I too am new here, Mrs Potato Head. =)
Sorry that you haven't yet gotten a response to your post. I'm looking forward to hearing constructive answers to your questions.

Hi MPH, I'd ask a MD or qualified professional re. your questions, especially your Q.1. I can only offer my opinion as a non-professional and person that has a) read some of the literature on NAL for Alcohol treatment and b) personal experience taking NAL (other person's experience may differ).

Re. Q.2, in all the literature I have read I have never seen the dosage being adjusted due to body size. The standard dosage appears to be 50mg per day in most of the studies. TSM protocol is to take 25mg for the first two days and then up the dosage to the standard 50mg per day. Having said that, I have read that a few people here vary their dose between 25mg and 100mg per day. I'm sticking with 50mg.

Re Q.3, I've only gone AF a handful of times when on NAL treatment and have never noticed any receptor hypersensitivity. On or off NAL, I have noticed the effects of the medication only when I am drinking alcohol. When I drink the buzz is muted somewhat, although I can still get inebriated. NAL has not affected my experience of eating spicy or sweet food, listening to music, playing sports or watching a movie. Perhaps people with more experience of going on and off NAL can offer their opinion.

I don't notice my opioid receptors to be hypersensitive on days that I don't take nal, but then again I'm pretty new to this and I've actually had very few AF days. So far for me the nal only seems to affect the way I react to alcohol and KFC (strangely enough). I haven't noticed much else. Oh yeah, also a slightly decreased sex drive.

Mrs Potato Head, ideally you need to speak to a doctor and I am not one. My educated guesses as to the possible answers to your questions:

1. No known obvious adverse interactions. Which does not mean there are none. These things can vary greatly on individual level. So I'd be cautious. In fact, I am pretty sure there is some interaction but it is hard to say how strong and whether it will be detrimental or, to the contrary, beneficial.

2. Simple answer: No. More real answer is of course it matters, like for any other drug. But the usual trouble is that there are many other factors affecting pharmacokinetics and they vary greatly in individuals and so finding a pre-defined optimum corrected by body weight is going to be as wrong as simply disregarding body weight entirely. 90%+ of all studies stuck to 50 mg/day and that's what we know. Some users report experiencing differences when switching to 100 mg, some don't.

3. Good question! Nobody knows for sure. Personally I doubt it but that's no more than gut feeling. There is certainly no harm in attempting to do what you describe and there is a chance that this "reverse conditioning" will work great (but keep in mind that many receptors can still be blocked by naltrexone 48-72 hours after).

Welcome and hope you have a huge success with naltrexone/TSM!

P.S. BTW, your drinking habits don't seem odd to me. Rather typical of alcoholics who have not yet hit the bottom. I was just like that for a very long time ... until I started to secretly drink at work. Rarely and infrequently but that's when I finally realized that I am no longer in control of myself. A little over a year on TSM later and the thought of drinking during work hours does not even cross my mind anymore.

Thank you all for the replies. I started keeping track of drinks last night, my god what a pain in the a*#$! That, I imagine is going to be really annoying before it becomes a habit, but still, far, far better than an early death.

I plan to keep a very detailed track of my drinking habits, whether it works for me or not. Also whether its possible to condition myself into positive habits. I'm a prime candidate as I HATE exersise, I mean really loathe it and I don't drink every day so I will have nal free days. So if I start enjoying excersise or feeling a need for it (and other healthy, positive things like eating right, saving money, ect), it was either placebo or it is possible to use conditioning both ways, either way, result! If not, oh well, I'm in no worse position except that my drinking is under control.

Welcome Mrs PH! I think earlier posts answered your questions as well as I could. As far as body weight goes, I'm a female well north of 200lbs and I've been on 50 mg and all seems to be fine. I made the mistake of starting with 50 mg instead of the few days on 25 and that was a big mistake! I felt horrible and had insane nightmares.

I went from preTSM zero AF days to now averaging 2-3 nights a week AF with no effort or obsession with alcohol. I'm still drinking a lot when I do drink but I feel so much more in control (like Nutella I'd started to drink at work, and even though I thought I was hiding it well, in retrospect I'm sure my slip was showing). On my AF days I notice no difference in pleasurable activities. If you hate exercise you can also engage in other activities that make you happy (sex is my favorite) for the endorphin boost. I don't think it makes you extra sensitive to anything like sugar but perhaps chocolate my fall under the category of an endorphin-booster. I have yet to see anyone report becoming a chocoholic or cookie monster because of TSM...but hey, anything's possible