When and how much Low Dose Naltrexone LDN (dosage and what time evening or morning?)
Dosage and when to take LDN by Dr. Bihari
According to the Low Dose Naltrexone Homepage, which was created by former colleagues of the late Dr. Bihari, the best time to take LDN is between 9 pm and 3 am.
You will see below that this has become a hotly discussed subject
(and as usual) eventually a consensus may be reached.
This is Dr. Bihari's explanation of why evening dosing
"The reason the hour is important is that 90% of the
endorphins are made in the middle of the night, between 2
and 4 in the morning. If a small dose of naltrexone is taken
in the late evening, generally at bedtime, generally
endorphin production is boosted as much as threefold, 300%.
The naltrexone itself is gone in about 3 hours, but the
endorphins remain elevated all the next day. So the
naltrexone doesn't significantly block the endorphins
but does cause them to rise."
To test the hypothesis that evening dosing is preferable to
daytime dosing, Dr. Skip Lenz, a Florida pharmacist with
many years' experience dispensing LDN and counseling
people taking it, compared the results of two studies, both
of which involved LDN in the treatment of progressive forms
of MS. One study used morning dosing (because participants
complained of sleep issues), and the other used evening
dosing. Based on his comparison, he concluded that morning
dosing was a poor substitute for evening dosing.
I found this useful thread on the LDN forum talking about AM and PM dosing: ''In regard to daytime dosing, of all the clinical trials of LDN conducted with humans, only one used daytime dosing--a German study with a group of MS patients. While about a third of the group did experience limited benefit, this is the comment made about the trial by Dr. David Gluck. Unfortunately, because of some early complaints of sleep disturbance, the principal investigator of this trial switched all of the study group to taking LDN at 9 am in the morning, a questionable dosage time. It is generally recognized that the most effective time to take LDN is at bedtime, between 9 pm and 3 am, due to the fact that the endorphins for each day are always produced at their peak rate in the pre-dawn hours. A 9 am dosage time, as was used in this trial, might conceivably suppress—rather than boost—a patient's immune system.
Low Dose Naltrexone (LDN): The German MS Study
And also note that this study was not conducted to see if LDN would halt any disease progression of any type of MS, the study was way too short for that, 10days. I think it was basically to look at symptom improvement on only 3mg LDN''.
Here is a comment on the day/night LDN dosing by a very credible LDN Pharmacist, Skip Lenz...please read the entire comment as the two cycles he mentions pack different punch levels.
''I really hate to get involved with this question, and the he said,he said
responses. Who is right, Zagon or Bihari, well they both are right. One has to look at the diurnal nature of endorphin secretion to understand HOW they are both right. You get your zenith peak during your normal sleep cycle. You get your penultimate peak during your wake cycle. Taking LDN prior to your zenith peak will give you more bang for your buck than prior to your wake cycle peak.
Therefore you will get some increase taking LDN at times other than prior to bedtime but they will not be the most you can get. Now if you take it indiscriminately temporally, then depending of which peak is next in the cycle, you will get a fraction of the response you would get if taken at an appropriate time frame. This explains why both docs are right, for those taking it in the am, you get the PM peak to skew upwards, those taking the PM dose gets the am peak to skew upwards''.http://ldn.proboards.com/thread/2681
"Links to LDN forums discussing AM or PM dosing."
LDN-day/night dosing controversy/research
Mechanisms involved in beneficial effect of LDN
Changing time zones and LDN timing
Why I do Bihari dosing protocol over Zagon/Gilhooly
Taking LDN AM instead of PM ????
LDN Taken Morning or Night?
People who take LDN in the morning for allergies or depression can take the risk,
but people who use it for cancer, MS and other serious diseases should be careful
not miss the full potential of LDN and follow the Bihari protocol of evening dosing.
Dosage (Amounts) of LDN to be taken.
A lot of discussion has gone in to dosage, and how much
to take for your issue, and sensetivity to medication.
We never even suggest a dosage, we are not doctors, but this is
my experience as a user since 2009 and a supplier since 2012.
Also one must remember that Naltrexone has been deemed non-toxic, and was approved
by the FDA many years ago, in much higher dosages. 4.5mg is only about 5%
of the usual amount prescribed. We take almost a homeopathic dose one could say.
Dr Bihari says in his video (that is highly respected), that he found no effect below 1mg and little effect above 4.5mg.
I have read on forums that some people are very sensitive to medications, so they start at 0.05mg and build up to
say 3mg per day. For Hep C the blanket dosage they put all people
on was 4.5mg per day, taken at 9pm at night.
If people suffer insomnia from the LDN as some do (almost
the only side effect reportred) it is suggested they drop
the dose to say 2mg to 3mg per night, and if it still persists,
taking it in the day time.
Although 4.5mg per night has worked very well for me, after 5 years I have lowered my dosage to 3mg
per day, as that seems to be the perfect average dose for most people.
Here is some very good information and advice in regard
to LDN dosage ...
Side Effects and Dosing of Low Dose Naltrexone (LDN)
By Dudley Delany, R.N., M.A., D.C.
With regards to insomnia a neurologist Dr Turel was interviewed this year about LDN. He touches on the subject of why some people wake up after taking LDN at night and find it difficult to go back to sleep. He prescribes LDN to be taken in the morning as a result. Here’s a link to the interview if you’re interested https://www.youtube.com/watch?v=f2iSWKypWks
-- Jayne C
There are also a LOT of people on this forum who follow a morning dosing protocol because we have found that it works better for us than evening dosing does. When I first started taking LDN in the evening, I did not derive ANY benefits with taking LDN at night. Once I switched to morning dosing, I had numerous health benefits occur within the first week of starting morning dosing of LDN. Yes, I understand that initially Dr. Bihari's recommendation was to take LDN in the evening however, I think that we have seen with the numerous people on this site that have had success with morning dosing that it cannot be dismissed! That doesn't mean I am not going to tell people that they shouldn't try evening dosing but if that doesn't work for them then I will tell them to try morning dosing rather than have them quit LDN all together.
As we all know, the optimal dosage for a person varies and it is the same thing as to what TIME people take their LDN. Some people will find their optimal time is in the evening and some people like me will find that morning dosing is preferable. People respond differently to LDN and need to find what works best for them- both in dosage AND in timing of LDN. It is a shame that this argument continues because it doesn't have to- just agree to disagree. We all know that people take LDN at different times of the day and find success with those times thus proving that taking LDN at different times works for different people. Why disagree about something that has already been proven by numerous people on this forum? I'm pretty sure you're not going to talk any morning dosers out of their morning dosing time when clearly it works for them just as nobody will talk an evening doser out of taking LDN in the evening when it is working fine for them.
The most important thing here is that we need to help people find their optimal dosage and timing of their LDN. We have been lucky enough to find success with LDN, now I think we owe it to others to share our experience with LDN and help guide them to the best health that they can possibly get (or that we can help them get). I personally would like to start the new year off on a good note and try to work WITH each other and concentrate on how we can help people vs going over issues that aren't as relevant anymore.
Stay warm everybody and have a good day!
A question about timing of taking LDN
There is no evidence that night time works any better either. You just have to look at the number of posts in various FB groups and on this forum from PEOPLE who cannot tolerate night time dosing due to lack of sleep and therefore benefit from taking it in the morning.
We cannot dismiss or ignore these patients and even worse, make people feel like second class citizens because they cannot tolerate taking LDN at night. That is unprofessional and just wrong. LDN does not work to a clock as has been suggested when LDN first started being prescribed.
There's been so much ‘promoting’ about LDN based on a ‘boosting immune system and endorphin’ theory that it’s difficult for some who have built up a business on this theory to accept otherwise, even when the science stares at them in the face. For some reason we were all told that endorphins peak between 2-4am. If you can show me a published study proving this I would welcome it. But here's one study with humans showing endorphins peak at 8.25am and OGF (the magic behind LDN) at 5pm.
I agree with you, we have to be careful how we interpret a study and therefore wouldn’t you agree it’s best to share facts and links to studies that have been published in peer review journals rather than a misguided opinion? The German study switched to morning dosing because patients could no longer tolerate lack of sleep but it was a short study and has never been published (just someone’s “interpretation” of it).
If people still want to believe that LDN works best taken at night because of an endorphin boost between 2-4am when there’s no published studies supporting that, that’s fine. But think about this – if you believe taking LDN between 9pm – 2am which time is correct as taking it at 9pm means you have likely cleared your receptors by 1am, but taking it at 2am means your receptors are blocked till roughly 6am. It just doesn’t add up when you give a little bit of thought to it.
And yes I agree, LDN won’t work if not taken right. And this includes losing sleep because of taking it at night.. So I am saying take it when it suits you and for some that’s at 8am, others mid-day, some take it at 6pm, others 10pm - whatever!
-- Jayne C ( http://www.ldnnow.co.uk/ )
Thank you, Brenda, for confirming what I have heard from others on different LDN forums who switched from nighttime to daytime dosing. Usually, when people can't tolerate evening dosing, it's because their dose is too high. Lowering the dose generally solves that problem. I am not saying that daytime dosing doesn't work for some people, but I would first give evening dosing every chance before making the switch. For more information about dosing, visit
All of the studies except one used night dosing. According to the Low Dose Naltrexone Homepage, which was created by former colleagues of the late Dr. Bihari, the best time to take LDN is between 9 pm and 3 am.
This is Dr. Bihari's explanation of why evening dosing is preferable:
"The reason the hour is important is that 90% of the endorphins are made in the middle of the night, between 2 and 4 in the morning. If a small dose of naltrexone is taken in the late evening, generally at bedtime, generally endorphin production is boosted as much as threefold, 300%. The naltrexone itself is gone in about 3 hours, but the endorphins remain elevated all the next day. So the naltrexone doesn't significantly block the endorphins but does cause them to rise."
To test the hypothesis that evening dosing is preferable to daytime dosing, Dr. Skip Lenz, a Florida pharmacist with many years' experience dispensing LDN and counseling people taking it, compared the results of two studies, both of which involved LDN in the treatment of progressive forms of MS. One study used morning dosing (because participants complained of sleep issues), and the other used evening dosing. Based on his comparison, he concluded that morning dosing was a poor substitute for evening dosing.
I personally know of people who have switched from night to daytime dosing and have regressed.
If you are still having sleep issues at this point in time, I suggest reducing your dose to 3 mg.
For more information about LDN dosing, including an indepth discussion of evening vs daytime dosing, visit http://tinyurl.com/ldn-side-effects-and-dosing
-- Dudley Delany