The therapeutic dose. For the patient who's ready to stay here.
Cell Renew Capsules at 4.5mg deliver low dose naltrexone at the full therapeutic target — the concentration at which endorphin rebound is maximized, immune recalibration runs deepest, and the neuroinflammation that underlies autoimmune flares, brain fog, and cellular aging is most consistently addressed. For women who have completed titration from the 1.5mg protocol, or whose clinical presentation calls for starting at the maintenance dose, this is LDN operating at its full clinical capacity.
Size
100 capsules (30-day supply)WHAT TO EXPECT
At 4.5mg — the established therapeutic target for most LDN patients — the endorphin rebound mechanism is fully engaged. Results at this dose tend to be more pronounced and develop more steadily than during the titration phase.
WEEKS 1–4
Some patients stepping up from lower doses notice an initial adjustment period — vivid dreams or mild sleep changes may persist briefly as the body calibrates to the full dose. For patients starting directly at 4.5mg, this adjustment period is typically 1–2 weeks. Side effects at therapeutic LDN doses are typically mild and transient, resolving for most patients within the first two weeks.
WEEKS 4–8
Clinical studies on LDN have demonstrated significant improvements in pain, quality of life, and inflammatory markers across fibromyalgia, Crohn’s disease, MS, and other chronic conditions. Most of this data reflects patients at or near 4.5mg. Autoimmune flare activity begins to reduce. Neuroinflammation-related brain fog, energy, and cognitive clarity often improve in this window.
MONTHS 3–6
The cumulative anti-inflammatory benefit of consistent 4.5mg use builds over time. Antibody activity stabilizes. For patients with Hashimoto’s, thyroid antibody levels often begin to measurably decline. Sleep patterns improve as the neuroendocrine environment calms. The cellular repair signaling supported by stable endorphin levels compounds month over month.
LONG-TERM
4.5mg is designed for ongoing use. Unlike many anti-inflammatory medications that require dose escalation or cycling, LDN at 4.5mg can be maintained indefinitely as a chronic disease management and longevity protocol. Your HerTeleMeds clinician will monitor your response and adjust if needed.
LDN is generally well-tolerated — fewer than 10% of patients report side effects, and most are mild and resolve quickly. LDN is a cumulative protocol, not an acute intervention. Consistent nightly use is the single most important factor in results.
ABOUT THE TREATMENT
Low dose naltrexone works through an endorphin rebound effect — briefly occupying the body’s opioid receptors overnight, then clearing, triggering the brain to produce an elevated surge of its own endorphins. Those endorphins regulate immune function, reduce neuroinflammation, and support the cellular repair signaling that slows aging at the cellular level.
4.5mg is the concentration at which this rebound is most clinically effective. Endorphins are central regulators of the immune system. When endorphin levels stabilize at therapeutic levels, the misdirected antibody activity that characterizes autoimmune conditions begins to settle — the immune system recalibrates toward appropriate function rather than chronic dysregulation.
This formulation is for patients who have completed the titration protocol (1.5mg → 3mg → 4.5mg) and are ready to stay at the therapeutic target, or for those whose clinician has determined that direct prescribing at 4.5mg is appropriate for their profile.
In autoimmune conditions, the immune system produces antibodies against the body’s own tissue — directing inflammatory activity inward rather than outward. Standard treatments suppress this response. LDN modulates it: supporting the immune system’s return to normal regulatory function without eliminating its capacity to respond to genuine threats. LDN has demonstrated significant reductions in glial cell activation and pro-inflammatory cytokines in the CNS, which is why patients with Hashimoto’s, lupus, MS, fibromyalgia, and chronic Lyme consistently report symptom improvement on this protocol.
When cellular repair signaling is disrupted — by chronic inflammation, oxidative stress, or the hormonal changes of perimenopause and menopause — cells age faster, accumulate mutations, and replicate incorrectly with greater frequency. LDN’s endorphin-stabilizing effect supports the signaling environment in which healthy cellular repair happens. For patients with a family history of cancer or elevated inflammatory markers, 4.5mg LDN as a long-term protocol represents a meaningful preventive approach.
Neuroinflammation — the activation of the brain’s immune cells (microglia) — is the shared mechanism underlying brain fog across autoimmune disease, long COVID, chronic Lyme, fibromyalgia, and the cognitive changes of hormonal transition. At 4.5mg, LDN’s microglial modulation is fully engaged. Many patients report that the cognitive heaviness they attributed to aging or perimenopause lifts over the first 2–3 months of consistent use. Sleep improvements follow as stress hormones stabilize alongside the calmer neuroinflammatory environment.
HOW TO USE
STEP 01
Bedtime timing is clinically significant. LDN’s brief overnight receptor occupancy aligns with the body’s natural circadian endorphin cycle, maximizing the morning endorphin rebound that drives the therapeutic effect.
STEP 02
LDN requires consistent nightly administration to maintain the endorphin rebound effect. Take at the same time each night. Missing a dose occasionally is not a problem — simply resume the following night without doubling up.
STEP 03
Some patients experience vivid dreams or mild sleep changes during the first 1–2 weeks at 4.5mg, particularly if stepping up from a lower dose. This is expected and resolves. If disruption is significant, contact your HerTeleMeds clinician — a brief step-down to 3mg before returning to 4.5mg is sometimes appropriate.
STEP 04
The most meaningful changes at 4.5mg — reduced flare frequency, improved cognitive clarity, stabilized energy, improved sleep — develop over weeks to months. Keeping a brief symptom log during the first 3 months helps you and your clinician assess response and adjust if needed.
Critical: Do not take if you are currently using opioid medications. LDN and opioids act on the same receptors. Taking them together will prevent LDN from working and can precipitate opioid withdrawal. This includes prescription pain medications, methadone, and buprenorphine.
LDN has demonstrated significant improvements in pain, quality of life, and inflammatory markers in fibromyalgia, Crohn’s disease, MS, and other chronic conditions in clinical studies — primarily at 4.5mg.
LDN modulates immune function toward normal — recalibrating antibody activity without suppressing immunity, leaving the body able to fight infection normally.
LDN reduces microglial activation and neuroinflammatory cytokines in the CNS — addressing the brain fog, cognitive fatigue, and mental heaviness that accompanies chronic inflammation.
4.5mg is the established therapeutic target — the concentration at which endorphin rebound and immune recalibration are maximized in clinical research.
How HerTeleMeds Works
Answer a few questions about your skin and medical history.
A U.S.-licensed provider reviews your information within 24 hours.
If prescribed, your compounded formula is made fresh and arrives discreetly — often within 2–3 days.
One application a day. Results build gradually with consistent use.
Product details
FAQ
4.5mg is the established therapeutic dose for most low dose naltrexone patients — the concentration at which endorphin rebound is maximized and the downstream immune and anti-inflammatory effects are most clinically consistent. Most published LDN research on autoimmune conditions uses doses in the 4.5mg range. Clinical trials demonstrating significant improvement across fibromyalgia, Crohn’s disease, and MS were predominantly conducted at 4.5mg.
Conventional disease-modifying drugs for autoimmune conditions work primarily through immune suppression — reducing overall immune activity to limit the autoimmune response. LDN works differently: it recalibrates the immune system toward normal function rather than suppressing it. LDN modulates glial cell activation and pro-inflammatory cytokine production without the systemic immune suppression associated with conventional immunosuppressants. This means the body retains its ability to fight infection, doesn’t carry the organ toxicity risks associated with long-term methotrexate or biologic use, and doesn’t require the monitoring protocols those medications demand. LDN is typically used as a complementary or alternative option — discuss the right approach for your condition with your HerTeleMeds clinician.
Many patients use LDN to reduce their reliance on steroid cycles. LDN addresses the underlying inflammatory dysregulation that makes repeated prednisone courses necessary — rather than treating each flare reactively. Transitioning off steroids should always be done with clinician guidance; LDN does not replace urgent steroid use but may reduce how frequently that use becomes necessary over time. Discuss your current prednisone protocol with your HerTeleMeds clinician before starting.
Functional medicine supplements offer real support for mild inflammatory conditions. For patients whose inflammation has not responded sufficiently to OTC protocols — or whose autoimmune condition requires more targeted intervention — LDN works at the receptor and neuroimmune level with a precision that supplements can’t replicate. LDN has demonstrated measurable clinical improvements in conditions including fibromyalgia, Crohn’s disease, and MS in published studies. The two approaches can also coexist; LDN does not interfere with most supplements.
This is a clinical decision your HerTeleMeds clinician will make based on your history and profile. Many patients titrate from 1.5mg → 3mg → 4.5mg over 6 weeks to minimize adjustment symptoms. The Cell Renew 1.5mg capsules are the starting point for that protocol. Some patients are prescribed directly at 4.5mg — particularly those with established autoimmune diagnoses where reaching the therapeutic target quickly is clinically appropriate. Your clinician will advise.
LDN occupies the same opioid receptors as prescription pain medications, methadone, and buprenorphine. Taking them simultaneously prevents LDN from functioning and can precipitate opioid withdrawal. This is the one absolute contraindication. If you are currently taking opioid medications, LDN is not appropriate at this time.
Most patients begin to notice meaningful changes within 4–8 weeks, with fuller effects building over 3–6 months of consistent use. At 4.5mg — the full therapeutic dose — results tend to be more consistent and develop more steadily than during the titration phase.
Possibly — and this is a positive sign. For patients with Hashimoto’s, LDN may reduce thyroid antibody levels as immune function recalibrates. This can mean your thyroid medication dose needs adjustment downward. Your HerTeleMeds clinician will monitor thyroid function and adjust your protocol accordingly.
Cell Renew Capsules at 4.5mg are for women who have done the research, understand the mechanism, and are ready for LDN at the concentration the clinical evidence points to. A HerTeleMeds clinician will review your history, confirm this dose is right for your profile, and support you through a protocol built around what’s actually happening in your immune system — not just the symptoms that result from it.
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