Author Topic: Low Dose Naltrexone  (Read 17061 times)

NoFun

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Low Dose Naltrexone
« on: August 12, 2010, 03:21:08 PM »
One possible solution to our problem is low dose Naltrexone.

Naltrexone is an opioid antangonist. The idea is to take naltrexone before bed, which will temporarily blockade your opioid receptors for a while, and cause them to upregulate, so that while you're awake, you get more opioid activity and feel better. Naltrexone supposedly reverses sexual satiety, which is one thing that prevents orgasm.

The low dose naltrexone is quoted as about $15 a month from a compounded pharmacy that doesn't take insurance, around $40 for those that do. Look up low dose naltrexone (LDN) and endorphin deficiency syndrome (EDS) if interested.  LDN is touted as a cure for all sorts of things, and supposedly has no known negative side effects.

We've looked at all sorts of things, but I don't think anyone has looked at the opioid system, and it looks simple, safe, and cheap enough to try. I'm working on the hormone route right now, but I thought I'd throw this out there in case anyone else would want to give it a try.

NoFun

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Re: Low Dose Naltrexone
« Reply #1 on: August 12, 2010, 03:28:34 PM »
Just saw a paper on regular dose naltrexone. We've got to try this stuff.

http://www.arcmedres.com/article/S0188-4409%2801%2900279-X/abstract

Naltrexone-Induced Augmentation of Sexual Response in Men

Background

To ascertain the role of endogenous opioids in sexual response, naltrexone, an opiate receptor antagonist, was administered to men, and its effect on selected self-report measures of sexual response to masturbation was recorded.
Methods

The data are based on results from 20 healthy, sexually active (alone or with a partner) men, aged 20–29 years, who ingested naltrexone (25 mg/day × 3) or placebo in a randomized, double-blind crossover design. There was at least a 14-day interval between drug and placebo treatment. Between 18 and 22 h after the most recent dose of drug or placebo, subjects viewed sexually explicit videos in privacy for 2 h. They were instructed to masturbate and have as many orgasms as desired. The following three different self-report measures of their responses were recorded: number of orgasms; intensity of sexual arousal, and orgasmic intensity.
Results

Under the naltrexone condition, the volunteers experienced a significantly greater mean number of orgasms (3.4 ± 0.2 SEM) than under the placebo condition (2.6 ± 0.3). The total number of orgasms was 67 under the naltrexone condition and 51 under the placebo condition. At the first orgasm, the measure of intensity of arousal was significantly greater in the naltrexone (3.9 ± 0.2) than placebo (3.4 ± 0.2) condition, and the measure of orgasmic intensity was significantly greater in the naltrexone (3.7 ± 0.2) than in the placebo (3.0 ± 0.3) condition.
Conclusions

The present study provides evidence that endogenous opioids modulate orgasmic response and the perceived intensity of sexual arousal and orgasm in men. The findings suggest that naltrexone could be clinically useful in cases of inhibited sexual desire and erectile dysfunction.

researcher

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Re: Low Dose Naltrexone
« Reply #2 on: August 17, 2010, 04:23:02 PM »
thank you! i am definitly going to research this when i get some time.

rizsa

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Re: Low Dose Naltrexone
« Reply #3 on: August 18, 2010, 07:21:16 PM »
Is Low dose Naltrexone avalaible in your country over the counter?
It is not the case in my country.

NoFun

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Re: Low Dose Naltrexone
« Reply #4 on: August 19, 2010, 02:19:55 PM »
Is Low dose Naltrexone avalaible in your country over the counter?
Nope. Not over the counter. Even prescription isn't easy, because it is normally manufactured only in 50mg doses. To get low dose naltrexone, you need to go to a compounding pharmacy that will crush the 50mg pills, and make 5mg (or less) pills, or a liquid preparation.
I'm in the US. LDN has had limited use here for multiple sclerosis for maybe a couple of decades.

lostmojo

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Re: Low Dose Naltrexone
« Reply #5 on: August 20, 2010, 05:12:48 PM »
I showed the abstract from the original link you posted about Naltrexone to my Neurologist. He was not familiar with it but he was open to the idea it may be helpful.

He then looked for it at PubMed and found some research related to using it to treat internet sex addiction, in other words it has also been used to subdue sexual urges. He then said it's probably not the best thing to try as a first option seeing it may have a somewhat opposite effect to what we're looking for.

I'm still having more tests done but at this stage his thinking is that trying an SSRI is probably the first thing he thinks I should try. This is because I seem to have some general anhedonia like symptoms, and an SSRI will affect the neurotransmitter balance in my brain, hopefully for the better. But of course an SSRI can also cause erectile dysfunction and he has not tried to gloss over that fact.

michaelsad

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Re: Low Dose Naltrexone
« Reply #6 on: August 20, 2010, 05:30:52 PM »
SSRI could cause EA !   It seems more safe to research/experiement with GABA,  ginkgo biloba , 5HTP ... in order to alter the neurotransmitter balance in our brains. 

lostmojo

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Re: Low Dose Naltrexone
« Reply #7 on: August 20, 2010, 05:51:53 PM »
SSRI could cause EA !   It seems more safe to research/experiement with GABA,  ginkgo biloba , 5HTP ... in order to alter the neurotransmitter balance in our brains.  

I know that, and the neurologist knows that but I've tried all of those things (plus many others) and they have zero noticeable affect on me. Inositol and Royal Jelly are the only supplements that have given me a tiny but noticeable improvement. By the way my neurologist is open minded and willing to listen to alternative ideas. SSRI's can affect general anhedonia. I don't get a runners high, massages give me no pleasure, low level general anhedonia seems plausible in my case. I think I also have some degree of mild OCD.

Here's where I'm at with all the doctors I've been seeing.

I've had general sensation tested in the genital/perineal area, my responses are normal. According to the neurologist if you can feel, touch, pain, heat, cold etc then the nerves are fine. If there was a pudendal nerve issue you would feel nothing at all, the same nerve pathways are used for all sensations so that includes sexual sensation. I've also had a nerve conduction test done where they measure how long it takes for an electrical charge to travel from my ankles till it reaches my brain, the result was normal.

I've had lots of blood tests done, everything is normal, so it's unlikely to be hormonal. I'm booked in to have an MRI test done and I also have an appointment with a urologist. If these don't show anything up then the neurologist thinks that probably means everything is physically fine but my brain is just not registering the stimulus it is receiving and to his knowledge an SSRI is the best candidate to try first.
« Last Edit: August 20, 2010, 05:57:22 PM by lostmojo »

NoFun

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Re: Low Dose Naltrexone
« Reply #8 on: August 20, 2010, 07:42:20 PM »
He then said it's [Naltrexone's] probably not the best thing to try as a first option seeing it may have a somewhat opposite effect to what we're looking for.
...
I'm still having more tests done but at this stage his thinking is that trying an SSRI is probably the first thing he thinks I should try. This is because I seem to have some general anhedonia like symptoms, and an SSRI will affect the neurotransmitter balance in my brain, hopefully for the better.
...
I've had lots of blood tests done, everything is normal, so it's unlikely to be hormonal.
I'm not an MD, but I don't like the plan.

For starters, I believe Naltrexone is extremely safe at normal doses of 50mg, let alone the 5mg low dose level, and has no known long lasting issues after discontinuation.  One of the effects is supposed to be greater endorphin activity while you're awake, and one avenue I don't think anyone has looked at for EA is low endorphin levels. Endorphin deficiency is not looked at much for general anhedonia either. The onset of mood effects should be immediate the day after taking it.

Maybe it helps, maybe not - no harm, no foul, and you should have indication on mood pretty quickly.

Meanwhile SSRIs are known to cause sexual dysfunction (which was your first reason not to try Naltrexone), *and* it is known to cause lingering issues after discontinuation - I think some of the people on this list trace their problems to a trial of SSRIs. It is has a reputation for emotional flattening, which is not what is needed for general anhedonia. And its supposed to take a couple of weeks for the effects to set in.

Known to *cause* our problem, sometimes permanently. Known for emotional flattening. And it requires a greater investment of time and risk.

 I've considered it for myself. There are a few freak anecdotes of sexual enhancement after SSRIs, and we may just be the freaks for whom it will work. But SSRIs seem like a Hail Mary, try anything, do the opposite of what makes sense tactic with real risk of doing more harm than good. I'm saving that one for when I've exhausted all other avenues.

I'd actually like someone else to be an SSRI guinea pig, but honestly, I don't think it's a good plan.

On the hormones, please fill out the hormone poll, and post your numbers separately here. "Normal" in the reference range means next to nothing. My free testosterone is "in the reference range", but doctors who do HRT would say I have half or less of the minimum recommended levels. Then there is the issue of Estrogen/Testosterone ratios, etc.

I looked at some of your previous posts, and saw one with some blood test results for Testosterone, LH, and prolactin
LH                 4.0 U/L     (2.0 - 10.0)
Testosterone 13.9 nmol/L (9.5 - 28.0)   10.2 (2nd result)
Prolactin       83    mIU/L  (85  - 500)    90    (2nd result)
My testosterone level is very low for my age and the prolactin levels are extremely low also.
I think the Testosterone levels are very low too, and so would HRT Docs. Why are you calling your levels "normal" now? What are your Free T levels?

Your Testosterone is about where mine is, and I've decided to try hormone replacement therapy again. That tells you what I think about your T levels. Reading up on it, one of the things testosterone HRT helps is amotivational, general anhedonia, which I also have.

michaelsad

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Re: Low Dose Naltrexone
« Reply #9 on: August 20, 2010, 08:38:23 PM »
@nofun, 
is it safe for lostmojo to use 5-HTP instead of SSRI for experiementing a boost up of serotonin level ?

   


NoFun

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Re: Low Dose Naltrexone
« Reply #10 on: August 20, 2010, 10:55:16 PM »
@nofun, 
is it safe for lostmojo to use 5-HTP instead of SSRI for experiementing a boost up of serotonin level ?
I hope so, because I recently tried it for a couple of months. I thought it would be safer than an SSRI, just because I've never heard of problems associated with it. Just don't mix it with MAOIs, SSRIs, or other antidepressants. (You can mix, but you'd better know a fair amount about neuropsychopharmacology, or talk to someone who does.) I took 200mg per day, 100mg morning and night. Definitely damped down erections and feeling for me. I stopped a couple of weeks ago. Had a slight positive rebound effect, but have gone back to my normal baseline.

In almost all cases, generally increased serotonin levels are believed to dampen sexual response.

But per your question, if you really think you're serotonin deficient, I'd take a trial of 5-htp before an SSRI, and I did. I've always thought I had too much serotonin, not too little, but I've desperately grasped at straws as much as anyone else here.

After a little further reading on testosterone replacement, review of my old HRT trial blood tests, and reading on LDN, I definitely think those are real possibilities. I've already started on HRT, and will bug the doc for LDN when I go in for blood tests.

lostmojo

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Re: Low Dose Naltrexone
« Reply #11 on: August 22, 2010, 06:54:40 AM »
Well I'll give 5-HTP a try, that's the one thing I'm not sure if I've tried as the names of these things blur after trying so many.

DHEA and SAMe and other supposed "mood" enhancers I've definitely had recently and noticed no change. I've been taking 2 St Johns Wort a day for the last 4 weeks and I don't feel any different.

One other little complication with Naltrexone is that it's not on the "subsidized" list in my country, therefore it's quite expensive to buy relative to other medications.

Is 100mg of 5-HTP twice a day what you would suggest NoFun? I really appreciate your input gentlemen, I've been trying so many things over the last 10 years, I'm fresh out of ideas.

NoFun

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Re: Low Dose Naltrexone
« Reply #12 on: August 22, 2010, 04:19:47 PM »
DHEA and SAMe and other supposed "mood" enhancers I've definitely had recently and noticed no change. I've been taking 2 St Johns Wort a day for the last 4 weeks and I don't feel any different.

One other little complication with Naltrexone is that it's not on the "subsidized" list in my country, therefore it's quite expensive to buy relative to other medications.

Is 100mg of 5-HTP twice a day what you would suggest NoFun? I really appreciate your input gentlemen, I've been trying so many things over the last 10 years, I'm fresh out of ideas.
To be clear, DHEA is a hormone that has actions of its own, and is a precursor of other hormones, particularly steroids. That's the HRT route.

I wouldn't mix St. John's Wort with 5-HTP. It was once believed to be a MAOI, but now the theory seems to be that it is more of an SSRI. If it is either, it is potentially dangerous to take with 5-HTP. It also upregulates a number of P450 enzymes which metabolize a lot of drugs, and therefore will limit the effect of other things you do.

So, Wort is potentially dangerous to mix with 5-HTP, and potentially counterproductive to taking other things. Because its believed to have a lot of mechanisms of action, most of which we're not too sure about, I don't think it is good to take while testing the effects of other things.

LDN should be pretty cheap, because it is low dose. One 50mg tablet is all the naltrexone you need for 10 days. The compounding of it probably costs as much as the naltrexone itself, and I've seen various references to a monthly cost of $20-$30/month, with no insurance. It's offpatent, generics are available. Contact a compounding pharmacy in your country and ask if they can make it and for how much. Check out the LDN sites, and yahoo groups, and see what they have to say about availability and cost in your country. Show up on one of those sites and ask. People like to help. Find up what it would cost you before giving up on it because of what you guess the price would be.

The LDN page refers to multiple compounding pharmacies they claim are reliable, including one in Canada and Scotland.
http://www.lowdosenaltrexone.org/index.htm#How_can_I_obtain_LDN

I think you should look into HRT as well. Why did you give up on that? Testosterone is known to effect sexual function, you know you have low testosterone, it is fairly straightforward to supplement, it isn't that expensive, and you can monitor your progess with blood tests to see how you're doing. I'm not just saying that - I'm in the same boat, and doing it myself now.

I think LDN is potentially the better long term route, because it is supposed to stimulate GNRH release centrally, and so is a more systemic way of increasing testosterone, but I wanted to get a topical testosterone to try it directly to my penis, in case a lifetime of starvation of DHT and Testosterone has left penile nerves and muscles atrophied and in need of some building up.

lostmojo

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Re: Low Dose Naltrexone
« Reply #13 on: August 22, 2010, 05:41:34 PM »
I have a unused referral for another blood test. This one asks for the following:
DHEAS; FSH; LH; Oestradiol; Prolactin; SHBG; Testosterone.

I think I'll go and have those tests, some of them haven't been tested before. Anything obvious missing there?

I have ordered these 2 products, here's hoping I get some benefit:
http://cgi.ebay.com/BIOIDENTICAL-TESTOSTERONE-MEN-CREAM-GEL-4-OZ-JAR-/120592789069?pt=LH_DefaultDomain_0
http://cgi.ebay.com/Libido-Edge-Natural-Sexual-Enhancement-180-capsules-NEW-/350256251538?pt=LH_DefaultDomain_0

In relation to trying things to cure a problem that are known to cause that same problem, it's interesting to note that Homeopathy uses that exact principal, mind you it uses minute doses.
« Last Edit: August 22, 2010, 06:15:04 PM by lostmojo »

NoFun

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Re: Low Dose Naltrexone
« Reply #14 on: August 22, 2010, 06:39:27 PM »
I have a unused referral for another blood test. This one asks for the following:
DHEAS; FSH; LH; Oestradiol; Prolactin; SHBG; Testosterone.

I think I'll go and have those tests, some of them haven't been tested before. Anything obvious missing there? I will also buy some testosterone cream and try that.

What do you (NoFun) think of the ingredients in this product Now Foods TestoJack (I have never had Tongkat Ali before but I've had the rest): http://www.nowfoods.com/Products/078289.htm
You need to test for Free Testosterone. It's the most important thing to test. Few people test for it, but I think DHT could be important too. It's really the sexualizing hormone, more than testosterone. My Free T is at the bottom of the normal range, but my DHT is slightly below. Get it if you can. Because nobody tests for it, DHT may be what everyone is overlooking.

I test my PSA (prostate specific antigen) levels too. It's a test for antigens associated with prostate cancer. Those are usually checked before starting hormone replacement, and monitored for any increase while using them. If you let your doctor know you plan on starting testosterone cream, he'll probably go along with it. On the darker side, you should probably have a prostate exam. Not a lot of fun, but we're talking about cancer here, and should be responsible.

Add those, and you've got a good blood test suite for a baseline.

Wow - are you in one of those wonderful countries where you can get testosterone cream over the counter? I'm so jealous. If you can get DHT cream too, think about that.

Do your tests before you start any of the Testosterone or DHT, so you get a baseline.

Testojack, yeah, lots of reasonable things, but I'm down on the herbal mixes, because we've all tried that stuff with varying degrees of effect, and we don't have great science on what exactly those things do, and what the effective dose is, and which brands deliver what dose of the active ingredients. Like the St John's Wort, its nice in the sense that it is over the counter, but it becomes a stab in dark, and complicates testing of other things.

I think it's better to stick with well studied, well regulated stuff, if you can get them. And then keep up the blood testing. If you ever get something to work, then you can see about replacing the standardized stuff with over the counter stuff. I use the NOW brand a lot myself.