose is slowly increased to a maintenance dose of between 3 and 4.5mg, depending on your response [16].

It’s important to use a pharmacy that can compound the low-dose naltrexone, like Courier Pharmacy.

You may notice changes in your symptoms within a few weeks, but it can take up to three months to see the full benefits.

Some people report better sleep, less fatigue, improved mood, and fewer muscle spasms [6], [ 7],[ 8]. Others may not notice a big difference—everyone’s experience is unique.

Who might benefit from LDN and multiple sclerosis?

LDN is being explored as an option for people with all types of MS, including relapsing-remitting, secondary progressive, and primary progressive. It seems especially helpful for those struggling with fatigue, muscle stiffness, and low mood [6], [8], [9].

LDN is not a cure for MS, and it’s not a replacement for disease-modifying therapies. But for many, it can be a valuable add-on that helps improve daily life and wellbeing [7], [15].

What do real patients say about LDN and MS?

Many people with MS who try LDN report feeling more energetic, less stiff, and better able to cope with day-to-day challenges. In surveys and patient forums, the most commonly mentioned benefits are reduced fatigue, improved sleep, and a general sense of feeling “more like myself”[6], [7], [9].

Of course, results vary—some people notice a significant improvement, while others see little change. The good news is that LDN is very safe, so it’s worth discussing with your healthcare team if you’re looking for extra support [17].

Are there any downsides to LDN?

Like all medicines, low-dose naltrexone can have side effects. The most common are mild and include vivid dreams, insomnia, or headaches—usually these improve as your body adjusts. Rarely, some people may feel more anxious or notice changes in mood [6], [7] ,[8], [17]

LDN should not be used with opioid painkillers (like codeine or morphine), as it can block their effect. Always let your pharmacist know about all the medicines you take [16], [17].

Practical tips for trying LDN

• Always get your LDN from a reputable compounding pharmacy, like Courier Pharmacy, to ensure the correct dose and formulation. 
• Start low and go slow—begin with a small dose and increase gradually as advised by your doctor.
• Keep a symptom diary to track changes in fatigue, mood, and muscle stiffness.
• Be patient—give LDN at least 2–3 months before deciding if it works for you.
• Stay in touch with your MS nurse or pharmacist for ongoing support and advice.

The future: where does LDN fit in MS care?

LDN is not a cure for MS, but it’s an exciting example of how “repurposed” medicines can offer new hope.

The research so far is promising, especially for symptom relief and quality of life. Larger, high-quality trials are needed to confirm its benefits, but for now, LDN is a safe, affordable option worth considering for people with MS [7], [8], [15].

FAQs: LDN and multiple sclerosis

What is LDN, and why is it being used for MS?

LDN is a low dose of naltrexone, a medicine that boosts endorphins and may help calm the immune system. It’s being explored as a safe, affordable way to manage MS symptoms and improve quality of life.

Is LDN safe to take with other MS medicines?

Yes, studies show LDN can be used alongside standard MS treatments without causing harm or affecting blood tests.

How quickly does LDN work for MS?

Some people notice benefits within a few weeks, while others may need 2–3 months to see improvement.

What side effects should I watch for?

Mild side effects like vivid dreams or insomnia are most common, but they usually improve. Serious side effects are rare.

Can I take LDN if I’m using opioid painkillers?

No—LDN can block the effects of opioid painkillers. Always tell your pharmacist about all your medicines.

Is LDN right for everyone with MS?

Not everyone will benefit, but many people with MS report improved fatigue, mood, and quality of life.

How can I get LDN in the UK?

LDN is not available as a standard prescription for MS on the NHS, but you can obtain it privately through specialist pharmacies like Courier Pharmacy after completing an online consultation.

This information is for general guidance only. For medical advice, please consult your doctor or healthcare provider.

References:

1. NHS (2024) Multiple sclerosis. Available at: https://www.nhs.uk/conditions/multiple-sclerosis/ (Accessed: 18 August 2025)
2. Dobson, R. and Giovannoni, G., 2019. Multiple sclerosis–a review. European journal of neurology, 26(1), pp.27-40.
3. Courier Pharmacy (2025). What is multiple sclerosis? Available at: https://courierpharmacy.co.uk/what-is-multiple-sclerosis/ (Accessed: 23 August 2025)
4. Agrawal, Y.P., 2005. Low dose naltrexone therapy in multiple sclerosis. Medical hypotheses, 64(4), pp.721-724.
5. Gironi, M., Martinelli-Boneschi, F., Sacerdote, P., Solaro, C., Zaffaroni, M., Cavarretta, R., Moiola, L., Bucello, S., Radaelli, M., Pilato, V. and Rodegher, M.E., 2008. A pilot trial of low-dose naltrexone in primary progressive multiple sclerosis. Multiple Sclerosis Journal, 14(8), pp.1076-1083.
6. Turel, A.P., Oh, K.H., Zagon, I.S. and McLaughlin, P.J., 2015. Low dose naltrexone for treatment of multiple sclerosis: a retrospective chart review of safety and tolerability. Journal of Clinical Psychopharmacology, 35(5), pp.609-611.
7. Sharafaddinzadeh, N., Moghtaderi, A., Kashipazha, D., Majdinasab, N. and Shalbafan, B., 2010. The effect of low-dose naltrexone on quality of life of patients with multiple sclerosis: a randomized placebo-controlled trial. Multiple Sclerosis Journal, 16(8), pp.964-969.
8. Cree, B.A., Kornyeyeva, E. and Goodin, D.S., 2010. Pilot trial of low?dose naltrexone and quality of life in multiple sclerosis. Annals of neurology, 68(2), pp.145-150.
9. Ludwig, M.D., Turel, A.P., Zagon, I.S. and McLaughlin, P.J., 2016. Long-term treatment with low dose naltrexone maintains stable health in patients with multiple sclerosis. Multiple Sclerosis Journal–Experimental, Translational and Clinical, 2, p.2055217316672242.
10. Raknes, G. and Småbrekke, L., 2017. Low dose naltrexone in multiple sclerosis: Effects on medication use. A quasi-experimental study. PLoS One, 12(11), p.e0187423.
11. Ludwig, M.D., Zagon, I.S. and McLaughlin, P.J., 2017. Featured Article: Serum [Met5]-enkephalin levels are reduced in multiple sclerosis and restored by low-dose naltrexone. Experimental Biology and Medicine, 242(15), pp.1524-1533.
12. Zagon, I.S., Donahue, R.N., Bonneau, R.H. and McLaughlin, P.J., 2011. T lymphocyte proliferation is suppressed by the opioid growth factor ([Met5]-enkephalin)–opioid growth factor receptor axis: implication for the treatment of autoimmune diseases. Immunobiology, 216(5), pp.579-590.
13. Zagon, I.S., Donahue, R.N., Bonneau, R.H. and McLaughlin, P.J., 2011. B lymphocyte proliferation is suppressed by the opioid growth factor–opioid growth factor receptor axis: Implication for the treatment of autoimmune diseases. Immunobiology, 216(1-2), pp.173-183.
14. Ludwig, M.D., Zagon, I.S. and McLaughlin, P.J., 2018. Featured article: modulation of the OGF–OGFr pathway alters cytokine profiles in experimental autoimmune encephalomyelitis and multiple sclerosis. Experimental Biology and Medicine, 243(4), pp.361-369.
15. Toljan, K. and Vrooman, B., 2018. Low-dose naltrexone (LDN)—review of therapeutic utilization. Medical Sciences, 6(4), p.82.
16. Courier Pharmacy (2025). How does low-dose naltrexone (LDN) work? Available at: https://courierpharmacy.co.uk/how-does-ldn-work/ (Accessed: 23 August 2025).
17. Courier Pharmacy (2025). Is LDN safe? Available at: https://courierpharmacy.co.uk/is-ldn-safe/ (Accessed: 23 August 2025).

Byline

Written by Shazlee Ahsan, Medical writer at Courier Pharmacy. Content reviewed by a registered pharmacist and based on clinical studies, patient stories, and up-to-date guidelines.

How this content was created

This article was researched and written by a professional copywriter, reviewed by a registered pharmacist, and shaped by real patient experiences. All information is based on clinical studies and trusted sources, with references provided for further reading.