How can low-dose naltrexone help you? What the research says

Authors

Clinical reviewer

Laura Pole, MSN, RN, OCNS

Senior Clinical Consultant

View profile

Last update: June 22, 2026

We summarize the clinical evidence for each medical benefit here. We begin with our assessment of the strength of evidence within each category, followed by a brief summary of individual studies or reviews of several studies. In assessing the strength of evidence, we consider the study design, number of participants, and the size of the treatment effect (how much outcomes changed with treatment).

To see more details, click the plus sign to the right of any section.

Our assessments of evidence for each medical benefit fall into one of these categories:

Strong evidence: consistent, significant effects in several large (or at least one very large) well designed clinical studies or at least two meta-analysesa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of clinical studies of moderate or better quality (or one large meta-analysis) finding similar results
Good evidence: significant effects in one large or several mid-sized and well-designed clinical studies ( randomized controlled trialsa study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects with an appropriate placebo or other strong comparison control or observational studies that control for confounds)
Modest evidence: significant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods studies), or several small studies aggregated into a meta-analysis
Preliminary evidence: significant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect
Weak evidence: one or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects
Insufficient evidence: preclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example)

Learn more about how we research and rate therapies and practices in How We Rate Therapies ›

Improving treatment outcomes

Is low-dose naltrexone linked to improved survival? Is it linked to less cancer growth or metastasis? Does it enhance the anticancer action of other treatments or therapies? We present the evidence.

Brain cancer

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently): People with high grade malignant gliomas treated with naltrexone and radiotherapy showed better survival at one year.

Breast cancer

No evidence: People with estrogen receptor (ER)-positive breast cancer treated with naltrexone did not show evidence of an effect on progression in one study.

Naltrexone combined with other therapies

Naltrexone and alpha-lipoic acid: weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently)

Improvement in symptoms of follicular lymphoma at 1 year in 1 person treated with LDN and initially with alpha-lipoic acid in a case report³Berkson BM, Rubin DM, Berkson AJ. Reversal of signs and symptoms of a B-cell lymphoma in a patient using only low-dose naltrexone. Integrative Cancer Therapies. 2007 Sep;6(3):293-6.
Extended survival compared to expectations and 2 complete remissions among people with metastatic pancreatic cancer treated with a protocol of alpha-lipoic acid and low-dose naltrexone in case studiesa descriptive and exploratory analysis of a person, group, or event regarding changes observed over time; because changes due to treatment are not compared to similar changes over time without treatment, a case study is considered a weak study design⁴Berkson BM, Rubin DM, Berkson AJ. Revisiting the ALA/N (alpha-lipoic acid/low-dose naltrexone) protocol for people with metastatic and nonmetastatic pancreatic cancer: a report of 3 new cases. Integrative Cancer Therapies. 2009 Dec;8(4):416-22; Berkson BM, Rubin DM, Berkson AJ. The long-term survival of a patient with pancreatic cancer with metastases to the liver after treatment with the intravenous alpha-lipoic acid/low-dose naltrexone protocol. Integrative Cancer Therapies. 2006 Mar;5(1):83-9.

Intravenous alpha-lipoic acid and vitamin C, low-dose naltrexone, hydroxycitrate, and a healthy lifestyle program: weak evidence

Recovery from metastatic renal cell carcinoma (RCC) to stable disease with disappearance of the signs and symptoms of stage IV RCC and a return to work, continuing 9 years past first treatment in 1 person treated with intravenous alpha-lipoic acid and vitamin C, low-dose naltrexone, hydroxycitrate, and a healthy lifestyle program in a case study⁵Berkson BM, Calvo Riera F. The long-term survival of a patient with stage iv renal cell carcinoma following an integrative treatment approach including the intravenous α-lipoic acid/low-dose naltrexone protocol. Integrative Cancer Therapies. 2018 Sep;17(3):986-993.

Lipoic acid, hydroxycitrate, and low-dose naltrexone: weak evidence

Tumor response during chemotherapy (1 person), or stable disease or very slow progression among 5 of 10 people with chemoresistant advanced metastatic cancers treated with a combination of intravenous lipoic acid at 600 mg (Thioctacid), hydroxycitrate at 500 mg t.i.d. (Solgar), and low-dose naltrexone at 5 mg (Revia) at bedtime in case studies. However, the remaining 4 patients had disease progression or needed to begin chemotherapy.⁶Schwartz L, Buhler L, Icard P, Lincet H, Steyaert JM. Metabolic treatment of cancer: intermediate results of a prospective case series. Anticancer Research. 2014 Feb;34(2):973-80.

Optimizing your body terrain

Does low-dose naltrexone promote an environment within your body that is less supportive of cancer development, growth, or spread? We present the evidence.

See Optimizing Your Body Terrain ›

Find medical professionals who specialize in managing body terrain factors: Finding Integrative Oncologists and Other Practitioners ›

Inflammation

Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently): People with non-cancer chronic illnesses who took LDN saw lower markers of inflammation in two uncontrolled studiesa study in which a therapy is used, but without a comparison group against which to judge outcomes; an uncontrolled trial is considered a weak study design.

LDN combined with other therapies

LDN and melatonin: preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of higher counts of white blood cells (lymphocytes) among people with untreatable metastatic solid tumors treated with LDN and melatonin

Managing side effects and promoting wellness

Is low-dose naltrexone linked to fewer or less severe side effects or symptoms? Is it linked to less toxicity from cancer treatment? Does it support your quality of life or promote general well-being? We present the evidence.

Symptoms not specific to cancer

Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently): People without cancer who took LDN showed less pain due to inflammation across several low-quality studies, and less pain due to fibromyalgia in one.

← Back to the full Low-dose Naltrexone therapy guide

References[+]

1	Lissoni P, Meregalli S et al. Radioendocrine therapy of brain tumors with the long acting opioid antagonist naltrexone in association with radiotherapy. Tumori. 1993 Jun 33;79: 198-201.
2	Vijayakumar J, Haddad T et al. An open label phase II study of safety and clinical activity of naltrexone for treatment of hormone refractory metastatic breast cancer. Investigational New Drugs. 2023 Feb;41(1):70-75.
3	Berkson BM, Rubin DM, Berkson AJ. Reversal of signs and symptoms of a B-cell lymphoma in a patient using only low-dose naltrexone. Integrative Cancer Therapies. 2007 Sep;6(3):293-6.
4	Berkson BM, Rubin DM, Berkson AJ. Revisiting the ALA/N (alpha-lipoic acid/low-dose naltrexone) protocol for people with metastatic and nonmetastatic pancreatic cancer: a report of 3 new cases. Integrative Cancer Therapies. 2009 Dec;8(4):416-22; Berkson BM, Rubin DM, Berkson AJ. The long-term survival of a patient with pancreatic cancer with metastases to the liver after treatment with the intravenous alpha-lipoic acid/low-dose naltrexone protocol. Integrative Cancer Therapies. 2006 Mar;5(1):83-9.
5	Berkson BM, Calvo Riera F. The long-term survival of a patient with stage iv renal cell carcinoma following an integrative treatment approach including the intravenous α-lipoic acid/low-dose naltrexone protocol. Integrative Cancer Therapies. 2018 Sep;17(3):986-993.
6	Schwartz L, Buhler L, Icard P, Lincet H, Steyaert JM. Metabolic treatment of cancer: intermediate results of a prospective case series. Anticancer Research. 2014 Feb;34(2):973-80.
7, 11	Parkitny L, Younger J. Reduced pro-inflammatory cytokines after eight weeks of low-dose naltrexone for fibromyalgia. Biomedicines. 2017 Apr 18;5(2):16.
8	Lie MRKL, van der Giessen J et al. Low dose naltrexone for induction of remission in inflammatory bowel disease patients. Journal of Translational Medicine. 2018 Mar 9;16(1):55.
9	Lissoni P, Malugani F et al. Neuroimmunotherapy of untreatable metastatic solid tumors with subcutaneous low-dose interleukin-2, melatonin and naltrexone: modulation of interleukin-2-induced antitumor immunity by blocking the opioid system. Neuro Endocrinology Letters. 2002 Aug;23(4):341-4.
10	Hatfield E, Phillips K, Swidan S, Ashman L. Use of low-dose naltrexone in the management of chronic pain conditions: a systematic review. Journal of the American Dental Association. 2020 Dec;151(12):891-902.e1.

Low-dose Naltrexone