Can CBD Help With Chronic Fatigue Syndrome, and if So, How?
- Chronic fatigue syndrome (CFS) is distinguished by extreme tiredness that does not improve with rest, among several other specific symptoms. CFS is considered a long-term condition as it can persist for six months or more. It is typically a diagnosis of exclusion, meaning that other serious conditions must be ruled out first.
- A study has shown that patients with CFS have increased production of cells that promote inflammation(1). Meanwhile, oxidative stress has also been linked as a potential mechanism of chronic fatigue(2).
- Findings from a study published in the journal Antioxidants have led researchers to believe that cannabidiol (CBD) could inhibit inflammation in the body through multiple pathways(3). The authors also learned that CBD might counteract oxidative stress, which may contribute to CFS.
- Studies have shown that CBD’s interaction with the endocannabinoid system (ECS) and its receptors is responsible for its therapeutic properties(4). Cannabidiol is said to provide relief for inflammation, pain, and anxiety(5).
- However, there is a definite lack of evidence regarding CBD’s effectiveness in treating chronic fatigue syndrome. Most studies on cannabidiol were performed on animals, with a limited number of clinical trials done on human subjects.
Chronic fatigue syndrome (CFS) is a complex illness characterized by extreme fatigue that does not improve with rest. Also known as systemic exertion intolerance disease (SIED), and formerly myalgic encephalomyelitis (ME/CFS), this disorder often comes with feelings of being exhausted despite not being active. There is also intolerance of exercise, nonrefreshing sleep, and possibly dementia or standing intolerance.
In many cases, CFS appears suddenly and is often accompanied by a flu-like infection or physical trauma, such as surgery or an accident(6). In other instances, chronic fatigue syndrome develops in a person gradually.
CFS is considered as a long-term condition since it persists for more than six months(7). It is often linked with sleep dysfunction, muscle pain, and cognitive issues, with the potential to worsen with physical or mental activity(8).
There are also indications that inflammation and oxidative stress contribute to chronic fatigue syndrome.
In one study, increased production of proinflammatory cytokines (cells that promote inflammation) has been observed in CFS patients(9). Meanwhile, a study published in the peer-reviewed journal Scientific Reports hints that oxidative stress may be a possible mechanism of chronic fatigue(10).
The U.S. Food and Drug Administration (FDA) has not approved any medication to treat chronic fatigue syndrome(11). However, due to the range of its symptoms, many forms of treatment at present could potentially help with CFS.
Doctors may prescribe antidepressants to patients since chronic fatigue syndrome is often linked to depression. Headaches, which are prevalent with CFS, can also be treated with medications, such as aspirin and ibuprofen(12).
Some physicians also recommend lifestyle changes, such as minimizing physical exertion and avoiding triggers for psychological stress. Meanwhile, aerobic physical activity is believed to help improve one’s level of function(13).
Another potential approach that could help alleviate the symptoms of CFS is the consumption of cannabidiol or CBD. CBD is a chemical compound that can be derived from a cannabis strain called hemp.
Cannabidiol is believed to have numerous therapeutic applications(14).
A study published in the international journal Antioxidants reviewed the primary biological effects of cannabidiol, particularly on its supposed ability to inhibit inflammation(15). The researchers of the study analyzed several preclinical trials of CBD on both human and animal models.
They learned that cannabidiol could calm the inflammatory response in the body through multiple pathways, reducing associated symptoms. By the end of the study, the researchers concluded that CBD exhibits anti-inflammatory effects.
They also reported that CBD might have the ability to counteract oxidative stress(16).
A study published in the journal Frontiers in Immunology claimed that a combination of CBD and THC (tetrahydrocannabinol) is capable of suppressing inflammation of nervous tissue(17). This type of inflammation is said to be linked to cognitive impairment, which has been observed in brain areas of CFS patients(18).
This connection could mean that CBD may be able to contribute to treating neuroinflammation in people with chronic fatigue syndrome.
CBD may also be useful in alleviating mood problems that some CFS patients experience.
In a 2012 study, researchers stated that cannabidiol offers therapeutic potential for psychiatric disorders, such as depression and anxiety(19). They hypothesized that CBD exerts its antidepressant-like effects when interacting with receptors in the brain.
A few studies investigated CBD’s usefulness as a sleep aid. However, the science behind them is still unclear(20).
One study attempted to assess CBD’s effectiveness compared to nitrazepam, a hypnotic medication used for short-term relief of anxiety and insomnia. The insomniac participants, who were given 160 mg of CBD, reportedly slept more than those who received the hypnotic drug(21).
Furthermore, the subjects were also recorded to have notably less dream recall. A high dream recall frequency (DRF) is believed to be associated with sleep disorders(22).
According to the Centers for Disease Control and Prevention, pain is a common symptom in people with CFS. The most prevalent types that are experienced include muscle pain and aches, joint pain without redness or swelling, and headaches(23).
A review in 2018 assessed CBD’s effectiveness in relieving various types of chronic pain, including cancer pain, neuropathic pain, and fibromyalgia. The report analyzed studies that were conducted between the years 1975 and 2018.
The authors of the review stated that CBD has significant analgesic activity. They also mentioned that the chemical compound contributes to regulating the perception of pain(24).
Results suggest that cannabidiol may benefit individuals suffering from various types of pain associated with chronic fatigue syndrome.
However, despite the positive outlook, most of the research studies on CBD were done on animal models.
More human clinical trials are needed to prove that cannabidiol can be beneficial in treating chronic fatigue syndrome.
How CBD Oil Works to Help with Chronic Fatigue Syndrome
To understand how CBD may help with chronic fatigue syndrome, one must first learn how the endocannabinoid system (ECS) operates.
The ECS, a system present in all mammals, is responsible for maintaining various bodily functions. It regulates the physiological functions in an individual by way of its receptors(25).
A 2018 review stated that CBD had shown neuroprotective properties based on how it interacted directly with the ECS and its receptors(26). It also mentioned that CBD might help relieve depression, anxiety, and inflammation.
The CB1 and CB2 structures are the most prominent receptors in the endocannabinoid system, with each having different roles.
The CB1 cannabinoid receptors are believed to influence pain sensation, mood, sleep, appetite, memory processing, and motor regulation(27).
Activating the CB1 receptors has been associated with neuroprotective responses(28) that could potentially benefit people with conditions, like multiple sclerosis and Alzheimer’s disease.
On the other hand, CB2 receptors are present mainly on cells in the immune system of the body. When activated, they cause a response that combats inflammation, potentially reducing pain and damage to tissues(29).
Cannabinoids, which are chemicals naturally produced by the human body, are designed to interact with CB1 and CB2 receptors to maintain balance.
Scientists learned that phytocannabinoids, which are primarily obtained from plants, like Cannabis sativa, also effectively stimulates these receptors(30).
CBD, one of the numerous phytocannabinoids, is of particular interest to researchers(31) due to its potential anti-inflammatory, analgesic, and anti-anxiety effects.
Researchers believe that CBD also engages with receptors outside of the endocannabinoid system, such as the serotonin 5-HT1A receptor(32). This receptor is said to modulate anxiety and depression, with any imbalance resulting in related mood disorders(33).
Serotonin receptors, like 5-HT1A, have been linked with the therapeutic effects of CBD(34). This connection, together with how CBD interacts with these receptors, could indicate that it may benefit people with depression, a common CFS symptom.
The Pros and Cons of CBD Oil for Chronic Fatigue Syndrome
- CBD may suppress neuroinflammation, which is a type of inflammation that affects the nerve tissue. It is believed to be associated with cognitive impairment as the condition was observed in the brain of CFS patients.
- Phytocannabinoids, like CBD, interact with receptors in the body to bring about its supposed therapeutic effects. Some of these effects may help people with depression and anxiety. These two conditions are often associated with chronic fatigue syndrome.
- CBD may possess analgesic activity. This trait could be beneficial to CFS patients, especially since their condition is usually accompanied by various types of body pain.
- Purchasing and consuming cannabidiol is allowed in most states. Users can even obtain CBD products without a prescription in areas where they are legally sold.
- CBD does not give users a euphoric high compared to THC, which is its psychoactive counterpart.
- Most of the studies on cannabidiol were performed on animals, with only a limited number of clinical trials made on human subjects.
- There is a general lack of data to determine whether CBD is useful or not in treating conditions other than those approved by the FDA. At the time of writing, Epidiolex, a medication prescribed for epilepsy, is the only CBD product approved by the FDA (35).
- Researchers in a 2017 review analyzed the safety and side effects of CBD. They stated that although the chemical compound has a favorable safety profile, it may interact with other drugs and lead to adverse reactions(36).
- CBD products, especially those sold online, are particularly prone to inaccurate labeling. People who purchase CBD online risk obtaining the chemical compound in quantities that are either more or less than what they expect or need(37).
How CBD Oil Compares to Alternative Treatments for Chronic Fatigue Syndrome
There are several other potential treatments for chronic fatigue syndrome. These treatments include the consumption of Siberian ginseng, magnesium, and food rich in omega-3 fatty acids.
A randomized controlled trial in 2004 was carried out to evaluate Siberian ginseng’s effectiveness in patients with chronic fatigue. The researchers of the study found that fatigue among subjects was considerably reduced after one month(38).
Likewise, 86 subjects with less severe conditions reported a significant reduction of fatigue after two months of Siberian ginseng treatment.
Additionally, patients with CFS are believed to have low red blood cell magnesium. Magnesium treatment is known to help improve the well-being of CFS patients.
A study in 1991 assessed the efficacy of magnesium to see if it can help people with chronic fatigue syndrome(39).
Fifteen individuals with CFS were given intramuscular magnesium sulfate every week for six weeks. Those who were treated with magnesium claimed that they had higher energy levels, experienced less pain, and were in a better emotional state.
Furthermore, red cell magnesium was said to have returned to normal levels for those who took the treatment(40). The findings from this clinical trial suggest that magnesium may have a role in alleviating chronic fatigue syndrome.
Another potential alternative treatment for CFS is the consumption of food rich in omega-3 fatty acids. Omega-3 is believed to reduce the production of cell signaling molecules that are responsible for inflammation in chronic fatigue syndrome(41).
Several studies have also reported that omega-3 fatty acids could potentially reduce fatigue. These findings have led researchers to consider omega-3 rich diets as a viable approach to help patients cope with chronic fatigue syndrome(42).
Meanwhile, CBD has been shown to possess properties that may help deal with CFS.
A review published in the journal Current Neuropharmacology assessed the potential role of CBD as a wake-inducing agent. The authors analyzed several studies with significant findings on the said pharmacological property.
Although the trials were performed on rodents, the researchers hypothesized that CBD enhances a part of the hypothalamus, which they believe is responsible for modulating alertness(43). This information led them to conclude that CBD may benefit people with extreme sleepiness, which is a common sign of chronic fatigue syndrome.
There are also products in the form of topicals and sprays that combine cannabidiol and magnesium. These items are said to help relax the muscles while providing relief for pain and inflammation.
Finally, there are CBD supplements infused with omega-3 that are advertised to help people alleviate stress and get deep, restorative rest. These products are usually sold as tinctures, capsules, and softgels for oral intake.
Instead of using fish oils, some of these supplements contain omega-3 obtained from algae. There is widespread interest in microalgae for large-scale production of omega-3 fatty acids due to its sustainability(44).
How to Choose the Right CBD for Chronic Fatigue Syndrome
Manufacturers produce three types of CBD oil products for public consumption. These variants are known as full-spectrum, broad-spectrum, and isolates.
The most well-known of the three is the full-spectrum variety. This type of CBD has all of the naturally-occurring chemical compounds in the Cannabis sativa plant.
Full-spectrum CBD contains THC, flavonoids, terpenes, and other minerals, like fatty acids. The ideal full-spectrum CBD product is rich in cannabidiol, with small amounts of the other compounds and THC.
The synergy called “the entourage effect” is said to be present when consuming full-spectrum CBD. This kind of effect is believed to bring out the full potential of phytocannabinoids, with some claiming that the compounds work better when consumed together.
A study published in the British Journal of Pharmacology supports the concept that cannabinoids synergize with each other. The results of this synergy may be beneficial for treating several medical conditions(45).
Broad-spectrum CBD also possesses the same compounds from cannabis plants, except for THC. This CBD variant undergoes a complex extraction process that explicitly eliminates tetrahydrocannabinol from the final output.
THC is a psychoactive compound that can be found in high concentrations in medical marijuana plants.
The most common extraction technique is the supercritical CO2, which is believed to be a safe and clean method for creating organic, solvent-free extracts(46).
The CBD extract then undergoes a chemical process called chromatography, which removes THC from the rest of the mixture.
With this process, manufacturers are able to create THC-free CBD products that still contain all of the chemical compounds found in cannabis.
However, some companies take this step further by separating all of the chemicals and leaving behind only pure CBD. The final output is known as CBD isolate, which is available in crystalline or powdered form.
CBD as an isolate is the purest state of cannabidiol that is extracted from industrial hemp. It is ideal for people who only want to have CBD.
Broad-spectrum CBD is preferred by some individuals who would like to benefit from various cannabinoids but do not wish to consume THC. This type of CBD may be beneficial for people that do not want to test positive for THC during drug tests.
Finally, full-spectrum CBD is appealing for those looking to benefit from the synergistic effect of combining all cannabis chemical compounds.
Whichever type of CBD product one chooses, it is vital that buyers purchase only the best quality available to maximize the benefits of CBD.
Here are the following tips to help ensure that one selects only the safest and most reliable CBD products today:
- Look for the certificate of analysis (COA) or the laboratory report of the CBD product selected. This document is especially important since it indicates that the item has undergone thorough testing and contains precisely the specifications listed on its label.
- Read up on product and shop reviews if buying from an online store. If purchasing from a physical dispensary, check if it has proper authorization to sell CBD.
- Only buy organic CBD derived from hemp. The hemp plant is the most reliable source of quality cannabidiol.
- Ensure that the legalities involving CBD are followed in the state where it is planned to be bought and used.
- Consult a medical professional, preferably someone experienced in medical cannabis, before deciding to use CBD for the symptoms of CFS.
Additional Tips to Get the Best CBD Oil Products
- Be wary of CBD brands that claim to have CBD obtained from the seeds and stalks of hemp plants. Cannabidiol is not present in hemp seeds, while there are only trace amounts of CBD in hemp stalks.
- Avoid purchasing CBD vape cartridges that contain thinning agents, like propylene glycol and polyethylene glycol, since these could be harmful when inhaled.
- Do not buy CBD edibles and gummies that are of low-quality. Some providers sell CBD snacks that are made of artificial and sub-standard ingredients.
- Do not hesitate to contact CBD brands directly for any inquiries or concerns. Try another CBD provider if there is no response from the brand’s customer service.
CBD Dosage for Chronic Fatigue Syndrome
Since the FDA has not approved cannabidiol for treating chronic fatigue syndrome, there are no guidelines on its correct dosage.
Some people believe there are several factors to consider in determining the proper dose for each person. One’s body weight and the amount of CBD in each product are the most commonly cited.
Authors of a 2016 study said that they do not have a foundation to recommend the right dosage based on their studies. However, they hypothesized that consuming a low dose of 12 mg to 25 mg of CBD once each day appears to provide relief for anxiety and sleep disorders(47).
It is clear that further large scale studies are needed for experts to come up with CBD dosing that is safe and effective for the general population.
Although CBD is considered generally safe for human consumption, it is still possible for users to experience side effects.
According to a 2017 clinical review of CBD, the most commonly reported adverse reactions, based on several studies, include tiredness, diarrhea, and appetite loss(48).
How to Take CBD Oil for Chronic Fatigue Syndrome
The most convenient and direct way of taking CBD is to consume CBD oil capsules and edibles. CBD products in the form of gummies, brownies, and tablets are ideal for CBD beginners.
Consuming CBD oil by way of tinctures or drops might be a practical option for users looking for maximum dosage control and immediate results.
CBD tinctures can be applied directly under the tongue (sublingual) using a dropper to allow the oil to be absorbed into the bloodstream. Some individuals prefer this type of application as they believe it to be an efficient approach to consuming cannabidiol.
A study published in 2010 supports this concept, stating that peak blood levels of most substances applied sublingually are achieved in 10 to15 minutes. The study also mentioned that sublingual application is generally much quicker compared to ingesting the same substances orally(49).
Individuals that do not find the pure CBD hemp extract taste desirable may opt for CBD gummies instead. These products are usually available in many flavors, including pineapple, grape, watermelon, and raspberry.
Each piece of gummy comes at a fixed dosing level, which makes it a great way to provide CBD, even to children.
It is possible to mix CBD oil with food and drinks. Keep in mind, however, that oil and water do not mix.
Researchers in a 2018 study mentioned that taking CBD after eating is highly advised to allow for optimal absorption of the compound. The authors believe that, due to it being highly lipophilic (the state of being soluble in fats or lipids), CBD may dissolve in the fat content of food easily(50).
Consuming milk, for instance, might be necessary for CBD oil to bind and dissolve completely.
There are also CBD topicals that people may use in massage therapies for relaxation and its perceived benefits for anxiety disorders and sleep disturbances.
Many brands are presently selling CBD products in the form of creams, balms, lotions, and salves.
When browsing topical CBD products, search for keywords on the labels indicating that it used nanotechnology or encapsulation of CBD.
These terms mean that the CBD solution can go through the dermal layers of the skin, rather than stay on its surface only.
Vaping CBD is also becoming a popular method of consuming CBD. Inhaling CBD vapors is a quick way to get CBD into the body since it enters the bloodstream immediately through the lungs.
However, vaping is not suitable for every person, especially those suffering from lung disorders. Some ingredients used in CBD vapes are harmful when inhaled(51).
Thus, people who wish to use CBD vaping products for the first time should proceed with caution. It is best to consult a doctor experienced in cannabis products before trying out CBD.
Can CBD Cause Tiredness?
Although several studies indicate that using cannabidiol may benefit people with CFS, there are some concerns as to whether the compound may cause weariness or not.
According to Mayo Clinic, the use of CBD carries with it the risk of experiencing side effects, such as tiredness and fatigue(52).
Their statement is in parallel with the results of a 2017 study on the use of Epidiolex in 261 patients with severe epilepsy. After three months of CBD use, 10% of the subjects reported experiencing tiredness and exhaustion(53).
The authors of the study, however, concluded that CBD’s side effects appear to be generally mild and infrequent. Their conclusion was based on the available trials that were performed during that time.
How Is Chronic Fatigue Syndrome Diagnosed?
Chronic fatigue syndrome is a challenging condition to diagnose due to how its symptoms appear similar to many other disorders.
According to a study published in 2018, around 1.7 to 3.38 million people in the United States are diagnosed with CFS(54).
Currently, no single test can diagnose chronic fatigue syndrome. Doctors make a diagnosis only after excluding all other disorders. Also, the symptoms should have continued in the last six months.
A crucial part of chronic fatigue syndrome diagnosis is the ruling out of other possible causes of the condition. Some illnesses that have similar symptoms of CFS include:
- Lyme disease
- Multiple sclerosis
- Clinical depression
- Bipolar disorder
- Sleep disorders, like OSA
- Severe obesity
The side effects of consuming excess alcohol and using certain drugs, like antihistamines, may also mimic the symptoms of CFS.
Since the signs of chronic fatigue syndrome share similarities with that of other conditions, it is essential to avoid self-diagnosis. Talk to a doctor concerning CFS symptoms. Medical professionals can work with patients to obtain relief using safe, established medications.
Exercise and Chronic Fatigue Syndrome
Individuals with CFS react differently to physical activity. To some, exercise may be a problem since their symptoms can worsen with physical exertion.
Whether or not a person with CFS should exercise seems to be debatable.
Although aerobic exercise may be beneficial for certain illnesses, some CFS patients cannot tolerate regular exercise routines due to post-exertional malaise. Individuals may have to learn how to pace themselves first.
Patients must seek advice from their healthcare provider or physical/occupational therapist to develop a personalized weekly routine based on their condition and capabilities.
People with CFS should never be forced into pushing past their limits, as this may cause a long-term relapse. It is essential to start any activity plan slowly, as some patients may only be able to do stretches for a few minutes.
For others, CFS symptoms may improve as time passes. Achieving better control over one’s body is a slow and gradual process for those with chronic fatigue syndrome.
Chronic fatigue syndrome, also known as CFS, is a disorder characterized by extreme tiredness that does not go away even with rest. CFS may occur suddenly, as in most cases, or it can slowly develop in an individual. It may be diagnosed after other conditions are ruled out.
CFS is a long-term condition that is often associated with sleep dysfunction, muscle pain, and cognitive issues. Since it has numerous symptoms, many forms of treatment are available that could potentially help with chronic fatigue syndrome.
Some people recommend lifestyle changes and avoiding psychological stress triggers. Other individuals prefer aerobic physical activity to improve the body’s level of function. A physical and/or occupational therapist would be very helpful to customize an exercise regimen.
Studies show that CBD may help alleviate the symptoms of CFS due to its therapeutic effects.
According to studies, cannabidiol has properties that may inhibit inflammation, alleviate pain, help with sleep, and improve one’s overall mood.
Researchers hypothesize that compounds, like CBD, express their potential health benefits by interacting with receptors in the endocannabinoid system (ECS).
The ECS is a system found in all mammals that is responsible for regulating essential functions of the body. The primary receptors used by the endocannabinoid system are the CB1 and CB2 receptors.
The CB1 receptors are said to influence a person’s pain sensation, sleep, mood, appetite, memory processing, and motor regulation. Meanwhile, CB2 receptors are primarily present on cells in the immune system and are believed to carry out the immunomodulatory functions of the ECS.
Researchers also believe that cannabidiol engages with receptors outside of the ECS. Serotonin receptors, like 5-HT1A, have been implicated in the therapeutic effects of CBD, particularly in regulating anxiety and depression.
Despite CBD’s potential, most studies on this cannabinoid have been performed on animals. There is a distinct lack of clinical trials conducted on human subjects, preventing researchers from concluding whether or not cannabidiol may benefit CFS patients.
As with any medication, individuals interested in giving CBD a try should consult with a doctor to avoid complications. It is best to seek advice from a physician experienced in cannabis use.
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