Comparison
Low-Dose Naltrexone vs Urolithin A
Side-by-side of Low-Dose Naltrexone and Urolithin A. Every row below is pulled from the compound schema and will update as our data grows. For deeper reads, follow through to each compound page.
Low-Dose Naltrexone
Low dose naltrexone at 1.5 to 4.5 mg, one-tenth the 50 mg addiction dose. Compounded Rx. Small trials in fibromyalgia, Crohn's, Hashimoto's.
Urolithin A
Urolithin A supplement guide: pomegranate-derived metabolite, 500-1000 mg Mitopure dosing, mitophagy and muscle endurance evidence.
Effects at a glance
Low-Dose Naltrexone
- •Off-label use at 1.5 to 4.5 mg, roughly one-tenth the FDA-approved 50 mg addiction-treatment dose
- •Proposed mechanisms include brief opioid receptor blockade triggering rebound endogenous opioid release, plus TLR4 antagonism
- •Compounded prescription only; insurance rarely covers; cash prices 20 to 80 USD per month
- •Younger 2013 reported ~30% pain reduction in fibromyalgia at 4.5 mg in a small crossover trial
- •Smith 2011 reported endoscopic improvement in active Crohn's disease (n=40 placebo-controlled)
- •Vivid dreams affect 20 to 40% in first 2 weeks; manageable by switching to morning dosing
Urolithin A
- •Gut-microbiome-derived metabolite of pomegranate and walnut ellagitannins
- •Roughly 40% of adults are 'urolithin producers' from dietary intake; ~60% are non-producers
- •Ryu 2016 (Nature Medicine) reported lifespan extension in C. elegans and muscle benefits in aged rodents
- •Andreux 2019 first-in-human trial (n=60) established safety and mitochondrial gene-expression upregulation
- •Singh 2022 (n=66, 4 months, 1000 mg/day) reported improved muscle endurance in older adults
- •Most human trial portfolio is Amazentis-funded; independent replication is thin
Side-by-side
| Attribute | Low-Dose Naltrexone | Urolithin A |
|---|---|---|
| Category | pharmaceutical | supplement |
| Also known as | LDN, naltrexone (low dose) | UA, Mitopure, ellagitannin metabolite |
| Half-life (hr) ↗ | 4 | 17 |
| Typical dose (mg) ↗ | 4.5 | 500 |
| Dosing frequency | once daily, typically at bedtime | daily, morning with food |
| Routes | oral | oral |
| Onset (hr) | 1 | 2 |
| Peak (hr) | 1.5 | 4 |
| Molecular weight | 341.4 | 228.2 |
| Molecular formula | C20H23NO4 | C13H8O4 |
| Mechanism | Brief mu-opioid receptor antagonism proposed to trigger compensatory upregulation of endogenous opioids; secondary TLR4 antagonism on microglia and immune cells contributes to anti-inflammatory effect. | Induces mitophagy via potentiation of PINK1/Parkin signaling, leading to selective degradation of damaged mitochondria. Secondary anti-inflammatory effects via NF-kB modulation. |
| Legal status | Off-label compounded prescription (naltrexone is FDA approved for opioid and alcohol use disorder at 50 mg) | OTC dietary supplement (US GRAS 2018; EFSA Novel Food 2021) |
| WADA status | allowed | allowed |
| DEA / Rx | Rx only (not a controlled substance) | OTC supplement (not scheduled) |
| Pregnancy | Insufficient data; not routinely recommended | Insufficient data; not routinely recommended |
| CAS | 16590-41-3 | 1143-70-0 |
| PubChem CID | 5360515 | 5488186 |
| Wikidata | Q426444 | Q27101321 |
Safety profile
Low-Dose Naltrexone
Common side effects
- vivid dreams
- sleep disruption
- headache
- mild GI upset
- fatigue (early)
Contraindications
- concurrent opioid use
- acute hepatitis or liver failure
- opioid dependence
- pregnancy (insufficient data)
Interactions
- opioid analgesics (oxycodone, morphine, codeine): blocks analgesic effect; precipitates withdrawal in dependent users(major)
- tramadol: blocks opioid component of analgesia(major)
- thyroid hormone replacement: may alter dose requirements after immune modulation; monitor TSH(minor)
Urolithin A
Common side effects
- mild GI upset (rare)
- soft stools (rare)
Contraindications
- pregnancy and lactation (insufficient data)
- active chemotherapy (consult oncology)
Interactions
- chemotherapy agents: theoretical interaction with mitochondrial-targeting agents; consult oncologist(moderate)
Which Should You Take?
Urolithin A comes out ahead for most readers on the criteria we weight: 3 catalogued goals, OTC dietary supplement, oral dosing, with a Tier-A outcome catalogued. Low-Dose Naltrexone is the right call when one of the conditionals below applies.
- → If your priority is immune support, pick Low-Dose Naltrexone.
- → If your priority is pain modulation, pick Low-Dose Naltrexone.
- → If your priority is healthspan extension, pick Urolithin A.
- → If your priority is muscle hypertrophy, pick Urolithin A.
Edge case: If you want to avoid prescription-only, Urolithin A is the more accessible choice.
Default choice: Urolithin A. Lower friction to source, a Tier-A evidence outcome catalogued, and broader goal coverage. Reach for Low-Dose Naltrexone only if your priority sits squarely in the goals it owns above.
This verdict is generated from each compound's schema (goals, legal status, evidence outcomes, dosing route). It updates automatically as our compound data evolves; the deeper read sits on each individual compound page.
Common questions
What is the difference between Low-Dose Naltrexone and Urolithin A?
Low-Dose Naltrexone and Urolithin A differ in category (pharmaceutical vs supplement), mechanism, and typical dosing. See the side-by-side table for full details.
Which has a longer half-life, Low-Dose Naltrexone or Urolithin A?
Low-Dose Naltrexone half-life is 4 hours; Urolithin A half-life is 17 hours.
Can you stack Low-Dose Naltrexone with Urolithin A?
Stack compatibility depends on mechanism overlap, legal status, and individual response. Check each compound page for specific interactions and contraindications before combining.
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