Couple of quick points (based solely on my personal experience..not to be confused with expertise... I don't think there are any experts in the field of LDN in relation to crohns..yet.) First off, I didn't ramp up on the LDN.. I started off at the full 4.5 mg dosage... yet I got worse before I slowly got better. Not sure if that is typical, or if ramping up might make that process even slower, but my logic back then was... well, since 4.5 mg of naltrexone is pretty safe anyway, why do the ramp up... But, bear in mind that I'm 6' 3" and 245 lbs... so a person of normal size MIGHT want to take it slow.... but (and I'm strictly guessing here... the ramp up may slow you down... I wouldn't start marking the days off the calendar on this treatment till you are at the full 4.5 mg dose, OK?)
Second item... colds, flu, other serious ailments, AND (again another pure guess) "STRESS" may likely cause you to flare. WHY? I dunno.. and I really dont' think the "experts" (on crohns) know either. time and again, personal story after personal story on here of how/when people 1st became ill with this disease a major stress event had preceeded... either illness, emotiona turmoil, whatever. I know "they've" done study after study looking for a cause/effect link to crohns AND haven't found one, but I think that's because they haven't looked in the right area yet. I think most members will agree stress plays pure havoc with their crohns AND many can recall stressors in their lives just before crohns came along. Maybe not every case, but enough to cause us crohnies to believe in it like a 4 year old believes in Santa.
Anyway, my long winded point is... if you don't see significant improvement in your situation within 3 months of starting on 4.5 mg of naltrexone, it probably isn't going to work. I'm not suggesting you give up... the naltrexone forum has tips on making it work... including how to test for candida, and adding a diet like the SCD to your regimen. The potential benefits of getting LDN to fight your crohns for you are good enough to make it worth fighting for, at least thats the way I looked at it. When it is good, it is very, very good, but it is NOT bulletproof. I still have the occasional flare... but I stick to LDN and it always has turned things around for me. Pre LDN, when I started to flare, I always had to increase my meds, or switch meds, and I was always going downhill.
You know what I mean? Seems every time I flared I ended up seeing my GI who had to put me on something stronger, etc., etc., just to get back to where I was before I flared. LDN has stopped that viscious cycle for me permanently.