Hi. Lula - part of the problem is that many doctors are not even aware of LDN, because there have been no formal clinical trials that I am aware of. And the naltrexone pills or capsules don't come in any dose lower than 50 mg., so you have to go to a special compounding pharmacist to even get the very low-dose used in LDN therapy, or risk ordering from the internet - which can be a dangerous thing to do. Although it does look really promising for MS, rheumatologist worry about using LDN in lupus because it boosts immune function, and counteracts the effects of immune-suppressing medications like steroids. LDN can also cause liver problems in some people, and right now it hadn't been studied enough to predict which patients are at risk from developing liver toxicity. So people taking LDN need to get their liver enzymes checked. And many doctors are reluctant to prescribe it without some clinical trial evidence to back up anecdotal reports. Some clinical trials have been funded for LDN in MS, so hopefuly someone will fund a study for lupus too.
At the 50 mg. dose used to treat narcotic addiction, naltrexone has significant side effects but these don't seem to be an issue in doses under 5 mg. But people who are taking any type of narcotic pain medication should not take naltrexone, even low dose, because it is an opiate agonist and will induce narcotic withdrawal. Women who have been treated for estrogen-sensitive cancers, or women at high risk for developing these types of cancers, probably shouldn't take LDN because it seems to affect estrogen metabolism. I think it will be interesting to hear your doctor's reaction - let us know how it goes.