Re: Advice required please

[Guest guest]

This is one reason why I want to keep taking LDN at night. There might be the

off-chance of me needing urgent medical treatment, but the chance of needing

that during the day is much bigger. As it's out of your system within hours by

the time morning comes the pain medication is likely to work again. For planned

surgery you stop taking LDN for a few days before. And if you are out cold

because you had an accident after you took your LDN you probably won't care

either way.

Silvia

>

> I am posting this for a person who is thinking about going on LDN but is not

sure because she does not have all the answers to things about LDN. Hopefully

someone will be able to answer this comment and I will forward it on to her.

>

> I am still very undecisive about LDN. Maybe because the support system in

South Africa is non existent in terms of side affects on LDN. My question is

what happens if someone needs urgent anaesthesia, and according to information

on side affects that LDN blocks painmeds and anaesthesia, what will the outcome

be?

>

> Thank you

> Cam

>

[Guest guest]

Another option regarding the co-use of naltrexone and pain medication:

Discontinuing LDN isn't like suddenly stopping opiate agonists (naltrexone is an

ANTagonist); there should be little to no " rebound " effects, and as soon as it's

out of your system (24-36 hours max for near 100% clearance, IIRC) you're good

to go even with anesthesia. There's some chance that your natural

endorphin/enkephalin levels will still be somewhat elevated compared to a

" normal " person, but that shouldn't be too big of a problem -- particularly

after a few days.

With pain meds (opiate agonists), the option I'd suggest is switching from " Low "

(milligrams, 1.0-4.5 as most of you know) to an " Ultra-Low " (micrograms: any

amount under 1mg, normally somewhere between 25 and 500mcg) regimen.

At these amounts, there should be little to no interference with agonists

binding at the mu opioid receptors, those most responsible for pain relief. In

microgram (or approx. 1mg) amounts, the naltrexone is only enough to

significantly bind to " delta " receptors, which allow is to continue to provide

most of the same benefits as with LDN, just potentially not as active in terms

of immune modulation for example.

It will also prevent you from developing a tolerance to the pain medication,

because agonization of the delta receptors (which doesn't happen with ULDN) is

one of the primary ways your neurons develop tolerance/dependency (more commonly

referred to as " addiction, " though this is a culturally charged and frequently

mis-used term). In fact it may help the opiate work better, with fewer side

effects.

This combination (an opiate, usually oxycodone or morphine, mixed with an " ultra

low " dose of naltrexone) is being studied for use in new pharmaceutical

products, but so far most of the companies bringing these to market are using

excessively low (as little as 1mcg with 10mg of oxycodone, for example) doses of

the naltrexone whereas most patients using a blended opiate agonist/ULDN regimen

report optimal dosages in the 125-500mcg range. Thusly, not enough of a

prevention of tolerance has been documented so far by these companies.

I'm still trying to fully grasp the differences between LDN and ULDN,

particularly in terms of whether LDN or ULDN+Opiate will be the right regime for

me with my severe chronic pain. I do of course have some hope for the

immune-modulating benefits of naltrexone therapy, but right now I'm trying not

to get my hopes up on that score. I'm mostly concerned at the moment with

optimizing my pain management situation so that I can function better for my

kids.

If anyone wants to delve deeper into these issues of leaving room for unexpected

need of pain medication, anesthesia (I myself will be having a fully sedated

endoscopy/colonoscopy this summer so it's an issue of interest to me), emergency

surgery etc....I'm happy to share whatever information I can and soak up any

knowledge that others may be able to bring to the table.

- from Maine.