I think flutemaker has offered a good explanation of what LDN is doing, at least as good an explanation as anyone probably can . . . but no one knows anything for sure with this disease, or the meds we use.

There have been various ways of looking at "progression" with this disease, and in recent years we have been lead to believe that "relapses" and/or "enhancing or more holes in the brain" are important factors in the disease process. The drugs we currently use measure the number of relapses we have, and/or the number of transitory (or permanent) holes we get in our brain . . . so you will hear stats like "X drug reduces relapses by X%".

They compare "efficacy" on this basis too. The drugs trials (and our subsequent MRI's) also measure "X number of enhancing lesions", and sometimes they try to evaluate whether a drug "appears" to be working for us on this basis.

Unfortunately, these measurements do not necessarily pan out to a reduction in how disabled we may or may not become, or even how bad we feel as we progress. For me, those are the two most important points.

Nobody wants relapses (yuck!), but it used to be thought that it was the relapse that CAUSED the damage which resulted in "progression". Sometimes this is the case, especially with spinal lesion inflammation, but our brains can re-route fairly adequately, and most times a relapse does not result in "permanent" damage.

Once we reach Secondary Progressive, we continue to decline even though we aren't having relapses any more. There is "something" going on, that isn't necessarily obvious by a MRI, or fixed by reducing inflammation . . . but they don't know what yet.

At the end of the day, they don't have the answers. There are meds that can help some people (CRABs, Tysabri, etc.), no doubt, but in the long run, they don't seem to help significantly for the majority who try them. There can be some side-effects, and risks to weigh up too . . . with any drug.

We all just want to feel good, and to NOT progress with disability as much as possible. Trialled or not, LDN reportedly is doing that for some people . . . so we keep on taking it.

Cherie