Quincy IL Integrative & Functional Medicine: Q&A LDN & Sjogren's syndrome on Opioid medication:

"I have Sjögren’s syndrome, causing sensitive mucous linings and severe pain, including extreme intestinal pain. I use oxycodone (5 mg, 1–6 times daily) to manage varying pain levels. To enhance oxycodone's effect, reduce tolerance, and improve my condition, I started ultra-low-dose naltrexone (LDN). I began at 0.00125 mg, noticed little effect, then increased to 0.0025 mg, feeling slightly better with enhanced oxycodone effects. At 0.005 mg, I experienced severe nausea for two weeks. Given my sensitivity, could this low dose cause nausea? Is 0.0025 mg my optimal dose? After pausing for two days, nausea improved but persists. How should I proceed with titration, and is it realistic to aim for reduced oxycodone use or symptom improvement with LDN? Thank you!"

Answer: Absolutely — here is your blog-formatted post, styled with headings, subheadings, and natural, reader-friendly flow. It is designed to educate, validate, and empower others exploring ultra-low-dose LDN for Sjögren’s syndrome and opioid-related chronic pain.

🌿 Quincy IL Integrative Functional Medicine: Can Ultra-Low Dose Naltrexone Help Sjögren’s Syndrome and Chronic Pain?

Living with Sjögren’s syndrome can feel like walking a tightrope. Between fatigue, pain, and hypersensitive mucous membranes, many patients find themselves juggling multiple medications just to get through the day. For some oxycodone may be a necessary tool to manage severe, ongoing pain. But what if there were a way to reduce opioid dependence, and improve how your body responds to inflammation?

That’s where Low Dose Naltrexone (LDN) — especially at ultra-low doses — enters the conversation.

1. 💊 What is LDN?

Naltrexone was originally developed to block opioid receptors at high doses (typically 50 mg) for people dealing with addiction. But over the past two decades, researchers and patients have discovered that at much lower doses — known as Low Dose Naltrexone (LDN) — this medication works very differently.

At doses ranging from 0.1 mg to 4.5 mg, LDN may:

• Modulate the immune system

• Stimulate natural endorphin production

• Reduce inflammation

• Enhance nervous system regulation

At even lower doses — micrograms instead of milligrams — the effects shift again, offering potential benefits with far fewer side effects. This is sometimes called Ultra-Low Dose Naltrexone (ULDN).

2. 🔄 LDN and Autoimmune Disease

Autoimmune diseases like rheumatoid arthritis, multiple sclerosis, Hashimoto’s thyroiditis, and Sjögren’s syndrome are driven by immune system dysregulation — often leading to inflammation, tissue damage, and systemic symptoms.

LDN is thought to help calm the immune response by:

• Increasing T-regulatory cells (which help prevent autoimmunity)

• Reducing pro-inflammatory cytokines

• Modulating glial cells in the nervous system (which drive pain and fatigue)

Patients with autoimmune diseases have reported:

• Less joint and muscle pain

• Improved mood and energy

• Reduced frequency of flares

But — and this is important — many of these patients are highly sensitive to medications. That’s where ultra-low dosing comes in.

3. 💧 LDN and Sjögren’s Syndrome: A Delicate Balance

Sjögren’s syndrome is a uniquely complex condition. Beyond the well-known dry eyes and dry mouth, many patients experience:

• Severe gastrointestinal pain

• Neuropathy and nerve pain

• Debilitating fatigue

• Autonomic symptoms like dizziness or nausea

For some, standard LDN doses (0.1–4.5 mg) may be too stimulating, causing side effects like:

• Nausea

• Sleep disruption

• Headaches

• Anxiety or restlessness

I have used as low as 1 microgram to treat patients with autoimmune conditions.

4. ⚖️ Ultra-Low Dose LDN with Opioids: A Promising Combination

Interestingly, researchers have discovered that ultra-low doses of LDN (as little as 1 microgram = 0.001 mg) may enhance the effect of opioids like oxycodone — rather than block them.

In fact, studies show that at microdoses:

• LDN may reduce opioid tolerance

• It may amplify the pain-relieving effect of lower opioid doses

• It may prevent opioid-induced hyperalgesia (when opioids make pain worse over time)

This makes ultra-low-dose LDN especially appealing for people like me — those living with autoimmune conditions and on long-term pain management who want to:

• Stabilize opioid response

• Reduce total daily opioid use

• Address underlying inflammation and immune dysfunction

But this only works if the dose is right — and that may mean going far lower than what’s typically prescribed.

🧭 My Personal Takeaway: Less Can Be More

Here’s what I’ve learned from my own LDN journey:

• Start ultra-low — even at 0.001 mg or less

• Increase very slowly — microgram by microgram if needed

• Listen to your body — nausea, sleep changes, or mood shifts may signal that your nervous system is overstimulated

• Stabilize before increasing — don’t feel pressure to “get to” 0.1 or 4.5 mg if your body does better at 0.001 mg

• Work with a knowledgeable provider — not all practitioners understand ultra-low dosing

My hope is that over time, this tiny dose of LDN will help me rely less on opioids, improve my resilience, and gently regulate the deeper immune and nervous system issues that Sjögren’s syndrome brings.

💬 Final Thoughts

If you live with Sjögren’s syndrome and have found that most medications feel “too much,” ultra-low-dose LDN may offer a new path forward — especially if you’re also managing chronic pain with opioids.

You don’t need to take large doses to see benefits. Sometimes, a microdose is all your body needs to start healing.

Disclaimer: Always consult your healthcare provider before starting or changing medications. Ultra-low-dose LDN should be used under the guidance of a knowledgeable professional, especially when combined with opioids.

Have you tried LDN or ultra-low-dose LDN for autoimmune illness or chronic pain? I’d love to hear about your experience in the comments. 🌿

📞 Now accepting new patients for virtual consultations🌐 www.directintegrativecare.com

Yoon Hang Kim, MD is a board-certified physician specializing in integrative and functional medicine. He provides personalized, root-cause care for chronic and complex conditions through a holistic, evidence-informed approach.

At Direct Integrative Care, Dr. Kim blends conventional medicine with lifestyle, nutritional, and systems-based strategies to help patients uncover the deeper imbalances behind illness.

🩺 Telemedicine appointments available for residents of Quincy, IL, Hannibal, MO, Carthage, and Macomb, IL.

Get to the root. Feel better. Stay better.