LDN Dose Timing
News February 23rd. 2009, 2:03pmThere has been much discussion recently on LDN fora about the correct timing for LDN dosing. In my experience of treating patients over the past five years, the timing of the LDN dose not affect it action and as such is down to individual preference. In treating chronic fatigue syndrome we always advise a morning dosing as these patients tend to have very poor sleep. In MS I tell the patient to vary the time to suit their needs and sleep requirements. There has been no obvious difference in response to the drug with these varying times but the preference is now usually for day time dosing.
Dr Tom, I see what you say above, but what about cancer patients, more work needs done in this area for the ultimate time for them to take LDN.
Celia
Surely then this discounts the current theory of how it works, as Endorphin release is mainly at night??
LDN has more than one action, we know about the endorphin theory which Dr Zagon has documented. Interestingly he does not feel night time administration is required to have this effect and in my clinic over the past five years I have many patients who have derived great benefit from LDN but take their dose in the morning. The other theory is that LDN reduces peroxynitrite production which in many ways makes more sense in autoimmune disease. We need to do more work to tease this out but it could be that both actions are important as increased endorphins will reduce nitric oxide production which in turn reduces peroxynitrites. We also suspect that LDN reduced superoxide production and are seeking to show this in a study.
Tom Gilhooly
so if you have insomnia from the LDN if taking it at night (for MS) - its ok to take it during the day?
dear dr Tom,i’m Emiliano from italy,using ldn since last sect.07 for sp ms.i’m also the web master of the italian ldn website(www.ldnitalia.org).i have read a lot about ldn and dr bihari before i decided to try it and any documents wrtten by dr bihari clearly informs to take ldn every day before going to bed after 9 pm and not over 03.00 am.it should be a very good new if someone can take it in the mornig,considering that sleep disurbance is the main side effect of ldn.
my best regards
emiliano
Emiliano,
I have used LDN for the past five years now and have noticed no difference in dosing in the morning or at night. It is an individual choice and interestingly Prof Ian Zagon from Penn State University who published on LDN before Dr Bihari, is of the same opinion. I actually encourage day time use to minimise the impact on sleep and the response is very good.
Regards
Dr Tom Gilhooly
I seem to take my LDN when I remember at any time of day and it just works in the most amazing way. It is just amazing.
I attend Dr Rachael Thomas at the Southern General hospital. I wasn’t diagnosed until just over three years ago, although I have had symptoms from my early twenties. I am 47. I have tried the usual assortment of drugs available i.e. gabapentine and amitryptiline and have had no success, in fact they have tended to make my symptoms worse. I am trying to stay away from steroid type drugs for as long as possible.
I would love to try LDN as I feel I have no other way to go. Can you recommend the best way for me to persuade my GP or neurologist to let me try it? Can you prescribe it? Sorry, had to ask.
My main area of disability is my legs, I have a lot of pain and feel like I’ve just run the London marathon for most of my day, which tires me easily. I really do need some sort of help as I am caring for my disabled son at the moment (age 20) and he is far too much for me. Any information I could get would be of great help to me.
Sorry to post again. I should have added that I have factor 5 lyden deficiency too. A recent dropped foot caused me to have a large thrombosis in my groin. I am on warfirin. Will LDN affect this? I am desperate for some sort of help as DVT’s are not fun at all and my being unable to regularly exercise leaves me vulnerable.
Dear Dr. Tom, I just happened upon this site and very interested in the dosing as I have been on LDN for nearly 2 months now for MS, Fibromyalgia, etc. I am improving but have to travel next month and will have a 3 hour time change. How then do I take my LDN? I presently take it at night around 10:00PM but will be arriving at my destination at 11:30PM (8:30PM my time). Does it make a difference if I take it when I arrive and then for the next two weeks take it at 10:00PM? I am feeling so well, I do not want to do something that will make me feel poorly again.
Thank you. Alana
Alana,
don’t worry too much about the time difference. I have found no difference in the clinical response in my clinic with different timings of dose and Prof Ian Zagon who first published on LDN 28 years ago, agrees.
Have a good trip.
Dr Tom Gilhooly
LDN should not interfere with either Leiden V or Warfarin and would be a great idea for anyone with MS. The best tack with your doctors is just to ask, you will find about 20% will agree. The arguement is that this is non toxic, there is some published evidence and not treating is definately detrimental . I can only prescribe LDN to those I have seen personally so you would have to come to Glasgow and have a consultation if you cannot get any luck with your current physicians.
Dr Tom Gilhooly
Am on Rebif for MS, diagnosed a year ago, wanted to know if I can take LDN with Rebif, if so, what’s the dosage? Also who will prescribe it ?
I have been on LDN for 7 years for my MS. I went to see Dr.Bihari and he specifically said it should be taken between 9pm and 3am . He tried to explain it has to do with rotation of the earth or something scientific like that. I was so overwhelmed with info after 2 1/2 hrs with him , I did not recall the explanation. After the NY LDN Conference and hearing the German Clinical Study results, I called Dr. B and asked him if I can try Morning dosing. He agreed and after a week I had to stop. I was stiff as a board the every day, for the week. I returned to the evening dose.After 7 yrs on the evening dose without much progression….I am staying on the night shift. There had to be a good reason Dr. B believed this.
Dear Dr. Tom,
I am starting LDN for fatigue associated with Hep C 1a. This is day 5, I’ve had no sleep problems..just morning tiredness. Can you tell me how long it has taken for people to experience the feeling of fatigue to pass? I’d also like to be an example for people with Hep C and LDN.
I have severe fibromyalgia and take 100 mg of Tramadol a day and often have to take Oxycodone because the pain is so severe. How will LDN effect my usage of these drugs?
Thanks,
Connie
I plan to ask my doctor for a prescription for LDN. Is there a standard dose? What should I ask her to write?
I have stage 1 Breast Cancer w/HER2 Neu positive, a spinal cord injury, and RLS (Restless Leg Syndrome). I have refused Chemo, radiation and all drugs. I take 3 mg Requip for RLS and Darvocet N-100. I am hoping LDN will help my RLS, also.
My daughter has lyme’s. For years she showed a neg. to test. She was positive on last test. Very sick. We are waiting to try LDN but she has to get off oxycodine. What have you heard if any on LDN and lyme’s…. has worked? What about antibiotics and side effects with LDN any? Thanks so much
Dr Tom Gilhooly,
What dose have you used in the past for Alopecia Universal? My son is going to the top doctor here in Colorado for Aopecia and I would like to bring this info to him.
Currently he is on Predisone but they are reducing his dose to take him off.he was then going to put him on some other canser drug. But if LDN has few effects i would rather try it.
He also is on throid medicine for Hypothroidism.
What can take with LDN?
How long will he have to use this drug?
Do you know of any docs in Colorado who use LDN and treat auto immune diseases.
Dear Dr Gilhooly,
Been suffering from psoriasis for 33yrs never been clear although sometimes gets a lot better but still there and then like know flares up. The problem areas I have is on my arms and hands which as I’m sure you know is very distressing as it cant be hidden. I also have it on my legs and a little on my body. Tried everything, take probiotic powder and essential oil capsules everyday and use pure salt crystals in my bath and the normal ointments eumovate and dovernex.
Just recently heard about LDN and that it can help psoriasis the problem is how do i get help on who to contact with regard to a doctor who knows about and perscribes LDN.
I would be so very greatful for any help you can give and will understand if this is not the way you conduct things.
I live in Northampton England so just a bit to far away from yourself in Glasgow.
Yours sincerely
Tina
Good to know about the timing. A question, if I may: any interaction concerns between LDN and the following drugs? Levetiracetam (Keppra), Plavix, Omeprazole, Levothyroxine NA, Lisinopril, Zoloft, Potassium Chloride, Terazosin HCL?
My 84-year-old dad is taking all of the above and has multiple conditions, mostly stemming from a stroke in 2000 and a cerebral hemorrhage in 2001. He has balance issues, walking issues, severe sleep apnea, severe lumber stenosis, basil cell and squamous carcinoma. Local docs and Chicago docs disagree as to whether also Parkinsons (Normally no visible tremors and both Sinemet and Mirapex had adverse affects on his walking and were discontinued.) In spite of all his conditions, he’s in fairly good health but the walking and incontience is becoming greater. Says he feels like he’s going to fall over all the time so he doesnt want to walk much. Specialists say balance issue is probably a combination of factors, the greatest being the stenosis/neuropathy and the brain injury. He’s desperate to improve his balance and improve his walking. Trying CPAP soon for endurance, but that wont help balance. He heard about LDN from another patient and got excited.
(Any thoughts on the above you might wish to offer greatly appreciated.)
I am so glad to hear that LDN can be taken during the day as my wife is having a very difficult time with sleeping on the low dose she is taking for Lung Ca. She is also having some hyper activity where she can’t sit or lay still for more than a few minutes before she has to get up and walk around. This cycle goes on all day. Is this also a side effect to LDN?
Dear Dr. Tom My wife has RA, MS, Fibromyalgia, Hashimoto’s disease (Not on meds as of yet) and had Breast Cancer over five years ago! Her MS has been quite for now, but her RA and Fibromyalgia have been active. I think she would be a good candidate for LDN. How should I approach her doctor’s and what references should I use?
Is there a link where one may obtain LDN without a prescription? I would like to hear anyone’s experiences with purchasing LDN through those channels.
Thank you.
DEAR DR.GILHOOLY,
I AM RETIRED GP.RETIRED AFTER 47 YRS.AGE 74. I HAVE BEEN DIAGNOSED AS CIPD BY DR.MARK ROBERTS OF SALFORD ROYAL HOSPITAL,MANCHESTER.
I AM VERY IIMPRESSED BY LDN AND HAVE DISCUSSED WITH DR. ROBERTS. AS IT IS NOT LICENCED, I AM HAVING TO EITHER TRY INTERNET OR BUY IT FROM USA,
I HAVE HAD USUAL INITIAL TREATMENTS AND HAVE COME OFF STEROIDS RECENTLY. MY MAIN SYMPTOM IS FATIGUE.I WONDER IF YOU FEEL LDN WILL WORK ON CIPD.I AND MY NEUROLOGIST ARE VERY INTERESTED. I HAVE TO REPORT TO DR.ROBERTS IN SIX MONTHS.
ALSO I WOULD ATTEND THE CONFERENCE NEST YEAR.
COULD YOU RECOMMED LDN FOR CIPD.IF SO IS IT SAFE TO USE INTERNET TO BUY IT.
SORRY I AM UNABLE TO TRAVEL TO SEE YOU AS I FIND IT IMPOSSIBLE DUE TO FATIGUE. YOURS SINCERELY DR.YAHYA KHAN
I have just started taking LDN for Psoriasis, Fibromyalgia and Arthritis in the neck. My neck seems better already after two nights, I doubt that, but it does. I am sleeping differently. I normally take 1/4th of a 1 mg. klonipan (like valium) for leg muscle cramps, but I didn’t know if I could take it along with the LDN. I am not sleeping as soundly, but very relaxed and feel rested when I do get up. Now I am thinking if I have been taking it at night and decide I want to switch to day time, should I just skip one day. Like I took it last night and instead of taking it again during today, just wait and take it in the next morning. I hope I am making sense.
Dear Dr. Gilhooly,
I have been taking 1 mg. of LDN (for Crohn’s Disaese) for only one week and find I am very very nervous and dizzy. I am also on 13 mgs of prednisolone, which i have been on for 5 years and have been unable to come off as well as Fioricet (from USA - I am American but live in Cumbria -
for migraine headaches.
My concern is drug interaction and will be able to tolerate LDN?
I wonder if i should start with .5 mg for awhile untl stable but am concerned as i am suppose to travel to see my famly a week from Monday…can you advise please?
Sincerely, Rebecca
Dear Dr. Tom,
I have had MS for 20 years and have had 2 attacks in the last year, making it possible to go on the IMD Drugs for MS. Guess what, I am not excited, as my MS is around longer than these crummy, expensive drugs. I would like to try the LDN Drug, and since I live in Edmonton, Alberta, Canada, I was wondering how to go about getting the drug prescribed and made. I look forward to being your new advocate in Edmonton, one of the cities hit the hardest by MS throughout the world.
Dear Dr Tom
I was diagnosed with MS in April this year and at present my symptoms are fairly mild I am taking Gabapentin but I am trying to get my GP To Prescribe LDN to me as soon as possible. If this fails do you know of any GP’s who prescribe LND in Surrey, if not I would like to see you in Glasgow.
I am really keen to get involved with getting the message across on LDN not sure how though?
Many thanks
I want to have a 3mg capsule made up of LDN with the appropriate fillers - how do I find a pharmacist that will do this for a reasonable price.
Would you please forward this email to Dagmar Lofts in Canada. You may also give him my email address.
Dagmar,
People in northern latitudes suffer much more from MS than people closer to the equator. Scotland has one of the highest rates of MS in the world. One explanation is low levels of vitamin D, because of lack of sun exposure.
Here is a link you can use to get more information.
The video portion is one hour long, but the written portion summarizes everything in the video and can be read in 5 minutes.
http://articles.mercola.com/sites/articles/archive/2008/12/16/my-one-hour-vitamin-d-lecture-to-clear-up-all-your-confusion-on-this-vital-nutrient.aspx
Here are some compounding pharmacies in Canada. You can call one pharmacy and they should be able to give you the name of a doctor who would prescribe LDN for you.
Clinic Pharmacy Oshawa, Ontario, Canada (905) 576-9090
Smith’s Pharmacy, Toronto, Ontario, Canada (800) 361-6624
Canadian Apothecary, London, Ontario, Canada (519) 439-4100
The Medicine Shoppe, Toronto, Ontario (416) 239-3566
Taking vitamin D is something you can start immediately, because no prescription is required. I would recommend 4,000 IU per day in a gel cap.
Hope this helps,
Joseph Gustafson