CBD Oil for Diabetic Neuropathy: What Scientific Research Shows
Diabetic neuropathy is a form of neuropathic pain. It results from damage done to nerves due to chronically elevated blood glucose levels. Consistently high blood glucose levels are also related to a weakening of the walls of small blood vessels. This weakening can compromise the vessel’s ability to deliver oxygen, sugar, and other vital nutrients to nerve cells.
When compromised in this manner, nerves cease to communicate with the central nervous system in a normal way. As such, people suffering from diabetic neuropathy can experience sharp shooting pains, dull numbing pains, or even complete numbness.
In this article, we discuss some of the common causes of diabetic neuropathy. We will also look at the populations that are most at risk. Finally, we’ll explore what (if any) potential benefits CBD oil has to offer in terms of helping with this condition.
The Four Most Common Types of Neuropathic Pain Associated with Diabetic Neuropathy
The following are four common types of pain associated with diabetic neuropathy. However, patients may suffer from more than one type.
This is the most common form of diabetic neuropathy. It primarily affects the lower extremities (legs and feet). In later stages, however, it can affect the arms and hands as well. Symptoms can include sharp or dull pains, numbness, tingling sensations, and loss of muscle strength in the afflicted areas.
This is nerve damage that occurs in organ systems such as the heart, stomach, intestines, reproductive systems, and eyes. Naturally, nerve damage in any of these areas can cause severe side effects. These include:
- Increased heart rate
- Erratic blood pressure
- Erectile dysfunction
- Inability to control bladder and/or bowel movements
- Difficulty swallowing
- An inability to regulate body temperature
This form of neuropathy is most common in people with Type II diabetes. It affects nerves in the thighs, hips, legs, and buttocks (typically on just one side of the body). Symptoms include atrophy of the leg and thigh muscles, abdominal swelling, and unexpected weight loss.
This is damage to a single nerve. This most commonly occurs in the foot, lower leg, chest/abdomen, and face, and causes extreme and sudden pain.
Risk Factors Associated with the Onset of Diabetic Neuropathy
Research has shown that all of the following may increase the likelihood of developing diabetes-induced nerve damage:
- Smoking:Smoking is known to cause arteriosclerosis (hardening of the arteries), which reduces blood flow to the legs and feet.
- Inadequate maintenance/control of blood sugar levels
- The length and severity of a patient’s condition: The longer a patient has had diabetes, the more likely they are to develop some form of diabetic neuropathy.
- Elevated Body Mass Index (BMI)
CBD Oil for Diabetic Neuropathy: What We Know from the Scientific Research
To date, no clinical trials have been conducted on the effects of CBD oil for diabetic neuropathy. Therefore, we can’t make any definitive conclusions about how useful CBD or other cannabis compounds are for treating diabetic neuropathy. The evidence so far mainly stems from speculative research carried out on animal models and/or cultured nerve cells.
That said, the roles of CBD as a neuroprotectant and an analgesic (pain reliever) are well known and well-documented. In fact, the U.S. government holds a patent on cannabinoids for their “application as neuroprotectants … for example, in limiting neurological damage [or] in the treatment of neurodegenerative diseases.” The patent identifies cannabidiol specifically, as it is “particularly advantageous to use because [it avoids] toxicity that is encountered with psychoactive cannabinoids at high doses…”
For these reasons, some speculate that high-grade CBD oil may protect nerve cells from diabetes-induced neuropathy. Others even suggest that CBD could reverse neuropathic damage that has already begun.
Of course, this is only speculation at present; advanced research and data would need to be collected to confirm or deny the assumption. Let’s take a look at a few of the most relevant studies carried out to date.
Relevant CBD Studies
The following cannabinoid and CBD-based studies are relevant to the topic of diabetes-related neuropathic pain. Remember, however, that there is a difference between initial research and advanced clinical trials.
2012 publication in the Journal of Experimental Medicine suggests CBD suppresses inflammatory and neuropathy-induced pain
This study primarily observed the effects of CBD on nociceptive (pain) regulation in rat nerve cells. The researchers found that the active compound acted as an analgesic (pain reliever) for neuropathy-related pain.
Here is a statement released by the lead researchers:
“We report that systemic and intrathecal [spinal cord] administration of cannabidiol (CBD), a major non-psychoactive component of marijuana, and its modified derivatives significantly suppress chronic inflammatory and neuropathic pain without causing apparent analgesic tolerance in rodents.”
Based on this statement, it appears that CBD significantly reduces neuropathy-related pain without establishing any serious form of tolerance to the active compound. Drug tolerance is one of the main problems in other neuropathy pain relievers like prescription opioids.
2008 study in Phytotherapy Research shows analgesic effects of Cannabis sativa extract on neuropathic pain in rodent models
This study aimed to identify some of the chemical/physiological mechanisms involved in the cannabinoid-based management of neuropathic pain. The study involved testing of a “rat model of neuropathic pain.”
Researchers found that cannabis extracts provided “better antinociceptive (pain-relieving) efficacy than [a] single cannabinoid given alone.” Therefore, the study demonstrated that the cannabis extract, which contained “multiple cannabinoids,” was more effective than a single cannabinoid.
While the study verified that active cannabinoids are an effective means of addressing neuropathy-related pain, whole-plant extracts are better. Whole-plant extracts include CBD, terpenes, flavonoids, and other natural cannabis compounds. Together, they are more effective than CBD by itself. This has been verified in other studies as well. This phenomenon is known as the entourage effect.
Research on the Therapeutic Value of CBD and its Role in Pain Management
A 2006 study in Current Neuropharmacology suggests that cannabinoid receptors have therapeutic value against neuropathic pain. The study offered a review of existing research on cannabis extracts (including THC and CBD) and their role in treating both acute and chronic pain (including neuropathic pain).
The authors of the study concluded that “cannabinoid receptor agonists have shown therapeutic value against inflammatory and neuropathic pains.” Researchers also noted that these agonists are “often refractory [unresponsive] to therapy.”
Furthermore, the study acknowledged that advanced, “double-blind, placebo-controlled clinical trials,” were needed to develop a clearer understanding of how exactly the physiological pathway works.
Final Thoughts on CBD Oil for Neuropathic Pain
As we already mentioned, there have not yet been any specific clinical trials carried out on CBD for diabetic neuropathy. There are studies suggesting that CBD can act as a neuroprotectant, and also aid in neuropathy-related pain management. However, FDA-approval and advanced clinical trials would be needed before any definitive claims can be made.
So, will CBD oil work for diabetic neuropathy, and can it help in the day-to-day management of nerve-related pain? While there is no direct clinical evidence on the matter, it is difficult to ignore the fact that CBD is a known neuroprotectant, meaning it can prevent the damage and degeneration of nerve cells. Research also suggests that CBD has nerve-related analgesic (pain-relieving) properties.
For those considering CBD oil for diabetic neuropathy, it’s essential to discuss this with a doctor or medical professional.
Readers may find the following review helpful for more information regarding the use of CBD oil for pain relief. It focuses on the 10 best CBD oils on the market and includes high-quality CBD oil from several reliable brands.
CBD for Type 2 Diabetes: What Are the Benefits and Risks?
The trendy complementary treatment is rising in popularity. Here’s what you need to know before you use CBD to manage type 2 diabetes.
CBD may help relieve symptoms that can contribute to high blood sugar in type 2 diabetes. Everyday Health
You probably don’t have to look farther than your local drugstore or beauty product supplier to know CBD has taken a starring role in everything from sparkling water and gummies to tincture oils and lotions. Some may even say that cannabidiol (CBD) — which, like THC, is a component of the cannabis plant, but doesn’t contain its psychoactive effects — is the “it” ingredient of our age.
You’ve probably also heard that CBD can help lessen stress, anxiety, and pain. “When people are in pain, they have a stress response, which causes an increase in cortisol and an increase in blood sugar,” says Veronica J. Brady, PhD, CDCES, a registered nurse and an assistant professor at the Cizik School of Nursing at the University of Texas in Houston. Relieving pain can help alleviate the stress response and improve blood sugar levels, as well as aid sleep, she says.
If you’re managing type 2 diabetes, it’s natural to be curious about whether CBD might help you manage those symptoms, too, to help stabilize your blood sugar. In fact, the prevalence of cannabis use increased by 340 percent among people with diabetes from 2005 to 2018, according to a study published in Drug and Alcohol Dependence in July 2020, which surveyed people on their use of cannabis (CBD or THC, in any form) in the previous 30 days.
But does it work for treating diabetes? Some healthcare professionals say CBD may have a role to play, but it’s important to understand that the only health condition CBD has proved effective for is epilepsy in kids. The jury is unfortunately still out, owing to the lack of comprehensive research on CBD and type 2 diabetes.
Still, in the aforementioned survey, 78 percent of people used cannabis that was not prescribed by a doctor. “Diabetes patients might still use cannabis for medical reasons, but not have a prescription,” says Omayma Alshaarawy, MBBS, PhD, an assistant professor in the department of family medicine at Michigan State University in East Lansing, who led the study. Recreational use is another factor. She points to a separate study, published September 2019 in the Journal of the American Medical Association, that found that more than 50 percent of people with medical conditions such as diabetes or cancer use cannabis recreationally.
How People With Type 2 Diabetes Are Using CBD
In Nevada, where Dr. Brady used to work as a certified diabetes educator, her patients with type 2 diabetes used CBD for nerve pain. She says patients would use CBD in a tincture or in oils that they rubbed on painful areas, including their feet. Patients could buy CBD at medical marijuana dispensaries, which would offer dosing instructions. “They worried about the impact on their blood sugars,” says Brady.
Ultimately, though, Brady says that her patients reported that CBD reduced their nerve pain and improved their blood sugar. She adds that those people who used CBD oils for nerve pain also reported sleeping better.
Heather Jackson, the founder and board president of Realm of Caring in Colorado Springs, Colorado, a nonprofit that focuses on cannabis research and education, senses an interest in CBD within the diabetes community. “In general, especially if they’re not well controlled, people are looking at cannabinoid therapy as an alternative, and usually as an adjunct option,” says Jackson. Callers have questions about CBD for neuropathy pain, joint pain, gastrointestinal issues, and occasionally blood glucose control, according to a spokesperson for Realm of Caring.
The organization receives thousands of inquiries about cannabis therapies a month. It keeps a registry of these callers, where they live, and their health conditions. Jackson says that people with type 2 diabetes are not a large percentage of the callers, but they currently have 540 people with diabetes in their database.
Jackson says that Realm of Caring does not offer medical advice, and it does not grow or sell cannabis. Instead, it offers education for clients and doctors about cannabis, based on its ever-growing registry of CBD users, their conditions, side effects, and administration regimen. “We are basically educating,” says Jackson. “We want you to talk to your doctor about the information you receive.”
Scientific Studies on CBD and Type 2 Diabetes, and Barriers to Research
Despite interest among people with type 2 diabetes, large, rigorous studies showing how CBD may affect type 2 diabetes are lacking, says Y. Tony Yang, MPH, a doctor of science in health policy and management and a professor at George Washington University School of Nursing in Washington, DC. Specifically absent are randomized controlled trials, which are the gold standard of medical research.
Early research suggests CBD and diabetes are indeed worth further study. For example, a small study published in October 2016 in Diabetes Care in the United Kingdom looked at 62 people with type 2 diabetes and found that CBD did not lower blood glucose. Participants were not on insulin, but some took other diabetes drugs. They were randomly assigned to five different treatment groups for 13 weeks: 100 milligrams (mg) of CBD twice daily; 5 mg of THCV (another chemical in cannabis) twice daily; 5 mg CBD and 5 mg THCV together twice daily; 100 mg CBD and 5 mg of THCV together twice daily; or placebo. In their paper, the authors reported that THCV (but not CBD) significantly improved blood glucose control.
Other CBD research is still evolving. Some CBD and diabetes studies have been done in rats, which leads to findings that don’t always apply to human health. Other studies have looked more generally at the body’s endocannabinoid system, which sends signals about pain, stress, sleep, and other important functions. Still other studies, including one published in the American Journal of Medicine, have looked at marijuana and diabetes, but not CBD specifically.
That there are so few studies of CBD in people with type 2 diabetes has to do with a lack of focus on CBD as an individual component. Historically, cannabinoids (a group of chemicals in the cannabis plant) have been lumped together, including CBD, THC, and more than 100 others. The 1970 U.S. Controlled Substances Act classifies cannabis as a Schedule 1 drug with the highest restrictions. Currently, 33 states and the District of Columbia allow cannabis for medical use and 11 states allow cannabis for recreational use.
The 2018 Farm Bill removed industrial hemp from the controlled substances list, clearing the way for more production and research of CBD. Meanwhile, growers and manufacturers are better able to isolate CBD, mainly by cultivating industrial hemp that is high in CBD and very low in THC, says Jackson. So, perhaps in the coming years, more research on CBD and diabetes will emerge.
How the FDA Views and Regulates CBD for Disease Treatment
Yet, as evidenced by the July 2020 study in Drug and Alcohol Dependence, people with type 2 diabetes aren’t waiting for further study to hop on the trend. Brady says her patients have been open about using CBD, particularly the younger patients. She says one of her older patients was initially uncomfortable about buying CBD in the same shop that sold marijuana but eventually gave in. Brady adds that many people associate CBD with smoking marijuana, despite their distinctly different effects on the body.
The U.S. Food and Drug Administration (FDA) approved the first CBD medication in 2018, for treating childhood epilepsy. Currently, there is no other FDA-approved CBD medication for diabetes or any other condition, according to the FDA. In December 2018, the FDA said it was unlawful under the Federal Food, Drug, and Cosmetic Act to sell food or dietary supplements containing CBD. In April 2019, the FDA stated that it would be taking new steps to evaluate cannabis products, and it held a public hearing about cannabis products in May 2019.
“The FDA, for the time being, has focused its limited enforcement resources on removing CBD products that make claims of curing or treating disease, leaving many CBD products for sale,” wrote Pieter Cohen, MD, and Joshua Sharfstein, MD, in a July 2019 perspective in the New England Journal of Medicine. Dr. Cohen is an assistant professor of medicine at Harvard Medical School in Boston, and Dr. Sharfstein oversees the office of public health practice and training at the Johns Hopkins Bloomberg School of Public Health in Baltimore.
Precautions for People With Diabetes Looking to Try CBD
For the CBD products already on the market, Jackson says it’s often difficult to know what’s inside. A study published November 2017 in the Journal of the American Medical Association found that only 30 percent of CBD products were accurately labeled, with under- and over-labeling of CBD content, and some products containing unlisted chemicals such as THC.
Vaping liquids were the most commonly mislabeled CBD products in the study. The International Research Center on Cannabis and Health in New York City warns that consumers should not purchase vape products from unregulated and illicit markets. A small investigation by the Associated Press in 2019 showed that some CBD vapes had synthetic marijuana.
Jackson points out that CBD may affect certain cholesterol and blood pressure drugs, and a study published in June 2017 in Cannabis and Cannabinoid Research detailed these interactions. Other side effects of CBD include tiredness, diarrhea, and changes in weight or appetite, the researchers write.
“What you put in your body is really important,” says Jackson, adding that’s especially true for people with major health conditions like diabetes. Jackson speaks from personal experience as a mom finding CBD treatments for her son’s epilepsy. She says consumers should ask manufacturers whether CBD products are free of mold, pesticides, and other toxins.
Realm of Caring, Jackson’s nonprofit, created a reference sheet for evaluating products and manufacturers. It also endorses products that adhere to standards such as those from the American Herbal Products Association and the FDA’s Current Good Manufacturing Practice regulations.
“There is little known about cannabis health effects, especially among patients with chronic conditions. Research is growing, but still solid evidence evolves,” says Dr. Alshaarawy. For these reasons, she recommends that patients talk to their doctors so they can discuss the benefits and potential harms of cannabis and monitor their health accordingly.
How to Talk to Your Healthcare Provider About Using CBD for Type 2 Diabetes
Jackson and Brady advise people who are considering CBD for diabetes to ask their providers about the complementary therapy before adding it to their treatment plan. Brady says it’s difficult to find research about CBD and type 2 diabetes, even in her capacity as a diabetes educator. Still, in her experience, if people are looking for a natural way to manage pain, it’s worth a conversation with their healthcare provider. “It’s something that should be talked about, especially if they’re having significant amounts of pain, or really any pain at all associated with their diabetes,” says Brady.
“It’s a reasonable alternative,” says Brady. “As it gains in popularity, there needs to be some information out there about it.