Ask CLYR: We found no clinical trials of LDN for Hashimoto's thyroiditis. A 2022 endocrinology review concluded there is little to no evidence that LDN affects thyroid disorders. Any use is off-label. Keep taking thyroid medicine as prescribed, and let a provider decide whether LDN is appropriate for you.

Hashimoto's thyroiditis is one of the conditions most often linked with low-dose naltrexone (LDN) in online forums and social media. LDN is a compounded capsule, not FDA-approved at this dose, and any use for a thyroid condition is off-label. When we searched the medical literature, we did not find a single clinical trial of LDN in Hashimoto's. This short article explains what is known, what is not, and how to approach the question with a provider. For background, see what low-dose naltrexone is.

The short answer

We found no clinical trials. A 2022 review in the Journal of Clinical Endocrinology and Metabolism by Larsen and colleagues concluded that low-dose naltrexone has little to no evidence of any impact on thyroid disorders.

Why it is discussed online

Hashimoto's is an autoimmune condition, and LDN is studied for possible effects on immune signaling. Reviews such as Toljan and Vrooman (2018) describe hypotheses about how a low dose might influence immune cells. Those are theories. They have not been tested in thyroid trials, and personal stories online cannot tell us whether LDN, time, or other changes made a difference.

What the 2022 review said

Larsen and colleagues reviewed diet and alternative approaches to thyroid disease, including supplements and LDN. Their summary grouped LDN with other options that "have little to no evidence of any impact on thyroid disorders". That is the most direct published assessment we found, and it is the basis for this article's evidence grade: none.

If you take thyroid medicine

Keep taking it exactly as prescribed. Do not stop or change prescribed thyroid medicine without talking to the clinician who manages it. Tell any prescriber about every medicine and supplement you take, and let your provider decide whether LDN is appropriate and what monitoring you need. There is no trial evidence that LDN changes thyroid labs or antibodies. Side effects and the conditions that rule LDN out are covered in LDN side effects.

How to decide with a provider

A good conversation covers what the evidence does and does not show, your other conditions and medicines, and what you would watch for. Evidence in other autoimmune conditions is also limited; see LDN and multiple sclerosis. At CLYR, a licensed provider reviews your screening and decides whether LDN is appropriate for you. At CLYR, low-dose naltrexone 4.5 mg is $119 for 30 capsules or $169 for 90 capsules. Each order is billed once and nothing renews. Provider review and shipping are included, and your provider sets the days of supply. See the LDN page.

Frequently asked questions

Is there research on LDN for Hashimoto's?

We found no clinical trials. A 2022 review in an endocrinology journal concluded there is little to no evidence of an effect on thyroid disorders.

Why do people talk about LDN for thyroid conditions?

Hashimoto's is autoimmune, and LDN is studied for possible effects on immune signaling. That theory has not been tested in thyroid trials.

Can I take LDN with thyroid medicine?

Tell your provider about every medicine you take. Your provider decides whether LDN is appropriate and what monitoring you need.

Will LDN replace my thyroid medicine?

No. Do not stop or change prescribed thyroid medicine without talking to the clinician who manages it.

Important safety information

Compounded low-dose naltrexone is a prescription capsule dispensed only after a licensed provider independently reviews your intake and determines it is appropriate for you. Do not take naltrexone if you take any opioid medicine or have taken one in the last 14 days, including tramadol, codeine, methadone or buprenorphine, because naltrexone blocks them and can cause sudden withdrawal; do not take it if you currently take or need opioid medicines, have liver disease, hepatitis or abnormal liver tests, or are allergic to naltrexone. Tell your provider about kidney disease, pregnancy, breastfeeding or plans for pregnancy, and about every medication and supplement you take. Side effects may include vivid dreams, trouble sleeping, headache, nausea, dizziness or anxiety. Carry a note that you take naltrexone, because opioid pain medicines may not work normally while it is in your system. Compounded medications are made by a licensed U.S. 503A pharmacy to a provider's prescription; they are not FDA-approved and have not been reviewed by the FDA for safety or effectiveness. Individual results vary. Not everyone qualifies. This page is informational and is not medical advice. Call 911 in an emergency.

The same text appears in the Important Safety Information on the LDN page.