Step 1
The therapeutic dosage range for LDN is from 1.75 mg to 4.5 mg every day. Dosages below this range might have no effect at all, and dosages above this range are likely to block endorphins for too long a period of time, and interfere with its effectiveness.
Ideal dosage when treating most illnesses is 3 mg to 4 mg, however many people prefer to start with the lower dose of 1.5 mg. It is recommended that those with Multiple Sclerosis, who have spasms, begin with 1.5mg and slowly work up to 3 mg and no more, since starting at the higher dosage may cause worsening of the spasms. Those who take thyroid medicine need to keep track of their symptoms, since LDN can help lower the dose of thyroid medication that you need, and it may need to be lowered. Less LDN is not the answer, but less thyroid medication.
If you have spacicity, it is a good idea to start as low as 1.5 mg per day, or even lower, as the first flush on Naltrexone can increase the spacicity for up to two weeks. Don't increase your dose until the stiffness starts to subside.
Step 2
Begin by taking 1.5 mg each day, whether using compounded tablets or liquid LDN. Continue taking 1.5 mg daily for 1-4 weeks. If you experience side effects of hyperness, or sleep disturbances, do not increase the dosage until side effects disappear. The usual adult dosage is 3 to 4 mg taken once daily. Most patients take it at bedtime but we are now finding that any time of the day can work, so experiment to find what is best for your lifestyle.
Step 3
When any mild side effects subside, increase dosage gradually to 4 mg each night. After a couple of weeks, you will know if the 4 mg dose is better for you, or if you want to drop down to slightly less. Some people end up taking as little as 2 or 2.5 mg. You can experiment to find what is best for you. Less is more with LDN, so taking the lowest dose that still gives you the relief that you wanted, is the right dose.
Step 4
Keep a simple symptom log. Track all MS symptoms and LDN side effects, so you can see at a glance how the Low Dose Naltrexone effects you. When you start feeling better it is easy to forget just how sick you were. A written log is a great help.
Step 5
The usual warning is to talk to your doctor or pharmacist about each dosage increase. If you do not have a doctor to help, there is a great deal of experience and wisdom on the LowDoseNaltrexone Yahoo Newsgroup. There is also a very active Facebook group called "Got Endorphins? LDN"