MS, Lupus, LDN, and the Hormone Connection

Multiple Sclerosis, Lupus, Low-Dose Naltrexone, and the Hormone Connection

Written by Carol Petersen, RPh, CNP – Women’s International Pharmacy

Nerve cells are affected by autoimmune diseases such as MS.

According to the American Autoimmune Related Diseases Association (AARDA) about 50 million Americans have an autoimmune disease and 75% of Americans with autoimmune disease are women. Multiple sclerosis (MS) and lupus are the most common of the more than 100 different autoimmune diseases.[i] Research suggests that low-dose naltrexone (LDN)—and its potential effects on hormone imbalance—may prove a positive treatment option for these diseases.

Multiple Sclerosis and Lupus

Multiple sclerosis is an autoimmune disease that affects the central nervous system. The immune system attacks the myelin sheath, the insulating layer of cells that surround and protect the nerve cells. A healthy myelin sheath allows electrical impulses to transmit quickly and efficiently along the nerve cells. When the myelin sheath is damaged, the nerve cells are left exposed and inflamed and plaques begin to form along the central nervous system. The inflammation and plaques can slow or disrupt the electrical impulses moving between the brain and the rest of the body which may cause symptoms such as numbness, weakness, tingling, dizziness, fatigue, pain, vision disturbances, difficulty walking, slurred speech and difficulties with bladder and bowel function.[ii]

Lupus is an autoimmune disease that targets the body’s tissues and organ systems including the skin, joints, cardiovascular system, brain, and kidneys. There are several types of lupus and one type may be induced by medications such as blood pressure medications, antibiotics and anticonvulsants.[iii] Because tissue damage can occur anywhere in the body, lupus can be difficult to diagnose.

While the causes for MS and lupus are unknown, environmental factors may be an instigator in susceptible people. Environmental factors that may instigate MS or lupus include:

  • Nutritional deficiencies (possibly caused by poor food quality)
  • Pathogens and distortion of the gut microbiome
  • Disturbed sleep or sleep deprivation
  • Chemical exposures
  • Hormone imbalances
  • Gluten sensitivity
  • Emotional or physical stress.
  • Vitamin D deficiency (MS)
  • Smoking (MS)
  • Epstein Barr infection (MS)


Low-Dose Naltrexone

Low-dose naltrexone (LDN) has emerged as particularly effective in treating autoimmune diseases that involve impaired gastrointestinal function. Crohn’s disease, irritable bowel syndrome, and ulcerative colitis have responded, sometimes dramatically, to LDN treatment.[iv] Autoimmune disorders such as MS and lupus may also be associated with gut disturbances. Recent research on MS has found a connection with the gut microbiome, providing a reason to consider low-dose naltrexone as part of a treatment plan.[v]

Naltrexone was originally developed as a drug to block opioid receptors. These receptors are meant to be activated by hormones produced by the body called endorphins and enkephalins, which can relieve pain and contribute to wellbeing. However, these receptors can also be stimulated by opium-derived drugs called opioids. The developers of naltrexone reasoned that when opioid receptors were blocked, there would be no need to use or abuse opioid drugs. While a logical theory, in actual practice they had little success.

Low doses of naltrexone act by temporarily blocking opioid receptors. The body responds by producing increased amounts of endorphins and enkephalins. The opioid receptors also increase in sensitivity and in number.

Naltrexone is commercially available in a 380mg injection and 50mg tablets to be used as part of a treatment program for alcohol or opioid dependence. It is also added as an abuse deterrent to opioid medications and available in combination with an antidepressant for weight loss. LDN, however, is currently only available from compounding pharmacies.

The use of very small doses of naltrexone was pioneered by Dr. Bernard Bihari. He first demonstrated the effectiveness of LDN in the treatment of patients with AIDS. He established that endorphin levels were low in patients with AIDS and LDN treatment provided substantial increases in these levels. LDN treatment not only improved these patients’ quality of life, but also reduced the rate at which they died.

LDN has since been shown in studies to have multiple health benefits. LDN appears to improve the body’s response to infection with an immunomodulatory effect, resulting in patients having fewer and less frequent infections. LDN also can help the body eliminate and manage toxic exposures by improving glutathione levels, which aids in detoxification and decreases oxidative damage, making it easier to clear the body of toxins. Oxidative stress has been implicated as a triggering factor of both MS and lupus due to loss of antioxidant/oxidant balance.[iv] LDN may help to repair the linings of the gut and brain barriers that prevent absorption of foreign substances, thus healing issues caused by a damaged microbiome. Additionally, LDN may balance stress hormones and also relieve anxiety and depression by improving brain neurotransmitter function.


Dr. Deanna Windham, a contributor to The LDN Book,[iv] explored treating patients with MS and lupus with LDN. While it is not the only treatment option she uses for MS and lupus, Dr. Windham does not hesitate to use LDN because of the many benefits she has seen it provide. She cautions that full benefit may not be achieved for 12 to 18 months, so patience and commitment is essential. Dr. Windham individualizes treatment to each patient’s needs by taking a holistic approach.

  • Address diet by eliminating gluten, sugar, saturated fats, and non-foods, and add nutrient supplements
  • Help patients with detoxification of metals and solvents
  • Assist patients in smoking cessation
  • Help patients with sleep problems
  • Test hormone levels, and treat deficiencies with bioidentical hormones
The Hormone Connection

So, how are MS, lupus, and LDN connected to hormones?

High levels of estrogen relative to progesterone, or exposures to estrogen-like chemicals, may be linked to the development of autoimmune disease. In addition, high estrogen levels in men with MS correlate with more brain damage.iv However, research has shown that one specific estrogen, estriol, can have an anti-inflammatory effect in MS. Women’s International Pharmacy provided the estriol capsules used in this landmark study.[v]

Adrenal and thyroid function may also play a role in autoimmune disease. Individuals with autoimmune disease commonly experience low levels of adrenal hormones, specifically cortisol and DHEA. In fact, DHEA has reached clinical trials for FDA-approval for the treatment of lupus. Treating even subclinical thyroid deficiencies can help fatigue, brain fog, memory and sleep. Additionally, increased endorphins stimulated by LDN may even help with hormone balance.[iv]


Seeing the benefits of using LDN has directed research into studying previously unknown connections between the immune and endocrine systems. According to Dr. Windham’s experience, the key to treating MS and lupus may be using LDN in conjunction with diet, addressing other health concerns, and a healthy balance of hormones.

MS, Lupus, LDN, and the Hormone Connection2018-04-09T13:55:26-05:00

Hormones on Our Minds and Nerves

Hormones on Our Minds and Nerves

Written by Carol Petersen, RPh, CNP – Women’s International Pharmacy

George Orwell’s novel 1984 predicted a society with language controls and “double speak.” It astonishes me how accurate these predictions have been in the field of medicine, as evidenced by the fact that various medical establishments meet regularly to decide how their members ought to think about issues such as hormones.

Some say that, without sufficient evidence to the contrary, all estrogens are alike and all progesterone/progestins are alike. Even basic science courses, going back decades, teach that very small differences in shape and size between molecules can have significant differences in their effects on the body. Recently, the KEEPS study opened the door to the idea that perhaps all estrogens are NOT alike. (See KEEPS Study for more info.)

One of the most enduring (and preposterous) pronouncements has been that women without a uterus do not need progesterone. The idea is that the hormone progesterone has a single function, which is to slough off accumulated tissue in the uterus and in doing so, preventing uterine cancer, and that it has no other effects on the body. In a perverse way, this pronouncement has saved numerous women from the effects of progestins (altered progesterone molecules) such as medroxyprogesterone, which was linked in the Women’s Health Initiative Study with an increase in breast cancer risk.

This type of limited thinking perseveres, potentially leading to serious deficits in medical care. Over 40 years ago, Dr. Katharina Dalton wrote that women without a uterus most likely had surgery to remove their uterus because of a long-standing deficit of progesterone, and actually needed much more progesterone than women reaching a natural menopause.

One area of research that is currently opening minds to the potential of hormones focuses on “neurosteroids,” which are hormones produced by nerve cells in the brain, spinal cord and peripheral nervous system, independently of hormone production elsewhere in the body. In essence, this research indicates that the “sex” hormones we commonly identify as being produced by the ovaries, testes, and adrenal glands (such as the estrogens, progesterone and its derivatives, DHEA, testosterone, pregnenolone, and others) are so important to neural function that they are also independently produced by neural tissue.

The neural tissue responds to the hormones circulating in the blood stream and to the neurosteroids (i.e., the hormones produced locally by the nerves themselves). The local neurosteroid production allows for higher concentrations of hormones when and where they are needed, and these concentrations can be 20 to 50 times the level circulating in the blood stream. Different areas of the brain, or different nerve cells, may produce or concentrate different hormones. Some hormones may also trigger opposing activities, depending on their concentrations.

The interplay of neurosteroids is extremely complicated, and the science is just getting started. What is equally exciting is that our minds are being opened to the possibilities that the so-called “sex” hormones might now also prove useful for treating neurodegenerative diseases!

Steroidal hormones are believed to help heal damaged neural tissue. For example, in the disease ALS (amyotrophic lateral sclerosis), it has been hypothesized that motor neurons may be affected by a deficiency of receptors for testosterone. Estrogens can make it worse by causing neuronal excitement. Progesterone may help repair the neurons by repairing the myelin sheath that protects them. Notably, patients with ALS typically have low progesterone levels.

With Alzheimer’s disease, changes occur in brain cells that can be linked to hormone levels, according to Dr. Ray Peat. Of prime importance is the ability of the mitochondria (i.e., the part of a cell responsible for energy production) to use oxygen. The enzyme needed for oxygen uptake is dependent upon sufficient thyroid hormones, and antagonized by the presence of estrogen, iron and toxins. A low progesterone level, relative to estrogen, results in increased levels of LH and FSH (pituitary hormones associated with menopause, when elevated). Both LH and FSH are themselves very inflammatory, and may be balanced by DHEA and testosterone, and even more so by progesterone.

Dr. Dalton found that progesterone helped women eliminate premenstrual epileptic seizures. Neurosteroid scientists have demonstrated the effectiveness of both progesterone and its metabolite allopregnanolone in preventing convulsions.

As this research continues, we may discover that vision and hearing could be improved by ensuring the healthy functioning of the nerves involved. Cognition, memory, and mood may be improved with a healthy nervous system. Mental diseases, such as schizophrenia, may be curtailed with neurosteroid hormones. And we may find that one of the brightest neurosteroid stars, progesterone, is not just for the uterus.

  • Dalton K. Once a Month: Understanding and Treating PMS. Hunter House Inc.; Alameda, CA; 1999.
  • Peat R. Demystifying Dementia, Protective Progesterone. Ray Peat’s Newsletter, Jan 2013.
  • King SR. Neurosteroids and the Nervous System. SpringerBriefs in Neuroscience; Springer Science+Business Media; New York, NY; 2013.
  • Baulieu E, Schumacher M. Progesterone as a neuroactive neurosteroid with special reference to the effect of progesterone on myelination. Steroids; 65 (2000) 605-612.
  • Schumacher M, et al. Novel Perspectives for Progesterone in Hormone Replacement Therapy with Special Reference to the Nervous System. Endocrine Reviews; 28 (4) 387-439; 2007.
Hormones on Our Minds and Nerves2017-12-14T12:54:27-05:00

Medications and Thyroid Function

Medications and Thyroid Function

Written by Kathy Lynch, PharmD – Women’s International Pharmacy


Many medications can have a negative impact on thyroid function. For example, thyroid dysfunction often accompanies the debilitating brain and muscle side effects that have occurred in women who have received the hormone-suppressing drug Lupron or the HPV vaccine Gardasil.

These side effects are unusually similar to the inflammatory symptoms that accompany multiple sclerosis (MS). Years of animal research have demonstrated an improvement in MS symptoms after triiodothyronine (T3) administration. T3 seems to put the brakes on damage to the nerve sheath and actually promotes healing of the nerve.

People with inflammatory nerve conditions, who are also experiencing hypothyroid symptoms, may benefit from taking T3. Levothyroxine (T4) alone may not be enough, as studies have shown that critically ill patients with low thyroid function do not benefit from taking just T4.

  • Marrs C. Thyroid Dysfunction with Medication or Vaccine Induced Demyelinating Diseases. Hormones Matter. October 26, 2015.
  • Sutton I, et al. CNS demyelination and quadrivalent HPV vaccination. Mult Scler. 2009 Jan;15(1):116-119. Epub 2008 Sep 19.
  • D’Intino G, et al. Triiodothyronine administration ameliorates the demyelination/remyelination ratio in a non-human primate model of multiple sclerosis by correcting  tissue  hypothyroidism. J Neuroendocrinol. 2011 Sep;23(9):778-790.
  • Economidou F, et al. Thyroid function during critical illness. Hormones. 2011;10(2):117-124.
Medications and Thyroid Function2018-04-04T15:39:34-05:00

Treating Multiple Sclerosis with Sex Hormones

Treating Multiple Sclerosis with Sex Hormones

Written by Kathy Lynch, PharmD – Women’s International Pharmacy


Multiple sclerosis (MS) is an autoimmune disorder characterized by inflammation and nervous system degeneration. Both estrogen and testosterone exhibit anti-inflammatory and neuro-protective effects when administered to MS patients in studies.

Male MS patients were treated with 100 mg of transdermal testosterone daily. At the end of the twelve month treatment period, cognitive performance improved while brain atrophy diminished. When female MS patients were treated with 8 mg of oral estriol daily for six months, evidence of lesions on MRIs decreased while brain function increased.

In addition, female MS patients are often plagued with chronic urinary tract infections (UTIs). Intravaginal estriol significantly decreases UTIs in postmenopausal women.

Further studies regarding hormones in the treatment of MS are ongoing.

  • Gold SM, Voskuhl RR. Estrogen and Testosterone Therapies in Multiple Sclerosis. Prog Brain Res. 2009; 175:239-251.
  • Raz R, Stamm WE. A Controlled Trial of Intravaginal Estriol in Postmenopausal Women with Recurrent Urinary Tract Infections. N Engl J Med. 329(11):753-756.
Treating Multiple Sclerosis with Sex Hormones2018-04-05T10:58:22-05:00