I have been researching LDN for over a week now. It seems people start out at larger doses than what I would consider "protocol". If you're new to the drug, it is recommended you start at 1.5mg for 2 weeks or more, then go to 3.0. If your still doing well with little improvements, you can jump again in a month to 4.5. If at anytime the increase effects you, with more stiffness, pain, symptoms, you should drop back down to smaller dose.
So when I read about people starting at 4.5 and feeling worse, that makes sense. It's to much for someones system to start with. I see my doctor on Thursday and will be asking to start LDN at 1.5mg. We are in control of our own bodies. Don't let a doctor set you up to fail on LDN. If they agree to give it to you, insist on starting at 1.5 and moving up to what works for you. Good luck to all that try LDN, including myself!