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The Interplay between Low Dose Naltrexone and Hashimoto’s Thyroiditis - M

The Interplay between Low Dose Naltrexone and Hashimoto’s Thyroiditis

Reviewed by Michael Hua, Pharm D
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Hypothyroidism: Causes and Effects

Hashimoto’s thyroiditis and hypothyroidism, in general, have been viewed in conventional medicine as an easy and straightforward treatment. However, having worked at Harbor Compounding Pharmacy and helping many patients and prescribers nationwide to dose, monitor, and find the right treatment for hypothyroidism, we know that this disease is far more complicated and multifaceted than meets the thyroid.

What usually ends up happening when a patient goes to her primary care provider (PCP) with chief complaints of symptoms of low thyroid hormones, such as depression, weight gain, insulin resistance, fibromyalgia, chronic fatigue, irritability, dry hair, and constipation, is that her PCP will treat these conditions each separately by prescribing a multitude of medications. Traditional medical doctors will not typically initiate thyroid replacement until TSH levels reach around 5-10. Furthermore, studies have shown that TSH is an insufficient and inconclusive measurement of poor thyroid function.

Hashimoto’s thyroiditis is the most common cause of hypothyroidism due to dysfunction of the autoimmune system leading to chronic inflammation and destruction of the thyroid gland. Interestingly, there are also many other patients whose thyroid blood tests display normal ranges but experience the same Hashimoto’s hypothyroid symptoms. These patients exhibit what is called “cellular or peripheral hypothyroidism”. In cellular hypothyroidism, although the pituitary is working sufficiently to convert T4 into active T3 (thereby showing normal thyroid ranges), there is deficiency in mitochondrial energy that is required to transport these active T3 into cellular tissues. In addition, an enzyme called Deiodinase Type 3 found in cellular tissues is furthermore converting T4 into inactive Reverse T3. Therefore, standard thyroid blood levels are not indicative of thyroid function due to impaired cellular thyroid transport.

Thyroid hormones are important because they regulate metabolism, cardiovascular health, digestive function, muscle control, brain development, mood, and bone maintenance. Therefore, it is crucial to have sufficient levels of active T3 in not only the thyroid but all systems in our body to maintain optimal homeostasis.

Hashimoto’s and cellular hypothyroidism are both exacerbated by the following:

  • Physical and psychological stress; depression
  • Chronic infection
  • Cancer
  • Obesity and weight gain
  • Diabetes
  • Leptin resistance
  • Chronic fatigue
  • Fibromyalgia
  • Inflammation
  • Autoimmune disease
    (Lupus, Hashimoto’s, Multiple Sclerosis, Arthritis)
  • Exposure to toxins and plastics

As discussed, the symptomatic result of Hashimoto’s is congruent with effects of cellular hypothyroidism, in which these patients with decreased levels of T3 will exhibit:

  • Fatigue
  • Low mood
  • Heart disease
  • Muscle weakness and pain
  • Constipation
  • Dry skin
  • Hair loss or thinning
  • Poor concentration
  • Weight gain
  • Fertility issues
  • Menstrual irregularities

How Low Dose Naltrexone Plays a Role in Treating Hypothyroidism

For many years, low dose naltrexone (LDN) has been used in adjunct with thyroid replacement therapy in patients with Hashimoto’s. Health care professionals are now gaining more knowledge into how LDN can provide synergistic relief in not only Hashimoto patients but all patients with hypothyroidism symptoms. The reason for adding LDN to thyroid regimen is quite simple: LDN has anti-inflammatory properties which can negate the potential root causes mentioned above (i.e. emotional stress, diabetes, toxins, obesity, etc.) and increased endorphin function may help in modulating the immune system. By decreasing inflammatory cytokine concentration, reducing interleukin activity, and lowering IFN-a and TGF-a (inflammatory markers), it is thought that LDN could improve thyroid function both in the pituitary and out in the periphery cells. These physiological mechanisms have been shown to further improve T4 conversion into Active T3. Moreover, LDN has been shown to inhibit cells that cause the autoimmunity process.

LDN is normally taken orally with starting dose of 0.5mg once daily at night and is titrated up every week to the optimal dose of 4.5mg or 6mg, depending on the individual. Results can be seen very rapidly even in the first week so patients are to monitor for signs and symptoms of hyperthyroidism, such as increased and/or irregular heart rate, sweating, and irritability. When a patient is at her optimal LDN dose, lab results will begin to manifest with decreased thyroid markers (i.e. TSH, T4, T3, and TPO levels). As the patient start to feel better and thyroid markers begin to decrease, thyroid replacement medications will need to be adjusted, as well. A significant amount of patients have seen major benefits of LDN on their thyroid function and quality of life:

a number of different types of blood types

LDN and the Holistic Approach

Although LDN can be viewed as a miracle drug by those who have benefited from it, as health care professionals at Harbor Compounding Pharmacy, we understand that medications rarely work to its maximum potential when taken alone. Hypothyroidism, like many other diseases, is a condition that requires a holistic approach in which diet and lifestyle changes need to be prioritized. Since thyroid hormones facilitate metabolism, patients with hypothyroidism tend to have low metabolism and burn less calories. Research shows that hypothyroid patients will largely benefit with moderate to high intensity aerobic exercise to lose weight, decrease health risks (such as heart disease), and even increase thyroid hormone levels. Also, diets which include high protein will boost metabolism.

In order to rebalance the immune system, consuming a diet that improves gut health is crucial to the process. Health care providers believe that LDN works best when used synergistically with a “leaky gut” diet to further decrease inflammation and positively stimulate the immune response. It is proposed that the “leaky gut” diet will help prevent harmful toxins, bacteria, and undigested food particles from permeation into the bloodstream. Talk to our LDN specialist at Harbor Compounding Pharmacy to learn more about the “leaky gut” diet.


At Harbor Compounding Pharmacy, we strongly believe that supplements can add a profound range of health benefits. Studies show that LDN increases rate of remission when combined with Vitamin D and probiotic intake. Most health care practitioners prescribe LDN together with at least 1,000 IU of Vitamin D taken once daily. Vitamin D has been shown to help mood disorders such as depression, resistance in breast and prostate cancers, autoimmune diseases such as multiple sclerosis, Type I Diabetes, reducing inflammation to improve cardiovascular health, and is important for neuromuscular and immune function. Request a bottle of Vitamin D3 and Probiotic today at Harbor Compounding Pharmacy. We have done our due diligence to find the best brand of supplements on the market for you.

To find out more about Low Dose Naltrexone, check out our other blogs:

Discovery of Low Dose Naltrexone

An Introduction to Low Dose Naltrexone

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  1. Holtorf, Kent M.D. (2019) ‘Hashimoto’s Thyroiditis’ [PowerPoint presentation at LDN Conference 2019]. Available at:
  2. Jones, Carrie (2019) ‘LDN and Cellular Hypothyroidism: Why you can’t convert T4 into T3’ [PowerPoint presentation at LDN Conference 2019]. Available at:
  3. Low Dose Naltrexone and Hashimoto’s [Web post]. Retrieved June 7, 2019, from
  4. The Leaky Gut Diet Plan: What to Eat, What to Avoid [Web post]. Retrieved June 7, 2019, from
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