Guest guest Posted February 13, 2011 Report Share Posted February 13, 2011 I know this topic has come up before but there are so many posts that I cannot remember. How long do you need to be off ldn if you are going to have surgery? Was it 10 days?Thanks. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 27, 2011 Report Share Posted April 27, 2011 My mother takes LDN for her Crohn's. LDN keeps it totally in remission. HOWEVER, three times she has gone off of it, and all three times, the diarrhea has come back with a vengeance within three days. Once she drove to Oklahoma to visit a friend and forgot to take it with her. She drove back in diapers. Once she had to go off of it for surgery and spent hospital time with diarrhea as well. It did not help that they knew that she was lactose intolerant and they gave her ice cream. The third time, she simply forgot to make up a new batch, and being 83, you forget that the reason that you are doing so well is because you take it each day. It seems to fall into the background and one has to be reminded. For me, the only time that I went off of it was for major surgery. I found that the fatigue and depression of MS sets back in after about 5 days off of it. I had surgery on a Friday morning and quit the LDN after my Wednesday night dose. My surgeon was very aware of the LDN and what to prescribe for me (in Mexico, they are more open minded with " alternative " treatments, I have found). I did use a codeine pain reliever for as many days as I could handle it until the return of fatigue and depression (I think it was about four days post surgery) and then had him transfer me over to something without an opiate. I went on the LDN for three nights and then needed to drive many hours to get home and went back on the heavier pain relievers for two more days, while skipping the LDN those nights. A couple of thoughts: Some think that LDN can build up and quit working as well. I have occasionally skipped one dose a week and found no difference, so feel that the LDN easily clears my system. Therefore, the short down time that I allowed before the surgery. Since I don't build up LDN, the switching back and forth between LDN and opiate pain relievers worked for me. I used the one that I needed the most. I don't do pain well, so was surely ready to sacrifice my LDN for the best pain reliever that I could have post surgery. But I so hate and fear the symptoms of MS that when they started to rear their ugly head again, I was ready to use a different pain reliever to keep the MS at bay. Going back on the heavier pain reliever for the hours of driving was my decision. I love being in charge of my body. I know better than the doctor, what I can tolerate, what is important to me. I know how long I can stay off of the LDN and hope that it is long enough to get past the pain. It was also reassuring that going back on the LDN, alleviated the MS symptoms once again. In each case above, there was no problem going back on it at full strength after a short break. Since everybody that I know started at 3 ml and went to 4.5 ml and then found their own healthful level, there was not much reason to try to titrate it up. I hope this helps, Francie http://LDN-for-MS.com > > Hey, > > I've been on 4.5 mg LDN for Crohn's for over a year now, and have had normal blood results every since (my inflammation levels have always been abnormal before LDN). But i have to have surgery on my sciatic nerve and this will involve a general anesthetic and two nights in hospital on strong pain killers. So i'm wondering, how long before the surgery do i need to stop the LDN? and how long after i stop taking the painkillers can i restart the LDN? > > i'm also curious as to other people's experiences with stopping LDN and going back on it? Did your symptoms come back? Do the LDN side effects come back when you started it again? > > Look forward to hearing your advice, > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 27, 2011 Report Share Posted April 27, 2011 Hi I typed " LDN and surgery " in the search box here and found answers ranging from 1 day to 1 week: messages #99226 and #100563. Try it. There's a lot more to read that might answer your other questions. Karyn > > Hey, > > I've been on 4.5 mg LDN for Crohn's for over a year now, and have had normal blood results every since (my inflammation levels have always been abnormal before LDN). But i have to have surgery on my sciatic nerve and this will involve a general anesthetic and two nights in hospital on strong pain killers. So i'm wondering, how long before the surgery do i need to stop the LDN? and how long after i stop taking the painkillers can i restart the LDN? > > i'm also curious as to other people's experiences with stopping LDN and going back on it? Did your symptoms come back? Do the LDN side effects come back when you started it again? > > Look forward to hearing your advice, > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 27, 2011 Report Share Posted April 27, 2011 Francie, thank you for such an informative/learning post, may the sun shine brightly in your world. david lubbock tx. On 4/27/11, FrancieS <francie@...> wrote: > My mother takes LDN for her Crohn's. LDN keeps it totally in remission. > HOWEVER, three times she has gone off of it, and all three times, the > diarrhea has come back with a vengeance within three days. Once she drove to > Oklahoma to visit a friend and forgot to take it with her. She drove back in > diapers. Once she had to go off of it for surgery and spent hospital time > with diarrhea as well. It did not help that they knew that she was lactose > intolerant and they gave her ice cream. The third time, she simply forgot to > make up a new batch, and being 83, you forget that the reason that you are > doing so well is because you take it each day. It seems to fall into the > background and one has to be reminded. > > For me, the only time that I went off of it was for major surgery. I found > that the fatigue and depression of MS sets back in after about 5 days off of > it. > > I had surgery on a Friday morning and quit the LDN after my Wednesday night > dose. My surgeon was very aware of the LDN and what to prescribe for me (in > Mexico, they are more open minded with " alternative " treatments, I have > found). I did use a codeine pain reliever for as many days as I could handle > it until the return of fatigue and depression (I think it was about four > days post surgery) and then had him transfer me over to something without an > opiate. I went on the LDN for three nights and then needed to drive many > hours to get home and went back on the heavier pain relievers for two more > days, while skipping the LDN those nights. > > A couple of thoughts: > > Some think that LDN can build up and quit working as well. I have > occasionally skipped one dose a week and found no difference, so feel that > the LDN easily clears my system. Therefore, the short down time that I > allowed before the surgery. > > Since I don't build up LDN, the switching back and forth between LDN and > opiate pain relievers worked for me. I used the one that I needed the most. > I don't do pain well, so was surely ready to sacrifice my LDN for the best > pain reliever that I could have post surgery. But I so hate and fear the > symptoms of MS that when they started to rear their ugly head again, I was > ready to use a different pain reliever to keep the MS at bay. Going back on > the heavier pain reliever for the hours of driving was my decision. > > I love being in charge of my body. I know better than the doctor, what I can > tolerate, what is important to me. I know how long I can stay off of the LDN > and hope that it is long enough to get past the pain. It was also reassuring > that going back on the LDN, alleviated the MS symptoms once again. > > In each case above, there was no problem going back on it at full strength > after a short break. Since everybody that I know started at 3 ml and went to > 4.5 ml and then found their own healthful level, there was not much reason > to try to titrate it up. > > I hope this helps, > > Francie > http://LDN-for-MS.com > > >> >> Hey, >> >> I've been on 4.5 mg LDN for Crohn's for over a year now, and have had >> normal blood results every since (my inflammation levels have always been >> abnormal before LDN). But i have to have surgery on my sciatic nerve and >> this will involve a general anesthetic and two nights in hospital on >> strong pain killers. So i'm wondering, how long before the surgery do i >> need to stop the LDN? and how long after i stop taking the painkillers can >> i restart the LDN? >> >> i'm also curious as to other people's experiences with stopping LDN and >> going back on it? Did your symptoms come back? Do the LDN side effects >> come back when you started it again? >> >> Look forward to hearing your advice, >> >> > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 27, 2011 Report Share Posted April 27, 2011 Over the holidays this past year for some reason I totally forgot to take my LDN for 2 weeks. Very odd of me, but there it is. The IBS component of the fibro came back very hard and was what finally reminded me that I wasn't taking the LDN. If I forget to take it for a day or two, my pain levels start rising and my ability to be productive and work starts to fall off. If I remember to take it every night regularly, my productivity increases and stays high. -- > > My mother takes LDN for her Crohn's. LDN keeps it totally in remission. > > HOWEVER, three times she has gone off of it, and all three times, the > > diarrhea has come back with a vengeance within three days. Once she > drove to > > Oklahoma to visit a friend and forgot to take it with her. She drove > back in > > diapers. Once she had to go off of it for surgery and spent hospital time > > with diarrhea as well. It did not help that they knew that she was lactose > > intolerant and they gave her ice cream. The third time, she simply > forgot to > > make up a new batch, and being 83, you forget that the reason that you are > > doing so well is because you take it each day. It seems to fall into the > > background and one has to be reminded. > > > > For me, the only time that I went off of it was for major surgery. I found > > that the fatigue and depression of MS sets back in after about 5 days > off of > > it. > > > > I had surgery on a Friday morning and quit the LDN after my Wednesday night > > dose. My surgeon was very aware of the LDN and what to prescribe for me (in > > Mexico, they are more open minded with " alternative " treatments, I have > > found). I did use a codeine pain reliever for as many days as I could > handle > > it until the return of fatigue and depression (I think it was about four > > days post surgery) and then had him transfer me over to something > without an > > opiate. I went on the LDN for three nights and then needed to drive many > > hours to get home and went back on the heavier pain relievers for two more > > days, while skipping the LDN those nights. > > > > A couple of thoughts: > > > > Some think that LDN can build up and quit working as well. I have > > occasionally skipped one dose a week and found no difference, so feel that > > the LDN easily clears my system. Therefore, the short down time that I > > allowed before the surgery. > > > > Since I don't build up LDN, the switching back and forth between LDN and > > opiate pain relievers worked for me. I used the one that I needed the most. > > I don't do pain well, so was surely ready to sacrifice my LDN for the best > > pain reliever that I could have post surgery. But I so hate and fear the > > symptoms of MS that when they started to rear their ugly head again, I was > > ready to use a different pain reliever to keep the MS at bay. Going back on > > the heavier pain reliever for the hours of driving was my decision. > > > > I love being in charge of my body. I know better than the doctor, what > I can > > tolerate, what is important to me. I know how long I can stay off of > the LDN > > and hope that it is long enough to get past the pain. It was also > reassuring > > that going back on the LDN, alleviated the MS symptoms once again. > > > > In each case above, there was no problem going back on it at full strength > > after a short break. Since everybody that I know started at 3 ml and > went to > > 4.5 ml and then found their own healthful level, there was not much reason > > to try to titrate it up. > > > > I hope this helps, > > > > Francie > > http://LDN-for-MS.com > > > > > >> > >> Hey, > >> > >> I've been on 4.5 mg LDN for Crohn's for over a year now, and have had > >> normal blood results every since (my inflammation levels have always been > >> abnormal before LDN). But i have to have surgery on my sciatic nerve and > >> this will involve a general anesthetic and two nights in hospital on > >> strong pain killers. So i'm wondering, how long before the surgery do i > >> need to stop the LDN? and how long after i stop taking the painkillers can > >> i restart the LDN? > >> > >> i'm also curious as to other people's experiences with stopping LDN and > >> going back on it? Did your symptoms come back? Do the LDN side effects > >> come back when you started it again? > >> > >> Look forward to hearing your advice, > >> > >> > > > > > > > > >------------------------------------ > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 27, 2011 Report Share Posted April 27, 2011 Two answers from Dr. Skip Lenz: The elimination half-life of naltrexone has been reported to be anywhere from 4 hours to 24 hours. Generally recognized kinetics suggest that no less than 5 times the half life is required to reduce the concentration to below a level that is detectable. So at minimum (and I don't believe this) you will need 20 hours off and maximum 5 days off before taking an opioid. Now you are going to get an argument from some docs and pharmacists about this, first thing to ask is how many patients do they have, second is how many times have they been involved with this issue. I honestly can't tell you how many times in the last 10 years we have been involved with this question. My experience is that you should wait no less than 5 day after taking the last LDN and taking an opiate and visa versa. Dr.Skip -- This is a monograph from Gold Standard. It is for the 50mg dose, but should be considered " official " for LDN because there is NO other data that reflects accurate info on this drug. Naltrexone is contraindicated in patients who are receiving opiate analgesics or who have or are suspected of having active opiate agonist dependence or substance abuse habits. Severe opiate withdrawal may occur in these patients. Naltrexone is contraindicated in patients experiencing opiate agonist withdrawal. Use of naltrexone does not eliminate or prevent withdrawal symptoms. However, naltrexone may be used as part of opiate detoxification procedures in controlled settings. To prevent the occurrence of an acute abstinence syndrome (withdrawal) or to prevent the exacerbation of a pre-existing subclinical abstinence syndrome, patients must be opiate agonist free for a minimum of 7†" 10 days. Since the absence of an opiate drug in the urine is often not sufficient proof that a patient is opiate-free, a naloxone challenge should be done if there is a risk of precipitating a withdrawal reaction following the administration of naltrexone. A positive reaction to the naloxone challenge predicts a similar response to naltrexone. Use of naltrexone is contraindicated in an individual who fails the naloxone challenge test or who has a positive urine test for opioids. If a painful procedure such as surgery is planned, then naltrexone should be discontinued 72 hours prior to the procedure. Patients should be abstinent from opiate analgesia for at least 7 days before restarting naltrexone. Naltrexone treated patients who require emergent opiate analgesia may require the administration of large opiate doses to provide adequate pain control, which may increase the risk of deep or prolonged respiratory depression. A rapidly acting opiate agonist is preferred for emergent analgesia to limit the duration of respiratory depression. Non-opiate receptor mediated actions (i.e., histamine-mediated) may occur with the use of opiates and should be expected (e.g., facial swelling, itching, generalized erythema or bronchoconstriction). Other alternatives for emergent analgesia in patients taking naltrexone include the use of regional analgesia, conscious sedation, non-opiate analgesics, or general anesthetics. Dr. Skip -- > > Hey, > > I've been on 4.5 mg LDN for Crohn's for over a year now, and have had normal blood results every since (my inflammation levels have always been abnormal before LDN). But i have to have surgery on my sciatic nerve and this will involve a general anesthetic and two nights in hospital on strong pain killers. So i'm wondering, how long before the surgery do i need to stop the LDN? and how long after i stop taking the painkillers can i restart the LDN? > > i'm also curious as to other people's experiences with stopping LDN and going back on it? Did your symptoms come back? Do the LDN side effects come back when you started it again? > > Look forward to hearing your advice, > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 28, 2011 Report Share Posted April 28, 2011 Thanks Art This is really the definitive post - the rules you should hand to a surgeon in case you need surgery. I have copied and saved just in case. Karyn > > > > Hey, > > > > I've been on 4.5 mg LDN for Crohn's for over a year now, and have had normal blood results every since (my inflammation levels have always been abnormal before LDN). But i have to have surgery on my sciatic nerve and this will involve a general anesthetic and two nights in hospital on strong pain killers. So i'm wondering, how long before the surgery do i need to stop the LDN? and how long after i stop taking the painkillers can i restart the LDN? > > > > i'm also curious as to other people's experiences with stopping LDN and going back on it? Did your symptoms come back? Do the LDN side effects come back when you started it again? > > > > Look forward to hearing your advice, > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 28, 2011 Report Share Posted April 28, 2011 Can anyone explain to me what happens if you take an opiate painkiller while on ldn? Does it make pain worse? Does it make the ldn not work? Or does the opiate just not adhere to receptors and pass through your system? I'm confused on this point. Thanks in advance...amy On Wed, Apr 27, 2011 at 8:10 PM, skystone42 <kcjlr@...> wrote:  Thanks Art This is really the definitive post - the rules you should hand to a surgeon in case you need surgery. I have copied and saved just in case. Karyn > > > > Hey, > > > > I've been on 4.5 mg LDN for Crohn's for over a year now, and have had normal blood results every since (my inflammation levels have always been abnormal before LDN). But i have to have surgery on my sciatic nerve and this will involve a general anesthetic and two nights in hospital on strong pain killers. So i'm wondering, how long before the surgery do i need to stop the LDN? and how long after i stop taking the painkillers can i restart the LDN? > > > > i'm also curious as to other people's experiences with stopping LDN and going back on it? Did your symptoms come back? Do the LDN side effects come back when you started it again? > > > > Look forward to hearing your advice, > > > > > -- Amy Paliwoda213.249.5861amypaliwoda.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 28, 2011 Report Share Posted April 28, 2011 Does this include local anesthetics like novocaine/lidocaine prior to dental cavity work ?I quit my daughter's LDN for one night prior to the filling we had and she seemed like she was still in pain. However she is ASD and therefore prone to dramatic reactions. We have to do more work next month so I just need to know when to quit her LDN again! :-)(Guessing the 5 day answer is sufficient)On Wed, Apr 27, 2011 at 5:35 PM, art_ldn <rtee54@...> wrote: Two answers from Dr. Skip Lenz: The elimination half-life of naltrexone has been reported to be anywhere from 4 hours to 24 hours.  Generally recognized kinetics suggest that no less than 5 times the half life is required to reduce the concentration to below a level that is detectable.  So at minimum (and I don't believe this) you will need 20 hours off and maximum 5 days off before taking an opioid.  Now you are going to get an argument from some docs and pharmacists about this,  first thing to ask is how many patients do they have, second is how many times have they been involved with this issue.  I honestly can't tell you how many times in the last 10 years we have been involved with this question.  My experience is that you should wait no less than 5 day after taking the last LDN and taking an opiate and visa versa. Dr.Skip -- This is a monograph from Gold Standard.  It is for the 50mg dose, but should be considered " official " for LDN because there is NO other data that reflects accurate info on this drug. Naltrexone is contraindicated in patients who are receiving opiate analgesics or who have or are suspected of having active opiate agonist dependence or substance abuse habits. Severe opiate withdrawal may occur in these patients. Naltrexone is contraindicated in patients experiencing opiate agonist withdrawal. Use of naltrexone does not eliminate or prevent withdrawal symptoms. However, naltrexone may be used as part of opiate detoxification procedures in controlled settings. To prevent the occurrence of an acute abstinence syndrome (withdrawal) or to prevent the exacerbation of a pre-existing subclinical abstinence syndrome, patients must be opiate agonist free for a minimum of 7†" 10 days. Since the absence of an opiate drug in the urine is often not sufficient proof that a patient is opiate-free, a naloxone challenge should be done if there is a risk of precipitating a withdrawal reaction following the administration of naltrexone. A positive reaction to the naloxone challenge predicts a similar response to naltrexone. Use of naltrexone is contraindicated in an individual who fails the naloxone challenge test or who has a positive urine test for opioids. If a painful procedure such as surgery is planned, then naltrexone should be discontinued 72 hours prior to the procedure. Patients should be abstinent from opiate analgesia for at least 7 days before restarting naltrexone. Naltrexone treated patients who require emergent opiate analgesia may require the administration of large opiate doses to provide adequate pain control, which may increase the risk of deep or prolonged respiratory depression. A rapidly acting opiate agonist is preferred for emergent analgesia to limit the duration of respiratory depression. Non-opiate receptor mediated actions (i.e., histamine-mediated) may occur with the use of opiates and should be expected (e.g., facial swelling, itching, generalized erythema or bronchoconstriction). Other alternatives for emergent analgesia in patients taking naltrexone include the use of regional analgesia, conscious sedation, non-opiate analgesics, or general anesthetics. Dr. Skip -- > > Hey, > > I've been on 4.5 mg LDN for Crohn's for over a year now, and have had normal blood results every since (my inflammation levels have always been abnormal before LDN). But i have to have surgery on my sciatic nerve and this will involve a general anesthetic and two nights in hospital on strong pain killers. So i'm wondering, how long before the surgery do i need to stop the LDN? and how long after i stop taking the painkillers can i restart the LDN? > > i'm also curious as to other people's experiences with stopping LDN and going back on it? Did your symptoms come back? Do the LDN side effects come back when you started it again? > > Look forward to hearing your advice, > > ------------------------------------ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 28, 2011 Report Share Posted April 28, 2011 When LDN is taken and you take a narcotic close to the LDN dose, the LDN will fully block or lessen the effect of the narcotic. , LDN user almost 8 yrs for chronic progressive MS Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 29, 2011 Report Share Posted April 29, 2011 Absolutely NOT. It's only painkillers with morphine or codeine in them that are blocked by naltrexone. General anesthetics and dental anesthetics do not contain those ingredients. There is ZERO need to stop LDN for routine dental work. If there is surgery or an extraction that will require codeine-based pain relief following, then you need to stop the LDN. -- >Does this include local anesthetics like novocaine/lidocaine prior to >dental cavity work ? > >I quit my daughter's LDN for one night prior to the filling we had and she >seemed like she was still in pain. However she is ASD and therefore prone >to dramatic reactions. > >We have to do more work next month so I just need to know when to quit her >LDN again! :-) >(Guessing the 5 day answer is sufficient) > >On Wed, Apr 27, 2011 at 5:35 PM, art_ldn ><<mailto:rtee54@...>rtee54@...> wrote: >Two answers from Dr. Skip Lenz: > >The elimination half-life of naltrexone has been reported to be anywhere >from 4 hours to 24 hours. Generally recognized kinetics suggest that no >less than 5 times the half life is required to reduce the concentration to >below a level that is detectable. So at minimum (and I don't believe >this) you will need 20 hours off and maximum 5 days off before taking an >opioid. Now you are going to get an argument from some docs and >pharmacists about this, first thing to ask is how many patients do they >have, second is how many times have they been involved with this issue. I >honestly can't tell you how many times in the last 10 years we have been >involved with this question. My experience is that you should wait no >less than 5 day after taking the last LDN and taking an opiate and visa versa. > >Dr.Skip >-- > >This is a monograph from Gold Standard. It is for the 50mg dose, but >should be considered " official " for LDN because there is NO other data >that reflects accurate info on this drug. > >Naltrexone is contraindicated in patients who are receiving opiate >analgesics or who have or are suspected of having active opiate agonist >dependence or substance abuse habits. Severe opiate withdrawal may occur >in these patients. Naltrexone is contraindicated in patients experiencing >opiate agonist withdrawal. Use of naltrexone does not eliminate or prevent >withdrawal symptoms. However, naltrexone may be used as part of opiate >detoxification procedures in controlled settings. To prevent the >occurrence of an acute abstinence syndrome (withdrawal) or to prevent the >exacerbation of a pre-existing subclinical abstinence syndrome, patients >must be opiate agonist free for a minimum of 7†" 10 days. Since the >absence of an opiate drug in the urine is often not sufficient proof that >a patient is opiate-free, a naloxone challenge should be done if there is >a risk of precipitating a withdrawal reaction following the administration >of naltrexone. A positive reaction to the naloxone challenge predicts a >similar response to naltrexone. Use of naltrexone is contraindicated in an >individual who fails the naloxone challenge test or who has a positive >urine test for opioids. > >If a painful procedure such as surgery is planned, then naltrexone should >be discontinued 72 hours prior to the procedure. Patients should be >abstinent from opiate analgesia for at least 7 days before restarting >naltrexone. > >Naltrexone treated patients who require emergent opiate analgesia may >require the administration of large opiate doses to provide adequate pain >control, which may increase the risk of deep or prolonged respiratory >depression. A rapidly acting opiate agonist is preferred for emergent >analgesia to limit the duration of respiratory depression. Non-opiate >receptor mediated actions (i.e., histamine-mediated) may occur with the >use of opiates and should be expected (e.g., facial swelling, itching, >generalized erythema or bronchoconstriction). Other alternatives for >emergent analgesia in patients taking naltrexone include the use of >regional analgesia, conscious sedation, non-opiate analgesics, or general >anesthetics. > >Dr. Skip >-- > > > > > Hey, > > > > I've been on 4.5 mg LDN for Crohn's for over a year now, and have had > normal blood results every since (my inflammation levels have always been > abnormal before LDN). But i have to have surgery on my sciatic nerve and > this will involve a general anesthetic and two nights in hospital on > strong pain killers. So i'm wondering, how long before the surgery do i > need to stop the LDN? and how long after i stop taking the painkillers > can i restart the LDN? > > > > i'm also curious as to other people's experiences with stopping LDN and > going back on it? Did your symptoms come back? Do the LDN side effects > come back when you started it again? > > > > Look forward to hearing your advice, > > > > > > > > >------------------------------------ > > Quote Link to comment Share on other sites More sharing options...
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