Accumulating evidence suggests that Low Dose Naltrexone (LDN; 3.0-4.5 mg orally, taken once daily at bedtime) can promote health supporting immune-modu­lation which may reduce various oncogenic and inflammatory autoimmune process­es. Since LDN can upregulate endogenous opioid activity, LDN may also play a role in healing and repair of tissues, as well as promoting stress resilience, exercise, social bonding, and emotional well-being, and ameloriating psychiatric problems such as autism and depression.

   After it was demonstrated that immune cell activation and proliferation were sensitive to the effects of naltrexone, Meng et al. hypothesized that LDN could exert modulating effects on bone marrow dendritic cells (BMDCs) and studied influence of LDN on both phenotypic and functional maturation of BMDCs. They concluded that LDN can efficiently promote the maturation of BMDCs via precise modulation inside and outside BMDCs. This study provided a meaningful mode of action and role of LDN in immunoregulation, and rationale for future application of LDN for enhancing host immunity in cancer therapy.

Med Hypotheses. 2009 Mar;72(3):333-7.

    Chronic Lyme disease is a symptom complex of borrelial organisms and multiple co-infections with bacteria and other parasites. Krause et al. noted that multiple co-infections may suppress the immune system or may cause a nonspecific stimulation of the immune system, leading to inflammation, pain, and immune dysfunction.

   At the 2012 Integrative Healthcare Symposium, Richard Horowitz, MD, of Hudson Valley Healing Arts Center, Hyde Park, N.Y., and President of the International Lyme and Associated Diseases Educational Foundation, noted, "Usually, the sickest patients require a combined approach using pharmaceuticals and nutraceuticals." Dr. Horowitz notes that low-dose naltrexone (LDN) has helped patients with Crohn's disease, multiple sclerosis, and fibromyalgia. In his open-label study of 500 patients with Lyme disease and MCIDS, approximately 75% of patients experienced less fatigue, myalgia, and arthralgia when the naltrexone dose was titrated to 4.5 mg at bedtime, using compounded LDN.

   For the patient with a stimulated immune system that produces inflammatory cytokines, alpha-lipoic acid (ALA), glutathione, resveratrol, and curcumin have been found to relieve pain, fatigue, and "brain fog." Dr. Horowitz concluded that treating the three forms of B. burgdorferi, co-infections, hormonal abnormalities, heavy metals, neurotoxins, sleep disorders, psychiatric problems, and nutritional deficiencies is the best way for patients to regain their health and to decrease pain.

   "Most conventional practitioners don't believe that Lyme disease exists in chronic form, because they think the blood tests are reliable when they come up negative. But ELISA (enzyme-linked immunosorbent assay) is unreliable; you need a Western blot looking at the Lyme-specific bands from a good lab," Dr. Horowitz said.

   ASC (autism spectrum conditions) may result from a failure of striatal beta endorphins to diminish with maturation. Many symptoms of ASC resemble behaviors induced in animals or humans by opiate administration, including decreased socialization, diminished crying, repetitive stereotypies, insensitivity to pain and motor hyperactivity. Naltrexone, an opioid antagonist, has been used in the management of children with ASC and can produce a clinically significant reduction in the serious and life-threatening behavior of self-injury for individuals who have not been responsive to any other type of treatment and is important for this reason. A review of the literature from 2010 until 2013 revealed that 155 children participated in 10 studies. In these studies, 27 received placebo. Of the 128 that received naltrexone, 98 (77%) showed statistically significant improvement in symptoms of irritability and hyperactivity. Side effects were mild and the drug was generally well tolerated. The review concluded that naltrexone may improve hyperactivity and restlessness in children with autism but there was not sufficient evidence that it had an impact on core features of autism in the majority of the participants.

J Intellect Disabil Res. 2014 Mar 4. [Epub ahead of print]

   Glutamine is a nutrient for rapidly dividing cells and the major energy source for intestinal epithelium.  The incidence of severe mucositis in the oral cavity, pharynx and larynx is high among patients with head and neck cancer (HNC) receiving chemoradiotherapy (CRT), resulting in significant pain and impairment of quality of life. A double-blind, randomized, placebo-controlled trial investigated whether L-glutamine (glutamine) decreases the severity of mucositis induced by CRT. Forty patients with squamous cell carcinoma of the nasopharynx, oropharynx, hypopharynx or larynx received radiation therapy, and cisplatin (20 mg/m2) and docetaxel (10 mg/m2) were intravenously co-administered once a week for 6 weeks. Patients were randomized to orally receive either glutamine (group G) or placebo (group P) at a dose of 10 grams 3 times a day throughout the CRT course. Mucositis was assessed using the National Cancer Institute Common Terminology Criteria for Adverse Events version 3.0. The primary end point was mucositis severity. Mucositis developed in all patients. Glutamine significantly decreased the maximal mucositis grade and pain score at weeks 4, 5 and 6.

   Anderson et al. of the Mayo Clinic reported that administration of glutamine suspension after chemotherapy (2 g/m2/dose for adults, swish and swallow twice daily on days of chemotherapy and for at least 14 additional days) has resulted in significant amelioration of stomatitis (duration of mouth pain was 4.5 days less when compared to placebo). The severity of oral pain was also reduced significantly when glutamine was provided with chemotherapy - the amount of days mucositis restricted oral intake to soft foods was 4 days less with glutamine. No toxicity of glutamine was observed. Oral glutamine appears to be a simple and useful measure to increase the comfort of many patients at high risk of developing mouth sores as a consequence of chemotherapy.