As a clinician who utilizes LDN therapy in clinic I have noticed a few things that ring true across the board. One of those is fillers cause issues. Since dealing with MCAS both personally and with many of my autoimmune patients, I can honestly say that quality matters when it comes to not only our supplements but also our medications.
We advocate so hard to get LDN prescribed but then fall short at ensuring the medication is top notch. With Hashimoto’s, MCAS and a few other autoimmune conditions, you really need to pay attention to the fillers. While one patient may react to one filler, another may have the opposite reaction. It’s one of the reasons I advocate for liquid versions of LDN, custom compounded to avoid issues right out the gate.
I’ve had patients come to me saying LDN didn’t work and when I dig a little deeper sure enough it was usually the fillers. Either a pharmacy has said they offer compounded LDN (when it in fact was not) or they are using fillers.
These can come in a variety of strengths however I strongly recommend you purchase ONLY from proper compounding pharmacies with a significant level of experience formulating.
Administered with a baby syringe orally, this is my preference. When we have malabsorption issues (which most of us do), especially in the case of autoimmune conditions, this is a format that is best utilized.
Sublingual (suspension compounded)
The “new” guy on the block. This is a newer formulation, allowing for LDN to be absorbed directly from the mucosal lining of the mouth. It’s more concentrated than the liquid version and not available everywhere… yet. You get a more rapid absorption as it is able to bypass the liver and digestive tract. Making this more effective and also avoiding a hostile gut environment or food issues. This may be ideal for patients experiencing nausea or medically challenged where absorption is concerned.
This image shows the difference between oral dose swallowed and sublingual route.
LDN and how it works
Oral LDN is metabolized through the liver, allowing it to get to the target tissues. This means you need to be taking care of your liver so it works to it’s best potential.