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LDN for trigeminal neuralgia (opthalmic neuralgia): Carthage IL Integrative Functional Medicine: Dr. Kim - Q&A:

Treating Trigeminal Neuralgia with Low-Dose Naltrexone: A Promising Approach

Posted by Dr. Yoon Hang Kim, MD | Integrative & Functional MedicineEstimated reading time: 7–8 minutes

Trigeminal neuralgia (TN) is a chronic pain condition marked by sudden, severe facial pain—often described as electric shocks or stabbing sensations. For many, simple actions like chewing or brushing teeth can trigger excruciating episodes. While traditional treatments such as anticonvulsants (e.g., carbamazepine) or surgical interventions offer relief for some, they can fall short or lead to unwanted side effects.

Enter Low-Dose Naltrexone (LDN)—an emerging therapy that is gaining attention for its potential to reduce TN symptoms with fewer side effects. This article explores what LDN is, how it works, and its promise in managing trigeminal neuralgia.


🧠 Understanding Trigeminal Neuralgia

Trigeminal neuralgia affects the trigeminal nerve, responsible for facial sensation. Common symptoms include:

  • Sharp, electric shock-like pain in the cheeks, jaw, or lips

  • Pain triggered by light touch, brushing, or even wind

  • Sudden episodes lasting seconds to minutes, often recurring in clusters

Conventional treatments include:

  • Anticonvulsants like carbamazepine or oxcarbazepine

  • Surgical options such as microvascular decompression

However, not all patients tolerate medications well, and surgical risks or relapses remain concerns—prompting interest in alternative therapies like LDN.


💊 What Is Low-Dose Naltrexone?

Naltrexone is traditionally used in high doses (50–100 mg) to treat opioid or alcohol dependence. At low doses (0.5–4.5 mg/day), however, it acts very differently—providing anti-inflammatory and pain-modulating benefits without narcotic effects.

LDN must be compounded by a pharmacy and is typically taken once daily at bedtime.

🔬 Mechanisms of Action:

  • Endorphin Boost: Temporarily blocks opioid receptors, triggering the body to increase natural endorphin production

  • Anti-Inflammatory: Modulates microglia and reduces pro-inflammatory cytokines in the central nervous system

  • Neuroprotection: Influences biomarkers like BDNF and IL-10 that play a role in nerve health and pain regulation

These effects make LDN a potential game-changer for people with neuropathic pain like TN.


📚 What the Research Says

While human trials for LDN and TN are still limited, early research is promising.

🧪 A 2020 rat model study (Neuroscience Letters) found that:

  • A single dose of LDN partially reversed facial allodynia (sensitivity to touch)

  • After 10 days, LDN fully reversed pain symptoms—comparable to carbamazepine

  • LDN significantly increased IL-10 and BDNF levels, key to nerve recovery and pain control

🧠 Clinical anecdotes:

  • A patient with atypical TN on Reddit reported significant symptom relief on 0.5–1.5 mg/day LDN

  • Duke Health neurologist Dr. Wolfgang Liedtke shared a case where a TN patient stabilized on LDN + lacosamide, allowing dose reductions of other medications

  • LDN for neuropathic corneal pain, a similar trigeminal condition, showed reductions in pain and improved quality of life in a 2021 study


✅ Benefits of LDN for TN Patients

Benefit

Description

🛡️ Fewer Side Effects

Compared to anticonvulsants, LDN side effects (e.g., vivid dreams, mild nausea) are minimal and manageable

🔐 Non-Addictive

LDN is not a narcotic and carries no risk of dependence

💰 Affordable

Typically $50–$100/month via compounding pharmacies

🔄 Complementary Use

Can be paired with other meds like carbamazepine or lacosamide to reduce needed doses


⚠️ Safety Considerations

  • Avoid opioids while on LDN

  • Consult your doctor before mixing with other medications

  • Use clean, sterile supplies to prepare solutions

  • Check for allergies to naltrexone or fillers


📌 Practical Tips & Next Steps

  • 📍 Find a compounding pharmacy experienced in LDN

  • 📈 Track your symptoms in a daily log

  • 💬 Discuss combination therapy options with your doctor

  • 🧘‍♀️ Lifestyle changes, such as stress management and anti-inflammatory diets, can enhance LDN’s benefits

🧾 Conclusion

Low-dose naltrexone (LDN) presents a hopeful path forward for those living with trigeminal neuralgia. It offers a well-tolerated, non-addictive, and cost-effective alternative or adjunct to conventional therapies.


Though more research is needed, growing anecdotal evidence and preclinical data support its role in reducing pain and improving life quality. If you're considering LDN for TN, work with a knowledgeable healthcare provider to develop a personalized and safe treatment plan.


Dr. Yoon Hang Kim, MD is a board-certified physician specializing in integrative and functional medicine, dedicated to uncovering root causes and providing personalized healing for chronic and complex conditions. He is a recognized expert in Low Dose Naltrexone (LDN) therapy and offers telemedicine services across multiple states—including Quincy, IL and throughout Illinois, San Antonio and all of Texas, Missouri, Florida, and Atlanta as well as the rest of Georgia.



🔗 References

  1. de Oliveira CL, et al. Low-Dose Naltrexone Reverses Facial Mechanical Allodynia in a Rat Model of Trigeminal Neuralgia. Neuroscience Letters, 2020. Read more

  2. Wolfgang Liedtke, MD, PhD. Trigeminal Neuralgia Case Study. Duke Health, 2017. Read more

  3. Reddit User on r/TrigeminalNeuralgia, 2024. Community Post

  4. Park Compounding Pharmacy. LDN for Orofacial Pain, 2021. Visit Site

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