Brief Update: Did you hear the news? Lilly pharmaceutical, just this month of August 2026, sued six companies for the illegitimate production of Retatrutide. Retatrutide is an upcoming GLP-1 product still in Clinical Phase Three trials, not yet released to the public. The lawsuit names entities including Aesthetic Envy Cosmetic Centers, Astra LLC, Legendary Peptides, Striker Pharmacy, Texas Peptides and Lone Star Peptide Co. (source: (https://www.msn.com/en-us/money/general/lilly-sues-six-companies-over-alleged-illegal-sales-of-experimental-obesity-drug-retatrutide/ar-AA29UWRE?ocid=BingNewsSerp). So, it appears Dr. Bryana’s advice from last week’s article was right on target!
To this day, I would wager that 95% of my prescriptions are written via a compounded pharmacy order. While, yes – Kalon West functions at baseline to provide bioidentical hormone therapy, which naturally means crafting custom creams, pills, troches, suppositories and things… I thought I would dedicate the remainder of this chapter to highlighting a few unique and off-label, compounded products that you might not be aware of. The following are compounded medications, peptides and hormones that my team and I commonly employ to assist with restoring health and enhancing longevity routinely.
This week, let’s focus on Low-dose naltrexone. Now, this is not to be confused with Naloxone, or “Narcan”. Naloxone, briefly, so you know the difference – functions as an opiate antagonist. You may be familiar with the TV commercials or Billboard signs often placed at the ‘seedy’ intersections of towns these days, which promote over the counter purchase of Narcan to rapidly reverse opioid-drug overdosing. Every human has opioid-receptors, a family class of proteins, responsible for the body’s sense of pain. Narcan has an affinity for binding to μ-opioid receptors, preferentially, to acutely displace opioid drugs (ie. fentanyl, heroin, morphine, oxycodone, or methadone) from oversaturating a person’s μ-opioid receptors. This can help reverse respiratory or central nervous system depression as a dangerous opiate drug side effect. Naloxone most frequently comes in a 2 or 4mg/nasal spray and/or 0.4mg intramuscular injection. Naloxone is FDA approved and is not to be used in an ongoing manner.
Why is Naloxone relevant to discuss in light of compounded Low-dose naltrexone??? Well, first off – their names sound the same! But also, compounded Low-dose naltrexone or, “LDN”, behaves similarly to Naloxone, yet compounded Low-dose Naltrexone serves a more pluripotent purpose. LDN, likewise interacts with the body’s opioid receptors but at a low-dose (hence its name) stimulation, routinely vs. acute high-dose Naloxone’s one-time-use function only. Oral capsular, sublingual tablet and liquid form LDN provides a transient opiate receptor blockade for about four to six hours after it’s ingested. Then, once the LDN “unroofs” or detaches from the opiate receptors at the four to six hour mark, this triggers a release of endogenous (your own production of) enkephalins and endorphins. What are enkephalins and endorphins? Yes, they sound like each other’s long-lost cousins! Well, think of that “post-runner high” that follows a good workout – you often notice more energy, less bodily inflammation and augmented mental clarity. For these three things, you can thank your enkephalins and endorphins, as they are responsible for those outcomes. However, enkephalins and endorphins are also both powerfully positive modulators of the immune system. There are other mechanisms of actions with LDN, but for the purpose of simplicity and this article, we will not go into those today.
LDN, compounded, serves to assist in a wide range of dis-eased conditions. Most commonly I have used LDN within my primary practice for the subsequent categories (although the following does not compile an exhaustive list):
- Autoimmune: Hashimoto’s Thyroiditis, Sjogren’s Disease, Scleroderma, and Lyme’s Disease.
- Dermatological: Eczema, Psoriasis, and Atopical Allergies.
- Gastrointestinal: Celiac, Chron’s and Ulcerative Colitis.
- Neurological: Multiple Sclerosis, Parkinson’s and Headaches/Migraines.
- Other: Weight Loss (food noise), Chronic Pain, Depression, Mast Cell Activation Syndrome, Fertility.
One of the hallmark stories, which first clued me into compounded LDN’s potency, occurred during early 2023. At that time, I had met with a gentleman suffering from recurrent mononucleosis and long-haul COVID. Aged 60+ years, he, at his baseline, used to run a full farm and bicycle 30+ miles several times per week prior to falling ill. However, due to physical limitations and deterioration manifesting from the fallback of his conditions, at that time he could hardly get up off the couch to make a sandwich – unfortunately, I am not exaggerating. Of primary strategy, we employed the use of oral capsular compounded LDN, titrating up to 4.5mg over six weeks. At month one of therapy (around 3.0mg into the titration process), he hopped onto a video camera for telehealth consultation and told me: “I am gardening again” – a huge improvement from his couch potato land. At month two, he was walking the property and engaging with his animals. And, at month three, he was up on his bicycle riding 15-20miles 3x/wk. Talk about a game changer for his wellness and lifestyle!
While I cannot promise these results for everybody, I have time over time witnessed the benefits of compounded LDN most securely when it comes to relieving joint aches/pains in fibromyalgia, Lyme’s disease and neuropathies. I’ve also witnessed LDN’s ability to gently calm mast cell activation symptoms, relieve itching in Scleroderma and relax gastrointestinal (GI) flares in those with GI disease. I have experienced LDN to lower TPO (thyroid peroxidase) antibodies (antibodies that target the eventual destruction of your thyroid gland cells over time), favorably improving thyroid function over time.
How does one take a compounded LDN? Orally, you must titrate it – some clinicians start as low as dosing 0.5mg capsules daily, which they then adjust up by 0.5mg every two weeks. Others begin dosing at 1.5mg capsules daily, titrating it up by 1.5mg additionally every subsequent two weeks. The most common total dosage form of LDN is to take a 4.5mg capsule daily. However, in rare cases, we have exceeded that dose (ie. 9-10mg capsules) or split up the doses into a twice daily usage (ie. use 2.0mg in the morning and 2.0mg in the evening). As previously mentioned, LDN can be compounded into sublingual tablets or an oral liquid, when clients may have swallowing issues or need to bypass the GI tract completely with the capsular route of its administration. Lastly, I should mention: LDN has also been used in compounded topical eczema/psoriasis creams or hair scalp solutions but as these have different mechanisms than the oral form, we won’t dive into this discussion. Talk with your provider though, if this may apply to you!
Oh, and I should make note, an interesting fact about the compounded oral forms of LDN is that you take it at night, right before bedtime. While you are sleeping, you are naturally refreshing and producing your endorphins for the upcoming morning. Hence, by ingesting LDN in the evening – we anticipate its mechanism of action (to produce enkephalins and endorphins) to mimic your circadian rhythm. However, for some clients this “double potency” of endorphin release can cause insomnia or vivid dreams. In such a case, we would then switch clients to use LDN in the daytime consistently. The only effective difference would be the LDN “peak” effect might be felt around lunchtime vs. first thing in the morning. However, LDN steady states homeostatically after one takes it routinely for three + months and so, the benefits from its consistent use would balance out overtime whether it’s taken in the evening or day.
For more information, a great resource showcasing compounding LDN research, user testimonials and education can be found at: LDNRESEARCHTRUST.ORG. Give it a glance over. And, if you find that LDN may fit your needs, schedule a discovery call with Kalon West today (https://kalonwest.com/new-patient/).