Can CBD oil help with fibromyalgia?
- Fibromyalgia is a severe health disorder characterized by widespread symptoms such as chronic pain, cognitive difficulties, exhaustion, and sleep disorders. Doctors were initially confused about fibromyalgia due to having no direct understanding of its causes and effects in the body(1).
- Several FDA-approved drugs, such as mirtazapine and duloxetine, seemingly lack the effectiveness in providing relief to fibromyalgia symptoms (2-3). Most of the patients are also subject to the adverse reactions caused by consuming these medications, such as nausea, drowsiness, lack of energy, and fatigue.
- People have been seeking alternative treatments to fibromyalgia, with cannabidiol (CBD) showing much promise due to its alleged therapeutic benefits. Clinical trials and studies suggest that CBD can treat symptoms related to the disorder, such as chronic pain, low sleep quality, depression, and anxiety (4-5).
- Dr. Ginevra Liptan, a CBD advocate, hints that patients may benefit from taking full-spectrum CBD oil. She adds that the synergistic effect from these components of cannabis is what gives CBD its healing properties.
- CBD is not a panacea or miracle cure that can solve the problems related to fibromyalgia. People should instead see it as a possibly safer, more natural alternative in providing relief to the many symptoms of the medical condition.
Why People are Turning to CBD for Fibromyalgia
Fibromyalgia is a medical condition that is marked by widespread chronic pain, cognitive difficulties, sleep disturbances, and exhaustion. The disorder used to be quite controversial due to medical experts previously having no clear understanding of its causes and effects in the body (6).
Even worse is that medications approved by the Food and Drug Administration (FDA) such as duloxetine and mirtazapine are not effective in alleviating fibromyalgia symptoms (7-8). Many fibromyalgia patients are also subject to the side effects that are often associated with these drugs.
With an estimated 2% to 4% of the worldwide population being people that suffer from this disorder, many are becoming interested in trying alternative treatments that could provide relief for its symptoms (9). Cannabidiol (CBD), the non-psychoactive component obtained from the cannabis plant, is one of the treatments that people are looking into today.
At the time of writing, no precise study is available showing CBD oil as a reliable treatment for people who have fibromyalgia. However, sufficient data exists suggesting that CBD can be used to effectively alleviate symptoms of the illness, such as pain, anxiety, depression, and sleep disorders.
A study in 2018, published in the Journal of Clinical Rheumatology, mentions how medical cannabis use may be a potent treatment for fibromyalgia. Scientists performed the research on 26 patients who were given a consistent dosage for at least three months (10).
After starting the cannabis treatment, all of the subjects reported a vast improvement in their symptoms. The patients experienced so much relief from the therapy that half of them even decided to stop taking other fibromyalgia medications (11).
Another study in 2019 continues the investigation on the safety and effectiveness of medical cannabis therapy for fibromyalgia treatment. Approximately 300 patients were involved in the research who were instructed to increase their THC (tetrahydrocannabinol) and CBD dosage gradually over six months (12).
All of the patients received follow-up interviews a month into their treatments and another one six months after.
By the end of the study, most of the subjects reported positive results, particularly experiencing less pain than when they first started. It also shows low rates of addiction for medical cannabis as well as minimal adverse effects encountered by the patients (13).
The scientists conclude that CBD may be a safe and effective treatment for fibromyalgia, especially when applied slowly and gradually. The study also mentions that cannabis therapy should be considered as an option to ease the burdens of the symptoms associated with the said disorder (14).
How CBD Oil Works to Help with Fibromyalgia
One of the main areas in the body that fibromyalgia affects is the brain, with inflammation of this part, significantly contributing to pain and brain fog. A study in 2019 mentions how the spinal cord and microglia in the brain play an essential role in amplifying the pain signals of the medical condition (15).
The human body also possesses cannabinoid receptors known as CB1 and CB2, or cannabinoid receptor types 1 and 2. Specifically, CB2 receptors are the proteins in the endocannabinoid system (ECS) that are heavily involved in regulating the immune system.
These same receptors are capable of affecting microglial cell function, which is the main form of active immune defense of the central nervous system.
A Swiss journal in 2016 published a study suggesting there are possible therapies that can help target these CB2 receptors to provide a potential treatment for inflammation (16). CBD is said to have therapeutic anti-inflammatory effects according to several studies, which is the case with one review published in 2015 (17).
The research suggests that CBD can provide neuroprotective properties while stimulating cell repair of the brain. These scenarios could improve the brain function of patients that are impaired by fibromyalgia.
A study in 2012 suggests that CBD may also suppress behaviors related to depression and anxiety by improving anandamide signaling (18). Anandamide is a neurotransmitter in the brain that balances moods and regulates homeostasis.
Anandamide is also part of the ECS (endocannabinoid system) of the human body. This system is where cannabinoid receptors can be found and are said to be compatible with CBD.
Apart from potentially providing relief to inflammation and anxiety, CBD oil may also lessen neuropathic pain caused by malfunctioning or damaged nerves. Such were the findings in a 2019 study on rats where repeated low doses of CBD were found to induce analgesia, providing relief similar to painkillers (19).
The research could suggest that regular intake of CBD may alleviate the pain symptoms that are often associated with fibromyalgia. This statement is especially true concerning neuropathic pain caused by the condition (20).
Experiencing low sleep quality is also another symptom that people living with fibromyalgia endure. Another recent study revealed that one large dose of CBD brought about sleepiness in 30% of the treatment-resistant epilepsy patients (21).
In another clinical trial, healthy volunteers were also tested to see if large doses of CBD can affect sleep and wake cycles. Although more research is required, the preliminary results turned out negative, hinting that CBD oil may be used to improve sleep quality in fibromyalgia patients (22).
Chronic pain is a common symptom in fibromyalgia and is often accompanied by depression. A human study in 2017 suggests that oral intake of 300 milligrams of CBD can contribute to lowering cortisol levels while helping ease anxiety (23).
The Pros and Cons of CBD Oil for Fibromyalgia
- The healing properties of CBD may provide relief to pain levels and inflammation to patients with fibromyalgia, as per the studies mentioned above.
- Cannabidiol is a hemp-derived, non-psychoactive component of cannabis. It is not similar to tetrahydrocannabinol, which is the chemical that causes a high in marijuana.
- According to a study, CBD may help improve the sleep quality of people living with fibromyalgia, as a single large dose can cause sleepiness.
- Both animal and human test subjects experienced minimal side effects after given doses of CBD.
- The rules and regulations on CBD use are still in the process of being finalized, and existing laws at this time may no longer be applicable in the coming months.
- Although considered safe, users can still experience the side effects of CBD consumption, such as chronic fatigue, diarrhea, appetite loss, and weight changes.
- Drug interactions with CBD are possible, and some medications can cause more harm than good when used together with cannabidiol.
- Many participants that were subject to the CBD trials were asked about their symptoms without the use of objective measurement.
The most significant risk related to CBD use is its legality. Although cannabidiol is primarily obtained from non-GMO hemp plants and is legal under the United States Farm Bill, there is still confusion regarding the specifics.
Many states in America, such as Colorado, allow hemp-based CBD, yet others still prohibit it. Consumers should keep in mind that Epidiolex, a CBD-based medication for epilepsy, is the only CBD product that has been approved by the FDA (24).
With the lack of proper trials and regulation, it is in the best interest of users to consult their doctors before deciding to implement CBD in their diet.
How CBD Oil Compares to Alternative Treatments for Fibromyalgia
The typically prescribed medications in treating fibromyalgia are largely ineffective in treating the condition overall. Most of the patients that take these drugs are also subject to adverse reactions such as nausea, constipation, dizziness, dry mouth, and weakness.
Cannabidiol is a natural alternative that has shown minimal adverse side effects when taken continuously. These reactions to CBD are also uncommon compared to most of the pharmaceutical medications in treating fibromyalgia.
The World Health Organization (WHO) backs this statement by carrying out a report of their own regarding CBD. In their review, the WHO confirmed that CBD has an excellent safety profile and is generally well tolerated during a number of open-label trials (25).
One thing to note is that the symptoms of fibromyalgia are different for each individual. Since CBD provides a range of therapeutic effects, it may not always be the best choice in alleviating the symptoms associated with the medical condition.
How to Choose the Right CBD for Fibromyalgia
Dr. Ginevra Liptan, the director of the Frida Center for Fibromyalgia in Portland, claims that most of her patients have experienced relief for fibromyalgia symptoms after mixing CBD oil with their prescribed medicines. Like other medical experts, Dr. Liptan emphasizes CBD products can effectively treat the disorder when combined with tetrahydrocannabinol.
“CBD oil on its own, without any other medications or treatments, typically does not give strong analgesic effects,” explains Dr. Liptan. “Successful pain relief without any additional prescription medications usually requires products that contain some amount of THC in addition to the CBD.”
Following this statement, she recommends the use of full-spectrum CBD oils when addressing the symptoms of fibromyalgia. Full-spectrum CBD products possess all of the cannabinoids naturally found in cannabis, including THC and terpenes.
Dr. Liptan adds, “I see much greater benefit from full-spectrum CBD oils, which contain other cannabinoids and sometimes trace amounts of THC, compared to the CBD isolates, which do not have the synergistic effects of the whole plant extract.”
She also reminds readers that CBD hemp extract is not a panacea, nor is it the miracle cure for fibromyalgia. To her, CBD oil represents a relatively safe alternative in providing pain relief to the condition, which makes it worth considering.
Getting medical advice from a trusted doctor is vital for anyone planning to use CBD for fibromyalgia.
The following factors are essential to ensure the safety and reliability of the CBD products purchased:
- Research on the exact legal stipulations applicable to CBD in the area where it would be purchased and used.
- Purchase only high-quality CBD products from legitimate and reliable brands. The majority of companies that manufacture the best CBD oil products grow their hemp from their farm, or purchase from licensed hemp producers.
- Research product reviews before buying from an online store. When purchasing from a physical store or dispensary, check whether the store is authorized by the government to sell CBD.
- One important thing to look for in CBD products is certification codes. Several certification authorities approve certain products only after some thorough screening tests.
- Compare company claims about their products’ potency with that of the third-party lab reports.
- Consulting with a trusted medical professional who is experienced in CBD use is ideal before one purchases his or her first bottle of CBD.
CBD Dosage for Fibromyalgia
Despite the preliminary findings that show the potential therapeutic uses for cannabidiol, many doctors are still hesitant in prescribing CBD to their fibromyalgia patients. There are two main reasons for this sentiment.
The first is that there is no recommended daily allowance (RDA) for people suffering from the said condition. Thus, doctors cannot prescribe cannabinoids but can only recommend them.
The second reason is that most medical schools have not tackled cannabidiol therapy in pharmacology courses. Most drug curriculums revolve mainly on substances that are patented.
Although there is no official recommended dosage on CBD oil for fibromyalgia, experts have analyzed the publications, anecdotal evidence, and studies to come up with a suggested CBD dose range.
The following is a chart from Mayo Clinic that provides specific dosage suggestions for the following conditions:
- Chronic fibromyalgia pain: 2.5-20 mg of CBD with or without THC orally
- Sleep problems: 40 mg-160 mg of CBD orally
- Loss of appetite: 2.5 mg of THC orally, with or without 1 mg of cannabidiol for at least six weeks
How to Take CBD Oil for Fibromyalgia
There are several ways of consuming CBD hemp oil, with different delivery formats depending mostly on personal preference or the suggested route of intake.
- Liquid CBD oil in the form of tinctures or droppers
- Encapsulated CBD oil
- Phytocannabinoid sprays
- CBD-infused edibles such as brownies, gummies, and cookies
- Dissolvable powders that contain CBD
- CBD-infused chewing gum
- Crystalline isolates
- CBD-rich vape cartridges or vaping e-liquids
- CBD-rich bath bombs
- Cannabidiol-infused transdermal patches
- CBD salves, lotions, balms, soaps or shampoos
The medical condition known as fibromyalgia is characterized by widespread pain, low sleep quality, exhaustion, and cognitive difficulties. This disorder had a contentious past with physicians unable to have a direct understanding of its causes and how its effects work in the body.
FDA-approved medications such as duloxetine and mirtazapine lack the efficacy in alleviating the symptoms of fibromyalgia. Furthermore, most patients experience adverse reactions when using these drugs.
CBD is seen as a potential treatment due to the numerous data regarding its alleged health benefits. Clinical trials show that CBD can effectively provide relief to pain, anxiety, depression, and even sleep disorders to fibromyalgia patients.
Scientists also view the endocannabinoid system present in the human body as a possible target for cannabidiol. In particular, the CB2 receptors responsible for helping regulate the immune system may be exposed to CBD, and hopefully, improve fibromyalgia symptoms in patients.
Medical experts, like Dr. Ginevra Liptan, suggest full-spectrum CBD oil instead since most studies and claims regarding symptom relief were from using CBD quality products that had a mix of other cannabinoids, THC, and terpenes. THC is the primary compound of marijuana that causes psychoactive effects.
She concludes that the entourage effect from all these chemical components is what gives CBD extracts the healing properties.
Dr. Liptan also adds that the use of CBD should not be considered a miracle cure for fibromyalgia. Instead, it should be seen as a relatively safer alternative in providing relief to its many symptoms.
For people planning to use CBD, it is always essential to consult a doctor first before deciding to include this in their regimen.
- Cohen H. Controversies and challenges in fibromyalgia: a review and a proposal. Ther Adv Musculoskelet Dis. 2017;9(5):115‐127. doi:10.1177/1759720X17699199
- Lunn MPT, Hughes RAC, Wiffen PJ. Duloxetine for treating painful neuropathy, chronic pain or fibromyalgia. Cochrane Database of Systematic Reviews 2014, Issue 1. Art. No.: CD007115. DOI: 10.1002/14651858.CD007115.pub3
- Welsch P, Bernardy K, Derry S, Moore RA, Häuser W. Mirtazapine for fibromyalgia in adults. Cochrane Database Syst Rev. 2018;8(8):CD012708. Published 2018 Aug 6. doi:10.1002/14651858.CD012708.pub2
- George Habib, MD, MPH and Suheil Artul, MD (2018). Medical Cannabis for the Treatment of Fibromyalgia. Retrieved from: https://www.sativaisticated.com/wp-content/uploads/2018/04/Medical-Cannabis-for-the-Treatment-of-Fibromyalgia-Medical-Cannabis-Medical-Marijuana-Research-for-Autoimmune-Disease-Fibromyalgia.pdf
- Sagy I, Bar-Lev Schleider L, Abu-Shakra M, Novack V. Safety and Efficacy of Medical Cannabis in Fibromyalgia. J Clin Med. 2019;8(6):807. Published 2019 Jun 5. doi:10.3390/jcm8060807
- Cohen H. et al. op. cit.
- Lunn MPT. et al. op. cit.
- Welsch P. et al. op. cit.
- Häuser W, Fitzcharles MA. Facts and myths pertaining to fibromyalgia. Dialogues Clin Neurosci. 2018;20(1):53‐62.
- Habib G. et al. op. cit.
- Sagy I. et al. op. cit.
- Albrecht DS, Forsberg A, Sandström A, et al. Brain glial activation in fibromyalgia – A multi-site positron emission tomography investigation. Brain Behav Immun. 2019;75:72‐83. doi:10.1016/j.bbi.2018.09.018
- Turcotte C, Blanchet MR, Laviolette M, Flamand N. The CB2 receptor and its role as a regulator of inflammation. Cell Mol Life Sci. 2016;73(23):4449‐4470. doi:10.1007/s00018-016-2300-4
- Burstein, S. Cannabidiol (CBD) and its analogs: a review of their effects on inflammation. Department of Biochemistry & Molecular Pharmacology, University of Massachusetts Medical School, 364 Plantation St., Worcester, MA 01605, United States. https://doi.org/10.1016/j.bmc.2015.01.059
- Leweke FM, Piomelli D, Pahlisch F, et al. Cannabidiol enhances anandamide signaling and alleviates psychotic symptoms of schizophrenia. Transl Psychiatry. 2012;2(3):e94. Published 2012 Mar 20. doi:10.1038/tp.2012.15
- De Gregorio D, McLaughlin RJ, Posa L, et al. Cannabidiol modulates serotonergic transmission and reverses both allodynia and anxiety-like behavior in a model of neuropathic pain. Pain. 2019;160(1):136‐150. doi:10.1097/j.pain.0000000000001386
- Cheng CW, Wong CS, Hui GK, Chung EK, Wong SH. Fibromyalgia: is it a neuropathic pain?. Pain Manag. 2018;8(5):377‐388. doi:10.2217/pmt-2018-0024
- Laux LC, Bebin EM, Checketts D, et al. Long-term safety and efficacy of cannabidiol in children and adults with treatment resistant Lennox-Gastaut syndrome or Dravet syndrome: Expanded access program results. Epilepsy Res. 2019;154:13‐20. doi:10.1016/j.eplepsyres.2019.03.015
- Linares IMP, Guimaraes FS, Eckeli A, et al. No Acute Effects of Cannabidiol on the Sleep-Wake Cycle of Healthy Subjects: A Randomized, Double-Blind, Placebo-Controlled, Crossover Study. Front Pharmacol. 2018;9:315. Published 2018 Apr 5. doi:10.3389/fphar.2018.00315
- Zuardi AW, Rodrigues NP, Silva AL, et al. Inverted U-Shaped Dose-Response Curve of the Anxiolytic Effect of Cannabidiol during Public Speaking in Real Life. Front Pharmacol. 2017;8:259. Published 2017 May 11. doi:10.3389/fphar.2017.00259
- GW Pharmaceuticals (2020, April 6). GW Pharmaceuticals plc and Its U.S. Subsidiary Greenwich Biosciences, Inc. Announce That EPIDIOLEX® (cannabidiol) Oral Solution Has Been Descheduled And Is No Longer A Controlled Substance. Retrieved from: https://www.globenewswire.com/news-release/2020/04/06/2012160/0/en/GW-Pharmaceuticals-plc-and-Its-U-S-Subsidiary-Greenwich-Biosciences-Inc-Announce-That-EPIDIOLEX-cannabidiol-Oral-Solution-Has-Been-Descheduled-And-Is-No-Longer-A-Controlled-Substan.html
- World Health Organization (2018 June). Cannabidiol (CBD) Critical Review Report. Retrieved from: https://www.who.int/medicines/access/controlled-substances/WHOCBDReportMay2018-2.pdf