LDN | The Force Multiplier for Peptides and HRT
Low dose naltrexone is one of my favorite compounds. Not because it does any one thing dramatically. Because it makes everything else in your stack work better.
I've talked about LDN before. But it's 2026, and I wanted to revisit it. Specifically how it layers on top of peptides and hormones. That's the conversation almost nobody is having, and it's the one I think matters most.
Here's the thing. LDN is cheap. It's been around 40 years. It has a clean safety record. And most people in the peptide world are leaving it on the table.
What LDN Actually Is
Naltrexone got FDA approved in 1984 at 50 milligrams for opioid addiction. At that dose, it's a full 24-hour receptor blocker.
Then in 1985, a Harvard-trained neurologist named Dr. Bernard Bihari noticed something weird. HIV and AIDS patients had less than 20% of normal endorphin levels. So he ran a dose-ranging experiment from 1 to 4.5 milligrams at bedtime.
What he found was counterintuitive. A tiny dose only blocks opioid receptors for 3 to 6 hours instead of 24. The body responds with a 200-300% surge in endorphins and enkephalins. The drug clears. You're left with enhanced opioid signaling for the next 18 to 20 hours.
His placebo-controlled HIV trial was small. Around 50 patients. But only 8% of the LDN group died. 33% of the placebo group did. That's a big swing for such a tiny dose.
Bihari went on to treat thousands of patients with autoimmune disease, cancer, and chronic pain before his death in 2010. LDN remains entirely off-label. You have to get it from a compounding pharmacy with a prescription. Capsules are what I'd recommend. Skip the liquids and topicals.
A 90-day supply usually runs $30 to $80. About a dollar a day. Hard to beat.
How It Works
There are four mechanisms running at the same time. They're all worth understanding.
Endorphin rebound. The bedtime dose triggers a compensatory surge in beta-endorphin and met-enkephalin. Receptor density and sensitivity also climb. When the blockade wears off, more endorphins hit more sensitive receptors. You get better pain modulation, mood, and immune surveillance the rest of the day.
The OGF/OGFR axis. Doctors Ian Zagon and Patricia McLaughlin at Penn State spent 35 years characterizing this. Met-enkephalin (OGF) binds to OGFR on the nuclear envelope and upregulates P16 and P21. This slows cell replication at the G1/S checkpoint. Anti-proliferative, not cytotoxic. This is the cancer-relevant pathway.
TLR4 antagonism. In 2008, researchers found naltrexone directly blocks toll-like receptor 4 on microglia and macrophages. Completely independent of opioid receptor activity. Even the isomer with zero opioid activity does this. The result is shifted microglia from pro-inflammatory M1 to anti-inflammatory M2. This is where the chronic pain and neuroinflammation benefits come from.
Broad anti-inflammatory signaling. Parkitny and Younger showed in 2017 that 8 weeks of LDN significantly reduced 17 pro-inflammatory markers in fibromyalgia patients. It rebalances TH1 and TH2, increases T-regs, and normalizes the HPA axis.
That last piece is why LDN is a force multiplier. It clears the road for everything else you're putting into your body.
Where LDN Shines
The trials are small. But the direction of effect is consistent. Benefit after benefit with almost no downside.
Autoimmune and gut. Hashimoto's, MS, Crohn's, rheumatoid arthritis, lupus. Around 40% of Hashimoto's patients see meaningful improvement with antibody reductions. Dr. Jill Smith's NIH-funded RCT in Crohn's showed 78% endoscopic response versus 28% on placebo. That's documented mucosal healing on scope, not just symptom relief.
Chronic pain. Stanford's RCT showed 28.8% pain reduction versus 18% placebo. The diabetic neuropathy RCT showed efficacy similar to amitriptyline with 8 adverse events versus 52. People always ask me what the best peptide for neuropathy is. LDN deserves a seat at that table.
Depression. A Harvard RCT showed an effect size of 1.45 in treatment-resistant depression. That's a huge psychiatric effect.
Cancer support. The OGF/OGFR axis is present in 31 human cancer cell lines. LDN enhances chemo efficacy while reducing side effects.
PCOS and fertility. Menstrual cycles normalized in 80% of obese PCOS women in one trial. 49 of 66 women with hypothalamic ovarian failure normalized their cycle.
Skin. The JAMA Dermatology systematic review found LDN safe and effective across multiple inflammatory skin conditions. I'll say from personal experience that LDN crushed my acne. I struggled with it as a kid and as an adult on my back. I'm mostly clear now. The occasional flare-up is hygiene, not LDN failing.
Dosing
You have to be patient with this one. Allow 1 to 3 months for meaningful results. Stanford says at least 2 months at target dose before assessing.
Most people start at 1.5 milligrams. One to four weeks there, then up to 3 milligrams. Another one to four weeks, then 4.5 if you tolerate it well. I personally went 1.5, 3, 4.5. My sweet spot is 3 milligrams. At 4.5 I find it a little too stimulating at night. At 3 I fall right asleep.
Always use immediate release. Never slow release. The rebound depends on the short clearance window.
Bedtime works for 80 to 90% of people. The other 10 to 20% just don't tolerate it at night and need to switch to morning dosing. That's fine. You still get the benefits.
Vivid dreams are the most common side effect. About 37% of people get them. They usually subside as you normalize. Mild headache and nausea in some people, also fades within 2 weeks.
Adverse events in the 2019 meta-analysis matched placebo. The FDA hepatotoxicity warning is based on 300 milligrams a day. That's way higher than even the addiction dose of 50 milligrams.
One hard contraindication. If you're on sustained release opioids, you need a 7 to 10 day washout before starting LDN. Don't stack them.
LDN With Hormone Replacement
This is where it gets interesting. LDN isn't just compatible with HRT. It can make your hormones work better.
Chronic inflammation disrupts receptor sensitivity to exogenous hormones. It can drive SHBG up or down, which wrecks free hormone levels. It can push aromatase overexpression in people carrying inflammatory visceral fat. It can impair thyroid conversion.
LDN's drop in IL-6, TNF-alpha, IL-1-beta, and a dozen other markers clears that noise. Hormones can actually signal properly.
For Hashimoto's specifically, LDN addresses the autoimmune component directly. It reduces antibodies and slows thyroid destruction. A phase 2 RCT got registered in 2025. We're waiting on data, but the correlative work looks good.
Women tend to get a more pronounced HPA response to LDN than men, especially at high-estrogen phases of their cycle. LDN's anti-inflammatory effect complements estrogen's own.
For PCOS, LDN normalizes LH and FSH ratios, lowers cortisol, and improves insulin sensitivity.
For men on TRT or enclomiphene, LDN helps disinhibit the HPG axis. In rhesus monkeys, all doses stimulated LH and testosterone within 20 to 60 minutes. And there's a sexual function angle. One study showed 11 of 15 men with idiopathic impotence had improved erectile function on LDN. Hormones stayed stable. The benefit came from central endorphin-mediated reward signaling. If you're a guy with great labs but suboptimal sexual function, this is worth a look.
Bottom line. If your hormones look good on paper but you feel suboptimal, inflammation might be the bottleneck. Hormones aren't going to fix that. LDN can.
LDN With Peptides
No published RCTs for LDN plus peptide combos. But the mechanistic case is strong.
LDN's TLR4 antagonism dials down overactive innate immunity. That means less injection site reaction and mast cell degranulation. Increased T-regs shift the immune system toward tolerance, which means fewer anti-drug antibodies forming over time.
In practice, this is what I've seen. LDN can extend the useful window of a peptide. Where you might lose response at 8 to 12 weeks, LDN can stretch that. I wouldn't run LDN just to squeeze more time out of peptides. But it's a real effect.
A few specific pairings I think about often.
BPC-157. Complementary gut barrier work. LDN reduces inflammation, BPC upregulates tight junction proteins. Both modulate nitric oxide. This is a clean pair for IBD and gut permeability.
TB-500. TB-500 handles tissue repair through actin sequestration and angiogenesis. LDN brings down the inflammation that's blocking repair from happening. I get a lot of people telling me BPC and TB-500 didn't work for their shoulder. Sometimes there's just too much inflammation at the site for repair signals to land. LDN and KPV help with that.
GH secretagogues. Separate dosing by 2 to 3 hours. LDN at 9 p.m., GH peptides closer to bedtime. LDN may blunt the GH pulse during blockade but amplify what comes after.
GLP-1 agonists. This pairing is special. There's already an FDA-approved drug called Contrave that combines naltrexone with bupropion for obesity. LDN blocks hedonic eating. GLP-1s target homeostatic hunger. Together they address both types. What I've seen with LDN added to GLPs is that I can stay at a lower dose and keep getting appetite suppression and fat loss. Most people start 2 milligrams of tirzepatide or retatrutide, run 4 to 8 weeks, then stall. Add LDN at 1.5 or 3 milligrams and the lower dose keeps working longer. You still might titrate up eventually, but maybe at 12 to 16 weeks instead of 4 to 8.
Thymosin alpha-1. The most immunologically logical pair for autoimmune conditions. TA-1 drives CD4+ T cell differentiation. LDN shifts TH2/TH1 balance. Both knock down TNF-alpha and IL-6.
KPV. Direct mechanistic convergence through NF-kappa-B inhibition. KPV targets inflamed intestinal cells through PEPT1. LDN inhibits NF-kappa-B through TLR4. LDN may also raise endogenous alpha-MSH, which is KPV's parent molecule.
Selank and Semax. Selank inhibits enkephalin-degrading enzymes. LDN upregulates enkephalin production. More production plus less degradation equals significantly higher sustained enkephalin levels. Clean stack for anxiety, cognition, and neuroinflammation. Mood is one of the most underappreciated LDN benefits.
SS-31. Top two or three peptide for me. SS-31 targets mitochondria through cardiolipin binding. LDN reduces the cytokine burden that damages mitochondria and impairs the electron transport chain. Non-overlapping pathways for cellular energetics and neuroimmune dysregulation. Big upside for chronic fatigue, long COVID, and aging.
My Take on Cycling
For the last couple years I went 3 months on, 3 months off. I felt great either way. But I felt noticeably better on.
For the last 8 months I've been running 3 milligrams nightly without breaks. Only noticing benefit. I'll probably run a full year and then come off to see if I notice anything.
The old conventional wisdom was 3 on, 3 off. Looking at the literature now and talking to a lot of people in my group who use LDN daily, I think this moves into the daily category for most people. If you're new to it, try both. Three months on, three off to start. See how you feel. Adjust from there.
My Perspective
LDN is a support molecule. It's not going to do what your peptides do.
But it does one quiet thing. About 20 subtle things, actually. That make the rest of your protocol work better.
Most of you reading this are high performers. You wouldn't be in the peptide world if you weren't. Some of you came in to heal something major. A lot of you are always hunting for the next 5%.
LDN is that 5 to 10%. It has its own direct effects, and then it makes everything else work better. In my own life it's been one of the most consistent additions I've made.
It's cheap. It's safe. It's easy to source if you know where to look. And almost nobody in this space is talking about how well it stacks with what we're already doing.
Worth a shot.
Full transcript click any paragraph to jump video
Hey everybody, this is Hunter Williams. I hope you're doing amazing wherever you might be in the world. Today's video is going to be all about low dose naltrexone. This is something that I've made a video out about before and I talked, I know pretty good length on different podcasts and different live streams and things I have done in past. But today for 2026 and it's April 20 26 right now, i wanted to do an updated video with LDN again, AKA low-dose naltrexon. this one of my favorite compounds out there. Obviously it is a pharmaceutical and It's been around for a long time.
Now, trexelone itself is actually a drug that is used to help people come off of opioids to, help with opioid withdrawal. But when we use it at very low doses, it actually has a very different effect on the body and actually kind of works as like an immune system modulator. So it helps bring our immune systems into balance, whether we have an overactive immune, system like in autoimmune disease, or you have a, very suppressed immune. It kind, of helps bringing it back into balancing. What I wanted to today is talk about specifically about what LDN can do just for the health benefits of it, because even if it didn't relate to peptides and hormones and that stuff, I think there are many health benefit that we can get from LDM.
But then also, we're going to talk specifically, about how it relates to our peptide use and our hormone use. And that's one thing I've not really heard anyone other than myself talk, and I kind of want to help get this information out there because I it's a very underutilized tool, especially when we look at all the chronic disease and all of these weird immune Slash autoimmune type diseases that we have out there because those are very relevant when we talk about the peptide conversation So that's what we're gonna cover today as always. Thank you guys so much for being here I'm always overwhelmed with gratitude for the support that I get from you guy So thank you for that as I was just
make sure you're there on the email list censorship again is out There right now and so please make you around the e-mail list There's always gonna be a link to sign up wherever you watching this video just to stay in touch with me again I don't spam you I just send out different studies or things that I'm reading about or also content that i am publishing and working on. So make sure you check that out and join the email list and also too if you want to be in my private group make, sure, you have all of your questions answered. The best place to do that is inside the Axion Collective which is my Private Group so check, that, out as well we got over 200 people in there right now
and it's a really cool place. We do live coaching calls every Thursday night at 8 p.m. Eastern. Without further ado I am going to share my screen and today we're going, to talk about low dose naltrexone. All right, let's get into it. Today is going to be all about low dose naltrexone. And actually the cool thing about this is even if you're getting it prescribed from a doctor, which there's a lot of really good anti-aging telemed services out there now that will do that, it's only $1 per day in most cases. Pretty cheap, but why does LDN deserve a spot in our protocol? First of all, it has a 40 year safety record. So it's been around, like I said, for a really long time.
We've never really seen any adverse events in any published clinical trial, especially on the low dose. And then there's obviously broad clinical benefits. When we look at the benefits, we get autoimmune disease benefit, Chronic pain benefits for the gut, benefits from depression and mood disorders. We even see benefits in cancer. Side note, there's actually a big push right now to rename PCOS from a clinical perspective amongst practitioners to actually change it to, I think they're calling it female reproductive metabolic syndrome or something like that.
because it really is related to our metabolic health. And then we have obviously fertility, it being a benefit for fertility again is off pat generic. You can usually get a 90 day supply for like somewhere between 30 and 80 bucks. That's about how much I paid for it. Again, when we talk about LDN, not only does it work really well for the things that we just talked about, but it also pairs really synergistically with HRT. uh, peptides and all of the things that we love to talk about in our world and actually can amplify the effects that We get from those. And so that's what we're going to look at today to give you a little bit of background on it.
There was this guy named Dr. Bernard Bahari. Hopefully I'm pronouncing that right. But, uh it was now trexel in itself. So not the Lotus version, but now Trex on itself was FDA approved in 1984 at 50 milligrams for opioid addiction. It was a full 24 hour receptor blocker. However, in 1985, this Harvard trained neurologist Dr. Bernard Bihari found that HIV and AIDS patients had less than 20% of normal endorphin levels. So what he does is he ran a dose ranging experiment from one milligram to four and a half milligrams at bedtime to see how they responded.
And counter-intuitively, he found a tiny dose blocks receptors for only three to six hours instead of a full 24 hours. The body compensates with around a 200% to 300% surgeon endorfins and enkephalins probably heard of this peptide called met enkephalin, which kind of acts like, I don't know specifically because I haven't read enough on it, basically acts as an anti-pain peptid. Then the drug clears and it leaves the enhanced opioid signaling for around 18 to 20 hours, to allow us to have a low inflammatory state in the body because we're getting the surge of endorphins.
When we look at the results that he got from his trial, around in the 1985 to 86 placebo HIV controlled trials around 50 patients, only 8% of them died. Whereas the ones that didn't receive it around 33% percent of the died, so it was a drastic difference. Again, a small trial but we see a drastically difference in amount of people that died did not have LDN and the one's that did have And since then, Bahari has treated thousands of patients with autoimmune disease, cancer, and chronic pain before his death in 2010. An LDN remains entirely off-label.
It must be obtained from a compounding pharmacy, most times with a valid prescription. Again, in most cases, you're not going to see this for sale that it doesn't come from And the most common form is a capsule. You do see liquid, sublingual, or topical formulations, but I would recommend just the capsules to take. So let's look at the four mechanisms that LDN is actually working on to create these effects in the body. They're doing these simultaneously, But I think these are the 4 most important benefits that we get that it's going to confer.
One is the endorphin rebound. So again, to go back to Dr. Bahari, what he was talking about, the bedtime dose triggers a compensatory surge in beta endorfin and met in caliphin. Again, you've probably heard of that peptide circulating around there on the wild called met and caliphen, and receptor density and sensitivity also increase. Now when the blockade wears off, more endorphins hit more sensitive receptors, enhancing pain modulation, mood and immune surveillance for the rest of the day. So again, we get this blockaded bedtime, a surge of endorfins and then a clearance of rebound, which again helps with immune,
surveillance and all of those things that we're talking about. The next mechanism is going to be the OGF and OGFR axis. So this goes back to 35 years of research. Doctors Ian Zagon and Patricia McLaughlin at Penn State characterized this pathway. Again, OGIF, which is met in caliphate, binds to OG FR on the outer nuclear envelope, triggering the upregulation of P16 and P21 cyclin-dependent kinase inhibitors, not to confused with the peptide P 21. This slows cell replication at the G1S checkpoint, which means that it's purely anti-prolifitive and not cytotoxic,
and LDN transiently blocks receptors, causing the body to produce more OGF and upregulate more OGFR. So this is the mechanism most relevant to cancer applications. But as you see in this diagram here, we take naltrexone or low-dose naltrexon, it increases OG F which is met in calafen. And then we get this cycle with P16 and P21, lead to the things that would end up conferring anti-cancer effects from the LDN. We also have TLR4 antagonism, and this is where we see a lot of the immune benefits come in around low dose naltrexone.
So in 2008, They discovered that naltrexone directly blocks tol-like receptor 4 on microglia and macrophages completely independent of opioid receptor activity. So even the isomorph with zero opioid activity blocks TLR4 and this suppresses micro glial activation, shifts microglia from pro-inflammatory M1 to anti-inflamatory m2 and reduces neuroinflammation via the TRAF IRF3 pathway. So this is most relevant to chronic pain and neurological conditions.
This is where we see those pain benefits come in. And again, so that's shifting from the M1 state to the m2 state, the naltrexone induces that really helps the body. And then when we look at the fourth mechanism, it's just basically going to be broad anti-inflammatory signaling. I would think, and most people would agree, that antiinflammatories things are going be good for us, obviously, within a very specific context. Obviously, you want the inflammatory cascade that comes after exercise because that helps with the repair. But in 2017, Parkitny and Younger showed eight weeks of LDN significantly reduced 17 pro-inflammatory markers in fibromyalgia patients.
So we have TH1 and TH2 rebalancing. Again, this goes into your immune system. LDN will shift the immune response away from chronic inflammatory dominance, which a lot of people struggle with. I've struggled with that myself in the past. It also helps with regulatory T cells, so it increases T regs, reducing autoimmune and inflammatory activity. And then we also have a normalization of the HPA axis. So it modulates the stress response towards normalized function, not chronic activation. And then this mechanism is that this is what makes LDN really a force multiplier for everything else in the stack and then also is going to layer on top
of those peptides and hormones that we're taking to really get more of a benefit out of them. So where does LDN shine? Let's look at some of these use cases where we're really going to see a noted benefit. So a lot of trials are small, but the direction of the effect is remarkably consistent. Benefit after benefit with essentially no downside that we are seeing in people using these. So let's look at autoimmune pain and gut. So there's been benefits shown in Hashimoto's, MS, Crohn's Rheumatoid Arthritis, and Lupus.
Immune modulation without immune suppression, around 40% of Hashimoto's patients see meaningful improvement with significant antibody reductions, which is going to be, again, those thyroid antibodies being way up in Hasimoto. LDN is gonna help bring those down. And again, you talk about that synergizing with a peptide like thymus and alpha-1. Thymolin and LL-37 could do really well. We see benefits in chronic pain and fibromyalgia. So a Stanford randomized control trial, 28.8% pain reduction versus 18% reduction from placebo.
You also have a diabetic neuropathy RCT with similar efficacy to amitriptyline, but eight adverse events versus 52 from the amatriptaline. far significant for significantly lower adverse events to the LDN than the neuropathy medication with similar efficacy, which is pretty cool. And again, not something I get asked about neurapathy all the time. What's the best peptide for neuropy? Well, we have LDM and again it's going to work on top of some of these peptides to enhance the response. Then we look at gut health, Dr. Jill Smith's NIH funded RCT, 78% endoscopic response versus 28% placebo, so documented mucosal healing on endoscope, not just symptom relief,
which was pretty cool when we looked at Crohn's. And again, that's one of the larger use cases. You see really good benefits that people experience with LDN. Now let's look at a couple more depression. There was a Harvard RCT with an effect size of 1.45 and treatment resistant repression, which is a very large psychiatric effect when they use that scale measured in psychiatric disorders, cancer support. So the OGF and OGFR axis is present in 31 human cancer cell lines and LDN enhances chemotherapy efficacy while reducing side effects.
Again, whether or not you believe in chemotherapy, that comes up a lot in the conversation with peptides. I think a lot of peptides can help in relation to chemotherapy if you are doing chemotherapy. LDN is another one of those agents that works alongside it to kind of help some of the bad side effects that are coming from the chemotherapy when we look at PCOS and fertility, menstrual cycles normalized and 80% of obese PCO women when they used LDM in one trial and then 49 out of 66 women with hypothalamic ovarian failure achieved normalization of their cycle and 18 of when we talk about this in relation to nothing else being controlled or everything else
been controlled for, that's a pretty big jump when you look at some of those things. So we see benefits in psoriasis, eczema, and different skin issues. The JAMA Dermatology systematic review found LDN safe and effective across multiple inflammatory skin conditions. Again, I'm not saying that if you have acne or if we have exema psoriasis that LDM will absolutely heal everything, but it's absolutely something I would make sure that anyone dealing with those But absolutely. I could say that as someone that has struggled with acne as a young person and also as an adult person on my face when I was younger and then on back as
I've been an older person, LDN is absolutely a game changer when it comes to acne. And I noticed a much, much better response from LDM in terms of suppressing my acne and for the most part, I'm acne free now, but I will have like little flare ups here and there. That's related to just hygiene around like maybe I trained at the gym one day and if a gym that I went to didn't have showers, had to drive my car 20 minutes home to get in the shower. And so sometimes there's like kind of that festering of sweat. But anyway, let's talk about dosage. So you got to be kind careful with the dosages because if you start too high, too fast, you can get some weird side effects.
Again, nothing dangerous, but just something that's probably not pleasant. You really have to allow one to three months to see meaningful results. Stanford, based on their trials, recommends at least two months at target dose before assessing the efficacy of, has it done anything at all? And most people, right away you're going to get some vivid dreams, although those tend to subside after you normalize to the use. Morning dosing is a good alternative for those people. I will say in my experience, having worked with a lot of people, I'd say like 80 to 90% of the people do really well with it at night. And then there's like 10 to 20% people probably one or two out of 10 that just don't do well at the night, but if they take it in the morning,
they're fine. They don' get sleepy. But I wouldn't say that naltrexone necessarily makes you sleepy, But if you could pick one night would be a little bit better because you tend to get again that cycle of endorphin release that kind of carries over into the next day and helps you. feel well. So typically what most people do, the, titration schedules are different. Most people start at 1.5 milligrams. You want to do that for at least one to four weeks before you jump up to three milligrams and again, that another one, two, four, weeks. And then if you do well with that, you could try to go up four or five milligrams, and then just stay there.
I personally have gone from 1.5 to 3 to 4.50. I find three milligrams to be my sweet spot. So for me, 4 .5 milligrams tends to a little too stimulating at nighttime for meat, whereas three milligram is perfect, I fall right asleep. And then again, always use immediate release, so never slow release. The rebound mechanism depends on it clearing in those short hour windows for the cascade to happen after that. Um, and then, again just make sure if you're sensitive to fillers, if your getting compounded that you don't have any Sensitive to that,
especially in the case of LDN when a lot of the people using it might have some sort of immune action going on there. Looking at side effects, I'd say when you document it, about 37% of people get vivid dreams. That's a very common thing to see. 0% adverse events. So again, when we look at this, even a 2019 meta-analysis confirmed no excess adverse event versus placebo, which is pretty interesting. Again, for people that get mild headache and nausea, that usually resolves within two weeks. I'd say any of the weirdness usually goes away after two week.
FDA hepatotoxicity warnings based on 300 milligrams a day. Again that's way higher than even the dose being used for opioid withdrawal, which is usually 50 milligrams. The one harder contraindication, because I do ask this question more than you would think, the concurrent sustained release opioid use requires a seven to 10 a day washout. So if you are using opioids, The recommendation is to not use those concurrently. You want to make sure those are out of your system and then transition over to LDN. Also, there was a doctor he used LDM through 37 weeks of gestation and over 2000 pregnancies without reporting complications.
I'm not going to tell you if you're pregnant, whether or not to take it. And so, you know, just, use your discretion and work with your doctor when it comes to that. Now, onto the fun part, talking about LDN and hormone replacement therapy. Not only is LDM okay to take with your hormone-replacement therapy, but it's actually potentially synergistic through multiple pathways. So let's look at what those are. When we look inflammation, so chronic inflammation disrupts receptor sensitivity to the exogenous hormones we're taking. It can also increase SHBG. That's another thing for men and women.
They can be a massive, I would say, interrupter or a disruptor of their hormone therapy is how high their SHPG is, or even it being too low. And so we can modulate that with LDN because of helping with inflammation. We can also, for people that are over-expressing to aromatase, which I will acknowledge can be a real thing in some people, although I'm a proponent of estrogen, I would acknowledge that people who have lots of inflammation, inflammatory visceral fat, they can over express aromatase which can lead to not so good side effects from their hormones.
And also some of this inflammation can impair thyroid conversion. So LDN's reduction of interleukin-6, TNF-alpha, inter-leucin 1-beta, and 14 other markers clears the road for hormones to signal properly. do what they're supposed to do in the right way. When we look at Hashimoto's and thyroid optimization, so LDN addresses the autoimmune component directly, it reduces antibodies and slows thyroid destruction. So again, a phase two RCT with LDM was registered in 2025 looking at thyroid.
Again, we don't have the data back on that, but we are seeing a lot of correlative good data between LD and a thyroid, We look at estrogen progesterone women show greater HPA, which is their hypothalamic pituitary adrenal axis response to naltrexia on the men. So again, men can use it. I use that personally, but it just seems to have a more outsized effect in women because of this effect. Especially at high estrogen phases of their cycle and LDN's anti-inflammatory benefits complement estrogen's own properties and may improve receptor efficiency for their estrogen.
We also look at PCOS and fertility LDM blocks opioid toll and driving abnormal LH pulsatility. And it normalizes LH and FSH ratios, reduces if for people that have PCOS where there are androgens and estrogenes are out of balance, it will help normalize that ratio and also lower cortisol and improves insulin sensitivity. So again, It's going to help a lot of cases with that. We look at LDN for HRT in men, it's going to help disinhibit the HPG axis, which is the hypothalamic pituitary gonadal axis.
Stimulating LH and endogenous testosterone in a male rhesus monkeys, all doses significantly stimulated L H and testosterone within 20 to 60 minutes. And it is mechanistically complementary to clomophene and enclomophenes. Again, whether you're maybe just using enclomorphene or you are on TRT or going get a benefit from it. Interestingly for sexual function, there was one study that 11 out of 15 men with idiopathic impotence showed improved erectile function from LDN via the central endorphin mediated reward signaling, not the hormone change, the hormones stayed stable.
So it's useful for men, with good testosterone levels, but suboptimal sexual functions. I would say that's one thing you hear a lot about guys on TRT not necessarily having the best sexual functioning or maybe it is really good for a year or two and then their sexual tends to decline. I think LDN, although not in every case, is it going to be a savior? No, but it can be very beneficial for sex drive for some of those men that feel that way. Also for chronic inflammation, again, to go back to SHBG, the drives, you know, impaired aromatase conversion and impaired androgen receptor sensitivity.
LDL cytokine reduction helps testosterone work more effectively at the receptor level. And if levels look good on paper, which you feel suboptimal inflammation may be the bottleneck. So a lot of guys don't realize that they think And rightfully so that like all of their ills can be solved with hormones. And that's true in a lot of cases, but sometimes there's still this lingering inflammation, again, whether from obesity or environmental toxins or autoimmune disease or whatever that LDN can help address to make the hormones work better. And then at low doses, the endorphin rebound is proposed to normalize HPA axis function rather than chronically stimulated,
especially relevant for men whose testosterone issues are secondary to chronic stress. So again, I've dealt with this in the past. Like no amount of hormone therapy for me can change the fact that sometimes I'm stressed out and sometimes, like I have impaired adrenal function. And so LDN is one of those things that can help modulate and normalise some of that adrenal functional because my cortisol will be completely shot, you know, just especially depending on different things, that I had gone through in past with stress work and things like that. So I've found LDN to be very beneficial in those cases. Now when we look at peptides, it's pretty cool. So again, there's no published RCTs for LDn plus peptide combos.
However, what we're going to talk about is individual agent data with some of the more common peptids. The one we have TL4R agonism, or TLR4 aganism or antagonism which dials down the overactive innate immune tractors. We get less injection site inflammation and mass cell degranulation from our peptines. We see increased Tregs which shift the adaptive immune system toward tolerance, reducing anti-drug antibody formation. What that means in principle is that a lot of times LDN can extend the efficacy of our peptides, whereas maybe like eight to 12 weeks after using a peptide,
we completely down-regulate to it. LDN is actually going to help modulate that immune response to the peptide, potentially extending the shelf life or the window that we can use a peptid on. And I wouldn't recommend into getting this game of using LDM just to extend the life of peptides that you're using. However, it can be very beneficial for that in some cases. We also get lower systemic inflammation, which raises the threshold for triggering unnecessary immune responses to our peptides that we're injecting. It also enhances dendritic cell maturation, making the immune system more discerning and better at tolerating non-pathogenic antigens.
So let's look at some specific peptide. Talking about every peptide with LDN would be outside the concept or the scope of this video. However, I just took some pretty common ones and talked about like, okay, what can we do with these? So we look at LD and BPC 157. This is a very compelling pairing when we looked at peptides and what they can do. Both improve gut barrier function through complementary pathways. LDM reduces stress and BBC up regulates tight junction proteins. And there's complementary nitric oxide modulation, which is ideal for gut permeability and inflammatory bowel disease.
Then we have LD in TB 500. Complementary at different levels, TB500 drives cellular repair via actin sequestration and angiogenesis, which is the formation of new blood vessels. And then LDN operates at the neuroimmune level. So LDM provides the anti-inflammatory environment. Then TB 500 handles the tissue repair when it's LD and it helps bring down the. I think that's a very important thing to talk about, because I get a lot of people that are like, hey, I did this to my shoulder and BPC and TB 500 don't work, what's going on? And a lotta times, although those can be very helpful, and sometimes they're the only thing we need, sometimes there's still too much inflammation at the
site of the injury or the pain that needs to be brought down. That's why KPV pairs really well. that why LDN helps kind of accentuate those peptides. So we look at GH secretagogues. separate dosing by two to three hours, LDN at 9 p.m. and then peptides, maybe closer to bedtime if you're going to bed at like 10 to 11. So LDM may transiently blunt the GH pulse during blockade, but amplify subsequent pulsatility. Again, you might not want to take them right together, But they can be enhanced response to the IGF-1 and IGFP-3 appear unaffected by LDL.
And so again, they work synergistically there, just bringing down inflammation. And then we look at GLP-1 agonists. There was rationale for Contre, which is FDA-approved naltrexone, plus bupropion for obesity, LDM blocks, hedonic eating, GLp-2 targets, homeostatic hunger, and together they address both types of hunger systems when we talk about overeating and then overlapping anti-inflammatory metabolic benefits. I would say actually if there's like one peptide or two peptides that LDN is very comparable to, and just in terms of what it does, it's the GLPs and your immune peptines.
So GLP's are going to help with a lot of the same things that LDN's helping with. Same thing with your thymus and alpha ones of world, because that's what helps bring down this immune response. And the cool thing about LDM that I've noticed from my GLp use is that, I can stay at a lower dose and get those benefits at longer clip than most people. Whereas most say they start two milligrams of TERS or RETA, They use it for a while, let's say four to eight weeks, and all of a sudden the two milligrams doesn't do anything for them. They stop losing fat, they stop getting appetite suppression.
Well, introduced LDN, it may be 1.5 milligrams or three milligrams. And now all the sudden, you're better able to get the appetite, suppression, the fat loss at that dose for longer. Now, does that mean you still won't have to tight trade up? No, but maybe it takes like 12 to 16 weeks before you get to that point, then maybe four or eight. And I think that's powerful because it allows us to use a lower dose because we're healing the environment in the body. We're modulating the immune response to the peptide, which again, keeps us at a lowered dose. And then maybe it helps us avoid some of the side effects that people get from doing higher doses.
Again, Thomas and Alpha 1, another great pairing. This is the most immunologically logical combination for autoimmune conditions. And TA1 stimulates CD4 plus T cell differentiation. LDN shifts TH2 to TH1 balance and both reduce TNF alpha and interleukin 6, which addresses immune dysregulation and neuroimmune levels at the same time. We have LDN and KPV, like I mentioned a second ago. So this is the most direct mechanistic convergence via NF-kappa-B inhibition. KPV targets inflamed intestinal cells via PEPT1 transporter, and LDM inhibits NF kappa B through TLR4.
LDMs blockade may also increase endogenous alpha melanocyte hormone, melanocytes stimulating hormone which is KPB's parent molecule. Pretty cool. So we do see mechanistically that LDN actually raises alpha MSH, which again, KPV is kind of like a fragment or derivative of, and we see LDM and C-link and CMax. C link actually inhibits enkephalin, I always mispronounce that word, encephaline degrading enzymes. LDL upregulates enkefalin production. More production equals less degradation.
which results in significantly higher sustained enkephalin levels and both reduce pro-inflammatory cytokines and modulate GABA-urgic signaling. So we have a clean combination for anxiety, cognition, and neuroinflammation. I think that's one thing that a lot of people don't realize or talk about enough with LDN is how much it helps modulating mood and anxiety. Then we have SS31 with LDN. Again, SS 31, it's one of my favorite peptides. I would say a top three or top two peptide targets mitochondrial function via cardiolipin binding. LDM reduces the cytokine burden and damages the damage of mitochondria and impairs electron transport chain efficiency.
So non-overlapping pathways addressing cellular energetics and neuroimmune dysregulation. And again, you see a lot of improvement around chronic fatigue, long COVID and aging. with those two combos. And then just to sum up LDN is the definition of a support molecule. Is it going to do all the things that our peptides do? Absolutely not. However, it does one dramatic thing. It's 20 subtle things, that make the rest of your protocol work better. I think for the person that is optimizing, is using peptide in an intelligent manner, LDN can be one thing that maybe you feel better,
but maybe there's like that last five to 10% that LDM can come in and just make everything better. And I know in my life it has, and I would even say for the person, most of you guys out there are what I call high performing people. You wouldn't be in this world if you weren't. you wouldn be seeking all the things that you're seeking in the peptide world. I knew a lot of people come at it from like having to heal something major in their life. But then a lot of people, too, are always looking for the next best thing, which, hey, I get I'm one of those people too. And that's where LDN is going to come in and maybe be that last 5% to 10% that not only has its effects, but also makes everything work better.
So again, just to sum up, clear cell inflammation modulates our immune system, upregulates endorphins, and reduces neuroinflammation. Again, we don't have a ton of trials specifically with HRT and peptides. However, it is something that I think is highly beneficial. That is it for the slides, and those are the studies. If you want to look those up, you can look them up. And that is my update for LDN and 2026. Hopefully that was helpful to you.
I did go a lot deeper on this presentation than the last one I made just because I wanted to bring in some more data to kind of support those things and also talk about it more in the context of hormones and peptides. Now I mentioned the fact that you can use LDM to extend the response that your having to a peptide. work longer and not have to titrate up the dose as fast. You could do that, but I just would not recommend playing that game.
I would think of LDN as something that you would bring in to help everything do better. Now, the one question I specifically didn't include in the slides, because I wanted to share my personal experiences, is the idea of cycling. So the last couple of years that I've been using LDM, I have gone back and forth between using it three months on and three month off. And I felt great doing that, but I just noticed that when I was on, I feel so much better. It's not that I've felt bad when was off, just felt so better when on. And so what I been doing, it's probably been the last eight months, have just been using it consecutively.
Every night, three milligrams, and I have only noticed benefit. So I'm gonna try it probably for about a year total and then maybe come off just to see if I notice any difference. But I do think in the past, that was probably more of the opinion, use it three months on and use three month off. But now, looking at a lot of the literature that's out there and just my own personal experience and a whole lot other people that I talk to inside my group who use it all the time, I think it is one of those things that would kind of move into the category as something that i would use every day. So again, that is just me personally. I would recommend that if you are going to try it, maybe try both.
Use it for three months on, three month off to start. See how you feel and then you can kind play with it over time. Again, the great thing about it is that it's very affordable, very easy to find if you know what you're doing and it can be used to enhance all of the things that we're already doing. So again, thank you guys so much. And closing, I am so blessed and honored to get to bring these messages to you. You have no idea what a dream come true it for me to be able to do these and kind of bring things to use. Thank you, guys, so whatever shape, form, or fashion it that you support me, whether it through just using my code at places,
being on the email list, sharing this with friends and family, liking, commenting, and all that stuff. I promise you that goes so much further, you know, in helping support me to bring these messages to you. So thank you guys for that. It gets a little redundant if you listen to all my stuff, but I just want to always make sure you do that because without you, guys, I don't exist. That's it for this one. Let me know your comments, thoughts, feedback, whether this has been helpful for you and I will see you in the next one, peace.