CBD Oil for Arthritis

Tim McComsey
July 9, 2019

According to the Arthritis Foundation, approximately 54 million adults and 300,000 children in the United States have been diagnosed with Arthritis or some other type of rheumatic disease-causing joint pain.  The Arthritis Foundation suggests that the actual number is closer to 91.2 million in total if you consider all the individuals who have arthritis but have not yet been diagnosed. This number is expected to increase to 49 percent by the year 2040.  The most unwarranted and incapacitating symptoms suffered by arthritis patients include stiffness, pain, and reduced movement within the joints, all of which can be severe and deteriorate over time. Furthermore, there are other symptoms that are just as wearisome, such as anxiety and depression which can especially be trying when you are struggling with other medical complications that tend to co-occur with arthritis, like heart disease, diabetes, and obesity.  Some medications and treatment programs can potentially help negate these effects, but many individuals are searching for a more natural pain relief solution. This is where CBD Oil has been an option for non-traditional means to address pain relief.  A review concluded that CBD products were generally recommended as a trial to help add to and possibly augment current pain treatment for patients.

What is CBD Oil?

CBD is short for cannabidiol, which is one of more than 80 chemical cannabinoids found in the marijuana plant Cannabis sativa. Thus, cannabis oil, or CBD Oil as it is more commonly known, is an oil that is developed using this particular compound.

Although CBD oil is just now becoming mainstream, largely because of the debates surrounding medical marijuana, cannabis has a long history of providing relief in many different countries around the world.

Before getting into the various uses of CBD Oil, it is important to differentiate between FDA approved indications and unapproved indications. FDA approved indications are medical uses that are accepted by the FDA. For this to happen, there are multiple phases of testing that drugs must complete before being approved. First, drugs go through pre-clinical trials in animals or cell cultures to determine if it may work in humans. Next, they go through Phase 1 which is done in a small group of healthy people to determine safety and dosages. Then, it goes through Phase 2 testing in a larger group of people with the disease they want to treat to test for efficacy and possible side effects. This is followed by Phase 3 testing in an even larger group of people with the disease to test for efficacy again and monitor any side effects. When it passes all of these phases to prove safety and efficacy, the drug gets approved by the FDA and goes on to Phase 4 testing. This is monitoring that is done by health-care professionals. If patients have side effects or reactions to drugs, health-care professionals report these to programs like MedWatch. If drugs get too many complaints, they can be taken off the market. As for unapproved indications, these are reasons why people take drugs even if it is not the official use for them.

As of right now, there are a limited number of FDA approved uses of CBD Oil. The most famous use is for epilepsy or seizures. Epidiolex is the first drug containing a purified  drug substance from marijuana plants that obtained FDA approval.

How Does CBD Oil Work?

According to Medical News Today, the body’s endocannabinoid system has two cannabinoid receptors: CB1 and CB2.  The majority of CB1 receptors are located in the brain and are associated with cognitive actions related to coordination, mood, thinking, memory, and appetite. The CB2 receptors, on the other hand, can be found in the immune system, making them more responsible for the body’s response to pain and inflammation.  CBD Oil impacts the CB2 receptors indirectly, not by attaching to the CB2 receptor, but by enticing the body to make more of its own cannabinoids. This creates a positive effect on the body’s pain and inflammation responses.

How Does CBD Oil Ease Arthritis Pain?

Many studies have been conducted on CBD Oil and preliminary discoveries have found that this compound offers several potential benefits for individuals diagnosed with arthritis.  Some research confirms one of the primary CBD Oil benefits for arthritis sufferers is its positive effect on pain.

One study published in the journal Pain in December 2017 examined whether CBD Oil could prevent osteoarthritis pain and joint neuropathy. Based on their findings, researchers concluded that it did both because it seemed to decrease joint inflammation and seemed to serve as a protectant to the nerves.

Further clinical trials were expanded in a 2018 article from the Journal of Clinical and Experimental Rheumatology. The authors noted that there are currently no randomized controlled trials for the use of CBD Oil for joint pain or arthritis. The only data they could find were from informal surveys and anecdotal evidence which ultimately found significant positive effects reported from participants in these studies. Authors also noted that more formal trials to assess the impact of CBD Oil — and other cannabinoid treatments – performed in Canada and Germany were found to have inadequate data reported based on public perception of cannabis-like products as well as bias against the use of cannabinoid products. Nonetheless, it was ultimately concluded that CBD products were generally recommended as a trial to help add to and possibly augment current treatment for patients.

Does CBD Oil Relieve Anxiety?

Contrary to popular belief, having an anxiety disorder is not the same thing as simply being stressed. Anxiety disorders are something that people struggle with daily and may be brought about from acute or chronic pain.

Anxiety disorders may be due to a variety of causes such as environment, genetics, personality, and even certain medical conditions.  Anxiety disorders are considered one of the most common mental illnesses in the United States.  Although, support of mental health has been increased in recent years, most people still do not share about their anxiety and depression because there is still a stigma around these topics. Additionally, the traditional anti-anxiety medications have several unpleasant side effects that deter patients from taking them. Side effects can include drowsiness, nausea, dry mouth, trouble sleeping, agitation, and sexual dysfunction. As you can see, these can seriously affect an individual’s quality of life.  Therefore, CBD Oil may be a way to offer some decreased anxiety for these patients. It may allow them to potentially change the dosage of these medications.

What Kinds of Anxiety Does CBD Oil Help With?

Research into CBD Oil and anxiety indicate that it may be able to help with several different kinds of anxiety disorders. Since most of this is preclinical data, it means that only animal studies or small studies in humans have been conducted and not full studies on randomized placebo-controlled trials like prescription anxiety medications.

Although, anxiety is one of the few health benefits of CBD Oil that have been studied in humans so far (small studies). Most of the other reported uses have only been in cell culture or animals. The preclinical data supports the possible use of CBD Oil with Generalized Anxiety Disorder (GAD), Social Anxiety Disorder (SAD), Panic Disorder (PD), Obsessive Compulsive Disorder (OCD), and Post Traumatic Stress Disorder (PTSD). But again, further research into these areas are required.

Some studies show that CBD Oil does not cause anxiety at high doses, which is contrary to other anti-anxiety medications. Also, CBD Oil is thought to counteract the anxiety that can be induced by its cousin compound – THC. Therefore, for individuals who can legally use THC, whether it be medically or recreationally, might want to consider adding CBD Oil to their mix if they are prone to experience anxiety or paranoia when using THC.

Is CBD Oil Safe?

Common question individuals have when it comes to CBD Oil for pain management or its anti-inflammatory properties is whether it is safe to use for Arthritis symptoms.

Patients are always concerned with additional potential and side effects.  According to some top health experts and agencies, the answer is yes. It is safe to use.

Cannabidiol (CBD Oil) is a chemical found in the Marijuana plant that does not contain Tetrahydrocannabinol (THC), the psychoactive ingredient that produces a high. From the various research and studies, the consensus among many conclude that CBD Oil is safe.  It is derived from hemp plants in a similar way to how olive oil comes from olives. It belongs to a chemical group called phytocannabinoids that are all chemicals purified from many members of the hemp plant family.

CBD Oil Variations

The manufacturing process involves how to get the CBD Oil into a bottle in a way that works for the customer.  There are many means to consider here.  The manufacturer must consider the viscosity of the product, the health impact of the carrier oils used, and how this choice relates to their core values.  Finally, there is a consideration of the taste.

There are several choices that are often made by the various manufacturers.  Some use Hemp Oil.  Some use MCT (Medium Chain Triglycerides – usually a coconut oil variant) and others use grapeseed oil.  Many are using Hemp Seed Oil. Any “healthy oil” that can be consumed is an option to be used as a carrier oil.

Manufacturers who are trying to adhere to core values related to “natural” products often dilute their CBD Oils in Hemp Oil.  This is obviously a healthy choice in that it contains all the parts of the plant used to make the oil, so there won’t be anything other components than the hemp plant items in it.  These often are not usually the best tasting oils.

Other manufacturers seek to enhance the flavor, and some argue health by utilizing other “healthy” oils.  MCT oil is one that is often chosen. MCT is medium chain triglycerides or medium chain fatty acids. These can come from many sources, but often it comes from coconuts.  It is a subset of coconut oil, and one difference is that it is liquid at room temp (as opposed to whole coconut oil which is solid at room temp).  The argument for using this to dilute the CBD OIL is that the MCT is very healthy and enhances the health effects of CBD Oil.

Another option often used is grapeseed oil.  This also is considered as a healthy alternative.  This oil is high in polyunsaturated fatty acids (PUFAs), especially Omega-6.  According to the American Heart Association, PUFAs can help reduce cholesterol levels and heart disease.  For this reason, some manufacturers utilize this oil to dilute their CBD Oil.

Some manufacturers are choosing other “healthy” oils, such as olive oil, canola oil, flaxseed oil, sesame oil, Hemp Seed Oil, and even walnut oil.  In addition to health, manufacturers are looking at how the diluent oil impact the product performance in terms of putting it into packages and customer experiences using it, particularly in tincture products.

CBD Research

Many people take CBD to help with a variety of health issues. However, it is important to note that these uses have not been researched to the extent that all CBD health benefits have been verified.  The data behind them are mostly preclinical data, specific case studies, or small groups of people. It is also hard to extrapolate this data to the general population because a lot of evidence is from special populations of people, such as children, elderly patients, or immunocompromised patients (meaning they have a disease that affects their immune system such as cancer). There is also a lack of long-term data, meaning that we do not know the effects of CBD when taking it for a while. Therefore, we cannot say that CBD will treat any of these conditions until further research is confirmed.

Some Possible CBD Oil Uses

Some people use CBD Oil to help with a variety of conditions:

  • Anxiety: CBD Oil reduced anxiety that was experimentally induced and reduced anxiety in small group of people with Social Anxiety Disorder.
  • Pain: A review concluded that CBD products were generally recommended as a trial to help add to and possibly augment current pain treatment for patients.
  • Depression: Studies show that CBD has a similar effect on the brain as anti-depressants called SSRIs (selective serotonin reuptake inhibitors).
  • Sleep: Preliminary research suggests CBD may help with insomnia.
  • Bone Health: Pre-clinical data in rats shows CBD may help with healing bone fractures.

Potential Risks of CBD Oil

Many health experts have deemed CBD Oil safe to use, but like with any substance, there does appear to be a few potential risks when it comes to using this extract.

Some studies indicate that CBD Oil can sometimes interact with certain prescription medications, primarily those that are “changed and broken down by the liver.”

These include, but are not limited to common medications such as:

  • ondansetron (Zofran)
  • clozapine (Clozaril, FazaClo)
  • progesterone (Endometrin, Prometrium)
  • testosterone
  • disulfiram (Antabuse)
  • ketamine (Ketalar)
  • phenobarbital (Luminal)
  • omeprazole (Prilosec)
  • lansoprazole (Prevacid)
  • diazepam (Valium)
  • carisoprodol (Soma)
  • ibuprofen (Motrin)
  • celecoxib (Celebrex)
  • amitriptyline (Elavil)
  • warfarin (Coumadin)
  • codeine
  • paroxetine (Paxil)
  • tramadol (Ultram)
  • venlafaxine (Effexor)
  • alprazolam (Xanax)
  • fexofenadine (Allegra)
  • benzodiazepines
  • morphine

Further studies state that there are other “drugs” that can potentially interact with CBD Oil as well, including caffeine and nicotine. However, research has not necessarily supported these claims.

CBD Bioavailability

When utilizing CBD Oil to help ease your arthritis pain, many individuals wonder how much to administer or apply. However, when talking about proper CBD dosing, it’s important to understand bioavailability.

Bioavailability is defined as the “amount of a substance that becomes available to an organism’s body for bioactivity when introduced through ingestion, inhalation, injection, or skin contact.” It is how much of the substance your body can effectively use based on the type and route taken.

In the case of CBD Oil specifically, the intranasal administration of CBD Oil has a bioavailability of 34 to 46 percent. Oral CBD Oil is thought to be as low as 6 percent, regarding significant first pass-metabolism. First-pass metabolism occurs in the gut or the liver and is when some of the drug is destroyed before it can be circulated around the body. Thus, taking CBD Oil in pill form may mean that your body only receives as little as 6 percent of the CBD component.

Another option is to administer the CBD Oil application topically.  It has therapeutic potential for relief of arthritis pain-related behaviors and inflammation without evident side-effects.

Final Thoughts

Overall, CBD Oil dosing is going to vary from person to person. The amount of CBD Oil you need depends on a variety of factors including age, weight, genetics, and other factors. Always talk with a healthcare professional before starting any new CBD products.

So, if you are patient with the trial and error process and follow the popular advice of “start low and go slow”, you will eventually find the right dose that allows you to experience the anti-anxiety benefits of CBD.

Though the data behind CBD Oil is promising and may offer additional help for certain health issues, you should always do your research and talk with health-care professionals before starting any new medications or supplements.

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