Fibromyalgia, does CBD give Hope?

Fibromyalgia affects with pain and numerous symptom symptoms, while school medical prescriptions often help little, there are success stories about CBD (cannabidiol)

 

What is fibromyalgia?

 

Fibromyalgia is a non-inflammatory and non-degenerative disease its main symptom is a generalized or alternating pain without any apparent organic cause. The pain associated with fibromyalgia is often described as a permanent dull pain.Diagnostic criteria are in particular:

 

  • The pain persists for more than 3 months
  • In both body halves, right and left
  • In the upper and lower half of the body

 

In addition to the pain, there are often sleep problems. Sleep is often disturbed by pain, and many patients with fibromyalgia have other sleep disorders, Eg, restless leg syndrome (RLS) and sleep apnea.

Cognitive difficulties are also concomitant, the ability to concentrate and remain attentive.

 

Frequent comorbidities are:

 

  • Irritable Bowel Syndrome
  • Migraines and other types of headaches
  • TMJ disorders
  • depressions
  • Premenstrual syndrome

 

The disease occurs in industrialized countries, depending on the study, about 3.5% of women and about 0.5% in men, but there is literature pointing out up to 15%.

 

Risk factors for fibromyalgia are:

 

  • Gender: Fibromyalgia is more common in women than in men.
  • Family history: Higher risk when a relative has fibromyalgia.
  • Comorbidity: If you have osteoarthritis, rheumatoid arthritis or lupus, you may develop fibromyalgia.
  • Increased psychological stress both current, as well as in the life history
  • Infections such as Epstein-Barr virus, Q-fever or Lyme-borreliosis as triggers
  • Intestinal infections with Campylobacter, Shigella or Salmonella and resulting postinfectious irritable bowel syndrome

Therapy

 

  • Physical therapy
  • Psychotherapeutic accompaniment
  • training therapy
  • In the case of drug therapy, it should be noted that no drug for the treatment of fibromyalgia syndrome is currently approved in Germany. Only when relevant diseases are present (eg a depression)drugs such as antidepressants can be prescribed, not for the treatment of the fibromyalgia syndrome but for the treatment of the depression. Medicaments often used in connection with fibromyalgia are in addition to antidepressants: serotonin reuptake inhibitor, painkillers (which generally do not help), soothing agents, muscle relaxants, antiepileptics (Note: these mentions refer to Germany and may be different in your country, especially USA)

 

Is CBD an alternative and what is CBD at all?

 

CBD oil is an extract made from hemp. However, not as hemp oil, from the seeds, but from flower buds and their distillation. These plants are almost free of the psychoactive substance THC, the content of THC is extremely low (0.2%). Psychoactive effects of the cannabis drug do not occur. The use and purchase are legal in most countries. In the hemp plant, there are over 80 so-called cannabinoids.

The main active substance of the CBD oil is the cannabidiol, however, the main cannabinoid is in cannabidiol acid. The proportion of one or other active substance is dependent on many factors, from the harvest of the plant to processing and storage. Early harvest, low light, and low temperatures increase the content of cannabidiol acid (CBDA). This is especially important when it comes to inflammation-inhibiting effects or the interaction with the serotonin receptor. CBDA is also important to increase the bioavailability of CBD. Other cannabinoids are CBDA – Cannabigerol, CBC – Cannabichromene, THCA – Tetrahydrocaanabinoloic Acid, THCV – Tetrahydrocannabivarin, CBN – Cannabinol.  All these active ingredients influence each other and contribute to the therapeutic use of the oil.

What is the proven effect of cannabidiol?

CBD has been shown to be beneficial in the Dravet syndrome and in the Lennox Gastaut syndrome, and in multiple sclerosis.

Numerous therapeutic effects have been described for cannabidiol, eg in REM sleep disorder. Its antioxidant activity, as well as anti-inflammatory, antibacterial, antiepileptic, neuroprotective, anticonvulsant, antiemetic, anxiolytic or antipsychotic effects, give perspective for the treatment of certain nerve infections, epilepsy, dizziness, vomiting, anxiety, and schizophrenia as well as neurodegenerative or cancer diseases. Cannabidiols pharmacological effects are mediated by G protein-coupled receptors, cannabinoid type I (CB1) and cannabinoid type II (CB2), which is strongly present in the hippocampus and other parts of the central nervous- and the immune system. When activated, CB1 receptors inhibit synaptic transmission by the action of stress-driven calcium and potassium channels. CB2 receptors are primarily present in the immune system and are only limited in the central nervous system. The effects of CBD are independent of a CB2 receptor. Studies have shown that CBD has low affinity for the CB1 receptors, but even at low concentrations, CBD decreases G protein activity and increase Anandamide. CB1 receptors are present on many glutamatergic synapses. CBD can act on the CB1 receptors to inhibit the release of glutamate. CB1 receptor expression is highly regulated in GABAergic synapses and down-regulated in glutamatergic synapses.

Other approaches for CBD are the transient receptor potential (TRP) channels involved in the modulation of intracellular calcium. Cannabinoids are very lipophilic, which allows access to intracellular sites, resulting in an increase in calcium in a variety of cell types, including hippocampal neurons. CBD actions on calcium homeostasis can provide a basis for CBD neuroprotective properties.

 

How can CBD help with fibromyalgia?

 

While the study of this area is not exhaustive, there is hope.

Particularly impressive was a survey of 2014 published in the National Pain Report. In this study, the medically prescribed drugs were compared with self-medication with cannabis or CBD. 62% assessed the self-medication as significantly more effective than the prescribed drugs. Unfortunately, the survey does not distinguish between marijuana and THC-free CBD.

Further considerations are in the direction of attaching to the endocannabinoid system in certain diseases, including fibromyalgia, among them are a migraine, and irritable bowel syndrome. Particularly prominent in these syndromes/disorders is an increased pain sensation and a general central sensitization. Research suggests that the cause could be an endocannabinoid deficiency. The endocannabinoid system is the interaction of endocannabinoids with cannabinoids and others

Receptors as well as the enzymes and mechanisms necessary for the synthesis and degradation of endocannabinoids. The endocannabinoid system is involved in far more body-specific processes than was initially assumed.

There were functions in the control of food intake, motor skills, memory and memory performance, pain relief, in inflammatory processes and various

Metabolic processes. Fibromyalgia is considered as a central sensitization state with secondary elevated pain sensations in these considerations.

Cannabinoids have similar ability as the endocannabinoids to block spinal, peripheral and gastrointestinal mechanisms, which promote pain in headaches, fibromyalgia, IBS, and related diseases. The evidence of these theories needs more research, however, there are studies that support this theory in some areas as they provide data for the evidence of diminished pain, improved sleep.For example, a meta-analysis from 2011 on chronic non-cancer pain (neuropathic pain, fibromyalgia, rheumatoid arthritis and mixed chronic pain) confirmed that 15 trials showed significant analgesic effects of cannabinoids compared to placebo and several reported significant improvements in sleep. There were no serious side effects. However, there are also missing information on TCH free interventions.

A further study from the same year in 56 patients also demonstrates the successful application of CBD against the pain in fibromyalgia.The efficacy of CBD with respect to irritable bowel syndromes has been demonstrated, here the neuroimmune axis is indicated by treatment with CBD. Inflammation is significantly reduced.While polymorphisms of the 5 HT receptor are at least in the context of certain also psychological symptoms of fibromyalgia, CBD shows effects on Ht, too. Unfortunately, with regard to the pure use of the THC-free CBD in studies, it must be said that the possibility of a significant improvement in the quality of life contrasts with a relatively poor study situation, in particular with regards to dosages, so that the use of CBD in fibromyalgia is not yet acknowledged. The responsibility remains, as is often, the responsibility of the suffering patient.

 

https://www.klinikum.uni-heidelberg.de/fileadmin/pressestelle/pressemappen/Chronische_Schmerzen__Aktiv-Sein_hilft/11a__Leitlinien_Fibromyalgie.pdf

https://www.rehaclinic.ch/wp-content/uploads/smf-01554.pdf

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http://nationalpainreport.com/marijuana-rated-most-effective-for-treating-fibromyalgia-8823638.html

http://nationalpainreport.com/marijuana-rated-most-effective-for-treating-fibromyalgia-8823638.html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3243008/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3080871/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3232190/

https://ipv6.fhsu.edu/uploadedFiles/academic/college_of_arts_and_sciences/psych/JPI/Vol%2018%20(2).pdf#page=6

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https://link.springer.com/article/10.1007/s11064-005-6978-1

Neuroendocrinology Letters Volume 29 No. 2 2008

Clinical Endocannabinoid Deficiency (CECD):  Can this Concept Explain Therapeutic Benefits of Cannabis in Migraine, Fibromyalgia, Irritable Bowel Syndrome and other Treatment-Resistant Conditions? Ethan B. Russo

http://hss.ulb.uni-bonn.de/2008/1611/1611.pdf