LDN (Low Dose Naltrexone) Flex-Tabs Service Fee STRIVE PHARMACY

You are requesting a service from Dr. K to provide the listed item above to be shipped to the specified address on the order. Because this requires a prescription, you must have received an *Approval Message* from Dr. K to your Push Health account prior to requesting this service. You also must also pay your New Patient Fee if applicable. Do not request this service without prior approval or your request may be refunded minus a 5% processing fee. Returning clients may request a service when ready and do not need permission to request a new service. Please message us with any questions before you request a service and we will happy to assist you.

***AVAILABLE IN ALL OF OUR STATES***

INFO:

1. Please fill out the LDN form BEFORE ordering to receive approval to order LDN. The form can be found here:
   
   https://app.formdr.com/practice/MzUxMTQ=/form/am8N...
   
   
2. These oral flex-tabs will be shipped to you from STRIVE Pharmacy's Missouri location and will ship to all patients.
3. This product can be stored at room temperature.
4. Please ORDER THE DOSE YOU PLAN TO TAKE. Use the 4.5mg flex-dose tablets for the 4.5mg or lower doses. Use the 8mg flex-tabs only for the 6mg and 8mg doses.
5. IF YOU ARE ORDERING LDN FOR THE FIRST TIME, YOU MUST CHOOSE THE INITIAL TITRATION PACKAGE FOR $75.
6. Patients that have been on the Synergy Bella Capsules from Empower or the Stella Capsules from Artisan/Rush within the past 4-6 weeks may start at the 8mg dose if desired.

DOSING:

• The most common dose for most conditions is 4.5mg a day. Some patients using LDN for obesity may need higher dosing of 6-8mg daily. Although it’s rare, some patients using the medication for obesity and food addition may need to take a 16mg daily dose (8mg twice daily). The best dose for each patient may vary.
  
  
• Strive offers Flex-dose tablets in several dosing options. I will be using the 4.5mg and 8mg flex-dose tabs. These tablets are designed to support a gradual tapering process, enabling adjustments in dosing. They can be taken whole or divided into 2, 3, and even 4 doses, depending on where you are in your taper.
  
  
• FIRST TIME ORDERING STARTER DOSING: You will be sent #30 flex-dose 4.5mg tablets and have the choice of three dose escalation options. I recommend the first option to minimize any side effects and to allow you to experience the effects of each dose to help determine the right dose for you. Increasing your dose more gradually can also help minimize side effects.
  
  
  • Option 1: This will be printed on your prescription. This allows for the most gradual dose increase, but you may opt for one of the below options as well.
    • Take 1/4 tablet a day X 14 days
    • Take ½ tablet a day X 14 days
    • Take ¾ tablet a day X 14 days
    • Take 1 full tablet a day thereafter (9 days left)
    • This initial supply will last you 51 days initially with this schedule.
      
      
  • Option 2: For those that want to reach the 4.5mg dose a little more quickly.
    • Take 1/4 tablet a day X 10 days
    • Take ½ tablet a day X 10 days
    • Take ¾ tablet a day X 10 days
    • Take 1 full tablet a day thereafter (15 days left)
    • This initial supply will last you 45 days initially with this schedule
      
      
  • Option 3: For those that want to reach the 4.5mg dose most quickly
    • Take 1/4 tablet a day X 7 days
    • Take ½ tablet a day X 7 days
    • Take ¾ tablet a day X 7 days
    • Take 1 full tablet a day thereafter (19 days left)
    • This initial supply will last you 40 days initially with this schedule
      
      
• REPEAT ORDERING: Most patients will have reached the 4.5mg (full tablet) dose by the end of the above starter period. When you are ready to reorder to continue the 4.5mg dose, you may select #30, #60, or #90 tablets. You will take one full tablet a day. For best results, DO NOT SKIP OR MISS doses. LDN is most effective when taken regularly. Some patients see results right away, while some need 1-3 months.
  
  
• HIGHER DOSING: Patients that are using LDN for obesity, food addiction, and/or appetite suppression may need to use a higher 6mg or 8mg daily dose.
  
  
  • After competing your initial dose escalation to the 4.5mg daily dose, I recommend using the 4.5mg daily dose for at least another 30 days before moving up in dosing. However, this is not an absolute rule.
  • You will be using the 8mg flex-dose tablet for the 6mg and 8mg doses only. For the lower doses, please use the 4.5mg flex-tab.
  • Most patients will need the full tablet (8mg), but I recommend using ¾ tablet (6mg) for at least 2 weeks before moving up to the full 8mg dose. However, to avoid multiple directions and confusion for the pharmacy, your dosing instructions will be to take a full tablet daily.

LDN (LOW DOSE NALTREXONE) INFO FROM STRIVE PHARMACY

Indicated For:

• Addictions
• Arthritis (multiple types)
• Autoimmune Disorders
• Anxiety
• Chronic Fatigue Syndrome (CFS)
• Chronic Pain
• Crohn’s Disease
• Eczema
• Fibromyalgia
• Hashimoto’s Disease
• Inflammatory Bowel Disease
• Irritable Bowel Syndrome (IBS)
• Lupus
• Lyme Disease
• Migraine Headaches
• Multiple Sclerosis (MS)
• Obsessive Compulsive Disorder (OCD)
• Polycystic Ovarian Syndrome (PCOS)
• Psoriasis
• Rheumatoid Arthritis
• Weight Loss/Obesity/Food Addiction

AND SO MANY MORE CONDITIONS!

Medication Information

Low-Dose Naltrexone (LDN) provides a temporary blockade of opioid receptors resulting in a rebound effect, yielding an increase in endorphin production. This boost in endorphins promotes healing, regulates immunity, provides pain relief, and reduces inflammation. Therapeutic benefits of LDN are evident in autoimmune diseases, gastrointestinal disorders, chronic pain, mental health challenges, and inflammation.

Mechanism of Action

Low-Dose Naltrexone is simply a lower-than-standard dose of Naltrexone. Rather than its typical dosing of 50-100 mg for treating opioid-related issues, LDN is often prescribed in 0.5 - 4.5 mg doses. Sometimes it is even used in ultra-low-doses down to 0.1 mg for specific treatments. Unlike the normal function of Naltrexone in it's common dosing form, when used in a low-dose Naltrexone has a paradoxical effect in which it behaves differently when taken in low-dose compared to when taken in its standard dosage.

Transient Blockade of Opioid Receptors:

• Naltrexone is an opioid receptor antagonist, blocking these receptors for only a short number of hours.
• The temporary blockade of the opioid receptors (particularly the mu-opioid receptors) is believed promote an increase in endogenous opioids such as endorphins once the effects of the receptor blockade wears off.

Immune System Modulation:

• Due to the increase in endogenous endorphin production, Low-Dose Naltrexone helps the body decrease the production of Pro-Inflammatory Cytokines while simultaneously increasing the production of Anti-Inflammatory Cytokines.
• LDN has also been shown to modulate the function of T Cells, Microglia and other cells within the body's immune system.

Modulation of Glial Cells:

• The use of LDN may suppress overactive Glial Cells within the nervous system, which are related to chronic inflammation and nerve pain.

Toll-like Receptors:

• Low-Dose Naltrexone inhibits Toll-like Receptors such as TLR4s, which play a role in Immune Response as well as Inflammation. This observed behavior has been linked to LDN's ability to modulate Immune Response as well as playing a role in the reduction of Inflammation.

Warnings:

LDN can cause vivid dreams the first few weeks of therapy. Most common side effects include fatigue, insomnia, flu-like symptoms, decreased appetite, fatigue, anxiety, headache, or dizziness.

Do not use LDN treatment in patients who are receiving opioid analgesics, dependent on opioids, and those individuals who have failed the naloxone challenge test or who have a positive urine screen for opioids.