CBD for Multiple Sclerosis: Does it help?
Table of contents
Overview of Multiple Sclerosis
Can CBD help with Multiple Sclerosis
- Research on the use of CBD supplementation on standard therapy of MS (Multiple Sclerosis)
- Choose the right dose
- How to use
- Notice about using CBD to treat nausea/vomiting
- Drug - CBD interaction
Overview of Multiple Sclerosis
What is multiple sclerosis?
Multiple sclerosis is an autoimmune and disabling condition affecting the brain and spinal cord. In MS, the immune system attacks the myelin which is a protective sheath covering nerve fibers. As a result, the communication between the brain and the rest of the body is disturbed, resulting in permanent damage or deterioration of the nerves.
There is no cure for multiple sclerosis, and the goals of therapy mainly focus on managing the symptoms, maintaining quality of life, and controlling disease progression.
Symptoms and disease course
The symptoms of MS vary and depend on the number and types of nerve damage. Some people may lose the ability to walk, while others experience long periods of remission without any new symptoms.
Generally, the disease often affects movement and sensation in limbs and arms, such as:
- Numbness or weakness in one or more limbs
- Muscle stiffness and spasm
- A tendency to drop things
- A lack of coordination and tremor
- A feeling of heaviness
- electric-shock sensation with certain neck movement
Sometimes, the patient may experience vision issues (e.g. partial or complete loss of vision, pain during eye movement, blurry vision), slurred speech, fatigue, dizziness, and loss of bladder function.
Most people with MS have relapsing-remitting disease progression By this I mean that they may suffer new symptoms or relapses, and usually improve after that. The relapses followed quiet periods of disease remission. Unluckily, 50% of MS patients eventually develop to a steady progression within 10 to 20 years of disease onset. This is known as secondary - progressive multiple sclerosis.
Some people experience gradual and stable onset of disease without any relapses, known as primary MS.
Causes and risk factors
To date, the exact causes of MS is still unknown. The experts considered it as an autoimmune disease in which the body’s immune system attacks its own tissue. In cases of Multiple sclerosis, the affecting tissue is myelin sheath which coats and protects the nerve fiber. When it is destroyed, the signals or messages that are transmitted along the nerve fiber are slowed, or blocked.
However, the scientist indicated that there are some risk factors are associated with MS, including:
- Age: Although the disease can occur at any ages, but it usually occurs between 20 and 40 years of age
- Gender: Women have higher rates of experiencing MS, but men often have poor disease prognosis
- Family history
- Viral infections
- Race: White people who live in areas with low sunlight exposure, such as Northern European, Northern America.
- Low levels of Vitamin D due to insufficient sunlight exposure.
- Autoimmune disease: You are at a slightly higher risk of developing MS if you have type 1 diabetes, thyroid disease, IBD, etc.
Treatment for Multiple Sclerosis
There is no cure for MS, and treatment mainly focuses on managing the symptoms, speeding recovery from MS attack, and slowing progression of the disease.
- For multiple sclerosis attacks, physicians often use corticosteroids to suppress inflammation of nerve fiber. However, they have many side effects, such as increased glucose levels, depression, fluid retention, mood swings, etc.
- For slowing disease progression, disease-modifying therapies can be applied as soon as possible to lower the relapse rates, prevent new lesion formation, and potentially reduce the risk of disability. Treatment includes injectable medications (e.g. interferon beta, glatiramer acetate), oral medications (e.g. fingolimod, dimethyl fumarate, and so on). Most disease-modifying drugs carry significant health risks, such as tumor, infection, blood issues, liver impairments, which must be monitored carefully to minimize the side effects. Although there are a variety of treatment options, selecting the right drugs will depend on various factors, including severity of disease, child-bearing status, responsiveness, efficacy, cost, and side effects.
- In addition, managing the symptoms is also an important goal therapy in treating MS. Strengthening exercise or stretching with physical therapists may help build muscle strength, and ease movement problems. Physical therapy along with the use of mobility aid is beneficial for patients with leg weakness, and gait issues.
Can CBD help with Multiple Sclerosis
Currently, many patients with multiple sclerosis use cannabis as a supplement to treat the symptoms, such as spasticity, imobility. A survey conducted by Kindred, which was funded by the National Multiple Sclerosis Society, showed that 66% of patients use cannabis for their symptoms . In Particular, a study from Canada found that about 50% of patients would consider cannabis-based products if they are legal and there is enough scientific evidence to support its use . In fact, the increase in social acceptance will lead to growth of patients using cannabis to treat symptoms of Multiple Sclerosis. Based on these considerations, it is my opinion that CBD supplementation may be added to conventional therapy to treat the symptoms of Multiple Sclerosis. In this section, we provide an overview of some research about the use of CBD to manage the symptoms of Multiple Sclerosis.
Research on the use of CBD supplementation on standard therapy of MS (Multiple Sclerosis)
The effects of CBD and THC on driving ability in patients with multiple sclerosis - related spasticity.
Driving disability is a key function for the majority of patients with multiple sclerosis to maintain daily activities. Both physical and cognitive impairment in multiple sclerosis affects the ability to drive. One of the causes is due to spasticity which is a common symptom of MS. Experts from the department of neurology, Oslo University Hospital review evidence about Sativex (THC:CBD) to treat spasticity and its potential impact on driving performance. After using Sativex, the majority of patients reported an improvement in driving ability and it may be related to reduced spasticity and/or better cognitive function. However, the authors noticed that the blood level of THC should be lower than the levels associated with recreational purposes. The studies also showed no evidence of an increase in vehicle accidents associated with THC-CBD consumption .
Sativex as add on therapy in resistant multiple sclerosis spasticity - A double-blind, placebo-controlled, and randomized clinical trial
The purpose of the trial was to evaluate the effects of THC:CBD spray when added on standard therapy to treat plasticity in patients with multiple sclerosis. 191 eligible patients received THC:CBD spray for 4 weeks to identify responders which is considered over 20% improvement from baseline in spasticity numerical scale. Following this, 106 eligible respondents received THC:CBD spray or placebo for a 12-week period. After 12 weeks, the proportion of patients shown improvement in spasticity scale was higher with THC:CBD spray than placebo. The side effects were mild or moderate without new safety concerns. In conclusion, the experts indicated that THC:CBD spray when added on anti plasticity treatment provided better clinical improvement of spasticity than conventional therapy .
A review of the role of CBD and its combination with THC in Multiple sclerosis treatment
Sativex - a synthetic medication of CBD and THC has been approved to treat plasticity. In animal studies, CBD has shown to delay symptom onset and slow disease progression due to anti-inflammatory properties. In addition, combination of CBD and THC is also effective to treat multiple sclerosis. While CBD suppresses inflammation by preventing cell penetration into the spinal cord, THC reduces the levels of spasticity. However, in human studies, a combination of THC and CBD appears to be effective in reducing spasticity score, and causes less side effects than other treatments, such as Baclofen. The findings of the studies suggest that CBD may help treat neuropathic pain associated with Multiple Sclerosis as add-on therapy to conventional pain treatment .
In addition to effects of CBD on spasticity, there is numerous evidence to suggest that CBD may be effective to manage depression, and pain, which are common symptoms of Multiple Sclerosis.
Choosing the right dose of CBD
There is no one size fits all dosage for CBD. What’s optimal mainly depends on a range of factors, such as body weight, tolerance, symptoms, metabolism, and so on. These factors can yield unique effects for each CBD consumer. Keep in mind that you should pay close attention to how you feel after each dose. It might not occur immediately, and you should be patient to remember that you’re unlikely to get immediate results. As soon as you experience positive effects, lock in that dose and stick with it.
With oral route, start at a dose of 20 milligrams per day (using twice or three times a day) and increase the dose gradually to achieve desirable effects. Do not increase or decrease your dose more often or longer than recommended. Your condition may not improve faster, your risks of side effects will increase.
With topical CBD products, take sufficient amounts of CBD to apply directly into the skin (2-3 times a day) and start at low dose and increase the dose gradually. You can combine using topical CBD products with oral route for maximizing effects.
The recommended dosage forms are CBD capsule and CBD oil. As compared to capsule, CBD oil is extremely versatile because it can be taken under the tongue, vaporized, infused in food, or cosmetics.
How to use
Taking capsules is the simplest and most convenient way to use CBD. You only need to swallow the capsule with at least 300 ml of water. The drawbacks of the oral route are low availability and delayed onset of effects.
There are some ways to take CBD oil, and we will provide two most common and effective methods to use CBD in this section.
Firstly, applying CBD sublingually is incredibly easy. CBD oil needs to be put under the tongue and held from 60 to 120 seconds without swallowing to allow adequate time for CBD to diffuse completely across the epithelial cells. The method remains the same when you use CBD oils or tinctures. You must hold the CBD under the tongue since different areas of the mouth might not be permeable enough for diffusion into the bloodstream. Taking CBD sublingually provides fast onset of action and high bioavailability.
Vaping CBD seems to be slightly more difficult than taking CBD sublingually. The first step to vaping properly is to determine how much CBD you consume each time. If you feel unconfident at first, you should start with the easiest option. Disposable cartridges and pods are the simplest tools for new users. Refillable vape pens are a little bit more advanced but more cost-effective in the long term. It is important to read the instructions carefully before using them.
Notice about using CBD for Multiple Sclerosis
How you choose the best CBD products for Nausea and Vomiting
Overall, it is vital that your doctor check your improvements, disease progression, side effects, and interaction with food or drugs at regular visits to make sure CBD is working properly.
- Notice any side effects and tell your doctor right away.
- Don’t take other medicine (including ETC, OTC medicines, herbal, or vitamin supplements) unless they have been discussed with your doctor.
As regards CBD products, they are made by a company that provides
- Third-party test
- Business certification
- Certificate of analysis (COA), no contain more than 0.3% THC and pass tests for heavy metals, pesticides, etc.
- Source of their hemp
- Product information (Brand, CBD content, ingredients, potency, route of administration, indication, instruction)
- Customers’ review
- No subject of FDA warning letter or make any unsupported health claim
If you use CBD by taking it under the tongue or vaping, there are a few things that you should take into account. We will provide details in the following section.
Applying CBD sublingually
Shake well before use
Determine the number of drops in accordance with the dose of CBD consuming each time
Start at a low dose as we recommend above and increase the dose to have the therapeutic effects.
Hold the CBD under the tongue for at least 60 seconds
Accidentally swallowing the CBD oil won’t pose any risks to your body. However, once you swallow this substance, you no longer take it sublingually. Instead, you are eating it, which means that it has to pass the digestive system and metabolism before your body can utilize it. Although it’s not dangerous, it does mean decreased bioavailability and slower onset of action.
Taking CBD sublingual bypasses the digestive system, there’s no need to worry about taking it with or without food.
After the necessary time is up, drinking water or eating food won’t interfere with the working of the CBD. At best, you might wait a few minutes prior to drinking water.
Putting a few drops of CBD under the tongue won’t turn your teeth yellow as well as make your breath smell.
Determine your suitable CBD dosage, the number of puffs each time, and types of CBD vape
Read carefully the user manual, especially if you are a new user
Wait 5 – 10 minutes between puffs and observe how CBD affects you
Always start at low dose, and work your way up to the optimal dose
After inhaling, you should check the battery life or clean the vape tank if needed
CBD - Drug interaction
People considering or taking CBD products should always mention their use to their doctor, especially if you are taking other medications or have underlying ailments, such as kidney disease, liver disease, heart failure, or immunocompromised condition. Pharmacists are also a reliable source to help you learn about potential drug interaction with supplements, over-the-counter drugs or prescribed drugs.
Although more studies are needed to investigate the role of CBD in treating symptoms of Multiple Sclerosis, the experts have some good reasons to believe that CBD is useful to treat spasticity and improve immobility in patients with MS . If you try using CBD to manage these symptoms of MS, you should talk to your doctor, they can help you determine the most effective and safest way to take CBD.
. Kindred JH, Li K, Ketelhut NB, Proessl F, Fling BW, Honce JM, et al. Cannabis use in people with Parkinson’s disease and multiple sclerosis: a web based investigation. Complement Ther Med (2017) 33:99–104.
. Banwell E, Pavisian B, Lee L, Feinstein A. Attitudes to cannabis and patterns of use among Canadians with multiple sclerosis. Mult Scler Relat Disord (2016) 10:123–6. 10.1016/j.msard.2016.09.008