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Scholarly articles on use of cbd oil for immune disorders

Article

Katz D 1,2 , Katz I 1,2 , Shoenfeld Y 1,3*

1 The Zabludowicz Center for Autoimmune Diseases, Chaim Sheba Medical Center, Tel-Hashomer, Israel
2 Faculty of Medicine, The Hebrew University of Jerusalem, Israel
3 Incumbent of the Laura Schwarz-kipp chair for research of autoimmune diseases, Sackler Faculty of Medicine, Tel-Aviv University, Israel

Introduction

The tale of Cannabis sativa is as old as time. Through its first days as an herbal remedy, ranging back to 4000 BC and to Emperor Shen Nung’s Rule (2700 BC), to cannabis low point of being banned internationally at 1925 to its recent re-emergence by prof. Mechoulam isolation of the Tetrahydrocannabinol (THC, 1963), Cannabis is slowly gaining its place in medicine 1,2 .

Cannabis sativa, also known as Marijuana has been called many names, yet the variety of names given to Cannabis does not encompass the vast medical opportunities that lie within the cannabis. As of now, 545 ingredients have been identified, of which over 100 classified as unique to Cannabis 3 . The two main and most researched active ingredients are – Tetrahydrocannabinol (THC) which holds a psychoactive properties and on the other hand, Cannabidiol (CBD) which is considered non psychoactive. The components are joined by the two main known endocannabinoids – Ananamide (AEA) and 2-Arachidonoylglycerol (2-AG) (also discovered by prof. Mechoulam and colleagues) 4,5 . The other half of the cannabinoid system (as we know thus far) comprises of CB1 and CB2 receptors, G-protein coupled receptors. The two receptors differ in distribution and function. While the major psychoactive effect of cannabis is attributed to the CB1 receptor and accordingly widely distributed in neurons, while the CB2 receptor has been linked to maintaining homeostasis and commonly appears in cells of the immune system 6,7 .

Cannabis and the Brain Immune System

It is well established that murine microglial cells express both CB1 and CB2 receptors, yet the pattern of receptors expression differs in location as well as in levels of expression. While CB1 receptor is consistently expressed in microglial cells in low levels, CB2 receptor is indetectable in resting state cells and highly expressed in activated microglia 8,9 . The pattern of expression and distribution of CB2 receptor in microglial cell suggest a role in microglial migration, CB2 receptor was found to be expressed heterogeneously throughout murine microglial cells with particularly high density at the leading edges of lamellipodia and microspkies (cellular protrusions that mediate cell migration). Moreover, 2-AG, AEA and abnormal-cannabidiol increase microglial cell migration 10 .

Another aspect of the endocannabinoid system effect on microglial cell is the attenuation of the immune response induced by LPS (Lipopolysaccharide) stimulation, AEA attenuates the immediate release of IL-6 and NO by microglial cell by induction of MPK-1 11 .

A different mechanism of action is suggested by the inhibition of the IL-1 signaling pathway following administration of the synthetic cannabinoid R(+)WIN 55,212-2. Appling R(+)WIN 55,212-2 to astrocytoma cells priori stimulated by IL-1 resulted in dose dependent inhibition of ICAM-1 and VCAM-1 adhesion molecules induction, as well as IL-8 and NFκB. The effect aforementioned is independent from the cannabinoids receptors CB1 and CB2 as suggested by the lack of regulation of CB1 and CB2 antagonist on the immunomodulating effects mentioned above, implying that there is still much to learn in the field of Cannabis and immunomodulation 12 .

Cannabis and the Blood-Brain-Barrier

The blood-brain-barrier (BBB) as well as the blood-spinal cord-barrier (BSCS) and their disturbance is often postulated as a possible mechanism of pathogenesis in neurological autoimmune disease. A possible link of pathogenesis has been suggested in Multiple Sclerosis 13 , Neuromyelitis Optica1 14 , Guillain-Barré Syndrome 15 , Chronic Inflammatory Demyelinating Polyneuropathy 16 and Antiphospholipid Syndrome with neurological involvement 17 .

In murine model of LPS induced vascular and inflammatory changes CBD counteracts the effect of LPS. Mice which received LPS+CBD showed no cerebral vasodilation, no leukocyte migration, reduced TNF-α and COX-2 levels compared to LPS treated mice and more over exhibited reduced dextran extravasation (dextran extravasation is used as a quantification instrument of BBB integrity) 18 .

Similar effect is obtained by administration of Anandamide to TMEV-infected endothelial brain cell. AEA inhibits VCAM-1 induction in vitro, and thus limit leukocyte migration through a transwell filter (coated with collagen type I and fibronectin) model of the BBB. Accordingly, in vivo experiment correlated the result of the in vitro experiments. AEA increased tone (by UCM-707, an AEA uptake inhibitor) inhibited VCAM-1 induced expression, as well as attenuated microglial cell activation 19 .

A role for CB2 receptor was also exemplified by in vivo murine model. Ex vivo CB2-activted leukocytes were injected to LPS treated mice resulting in adhesion reduction of up to 96% using GP1a (CB2 receptor agonist) in comparison with to non GP1a treated mice 20 .

The beneficial effect of cannabinoid also extends to human brain endothelial cells (BMVEC). Using human cells from HIV-1 CNS infected patients and from seronegative controls, a group of researches demonstrated enhanced CB2 receptor expression in HIV infected cells compared to controls. Further investigation of naive human BMVEC revealed that the increased expression of CB2 receptor can also be accomplished separately by IL-1β, TNF-α and LPS. Once induced and activated, CB2 receptor decreased leukocyte adhesion, prevented up regulation of adhesion molecules, promoted 2.2-2.7 increase in tight junction proteins (occludin and claudin-5) and significantly reduced BBB resistance drop induced by LPS 21 .

The coherence of the above mentioned experiments is also exemplified at the genetic level. Human BMVEC isolated from eleptogenic patients were activated using TNF-α to evaluate consequent gene expression. Out of 33 genes that were up regulated by TNF-α, 31 and 32 genes were suppressed using CB2 agonist O-1966 or JWH-133 respectively 22 .

Cannabinoids protective effect goes beyond the BBB and also extends to the BSCB. Pretreatment by JHW-015, a CB2 receptor agonist prevents down regulation of occludin and ZO-1 induced by spinal cord ischemia reperfusion injury (SCII) in murine in vivo model. Moreover, JWH-015 pretreatment reduces BBB leakage (measured by Evans blue) compared to SCII only group 23 .

Cannabis potential ability to protect BBB integrity is of possible great importance, not only in autoimmune neurologic disorders, but in a vast verity of neurological fields as in Alzheimer’s disease and ischemia injury.

Cannabis and Autoimmune Demyelinating Disease

Multiple Sclerosis (MS) is known as the hallmarks of neurological autoimmune disease with prevalence as high as 200:100,000 in some countries in northern Europe 24 .

MS Patients are characterized by high CSF levels of AEA compared to healthy control. In accordance high levels of AEA were also measured in autoimmune encephalomyelitis (EAE), a murine model of MS. Moreover, increased NAPE-PLD (part of AEA production) activity and reduced FAAH (degrades AEA) activity 25 . CB1 receptor deficient mice exhibit substantial neurodegeneration following EAE induction including higher prevalence of residual paresis and axonal pathology in relation to wild type mice 26 .

CBD treatment of TMEV infected mice induces a wide range of immunomodulatory outcomes. CBD reduce the infiltrate of immune cell to the brain parenchyma and decreased microglial activation. Moreover, CBD treatment has a long lasting effect, an 80 days follow up of the treatment group revealed restoration of both horizontal and vertical motor activities to that of the healthy mice and a correlating reduction in the expression of TNF-α and IL-β1 27 .

MS is positively influenced by a variety of cannabinoids, both natural and synthetic, each demonstrating a different mechanism of action to our knowledge. Among the different cannabinoids we can find Cannabidiol which holds the ability to attenuate a range of neuronal apoptotic pathways 28 , Cannabigerol Quinone which its application on murine neuronal culture results in inhibition of IL-1β, IL-6 and PGE2 release 29 . Also Gp1a, a selective CB2 receptor agonist that modulates EAE development by reducing Th17 differentiation 30 , HU-446 and HU-465 (CBD derivatives) and many more which we won’t elaborate on 31 .

There is scarce evidence regarding clinical use of Cannabis in MS patients. A recent Meta-analysis concluded that cannabinoids (nabilone and nabiximols) were associated with a greater average improvement in spasticity assessed by using numerical rating scale (mean difference, -0.76 [95% CI, -1.38 to -0.14]). Also, the average number of patients who reported an improvement on a global impression of change score was greater using nabiximols rather placebo (OR, 1.44 [95% CI, 1.07-1.94]) 32 . Notably, a new large multi centered blinded study was recently published, in which 489 MS patients participated and received either oral dronabinol (THC) or placebo. The study failed to prove the beneficial outcome of dronabinol use in two main outcomes (time to confirmed EDSS [Extended Disability Status Scale] score progression and change in MSIS-29 [Multiple Sclerosis Impact Scale-29] score). However, while taking into consideration the results of this trail, it is worth mentioning a possible weakness in the trail inclusion criteria. The disease progression in MS as measured by the EDSS scale is not linear, and progression through EDSS 4-5.5 is faster the in EDSS 6-6.6. hus making the EDSS 6+ patient’s population insensitive to treatment during the study period of time, leaving the question of Cannabis medical use in MS patients in need of further research 33,34 . Currently, evidenced based recommendation published in 2014 by the American academy of neurology are: oral cannabis extracts (CBD/THC or CBD alone) are the only products with an A – effective rating, next in line is THC (dronabinol/nabilone) with B rating- probably effective 35 .

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Another demyelinating autoimmune disease that shows promise for cannabis treatment is Neuromyelitis Optica (NMO). Plasma levels of 2-AG were found to be elevated in NMO patients compared to healthy patients. Moreover, 2-AG levels were negatively correlated with pain sensitivity, while AEA correlated positively with pain sensitivity 36 .

Multiple Sclerosis and Neuromyelitis Optica are the milestones of medical cannabis implantation in neurologic autoimmune disease, yet only the foundation has been accomplished up to now and further clinical investigation is the core of establishing Cannabis Sativa and its products as a new therapeutic solution.

Cannabis Adverse Effects

Cannabis addiction is one of the main adverse effects of chronic cannabis use, though once considered as only “psychological addiction”, recent evidence revels a physiological ingredient to the addiction 37 . Epidemiological studies indicate that about 9% of adult marijuana users will develop cannabis addiction, while adolescent’s percentages of addiction is as high as 17% 38 .

Another adverse effect of great importance lurking chronic cannabis users is the consequence anatomical changes, a 2013 meta-analysis concluded that chronic cannabis consumption results in reduction of hippocampal grey mater 39 . Accordingly a new research conducted at 2015 demonstrated reduced hippocampus and amygdala volumes 40 .

Acute adverse effects (some may be found beneficial in some indications) include anxiety, dysphoria, psychosis/hallucinations, tachycardia, and stimulation of appetite 39 . Further side effects are listed in table 1.

System Adverse Effect Statistics a References
Neurologic ↓hippocampus & amygdala volumes
↑ Incidence of acute ischemic stroke
Age 15-54
Age 25 -34
Age 45 – 54
Drowsiness
Dizziness
↓Educational performance (adolescents)
Lower IQ
RR 1.13 (1.11-1.15)*
RR 2.26 (2.14 – 2.38)*
RR 1.45 (1.42 – 1.54)*
OR 3.68 (2.24-6.01)*
OR 5.09 (4.10-6.32)*
↓11% (% GCSE† points)*
Linear trend, t test
t: -3.36***
32,40-43
Psychiatric Psychosis Schizophrenia
Anxiety
Depression
OR 1.41 (1.20–1.65)*
OR 1.9 (1.1–3.1)*
OR 1.98 (0.73-5.35)*
OR 1.49 (1.15–1.94)*
32,44,45
Cardiovascular Tachyarrhythmia
Palpitation
Angina
RR 1.5 (1.1–2.1)*
↓ 48% (↓time to, during exercise)**
38,46,47
Pulmonary (cannabis smoking) Chronic Bronchitis symptoms
↑health services for respiratory infections
25%-33% of smokers 46,48
Gastrointestinal Nausea
Diarrhea
Vomiting
Abdominal pain
Constipation
OR 2.08 (1.63-2.65)*
OR 1.65 (1.04-2.62)*
OR 1.67 (1.13-2.47)*
32, 49,50
General Dry mouth OR 3.50 (2.58-4.75)* 38
Cannabis dependence
Withdrawal syndrome
Adults, Adolescents
Anxiety
Insomnia
Appetite disturbance
Depression
Irritability
9%, 17% (percentage of users who will
become addicted)
38
51
Pregnancy Maternal anemia
Decrease birth weight
↑Intensive care unit
pOR 1.36 (1.1 – 1.69)*
pOR 1.77 (1.04 – 3.01)*
pOR 2.02 (1.27 – 3.21)*
52

Table 3: Perfusion analysis from 1H-NMR in 12-month-old female mdx mice.

Reperfusion mean has been calculated during the first 25 minutes after release of ischemia. Wild-type mice, n=6; mdx mice, n=7. **p < 0.01.

(a)The set-up of the tourniquet was sufficient to induce an absence of perfusion in both groups. After release of tourniquet, a rapid and important increase of perfusion was detected and the reperfusion of mdx mice was greater than wild-type mice. A single peak of reperfusion was however observed in mdxmice, when a first rapid and strong peak followed by a second attenuated peak of reperfusion was observed in wild-type animals.
Because the release of ischemia induced movements of the leg, images affected by these movement artifacts, at the moment of ischemia release, were removed from analysis of muscle perfusion.

(b) In the first 5 minutes after ischemic stress release, below a threshold of 250 mL/100 g reperfusion (concerning mostly wt mice), PCr resynthesis rate was dependent on perfusion, an increase in reperfusion leading to a decrease of τPCr. In contrast, above the threshold of 250 mL/100 g reperfusion (concerning mostly mdx mice), PCr resynthesis rate was poorly affected by the increase of post-ischemia reperfusion.

a: Perfusion analysis was performed through from 1H-NMR as described in the Material and Methods section; b: Correlation between reperfusion and PCr resynthesis rate (from 31P-spectroscopy analysis) during the first 300 seconds (5 minutes) after ischemia; n = 6 (wt, a, b); n = 7 (mdx, a, b); τPCr: time of creatine rephosphorylation.

Conclusion

Nowadays Cannabis tends to be considered as a “buzz word”, with global recognition of the potential embodied in medical Cannabis, more and more countries legalize the use of medical cannabis, leaving many physicians overwhelmed due to the rapid changes. In this article we aimed to review the laboratory and clinical evidence regarding Medical Cannabis and neurological autoimmunity diseases.

Unfortunately, lack of clinical data prevents a definitive conclusion. Nonetheless, clinical trials conducted upon MS and NMO patients suggests a future role for medical cannabis in MS and NMO treatment by obtaining relief in patient symptoms. Yet, the trails aforementioned only paves the beginning, much research is yet to be done in order to evaluate the therapeutic effects of cannabis in treating autoimmune neurologic diseases versus.

Unfortunately, lack of clinical data prevents a definitive conclusion. Nonetheless, clinical trials conducted upon MS and NMO patients suggests a future role for medical cannabis in MS and NMO treatment by obtaining relief in patient symptoms. Yet, the trails aforementioned only paves the beginning, much research is yet to be done in order to evaluate the therapeutic effects of cannabis in treating autoimmune neurologic diseases versus.

Another promising aspect is cannabis protective effect on the BBB, having great potential not only in the field of autoimmunity but also in a variety of other pathologies with attributed BBB damage pathogenesis. The field of cannabis immunomodulation and BBB protection is an exciting new medical pathway, but only further research is to say what will be Cannabis sativa place in medical history.

Abbreviations

THC : Tetrahydrocannabiol; CBD : Cannabidiol; AEA : Ananamide; 2-AG : 2-Arachidonoylglcerol; LPS : Lipopolysaccharide; IL-6 : Interleukin 6; NO : Nitric oxide; MPK-1 : Mitogen-activated protein kinase 1; IL-1 : Interleukin 1; ICAM-1 : Intercellular Adhesion Molecule 1; VCAM-1 : vascular cell adhesion molecule 1; IL-8 : Interleukin 8; NFκB : Nuclear factor kappa-light-chain-enhancer of activated B cells; BBB : Blood – brain – barrier; BSCB : Blood – spinal cord – barrier; TNF-α : Tumor necrosis factor α; COX-2 : Cyclooxygenase-2; TMEV : Theiler’s Murine Encephalomyelitis Virus.

CBD Oil for Autoimmune Diseases: Benefits, Dosage, & How to Use?

Getting to the underlying cause of a chronic disease can be difficult despite advancements in science and a better understanding of our health. Autoimmune diseases are still largely misunderstood. Worse yet, there are over 80 registered autoimmune conditions (still counting), affecting various regions of the body.

According to medical researchers, the immune system is interconnected with the endocannabinoid system, which response to cannabis compounds such as CBD and THC. These two molecules have been identified as potent anti-inflammatories with the ability to modulate the communication of the immune system cells. There’s also a clear link between the onset of autoimmune diseases and a condition known as clinical endocannabinoid deficiency (CECD).

Several clinical trials have investigated the efficacy of CBD in the treatment of chronic conditions, including chronic pain, inflammatory bowel disease, epilepsy, autism, and arthritis. Despite minor differences in the consistency of its effects, scientists agree that CBD is the potential therapeutic agent for the management of autoimmune diseases.

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Today we explain the mechanism of action behind CBD’s benefits for autoimmune conditions.

Why People Are Turning to CBD for Autoimmune Diseases?

Autoimmune diseases develop when the immune system gets triggered and mistakenly treats the body’s healthy tissues as the potential threat. The immune system is mediated by various cells — including T-cells, which are in charge of protecting our body against foreign invaders. When these cells go out of whack, they take action as if the body’s own cells were those invaders. This results in chronic inflammation, the root of any autoimmune condition.

Autoimmunity is both difficult to diagnose and treat. The reason why the self-attack happens is still unknown. Some researchers argue that autoimmunity derives from hereditary factors, while others turn to events like parasites, infection, traumatic experiences, and leaky gut syndrome. When it comes to treatment options, doctors typically go with immunosuppressants, which — in simple terms — shut down the immune system to prevent the auto-aggressive response.

However, immunosuppressants can weaken the immune system over time, making it more susceptible to infections, which can further deteriorate an autoimmune disease.

And the blind circle continues to spin.

This is where CBD steps in.

The Link Between the Endocannabinoid System and Immune System

Despite being a relatively new discovery, the endocannabinoid system (ECS) has been confirmed to play an important role in the regulation of many biological processes, including brain functions and immune response. Endocannabinoid receptors (CB1 and CB2) are found throughout the central nervous system, as well as in the immune system and other organ systems. The ECS produces its own chemical messengers (endocannabinoids) that interact with these receptors (1).

The main role of the ECS is to help the body maintain homeostasis — the internal balance between the said functions. The ECS controls mood, emotions, pain perception, memory, appetite, reproduction, body temperature, and hormone secretion on top of other physiological and psychological processes.

The ECS works ‘on-demand,’ meaning it only gets activated when the body needs its assistance. The endocannabinoids are available for use only for a short span, and worse yet, the ECS doesn’t store them for later. The system depends on its own ability to produce more cannabinoids “here and now.”

At some point, the ECS becomes deficient in cannabinoids, compromising the activity of other systems and organs (2).

When you take CBD, it indirectly interacts with your endocannabinoid system, signaling it to produce more of its natural cannabinoids. It also inhibits the enzyme that breaks them down, so you end up with more endocannabinoids circulating in the body for a longer duration. Your body can use them more efficiently and return to homeostasis.

On top of that, CBD has over 65 molecular targets, which makes it a versatile tool for the management of many health concerns.

Let’s see how CBD may address the underlying cause of autoimmune conditions.

How Does CBD Help Manage Autoimmune Diseases?

The clinical endocannabinoid deficiency has been mentioned as the potential root cause of many chronic conditions, including chronic pain, migraines, type 1 diabetes, Crohn’s disease, fibromyalgia, arthritis, and mental disorders such as depression, schizophrenia, and post-traumatic stress disorder (PTSD).

CBD can help the ECS fix these deficiencies by interacting with the CB1 and CB2 receptors in the affected parts of the body. Since cannabinoid receptors are present in the immune system, CBD can have a positive effect on its functioning.

Below we explain how CBD may correct your body’s immune response.

Immunomodulatory Effects of CBD

Clinical dieticians recommend herbs and foods that produce modulatory effects in the immune system for people with autoimmune diseases. Cannabis therapy and dietary changes appear to be less expensive, safer, and possibly more effective for treating the symptoms and addressing the root cause than pharmaceutical medications.

Cannabis compounds such as CBD are known to modulate the immune system. They act as regulators, bringing an over or under-reacting immune system back on track. However, it’s difficult to tell the difference between “immune-modulating” and “immune-boosting.” It’s commonly agreed that people with autoimmune conditions are better off without taking anything which boosts the immune system.

According to researchers from the National University of Natural Medicine, cannabinoids offer a beneficial strategy to treat autoimmune disorders. Immunomodulation is known for its biphasic nature. For example, if your immune system’s response is exaggerated, an immunomodulatory compound will downregulate it. On the other hand, if your immune system has problems identifying potential threats, it will increase immune activity to fix the deficient response (3).

Cannabinoid receptors type 2 (CB2) regulate many pathways of the immune system. CBD is the agonist of the CB2 receptors; studies have shown that activating CB2 receptors can suppress the immune response, which can be helpful for those with autoimmunity. CB2 can also block the release of pro-inflammatory cytokines and boost the secretion of anti-inflammatory cytokines, balancing the immune system (4).

CBD has been found to modulate the immune system in autoimmunity disease models. CBD also suppresses immune system memory and slows down T-cell production, meaning that it could reduce the likelihood of future autoimmune flare-ups.

On top of that, CBD can increase the expression of genes that combat oxidative stress, reducing cell damage from autoimmune attacks. Unlike THC, CBD doesn’t require high doses to produce immunosuppressive effects.

Terpenes found in CBD oil, such as beta-caryophyllene, decrease inflammation through its interaction with the CB2 receptor. Myrcene, another terpene, is known for anti-inflammatory effects (5–6).

Long story short, CBD can help the immune system return to homeostasis, provide protection against damage from AI attacks, slow down excess T-cell production, and prevent future attacks.

Anti-Inflammatory Effects of CBD

Inflammation is the trigger of many illnesses, and autoimmunity falls into that bracket. Medical researchers have broadly described the anti-inflammatory properties of CBD and other cannabis ingredients. Regulating inflammation reduces the likelihood of an autoimmune attack. Cannabis therapies are known to assist people with autoimmune conditions by curbing inflammation with little to no adverse reactions. According to preclinical studies, CBD can attenuate autoimmune response on top of decreasing the gene transcription that promotes inflammation.

Although there’s a lack of specific human clinical trials, patients with autoimmune diseases report that they have been able to improve their condition by incorporating cannabis-based medicine into their regime. According to Dr. Bonni Goldstein, cannabinoids like CBD could be useful for people who demonstrate symptoms of arthritis and lupus. Goldstein reported that a two-month treatment with cannabis allowed her patients to participate in their life again, encouraging more people to try various CBD/THC ratios.

Cannabinoids are described in scientific literature as novel anti-inflammatory drugs based on preclinical evidence (7). But in order to benefit from cannabinoids, you need to choose a product from the right source.

Hemp vs Marijuana-derived CBD for Autoimmunity: Know the Difference

CBD is found both in hemp and marijuana. These two names refer to plants that are members of the Cannabis genus. Despite coming from the same family of plants, hemp and marijuana have a different chemical makeup.

Marijuana is known for its high THC content, ranging anywhere between 5–35%, and they’re bored with the intoxicating effects in mind. Hemp, on the other hand, contains only traces of THC (less than 0.3%) — nowhere near to get anybody high. It also has a higher concentration of CBD, the non-intoxicating compound.

If you’re looking for a federally legal CBD product for autoimmune conditions, hemp-derived CBD oil will be your best. But if you have the opportunity to try a medical-grade CBD from marijuana, feel free to experiment with different ratios under the supervision of your doctor.

You don’t need a prescription to buy hemp-derived CBD oil; it’s widely available over-the-counter in organic health stores, dispensaries, head shops, and online.

Keep in mind that CBD oil isn’t the same as hemp seed oil. The latter comes from the seeds and despite being a rich source of nutrients, it is devoid of cannabinoids. CBD oil should always be labeled as CBD oil, not ‘hemp oil’ or other umbrella terms.

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CBD Dosage for Autoimmune Diseases

Everybody is different, and considering the nature of autoimmune disorders, the effective dosage range varies greatly between individuals. It will take some experimenting to find the best dose for you. If you want to get a better understanding of CBD dosage, consult your doctor; doing so will also help you avoid potential interactions with other medications.

The general recommendation is to start low and slow. Take the minimum dose based on your weight — 2–6 mg per every 10 pounds of your body weight — and observe the effects over the course of one week. Adjust the dosage as needed and continue for another week. Once you’ve found the sweet spot, you can lock that dosage in and stick to it, as people don’t build a tolerance to CBD.

CBD is well tolerated in doses as high as 1,500 mg. That being said, there are a few mild side effects that might occur when you take too much of it at a time. These include dry mouth, appetite fluctuation, lowered blood pressure, fatigue, and diarrhea.

Fortunately, since cannabinoid receptors aren’t found in the brain stem area that controls respiratory function, it’s impossible to fatally overdose on CBD.

CBD Oil Options for Autoimmune Diseases

  • CBD Oil – most CBD is sold as a liquid extract suspended in an inert oil for better absorption. You take this sublingually, placing the desired dose under the tongue and holding them there for up to 60 seconds to enhance bioavailability.
  • CBD Capsules – if you dislike the flavor of CBD oil, capsules are a good alternative. They have no odor, no taste, and can be easily swallowed down with water. Most capsules come in the form of small, convenient soft gels, providing a fixed dose of CBD per serving. It will take longer to experience the effects of CBD when you take it this way, as capsules need to pass through the digestive system before they make it to the bloodstream.
  • CBD Edibles – CBD is infused into lots of foods and drinks to make the supplementation more enjoyable. The most popular formats are gummies and honey sticks which are often referred to as honey straws. When looking for the best CBD edibles for autoimmune disorders, make sure to carefully read the list of ingredients; adding CBD to food doesn’t make it healthy.
  • CBD Vape Pens – vaping provides the fastest way to feel the effects of CBD. It also delivers more CBD to your system than other forms, although studies have yet to analyze the safety of long-term vaping for the lungs.
  • Topicals – topical products such as CBD creams are formulated to address localized problems. If you suffer from an autoimmune skin condition, topicals combined with a sublingual or oral form of CBD should provide relief from flare-ups while modulating the activity of the immune system from within.

Always make sure to check the potency of your CBD oil. Look at the label to see the total amount of CBD and the amount you’re getting with each serving. A high-potency CBD product will contain more servings per container than a lower-potency option of the same size.

How to Find a Trustworthy CBD Brand?

  • Hemp farming methods – choose a brand that sources its hemp from local organic farms. This will greatly narrow down your options. Plants grown with natural methods contain higher levels of CBD and are free of common contaminants from the soil and the plant’s environment.
  • Extraction method – getting the CBD out of the plant involves some work. The most common technology is CO2 extraction due to the lack of additional heat and solvents involved in the process.
  • Ingredients – the best CBD products for autoimmune diseases should have a very short list of ingredients: CBD extract and a quality carrier oil such as MCT oil. Flavored CBD oils may contain natural terpenes or other flavorings. Steer clear of companies using artificial sweeteners, flavorings, or emulsifiers in their products.
  • Certificates of Analysis (COA) – the CBD market is booming and unregulated, which provides opportunities for many fly-by-night vendors to churn out poor-quality products and label them as “premium.” The best way to find out whether or not you’re buying from a trusted provider is to check if they provide third-party lab testing reports. The testing should be multifaceted, informing the user about potency and the lack of potential contaminants such as pesticides, heavy metals, and mycotoxins.

CBD vs. Immunosuppressants for Autoimmune Diseases

The reason why people are turning to CBD for autoimmune diseases lies in its high safety profile. Unlike conventional immunosuppressants, CBD doesn’t shut down the immune system. Instead, it reduces inflammation while modulating the communication between the system’s cells. In other words, CBD helps the body fix the immune response without harming it — something which pharmaceutical medications fail to achieve.

Still, if you’re considering taking CBD for your autoimmune condition, consult the idea with a holistic doctor experienced in cannabis therapies. Only then will you be able to determine if CBD oil will be safe for your situation.

Does CBD Interact with Medications for Autoimmune Diseases?

CBD is known for interacting with a wide range of medications. It uses the same mechanism as grapefruit juice, so any medication with a grapefruit warning on it shouldn’t be taken along with CBD oil. CBD inhibits the cytochrome p450 system, a group of enzymes that metabolize active ingredients in drugs. Taking CBD with other medications can result in a subtherapeutic effect or, on the contrary, substance toxicity — none of which are good for your health.

Summarizing the use of CBD for Autoimmune Conditions

Autoimmunity may be a challenging situation that requires a multifaceted approach due to its complex nature. Hopefully, there are holistic approaches you can take to address your symptoms and manage the condition. Coping with an autoimmune disease puts much burden on the sufferer, but it can also be a chance to get back in touch with your body.

On top of supplementation with CBD oil, you can incorporate some lifestyle changes, such as a nutrient-rich diet, exercise, sufficient sleep, herbal medicine, and probiotics to support your immune system from many angles.

Many pieces of research have been made to confirm the preclinical findings on CBD and autoimmune conditions like systemic lupus erythematosus, diabetes, migraines, and more, but what we’ve learned so far is very promising. Again, we recommend that you consult a doctor before buying any CBD product to avoid potentially negative interactions with your medications and establish the right dosage.

Literature:

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  2. Russo, Ethan B. “Clinical Endocannabinoid Deficiency Reconsidered: Current Research Supports the Theory in Migraine, Fibromyalgia, Irritable Bowel, and Other Treatment-Resistant Syndromes.” Cannabis and cannabinoid research vol. 1,1 154-165. 1 Jul. 2016, doi:10.1089/can.2016.0009
  3. Lee, Wen-Shin et al. “Cannabidiol Limits T Cell-Mediated Chronic Autoimmune Myocarditis: Implications to Autoimmune Disorders and Organ Transplantation.” Molecular medicine (Cambridge, Mass.) vol. 22 (2016): 136-146. doi:10.2119/molmed.2016.00007
  4. Turcotte, Caroline et al. “The CB2 receptor and its role as a regulator of inflammation.” Cellular and molecular life sciences: CMLS vol. 73,23 (2016): 4449-4470. doi:10.1007/s00018-016-2300-4
  5. El-Sheikh, Sawsan M A et al. “Anti-arthritic effect of β-caryophyllene and its ameliorative role on methotrexate and/or leflunomide-induced side effects in arthritic rats.” Life sciences vol. 233 (2019): 116750. doi:10.1016/j.lfs.2019.116750
  6. Rufino, Ana Teresa et al. “Evaluation of the anti-inflammatory, anti-catabolic and pro-anabolic effects of E-caryophyllene, myrcene, and limonene in a cell model of osteoarthritis.” European journal of pharmacology vol. 750 (2015): 141-50. doi:10.1016/j.ejphar.2015.01.018
Livvy Ashton

Livvy is a registered nurse (RN) and board-certified nurse midwife (CNM) in the state of New Jersey. After giving birth to her newborn daughter, Livvy stepped down from her full-time position at the Children’s Hospital of New Jersey. This gave her the opportunity to spend more time writing articles on all topics related to pregnancy and prenatal care.

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