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I have been alternating 3mg one night and 4.5mg the next... I seem to be better like this. For me, 4.5mg every night makes me extra stiff. I can't walk either. I'm PPMS, of course I think MS is such a subjective term that really doesn't mean anything! Who cares what it is called?! Your daughter might try this. I just had each separate prescription filled. My doc is very good about trusting me that I know what is working best for me.

Marcie

In a message dated 4/5/2004 11:10:48 AM Central Standard Time, b_hammel@... writes:

Subj:[low dose naltrexone] dosage

Date:4/5/2004 11:10:48 AM Central Standard Time

From: b_hammel@... (paatti1)

Reply-to: low dose naltrexone

low dose naltrexone

My daughter was doing very well on 3mg - has been on since September. But she still cannot walk - she has SPMS. Her dr. is trying the higher dosage of 4.5 - she has been on it since Monday, 7 days, and since the second day has been so tired she cannot do much of anything - sleeps most of the time. Otherwise no bad side effects, except for loss of appetite which I imagine comes with the tiredness. She wants to go back to the 3mg immediately. Her dr. wants her to try another few weeks. I find her not so mentally responsive and she is definitely not happy - she is usually a very upbeat and happy person, in spite of the ms. Has anyone gone through this and what are your suggestions? I think you are all more "in the loop" than any of the drs. Thanks for your help.

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That's what I found too, and some other things. I didn't think it was a good time period to test it, unforeseen circumstances popped up. But 2 days after being back on 3.0 I realized 3.0 MG is the best dose for me, too.

Bill M. here mentioned he things 4.5 isn't as powerful as 3.0... I think he may have something there.

----- Original Message -----

From: paatti1

low dose naltrexone

Sent: Monday, April 05, 2004 13:02

Subject: [low dose naltrexone] dosage

My daughter was doing very well on 3mg - has been on since September. But she still cannot walk - she has SPMS. Her dr. is trying the higher dosage of 4.5 - she has been on it since Monday, 7 days, and since the second day has been so tired she cannot do much of anything - sleeps most of the time. Otherwise no bad side effects, except for loss of appetite which I imagine comes with the tiredness. She wants to go back to the 3mg immediately. Her dr. wants her to try another few weeks. I find her not so mentally responsive and she is definitely not happy - she is usually a very upbeat and happy person, in spite of the ms. Has anyone gone through this and what are your suggestions? I think you are all more "in the loop" than any of the drs. Thanks for your help.

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paattil, let me give you an example of my limited knowledge of endorphins

yet accurate from a scientific perspective. Cocaine increases endorphin

production which are the happy hormones but when you come down from the drug

you are depleted and depressed. I lived with an addict many years ago and

became knowledgable about the changes in brain chemistry. Perhaps your

daughter is getting too high of a dosage and it is depleting her endorphins.

They cannot be continually increased. There are not enough to go around.

This is what makes an addict an addict. They do not get the same effect

because their body cannot keep supplying the endorphins. Try going back to

3.0 and if her diet is not a good one try the Swank or Ashton Embrys diet

for ms. With proper b complex, essential fatty acids , green drinks to help

with the acidosis in her body (most of us are acidic) and your own research

playing around with different nutrients I beleive her fatigue will be a

thing of the past. Take care and God bless you both. Kathy

----- Original Message -----

From: " paatti1 " <b_hammel@...>

<low dose naltrexone >

Sent: Monday, April 05, 2004 1:02 PM

Subject: [low dose naltrexone] dosage

> My daughter was doing very well on 3mg - has been on since

> September. But she still cannot walk - she has SPMS. Her dr. is

> trying the higher dosage of 4.5 - she has been on it since Monday, 7

> days, and since the second day has been so tired she cannot do much

> of anything - sleeps most of the time. Otherwise no bad side

> effects, except for loss of appetite which I imagine comes with the

> tiredness. She wants to go back to the 3mg immediately. Her dr.

> wants her to try another few weeks. I find her not so mentally

> responsive and she is definitely not happy - she is usually a very

> upbeat and happy person, in spite of the ms. Has anyone gone

> through this and what are your suggestions? I think you are all

> more " in the loop " than any of the drs. Thanks for your help.

>

>

>

>

>

>

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paattil, I did not mean to come across like a know it all but I have a

pretty extensive medical background and it makes physiological sense to me

but maybe my views are not correct. Someone who is a patient of Dr. Bihari

could present him with my theory and see what he says. It would be

interesting. I also agree with Dr. Lawrence about taking the occassional few

days off. I feel very strong in mind and body afterwards. However, I guess

we are all different. Kathy

----- Original Message -----

From: " paatti1 " <b_hammel@...>

<low dose naltrexone >

Sent: Monday, April 05, 2004 1:02 PM

Subject: [low dose naltrexone] dosage

> My daughter was doing very well on 3mg - has been on since

> September. But she still cannot walk - she has SPMS. Her dr. is

> trying the higher dosage of 4.5 - she has been on it since Monday, 7

> days, and since the second day has been so tired she cannot do much

> of anything - sleeps most of the time. Otherwise no bad side

> effects, except for loss of appetite which I imagine comes with the

> tiredness. She wants to go back to the 3mg immediately. Her dr.

> wants her to try another few weeks. I find her not so mentally

> responsive and she is definitely not happy - she is usually a very

> upbeat and happy person, in spite of the ms. Has anyone gone

> through this and what are your suggestions? I think you are all

> more " in the loop " than any of the drs. Thanks for your help.

>

>

>

>

>

>

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I felt moved to respond because your description of your daughter`so

difficulties with 4.5mg LDN struck a chord (actually several?) with me.

I have been taking LDN for about 40 days, adjusting the dosage as I went

along!

i.e..-commenced with : 8 days at 4.5mg.

then : 1 day zero.

~ : 12 days at 3mg.

~ : 15 days at 2.25mg.

~ : 1 day zero.

~ : 2 days at 1.5mg.

I started at 4.5mg because I was " keen to get on with it " ! Although I had

fleeting good patches, after 8 days I felt that the effects of 4.5 was

somewhat too strong or fierce for my (rather fragile) SPMS system, so I

eventually followed the course described above in my attempts to achieve

homeostasis! I intend to investigate larger doses again when it feels

appropriate.

The precise size of the various doses was determined by the need to divide

up 4.5mg capsules: Opening a capsule & tipping it`s content into your mouth

(-a bit bitter!) leaves you with an empty capsule, then opening 2 other

caps. & sharing the contents with the empty cap. one has three

3mg.caps! -In a similar way,for the smaller doses, one 4.5 cap. becomes two

2.25 caps. & finally, one 4.5 cap. becomes three 1.5 caps. -Emptying

capsules into the mouth, IS bitter ,but one soon

has plenty of empty caps. to use & you do get used to the taste!

CAUTION! -dividing up the caps. like this successfully does require a

degree of manual dexterity, patience & carefulness which unfortunately may

be beyond the capacity of some. But if you can manage it (or has someone who

can do it for you!) it does provide great freedom of choice re.dosage: ( &

also incidentally, significantly lower costs!)

The reason for the zero days was my understanding that Dr. Bob Lawrence

(leading UK medical advocate of LDN) recommends taking 2 days out every 2

weeks: I didn`t follow this protocol

fully as I am keen to maximize the effects of the LDN on my body a.s.a.p.,

but I may experiment with the zero days more fully in future.

I am still very hopeful of a positive eventual long term outcome to the

taking LDN, I have noticed improvements in bladder control, increased

sensation in legs feet & hands ( this was subtle, I hadn`t actually noticed

any diminution of sensation in the first place!): There does seem to be a

gradual increase in strength in my legs taking place ( & consequent

improvement in balance) & I feel REALLY good during my yoga! However, my

experience seems to indicate that, if one is in the " progressive " stage of

MS, considerable patience, & sensitivity to the delicacy of one`s own unique

situation is desirable: Unless a doctor is unusually well informed about the

effects of LDN , MS, diet, nutritional supplements (benfotiamine!!!...),

exercise etc,

& is also the possessor of great sensitivity/empathy/intuition etc., how can

(s)he

possibly understand what is appropriate as successfully as can a well

informed layperson who is actually experiencing MS 24/7? (-Thanks to this

amazing internet, some of us ARE quickly becoming " well informed

laypersons~! " - AND working at keeping up-to- date in our

knowledge!!!)...........

Enough already!

I am very grateful to the people on this site for all the info. & support I

have received over the last 3 months or so: THANK YOU for sharing!

May we ALL be healthy & happy!

Gerald (SPMS)

----- Original Message -----

From: " paatti1 " <b_hammel@...>

<low dose naltrexone >

Sent: Monday, April 05, 2004 6:02 PM

Subject: [low dose naltrexone] dosage

> My daughter was doing very well on 3mg - has been on since

> September. But she still cannot walk - she has SPMS. Her dr. is

> trying the higher dosage of 4.5 - she has been on it since Monday, 7

> days, and since the second day has been so tired she cannot do much

> of anything - sleeps most of the time. Otherwise no bad side

> effects, except for loss of appetite which I imagine comes with the

> tiredness. She wants to go back to the 3mg immediately. Her dr.

> wants her to try another few weeks. I find her not so mentally

> responsive and she is definitely not happy - she is usually a very

> upbeat and happy person, in spite of the ms. Has anyone gone

> through this and what are your suggestions? I think you are all

> more " in the loop " than any of the drs. Thanks for your help.

>

>

>

>

>

>

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