Naltrexone for Sjogren's Syndrome

Low-dose naltrexone (LDN) is a unique compound that has pain-relieving and anti-inflammatory properties. A few studies have shown benefit in helping relieve the pain in patients with sjogren's, fibromyalgia and autoimmune conditions such as inflammatory bowel disease and multiple sclerosis. It seems reasonable that the medication might be useful in Sjogren's Syndrome, an autoimmune condition that is associated with pain and inflammation.

In March of 2019, the first peer reviewed case report showing clinical improvement using low-dose naltrexone (LDN) in a patient with suspected SS was published in Cureus. 

This report describes two additional patients with SS whose conditions responded favorably to a treatment with LDN therapy. 

The first case is a 24-year-old female with documented SS. Her diagnosis was based on a history of dry eyes, dry mouth, joint pain, fatigue, and headache. In addition, she had very high measures of inflammation and a positive anti SS-A antibody. She improved clinically with LDN therapy. 

The second case is a 66-year-old female with documented SS based on a history of dry eyes and dry mouth, joint pain, and elevated anti-SSA and anti-SSB antibodies whose joint symptoms responded to treatment with LDN.


Naltrexone was synthesized in 1963 as an orally active competitive opioid receptor antagonist. Naltrexone is structurally and functionally similar to the opioid antagonist naloxone, but it has greater oral bioavailability.

The use of LDN for immunomodulation was developed and promoted by Dr Bernard Bihari, a neurophysician in the United States. LDN has been in use in the United States for treatment of Multiple Sclerosis since 1985.

Low-dose naltrexone refers to doses about 1/10th the size of the normal dose of naltrexone, typically 4.5 mg or within a couple of milligrams of that value. 

It is thought that low-dose naltrexone may inhibit opioid receptors and therefore cause the body to increase production of endorphins and upregulate the immune system.