What is LDN and How Does it Work for HE?

We’ve had quite the discussions on the forum lately about Low Dose Naltrexone (LDN) and if it is a viable treatment for HE.  2 people requested the “kid’s” version so they can better understand.  So here’s my attempt at an explanation.  Just so you know, I did do copious amounts of research and run this by my neurologist and he believes I am correct.  So here we go…

LDN has 2 primary functions in the possible benefit for those suffering from HT/HE.

1.  LDN works by blocking opioid receptors, (example seen in the picture 2 where it has accepted opioids into the receptors) which in turn release a bunch of endorphins.  But in diseases like HE and HT that have shown no evidence of a lack of endorphins, endorphins just make you feel good.  Picture 1 just kinda gives you a better view of the brain.  So LDN would kinda be like a placebo effect if it were not (possibly) for number two…

2. LDN blocks ‘toll-like receptor 4 (TLR4)’ on microglia.  See picture 3.  First of all, normally microglia are the first and the main form of active immune defense in the CNS.  They’re like the soldiers on the front line.  Glial cells form myelin, supply nutrients and oxygen to neurons and modulate neurotransmission.  It has been shown that dysfunctional microglia play a big role in neurodegenerative disorders.  See the right side of picture 3.

TLR4 are located at the surface of myeloid dendritic cells (immune cells), and are activated by specific ligands.  Once activated, it triggers inflammation and some have shown to participate in autoimmune diseases.  It produces IL-12 which is linked to autoimmunity.

 

Ok, I hope this clears things up a little better for people.  The primary benefit, I believe is the blockage of the TLR4 receptor so the microglia can’t become messed up and cause neurodegeneration.

Here’s a video someone posted:  (skip past the middle about 42:45 for the LDN brain stuff)