In this blog post, we will explore:
- The definition of thyroid dysfunction
- The most common thyroid conditions
- LDN as a treatment option for thyroid dysfunction
- LDN & thyroid resistance
- Risk factors and important safety information for LDN
Defining Thyroid Dysfunction
Hormone dysregulation is one of the Hallmarks of Aging. It is commonly known that the sex hormones, such as estrogen and testosterone, decline as we age. However, there are many other hormones that also become less functional, such as insulin, leptin, and thyroid-related hormones.
Thyroid dysfunction is a very common problem thought to affect at least 12% of the U.S. population. This a general term used to describe conditions that prevent your thyroid from making the right amount of hormones.
LDN & Thyroid Dysfunction
Low Dose Naltrexone (LDN) has become a popular accompaniment in helping to treat the symptoms of thyroid issues. While taking LDN is not a substitute for taking thyroid hormone medication, there have been many instances in which it has been shown to alleviate some or all symptoms of hypo and hyper-thyroidism, as well as helping to regulate the way the thyroid works—sometimes decreasing the amount of thyroid medication an individual has to take.
Before looking at how LDN works with the thyroid, let’s first cover the types of thyroid issues most commonly seen. Patients have either an under-active thyroid or an over-active thyroid.
Hypothyroidism: The most common type of thyroid problem is hypothyroidism, which translates to a low functioning thyroid. Often seen symptoms of hypothyroidism are weight gain, fatigue, intolerance to cold, dry and brittle hair, dry skin, peeling cuticles, constipation, joint pain, and insomnia. A variety of issues can lead to hypothyroidism, the most common being Hashimoto’s. Hashimoto’s is an autoimmune condition in which the body attacks the tissue of the thyroid gland and leads to decreased production of thyroid hormone such as thyroxine (T4) and Triiodothyronine (T3). T4 typically gets converted into T3, which is the hormone your body’s cells use to function in almost every capacity, from regulating metabolism to regulating body temperature.
Hyperthyroidism: Hyperthyroidism is considered as the thyroid being in overdrive. This is when the thyroid produces too much T4 and/or T3, and physiological processes move faster than they should. This can result in symptoms of heart palpitations, oily skin and hair, bulging eyes, weight loss, muscle weakness, diarrhea, sensitivity to heat, insomnia, and hyperactivity or mood swings. Graves’ Disease is the autoimmune condition that can cause hyperthyroidism. Some individuals with Graves also experience an itching or burning sensation of the skin.
Autoimmunity in general can typically be aligned with too much inflammation in the body. Low Dose Naltrexone (LDN) has the potential to help lower the inflammatory response in the body. By decreasing the amount of inflammation an individual is experiencing on a chronic basis, this can then lead to a decrease in the way the autoimmune condition is impacting the thyroid function, in turn helping to decrease or alleviate the symptoms being experienced.
LDN & Thyroid Resistance
One other thyroid issue that can potentially be helped with the use of LDN is referred to as “thyroid resistance.” Thyroid resistance is the concept that the cells are no longer properly responding to thyroid hormone like they should. It is very similar to the idea of insulin resistance, which leads to type 2 Diabetes. In fact, patients with insulin resistance/DM2 are known to have lower levels of T3 and are thought to be more prone to thyroid resistance.
Numerous resistance “syndromes” have been hypothesized, including leptin and others. The underlying cause of these resistance syndromes is inflammation and immune dysregulation. For diabetics with severe insulin resistance, you will see them on enormous doses of insulin injections just to keep their sugars under control. Likewise for thyroid resistance— it is not uncommon to see patients on doses of thyroid hormone that is 2, 3 or even 5 times as high as they should be (for reference, a normal replacement dose of thyroid is about 1.6mcg/kg, so about 112mcg of T4 or about 25mcg of T3 for a 70kg person).
What does LDN have to do with it? LDN works by reducing inflammation and helping to regulate the immune system. There are studies that show that LDN can reduce insulin resistance. It is also thought to be able to help reduce leptin and thyroid resistance, and probably many other hormone resistance syndromes.
Risk Factors & Important Safety Information
At AgelessRx, we warn anyone starting LDN to help improve thyroid symptoms who is also taking thyroid medication of any kind should monitor their thyroid hormones while finding their maintenance dose of LDN.
Who is at risk?
- Patients on supplemental T3 (Cytomel, desiccated thyroid such as Armour or NP Thyroid)
- Patients on high doses (above 150mcg total equivalent of T4)
- Patients who were started on thyroid medication relatively recently (in the last 5 years)
Should LDN improve the thyroid’s ability to produce its own natural thyroid hormone or make existing thyroid hormone work better, and an individual is also taking T4, T3, a combination, or a desiccated thyroid medication, there is the potential for the person to begin trending towards hyperthyroidism. Monitoring lab work to spot this trend before it becomes an issue is key as the individuals prescribing physician for thyroid medication can begin to lower the thyroid medication until optima thyroid hormone levels are achieved. A comprehensive thyroid panel- TSH, free and total T3, and free and Total T4- should be used to evaluate, not just TSH. If the individual is also experiencing a thyroid autoimmune condition (Hashimoto’s or Graves), then antibody levels (TPO, Thyroglobulin, and/or TSI) should also be measured as they can decline while using LDN.
What to do about it?
- Be aware of the symptoms of “resistance reversal”, which can lead to hyper-thyroid symptoms described above
- Reduce the LDN dose temporarily while you sort out the thyroid adjustment with your prescribing physician
- Monitor blood work more closely the first few months of starting and titrating LDN, including not only TSH but also Free T4 and Free T3
Blood work should be monitored every 6-8 weeks during the initial titration period of LDN, until a person finds their optimal dose – or as recommended by your prescribing provider. Once the thyroid hormones AND the individual’s dose of LDN are stable, monitoring can return to the usual 6 months to a year – or at the advice of the physician who prescribes the thyroid medication.
Should a previously hypothyroid person become symptomatic of hyperthyroidism while taking LDN (heart palpitations or racing, excessive sweating, etc) they should lower their dose of LDN temporarily or stop taking it until they can have their thyroid hormones measured and adjust their thyroid medication appropriately under the care of their physician. Persons taking T3, particularly those on high doses of T3 – 25mcg or above- either by itself or in the desiccated form, should be particularly aware of this and be consistent in monitoring their thyroid hormones.
NOTE: AgelessRx does not diagnose, treat, monitor or prescribe when it comes to thyroid conditions. You will need to continue working with whoever prescribed the thyroid medication.
The Bottom Line
When monitored, LDN can be an effective secondary treatment option for those suffering with thyroid dysfunction.
To learn more about the science behind LDN, click here.
To request an LDN prescription, click here.