Matt Kelly discusses low-dose naltrexone treatment, arguing that pushing higher doses can backfire. He recommends stopping escalation when a patient starts to worsen, then addressing underlying issues like vitamin D deficiency or infections that might later allow gradual increases.
The important thing I see clinically, and that I, when I get feedback from clinicians who are also doing a lot of low-dose naltrexone, is it's okay to stop and not continue escalating at whatever dose is tolerated, because the overall thing that we want to target with low-dose naltrexone is some low-dose naltrexone at a dose that's tolerated by the patient is better for the case as the case moves forward than trying to force them to a dose where they're aggravating. And what you often see with those cases, especially if you go back and, you know, look at is vitamin D appropriate and are there any infections we don't know about and the hormone things and all of that, if you go back and do that, oftentimes the more that the case is handled in the chronic areas that we talked about, then often you'll see that they can break through and go to a little bit higher dose. So, Let's say you topped out at 1 milligram before they aggravated, it's perfectly fine to leave them there, but then maybe a few months later as things are improving, try to escalate again.
