Reviews

Patients Say

Positives

  • Several patients reported that even small nightly doses (0.25–2.5 mg) “helped my fatigue” within weeks as they slowly titrated upward Mayo Clinic Connect.

  • One long-COVID patient on 1.5 mg felt leg-pain relief “right away,” then noticed more energy after increasing to 3 mg Mayo Clinic Connect.

  • One person with dysautonomia called LDN a “life saver,” reporting roughly a 70% symptom reduction—including fevers, overheating, fatigue, and brain fog—after increasing from 4.5 mg to 6 mg daily Reddit.

  • A forum user hiked miles without pain the day after their first 2.25 mg dose, describing LDN as key to reclaiming exercise Health Rising.

Negatives

  • Multiple posters noted zero benefit for POTS-type light-headedness even at 4.5 mg or higher, despite fatigue improvements Reddit.

  • One dysautonomia forum user quit after LDN “made me really depressed” Reddit.

  • Some felt early pain relief disappear after 2–3 months, leaving only side effects Mayo Clinic Connect.

Hurdles & Side Effects

  • CFS forum participants reported mild nausea and headaches during the first 4–5 days that eased on their own Reddit.

  • Responders warned that the therapeutic window is narrow—too low means no effect, too high means side effects—so they micro-titrated in 0.25–0.5 mg steps Health Rising.

  • Vivid dreams and disrupted sleep were common when dosing at night, leading several users to switch to morning dosing Mayo Clinic Connect.

  • LDN must be compounded; U.S. prices cited ranged from $29 for 90 days to $120 per month, and insurance rarely reimburses Reddit.

  • Patients on any opioid pain medication cannot use LDN—forum posters flagged abrupt withdrawal risk and the need to stop opioids first Reddit.

Was this summary accurate?

100% of people think this is accurate ( 3 / 3)

Tell us how this treatment affected you

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Natalie King

Natalie King

@guest

LDN got me from Severe to Moderate/Severe

Chronic Illnesses: Long COVID ME/CFS
Symptoms Treated: Chronic Fatigue - Major improvement - 1+ year
Side Effects Experienced: Felt Worse Initially - 1-7 days

Over the last 2 years I’ve slowly increased dosage from 0.5mg to now at 10mg. With so many viruses & infection I had to keep increase which has improved my body aches, fatigue. I went from shower once a week to know showering most days. I’m still house bound from PEM & other conditions.

Details

  • Dosage 10mg
  • Source Me/cfs specialist
  • Last used <6mo ago
  • Times used 50+ times
  • Insurance covered No
  • Cost per month $1-$99

posted Anonymously

@anonymous

Did nothing, slight side effects

Chronic Illnesses: Long COVID ME/CFS
Symptoms Treated: Fatigue - No change - 1-4 weeks PEM (Post Exertional Malaise) - No change - 1-4 weeks

Did not have any effect on my fatigue and PEM, and caused paresthesia (slightly shooting pain/discomfort) side effects every once in a while. Titrated from 0.5mg to 3mg over a few weeks. Also recently tried again with 0.01mg but still got paresthesia.

Details

  • Dosage 0.01mg to 3mg
  • Source AgelessRX

Sam Nolen

Sam Nolen

@Sam Nolen

Helps for pain and inflammation

Chronic Illnesses: Long COVID
Symptoms Treated: Brain Fog - Better long time Pain - Better long time Chronic Fatigue - Better long time Neuroinflammation - Better long time

For me LDN helped a little bit with everything across the board, but it did not improve anything very much. Most noticeably it decreased pain and inflammation in my face and head. Not a miracle worker but a solid first-line treatment.

Details

  • Dosage 6mg
  • Source AgelessRx
  • Last used <6mo ago
  • Insurance covered No
  • Cost per month $1-$99

Steph L RM

Steph L RM

@Steph L RM

Unsure

Chronic Illnesses: Long COVID
Symptoms Treated: Brain Fog - Moderate improvement
Side Effects Experienced: Fatigue Vivid Dreams Lack Of Appetite Drowsiness

LDN about 6 months. Unsure if it has helped anything. Started it with Metformin and also extra oral supplents. But my condition has improved only minimally if at all. I do know that it doesn't make anything "worse". O could possibly say I'm more aware in the moment but that turns in to the same short term memory loss very soon and cognitive deficits remain. One extra side effect I would add is severe lack of appetite, distaste for food or anorexia (non psychological form).

Details

  • Dosage 4.5mg nightly
  • Source Compound pharmacy
  • Last used <6mo ago
  • Insurance covered No
  • Cost per month $100-$500

Al

Al

@guest

One of the only treatments with noticeable difference

Chronic Illnesses: Long COVID
Symptoms Treated: Brain Fog - Major improvement Energy - Major improvement
Side Effects Experienced: Vivid Dreams

I responded well to LDN from the first dose. Helped my brain fog a lot & a little with fatigue. Truly gave me some life back when I had lost hope. I felt like I couldn't think & making decisions was hard. Finding the right dosage seems to be tricky for some - Titrating up to 4mg from 1mg to 2mg took months/year for me. I had weird dreams from it but that's all for side effects except when titrating it made me jittery/anxious/frazzled when I went up too fast. Overall it's been good for me & I notice when I miss a couple days. Helps me think clearer & have better mood. I got good grades growing up, wrote for fun/work & still struggle with feeling like I can't express what feels like thoughts that are fully formed but behind glass sometimes. LDN is worth a try if you're considering. My long covid doc said 50/50 helps long covid & is relatively low risk side effects wise. I've been on it for nearly 2 years now.

Details

  • Dosage Started 1mg, now 4mg
  • Source Dr. William Brode, UT health Austin Long Covid Clinic
  • Last used <6mo ago
  • Times used 50+ times
  • Insurance covered Yes
  • Cost per month $1-$99

Picklemelissa

Picklemelissa

@Picklemelissa

Only helped CRPS, not LC or ME

Chronic Illnesses: Long COVID
Symptoms Treated: Neurological Pain - Major improvement
Side Effects Experienced: None

Although it helped control CRPS pain, it did nothing for my ME or LC. It did not help with fatigue, PEM/PENE, or any cognitive impairment. LDN is a very individual drug. It doesn’t help everyone and, in Australia, it is quite expensive. It is worth trying IMHO, but it’s not the wonder drug many people think it is.

Details

  • Dosage 1.5mg for 30 days, 3mg for 30 days, 4.5mg thereafter.
  • Source Pain specialist
  • Last used <6mo ago
  • Insurance covered Yes
  • Cost per month $1-$99

posted Anonymously

@anonymous

Side effects went away with time

Chronic Illnesses: Long COVID
Symptoms Treated: Brain Fog - Better long time
Side Effects Experienced: Fatigue

takes awhile to have an effect, for me about 2 months. Best prescription drug for Long Covid. https://suomencovi­dyhdistys.fi/

Details

  • Dosage 3mg
  • Source Neurologist
  • Last used <6mo ago
  • Times used 50+ times
  • Insurance covered No
  • Cost per month $1-$99

1 other people found this review helpful
longcovidgoaway

longcovidgoaway

@longcovidgoaway

Night terrors and wired during the day

Chronic Illnesses: Long COVID
Symptoms Treated: Chronic Fatigue - Worse short time

This drug gave me night terrors and made me very wired during the day. I tried 0.5mg a day for about a week, two separate times months apart. For me, saw no noticeable benefit just unwanted sixe effects.

Details

  • Source Stanford ME/CFS Clinic
  • Last used 1+ years ago
  • Times used 2-10 times
  • Insurance covered Yes
  • Cost per month $1-$99

1 other people found this review helpful
Salvatore Mattera

Salvatore Mattera

@Salvatore Mattera

Tough to tolerate at first, unsure how much it has helped, but benefited me in other ways

Chronic Illnesses: Long COVID
Symptoms Treated: Heart Palpitations - Better long time Chest Pain - Better long time Chronic Fatigue - Moderate improvement Body Pain - Moderate improvement Heat Intolerance - Moderate improvement
Side Effects Experienced: Fatigue Brain Fog Irritability

I started LDN at 0.5mg and gradually increased my dose to 6mg over about 7 months. During this time, my Long COVID heart symptoms (which included stabbing chest pain and palpitations) gradually receded. I also found that it benefitted me in other ways. For example, even before developing Long COVID, I had some digestion problems that bothered me for most of my life. I noticed that these went away when using LDN and didn't come back so long as I kept taking it. Also, when I first started using LDN, it significantly reduced my appetite, and I lost about 5 lbs. Unfortunately, this only lasted for about a month. It was quite hard to start taking LDN--I had almost unbearable brain fog for about 5 days when I first began taking it, and I experienced severe fatigue crashes. This happened every time I increased my dosage, although it got less severe over time. My wife asked me to warn her when I was increasing my dosage, as it made me very irritable. Thankfully, these effects didn't last. I still take LDN today and will probably take it long-term even if I fully recover from Long COVID because of the improved digestion.

Details

  • Dosage 6mg
  • Source Linda Geng
  • Last used <6mo ago
  • Times used 50+ times
  • Insurance covered No
  • Cost per month $1-$99

Galen P.

Galen P.

@Galen P.

It helps me with fatigue and post-exertional malaise

Chronic Illnesses: Long COVID
Symptoms Treated: Fatigue - Better long time PEM (Post Exertional Malaise) - Better long time
Side Effects Experienced: Alertness Excessive Emotionality

Low Dose Naltrexone (LDN), has greatly helped with my profound fatigue and post-exert­ional malaise symptoms and helps many Long Covid patients. My optimal dose has been around 2.5mg, but the typical dose is 4.5mg per day (I've heard of co-workers taking higher doses, though, like 11mg). Make sure to start “low and slow,” around 1mg or lower, increasing the dose every few weeks. You can get the drug as a liquid solution so it’s easier to find the dose that works best for you. If it hurts your stomach, take it with food or ask for the drug in a lotion. I take it in the morning because it can keep me awake if I take it at night. To fill a prescription for LDN, you’ll probably need your doctor to send the prescription to a special kind of pharmacy called a compounding pharmacy. In San Francisco, I use Koshland Pharmacy. LDN is also available from AgelessRx.

Details

  • Dosage 2.5mg per day
  • Source Koshland Pharmacy, a compounding pharmacy