CBD Oil for Fibromyalgia

The last few years have witnessed a growing interest in CBD among consumers in the US. Many CBD advocates claim that CBD oil can effectively relieve the symptoms associated with numerous disorders including fibromyalgia (FM).
cbd oil for fibromyalgia

A report published in the Journal of Clinical Rheumatology shows that CBD improved the symptoms of fibromyalgia. Similarly, a 2013 review revealed that CBD could help alleviate pain caused by FM and other conditions, including multiple sclerosis and rheumatoid arthritis. The FDA, however, has not approved the use of CBD oil for treating fibromyalgia. Notwithstanding, CBD oil remains a popular choice among consumers in treating FM.

What is CBD?

CBD, short for cannabidiol, is one of the active natural compounds known as cannabinoids present in the Cannabis sativa family. CBD and its cousin THC are the two active cannabinoids in the Cannabis sativa. CBD, in contrast to THC delta-9-tetrahydrocannabinol, does not produce the euphoric effect associated with marijuana. CBD is a non-psychoactive compound that does not ‘get you high’. It does not influence the brain in ways that could lead to temporary changes in behavior, consciousness, mood, and perception.

Difference between CBD and Marijuana

CBD is different from marijuana as it does not contain THC. However, both CBD and THC have the similar chemical formulas and interact with the body’s endocannabinoid system. The endocannabinoid system regulates several functions and processes that include sleep, memory, appetite, mood, and reproduction & fertility. However, there is a difference in the arrangement of their atoms. This minor difference is thought to be responsible for their differing effects on the body. According to the World Health Organization, “CBD does not show any effect either of abuse or dependence potential. Also, there is no evidence to date of any public health related problems linked to the use of pure CBD.” On the other hand, THC, which is the main psychoactive natural compound in marijuana, is responsible for the euphoric effect associated with marijuana. This is the effect that many consumers wish to avoid, hence the popularity of CBD products.

Is CBD Legal?

The legality of CBD appears complicated due to varying laws across the states regarding its use. This depends on where you live. CBD or any of its related products made from cannabis are illegal under the federal law, except for Epidiolex. This is a prescription drug approved for the treatment of a rare form of epilepsy in children and adults, age 2 and above. However, more than 30 states have legalized the use of medical marijuana.

Under the 2018 Farm Bill, CBD products derived from the hemp plant with less than 0.3 percent THC are legal at the federal level, but other states deem it as illegal. Depending on where you are, you may order CBD products online. But, be careful because flying with CBD products may land you in trouble with federal authorities.

How CBD can help Fibromyalgia ~ What is Fibromyalgia and what causes it?

Fibromyalgia (FM) is a disorder characterized by chronic widespread musculoskeletal pain accompanied by poor sleep quality, fatigue, memory, and mood issues. According to the National Fibromyalgia Association (NFA), fibromyalgia affects close to 10 million people in the United States and about 3 to 6 percent of the global population. FM is more common in women with about 75 to 90 percent of all cases. It also occurs in children and men.

Based on current research, the medical community does not know what causes fibromyalgia. Studies indicate the following primary causes or triggers of FM.

  • Infection: Some ailments can aggravate or trigger fibromyalgia.
  • Genetics: If either or both of your parents have the disorder, you might also develop the disease.
  • Emotional or physical trauma: Physical trauma, including a car accident, could trigger FM; also, emotional stress may cause the disorder.

CBD and Fibromyalgia

CBD interactions with your body’s endocannabinoids system by activating the serotonin receptors. Serotonin plays a role in

  • Minimizing inflammation
  • Pain perception
  • Regulating body temperature

Currently, there is little scientific evidence in humans to establish the effectiveness of CBD for fibromyalgia. However, animal based studies show promise that CBD relieves some of the symptoms of fibromyalgia including

  • CBD lowers brain inflammation that contributes to brain fogging and pain in people with fibromyalgia.
  • CBD inactivates the glial cells in the brain; active stimulation of the glial cells is essential in chronic pain development and the severe pain experienced by people with fibromyalgia.
  • CBD shows some neuro-protective abilities. For example, it might reduce brain damage after trauma by triggering cell repair. This is thought to improve brain function and reduce the fogging in fibromyalgia.
  • CBD reduces the fight or flight nervous system activity in rats exposed to stress. Most people with fibromyalgia experience similar fight or flight responses when subjected to stress due to over secretion of sympathetic nervous system messengers.
  • CBD both topically and orally lessened pain behaviors in rats with painful and inflamed joints and damaged nerves (“neuropathic pain”). Both inflammation and malfunctioning nerves contribute to fibromyalgia pain.

Research and Evidence of CBD in Fibromyalgia

The use of CBD in patients diagnosed with fibromyalgia produced significant improvement in some of the symptoms associated with FM. This statement is based on findings from research involving 26 patients conducted in Israel. Based on the study, 50 percent of the patients stopped using any other medication apart from CBD to manage the symptoms of fibromyalgia.

In addition, there are studies from similar research performed in 2011 involving 56 patients diagnosed with FM. They were divided into two groups of 28 people and each showed similar results. CBD was part of the treatment administered to one group, while the second group was not-given CBD. Based on the investigation, members of the CBD user group demonstrated some improvement in symptoms. This included pain reduction, increased relaxation and feelings of well being compared to the non-CBD users.

Also, many other studies including a 2019 Dutch study and 2019 Israeli study on CBD effects on fibromyalgia have been conducted, but the results appear inconclusive. There is a need for more humans based clinical research to validate the safety and efficacy of CBD in treating fibromyalgia.

Other Potential Benefits of CBD ~ Why People Use CBD Oil

The FDA approved three prescription drugs – Lyrica (pregabalin), Cymbalta (duloxetine hydrochloride), and Savella (milnacipran HCI) for the treatment of FM symptoms. There is widespread criticism from researchers regarding the safety and efficacy of these drugs. 

Many consumers complain of side effects that include insomnia, dizziness, constipation, nausea and the possibility of addiction. This has resulted in individuals diagnosed with FM to abandon their use and seek alternative treatments.

The use of CBD oil, despite the illegality surrounding its use, has received a lot of publicity as an alternative treatment for fibromyalgia. Most of the studies on CBD effectiveness are animal based. However, according to the Institute of Medicine, there is strong evidence, that CBD is effective in treating symptoms of chronic pain in adults.

Potential Benefits of CBD Oil

CBD oil is made from a CBD extract of the cannabis or hemp plant. This product has gained acceptance among consumers in the wellness and health world. There are many unproven claims in humans by CBD proponents about its effectiveness. Lots of research is ongoing in most parts of the world to bolster and validate some of these claims. The results of CBD oil, trials in animal based studies support assertions that CBD is able to ease some of the symptoms associated with FM. Some of the potential benefits of CBD oil and scientific studies that back such claims include:

May help relieve chronic pain: History has it that the ancients used cannabis as far back as 2900 B.C. in treating pain syndromes. Scientists determined that CBD binds with the endocannabinoid system. This association is believed to help reduce inflammation by interacting with your neurotransmitters. Similarly, some studies conducted in rats reveal that CBD injections alleviate the pain response to a surgical incision.

May alleviate depression and anxiety: Research indicates that CBD oil may effectively treat anxiety and insomnia in children with post-traumatic stress disorder. A study conducted in Brazil involved 57 men who received CBD either oral or placebo about 90 minutes before undergoing a simulated public speaking test gave credence to this claim. Based on the results, the researchers discovered that a 300 mg dose of CBD significantly reduced anxiety during the test.

May alleviate acne:  Acne, according to the National Institute of Health (NIH), affects more than 9 percent of the U.S. population. Many things that include bacteria, genetics, overproduction of sebum and underlying inflammation are thought to be responsible for pain. Based on results from a test tube study of CBD oil effects on the skin, it may be useful in treating acne. This is in part due to its anti-inflammatory properties and the ability to regulate sebum production in the sebaceous glands.

May reduce cancer related symptoms: Research indicates that CBD may reduce symptoms associated with the side effects of cancer treatment such as pain, vomiting, and nausea. A study was performed that involved 177 people with cancer related symptoms treated with two CBD extracts, one containing both CBD & THC, and the other THC alone. The result revealed that those treated with extract containing both compounds experienced a significantly greater reduction in pain than those who used THC extract alone. Furthermore, a test tube study revealed that concentrated CBD triggered cell death in human breast cancer cells.

May prevent diabetes: Based on a study conducted on diabetic mice, CBD reduced inflammation and the occurrence of diabetes by 56 percent. The FDA still considers the use of CBD and its allied products as unsafe. They have not recommended its usage in any product except for Epidiolex.

CBD Side effects – Is Cannabidiol safe?

The FDA asserts that cannabidiol (CBD) is unsafe due to many factors that include:

  • Dosage studies are few in number
  • Limited clinical trials
  • Potential side effects
  • Quality of CBD products
  • Potential interaction with other drugs
  • Lack of control by the FDA
  • Lack of placebo controlled, double blind studies

Side Effects and Safety

Some research indicates that CBD use might cause side effects that include:

  • Vomiting
  • Dry mouth
  • Anxiety
  • Changes in mood
  • Dizziness
  • Changes in appetite
  • Nausea
  • Drowsiness
  • Diarrhea

Children: A higher dosage of Epidiolex might result in side effects in children. You should adhere to the recommended dosage.

Pregnant and Lactating Women: There is limited information on the effects of cannabidiol in lactating or pregnant women. Based on a report from the American Academy of Pediatrics (AAP), pregnant and lactating women should avoid the use of CBD because of possible effects on the fetus. You should avoid cannabidiol use if you are breastfeeding or pregnant.

Parkinson’s disease: Based on studies, people diagnosed with Parkinson’s disease should avoid taking high doses of CBD. This might aggravate abnormal muscle movement and tremors. Furthermore, CBD oil may interact with some medications. These include some types of anti-epileptic drugs; therefore, you must discuss CBD with your doctor before starting any hemp based medication.

What form of CBD is best and how much should I take? ~ CBD forms

CBD products exist in a variety of forms that includes edibles, topicals, vapes, gummies, oils and tinctures. Every CBD dosage form has its advantages and disadvantages, which include the speed of absorption, duration of effects, plant source varieties, concentrations, and side effects. Your choice of CBD product will depend on your needs and personal preferences. Vaping remains the fastest form of getting CBD into your bloodstream, but not everyone vapes. Similarly, CBD topicals are commonly used in treating muscle and joint pain, and skin conditions. On the other hand, CBD oil and tinctures represent a good option for consumers who do not like taking CBD capsules or pills. You must always discuss the addition of a CBD containing product to your treatment plan with your health care provider before taking any form of CBD regardless of the purpose.

Different Consumption Methods of CBD

You can administer CBD by using any of the following methods.

CBD vaporizing (inhalation): You can inhale CBD with a vape. Administering CBD via this method is the fastest way to absorb CBD into your bloodstream. The CBD gets into your bloodstream through your lungs, and you start experiencing its effect almost immediately. CBD vaporizing when compared to other methods has the shortest active period. This means you need to keep taking more doses to experience the continual effect.

CBD cream and lotion (topical): CBD infused lotion and cream are reputed to be effective in treating arthritis pain, inflammation, and sore muscles. You may start experiencing relief an hour after use and this may last for up to 5 hours.

CBD skin patches: These small adhesive patches transmit CBD through your skin. The effect of CBD skin patches can last up to 4 to 6 hours on average.

CBD oil and tinctures: After CBD vaporizing, CBD oil and tinctures are the second quickest way to get CBD into the bloodstream. You take CBD oil and tinctures using a dropper under your tongue (sublingually). CBD oil typically is made of CBD and a carrier oil which can be hemp seed oil, MCT, or coconut oil.

CBD edibles (ingestion): They are foods infused with CBD that are offered in various forms. You may also add CBD to food and beverages. Some individuals prefer CBD formulated into gummies or in the form of chocolate, and baked goods. CBD edibles, when compared to other methods, take a bit longer before you start experiencing the effect.

CBD – Dosage

Based on current research, there is no approved standard guide for CBD dosage. Many factors determine the CBD dosage you should consume. These include

  • The condition you are treating
  • The concentration of CBD in the gummy, drop, pill, or capsule
  • Your body chemistry and weight
  • Individual disease progression

However, before starting any treatment with any CBD product, you must first discuss this with your doctor. Seek advice on possible drug interactions, dosage, and side effects. If your physician suggests a dosage, you should adhere to such recommendations. Always start with a low dosage and gradually increase the dose as your body adjusts to CBD use.

As suggested by Lindsay Slowiczek, PharmD, “It’s important to start with a low dose until you figure out how your body will react to CBD. A wide range of CBD doses has been tested in clinical studies, but more evidence is needed before safe and effective dose recommendations can be made for specific uses. For now, use the products recommended dose unless your doctor gives you the go ahead to take larger doses,” she continues, “People with certain health conditions, such as liver disease, may need lower doses to avoid serious side effects.”

Tips for Choosing a CBD products

The FDA does not regulate CBD products. This poses a risk to consumers with regards to the quality of the products. The quality of CBD products differs and this definitely will influence its effects on you. This has made it more complicated for consumers to choose a quality CBD product. Here are some tips that can guide you when selecting the best CBD oil for fibromyalgia.

Check the reviews

Start your research by reading the consumer reviews online and checking other consumers’ experiences. Checking a product review saves you money, stress and time spent on buying inferior CBD oil. This will provide you with valuable information about the other customers’ experience of the product that includes side effects, the dosage that works, and effectiveness. All this will help you in your buying decision.

Examine the test results of the manufacturers’ you want to buy from for it will provide you information such as

  • If they are certified
  • If they conduct third party lab tests
  • If they use artificial ingredients

Many sites provide valuable and unbiased information about CBD brands and products. Some other tips to use in choosing quality CBD oil for FM include

  • Learning how to read and understand the information in a laboratory report. It is your right as a consumer to request this information if it is not available on the manufacturer’s website.
  • Avoid using CBD oil from brands that make bogus health claims about their CBD products.
  • Avoid using gummies that contain artificial colors and corn syrup
  • Choose full spectrum CBD products
  • Choose products from brands that show on the label the quantity of CBD and THC per serving.
  • Ask colleagues, families, and friends having FM health challenges about which CBD oil works for them.
  • Consumer’s reports advise consumers to choose brand products made in the U.S. from states that have legalized hemp production.
  • Ask your physician about any online FM and CBD oil forum you can join. Discuss with your doctor before using any CBD oil for FM as potential side effects and drug interactions can occur.

There are misgivings by consumers about the recommended medications approved by the FDA for fibromyalgia treatment. This does not suggest that the medications are ineffective or that CBD oil is the solution for FM. Despite the claims about CBD oil’s effectiveness in treating FM by CBD advocates, more research is needed in humans to verify the safety and efficacy of CBD oil.

The CBD industry is moving faster than regulatory agencies and medical safety investigations. This is truly a buyer beware marketplace. Always place your health and safety first. Be diligent in completing your research and ask questions. It is vital to discuss CBD with your doctor before taking any CBD product, either oil, gummies or others for FM treatment.

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Diana Rangaves
Diana Rangaves
PharmD, Clinical Consultant, Google Scholar
Dr. Diana Rangaves is Doctor of Pharmacy (Pharm D). She graduated from the University of California, San Francisco and specializes in pharmacotherapy management. Diana has a broad range of acute clinical background and ambulatory care. She was an academic college professor; teaching critical thinking, ethics, pharmacology, addiction, behavior patterns, pharmacy, and nursing. As a Clinical Pharmacist, she is focused on chronic or disease state management.

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