Does CBD Work for Lupus?
- Lupus is an autoimmune disease that may affect the whole body. There is no treatment for lupus(1).
- Studies have shown that CBD may help manage and treat the symptoms of the disease, such as inflammation, pain, and hypertension, which may be caused by anxiety and stress(2).
- A 2018 study found that people with lupus, who have the lowest disease activity while having an elevated 2-AG and CB2 receptors for inflammation and pain, have an endocannabinoid system working effectively to suppress lupus(3).
- However, CBD is an immunosuppressant, based on a 2020 study published in Cannabis and Cannabinoid Research(4). CBD may weaken the immune response of the body and could be useful in autoimmune diseases where the immune system is overactive against ‘self’.
Why People Are Using CBD for Lupus
There are several medications for people with lupus because of the vast array of possible symptoms a patient may have. Treatments depend on the severity of the condition.
People with lupus are prone to have serious complications that affect the body’s major organs, such as the skin, heart, lungs, and kidneys(5).
Because of the numerous disorders that come with having lupus, several medications are prescribed by medical professionals as treatment options.
The Lupus Foundation of America’s list of drugs commonly used for lupus include(6):
- Antimalarial drugs, like hydroxychloroquine and chloroquine, for rashes and UV light protection
- Anti-inflammatory drugs, like non-steroidal anti-inflammatory drugs (NSAIDs), for swelling and pain reduction
- Biologics, like monoclonal antibody belimumab, to help the immune system function properly
- Immunosuppressants, like cyclophosphamide, methotrexate, and azathioprine, to control the overactive immune system
- Anticoagulants, like aspirin, heparin, and warfarin, to prevent blood clots
- Steroids (corticosteroids), like prednisone, prednisolone, methylprednisolone, and hydrocortisone, to help with the body’s inflammatory response
The mentioned drugs and medications can be combined as prescribed by doctors and may cause side effects.
Taking a higher dosage of NSAID can cause gastrointestinal problems, such as stomach ulcers. Too much of it can reduce the kidney’s blood flow and may affect how the organ eliminates waste(7).
Initially, doctors administer steroids in the lowest possible dosage. Long-term use and high dosage of steroids may have more adverse effects on patients than benefits(8).
Continuous consumption of the drug may lead to osteoporosis and may increase the risk of infections, especially on open wounds(9).
Medical professionals recommend immunosuppressants to those who have severe lupus cases but cannot take higher doses of steroids. Immunosuppressants lower the immune system’s activity that is attacking an individual’s tissues.
Lupus patients who are taking these drugs might have higher chances of developing other infections, like shingles, and severe diseases, like cancer(10).
Given these side effects, some people have turned to natural alternatives, like cannabis (medical marijuana) to treat lupus symptoms(11). Marijuana plants contain cannabinoids, the most active of which is tetrahydrocannabinol (THC).
THC is the psychoactive counterpart of CBD. Products with this component can make the user high, so caution is advised.
There is no concrete evidence and documentation that CBD alone can directly treat lupus. However, according to studies, CBD may help manage other autoimmune disorders, like rheumatoid arthritis, multiple sclerosis, fibromyalgia, and type 1 diabetes(12).
Autoimmune diseases are chronic medical conditions wherein the immune system attacks the body’s healthy tissues and cells.
How CBD Oil Works to Help Alleviate Symptoms of Lupus
There are four different kinds of lupus, but the most common is systemic lupus erythematosus (SLE). This kind of lupus elicits an abnormal response from the immune cells, enabling the immune system to attack the body’s healthy tissues(13).
These immune cells are called T cells and B cells. The former are white blood cells that fight foreign bacteria that enter into the body. The latter are the cells that produce antibodies.
There are four kinds of lupus, and they all share common symptoms, such as(14):
- Pain throughout the body including chest pain
- Inflammation or swelling of body parts and joints
- Light sensitivity
- Butterfly rash on cheeks and nose
- Hair loss
- Mouth and nose sores
CBD may help reduce inflammation and pain, the primary symptoms of lupus, through the endocannabinoid system (ECS) in the body.
The ECS impacts the body’s immune response, regulating pain and inflammation. It also controls other bodily functions, like sleep, cognition, and metabolism(15).
Endocannabinoids, like anandamide and 2-AG, act as neurotransmitters that activate cannabinoid receptors, namely CB1 and CB2. The ECS produces both of these endocannabinoids.
Anandamide has a direct correlation with CB1 receptors, with both of them functioning with the nervous system. Meanwhile, 2-AG and CB2 receptors are both associated with pain and inflammation relief(16). 2-AG or 2-Arachidonoylglycerol is the endocannabinoid linked with pain relief, appetite, and mimics the function of THC(17).
These two pairs working together create equilibrium, also known as homeostasis. This process links to how CBD can affect the processes in the body.
A 2018 study found that people with lupus have significantly increased levels of 2-AG, bound with CB2, compared to those who do not have the disorder.
The elevated 2-AG levels are evident in those who have the lowest disease activity. The findings suggest that the symptoms are under control, and the ECS is working effectively to suppress lupus(18).
The results showed that cannabis might serve as an immune-modulating and regulating tool to maintain balance in an over- or under-reacting immune system(19).
CBD for Inflammation
Inflammation caused by lupus can target different parts of the body, including joints, hands, feet, and even heart, especially during flare-ups or increased disease activity(20).
Researchers of a study published in the journal Future of Medicinal Chemistry discovered cannabinoids to be a potential lupus treatment because of its anti-inflammatory properties(21).
Some lupus patients may develop lupus myositis or the inflammation of skeletal muscles. According to a 2017 study, about 2% of the patients diagnosed with lupus have myositis and are more likely to have other complications, such as skin rash and alopecia areata(22).
Alopecia areata is an autoimmune disorder that attacks the hair follicles which results in hair loss and baldness.
CBD oil tinctures can treat skin rashes and other skin inflammation, like eczema, with a low level of cannabinoids(23). The topical use of CBD ointments on skin inflammations is also regarded as a safe and effective treatment, as cited in a 2019 study(24).
CBD for Pain Relief
A study showed that almost 100% of people suffering from lupus experience muscle and joint pain(25). More than half of the people stated that joint pain was the first symptom they felt after developing lupus.
When a lupus patient’s joints are inflamed, the person is more likely to develop lupus arthritis if not addressed quickly.
Compared to rheumatoid arthritis, lupus arthritis is less painful and less destructive. However, if untreated, lupus arthritis can lead to worsening joint and cartilage function that then can lead to muscle atrophy or loss of muscle tissue(26).
A 2018 study stated that chronic pain is the most common reason why people use cannabis for medical purposes(27). This kind of pain includes neuropathic pain or nerve pain that targets the sensory system and is difficult to treat or locate.
Significant studies show the positive effects of cannabinoids in suppressing inflammatory and nerve pains in rodents(28).
Based on a study conducted on rats with osteoarthritis, CBD may be safe and therapeutic for joint pain relief(29). CBD experiments with animals as test subjects showed no signs and symptoms of harmful side effects. These experiments show a promising result for the potential treatment of pain on humans.
CBD for High Blood Pressure
People with lupus who are long-term steroid users may pose a higher risk for cardiovascular diseases, like high blood pressure, heart failure, and stroke(30).
CBD has shown to have a positive impact on the cardiovascular system by widening blood vessels to increase blood flow and lower blood pressure(31).
Blood pressure can increase due to anxiety and stress about the medical condition. Based on a study published in Medicine, about 25% of lupus patients have depression, while 37% have anxiety(32).
High strength but moderate dosage of CBD can be an agent for relaxation for people suffering from anxiety-related disorders, such as panic disorder, post-traumatic stress disorder, and obsessive-compulsive disorder(33).
The Pros and Cons of CBD Oil for Lupus
- Studies aforementioned showcased CBD’s benefits in alleviating common symptoms for lupus. CBD may be safer than most drugs prescribed that may have severe side effects.
- The Lupus Foundation of America expresses its support for further research on using medical cannabis in treating lupus symptoms(34).
- CBD “is generally well-tolerated with a good safety profile,” according to the World Health Organization(35).
- CBD oil may be purchased over-the-counter in states and areas where they are legally available.
- Medical marijuana, cannabis plants used for treating illnesses and medical conditions, is not approved by the United States Food and Drug Administration (FDA)(36).
- CBD is an immunosuppressant, based on a 2020 study published on Cannabis and Cannabinoid Research(37). It means that CBD may weaken the immune response of the body, which may help people who have an overactive immune system. CBD also has anti-inflammatory and immune-boosting effects and thus may act as an immune modulator
- Some medications may negatively react when used at the same time with CBD. The reaction can result in adverse drug events, like injury, overdose, and allergic reactions(38). Consult with a doctor knowledgeable with medical marijuana before purchasing any CBD product.
- There are unregulated and unsafe CBD products that have unproven medical claims that can harm the user. FDA has been warning the public about particular claims(39).
How CBD Oil Compares to Alternative Treatments for Lupus
More than 50% of adults with lupus resort to complementary and alternative medicine as an addition or replacement to their prescribed medications(40).
Complementary treatments are services or medications that are added to the current treatment to treat lupus. Meanwhile, alternative medicines are treatments or services that are used as substitutes for prescription drugs.
Complementary and alternative treatments include the following(41):
- Traditional Chinese medicine, like acupuncture and Tai Chi
- Wellness programs, like massage therapy and meditation
- Herbal medicines and other supplements, like omega-3 fatty acids, turmeric, and N-Acetyl Cysteine
- Homeopathy and naturopathy, which are natural approaches to holistic healing
- Chiropractic pain relief treatment to correct bone alignment problems by “cracking” the spine
- Ayurveda, which is a non-traditional treatment that originated in India
- Biofeedback, which uses electrical sensors connected to the body to measure the body’s overall well-being
Though some of the mentioned treatments promote well-being and are harmless, these non-conventional practices still need further clinical research and rigorous scientific testing.
Consult a physician first to know if a particular treatment has side effects or may induce a specific reaction to the current medication.
On the other hand, CBD is also considered complementary and alternative medicine with the following characteristics:
- Hemp oil from cannabis seed can be a source of essential amino and fatty acids. These include eighteen different chemicals, such as hydrocarbons, carbohydrates, and terpenes, known for their medicinal properties(42).
- While there are no treatments for lupus, CBD may help manage lupus symptoms, like inflammation, chronic pain, high blood pressure, and anxiety(43).
How to Choose the Right CBD Oil for Lupus
Choosing the right CBD oil for lupus requires knowing which spectrum works best for lupus.
For more significant healing effects and enhanced health benefits, pick the full-spectrum CBD oil. It includes phytonutrients from hemp, which are the natural chemicals produced by plants.
Full-spectrum CBD oils deliver the entourage effect. The synergy of the combined chemicals, including THC, is a powerful and potent effect.
The broad-spectrum CBD oil is suitable for those who are sensitive and prone to allergic reactions. It delivers results slightly similar to the full-spectrum oil minus the THC.
Making informed choices based on the usage and purpose should be the top priority in considering the right CBD oil for any ailment or condition.
Other reminders that one should keep in mind while choosing the right CBD oil are the following:
- Research thoroughly and ensure that a reputable supplier or source manufactures the product.
- Be familiar with medical marijuana laws in the area and make sure to abide by those.
- Read product reviews before buying online. Look at positive and negative reviews about the store and the products. When buying a product in-store, ask if the store is authorized by the state or municipality to sell CBD.
- Look for certification codes or a certificate of analysis to ensure that the product underwent quality control from an accredited laboratory(44).
CBD Dosage for Lupus
There is no specific dosage recommended for lupus treatment since there is no FDA-approved CBD treatment for lupus. Keep in mind that every treatment differs from one lupus patient to another.
However, it is best to take small amounts of CBD or a CBD:THC ratio as an ideal and safe measurement. If dissatisfied with the results, the dosage can be gradually increased.
Observe and take note of any side effects that may occur. It is better to track the dosage and possible reactions, side effects, or improvements for later consultation with a trusted physician.
Ultimately, seek information first from a medical practitioner before adding any CBD medication to the prescribed medication.
How to Take CBD Oil for Lupus
CBD products come in different forms that can fit into a person’s lifestyle and condition.
The most common forms of CBD are oil and tincture. Both provide instant comfort and relief for pain and inflammation. The former can be used with vape, while the latter can be mixed with food.
Ingesting CBD oil can sometimes leave an oily taste. The tincture is more suitable for direct ingestion because it has a broad selection of flavors.
Topical CBD products, like creams, lotions, salves, and patches, work well with skin inflammations and body pain. Products like these can be applied directly to the skin. These products can treat skin rashes caused by lupus(45).
The American Academy of Dermatology suggested that topical CBD products may improve skin conditions, such as acne, psoriasis, and eczema(46).
Other CBD products also come in pills. Beginners can also explore other CBD products in the form of gummies, lozenges, and other food items, like brownies for convenient consumption.
The Legality of CBD Oil
Out of the 50 states of the United States, 33 allow the use of medical marijuana(47).
Out of the 33, only four states have been vocal about their permission to use marijuana to treat lupus, namely Hawaii, New Jersey, Illinois, and New Hampshire. Seven other states allow medical marijuana for lupus upon the recommendation of a physician.
Lupus is a life-changing autoimmune condition that has no cure. Every year records an estimated 16,000 new cases of lupus(48).
Living as an immunocompromised person can be difficult. However, knowing the right type, right dosage, and the right way to take alternative treatments, like cannabinoids, may be a significant step towards a better life.
CBD can help alleviate lupus symptoms, such as inflammation and pain, hypertension, anxiety, skin infections, and photosensitivity.
Because of the side effects that come with certain drugs, people with lupus should engage in a conversation with their
- Lupus Foundation of America. (2013, July 25). Finding the treatment approach for you. Retrieved from https://www.lupus.org/resources/finding-the-treatment-approach-for-you
- Nagarkatti, P., Pandey, R., Rieder, S. A., Hegde, V. L., & Nagarkatti, M. (2009). Cannabinoids as novel anti-inflammatory drugs. Future medicinal chemistry, 1(7), 1333–1349. https://doi.org/10.4155/fmc.09.93
- Navarini, L., Bisogno, T., Mozetic, P., Piscitelli, F., Margiotta, D., Basta, F., Afeltra, A., & Maccarrone, M. (2018). Endocannabinoid system in systemic lupus erythematosus: First evidence for a deranged 2-arachidonoylglycerol metabolism. The international journal of biochemistry & cell biology, 99, 161–168. https://doi.org/10.1016/j.biocel.2018.04.010
- Nichols J and Kaplan B. Immune Responses Regulated by Cannabidiol. Cannabis and Cannabinoid Research Vol. 5, No. 1. 27 Feb 2020. https://doi.org/10.1089/can.2018.0073.
- Johns Hopkins Lupus Center. (2019a). How Lupus Affects the Body. Retrieved from https://www.hopkinslupus.org/lupus-info/lupus-affects-body/
- Lupus Foundation of America., op. cit.
- Horizon, A. A., & Wallace, D. J. (2004). Risk: benefit ratio of nonsteroidal anti-inflammatory drugs in systemic lupus erythematosus. Expert opinion on drug safety, 3(4), 273–278. https://doi.org/10.1517/14740322.214.171.1243
- Ruiz-Irastorza, G., Danza, A., & Khamashta, M. (2013). Tratamiento del lupus eritematoso sistémico: mitos, certezas y dudas [Treatment of systemic lupus erythematosus: myths, certainties and doubts]. Medicina clinica, 141(12), 533–542. https://doi.org/10.1016/j.medcli.2013.02.014
- Amissah-Arthur, M. B., & Gordon, C. (2010). Contemporary treatment of systemic lupus erythematosus: an update for clinicians. Therapeutic advances in chronic disease, 1(4), 163–175. https://doi.org/10.1177/2040622310380100
- Johns Hopkins Lupus Center. (2019b). Treating Lupus with Immunosuppressive Medications. Retrieved from https://www.hopkinslupus.org/lupus-treatment/lupus-medications/immunosuppressive-medications/
- Q&A: medical marijuana (cannabis) and lupus. (2018, November 5). Lupus Foundation of America. https://www.lupus.org/resources/cannabis-and-lupus
- Russo S. Molecular Mimicry: The Role of Cannabis in Healing Autoimmune Disease. Retrieved from https://www.fundacion-canna.es/en/molecular-mimicry-role-cannabis-healing-autoimmune-disease.
- Centers for Disease Control and Prevention. (2018, October 17). Systemic Lupus Erythematosus (SLE). Retrieved from https://www.cdc.gov/lupus/facts/detailed.html
- Lupus Foundation of America. (2017, March 10). Lupus symptoms. https://www.lupus.org/resources/common-symptoms-of-lupus
- Skaper, S. D., & Di Marzo, V. (2012). Endocannabinoids in nervous system health and disease: the big picture in a nutshell. Philosophical transactions of the Royal Society of London. Series B, Biological Sciences, 367(1607), 3193–3200. https://doi.org/10.1098/rstb.2012.0313
- Zou, S., & Kumar, U. (2018). Cannabinoid Receptors and the Endocannabinoid System: Signaling and Function in the Central Nervous System. International journal of molecular sciences, 19(3), 833. https://doi.org/10.3390/ijms19030833
- National Center for Biotechnology Information. PubChem Database. 2-Arachidonoylglycerol, CID=5282280, https://pubchem.ncbi.nlm.nih.gov/compound/2-Arachidonoylglycerol
- Navarini, L., op. cit.
- Russo. S., op. cit.
- Squance, M. L., Reeves, G. E. M., & Bridgman, H. (2014). The Lived Experience of Lupus Flares: Features, Triggers, and Management in an Australian Female Cohort. International Journal of Chronic Diseases, 2014, 1–12. https://doi.org/10.1155/2014/816729
- Nagarkatti, P., op. cit.
- Liang, Y., Leng, R. X., Pan, H. F., & Ye, D. Q. (2017). Associated Variables of Myositis in Systemic Lupus Erythematosus: A Cross-Sectional Study. Medical science monitor : international medical journal of experimental and clinical research, 23, 2543–2549. https://doi.org/10.12659/msm.902016
- Tóth, K. F., Ádám, D., Bíró, T., & Oláh, A. (2019). Cannabinoid Signaling in the Skin: Therapeutic Potential of the “C(ut)annabinoid” System. Molecules (Basel, Switzerland), 24(5), 918. https://doi.org/10.3390/molecules24050918
- Palmieri, B., Laurino, C., & Vadalà, M. (2019). A therapeutic effect of cbd-enriched ointment in inflammatory skin diseases and cutaneous scars. La Clinica terapeutica, 170(2), e93–e99. https://doi.org/10.7417/CT.2019.2116
- Olesińska, M., & Saletra, A. (2018). Quality of life in systemic lupus erythematosus and its measurement. Reumatologia, 56(1), 45–54. https://doi.org/10.5114/reum.2018.74750
- Quismorio, F. P., Jr MD. (2013, July 12). How lupus affects the muscles, tendons and joints. Retrieved from https://www.lupus.org/resources/how-lupus-affects-the-muscles-tendons-and-joints
- Vučković, S., Srebro, D., Vujović, K. S., Vučetić, Č., & Prostran, M. (2018). Cannabinoids and Pain: New Insights From Old Molecules. Frontiers in pharmacology, 9, 1259. https://doi.org/10.3389/fphar.2018.01259
- Xiong, W., Cui, T., Cheng, K., Yang, F., Chen, S. R., Willenbring, D., Guan, Y., Pan, H. L., Ren, K., Xu, Y., & Zhang, L. (2012). Cannabinoids suppress inflammatory and neuropathic pain by targeting α3 glycine receptors. The Journal of experimental medicine, 209(6), 1121–1134. https://doi.org/10.1084/jem.20120242
- Philpott, H. T., OʼBrien, M., & McDougall, J. J. (2017). Attenuation of early phase inflammation by cannabidiol prevents pain and nerve damage in rat osteoarthritis. Pain, 158(12), 2442–2451. https://doi.org/10.1097/j.pain.0000000000001052
- Zeller, C. B., & Appenzeller, S. (2008). Cardiovascular disease in systemic lupus erythematosus: the role of traditional and lupus related risk factors. Current cardiology reviews, 4(2), 116–122. https://doi.org/10.2174/157340308784245775
- Stanley, C. P., Hind, W. H., Tufarelli, C., & O’Sullivan, S. E. (2015). Cannabidiol causes endothelium-dependent vasorelaxation of human mesenteric arteries via CB1 activation. Cardiovascular research, 107(4), 568–578. https://doi.org/10.1093/cvr/cvv179
- Figueiredo-Braga, M., Cornaby, C., Cortez, A., Bernardes, M., Terroso, G., Figueiredo, M., Mesquita, C., Costa, L., & Poole, B. D. (2018). Depression and anxiety in systemic lupus erythematosus: The crosstalk between immunological, clinical, and psychosocial factors. Medicine, 97(28), e11376. https://doi.org/10.1097/MD.0000000000011376
- Blessing, E. M., Steenkamp, M. M., Manzanares, J., & Marmar, C. R. (2015). Cannabidiol as a Potential Treatment for Anxiety Disorders. Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics, 12(4), 825–836. https://doi.org/10.1007/s13311-015-0387-1
- Lupus Foundation of America. (2016, May 6). Organizational statement on medical marijuana. Retrieved from https://www.lupus.org/resources/organizational-statement-on-medical-marijuana
- WHO. Expert Committee on Drug Dependence. (2017, Nov 6-10). Cannabidiol (CBD). Retrieved from https://www.who.int/medicines/access/controlled-substances/5.2_CBD.pdf.
- Food and Drug Administration. (2020, January 14). FDA and Cannabis: Research and Drug Approval Process. Retrieved from https://www.fda.gov/news-events/public-health-focus/fda-and-cannabis-research-and-drug-approval-process
- Nichols J., op. cit.
- Brown, J. D., & Winterstein, A. G. (2019). Potential Adverse Drug Events and Drug-Drug Interactions with Medical and Consumer Cannabidiol (CBD) Use. Journal of clinical medicine, 8(7), 989. https://doi.org/10.3390/jcm8070989
- Food and Drug Administration. (2020, March 5). What to Know About Products Containing Cannabis and CBD. Retrieved from https://www.fda.gov/consumers/consumer-updates/what-you-need-know-and-what-were-working-find-out-about-products-containing-cannabis-or-cannabis
- Lupus Foundation of America. (2018, July 19). The Expert Series: Season 1, Episode 7 [Video file]. Retrieved from https://youtu.be/9ldR6n1ayFc
- Huestis MA. Human cannabinoid pharmacokinetics. Chem Biodivers. 2007;4(8):1770–1804. doi:10.1002/cbdv.200790152.
- Nagarkatti, P., op. cit.
- Lopez, J. (2019, June 8). What is a CBD Certificate of Analysis (COA) (And How to Read It). Retrieved from https://citizentruth.org/what-is-a-cbd-certificate-of-analysis-coa-and-how-to-read-it/
- Palmieri, B., op. cit.
- American Academy of Dermatology. (2016, February 16). Public, researchers demonstrate growing interest in cannabis treatment. Retrieved from https://www.aad.org/news/topical-cannabis
- National Organization for the Reform of Marijuana Laws. (n.d.). Medical Marijuana. Retrieved June 18, 2020, from https://norml.org/legal/medical-marijuana-2
- Lupus Foundation of America. (2016, October 6). Lupus facts and statistics. Retrieved from https://www.lupus.org/resources/lupus-facts-and-statistics