Can Low Dose Naltrexone help POTS patients?
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- čas přidán 20. 07. 2024
- Introduction
One of my specialist interests is in a condition called POTS . This is a condition that affects young patients who struggle with severe chronic fatigue, an inability to stand up for a prolonged period of time, heart palpitations, brain fog, lack of refreshing sleep, IBS-like gut issues, fibromyalgia and chronic pain. Despite self management, lifestyle changes, and medications, patients still continue to struggle. I am always therefore interested in knowing about other possibly even unconventional medicaments that may become available and serve to improve symptoms and quality of life in my POTS patients.
Naltrexone is an opioid antagonist and it therefore used in acute and chronic states of abuse. It is classically given in doses of at least 50mg to be taken daily. Whereas some agents have a linear dose-effect curve, Naltrexone is interesting in that it has different pharmacodynamic effects at different doses. This is called the hormetic principle. Therefore different doses of Naltrexone may have different beneficial effects on the body. This is where the interest in lower doses of Naltrexone was generated.
Naltrexone doses of 0.5-4.5mg daily are termed Low dose
Doses of less than 1mcg/day have been termed ultra low dose
Anything in between 1mcg/day to 0.5mcg/day are termed as Very low dose.
In discrete low doses of 1-5mg/day Naltrexone acts as a glial modulator and in very simplistic terms reduces inflammation. Given these properties, there has been considerable interest in whether low dose Naltrexone may have beneficial effects in chronic inflammatory diseases such as Crohn’s disease, Fibromyalgia, Multiple sclerosis, cancer and even chronic pain states. I was interested in seeing if there is any evidence that LDN could help my POTS patients.
I have POTS and CFS for 18 years now ..LDN has given me a quality of life I never thought possible!
Cfs? Cystic fibrosis?
@@terrimurrell6037 Chronic Fatigue syndrome also known as ME ( Myalgic encephalopathy) it’s a common comorbidity with POTS patients.
@terrimurrell6037 hi 👋 CFS is chronic fatigue syndrome.
Have a good day 😊
I need this doctor! So refreshing to listen to someone who’s interested, understanding and knowledgeable!
how kind thank you!
Exactly. That is how I feel. This doctor is amazing. 😊
I have been on LDN (4.5mg per day) for two years now, and my health is much better! I am now a 33 year old woman, and I was constantly battling infections, colds, inflammation in my joints etc. My doctor (gynaecologist) put me on LDN and I am very thankful. I still struggle with my health which means I am still figuring out what exactly is going on and why, but LDN has clearly had a huge impact on me. I think I would be ill with something every 2 weeks, and never feeling well. I missed out on so much because I would be in bed recovering again. I have only gotten ill with something once a year now, which is unheard of for me.
Sexual side effects?
The description of POTS overlaps greatly with ME/CFS, and indeed they are very frequent comorbities (along with IBS, hypermobility, small fiber neuropathy). In ME/CFS also LDN seems to help somehow as a microglia inhibitor. I really wish more research was done on these illnesses and more quickly. Thank you for your video
Yes I totally agree with you 💯 percent.
I developed chronic severe anxiety after. Discontinuing lamictal after 12 years. LDN is the best thing I’ve found to stop the anxiety. I. Take 1.5 mg 3 times a day.
I am so greatful that you are open minded about medication; most doctors are not willing to prescribe anything that it's not originally approved for or prescribe anything on an off label use. I am new to LDN taking it about a week now and I love it. its miracle medication for my depression and fibromialgia.
Thank you for being you and being there for all of us! You give me hope, it's been a tough POTS day. The the hope I get from watching and listening to your insight and wisdom gives me just enough to be ok. Thank you.
I wish I could message u... u have helped me so much already!
This ‘pot’ is very new to me but describes my entire life. Being told for many, many years it’s was “all in my head”.
I’m going to reseat this, once again thank u so much!!!
Thank you for covering this subject. Your clear and simple explanation for those of us with brain fog is much appreciated!! Stay safe. 🙏💕
Thank you, can not believe how clearly & humbly you explain things. best communicator in the business
Easy on the eye too?
@@teddybear3552 HO HUM . . .!
Thank you for all you do for us 🙂❤️
This is really interesting! Thank you for sharing! ❤️🤗
You are an amazing Dr. I suffer from Pots and no one will help me or can help.
Your videos have helped me understand my POTS and possible treatments SO much better, Dr. Gupta! You have such a gift for synthesizing copious amounts of hard-to-understand data and relating it to patients in a way that is easily comprehended. Thank you for taking an interest in POTS and for staying ahead of the curve whenever new research and/or treatments become available. I have learned more from your excellent videos than all my POTS docs combined! So very grateful. :)
I've been taking it for about two years now to help with my autoimmune condition and chronic idiopathic urticaria. I had severe hives almost every day for at last 7 years which made my blood pressure go way high and I would get a fever and became lethargic. Since I started LDN, it completely stopped. I gave it to my son also for his immune system especially when Covid hit. He also has POTS and I watch your videos that pertains to his POTS and my LVH and Stent x3 placement. I'm so glad to know it helps with POTS. I know it's helpful with a lot of different conditions/ailments. Thank you very much for our informative videos. 👍
Thanks for the great information. God bless you DOCTOR. 🙏
This is really interesting doc, I’m going to look into this more before we speak in November 🤔
Can you educate on concentric remodeling? So much conflicting information out there. Your videos are excellent and informative. Thank you.
I really love watching your videos. You definitely are at the forefront of medicine.
Thanks for this. Great to hear a mainstream medical professional talking about uses for LDN. I first came across its use in regard to autoimmune disease and asked my GP if he'd be willing to give me a trial...he said it was only used it for drug addiction, and something else I can't recall. To be fair, that was a while ago. I had POTs symptoms when I was severely hypothyroid and originally diagnosed with FMs.
Did you try it? Did it help your POTS?
Thank you so much for this video! I am due to start LDN soon. I have EDS/POTS/FIBRO from the UK!
You are so welcome! Thanks for supporting our channel.
It would mean a tonne if you'd consider subscribing:-)
How's it going on the ldn Ellie?
You are real life hero sir, please upload more information god bless you
Excellent video thankyou. It greatly assists to hear a clear summary. Have you looked at CBD or medicinal cannabis for POTS related fatigue. I have had difficulty finding objective information on this.
POTS, IBS issues, pain through the body (I imagine also some anxiety-related issues as well?)...all part of dysautonomia due to mitochondrial dysfunction. Have you ever looked into Dr. Lonsdale's work? He's the lead researcher of thiamine deficiency disease in the world (referenced by the WHO multiple times on this subject), and all these symptoms correlate with thiamine deficiency disease. Along with magnesium as a cofactor, thiamine taken at high doses has helped a lot of people with dysautonomia due to mitochondrial dysfunction.
The human body only experiences so many symptoms. Think about it. If it’s not clear to you then read the symptoms of 100 diseases and you will see for yourself. Purely symptoms is not a way to diagnose a disease or judge a cure.
I've been taking LDN for 3 years now and couldn't live without it. I have hEDS and POTS so suffer with chronic pain and fatigue. I've gone from taking difene 3 times a day to maybe 3 times per week. Cant say theres a massive difference in fatigue, but theres a definite difference in brain fog.
I just started if for MCAS. I also have POTS and hEDS. What does were you started on? I have to micro dose everything
@@amandabuhlinger4504 I think it was 2ml in the evening. Now I'm on 3ml morning and 4ml evening
@@amandabuhlinger4504 Hiya, did it help reduce your MCAS reactions or how you feel in general? What dose are you on? Thanks
Great video 👍
I think it might have a genetic component. My mom and grandma have been loosing consciousness. I spent the first 5 years of my life in the ER with my mom because she would always pass out and have tachycardia. I remember a doctor grabbing me and putting me on my moms hospital bed when i was 3 telling me she would be fine and I never put 2 +2 together since no one in my family had ever heard of POTS despite visiting the hospital weeklym
Thank you, Dr. Gupta.
Alot is related to thyroid in this matter and adrenals
Thank you, Dr. Gupta👍👍🙏!
I wish I could see this Doctor!
We could use an update on How POTS folks are doing with this these days please 🙏
Hi Dr. Sanjay. It is interesting as usual. Was wondering if in fact there is a success rate with pots patients.I appreciate all you have today..Also is diet anything to do with this syndrome? Thank you so very much. How is your wonderful dog doing.? Kindest regards from me Patricia.
I read about the gentleman who ate black licorice and passed away supposedly because of his over indulgence. The article went on to state that black licorice can cause palpitations. I too, love black licorice a stick or two or three a day and since I stopped eating it my palpitations have ceased. It is true diet plays a role in one's overall health.😊😊
My traditional Chinese medicine doc told me to limit licorice, as it contributes to palpitations.
@@nlclemens Good to know, thanx 😊☺
I enjoy and share your videos. Am wondering though why you say POTS is a condition for young people. It's a common co-morbid condition in ME and CFS. Dr Peter Rowe, one of the pioneers in POTS and orthostatic intolerance, estimates up to 100% of people with ME or CFS have POTS and/or neurally-mediated hypotension, and now they're finding reduced blood flow to the brain without any heart rate or bp manifestations in people with ME and CFS as well.
You are making a statistical error in your thinking. It may be true that many with POTS also have ME/CFS, but, it is also true that the majority of POTS patients are young and female.
My 11 yr old has the symptoms of pots but we can’t test for it yet because she is too young , but it is very common with us zebras... eds.
Also mast cell activation is very common with us ... it’s hard to dx.
Having connective tissue disorder is really tough.
I'm taking low dose naltrexone for brain fog from having long covid. It has worked for me.
Hi, How long did it take to kick in? Im in the same boat, have been taking ldn at 5mg for two weeks, no benefits so far, only more headaches and have seemed to make my pots slightly worse
@@asifhanif3670 for me it worked the first day
LDN is also being used for Hashimotos.
I have been on it for 5 years. Hashi in remission and EBV not activated. I take many supps, thyroid optimized, walk, yoga, juicing etc etc but work full time and have very minor pain
I often think Should I go off LDN for a bit? But Im afraid to and its so affordable!
Great talk! especiallay side effect discussion and data. awesome job.
Different subject but was wondering if you could give us some information on low BP again? Such as if you sleep longer at night than usual..such as 8 hours versus 6 hours..will your BP in the morning be lower? I'm 71 and having some low BP issues lately..some when working outside in the heat which might be because of dehydration? But some low BP in early morning.
Patient with Fibromyalgia, hEDS, POTS, and Anorexia, Been on trial of ldn for just under a week and had crushing chest pains in the evenings, as well as a general worsening of symptoms. I am hopeful this is a good sighn as my body is reacting to it. Was worried that pots might make ldn dangerous because of the chest pains. But I think this is just another passive side effect coming from another part of my body that dosent work reacting to a new substance saying hello.
Some people only need 0.1mg of LDN to see a difference. Im currently on LDN 0.25 x3 a day and titrating up till i find the right dose. I follow Dr Norman Marcus protocol for EDS abd fatigue. Its only few days in and its helping. Love it❤
I have been on LDN for 6 months and am titrating up from 1-4.5mg over time. What I have found is that every time I go up in dosage (initially by 1mg then 0.5mg then 0.25mg) my resting heart rate drops significantly over 7-10 days. Then my RHR shoots up to above what it had been before the increase and stabilizes there. It has helped with the pain and brain fog (I have ME), but the benefit is beginning to be lost at higher doses. The higher RHR makes me feel sick (flulike symptoms), decreases my window of activity, and exacerbates other symptoms. Another side-effect if I increase the dose too soon or by too much is incredible brain fog, fatigue, and heaviness - it is awful. I am finding it very tricky to find the optimal dose!
Have you had any success finding the correct dose since?
@@cheggs9 I actually just quit taking it all together. I was not sure it was helping and I seemed to be getting worse in regards to POTS symptoms and neuropathy pain. I was at 3.25mg and had gone all the way to 3.75mg. If it does turn out that my muscle pain and brain fog get worse off of the LDN I think I will aim for going back on it to only 2mg as I didn’t have much in the way of side effects at that dose as far as I recorded and remember.
@@Wildgratitude I wish you all the best in your recovery. I started on 0.5mg 3 days ago for CFS & Fibro and am already experiencing pretty unpleasant side effects. I have a lot of hope invested in LDN, so will hang in there. Good luck.
@@Wildgratitude Do you use the liquid dose? Or tablets. I haven’t paid for my prescription yet but I’m not sure how to measure it.
Where are you getting it from? If not from a reputable compounding pharmacy then it may not be what you think it is. Some people are ordering it online without a script.
PLEASE DOCTOR, REVIEW WITH AN OPEN HEART, on CZcams
Dr Eric Berg
Valued Nutritionist has to say about POTS, B1, etc. Thank You.
With IBS we could expect there would be nutritional deficiencies.
Working on gut issues logically would be the place to start correcting the problem.
As one other commenter here said they corrected their POTS by changing their diet to a carnivore diet, reducing carbs which in turn reduces thiamine needs.
Thiamine is critical and gut issues can cause a deficiency, such a deficiency is known to cause pain issues as well as lack of energy issues, among others.
Could you give some of your patients a divided daily dose of 1 gram (1000mg) of oral thiamine, or IV thiamine to bypass gut issues and let us know if it was of benefit?
Hi Doctor,
Any chance you could do a video on DVT and its relation to PoTS?
Who says they are related?
Some people with M.E. take it. I didn't know GPs would precribe it.
You look like Mohinder Suresh from the Heroes!
What about Hyperadrenergic pots
Thank you so much for acknowledging that POTS meds alone don’t always bring sufficient symptom relief. LDN can lower BP in some, so it’s something to be aware of. Now to investigate POTS response to high dose B1 as thiamine HCL and/or Benfotiamine and/or TTFD. Thank you for your work
🙄🙄🙄🙄 not a thing
7:08 Evidence by inflammatory blood markers. Yes, that’s what we need.
how are you treating long haulers?
Doc what do you think of ivabradine?
I've had Dysautonomia, ulcerative colitis and Mast cell activation for more years than I can remember. I'm starting LDN today and have very high hopes that it works for me. The first dose has caused a few jitters and a very slight headache, but that seems to be somewhat normal from what I've read.
Did the ldn work for you and are you still using it?
Can i ask what the verdict has been to this question please?
Sir its bit urgent!!!
I have been having pain in left chest and left arm.Ecg was normal.I m an anxiety disorder patient since last 13 years. Left side chest pain is with me from last few years.It comes for few days n go its making me scared of heart attacks. I m on antidepressant from last 7 years.this time I'm having pain in arm too. No acid reflux symptoms..Could it be a heart related??
Is LDN good for Polymyalgia Rheumatics?
Im on LDn and 1.5 capsule caused severe headaches body jerks chest pain upper back pain neck stiffness and foot cramps. Lowered to diluting the capsule into 15mls water and taking .5mls from it. Leg weakness and body jerks still happening and BP drops are insane. It seems to be making my POTS and autonomic dysfunction worse. Can ldn dehydrate us? Im sleeping constantly. How long do we keep going with it till we quit as i need this to work for better quality of life as react to all other meds an ds dont want toxic meds anyway.
Where exactly did you get it from? If it's from some random place online it may not even be what you think it is.
Does cbd oil cause heart problems?
What if LDN actually makes you feel more pain?
Hello Dr Sanjay - Have I really been watching you for 11 minutes?
I like your beard - I like the change in lighting... BTW what were you talking about today? lol (Yes I am nawty!)
I like the beard too. I bet he has many gals chasing him!!
@@carolbenson6524 Hello Carol - I am glad I am not alone!!! Many years ago I had a Doco who was the spitting image of Omar Sharif... I swear!!! Funnily enough I saw him at the same time my husband had decided he had had enough of me... I told the doco I was crying all the time - he said - I would be crying if my wife left me... I thought Yeah Right (who would leave you?) lol - Thank you for your response... Stay Safe...
@@teddybear3552
Ha! Got a kick out of your response. My Primary Care Physician and also Cardiologist are both from India. I find these doctors are intelligent and take so much pride in their field. They come to this country and want to continue learning and expanding. And they are both so good looking and caring...just like this Sanjay Gupta. Have a great day and stay safe too!!!!
@@carolbenson6524 Yes, they are very dedicated to their work. An Indian Doctor saved my life and those of my twins (way back). To people who dislike those of colour - I say 'If a loved one was sick and dying would you say no to the help of someone of colour' I dont think so... Thank you for responding it has been a very nice day for me - talking with you. Take Care...
You cheating SOB!
You didnt answer the question whether ldn can help POTS patients? I.e does it actually reduce pot’s symptoms?
My GP is not allowed to prescribe LDN to me for polymyalgia rheumatica. I have been in awful pain for months, how can I get LDN in Uk please?
Contact Dickson chemist Glasgow
@@eviemorgs thank you so much Evie.
What do you mean by temperature dis-regulation
Perhaps, the body temp isn't regulated.
I would also like to know. I will be fine go outside on a hot day and then my gait is severely affected. It is frightening. I also have trouble with balance in the A.M. I have low blood pressure that know one seems to care about because it is low. 90/ 50. Sometimes it is lower. But the temperature thing drives me crazy because I will be walking fine and then not sure if I can walk 20-30 feet without falling.
Rose Ashmore You poor thing. That must be terrifying. My BP is low to, but not that low. Plenty of Salt and plenty of water.
It means your body struggles to control it's temperature. For example, on a hot day I find it almost impossible to cool down and on a cold day I find it impossible to warm up. Some days I can feel frozen while sitting down but as soon as I start moving around I overheat and start sweating. I even have days where my outside feels hot and my insides feel frozen.
Tracy Meggitt I experience the same. Problem is I quit sweating. I have an appointment with a neurologist at the VA this Thursday. Hopefully I find something out.
How can I contact you please
Your opening statement describes me to a “T”.
I hate heart issues 😢
I do to🙏🙏🙏🙏
Oh Come on - Have a Heart!!! lol
Me too!
Effects esp Lyme disease patients :(
York cardiology kink
I healed my POTS by switching to a carnivore diet, and also taking a supplement called NAC, every morning on empty stomach.
80's Nostalgia Guy NAC helps w gambling impulse issues also. It is great for the liver.
Does the carnivore diet include eliminating carbs?
@@mballer yes
What is nac ?
@@jainendramishra6855
n acetylcysteine
A precursor to glutathione.
Vitamin D improves POTS.
Hereditary Alpha Tryptasemia….learn about it.