CBD for Restless Legs Syndrome - April 2024

How CBD Oil May Help Alleviate Symptoms of RLS

Restless legs syndrome, known as Willis-Ekbom Disease, is a neurological disorder of the nervous system characterized by severe pain and disability⁽⁶⁾. 

RLS is a neurodevelopmental disorder that causes sleep problems⁽⁷⁾.

There is insufficient research regarding how CBD works in managing the symptoms of RLS. However, according to studies, women with fibromyalgia are more likely to be diagnosed with RLS⁽⁸⁾. 

Fibromyalgia causes pain all over the body. Cannabis and CBD have shown promise as therapeutic agents for such a condition⁽⁹⁾.  

CBD (cannabidiol) is a natural compound in the cannabis plant⁽¹⁰⁾. CBD is nonpsychoactive, unlike tetrahydrocannabinol (THC). Hemp, by law, usually contains less than 0.3% THC.

Clinical trials noted that many patients with RLS conditions experienced complete recovery after cannabis use⁽¹¹⁾.

Meanwhile, CBD noted significant potential efficacy in improving the sleep quality of patients with Parkinson’s disease⁽¹²⁾. 

Restless legs syndrome is a sleep disorder characterized by an urge to move the legs. The syndrome is linked to Parkinson’s disease⁽¹³⁾.

Treatments for both PD and RLS are available and respond to the same dopaminergic medications⁽¹⁴⁾.CBD is a partial dopamine agonist⁽¹⁵⁾.

CBD and THC play a neuroprotective role by reducing dopaminergic neuronal death. However, CBD may increase dopamine concentrations in the striatum⁽¹⁶⁾.  

CBD’s purported neuroprotective benefits and dopaminergic neural activity may elucidate how the nonpsychoactive compound may help with RLS and PD.

The Endocannabinoid System and Restless Legs Syndrome

The ECS (endocannabinoid system) maintains the body’s homeostasis or balance and modulates pain and inflammatory signals through cannabinoid receptors⁽¹⁷⁾.

The effects of cannabinoids, like CBD and THC, on neurotransmitter and neuropeptide release are known to exert analgesic effects⁽¹⁸⁾. 

CBD, in particular, has purported pain-relieving properties⁽¹⁹⁾. RLS is a common trigger of painful legs⁽²⁰⁾. Hence, CBD’s potential to help with pain management may benefit individuals with RLS. 

A study suggests that CBD may be used to manage insomnia and enhance sleep in chronic pain patients⁽²¹⁾. 

Getting up and moving can help relieve the pain caused by restless leg syndrome. Most individuals with the condition find it hard to fall and stay asleep⁽²²⁾.

CBD’s potential to help with sleep and pain management may benefit individuals with RLS. Still, studies regarding CBD and medical cannabis (medical marijuana), in general, are inconclusive. 

How CBD Oil Compares to Alternative Treatments for RLS

Generally,  RLS symptoms improve dopamine (chemical messenger between neurons) through taking dopamine agonists, antiseizure medications, or opiates are used alone or in combination⁽²³⁾.

However, such measures may cause significant adverse effects, including impulse control disorder⁽²⁴⁾. 

Impulse control disorders are mental health conditions that prevent people from controlling their actions and emotions⁽²⁵⁾.

Meanwhile, the effects of vitamin D on the severity of RLS were observed in a clinical trial⁽²⁶⁾. A study noted that vitamin D could help decrease the intensity of symptoms of RLS⁽²⁷⁾. 

Additionally, magnesium supplements, which help relieve muscle cramps, may be an alternative remedy for RLS⁽²⁸⁾.

Numerous cannabis strains include a variety of cannabinoids, terpenes, flavonoids, and other components. 

​​Flavonoids are antioxidant, antiviral, and anti-inflammatory active compounds⁽²⁹⁾.

Meanwhile, terpenes contribute to cannabis’ distinct aroma or scent⁽³⁰⁾.

Unlike medical marijuana, CBD oil is extracted from industrial hemp⁽³¹⁾.

CBD has anti-inflammatory and neuroprotective effects. Studies also showed that the compound may have anticonvulsant and muscle relaxant properties⁽³²⁾.

While CBD may help relieve RLS symptoms, it is not a cure. Consult with a healthcare specialist for proper diagnosis and treatment.

How to Take CBD Oil for RLS

When CBD users purchase high-quality CBD products, it is essential to know the full advantages of full-spectrum and broad-spectrum CBD oil and CBD isolates⁽³³⁾.

Full-spectrum CBD oil may include up to 0.3 % THC concentration. It also contains CBD, terpenes, flavonoids, essential oils, and other cannabinoids⁽³⁴⁾.

Additionally, full-spectrum CBD oil may also have an entourage effect. This effect occurs when all active components of the cannabis plant are consumed simultaneously⁽³⁵⁾. 

Broad-spectrum is similar to full-spectrum, except it is nearly THC free⁽³⁶⁾.

On the other hand, CBD isolates only have pure CBD without any other cannabinoids.

There are various ways to administer the best CBD oil to help manage RLS symptoms, such as the following:

• Oral: Sativex, an oral spray treatment for multiple sclerosis (MS), contains equal amounts of THC and CBD⁽³⁷⁾. Researchers observed that almost one in four MS patients had restless legs syndrome. Individuals with this health problem moved their legs more often due to pain⁽³⁸⁾.
• Sublingual method: CBD oil is usually taken under the tongue and can be easily mixed with food to minimize the cannabis plant’s naturally strong bitter taste⁽³⁹⁾.
• Topical application: CBD topicals are commonly applied to the affected area to activate CBD’s effects.
• Inhalation: Vaping is a fast-acting method to obtain high doses of CBD oil and does not involve harmful by-products, making the method safe and effective for ingesting CBD oil⁽⁴⁰⁾. 

However, CBD vape users are advised to take caution as smoking may be associated with lung issues.

Aside from CBD oil, American consumers may benefit from CBD tinctures and edibles like gummies. 

CBD Dosage for RLS

There is no standard CBD dosage for RLS. Consumers may use a CBD dosing guide based on one’s body weight⁽⁴¹⁾.  

For instance, micro CBD dosages are considered a low dose concentration, ranging from 0.5mg to 20mg of CBD daily⁽⁴²⁾.

Microdoses of CBD may help with sleep disturbances, one of the RLS symptoms⁽⁴³⁾. 

CBD oil for restless leg syndrome may be used with a dropper applicator to help with the dosing.

Safety and Side Effects of CBD Oil for RLS: Is CBD Safe for RLS?

Studies on CBD’s effects are insufficient.

One survey showed that individuals using CBD to help with anxiety and sleep issues may administer modest dosages to control RLS symptoms⁽⁴⁴⁾.

 However, moderate CBD side effects include dry mouth, nausea, sleepiness, and headache⁽⁴⁵⁾.

For the user’s safety, they must consult a healthcare specialist.

What Is Restless Leg Syndrome?

A study in Frontiers in Aging Neuroscience defines RLS as a common neurological disorder that causes patients to feel a need to move to relieve discomfort⁽⁴⁶⁾. RLS is a condition that worsens at night and can happen while patients are sleeping.

RLS may also be linked to other conditions such as peripheral neuropathy, diabetes, or iron deficiency anemia⁽⁴⁷⁾.

Origin of Restless Legs Syndrome: What Are the Causes of RLS?

According to the Johns Hopkins Neurology and Neurosurgery Department, the causes of RLS are as follows⁽⁴⁸⁾:

• Iron deficiency, which is a substantial environmental risk factor for RLS
• Dopamine levels and genes, which are potential causes of RLS symptoms that have yet to be verified by future studies 

The same study found that individuals with RLS may have low brain iron levels. This condition may cause RLS symptoms.

Low iron levels may alter brain cell function⁽⁴⁹⁾. Low dopamine levels due to iron insufficiency or low iron levels in the blood might induce restless legs syndrome⁽⁵⁰⁾.

Iron deficiency therapy may significantly improve RLS symptoms if not completely eliminated⁽⁵¹⁾.

Restless Legs Syndrome Symptoms

The symptoms of RLS include the following⁽⁵²⁾:

• Sleep disturbance
• Leg or arm discomfort
• Daytime sleepiness
• Work performance and behavioral issues

Forms of Restless Legs Syndrome 

RLS may manifest as either an early-onset or a late-onset condition. Each form may have its distinct characteristics⁽⁵³⁾:

Early-onset RLS is a psychological disorder that appears in one’s teenage years. It can be hard to tell if someone has the condition. 

In contrast, late-onset RLS is a condition that usually affects people who have no family history of the disorder. Late-onset RLS can cause lower leg pain and fatigue⁽⁵⁴⁾.

How Is Restless Legs Syndrome Treated?

Symptoms of RLS may be managed by finding and treating an underlying medical condition⁽⁵⁵⁾.

New antiseizure medications are now the first-line therapy for RLS. The FDA has authorized enacarbil for treating moderate to severe RLS⁽⁵⁶⁾.

Opioids and other narcotics may help relieve severe RLS symptoms⁽⁵⁷⁾.

Lastly, ​one study noted that massage may improve the quality of life of RLS patients⁽⁵⁸⁾. 

What Medications Can Cause Restless Legs Syndrome?

Anti-nausea drugs, antipsychotics, serotonin-stimulating antidepressants, and some cold and allergy meds may worsen RLS symptoms⁽⁵⁹⁾.

The World Association of Sleep Medicine stated that the leading cause of augmentation of symptom severity in RLS patients is dopaminergic treatment⁽⁶⁰⁾.

CBD Legality

The Food and Drug Administration or FDA has approved Epidiolex, a CBD-based medication, to help with tubular sclerosis and seizures associated with epilepsy⁽⁶¹⁾.Meanwhile, the 2018 Farm Bill authorized the sale of CBD products in the United States, provided that these products contain less than 0.3% THC⁽⁶²⁾.

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1. Restless Legs Syndrome Fact Sheet https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Restless-Legs-Syndrome-Fact-Sheet
2. Cannabidiol can improve complex sleep-related behaviours associated with rapid eye movement sleep behaviour disorder in Parkinson’s disease patients: a case series https://pubmed.ncbi.nlm.nih.gov/24845114/
3. Restless Leg Syndrome And Parkinson’s Disease https://www.apdaparkinson.org/article/restless-leg-syndrome/
4. Cannabidiol is a partial agonist at dopamine D2High receptors, predicting its antipsychotic clinical dose https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5315552/
5. Cannabidiol as a Therapeutic Target: Evidence of its Neuroprotective and Neuromodulatory Function in Parkinson’s Disease https://www.frontiersin.org/articles/10.3389/fphar.2020.595635/full
6. Restless Legs Syndrome Fact Sheet https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Restless-Legs-Syndrome-Fact-Sheet
7. Ibid.
8. Musculoskeletal pain is associated with restless legs syndrome in young adults https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-015-0765-1
9. Cannabis and cannabidiol (CBD) for the treatment of fibromyalgia https://pubmed.ncbi.nlm.nih.gov/33004171/
10. Cannabis, a complex plant: different compounds and different effects on individuals https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3736954/
11. Cannabis for Restless Legs Syndrome https://pubmed.ncbi.nlm.nih.gov/33537945/
12. Cannabidiol can improve complex sleep-related behaviours associated with rapid eye movement sleep behaviour disorder in Parkinson’s disease patients: a case series https://pubmed.ncbi.nlm.nih.gov/24845114/
13. Restless Leg Syndrome And Parkinson’s Disease https://www.apdaparkinson.org/article/restless-leg-syndrome/
14. Ibid.
15. Cannabidiol is a partial agonist at dopamine D2High receptors, predicting its antipsychotic clinical dose https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5315552/
16. Cannabidiol as a Therapeutic Target: Evidence of its Neuroprotective and Neuromodulatory Function in Parkinson’s Disease https://www.frontiersin.org/articles/10.3389/fphar.2020.595635/full
17. The Endocannabinoid System: A Potential Target for the Treatment of Various Diseases https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC8430969/
18. Ibid.
19. Research shows pain-relieving effects of CBD https://www.sciencedaily.com/releases/2021/04/210423130221.htm
20. Restless Legs Syndrome https://my.clevelandclinic.org/health/diseases/9497-restless-legs-syndrome
21. Cannabis, Cannabinoids, and Sleep: a Review of the Literature https://pubmed.ncbi.nlm.nih.gov/28349316/
22. Restless Legs Syndrome, Insomnia And Brain Chemistry: A Tangled Mystery Solved? https://www.hopkinsmedicine.org/news/media/releases/restless_legs_syndrome_insomnia_and_brain_chemistry_a_tangled_mystery_solved
23. More evidence of cannabis efficacy in restless legs syndrome http://azmedmj.pharmacy.arizona.edu/sites/default/files/More%20evidence%20of%20cannabis%20efficacy%20in%20restless%20legs%20syndrome%20(1).pdf
24. Ibid.
25. Impulse Control Disorders and Substance Abuse https://americanaddictioncenters.org/co-occurring-disorders/impulse-control-disorder
26. The effect of vitamin D supplements on the severity of restless legs syndrome https://pubmed.ncbi.nlm.nih.gov/25148866/
27. The effect of vitamin D supplements on the severity of restless legs syndrome https://pubmed.ncbi.nlm.nih.gov/25148866/
28. Magnesium supplementation for the treatment of restless legs syndrome and periodic limb movement disorder: A systematic review https://www.sciencedirect.com/science/article/abs/pii/S1087079219301868?via%3Dihub
29. Flavonoids as antioxidants https://pubmed.ncbi.nlm.nih.gov/10924197/
30. The Cannabis Terpenes https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7763918/
31. The Effects of CBD Oil on Restless Leg Syndrome https://www.centerforvein.com/blog/the-effects-of-cbd-oil-on-restless-leg-syndrome
32. Evidence for the efficacy and effectiveness of THC-CBD oromucosal spray in symptom management of patients with spasticity due to multiple sclerosis https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC4710104/
33. Cannabidiol primer for healthcare professionals https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7340472/q
34. Cannabidiol primer for healthcare professionals https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7340472/
35. The Case for the Entourage Effect and Conventional Breeding of Clinical Cannabis: No “Strain,” No Gain https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334252/
36. Cannabidiol primer for healthcare professionals https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7340472/
37. Nabiximols https://www.sciencedirect.com/topics/neuroscience/nabiximols
38. People with MS Are More Likely to Have Restless Legs Syndrome, Says New Study https://www.nationalmssociety.org/About-the-Society/News/People-with-MS-Are-More-Likely-to-Have-Restless-Le
39. Page 208 of Healing With CBD https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
40. CBD: A Patient’s Guide to Medical Cannabis pg. 113 https://drive.google.com/file/d/1MILU_6ZjYkII-XMUPHLFPiPQbrz__5Sh/view
41. Healing With CBD, page. 193 https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
42. Ibid.
43. Ibid.
44. Reasons for cannabidiol use: a cross-sectional study of CBD users, focusing on self-perceived stress, anxiety, and sleep problems https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7893882/
45. Safety and side effects of cannabidiol, a Cannabis sativa constituent https://pubmed.ncbi.nlm.nih.gov/22129319
46. Restless Legs Syndrome: From Pathophysiology to Clinical Diagnosis and Management https://www.frontiersin.org/articles/10.3389/fnagi.2017.00171/full
47. Restless Legs Syndrome Fact Sheet https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Restless-Legs-Syndrome-Fact-Sheet
48. Causes of Restless Legs Syndrome https://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/restless-legs-syndrome/what-is-rls/causes.html
49. The role of iron in restless legs syndrome https://pubmed.ncbi.nlm.nih.gov/17566122/
50. Causes -Restless legs syndrome https://www.nhs.uk/conditions/restless-legs-syndrome/causes/
51. Ibid.
52. Restless Legs Syndrome https://my.clevelandclinic.org/health/diseases/9497-restless-legs-syndrome
53. Restless legs syndrome and related disorders https://www.mountsinai.org/health-library/report/restless-legs-syndrome-and-related-disorders
54. Ibid.
55. Restless Legs Syndrome Fact Sheet https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Restless-Legs-Syndrome-Fact-Sheet
56. Treatment for Restless Legs Syndrome (RLS) https://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/restless-legs-syndrome/what-is-rls/treatment.html
57. Restless legs syndrome https://www.mayoclinic.org/diseases-conditions/restless-legs-syndrome/diagnosis-treatment/drc-20377174
58. Effectiveness and safety of massage in the treatment of restless legs syndrome https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7710177/
59. Restless Legs Syndrome Fact Sheet https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Restless-Legs-Syndrome-Fact-Sheet
60. Diagnostic standards for dopaminergic augmentation of restless legs syndrome: report from a World Association of Sleep Medicine-International Restless Legs Syndrome Study Group consensus conference at the Max Planck Institute https://pubmed.ncbi.nlm.nih.gov/17544323/
61. FDA Approves First Drug Comprised of an Active Ingredient Derived from Marijuana to Treat Rare, Severe Forms of Epilepsy https://www.fda.gov/news-events/press-announcements/fda-approves-first-drug-comprised-active-ingredient-derived-marijuana-treat-rare-severe-forms
62. Hemp Production and the 2018 Farm Bill https://www.fda.gov/news-events/congressional-testimony/hemp-production-and-2018-farm-bill-07252019

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