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Dosing of LDN: Quincy, IL Integrative Functional Medicine - Yoon Hang Kim MD

Updated: Aug 2


  • Current LDN Experience:

    • Started LDN at 1 mg in May, increased to 3 mg but felt terrible, returned to 1 mg in July and felt good initially.

    • Recent symptoms: exhaustion, joint pain, and reduced energy, suggesting a possible loss of efficacy or sensitivity to the current dose.

  • LDN and Your Conditions:

    • Lyme Disease: LDN may reduce inflammation and improve immune function by lowering cytokines (e.g., IL-6, TNF-alpha) elevated in Lyme. Anecdotal reports suggest benefits for pain and energy, but effects may take 6+ months.

    • Adrenal Fatigue: LDN’s impact on adrenal function is not well-studied, but side effects like weakness can mimic adrenal insufficiency. No direct contraindication with glucocorticoids (e.g., if prescribed for adrenal issues).

    • Thyroid Issues: LDN may reduce thyroid autoantibodies in Hashimoto’s and improve thyroid function, but this can necessitate thyroid medication adjustments. Monitor thyroid levels closely.

    • Long COVID: Small studies show LDN (1–4.5 mg) improves fatigue, pain, and quality of life in long COVID by reducing inflammation and modulating immunity. Benefits may take 8–12 weeks.

  • Why Symptoms May Worsen:

    • Dose Sensitivity: Some patients, especially with complex conditions, respond better to ultra-low doses (<1 mg even 1 microgram) or experience side effects at higher doses. Your reaction at 3 mg suggests sensitivity.

    • Fluctuating Response: Initial benefits may fade due to immune or hormonal adjustments, medication interactions, or disease flares (common in Lyme/long COVID).

    • Other Factors: Adrenal fatigue or thyroid imbalances may exacerbate symptoms if not optimized. Stress, diet, or co-infections could also play a role.

  • Action Steps to Consider:

    • Discuss Ultra-Low Dosing: Ultra-low-dose naltrexone (<1 mg, e.g., as low as 1 microgram) can be effective for sensitive patients. Request your doctor consult a compounding pharmacy to prepare these doses.

    • Monitor Thyroid/Adrenal Function: Request blood tests (TSH, free T3/T4, cortisol, ACTH) to rule out thyroid or adrenal imbalances affecting energy and pain.

    • Titrate Slowly: If adjusting LDN, increase/decrease by 0.25–0.5 mg weekly to minimize side effects. Morning dosing may help if insomnia occurs.

    • Address Co-Conditions: Work with your functional doctor to optimize Lyme treatment (e.g., antibiotics, herbals), long COVID support (e.g., anti-inflammatory diet), and adrenal/thyroid management.

    • Track Symptoms: Keep a daily log of symptoms, LDN dose, and other medications to identify patterns and guide adjustments.

    • Seek Specialist Input: If your doctor is unfamiliar with ultra-low dosing, consult a LDN-experienced practitioner (e.g., via LDN Research Trust) or Dr. Kim who has clinical expertise in LDN therapy, integrative medicine, and functional medicine (www.yoonhangkim.com).

  • Cautions:

    • LDN is off-label for these conditions; evidence is promising but limited to small studies.

    • Avoid opioid medications with LDN due to receptor antagonism, except possibly low-dose tramadol.

    • Side effects (e.g., vivid dreams, fatigue) are usually mild and resolve with dose adjustment, but monitor for worsening adrenal symptoms.

  • Next Steps:

    • Schedule a follow-up with your doctor to discuss ultra-low dosing and comprehensive testing.

    • Consider a consultation with an experienced LDN physician such as Dr. Kim who has more than two decades of experience with LDN therapy (www.yoonhangkim.com)

    • Consider joining LDN support groups (e.g., online forums) for patient insights on dosing and managing complex conditions.

    • Be patient; LDN benefits may take months, and fine-tuning is often needed for chronic illnesses.


📘 Learn More

My book, LDN Therapy: Low Dose Naltrexone plus Other Tools for Healing, dives deeper into how LDN works and how it can be combined with integrative strategies for chronic illness. Available now on Amazon.com.


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.




Dosing Question Video 1 - 3 mg v. 0.1 mg



Dosing Question Video 2 Ultralow dose (1 microgram)


Dosing Question Video 3: Increasing Dose



 
 
 

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