LDN, peptides & the fringe

Beyond the supplement shelf sits a fringe of off-label and injectable options people try in desperation. Most are unproven or worse — but one, low-dose naltrexone, is genuinely interesting, and worth understanding honestly.

Low-dose naltrexone (LDN)

The interesting one: LDN — a tiny dose (1.5–4.5 mg at night) of a drug normally used for addiction — is cheap, safe, and mechanistically plausible (it appears to calm neuro-inflammation). The evidence is genuinely mixed: it's best-proven for fibromyalgia (which often overlaps with RA), a large real-world register study found LDN users cut their painkiller and even DMARD use, but the one clean RA pain trial was negative. A reasonable supervised experiment as an adjunct — especially for lingering fibromyalgia-type pain — not a disease-modifier or a DMARD substitute. Evidence ●●○○○

Peptides — the candid answer

No human RA evidence: The peptides sold for 'healing' and autoimmunity — BPC-157, thymosin (TB-500), and the like — have essentially no human RA evidence (BPC-157's data is entirely in rodents), are unregulated gray-market injectables, are banned in sport, and BPC-157 raises a theoretical tumour concern by promoting blood-vessel growth. The marketing is far ahead of the science. Skip them. Evidence ○○○○○ in humans

The backwards-logic trap & scams

What to avoid: A crucial concept: RA is an over-active immune system, so 'immune-boosting' supplements point the wrong way and can stack dangerously with methotrexate's liver risk. And treat any product promising to 'cure' or 'reverse' arthritis — copper bracelets, magnets, shark cartilage, mystery blends — as a scam; regulators have prosecuted exactly these. Thunder god vine can help but is genuinely toxic without expert supervision. Evidence ○○○○○

If you must experiment, start with LDN — not injectables

Gray-market injectable peptides carry real risks (purity, sterility, unknown effects) and zero proven RA benefit. If you want to try an adjunct, LDN under a doctor is the far safer, cheaper, more evidence-based place to start — and none of it replaces your DMARD.

The RA Guide