Can CBD Oil Help With Migraines?
- A study published in Physiological Reviews in 2017 showed that the pain of migraine headaches might be at least partially caused by intense sensory nerve stimulation. This stimulation is the result of the release of inflammatory agents during a migraine attack (1).
- Studies suggest that the less-explored CB2 receptors, which possess anti-inflammatory potential, represent a promising target to counteract migraine (2).
- A study in the Journal of Pharmacology and Experimental Therapeutics, published in 2018, demonstrated CBD’s potent anti-inflammatory properties (3).
- According to an article by the American Migraine Foundation, CBD may be a viable topical option for individuals with joint and muscle pain associated with migraines. CBD may even prevent nausea and vomiting (4).
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Why People Are Using CBD for Migraines
People with migraines are willing to try nearly any type of medication for relief, which may explain the growing interest in CBD for migraines.
Migraines can cause excruciating and throbbing pain, or a pulsing sensation, often on one side of the head. It usually comes with vomiting, nausea, and extreme sensitivity to light and sound (5).
Migraine attacks can last from a few hours to several days. The pain can be severe that it interferes with an individual’s daily routines.
With the purported benefits of cannabidiol (CBD) to humans and animals, many people with migraine are curious whether or not the compound can indeed help with their medical condition.
CBD’s potential therapeutic benefits, including as an anti-inflammatory, antiemetic (prevents vomiting), and antipsychotic (calms nerves) agent, were highlighted in a study published in Frontiers in Pharmacology in 2018 (6).
At the same time, as a neuroprotective substance, CBD was shown to help protect nerve cells against damage, regression, or impairment of function. Headaches are considered neurologic conditions.
All of these properties may be beneficial for individuals experiencing migraine symptoms, like pain and light and sound sensitivity.
The authors also reported that CBD is safe, as it does not affect heart rate, blood pressure, and body temperature. Neither does CBD negatively impact psychomotor and psychological functions.
CBD for Migraine-Associated Pain Relief
The National Headache Foundation approximates that nearly 12% of the population experience migraine headaches (7).
Migraine headache pain is a result of signals interacting among blood vessels, the brain, and surrounding nerves.
During a headache, certain nerves of blood vessels are activated, and they send pain signals to the brain.
There is a migraine pain center, also called a generator, in the midbrain area. Migraines begin when overactive nerve cells send impulses to blood vessels, causing the release of prostaglandins and serotonin.
Prostaglandins are lipids that control processes such as inflammation and blood flow. Serotonin is a chemical that the body produces for nerve cells and the brain to function.
As these substances are released, the blood vessels in the vicinity of the nerve endings swell, resulting in pain (8).
CBD’s status as a potent analgesic or pain reliever is among the strongest points in favor of this type of use.
With nausea and vomiting that many people experience during migraines, CBD’s antiemetic properties, which prevent nausea and vomiting, are also incredibly helpful.
In an article published by the American Migraine Foundation, Dr. Stephen Silberstein outlined what patients should know about CBD oil as a treatment for migraines (9).
According to Dr. Silberstein, the director of the Headache Center at Jefferson University Hospital in Philadelphia, the United States, CBD may be a viable topical option for individuals with muscle and joint pain linked to migraines (10).
He says it is perfectly reasonable for those with neck pain or soreness to use CBD oil. He added that the compound might even prevent nausea and vomiting.
Several studies that demonstrate CBD’s antiemetic qualities seem to support Dr. Silberstein’s advice.
A study in the British Journal of Pharmacology revealed the anti-vomiting effects of cannabinoids in response to a toxic challenge.
Research indicated that cannabinoids, including CBD, may be useful for treating both nausea and vomiting produced by chemotherapy or other treatments (11).
In a review in the European Journal of Pharmacology, the potential of cannabinoids to control nausea and vomiting from several causes was established (12).
CBD for Reduced Inflammation Associated With Migraines
CBD’s anti-inflammatory effects may help with inflammation that is sometimes associated with migraines.
A study published in Neurology in 2005 looked into a migraine as an inflammatory disorder (13).
The authors said that although pain and inflammation usually go hand in hand, migraine has not classically been considered an inflammatory disease. The reason could be because it is not associated with heat, redness, and swelling.
However, a study published in Physiological Reviews in 2017, showed that the pain of migraine headaches might be at least partially caused by intense sensory nerve stimulation.
This stimulation is the result of the release of inflammatory agents during a migraine attack (14).
If this is the case, the properties of CBD may help counter inflammation, helping to relieve that pain.
One study showed how CBD inhibits inflammatory and neuropathic pain (15).
CBD’s potent anti-inflammatory characteristics were also shown in a 2018 study published in the Journal of Pharmacology and Experimental Therapeutics (16).
How CBD Oil Works to Help With Migraines
CB1 and CB2 are the two primary types of receptors found in different parts of the body. These receptors each have specialized roles in the ECS.
Various studies have reported that natural and synthetic cannabinoids are useful in the attenuation of acute and chronic pain, including neuropathic (nerve) pain (17).
Disruptions in supply or functionality of endocannabinoids have been linked to several mental state disturbances and, particularly, to migraine (18).
Studies have shown that cannabinoid receptors are distributed in many critical sites of pain pathways in the central (CNS) and peripheral nervous system (PNS).
The abundance of CB1 receptors in the brain makes them an attractive target for the treatment of migraines via the blocking of pain pathways (19).
Some studies suggest the less-explored CB2 receptors possess anti-inflammatory potential (20). These receptors represent a promising new way to counteract migraine (21).
CBD provides its benefits via interactions with the endocannabinoid system. This system’s receptors bind to the cannabinoids in CBD, affecting their functionality.
As the ECS controls pain, the immune system, mood regulation, muscle spasms, and anxiety, among other things, consuming CBD oil can help with all of these functions. In the case of migraines, it is the ability to assist with pain that becomes helpful.
A 2011 study published in the Journal of Headache and Pain examined, using an animal model, the effects of anandamide in migraine (22).
Anandamide is a cannabinoid naturally produced by the body, which interacts with CB1 and CB2 receptors.
The study confirmed that a dysfunction of the endocannabinoid system might contribute to the development of migraine attacks. Also, they indicated that the regulation of cannabinoid receptors could be useful for treating migraine pain.
The authors of a 2017 study, meanwhile, believe that there is evidence that patients with migraine have deficient levels of the anandamide. It is not known, however, if this is a localized or generalized phenomenon (23).
The Pros and Cons of CBD for Migraines
- Studies have shown that CBD can help with migraine symptoms, such as nausea, vomiting, headaches, pain, and inflammation.
- The 2018 Farm Bill has made CBD products derived from hemp legal. However, individual states in the United States have specific state laws (24).
- CBD has been well-received by the World Health Organization (WHO) that said, CBD “is generally well-tolerated with a good safety profile.” (25)
- CBD is non-addictive, says Nora Volkow, the director of the National Institute on Drug Abuse (NIDA), in an article in 2015. This quality makes CBD safe for daily intake (26).
- Like most over-the-counter (OTC) drugs and supplements, CBD oil may be purchased without a medical prescription in locations where they are legally available.
- There is not enough evidence to prove if CBD is a viable treatment for conditions other than those approved by the United States Food and Drug Administration (FDA).
In a review of studies, published in Cannabis and Cannabinoid Research in 2017, researchers saw a useful and practical role for medical cannabis in treating migraine (27). However, there are not enough studies on using CBD oil specifically yet.
- The multifaceted nature of migraine makes it challenging to define the exact criteria for clinical assessment. Also, migraine patients vary in their response to existing modes of treatment (28).
- There are risks in using CBD. CBD’s potential side effects include dry mouth, drowsiness, diarrhea, fatigue, and reduced appetite (29).
- CBD interacts with other drugs, which can alter how the body metabolizes certain medications, as a 2017 research noted (30).
- A 2017 review revealed labeling inaccuracies in some CBD products. Some products had less CBD than stated in the label, while others had more (31).
- Cannabis products and CBD do not have US FDA approval for migraine relief or cure. There is no regulation over the potency of CBD oil before marketing and sale in the United States for most uses.
How CBD Compares to Alternative Treatments for Migraines
There is currently no cure for migraines, although several treatments are available to help ease the symptoms.
However, some people who have migraines find that over-the-counter (OTC) painkillers, such as paracetamol, aspirin, and ibuprofen, can reduce their symptoms.
In some cases, triptans, which are specific painkillers for migraines, or anti-sickness medicines, may be prescribed by a general practitioner.
Like most pharmaceuticals, however, these medicines cause side effects. Thus, people are turning to natural and holistic treatments for relief.
Complementary and integrative treatment options can be beneficial for those living with migraines, says Dr. Deena Kuruvilla, Assistant Professor of Neurology at the Yale School of Medicine(32).
Unfortunately, there is currently not enough scientific evidence for doctors to recommend them as a primary form of treatment.
Still, research shows that up to 80% of patients living with migraine and headache disorders tried alternative treatments.
Many turn to holistic therapy because mainstream treatments have not been effective, have adverse effects, or have not yet been tried.
Alternative migraine treatments that have shown some proven efficacy include meditation and mindfulness training, essential oils and nutraceuticals (food with health benefits), or vitamins and minerals thought to have medicinal advantages.
Holistic treatments are to be used in combination with mainstream therapies, not serve as an individual remedy to migraine, Dr. Kuruvilla says. There is no substitute for conventional medicine (33).
Meanwhile, the nutritional value of CBD may be an excellent alternative treatment for migraine symptoms.
Hemp (Cannabis sativa L.), cultivated for making health products, like CBD oil, contains a variety of essential nutrients. The whole plant, from flower to seeds, is useful.
Many CBD oil products contain hemp seed oil as a carrier oil. Hemp seeds contain a high concentration of soluble and insoluble fiber, vitamins, minerals, and essential fatty acids like omega-3 and omega-6 (34).
Full-spectrum CBD contains a complete range of cannabinoids, terpenes, flavonoids, and other compounds naturally present in cannabis. These include other compounds and minerals, like fatty acids and fiber.
Terpenes are natural compounds in cannabis that give it distinctive aromas and flavors. Flavonoids give plants their vivid colors.
Combining all these compounds creates a synergy known as “entourage effect,” where all of the constituents working together are more efficient than their isolated elements (35).
CBD can be useful during mediation as well because of its calming effects. CBD has great psychiatric potential, including uses as an anxiolytic-like and an antidepressant-like compound, as a 2014 study published in CNS and Neurological Disorders – Drug Targets suggested (36).
In one study in Neuropharmacology, results showed that CBD could induce rapid-acting antidepressant-like effects and enhance neurotransmission (37). Neurotransmission is the process by which nerve cells communicate.
Coconut oil is another potential alternative treatment for migraine symptoms, specifically for fighting inflammation.
According to an article in PainPathways, the official magazine of the World Institute of Pain (WIP), coconut oil has the potential ability to lessen inflammation in joints and muscles (38).
A study published in Pharmaceutical Biology in 2010 showed that virgin coconut oil has anti-inflammatory and analgesic properties (39).
Coconut oil’s high levels of lauric acid help reduce inflammation, which directly impacts pain.
Many CBD oil manufacturers take advantage of coconut oil’s benefits by using medium-chain triglyceride (MCT) oil as a carrier oil in their tinctures. MCTs are fatty acids that are naturally present in coconut oil.
With its pain-relieving characteristics, CBD oil with MCT oil may be an excellent natural alternative for dealing with pain caused by inflammation or swelling.
Not to be overlooked as a potential alternative treatment for migraines is ginger. In a randomized controlled trial published in Phytotherapy Research in 2013, the effectiveness of ginger powder in the treatment of frequent migraine attacks was statistically comparable to that of sumatriptan (40).
Sumatriptan is a prescription drug commonly used to treat acute attacks of cluster headaches (41).
Cluster headaches, a type of migraine, are so severe that they are sometimes referred to as suicide headaches (42).
It is worth noting, however, that the 2013 study found that ginger also posed a better side effect profile than sumatriptan. Compared to that of sumatriptan, the clinical adverse effects of ginger powder were less.
Like ginger, curcumin has also been found to be useful for migraine headaches. Curcumin, the main active ingredient in turmeric, is known to possess potent anti-inflammatory characteristics.
A 2017 study in BioMed Research International used rat models to show that pretreatment with curcumin might be useful in reducing nociception, or the ability to feel pain (43).
CBD consumers can use the benefits of ginger and curcumin for migraines. Many CBD oils and tinctures contain ginger and curcumin to provide pain relief for those with migraine headaches.
How to Choose the Right CBD
Studies previously cited show that CBD is not the only cannabinoid found in cannabis that can help with migraine pain, severe headaches, nausea, vomiting, and inflammation. Hence, when choosing a CBD product, choose one that has full-spectrum CBD oil.
This type of CBD oil contains all phytonutrients from hemp, including trace amounts of THC, terpenes, flavonoids, and essential oils.
Broad-spectrum CBD oils are full-spectrum oils that are THC-free or contain trace amounts (less than 0.3%) of THC (tetrahydrocannabinol).
Broad-spectrum oil provides the benefits of all cannabinoids without the psychoactive properties of THC.
Meanwhile, CBD isolates carry only isolated CBD that is substantially pure CBD oil. CBD isolates are an excellent option for those who are allergic to the other compounds in cannabis plants, like hemp plants or medical marijuana (also called medical cannabis).
Consider the following to ensure the reliability and safety of the CBD products purchased.
- Buy non-GMO, organic, hemp-derived CBD oil products only from legitimate and reliable brands known for high-quality products.
Most manufacturers of CBD oil products grow their hemp from their farm or purchase from licensed hemp producers.
- Research on the legal stipulations applicable to CBD in the area where it would be bought and used.
The U.S. Farm Bill or Agriculture Improvement Act passed of 2018 has made hemp-derived CBD more accessible to many individuals.
The Farm Bill excluded hemp from the definition of marijuana in the Controlled Substances Act (CSA). Hemp was defined as cannabis (Cannabis sativa L.) and its derivatives with low THC(44).
Hemp, as stipulated in this legislation, should contain no more than 0.3% the psychoactive compound, delta-9-tetrahydrocannabinol (THC), on a dry weight basis.
- Read product reviews before buying from an online store. Check if the store is authorized by the government to sell CBD.
- Knowing the extraction methods used in making the CBD oil is also essential.
Researchers of a study indicate that the Supercritical-CO2 extraction process is recognized as safe by the U.S. Food and Drug Administration (FDA) in pharmaceutical manufacturing(45).
The supercritical CO2 extraction technique allows for the highest potency and purity because it does not extract any unwanted ingredients and impurities.
- Look for the product’s certificate of analysis (COA). A COA is a laboratory report that includes cannabinoid content and other tested compounds.
Consumers should pay attention to the dosage of CBD available in a product. Unscrupulous sellers may highlight quantities like milliliters of liquid in an oil or number of capsules in a bottle, instead of the CBD content.
Looking at the concentration of CBD contained in every serving or dose allows consumers to compare product value vs. price better.
- Compare company claims with that of third-party lab testing reports. A reputable CBD company values transparency with its consumers. It offers the most recent test reports of the products they provide.
CBD Dosage for Migraines
There are still no officially recommended CBD doses for any specific medical conditions. Determining the appropriate amount of CBD to take for migraines is going to be a trial and error process.
The CBD dose depends on age, body chemistry, frequency of migraine attacks, and severity of migraine symptoms.
A good rule of thumb is to follow the instructions on the product label that come with a particular CBD oil.
CBD manufacturers are likely to have guidelines for dosages found on the product itself, the accompanying paperwork, or their website.
Still, experts agree that one should start with a low dosage of CBD, or even err on the side of underdosing. Then, gradually increase the dosage as needed until the desired results are achieved.
How to Take CBD Oil for Migraines
A topical CBD cream, transdermal patch, or massage oil is ideal when dealing with inflammation or pain in a specific area of the body.
CBD topicals can target localized clusters of cannabinoid receptors, rather than interacting with the entire ECS. If properly formulated, they work instantly after skin contact, and relief can be felt in about 15 minutes.
Meanwhile, CBD oil capsules and edibles, such as gummies, brownies, and lozenges, are a straightforward and convenient way to take CBD oil, especially for beginners.
CBD in these forms comes in pre-dosed versions, which can easily be consumed at one’s convenience.
However, the downside is that these forms do not allow for as much flexibility with doses as one cannot easily cut a gummy or capsule in half.
On the other hand, CBD oil tinctures or drops are a practical option for those who seek fast results and maximum dosage control after a migraine attack.
A syringe, dropper, or easily-calculated number of drops is used for consistent and accurate dosing.
Sublingual application of CBD tincture allows for results to be experienced within 30 to 60 minutes after its use. The effects are felt for four to six hours.
Vaping CBD is one of the fastest strategies for getting the compound into the body. With this method, CBD enters the bloodstream through the lungs, without going through the digestive system.
However, the effects of vaping last only for 30 minutes to one or two hours. Also, it is difficult to determine precisely how much CBD is in each draw.
A 2018 study published in Molecules noted that the primary limitations of inhaling are the variability in individual inhalation techniques and respiratory tract irritation during inhalation (46).
Although labels for CBD oil vape products usually indicate the amount per inhale, the amount may vary in individuals. Thus, getting the right dose requires a bit of experimentation at first.
Vaping may not be for everyone. There could be problems that may arise from vaping, including chemical irritation or allergic reactions to various substances in the inhaled vapors (47).
Individuals contemplating vaping CBD for the first time must proceed with caution and first consult with a doctor experienced in cannabis use.
There are several different subtypes of migraines, including migraines with aura (called complicated migraines) and some without (common migraines)(48).
An aura is a series of sensory and visual changes. It ranges from seeing black dots and zig zags to tingling numbness on one side of the body. The experience can also be characterized by an inability to speak clearly.
The complexity of migraine makes it challenging to treat with any given medications. Adding to the challenge are the adverse side effects of pharmaceuticals.
These are only some of the reasons why people turn to holistic treatments, including CBD, for migraine pain relief.
Dr. Silberstein spoke with the American Headache Society, a professional society for doctors specializing in headache and migraine treatments, at the 60th Annual Scientific Meeting in San Francisco (49).
According to Dr. Silberstein, theoretically, CBD should not interact with migraine medications at all. It works on an entirely different mechanism. He also believes that CBD may even prevent nausea and vomiting.
Although studies have shown that CBD can help with most symptoms linked to migraines, it is not a cure-all.
To date, there is no scientific evidence on CBD as an effective treatment for migraines, primarily because it has not been formally studied.
Hopefully, more longitudinal research can help experts understand precisely how CBD works alone or with other cannabinoids to address migraines and other specific medical conditions.
Until CBD’s impact on migraine and its symptoms is fully understood, people with migraines should proceed with caution should they decide to use CBD as a supplementary therapy.
A consultation with a doctor experienced in cannabis use is ideal before deciding to try any CBD products.
- Goadsby, P. J., Holland, P. R., Martins-Oliveira, M., Hoffmann, J., Schankin, C., & Akerman, S. (2017). Pathophysiology of Migraine: A Disorder of Sensory Processing. Physiological reviews, 97(2), 553–622. https://doi.org/10.1152/physrev.00034.2015
- Gabral, G. A., Rogers, T. J., and Lichtman, A. H. (2015). Turning over a new leaf: cannabinoid and endocannabinoid modulation of immune function. J. Neuroimmune Pharmacol. 10, 193–203. doi: 10.1007/s11481-015-9615-z; Scherma, M., Muntoni, A. L., Melis, M., Fattore, L., Fadda, P., Fratta, W., et al. (2016). Interactions between the endocannabinoid and nicotinic cholinergic systems: preclinical evidence and therapeutic perspectives. Psychopharmacology 233, 1765–1777. doi: 10.1007/s00213-015-4196-3
- Petrosino S et al. Anti-inflammatory Properties of Cannabidiol, a Nonpsychotropic Cannabinoid, in Experimental Allergic Contact Dermatitis. Journal of Pharmacology and Experimental Therapeutics June 2018, 365 (3) 652-663; DOI: https://doi.org/10.1124/jpet.117.244368
- American Migraine Foundation. (2018, Dec 7). Migraine and CBD Oil. Retrieved from https://americanmigrainefoundation.org/resource-library/migraine-cbd-oil/
- Mayo Clinic. (2020, Jan 16). Migraine. Retrieved from https://www.mayoclinic.org/diseases-conditions/migraine-headache/symptoms-causes/syc-20360201
- Peres, F. F., Lima, A. C., Hallak, J., Crippa, J. A., Silva, R. H., & Abílio, V. C. (2018). Cannabidiol as a Promising Strategy to Treat and Prevent Movement Disorders?. Frontiers in pharmacology, 9, 482. https://doi.org/10.3389/fphar.2018.00482
- Cleveland Clinic. (2018, Aug 7). Migraine Headaches. Retrieved from https://my.clevelandclinic.org/health/diseases/5005-migraine-headaches
- American Migraine Foundation. op. cit.
- Parker LA, Rock EM, Limebeer CL. Regulation of nausea and vomiting by cannabinoids. Br J Pharmacol. 2011;163(7):1411–1422. DOIi:10.1111/j.1476-5381.2010.01176.x
- Sharkey KA, Darmani NA, Parker LA. Regulation of nausea and vomiting by cannabinoids and the endocannabinoid system. Eur J Pharmacol. 2014;722:134–146. DOI:10.1016/j.ejphar.2013.09.068
- Christian Waeber, Michael A. Moskowitz. (2005, May). Migraine as an inflammatory disorder. Neurology, 64 (10 suppl 2) S9-S15; DOI: 10.1212/WNL.64.10_suppl_2.S9. Retrieved from https://n.neurology.org/content/64/10_suppl_2/S9
- Goadsby, P. J. et. al. op. cit.
- Xiong W, Cui T, Cheng K, et al. Cannabinoids suppress inflammatory and neuropathic pain by targeting α3 glycine receptors. J Exp Med. 2012;209(6):1121–1134. doi:10.1084/jem.20120242
- Petrosino S et al. op. cit.
- Rahn, E.J.; Hohmann, A.G. Cannabinoids as Pharmacotherapies for Neuropathic Pain: From the Bench to the Bedside. Neurotherapeutics 2009, 6, 713–737; Pertwee R. G. (2001). Cannabinoid receptors and pain. Progress in neurobiology, 63(5), 569–611. https://doi.org/10.1016/s0301-0082(00)00031-9
- Leimuranta, P., Khiroug, L., & Giniatullin, R. (2018). Emerging Role of (Endo)Cannabinoids in Migraine. Frontiers in pharmacology, 9, 420. https://doi.org/10.3389/fphar.2018.00420
- Gabral, G. A. et. al. op. cit.
- Scherma, M., Muntoni, A. L., Melis, M., Fattore, L., Fadda, P., Fratta, W., et al. (2016). Interactions between the endocannabinoid and nicotinic cholinergic systems: preclinical evidence and therapeutic perspectives. Psychopharmacology 233, 1765–1777. doi: 10.1007/s00213-015-4196-3
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