The Compounder Logo

Larry's Headshot
 

MULTIPLE SCLEROSIS -
FILLERS AND LDN
(LOW DOSE NALTREXONE)
I often hear from people who are concerned about the fillers I use in our LDN capsules. Before describing our filler let's examine WHY we need fillers at all. It's a matter of physics. Fillers are also sometimes referred to as excipients.

An empty capsule (#3 size) can hold approximately 225mg of powder. The exact amount depends on the density of the material. Small amounts of some ingredients are heavier than the same volume of another. Consider 4.5mg of naltrexone. It is a very small amount that fills about 2% of the empty capsule. Something has to fill in that remaining space - the other 98%. That "something" is the filler.

The filler should be inert* and it should not interfere in any way with the activity of the active ingredient - naltrexone in this case. It should also flow well, not be so fluffy that it floats into the air, and pack well. One traditional filler is lactose (milk sugar). It is so common hat you will even find in in many commercial products. It has good physical characteristics and it is MOSTLY inert. We know, though, that some people can be sensitive to lactose - they are lactose intolerant. People with chronic illnesses seem to be bothered more than others. We do not use lactose in any preparations for humans. So, in some cases lactose is not completely inert. We think it is better to find a filler that would not bother anybody.

An alternative to lactose is a substance referred to as Avicel® (microcrystalline cellulose). It is a good filler. In our practice we found that the weight per volume varies from lot to lot. That requires us to sometimes recalibrate our compounding formulas. Sometimes it is fluffy and gets into the air (can be breathed by staff or just make more of a mess). We prefer to not use microcrystalline cellulose.

We don't use calcium carbonate in our filler because there have been reports that it can interfere with the absorption of naltrexone. If packed too tightly in the capsule it can be difficult to dissolve in the gut. It could then just pass through the body without any effect.

We do not use any derivative of methylcellulose in naltrexone capsules because those substances can make the formulation slow to release. The goal for LDN is rapid absorption. So, we don't use the fillers that can cause slow release.

If, by chance, any customer absolutely objects to our filler choice we can switch to another (as long as the request was for something truly inert). This change would not alter the cost. We strongly advise against lactose (even though some doctors recommend it), but we would even use that if the customer and doctor insist.

This should answer the majority of questions about LDN Fillers. If something is unclear or missing please contact me by email. I will answer your question and update this page when needed. My email is larry@thecompounder.com.
 
*INERT: having only a limited ability to react chemically; chemically inactive; "inert matter"; "an indifferent chemical in a reaction