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Pharmacology Update: Low-Dose Naltrexone as a Possible Nonopioid Modality for Some Chronic, Nonmalignant Pain Syndromes Diana Trofimovitch 1 , Steven J Baumrucker 2 Curr Pain Headache Rep 2020 Aug 26;24(10):64

This can increase the risk of B12 deficiency

Most preclinical studies utilize supraphysiologic doses, alternate routes of administration and short follow-up windows that do not mimic human reproductive timelines

Complications worsen the deficiency : Individuals with T2DM who also had microvascular complications (such as damage to small blood vessels in the eyes, kidneys, and nerves) showed even greater reductions in glutathione levels and synthesis rates

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