Low-Dose Naltrexone for Health & Longevity - Quick Reference Sheet
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Low-Dose Naltrexone for Health & Longevity

Created on 07/11/2026 – Quick Reference based on Evidence Review created using AI4L / Opus 4.8 – Audit

A tiny daily dose of an old, inexpensive medication, repurposed to calm inflammation and rebalance an overactive immune system. The most developed evidence is for fibromyalgia pain, with weaker signals in inflammatory bowel, other chronic-pain, and skin conditions. Side effects are usually mild. It cannot be combined with opioid painkillers. The longevity case remains speculative. (Full Review)

Protocol

Titration
1.5 mg daily → 4.5 mg
Increase in 1.5 mg steps every 1–2 weeks to the lowest dose that controls symptoms
Timing
Once daily, morning or night
Nighttime captures endorphin rebound; morning avoids sleep disruption
Formulation
Immediate-release
Compounded; sustained-release forms are generally avoided
Time to effect
Onset
Weeks
Benefits usually take weeks to appear
Response trial
2–3 months
Many judge response over a 2–3 month trial
Reassess
8–12 weeks
Defined trial period before deciding to continue

Benefits

Contraindications
  • Full opioid agonists (morphine, oxycodone, hydrocodone, fentanyl, tramadol, codeine)
  • Partial opioid agonists (buprenorphine)
  • Current or recent opioid use (within ~7–10 days)
  • Opioid agonist maintenance therapy
  • Acute hepatitis or hepatic failure
  • Pregnancy or breastfeeding
    •
Key Interactions
  • Over-the-counter opioid-containing medicines (codeine preparations, high-dose loperamide)
  • Thyroid hormone replacement (levothyroxine)
  • Additive immune or anti-inflammatory supplements (curcumin, omega-3 fatty acids)
    •

Risk & Side Effects

  • High: Blocked opioid analgesia & precipitated withdrawal
    •
  • Medium: Sleep disturbance & vivid dreams; gastrointestinal upset
    •
  • Low: Headache & transient fatigue; mood changes & anxiety
    •
  • Speculative: Liver enzyme elevation; unknown long-term effects
    •

Monitoring

Marker Target Why
ALT / AST (liver enzymes) ALT ~<25 U/L (men), <20 U/L (women) Confirm the liver is handling the drug without stress
Thyroid-stimulating hormone (TSH) ~0.5–2.0 mIU/L Detect reduced thyroid hormone need in autoimmune thyroid disease
High-sensitivity C-reactive protein (hs-CRP) <1.0 mg/L Track whether systemic inflammation is falling
Complete blood count Within normal limits Baseline immune and general health status

Cadence: Symptom check at ~4 weeks and 8–12 weeks during titration, then every 3–6 months once stable; liver enzymes and TSH rechecked periodically in at-risk groups

Qualitative Assessment

  • Pain intensity and the number of good versus bad days
  • Sleep quality and dream intensity
  • Daytime energy and fatigue
  • Cognitive clarity and mood
  • Condition-specific symptoms, such as bowel symptoms in inflammatory bowel disease
Not medical advice. Educational distillation of a single evidence review. Confirm any decision with a qualified clinician, especially in the presence of prescription drugs or chronic conditions.