Could low-dose naltrexone help Lyme disease patients?

Lyme disease patients presenting with an erythema migrans rash have been found to have elevated levels of pro-inflammatory cytokines. According to Aucott and colleagues, from Johns Hopkins University School of Medicine, these levels can remain high in patients even after three weeks of antibiotics. [1]

by Daniel J. Cameron, MD MPH

Now, a new study explores the effects of low-dose naltrexone (LDN) on cytokines in patients with fibromyalgia. The 10-week, single-blind pilot trial conducted by Parkitny and colleagues, from the University of Alabama, examined whether LDN was associated with reduced markers of inflammation in a small group of women with fibromyalgia. [2]

The authors found that after eight weeks of administering LDN, plasma levels of a range of broadly pro-inflammatory cytokines were decreased in patients with fibromyalgia syndrome (FMS). LDN is currently being used off-label for patients who fail to respond to medications approved for the illness. “One medication that has been used off-label for the treatment of [fibromyalgia] is naltrexone hydrochloride,” explains Parkitny. “When used in low doses, this medication is often called low-dose naltrexone (LDN).” [2]

[bctt tweet=”Study finds 8 weeks of low-dose naltrexone reduces pro-inflammatory cytokines in fibromyalgia patients.” username=”DrDanielCameron”]

Study participants self-administered a 4.5 mg dose of LDN at least one hour before bedtime. If individuals experienced unpleasant adverse effects, the dose was lowered to 3.0 mg. None of the subjects dropped out of the study due to side effects. But, “one individual reported an acute exacerbation of pre-existing anxiety and one individual reported an exacerbation of pre-existing, non-specific gastrointestinal issues,” according to the authors. “Both of these side effects were judged as unlikely to be associated with the administration of LDN.” [2]

Individuals reported less pain and fewer symptoms following LDN with a “significant reduction of FMS-associated pain (15%) and a reduction in overall symptoms (18%).”

The authors conclude that LDN might help chronic pain conditions, including fibromyalgia, “by acting as an atypical anti-inflammatory medication.” [2]



  1. Aucott JN, Soloski MJ, Rebman AW, et al. CCL19 as a Chemokine Risk Factor for Post-Treatment Lyme Disease Syndrome: A Prospective Clinical Cohort Study. Clin Vaccine Immunol. 2016.
  2. Parkitny L, Younger J. Reduced Pro-Inflammatory Cytokines after Eight Weeks of Low-Dose Naltrexone for Fibromyalgia. Biomedicines. 2017;5(2).

8 Replies to "Could low-dose naltrexone help Lyme disease patients?"

  • Brad
    04/08/2018 (4:48 pm)

    Here’s a thought: “fibromyalgia” is not a thing. It is a disease without even a hypothesized cause. It is a hodgepodge of symptoms that almost completely overlap with those known to be caused by actual infectious diseases like borreliosis, bartonellosis, ehrlichiosis, and others. How many “fibromyalgia” patients are referred to neurologists, who know less than nothing about Lyme disease and coinfections, and never even are directed to have a blood test for Lyme and coinfections?

    • Mindy
      03/16/2020 (3:41 pm)

      I’ve said this same thing over and over again! Even after my lyme diagnosis, I had a Dr diagnose me with fibromyalgia and also chronic fatigue syndrome. I tried to explain to them that I have lyme and not these other conditions but they wouldn’t listen to me.

    • ~ DiveGirl Deb
      10/31/2022 (3:32 pm)

      Actually, Fibromyalgia is a SYNDROME…never was/is a Disease.

  • Eric
    12/18/2017 (2:28 am)

    So you copied a study on Fibromyalgia and didn’t even comment as to your thoughts on why or how this may help Lyme? This is a cheap post.

    • Dr. Daniel Cameron
      12/27/2017 (10:41 pm)

      Many of my readers are curious as to why Naltrexone works. I shared the author’s findings that Naltrexone works for some people through a reduction in pro-inflammatory cytokines.

  • chris
    07/15/2017 (2:57 pm)

    does reducing the cytokine response enable the infection?
    Anti-cytokine therapeutics and infections

    • Dr. Daniel Cameron
      07/15/2017 (10:32 pm)

      The article posted in the 2003 issued of Vaccine questions whether treatment for cytokines alone might be counter productive. Cytokines can be quite high during a tickborne infections. The cytokines dropped in the Aucott study in patients successfully treated with 3 weeks of doxycycline but remained elevated in patients who remained ill. It may be helpful look into additional antibiotic treatment if there is a possibility of persistent infection.

  • Remmel Henry
    07/10/2017 (6:45 am)

    I have been hearing about low dose Naltrexone for relief of pain for patients with various pain syndromes, and a very good consideration for aiding fibromyalgia patients for over 5-10 years, since Dr. Ben Bihari talked about this for years after noting it’s usefulness in low doses. Dr. Bihari found that ONLY the LOW Dose Naltrexone was beneficial for these types of patients, and NOT the 50 mg used for drug addicts in its original aide for those kind of patients.
    My wife has suffered pain for many years due to back problems, and osteoporosis, or osteorheumatoid inflammation causing significant pain over all these years, and not ONE doctor around us here knows a thing nor do they care about their chronic pain patients, and the sudden dumping of their patients to whom THEY gave opioid therapies, as in millions of patients over the past many decades led to much now resultant return of pain, all because of the CDC decision to raise the Classification of hydrocodone 10mg/325 (acetaminophen) tablets to the Class II level from the Class III used for decades due to premature judgment that ALL patients on opioid therapies were possibly going to commit sucide as a result of flawed studies and premature evaluations that made doctors fearful of continuing this regimen,,mostly out of covering their perceived legal use of the Class III hydrocodone and others similar to it’s use proved to be the best medication for many years for patients who were NOT in any way likely to commit suicide due to it’s long term use successfully for many years. This has been a terrible judgement call and many thousands of patients now referred to pain management clinics that are a joke. The pain management clinics are NOT relieving the pain of many patients in the chronic pain categories and it’s been a severe injustice as the withdrawing of the very successful opioid derivatives has been a disaster. I am appalled that only NOW some have noted the benefits of Naltrexone as Dr. Bihari noted in works of his expertise over 20 years ago, and NOW somebody of note takes notice? I would like to know why our local institution so touted as a fine one has doctors who did refuse the regular Class III opiate derivatives, as they have never been proven to make “addicts” when used appropriately over all these year, but due to this regulatory change, too many doctors left their patients abruptly by refusing to write for these important
    medications and now many patients have been suffering like my wife for this past 18 months? Patients have every right to be upset.

Join the Lyme Conversation
(Note: comments are moderated. You will see your comment after it has been reviewed.)

Some html is OK