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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Maria3667 on December 1, 2008, at 12:25:06
Hi everyone,
Two weeks ago I started the use of Low Dose Naltrexone (LDN). I have an auto-immune disease and some people claim LDN can improve this. LDN is also reputed to have little to no side-effects.
However, the last few days I have definately felt an increase in anxiety.
I don't understand, 'cause I thought LDN would increase endorphines and thus cause a better mood. I'm wondering, does LDN somehow lead to an increase in dopamine? I'm very sensitive to that and it always results in greater anxiety for me.
Or could it be the thyroxine (thyroid hormones) I'm using as well?
I really do hope somebody can answer this for me.
Best wishes,
Maria
Posted by Phillipa on December 1, 2008, at 12:43:14
In reply to Is the LDN making me anxious??, posted by Maria3667 on December 1, 2008, at 12:25:06
Maria is your thyroid also in need of thyroid meds or was it an add on as they can definitely from my experience increase anxiety. Now LDN just don't know. Love Phillipa
Posted by Jimmyboy on December 1, 2008, at 12:56:54
In reply to Is the LDN making me anxious??, posted by Maria3667 on December 1, 2008, at 12:25:06
I also took LDN - for about 2-3 weeks and then again for a few days. I think its very possible that it could be causing your anxiety.
I also had a weird anxiety like reaction to it. Its kind of hard to explain, but it made me a little shaky and socially retarded. It didn't really make me have social anxiety per se, but interactions with others were definitely off , which was embarrassing.
And yes, you would think more endorphins = less anxious. But maybe there is a possibility that it is also raising the body levels not just of "good endorphins" ( beta endorphin) but maybe its also raising the bad endorphins (dynorphin). Dynorphin can casue anxiety and make you feel bad. Don't know if thats it though...
Anyway, you can stop it cold turkey at a low dose no problem. I would be interested in hearing if you have a "rebound" effect and feel a lot better for a few days after you stop taking it. This happened to me both times and someone else on the board had the same effect.
Posted by Maria3667 on December 1, 2008, at 13:20:06
In reply to Re: Is the LDN making me anxious?? » Maria3667, posted by Phillipa on December 1, 2008, at 12:43:14
Hi Phillipa,
Thyroid has been off duty for about 5 years. Thyroid meds really helped me overcome severe fatigue. I always thought they were helping me, although I did experience a slight increase in anxiety.
Love,
Maria
> Maria is your thyroid also in need of thyroid meds or was it an add on as they can definitely from my experience increase anxiety. Now LDN just don't know. Love Phillipa
Posted by Maria3667 on December 1, 2008, at 13:23:46
In reply to Re: Is the LDN making me anxious??, posted by Jimmyboy on December 1, 2008, at 12:56:54
Dear JB,
I'm trying to stick it out a while longer. Just read that 'nervousness' could be a side effect of LDN and that it should pass...
Interesting theory about the good & bad endorphins. However, I wonder why nobody speaks out about the increased anxiety. I've searched the web and couldn't find any user's experiences mentioning this.
Yours and Bleauberry's are the first.
Love,
Maria> I also took LDN - for about 2-3 weeks and then again for a few days. I think its very possible that it could be causing your anxiety.
>
> I also had a weird anxiety like reaction to it. Its kind of hard to explain, but it made me a little shaky and socially retarded. It didn't really make me have social anxiety per se, but interactions with others were definitely off , which was embarrassing.
>
> And yes, you would think more endorphins = less anxious. But maybe there is a possibility that it is also raising the body levels not just of "good endorphins" ( beta endorphin) but maybe its also raising the bad endorphins (dynorphin). Dynorphin can casue anxiety and make you feel bad. Don't know if thats it though...
>
> Anyway, you can stop it cold turkey at a low dose no problem. I would be interested in hearing if you have a "rebound" effect and feel a lot better for a few days after you stop taking it. This happened to me both times and someone else on the board had the same effect.
Posted by Jimmyboy on December 1, 2008, at 14:02:13
In reply to Re: Is the LDN making me anxious?? » Jimmyboy, posted by Maria3667 on December 1, 2008, at 13:23:46
I know,
I have not seen mention of "anxiety" in any of the info I have seen. I also know 3 other people taking it and they have no side effects whatsoever and they love it.
It should definitely be good for your auto-immune disorder, I think its a good call to stick with it awhile. Good luck to you!
Posted by desolationrower on December 1, 2008, at 14:36:42
In reply to Is the LDN making me anxious??, posted by Maria3667 on December 1, 2008, at 12:25:06
Maria, you are taking it at night?
I wonder if you are a slow metabolizer of it and your dose is actually lasting for most of the day. Have you notice it help your symptoms, do you think a lower dose would work?
-d/r
Posted by Maria3667 on December 1, 2008, at 16:05:51
In reply to Re: Is the LDN making me anxious??, posted by desolationrower on December 1, 2008, at 14:36:42
Dear D/r,
Yes am taking at night (11 pm).
How do you know if you're a slow metabolizer?
Don't know if a lower dose would work - I've only been taking it for 2 weeks. So far not much benefit.
Maria
> Maria, you are taking it at night?
>
> I wonder if you are a slow metabolizer of it and your dose is actually lasting for most of the day. Have you notice it help your symptoms, do you think a lower dose would work?
>
> -d/r
Posted by Phillipa on December 1, 2008, at 19:24:30
In reply to Re: Is the LDN making me anxious??, posted by Jimmyboy on December 1, 2008, at 12:56:54
Jimmyboy didn't know there were two endorphins. thanks Phillipa
Posted by Phillipa on December 1, 2008, at 19:58:35
In reply to Re: Is the LDN making me anxious?? » Jimmyboy, posted by Phillipa on December 1, 2008, at 19:24:30
Intersting let me know what you think Love Phillipa ps used to be a runner no depression anxiety then.
History
Opioid neuropeptides were first discovered in 1975 by two independent groups of investigators.and Hans Kosterlitz of Scotland isolated from the brain of a pig what they called enkephalins (from the Greek εγκέφαλος, cerebrum).[5][6]
Around the same time in the calf brain, Rabi Simantov and Solomon H. Snyder of the United States found[7] what Eric Simon (who independently discovered opioid receptors in the brain) later termed "endorphin" by an abbreviation of "endogenous morphine", which literally means "morphine produced naturally in the body".[citation needed] Importantly, recent studies have demonstrated that diverse animal and human tissues are in fact capable of producing morphine itself, which is not a peptide.[8][9][edit] Mechanism of action
Beta-endorphin is released into the blood (from the pituitary gland) and into the spinal cord and brain from hypothalamic neurons. The beta-endorphin that is released into the blood cannot enter the brain in large quantities because of the blood-brain barrier. The physiological importance of the beta-endorphin that can be measured in the blood is far from clear: beta-endorphin is a cleavage product of pro-opiomelanocortin (POMC) which is also the precursor hormone for adrenocorticotrophic hormone (ACTH). The behavioural effects of beta-endorphin are exerted by its actions in the brain and spinal cord, and probably the hypothalamic neurons are the major source of beta-endorphin at these sites. In situations where the level of ACTH is increased (e.g. Addison disease), the level of endorphins also increases slightly.Beta-endorphin has the highest affinity for the μ1-opioid receptor, slightly lower affinity for the μ2- and δ-opioid receptors and low affinity for the κ1-opioid receptors. μ-receptors are the main receptor through which morphine acts. Classically, μ-receptors are presynaptic, and inhibit neurotransmitter release; through this mechanism, they inhibit the release of the inhibitory neurotransmitter GABA, and disinhibit the dopamine pathways, causing more dopamine to be released. By hijacking this process, exogenous opioids cause inappropriate dopamine release, and lead to aberrant synaptic plasticity, which causes addiction. Opioid receptors have many other and more important roles in the brain and periphery however, modulating pain, cardiac, gastric and vascular function as well as possibly panic and satiation, and receptors are often found at postsynaptic locations as well as presynaptically.
[edit] Activity
Scientists debate whether specific activities release measurable levels of endorphins. Much of the current data comes from animal models which may not be relevant to humans. The studies that do involve humans often measure endorphin plasma levels, which do not necessarily correlate with levels in the CNS. Other studies use a blanket opioid antagonist (usually naloxone) to indirectly measure the release of endorphins by observing the changes that occur when any endorphin activity that might be present is blocked.Capsaicin (the active chemical in red chili peppers) also has been shown to stimulate endorphin release.[10] Topical capsaicin has been used as a treatment for certain types of chronic pain.
[edit] Runner's high
Another widely publicized effect of endorphin production is the so-called "runner's high", which is said to occur when strenuous exercise takes a person over a threshold that activates endorphin production. Endorphins are released during long, continuous workouts, when the level of intensity is between moderate and high, and breathing is difficult. This also corresponds with the time that muscles use up their stored glycogen. Workouts that are most likely to produce endorphins include running, swimming, cross-country skiing, long distance rowing, bicycling, hockey, tennis, weight lifting, aerobics, or playing a sport such as soccer, basketball, rugby, lacrosse, or American football.However, some scientists question the mechanisms at work, their research possibly demonstrating the high comes from completing a challenge rather than as a result of exertion.[11] Studies in the early 1980s cast doubt on the relationship between endorphins and the runner's high for several reasons:
The first was that when an antagonist (pharmacological agent that blocks the action for the substance under study) was infused (e.g. naloxone) or ingested (naltrexone) the same changes in mood state occurred as when the person exercised with no blocker.
A study in 2003 by Georgia Tech found that runner's high might be caused by the release of another naturally produced chemical, Anandamide. Anandamide is similar to the active endocannabinoid anandamide,[12][13] The authors suggest that the body produces this chemical to deal with prolonged stress and pain from strenuous exercise, similar to the original theory involving endorphins. However, the release of anandamide was not reported with the cognitive effects of the runners high; this suggests that anandamide release may not be significantly related to runner's high.[13]In 2008, researchers in Germany reported that the myth of the runner's high was not a myth but was in fact true. Using PET scans combined with recently available chemicals that reveal endorphins in the brain, they were able to compare runners brains before and after a run.[14] The runners the researchers recruited were told that the opioid receptors in their brains were being studied, and did not realize that their endorphin levels were being studied in regard to the runner's high.
The participants were scanned and received psychological tests before and after a two-hour run. Data received from the study showed endorphins were produced during the exercise and were attaching themselves to areas of the brain associated with emotions (limbic and prefrontal areas).[15]
[edit] Acupuncture
In 1999, clinical researchers reported that inserting acupuncture needles into specific body points triggers the production of endorphins.[16][17] In another study, higher levels of endorphins were found in cerebrospinal fluid after patients underwent acupuncture.[18] In addition, naloxone appeared to block acupunctures pain-relieving effects. However, skeptics say that not all studies point to that conclusion,[19] and that in a trial of chronic pain patients, endorphins did not produce long-lasting relief. Endorphins may be released during low levels of pain and physical stimulation when it lasts over 30 minutes. Questions remain as to whether the prolonged low level of pain stimulation as in Capsaicin, acupuncture and running or physical activity alone are the threshold that activates endorphin release.
[edit] References
^
Posted by bleauberry on December 1, 2008, at 20:07:43
In reply to Is the LDN making me anxious??, posted by Maria3667 on December 1, 2008, at 12:25:06
I don't know your dose, but you should be on 1.5mg. If you don't have that size, you can empty the capsules and make your own custom doses. Some people need to be on 1.5mg for up to two months before trying a higher dose.
LDN has been known to quickly improve thyroid problems requiring adjustments in thyroid meds. You might need less thyroid treatment.
As for dopamine, I am sure it somehow increases either DA or NE or both. The reason I know that is a weird one. I have a cluster of carbuncles (dormant boils) on a small part of the leg that I've had for years. Anything that boosts NE/DA causes them to flare up badly, very inflamed, puss, very painful to touch. DLPA, deprenyl, milnacipran, cymbalta, tyrosine, even a gluten free flour I use that has Fava bean flour as one of its ingredients (Fava is very high in DOPA). Extra NE/DA means bad flares ups for the carbuncles. Well, with LDN, I got a viscious flareup. Maybe it was the initial worsening of symptoms that I was warned would be normal? Or was it a boost in DA?
Your anxiety is in one of the above two scenarios, but I think dropping the dose down is the best bet. Even 1mg has proven very helpful to people. Just because the general trend is to shoot for 4.5mg as fast as possible doesn't mean it is the best thing for every single person to do. Some people do best on really tiny doses.
This is the end of the thread.
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Dr. Bob is Robert Hsiung, MD,
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