Can CBD Help with Nausea?
Nausea can be debilitating when it strikes. It is typically caused by a wide range of medical conditions, including brain injury, dizziness, motion sickness, morning sickness, low blood sugar, the flu, migraines, appendicitis, gastroenteritis, and food poisoning. Nausea is also a typical side-effect of chemotherapy and general anesthesia.
One can experience nausea without vomiting. However, vomiting frequently occurs in nausea sufferers as the neuron circuits in the brainstem are able to detect a toxic substance and attempts to expel it from the gastrointestinal tract.
Cannabis, particularly CBD, has shown some potential in preventing and alleviating nausea without inducing the side effects caused by pharmaceutical antiemetics.
CBD as an Antiemetic
Cannabinoids play an active role in dealing with nausea and vomiting. A review from the European Journal of Pharmacology established the potential of cannabis to limit or prevent nausea and vomiting from a wide range of causes. The results of the study led to extensive investigations that uncovered a crucial role for cannabinoids, as well as their receptors, in the regulation of nausea and vomiting.
Evidence from experiments demonstrates that CBD can regulate nausea by acting on the serotonin receptors in the brain. CBD reduces the release of serotonin, which generates a weaker stimulation on the vomiting mechanism in the brain.
The antiemetic properties of CBD are also associated with its influence on the CB1 cannabinoid receptors. These receptors materialize in the brainstem, which utilizes both THC and anandamide.
The increased production of anandamide, a CB1 proponent, relieves the feelings of nausea and decreases the inclination to vomit. However, anandamide has the tendency to metabolize immediately when the fatty acid amide hydrolase (FAAH) enzyme is present.
Studies on animal models have shown that CBD can block the FAAH enzyme and thus make anandamide more available for the body to utilize. The same results happen when one consumes both CBD and THC. THC manipulates the brain to think that there is more anandamide to utilize. Meanwhile, CBD extends the life of this endocannabinoid and concurrently inhibits the CB1 receptors that respond to the psychoactive effects of THC.
Best CBD Oils for Nausea
There are many CBD products available in the market today. To help one decide which product to choose for nausea, here are the top three best CBD oils. Product descriptions would include the hemp source, cannabinoid spectrum, extraction method, potency, and third-party testing.
1. Royal CBD Full Spectrum CBD Oil 1000 mg
This product helps with anxiety, upset stomach, and nausea, among other common ailments and disorders. At 1000 mg of CBD oil, this is the most potent product in the company’s lineup. It contains 33 milligrams of CBD in every milliliter of oil, so one does not have to consume half the bottle to reach high doses. The product contains full-spectrum hemp extract (CBD + other phytocannabinoids) sourced from organically grown, non-GMO hemp.
Royal CBD oil is dissolved into high-grade MCT oil to make the CBD more available for your body. Fats are absorbed through a unique pathway in the gut, which carries the fat-soluble cannabinoids along with it. Royal CBD is lab tested by a third party for potency, purity, and quality.
2. Hemp Bombs 300mg CBD Oil
Some consumers report experiencing stomach upset when taking high amounts of CBD. When this happens, one should opt for low doses of CBD or use it in moderation.
Hemp Bombs 300mg CBD Oil offers a low concentration of CBD to promote general wellness for everyday users. The company uses certified organic hemp from European farmers, and their CBD isolate is extracted using CO2. Each batch of Hemp Bombs products is tested in a 3rd-party lab for potency and purity. Hemp Bombs products are THC-free.
Hemp Bombs offers more affordable CBD extracts but at the cost of quality. Since this product contains pure isolates, it lacks the entourage effect from full-spectrum extracts.
3. CBDistillery CBD Oil
The company’s CBD is made from Colorado-grown hemp. It is available as full-spectrum CBD or isolates and lab-tested for purity and quality. The potency is impressive, from 250 to 500 mg CBD per bottle. Their products are also affordable, thus making it favorable to those looking to buy CBD on a budget. A 250-mg bottle only costs $20. If one only has mild nausea symptoms, this brand offers the best ratio of price to quality.
Before starting CBD therapy for nausea, one should consult with a doctor to see if cannabinoids may be an effective treatment for him or her. As a natural alternative to pharmaceutical antiemetics, CBD oil may be one good option for nausea sufferers.
Treatment of heartburn and acid reflux associated with nausea and vomiting during pregnancy
In addition to suffering from nausea and vomiting of pregnancy, which is being treated with antiemetics, some of my pregnant patients complain of heartburn and acid reflux. Should these symptoms also be treated and, if so, which acid-reducing medications are safe for use during pregnancy?
Increased severity of nausea and vomiting of pregnancy is associated with the presence of heartburn and acid reflux. Antacids, histamine-2 receptor antagonists, and proton pump inhibitors can be used safely during pregnancy, as large studies have been published with no evidence of adverse fetal effects.
Gastroesophageal reflux disease (GERD) is reported in up to 80% of pregnancies.1 It is likely caused by a reduction in lower esophageal sphincter pressure due to an increase in maternal estrogen and progesterone during pregnancy. Hormonal changes in pregnancy can also decrease gastric motility, resulting in prolonged gastric emptying time and increased risk of GERD.1 The most common symptoms of GERD are heartburn and acid reflux. Treatment algorithms suggest stepwise progression of options, starting with lifestyle modifications (eg, eat smaller and more frequent meals, avoid eating near bedtime, elevate the head of the bed) and trying pharmacologic therapy if symptoms are not adequately managed by lifestyle changes.1
Safety of acid-reducing agents
Antacids containing aluminum, calcium, and magnesium were not found to be teratogenic in animal studies and are recommended as first-line treatment of heartburn and acid reflux during pregnancy.2 High-dose and prolonged use of magnesium trisilicate is associated with nephrolithiasis, hypotonia, and respiratory distress in the fetus, and its use is not recommended during pregnancy.3 Bicarbonate-containing antacids are also not recommended owing to the risk of maternal and fetal metabolic acidosis and fluid overload.3 There are also case reports of milk-alkali syndrome in pregnant women who used daily doses higher than 1.4 g of elemental calcium obtained from calcium carbonate.4,5
Histamine-2 receptor antagonists (H2RAs)
Cimetidine, ranitidine, famotidine, and nizatidine are the H2RAs approved for use in Canada. Details of studies on the use of each agent during pregnancy were reviewed elsewhere.1 A recent meta-analysis involving 2398 pregnant women exposed to H2RAs in at least the first trimester compared with 119 892 women in the control group showed an odds ratio of 1.14 (95% confidence interval [CI] 0.89 to 1.45) for congenital malformation. There was no statistically significant difference in risk of spontaneous abortion or preterm delivery between the exposed women and the control group.6
Proton pump inhibitors (PPIs)
Proton pump inhibitors approved by Health Canada include omeprazole, pantoprazole, lansoprazole, esomeprazole, and rabeprazole. Safety of omeprazole, pantoprazole, esomeprazole, and lansoprazole use during pregnancy was reported elsewhere.7 Rabeprazole use in pregnancy has not been studied in humans; however, based on animal data on rabeprazole and human data of other PPIs, it is expected that rabeprazole would be safe for use in pregnancy.8 A recent meta-analysis that compared 1530 pregnant women exposed to PPIs in at least the first trimester with 133 410 unexposed pregnant women showed an odds ratio of 1.12 (95% CI 0.84 to 1.45) for congenital malformation. There was also no statistically significant difference in the odds ratios for spontaneous abortion or preterm delivery between the 2 groups.9
Treatment of nausea and vomiting in pregnancy
QUESTION My patient has severe nausea and vomiting of pregnancy (NVP). I am having difficulty treating her,
as nothing she has tried so far has been really effective. I heard that there is some new information regarding
the treatment of this condition.
ANSWER Even a less severe case of NVP can have serious adverse effects on the quality of a woman’s life,
affecting her occupational, social, and domestic functioning, and her general well-being; therefore, it is very
important to treat this condition appropriately and effectively. There are safe and effective treatments available.
We have updated Motherisk’s NVP algorithm to include recent relevant published data, and we describe some
other strategies that deal with secondary symptoms related to NVP.