Low-Dose Naltrexone for Fibromyalgia Pain

Published: August 10, 2012

Good news from the 2012 annual meeting of the American Academy of Pain: A study from researchers at Stanford University School of Medicine showed that a low dose of the drug naltrexone significantly reduced pain in patients with fibromyalgia. The study confirms earlier, similar findings from the same researchers, published in Pain Medicine in 2009.

High doses (50 to 200 mg) of naltrexone can block the effect of heroin and other narcotics — a heroin addict on naltrexone doesn't get high when he takes the drug, which of course helps overcome drug addition. An injection of naltrexone can also be used to counter a heroin overdose. The sedating action of heroin is blocked, and the addict wakes up. And naltrexone in doses of 50 mg is used to help alcoholics stop excessive drinking.

But in low doses (3 to 5 mg), naltrexone has a very different action — it affects the immune system. In that role, it's been used to address autoimmune diseases like multiple sclerosis and chronic diseases with an immune component, like cancer and CFS/FMS.

The new study, which was rated among the top six of the many studies presented at the meeting, involved 27 women with fibromyalgia. They took a daily dose of 4.5 mg of naltrexone for 12 weeks and then a placebo for 4 weeks. Compared to placebo, naltrexone decreased pain by 48.5%.

The lead researcher of the study theorizes that the drug works by suppressing the function of microglia, immune cells in the brain and spinal cord that have been "hypersensitized" and release inflammatory factors that cause pain and other symptoms seen in fibromyalgia.

I've been helping selected CFS/FMS patients with naltrexone for many years. Generally, I give 3.5 to 4.5 mg at bedtime. I order it by prescription from a compounding pharmacy (ITC Pharmacy). Your physician can call it in, and the pharmacy can guide your physician in how to prescribe the medicine. An important point is that you need to take it for at least two months for it to work.

For more information (and you should read this before starting low-dose naltrexone), visit the website Low Dose Naltrexone.

P.S. — Before I move on to the topic of nutrition in my continuing series "What's New in the SHINE Protocol," I'll be devoting a few newsletters to looking at pain in CFS/FMS. Coming in my newsletter for the week of April 7, 2012: "What's Causing Pain in Fibromyalgia?"


American Academy of Pain Medicine (AAPM) 28th Annual Meeting: Abstract 251. Presented February 24, 2012.

"Fibromyalgia Symptoms Are Reduced by Low-Dose Naltrexone: A Pilot Study," Younger, J, et al, Pain Medicine, Volume 10, Number 4, 2009, 663-672.

"Confirmation: Low-Dose Naltrexone Eases Fibromyalgia Pain," article at Medscape (free registration required).

Jacob Teitelbaum, MD

is one of the world's leading integrative medical authorities on fibromyalgia and chronic fatigue. He is the lead author of eight research studies on their effective treatments, and has published numerous health & wellness books, including the bestseller on fibromyalgia From Fatigued to Fantastic! and The Fatigue and Fibromyalgia Solution. Dr. Teitelbaum is one of the most frequently quoted fibromyalgia experts in the world and appears often as a guest on news and talk shows nationwide including Good Morning America, The Dr. Oz Show, Oprah & Friends, CNN, and Fox News Health.

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