Just thought I'd add my 2-cents.

I decided to jump my dose up to 75mg just to make sure I was completely covered and I'm not noticing any more/less side effects than what I do on 50mg.

Q

im stating on 75 and the doctor told me lets see what happens. if i still dont see a decline then i will go to 100 mg. im on month 4 and im going to wait it out just like dr. escpa told me, it could take 8 to nine month.

i dont see whats wrong with good results on a low dose? this is a relatively new therapy, and everyones different. 50mg is just an across the board standard. people should know there own bodies better than anyone else.

I disagree. 50mg is not the standard, it is the minimum. ALL of the research says that we need to take at least 50mg of naltrexone exactly one hour prior to drinking. Both Dr Eskapa and Dr Sinclair state that we need to take AT least 50mg of naltrexone.

There is no clinical evidence that doses less than 50mg will be effective with TSM.

Yes, people do know their own bodies, but this is a very poor way to judge the effectiveness of a medication. Most of us take the dosage of medications that our doctors tell us to take, not what ever we feel we should take. TSM treatment is no different. The dose is AT least 50mg.

FYI: TSM is not a new Therepy. It has been around since the 80s and has been used on thousands and thousands of people in europe and finland. It is only new to us here in the US. Read Dr Eskapas book and listen to Dr Sinclair's interviews

Q

i agree 50 mg. is what the studies showed to be effective. if anything they suggest 75 or 100 the only reason people drop to 25 is because bad side effects.i would stick to what has been mentioned in the book, the cure for alcholism. have a good day.

Does anyone have any other suggestions as to why some of us are more or less sensitive to Nal?

Natural endorphin levels has been suggested and I think it's a possible cause. The more endorphins we release drinking, the more Nal we need to block them.

Our body size and weight surely must influence how much Nal we can tolerate, for example a 120lbs female compared to a 200lbs male ? Many meds are prescribed according to the weight/size of a patient, antibiotics, for example.

Interaction with other medications?

Any other suggestions ?

Curi

email dr. escap with you concern

Curious One, I know this an old post, but I am hoping to find out if you continued on a low dose or not.

Greetings!

I, too, would like to know how the lower dosage went for you, Curi, and for others.

(I am new to the forum and TSM, and this is my first comment. I'll post an intro thread soon. Been on TSM for three weeks.)

I found this thread, especially the OP, to be especially interesting, because I have also had what I think may be similar side effects. I started with 50mg, and started feeling the nausea the next couple days, along with head and body aches. That seems to agree with some descriptions of the "nal-over" I have read about here. On my third day (21 Jan 16) I had an AF-day, or what I call a "zero-day", and the following day I felt a lot better. I dropped back to 25mg, having read that it's often used as a starting dose. Over the past week, I adjusted back upwards to 50mg, and then had a couple of really bad days on this past Saturday and Sunday. These were after a couple nights of going one over my current self-imposed "limit" (ha!) of 5 regular glasses of red wine. Nausea, stomach pain, and general malaise.

So I had another zero-day yesterday, and today I feel so much better.

There's no way I will give this up after only three weeks just because I haven't gotten past the initial side effects, but I have backed off again today to 25mg and will see how it goes. I know opinions are mixed -- some say 25mg may be enough for some people, and others say 50mg is the rock-bottom minimum. It may be that I just need a longer time for adjustment to this protocol.

-R

Welcome Ricker - it is suggested that you start out at either 12.5 or 25 mg until you get used to the Nal. I started out at 25mg and still had nausea for the first few days - make sure that you have food in your tummy and go up slowly. After a few days, I was fine - went up to 50mg and stayed there. good luck,

Hugs, Maggie