Sunday, August 26, 2018

Cannabis and Fibromyalgia






Cannabis and Fibromyalgia




Fibromyalgia is a chronic pain syndrome. A disorder characterized by widespread musculoskeletal pain – accompanied by fatigue, sleep, memory and mood issues, as well as difficulty focusing.

Symptoms may begin after physical trauma, surgery, infection, or significant psychological stress. In other cases, symptoms may gradually accumulate over time with no single triggering event.

Many patients with fibromyalgia may also experience tension headaches, temporomandibular joint disorders, irritable bowel syndrome, interstitial cystitis or painful bladder syndrome, anxiety and depression.

As of this date, there is no known cure for fibromyalgia. Patients are using a variety of medications to control symptoms. Natural remedies including exercise, healthy eating, relaxation and other stress-reduction measures such as yoga or meditation may also help ease discomfort of stress and pain.

Some patients are turning to Cannabis for help. Cannabinoids, found in the cannabis plant, have been known to offer healing therapeutic effects for many suffers. Cannabinoids work with your bodies Endocrine System and deliver relief or support, depending on your health needs.


Cannabis may be suggested as a potential treatment for those with fibromyalgia because it contains compounds that may offer relief from pain and nausea. THC and CBD are the most commonly studied. Some researchers believe that certain people have a deficiency of endocannabinoids in their natural Endocrine System, which is why they are experiencing pain and stomach problems associated with Fibromyalgia, IBS, Depression, Anxiety, Pain, and sometimes more vulnerable to Cancer. Read the article below in “Clinical Endocannabinoid Deficiency Reconsidered” by Ethan Russo, M.D.

THC is a cannabinoid chemical that occurs naturally in the body. It works by stimulating cannabinoid receptors in the brain. This activates the brain's reward system and decreases pain levels.

Unlike THC, CBD is not psychoactive and does not bind to cannabinoid receptors. Therefore, it does not produce the "high" associated with THC. CBD may help with pain however some have found that adding THC helps manage pain better than CBD alone.

Caution must be used when taking Cannabis for pain relief. Through studies it is found that too much cannabis consumption may cause other concerns that outweigh the benefits according to researchers at the University of Alberta Canada:

“A study weighing the risks and benefits of cannabis-based therapies for fibromyalgia has led to University of Alberta researchers developing a guideline to help primary care doctors decide whether to recommend such treatments to their patients.

The team that did the fibromyalgia review concluded that the risk of cannabinoids might outweight the benefits that patients with the disease would receive.

At the moment, the guideline is a proposal. Its creators are seeking feedback on it before coming up with a final version. They published the “Simplified Guideline for Prescribing Medical Cannabinoids in Primary Care” in Canadian Family Physician.

The guideline recommends that, in general, doctors limit their patients’ medical cannabinoid use. But it does suggest that physicians consider the treatment for certain conditions when standard therapies fail.”



Brief History of Medical Marijuana

Cannabis, and many other plants, have been known since the beginning of time, to both humans and animals, to help us heal. It has been used by our ancient ancestors in remedies, tinctures, teas, poltices, and so on. In the US cannabis was well known for healing and aiding certain illnesses and was documented in the US Pharmacopia in the 1850's!
http://antiquecannabisbook.com/Appendix/USP1851.htm

“Medical marijuana was prescribed by doctors until 1942. That's when it was taken off the U.S. pharmacopoeia, the list of commonly available drugs.

"Marijuana has been a medicine for 5,000 years," says Donald I. Abrams, MD. "That's a lot longer than it hasn't been a medicine." Abrams, who is an oncologist and director of clinical research programs at the Osher Center for Integrative Medicine at the UCSF School of Medicine in San Francisco, is one of a handful of top-flight doctors in the country researching medical marijuana. "The war on drugs is really a war on patients," he says.


"Medical marijuana has many uses," Abrams says. "It increases appetite while decreasing nausea and vomiting. It also works against pain and may be synergistic with pain medications, helps people sleep, and improves mood. I think it's a shame that we don't allow people to access that medicine."

Medical marijuana doesn't "cure" disease. But patients worldwide have used it to relieve a variety of symptoms, including:

  • increased intraocular pressure from glaucoma
  • nausea and vomiting from chemotherapy for cancer
  • pain, muscle spasticity, and insomnia from spinal cord injury
  • pain, stiffness, and muscle spasticity from multiple sclerosis
  • weight loss and loss of appetite





Dosing for Fibromyalgia

Because oral products deliver long-lasting relief, they are popular with fibromyalgia patients.

Avoid overmedication, especially for pain, since excessive doses have been shown to increase pain in a University of California study.

If THC and CBD are used together, a ratio of 1:2 is a good starting point, and the initial oral dose should be at the lower range, about 2.5mg/5mg THC:CBD. The doses can be raised over time. Start doses low and go slow when raising dose levels, only when needed.

Remember if you never used cannabis before or smoked THC before it could give some side effects. However, when using both CBD and THC together the side effect of THC will be mitigated. Look for an oil with both THC and CBD. If you can not find one you can either make oil out of cannabis bud, or you may smoke or vape the bud as well.

In case if your confused when searching for a product that may help with symptom relief here is a list to some of the Best Strains for Fibromyalgia from the website Leafly.com. It is important to look for a strain or any product that also contains CBD. The following strains are known as WINNERS, voted for their pain management and sometimes help with sleep.

If smoking, vaporizing or purchasing flower to turn into your own unique product, make sure to note: if it is for sleeping, you’ll want to look for an Indica dominant strain, if you need help functioning throughout the day, you will want to pick a Sativa dominant strain.



Cannabis Strains for Fibromyalgia Pain

There a lot of strains that can treat pain, fight fatigue, reduce depression and anxiety, sharpen focus, and crush insomnia. Consider trying other high-CBD strains, or cannabis in various other forms like edibles, topicals, or ingestible oils such as CBD:THC oil. Everyone’s body is different, so the key is to try different strains and products to see what works best for you.

Blue Dream is known to exhibit high levels of the relaxing terpene myrcene as well as CBG, a cannabinoid known to reduce inflammation and fight insomnia.

Harlequin’s high-CBD content helps curb the psychoactive and anxious side effects of THC, letting you go about your day without that dizzying euphoria that some unaccustomed users find distracting or unpleasant.

Cannatonic is the third most celebrated strain from Leafly.com users with fibromyalgia. It’s only mildly psychoactive due to its CBD dominance, making it an excellent choice for new users. However, even veterans will appreciate this hybrid’s ability to crush pain, anxiety, muscle spasms, and a myriad of other symptoms.

Critical Mass is a heavy indica strain whose tingly full-body effects radiate throughout the body, swiftly bowling down pain and stress. This strain sometimes expresses itself with enhanced levels of CBD for even better pain relief. Also preferred for treating depression, insomnia, and muscle spasms.

This is the strain you’ll need for when your fibromyalgia symptoms are keeping you up at night. Tranquilizing and dreamy, Tahoe OG is an indica-dominant strain that leads muscles into blissful relaxation, melting the pain and tension out of them.

More strains and info can be found at:




All this may be confusing. If you are not into purchasing flower products, I highly recommend looking for creams or oils which contain both CBD and THC.  They can be applied to the skin and absorbed to provide relief for pain in certain areas.

Mary’s Medicinals makes a Muscle Freeze that many users have been raving about. They also carry a CBD Transdermal Patch. You can find great Mary’s Medicinal Products here: https://marysmedicinals.com/products-properties/





Videos on Cannabis for Fibromyalgia

Sometimes it helps just to hear what others are saying about Cannabis for relief from Fibromyalgia pain. We love to share this information with others, if you like one of these videos please share it on your social media with friends and family who may suffer from Fibromyalgia and could use some good resources

Cannabis for the Treatment of Fibromyalgia


Cannabis and Fibromyalgia by: Hemp 4 Power!


Does CBD work for Fibromyalgia?


Medical Marijuana helps Fibromyalgia


Fibromyalgia and Cannabis: Sherry Cooper MO 2009





Scientific Research for Cannabis and Fibromyalgia

Here are some Scientific Research Data to back up our Patients Stories. We gathered this information through the website: ProjectCBD.org which is well known for delivering great research papers about the therapeutic use of cannabis.



Clinical endocannabinoid deficiency (CECD): Can this concept explain therapeutic benefits of cannabis in migraine, fibromyalgia, irritable bowel syndrome and other treatment-resistant conditions?


This study examines the concept of clinical endocannabinoid deficiency (CECD), and the prospect that it could underlie the pathophysiology of migraine, fibromyalgia, irritable bowel syndrome, and other functional conditions alleviated by clinical cannabis.

Available literature was reviewed, and literature searches pursued via the National Library of Medicine database and other resources.

Migraine has numerous relationships to endocannabinoid function. Anandamide (AEA) potentiates 5-HT1A and inhibits 5-HT2A receptors supporting therapeutic efficacy in acute and preventive migraine treatment. Cannabinoids also demonstrate dopamine-blocking and anti-inflammatory effects. AEA is tonically active in the periaqueductal gray matter, a migraine generator. THC modulates glutamatergic neurotransmission via NMDA receptors. Fibromyalgia is now conceived as a central sensitization state with secondary hyperalgesia. Cannabinoids have similarly demonstrated the ability to block spinal, peripheral and gastrointestinal mechanisms that promote pain in headache, fibromyalgia, IBS and related disorders. The past and potential clinical utility of cannabis-based medicines in their treatment is discussed, as are further suggestions for experimental investigation of CECD via CSF examination and neuro-imaging.

Migraine, fibromyalgia, IBS and related conditions display common clinical, biochemical and pathophysiological patterns that suggest an underlying clinical endocannabinoid deficiency that may be suitably treated with cannabinoid medicines.




Cannabis use in patients with fibromyalgia: effect on symptoms relief and health-related quality of life.


The aim of this study was to describe the patterns of cannabis use and the associated benefits reported by patients with fibromyalgia (FM) who were consumers of this drug. In addition, the quality of life of FM patients who consumed cannabis was compared with FM subjects who were not cannabis users.

Information on medicinal cannabis use was recorded on a specific questionnaire as well as perceived benefits of cannabis on a range of symptoms using standard 100-mm visual analogue scales (VAS). Cannabis users and non-users completed the Fibromyalgia Impact Questionnaire (FIQ), the Pittsburgh Sleep Quality Index (PSQI) and the Short Form 36 Health Survey (SF-36).

Twenty-eight FM patients who were cannabis users and 28 non-users were included in the study. Demographics and clinical variables were similar in both groups. Cannabis users referred different duration of drug consumption; the route of administration was smoking (54%), oral (46%) and combined (43%). The amount and frequency of cannabis use were also different among patients. After 2 hours of cannabis use, VAS scores showed a statistically significant (p<0.001) reduction of pain and stiffness, enhancement of relaxation, and an increase in somnolence and feeling of well being. The mental health component summary score of the SF-36 was significantly higher (p<0.05) in cannabis users than in non-users. No significant differences were found in the other SF-36 domains, in the FIQ and the PSQI.

The use of cannabis was associated with beneficial effects on some FM symptoms. Further studies on the usefulness of cannabinoids in FM patients as well as cannabinoid system involvement in the pathophysiology of this condition are warranted.




Cannabinoids for Fibromyalgia


This review is one of a series on drugs used to treat fibromyalgia. Fibromyalgia is a clinically well-defined chronic condition of unknown aetiology characterised by chronic widespread pain that often co-exists with sleep problems and fatigue affecting approximately 2% of the general population. People often report high disability levels and poor health-related quality of life (HRQoL). Drug therapy focuses on reducing key symptoms and disability, and improving HRQoL. Cannabis has been used for millennia to reduce pain and other somatic and psychological symptoms.

OBJECTIVES: To assess the efficacy, tolerability and safety of cannabinoids for fibromyalgia symptoms in adults. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE to April 2016, together with reference lists of retrieved papers and reviews, three clinical trial registries, and contact with trial authors. We selected randomised controlled trials of at least four weeks' duration of any formulation of cannabis products used for the treatment of adults with fibromyalgia.

Two review authors independently extracted the data of all included studies and assessed risk of bias. We resolved discrepancies by discussion. We performed analysis using three tiers of evidence. First tier evidence was derived from data meeting current best standards and subject to minimal risk of bias (outcome equivalent to substantial pain intensity reduction, intention-to-treat analysis without imputation for drop-outs; at least 200 participants in the comparison, eight to 12 weeks' duration, parallel design), second tier evidence from data that did not meet one or more of these criteria and were considered at some risk of bias but with adequate numbers (i.e. data from at least 200 participants) in the comparison, and third tier evidence from data involving small numbers of participants that were considered very likely to be biased or used outcomes of limited clinical utility, or both. We assessed the evidence using GRADE (Grading of Recommendations Assessment, Development and Evaluation).

We included two studies with 72 participants. Overall, the two studies were at moderate risk of bias. The evidence was derived from group mean data and completer analysis (very low quality evidence overall). We rated the quality of all outcomes according to GRADE as very low due to indirectness, imprecision and potential reporting bias. The primary outcomes in our review were participant-reported pain relief of 50% or greater, Patient Global Impression of Change (PGIC) much or very much improved, withdrawal due to adverse events (tolerability) and serious adverse events (safety). Nabilone was compared to placebo and to amitriptyline in one study each. Study sizes were 32 and 40 participants. One study used a cross-over design and one used a parallel group design; study duration was four or six weeks. Both studies used nabilone, a synthetic cannabinoid, with a bedtime dosage of 1 mg/day. No study reported the proportion of participants experiencing at least 30% or 50% pain relief or who were very much improved. No study provided first or second tier (high to moderate quality) evidence for an outcome of efficacy, tolerability and safety. Third tier (very low quality) evidence indicated greater reduction of pain and limitations of HRQoL compared to placebo in one study. There were no significant differences to placebo noted for fatigue and depression (very low quality evidence). Third tier evidence indicated better effects of nabilone on sleep than amitriptyline (very low quality evidence). There were no significant differences between the two drugs noted for pain, mood and HRQoL (very low quality evidence). More participants dropped out due to adverse events in the nabilone groups (4/52 participants) than in the control groups (1/20 in placebo and 0/32 in amitriptyline group). The most frequent adverse events were dizziness, nausea, dry mouth and drowsiness (six participants with nabilone). Neither study reported serious adverse events during the period of both studies. We planned to create a GRADE 'Summary of findings' table, but due to the scarcity of data we were unable to do this. We found no relevant study with herbal cannabis, plant-based cannabinoids or synthetic cannabinoids other than nabilone in fibromyalgia.

We found no convincing, unbiased, high quality evidence suggesting that nabilone is of value in treating people with fibromyalgia. The tolerability of nabilone was low in people with fibromyalgia.






CBD For Fibromyalgia and Opioid Withdrawal

A patient testimonial from a 72-year-old Oregon resident who has been weaning herself off opioids with the help of CBD-rich cannabis.

“I wanted to relay the experience I’m having with CBD aiding opiate withdrawal. I am a 72-year-old woman. A doctor put me on fentanyl patches about 10 years ago, after trying various painkillers for my intense fibromyalgia pain. They did not notify me how difficult, if not impossible, it would be to get off of them. I use the generic Mylan brand, which can be cut down without deleterious effects. Several times over the years I have attempted to taper down, but even cutting off the tiniest sliver of the patch resulted in intense withdrawal symptoms, so I gave up.

In the last year I had started making an olive oil tincture from a couple of high-CBD/low-THC strains I was growing for my dogs. Then I started using the tincture on myself. I have also since started juicing the leaves. A few months ago I decided to try and taper off of the patch again and, to my enormous surprise, there were NO withdrawal symptoms at all. I was able to cut out 5 mcg at a time. I’ve been cutting down more each week. When I started this process, I was taking 150 mcg. Now I’m about two weeks away from being at just 100 mcg. So far, I’ve had no increase in fibromyalgia pain, and no withdrawal symptoms.

I’ve been using about 40-50 mg a day of CBD in the form of the olive oil tincture. I grew ACDC and another a strain high in CBD and low THC. I took the flowers and decarboxylated them in olive oil for a few hours at a sufficiently low temperature. The final product comes out around 12 mg of CBD per ml. I also use a vaporizer with the AC/DC flowers that I grew. I’ve found that both vaporizing and using the tincture to be very effective for any pain. In the evening it contributes to a good night’s sleep.

In the last week or so since I have also been juicing cannabis, I’ve noticed a difference in the way I feel. I’ve had far more energy and no fibromyalgia aches in the evening. My fibromyalgia flares are much shorter. It will be interesting to see how things go in the future, as I continue to juice cannabis and use my tincture.

I estimate that I’ve been cutting off 3-5 mcg each week of the patches. I may try to cut off larger pieces now that I’m taking cannabis juice, and see what happens. After hearing that fentanyl is harder to get off of than heroin, it’s been pretty amazing.

I hope the efficacy of CBD in aiding opiate withdrawal becomes more commonly known. It’s truly incredible.”




Clinical Endocannabinoid Deficiency Reconsidered

Dr. Ethan Russo examines recent science on migraine, fibromyalgia, irritable bowel and other treatment-resistant syndromes that may respond to cannabinoid therapies.

By Ethan Russo, M.D. On August 02, 2016

Medicine continues to struggle in its approaches to numerous common subjective pain syndromes that lack objective signs and remain treatment resistant. Foremost among these are migraine, fibromyalgia, and irritable bowel syndrome, disorders that may overlap in their affected populations and whose sufferers have all endured the stigma of a psychosomatic label, as well as the failure of endless pharmacotherapeutic interventions with substandard benefit. The commonality in symptomatology in these conditions displaying hyperalgesia and central sensitization with possible common underlying pathophysiology suggests that a clinical endocannabinoid deficiency might characterize their origin. Its base hypothesis is that all humans have an underlying endocannabinoid tone that is a reflection of levels of the endocannabinoids, anandamide (arachidonylethanolamide), and 2-arachidonoylglycerol, their production, metabolism, and the relative abundance and state of cannabinoid receptors. Its theory is that in certain conditions, whether congenital or acquired, endocannabinoid tone becomes deficient and productive of pathophysiological syndromes. When first proposed in 2001 and subsequently, this theory was based on genetic overlap and comorbidity, patterns of symptomatology that could be mediated by the endocannabinoid system (ECS), and the fact that exogenous cannabinoid treatment frequently provided symptomatic benefit. However, objective proof and formal clinical trial data were lacking. Currently, however, statistically significant differences in cerebrospinal fluid anandamide levels have been documented in migraineurs, and advanced imaging studies have demonstrated ECS hypofunction in post-traumatic stress disorder. Additional studies have provided a firmer foundation for the theory, while clinical data have also produced evidence for decreased pain, improved sleep, and other benefits to cannabinoid treatment and adjunctive lifestyle approaches affecting the ECS.













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