Abstract
BackgroundLow dose naltrexone (LDN) is reported to have beneficial effects in several autoimmune diseases. The purpose of this study was to examine whether starting LDN was followed by changes in the dispensing of thyroid hormones to patients with hypothyroidism.MethodsWe performed a quasi-experimental before-after study based on the Norwegian Prescription Database. Study participants were identified by using reimbursement codes for hypothyroidism. Cumulative dispensed Defined Daily Doses and the number of users of triiodothyronine (T3) and levothyroxine (LT4) 1 year before and after the first LDN prescription was compared in three groups based on LDN exposure.ResultsWe identified 898 patients that met the inclusion criteria. There was no association between starting LDN and the subsequent dispensing of thyroid hormones. If anything, there was a tendency towards increasing LT4 consumption with increasing LDN exposure.ConclusionThe results of this study do not support claims of efficacy of LDN in hypothyroidism.
Highlights
Low dose naltrexone (LDN) is reported to have beneficial effects in several autoimmune diseases
If low dose naltrexone (LDN) is efficacious in hypothyroidism, it is plausible that it would result in changes in the use of triiodothyronine (T3) and/or levothyroxine (LT4)
Norwegian Prescription Database (NorPD) used reimbursement codes for hypothyroidism (International Classification of Disease (ICD-10) code E03 and International Classification of Primary Care (ICPC-2) code T86) to identify patients in the database according to our specifications
Summary
Low dose naltrexone (LDN) is reported to have beneficial effects in several autoimmune diseases. The purpose of this study was to examine whether starting LDN was followed by changes in the dispensing of thyroid hormones to patients with hypothyroidism. The opioid antagonist naltrexone in low doses (typically < 5 mg/day) is being used off-label against several autoimmune diseases. In 2013, the number of users of LDN in Norway increased from almost zero to 0.3% of the population within few months following a TV documentary [5]. We seized the opportunity to examine whether there were changes in the dispensing of thyroid hormones in selected patients following the initiation of LDN therapy. If LDN is efficacious in hypothyroidism, it is plausible that it would result in changes in the use of triiodothyronine (T3) and/or levothyroxine (LT4)
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