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How much cbd oil is recommended for arthritis

CBD For Rheumatoid Arthritis

Kimberly is a health and wellness writer with 8 years of experience in healthcare and a special passion for mental health awareness.

Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more.

Scott J. Zashin, MD, specializes in the treatment of rheumatologic and musculoskeletal conditions using both traditional and alternative therapies.

As cannabidiol (CBD) has grown in popularity over the years, major organizations like the Arthritis Foundation have released guidelines pertaining to its use in the treatment of rheumatoid arthritis (RA). CBD is a non-psychoactive component of cannabis. The CBD in most products is extracted from hemp, a variety of cannabis that only has traces (up to 0.3%) of THC, the active compound that gets people high. Studies have shown CBD can help reduce chronic pain by impacting endocannabinoid receptor activity, which may also reduce inflammation.

CBD comes in different forms, including oil, vape, edible, and topical. Oils, vapes, and edibles are taken orally, while topical CBD lotions can be applied to the skin. CBD dosage varies depending on the form, the indication, and other treatments being used.

What Is Rheumatoid Arthritis?

RA is an autoimmune inflammatory disease, in which the immune system attacks healthy cells in the body and causes inflammation. RA commonly affects joints in the hands, wrists, and knees, causing the joint lining to become inflamed and damaging the tissue. This causes chronic joint pain and leads to deformity. RA can also affect other tissues throughout the body, such as the lungs, heart, and eyes.

Vera Livchak / Getty Images

Health Benefits of CBD for RA

Animal studies have suggested that CBD has pain-relieving and anti-inflammatory properties, but these effects have not been validated with quality studies in humans. Anecdotally, some people who have tried CBD for treatment of arthritis symptoms report noticeable pain relief, improved sleep improvement, and reduced anxiety.

The trials that have been conducted in humans have not yielded strong evidence for the use of CBD in managing arthritic pain.

  • A randomized trial of topical CBD for treatment of knee osteoarthritis lasted only 12 weeks, and results were mixed.
  • One of the largest reviews examining the health effects of cannabis and CBD concluded that there is substantial evidence that cannabis is an effective treatment for chronic pain in adults. There was, however, no specific conclusion regarding CBD, as definitive studies were not available.
  • More recently, a new study showed that CBD can potentially help alleviate RA pain and inflammation by acting on immune cells that are attacking healthy cells in the body. It’s important to note that this study was also not conducted with human subjects.

Research in this area is ongoing.

If you are interested in trying CBD for RA pain management, be sure to talk to your healthcare provider first before using any CBD products.

Rising Popularity of CBD for RA

Based on a 2019 national survey of 2,600 people conducted by the Arthritis Foundation, 79% of respondents said they were using CBD, have used it in the past, or were considering using it to help with their arthritis pain.

Health Benefits Related to Arthritis

Given the lack of strong scientific evidence supporting the use of CBD, it is not recommended as the first choice for pain relief in RA.

If you have RA, you should not stop taking your prescribed medications that may be protecting your joints from future damage. You should discuss any changes you want to make to your medication regimen with your healthcare provider.

Additional Health Benefits

The strongest scientific evidence for effectiveness of CBD as a medical treatment is for seizure prevention in Dravet syndrome and Lennox-Gastaut syndrome, which are severe childhood epilepsy disorders that typically don’t respond to antiseizure medications. Several years ago, the FDA approved the first cannabis-derived medicine for these conditions, Epidiolex, which contains CBD.

Other potential health benefits of CBD include:

  • Reduce anxiety, insomnia, and depression
  • Relieve cancer or cancer treatment symptoms
  • Clear acne
  • Slow the progress of neurologic disease like Alzheimer’s disease

Possible Side Effects

Treatment with CBD should be started slowly and under the supervision of a healthcare provider, who will oversee its effectiveness and side effects. There have been reports of mild side effects of CBD.

The most common side effects include:

It’s important to note that CBD may interact with other drugs, including some of the medications that are prescribed for the treatment of RA.

Warnings and Interactions

There are some warnings and adverse drug interactions to be aware of before beginning using CBD for management of RA-associated pain.

Warnings

Do not stop taking any other treatments without consulting your healthcare provider. Additionally, CBD shouldn’t be a replacement for other therapies you are using.

Pregnant people and children should consult a healthcare provider before using CBD since there isn’t enough research on the effects of CBD on these populations. There has been concern about a possible link between inhaled cannabis and lower-birthweight babies, but it’s not clear if this applies to CBD.

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Currently, the U.S. Food and Drug Administration (FDA) does not regulate the safety and purity of CBD products, so you cannot know for sure that the product you buy has active ingredients at the dose listed on the label. The product may contain other unknown elements. The most effective therapeutic dose of CBD for any particular medical condition has not been established.

Are CBD Products Legal?

CBD products derived from hemp are no longer considered schedule I drugs under the federal Controlled Substances Act, but they still remain in a legal gray zone.   There are changes underway on federal and state levels that will ultimately clarify the laws and regulations related to CBD-based products and sales. Despite that, they’re widely available in nearly every state and online. People who want to use CBD should check their own state laws.

Interactions

Studies have found moderate interactions between CBD and medications commonly prescribed for treating RA.

Interactions can occur with these medications:

CBD can increase your level of coumadin, a blood thinner.

CBD may also raise levels of other medications in your blood by the same mechanism that grapefruit juice does.

Medications that interact with grapefruit juice can potentially interact with CBD, including:

  • Cholesterol medications
  • High blood pressure medications
  • Organ-rejection medications
  • Anti-anxiety medications
  • Corticosteroids
  • Heart medications
  • Some antihistamines

Preparation and Dosage

If you’ve decided to try CBD for treating your RA pain, the next step is figuring out how much to take.

Your dosage depends on a number of factors:

  • Body weight
  • Medical indication
  • The concentration and form of CBD that you’re taking

You will likely need to start with a low dose and find what works for you. Studies have found extreme differences in dosages, with some people using 5 milligrams (mg) and others as much as 600 mg.

Your healthcare provider may direct you to start with 20-40 mg per day and increase slowly each day until you feel the relief you’re looking for.

To ensure that you are using CBD safely and effectively for pain management, you should:

  • Choose an oral treatment (rather than inhaled products) and start with a low dose
  • Establish initial goals of treatment within a realistic period of time. For example, a reduction in knee pain that allows you to walk around the block within two weeks of starting treatment; later, if improved, the goals can be adjusted
  • Tell your healthcare provider(s) about your planned and current CBD treatment; monitor your pain and adjust medications with your medical providers, rather than with non-medical practitioners
  • When preparing to take a liquid form, be aware that the CBD extract is mixed with a carrier oil, so there are two measures to know: the amount of the liquid product to take (the dose) and the amount of CBD in each dose

If CBD alone doesn’t work and you are in a state where medical or recreational marijuana is legal, you could consider talking to your healthcare provider about taking CBD with a very low-dose THC product. Be aware that even at low levels, THC may make you feel high, resulting in cognitive, motor, and balance impairment.

If you experience any unwanted side effects when using a CBD product, immediately discontinue use and inform your healthcare provider.

What To Look For

Look for the following when choosing a CBD product:

  • Look for products manufactured in the United States with ingredients grown domestically
  • Choose products made by companies that follow good manufacturing practices established by the FDA for pharmaceuticals or dietary supplements or required by the state where they are manufactured
  • Buy from companies that test each batch and provide a certificate of analysis from an independent lab that uses validated standardized testing methods approved by the American Herbal Pharmacopoeia (AHP), the U.S. Pharmacopeia (USP), or the Association of Official Agricultural Chemists (AOAC)
  • Avoid companies that claim their products have disease benefits
  • Be aware that marketers and people behind retail counters are not health professionals. Your healthcare provider is your best source for guidance and monitoring when using an unregulated product

A Word From Verywell

CBD may sound like an appealing option for pain relief, but do your due diligence before jumping on the bandwagon. A lot of people say CBD can help reduce pain and inflammation for those with RA, but not a lot of strong scientific data have substantiated that claim. That said, serious effects are not commonly associated with CBD use.

If this is something you are interested in, you can work with your healthcare provider to figure out whether CBD is something you can try safely. Remember that CBD should not be used as a first-line treatment for RA pain and that it’s not advisable to stop taking disease-modifying treatments for RA.

Using CBD for Arthritis: Tips for How to Get Started

Enthusiasts of cannabidiol (better known as CBD) rave about the substance’s health benefits. Some small studies have shown that CBD could be a remedy for anxiety and help children with post-traumatic stress disorder get to sleep. The substance was even FDA-approved last year as a prescription drug to manage rare, severe forms of epilepsy.

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So naturally, you might be wondering: Can CBD help people with arthritis and related diseases cope with pain? Anecdotal reports from patients and some preliminary research suggests yes, but the science is still emerging and more research is needed.

Here’s what you need to know right now about how to use CBD to ease arthritis symptoms, how to find a high-quality CBD product, and how to work with your doctor to incorporate CBD into your arthritis treatment plan.

What Is CBD, and Can It Help with Arthritis?

CBD is a chemical found derived from hemp. Hemp and marijuana are both types of cannabis plants, but they are very different from each other. They each have different quantities of various phytocannabinoids, which are substances naturally found in the cannabis plant. (It’s sort of like how different kinds of berries contain different combinations of antioxidants.)

  • Marijuana contains an abundance of THC (tetrahydrocannabinol), which is the cannabinoid that gets you high.
  • Hemp contains less than 0.3 percent THC. It contains CBD, which is a cannabinoid that doesn’t have any psychoactive effects. CBD cannot make you feel high. Instead, CBD works in other ways with your endocannabinoid system, which is a group of receptors in the body that are affected by the dozens of other documented cannabinoids.

“Cannabinoids can inhibit or excite the release of neurotransmitters [brain chemicals] and play a role in modulating the body’s natural inflammatory response, which are the two things we’re concerned about when talking about CBD for arthritis,” says Hervé Damas,MD, a Miami-based physician and founder of Grassroots Herbals, a CBD product company.

CBD is thought to work on pain in two parts of the body: the site of soreness (such as your finger joints) and the central nervous system, which sends pain signals to the brain when it detects certain stimulation or damage to nerves and cells.

The ability for CBD to calm that response is one reason the compound might be a viable pain remedy for people with arthritis. Another is CBD’s anti-inflammatory properties. Inflammation occurs when your body is fighting a perceived infection. In autoimmune diseases such as rheumatoid arthritis, the immune system is attacking healthy parts of your body like your joints.

It’s important to note that while early research on animals has shown promise for CBD, more research is needed before we can draw anything conclusive for humans. However, anecdotal reports from people who have started incorporating CBD into their arthritis treatment are positive. One CreakyJoints member shared on Facebook that topical CBD “helps better than any other ointment I’ve ever used.” CBD could be worth exploring as a potential solution to pain as part of an overall arthritis treatment plan.

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With more and more people using marijuana and CBD to treat chronic pain, it is now more important than ever to have research-backed information and advice. Subscribe to CreakyJoints (it’s free) and we’ll notify you when opportunities to participate in CBD and medical marijuana research become available in your area, for your condition.

How to Find the Right CBD Product for You

From supermarkets and pharmacies to health food stores and online retailers, CBD can be found just about everywhere. But how do you choose the right CBD product for your health needs?

1. Pick the CBD Formulation You Want to Use

CBD comes in a few different forms. Commonly used ones include:

  • Edibles: You eat CBD infused into gummies, chocolates, sodas, baked goods, and other edible items
  • Vaporizer: You inhale CBD through a vape pen that heats up the oil
  • Sublingual drops: You take a few drops under your tongue of a high-concentrate solution of CBD
  • Topicals: You apply creams, lotions, balms and other products with CBD directly to your skin

The different types of CBD take effect in your body at different rates. Here’s how long you can expect different types of CBD products to kick in, according to Dr. Damas:

  • Edibles: 30 minutes to two hours
  • Vaporizer: Two minutes
  • Sublingual drops: 15-30 minutes
  • Topicals: 10 minutes

2. Look for Signs of High-Quality CBD

Don’t just buy the least expensive one on the shelf. There are lots of poor-quality CBD products on the market (some of which don’t contain the amount of CBD they claim, per these FDA warning letters).

Dr. Damas recommends looking for CBD products that are made in the United States, use a carbon dioxide-based extraction method (“It’s the cleanest,” he says), come from organically grown hemp, and don’t contain a lot of extra ingredients. Consumer Reports also has a thorough guide to shopping for CBD that can help you find a high-quality product.

3. Pick the Right Dose

As for dosing of CBD oil, the jury’s still out on just how much you should take. Start with a low dose (such as 5 to 10 mg), and gradually work your way up over a few weeks until you notice the effects.

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“Usually people find pain relief when they take 20 to 35 milligrams of CBD daily,” says Dr. Damas.

You can take the full dose at once or break it up throughout the day. Experiment with what makes you feel best. You should start seeing improvements shortly after you start supplementing with CBD, with more noticeable effects kicking in after two weeks.

How to Discuss CBD with Your Doctor

You should talk to the doctor who treats your arthritis before you start taking CBD or any other supplement. They can let you know if CBD might interact with any medications you currently take or potentially worsen a chronic condition. For example, “CBD may make it easier to bleed,” says Dr. Damas. “So if you’re going to have surgery, you might want to stop taking it before the procedure.”

Check out this list of potential drug interactions with CBD from the U.S. National Library of Medicine, but you should always check with your doctor about your individual case.

Keep in mind that your doctor’s knowledge of CBD might be limited. There isn’t a lot of research about the benefits of CBD or about ideal dosages or formulations, so your doctor might not be able to be overly specific in terms of their recommendations. However, they still need to know that you’re taking CBD. Chances are, they’ll be interested in hearing about your experience using CBD products and your self-reports on how CBD may be helping to manage your pain or other symptoms.

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CreakyJoints is a digital community for millions of arthritis patients and caregivers worldwide who seek education, support, advocacy, and patient-centered research. We present patients through our popular social media channels, our website CreakyJoints.org, and the 50-State Network, which includes nearly 1,500 trained volunteer patient, caregiver and healthcare activists.

About CreakyJoints

CreakyJoints is a digital community for millions of arthritis patients and caregivers worldwide who seek education, support, advocacy, and patient-centered research. We represent patients through our popular social media channels, our website CreakyJoints.org, and the 50-State Network, which includes nearly 1,500 trained volunteer patient, caregiver and healthcare activists.

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The contents of this website are for informational purposes only and do not constitute medical advice.CreakyJoints.org is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a physician or other qualified health provider with any questions you may have regarding a medical condition.
~ Copyright © 1999 – 2022 CreakyJoints. All rights reserved. Part of the Global Healthy Living Foundation, a 501(c)(3) non-profit organization. ~
La información contenida en el sitio web de CreakyJoints Español se proporciona únicamente con fines de información general. CreakyJoints no brinda consejos médicos ni se dedica a la práctica de la medicina. La organización no recomienda bajo ninguna circunstancia ningún tratamiento en particular para individuos específicos y, en todos los casos, recomienda que consulte a su médico o centro de tratamiento local antes de continuar con cualquier tratamiento.
~ Copyright © 1999 – 2022 CreakyJoints. Reservados todos los derechos. Parte de Global Healthy Living Foundation, una organización sin fines de lucro 501 (c) (3). ~
Le contenu de ce site Web est à titre informatif uniquement et ne constitue pas un avis médical. CreakyJoints.org n’est pas destiné à se substituer à un avis médical professionnel, à un diagnostic ou à un traitement. Demandez toujours l’avis d’un médecin ou d’un autre professionnel de la santé qualifié pour toute question que vous pourriez avoir concernant une condition médicale.
~ Copyright © 1999 – 2022 CreakyJoints. Tous les droits sont réservés. Membre de la Global Healthy Living Foundation, une organisation à but non lucratif 501 (c) (3). ~

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