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Cannabis and Cannabinoid Therapies for Headache

Shown effective for treatment of pain, Cannabis may have benefits for patients with headache, but more research is still needed.

Niushen Zhang, MD

Introduction

As legalization of marijuana has increased, so too has systematic and controlled research into medicinal uses for marijuana. The National Academies of Sciences, Engineering, and Medicine published a statement in 2017 that reported there is conclusive or substantial evidence to support the treatment of chronic pain, in adults, with Cannabis or cannabinoids. 1 There is still, however, a lack of prospective studies about Cannabis and cannabinoid treatments for headache. 2 Harnessing the medicinal potential of Cannabis for the treatment of headache is promising and requires understanding the biology, physiology, existing clinical evidence, and potential risks of Cannabis and cannabinoid treatments for headache.

Definitions of Terms

The term marijuana can be confusing (Table 1); it is primarily defined as any Cannabis plant that contains more than 0.3% delta 9 -tetrahydrocannabinol (Δ 9 -THC). 3-7 Each species of Cannabis has a unique biochemical composition, or cannabinoid profile, of varying amounts of more than 400 compounds. Delta 9 -tetrahydrocannabinol is the most common psychoactive cannabinoid and the major difference between species is often the relative amount of Δ 9 -THC vs cannabidiol (CBD); however, species with similar Δ 9 -THC to CBD ratio can still have markedly different effects. For example, C. indica and C. sativa have similar Δ 9 -THC to CBD ratios, but C. indica is known for having a calming effect, and C. sativa is known for having an energizing effect. 6

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Epidemiology, Availability, and Access

It is estimated that there are 183 million (3.8% of the global population) annual users of Cannabis, which has remained stable in recent years. In the US, however, there has been a notable increase in Cannabis use between 2007 and 2015, with an annual prevalence of 13.5% of the population over age 12 years. The number of people who use Cannabis daily or nearly daily almost doubled (1.9% in 2002 to 3.5% in 2015) and is the major driver of the increase in use in the US. 8

Cannabis use remains federally prohibited in the US, although only 3 states (Idaho, Nebraska, and South Dakota) have restrictions on all Cannabis and Cannabis-derived products. Most states allow medical marijuana use under certain circumstances. In 10 states and the District of Columbia, Cannabis is also legal for recreational use. 9 In 37 states, CBD derived from hemp is legal because of the 2018 Farm Bill, but specific state laws vary. 7 Cannabis products sold at dispensaries do not undergo the rigorous requirements of traditional pharmaceutical development. The Food and Drug Administration (FDA) has approved 3 cannabinoids. Dronabinol and nabilone are synthetic cannabinoids (containing synthetic Δ 9 -THC) approved to treat medically refractory nausea and vomiting associated with cancer chemotherapy. Dronabinol is approved for treating anorexia and weight loss in persons with AIDS. 10 The third is derived from the plant in conditions that ensure a consistent dose of CBD, which is approved for treatment of seizures associated with Lennox-Gastaut syndrome and Dravet syndrome. A June 2018 press release from the FDA noted, “This is the first FDA-approved drug that contains a purified drug substance derived from marijuana.” 11 Medical marijuana is being researched for treatment of many other neurologic conditions.

The Endocannabinoid System

Cannabis is promising for headache treatment because it affects the cannabinoid system in the brain, which plays a role in pain processing (Figure). In animal models, cannabinoid 1 (CB1) receptor activation has been implicated in reducing neuropathic, visceral, and inflammatory pain. 12,13 Both CBD and Δ 9 -THC are exogenous cannabinoids; there are also endogenous cannabinoids, the most studied of which are anandamide (AEA) and 2-arachidonoylglycerol. These endocannabinoids are only present in small amounts in the brain and are synthesized and released on demand and have presynaptic effects (Figure B). 4 The CB1 receptor is expressed less in the brainstem, which may account for low risk of respiratory depression in overdose. Cannabinoids interact with the cannabinoid 2 (CB2) receptor, primarily found in the immune system. 14 Agonists of CB1 receptors also release dopamine in the nucleus accumbens, where it plays a role in pain processing. 12 Cannabinoid central effects include short-term memory impairment, disruption of psychomotor control, appetite stimulation, antiemetic effects, and antinociceptive effects. 15

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Figure. Both exogenous and endogenous cannabinoids exert central effects through the CB1 receptor, expressed abundantly on presynaptic neurons in the cerebral cortex, hippocampus, hypothalamus, amygdala, basal ganglia, and cerebellum (A). Presynaptic CB1 receptor activation inhibits neurotransmitter release (GABA, glutamate, acetylcholine, noradrenaline) resulting in disinhibition of inhibitory input (B). Abbreviations: 2-AG, 2-arachidonoylglycerol; AEA, anandamide; CB1, cannabinoid receptor 1; CB2, cannabinoid receptor 2; CBD, cannabidiol; THC, delta 9 -tetrahydrocannabinol.

Cannabis and Cannabinoid Headache Treatments

Cluster Headache

The hypothalamus is thought to be the region of activation in cluster headache and other trigeminal autonomic cephalalgias, and there is a dense concentration of CB1 receptors in the hypothalamus, 4,16 suggesting Cannabis and cannabinoid treatments could hold potential for future cluster headache treatments; however, research is limited. There are few studies on the use of Cannabis and cannabinoid therapies for treating cluster headache. In a case study, a patient with chronic cluster headache had symptom relief within 5 minutes of inhaling marijuana and 15 minutes after taking 5 mg of dronabinol orally. 16 A survey study of 139 patients with cluster headache found that 45.3% had history of Cannabis use, and 19.4% had tried Cannabis to treat cluster headache. Only 25.9% of self-reported users had relief after inhaling Cannabis. 17

Intracranial Hypertension

In individuals with brain injury, intracranial pressure (ICP) is expected to rise in the 12 hours after head trauma. Several studies have shown that cannabinoids may reduce ICP in traumatic brain injury (TBI). 19,20 Cannabinoids are also thought to have a neuroprotective role after TBI. 19 In a prospective, randomized, double-blind, placebo-controlled, multicenter trial, intravenous dexanabinol—a synthetic, nonpsychotropic cannabinoid—was safe and well tolerated in 67 patients with severe head injury and resulted in improved ICP/cerebral perfusion pressure control without jeopardizing blood pressure. Mean ICP values in those treated with dexanabinol increased significantly less than with placebo, suggesting dexanabinol prevents rise in ICP, possibly by inhibiting the spread of edema. 20

Idiopathic intracranial hypertension (pseudotumor cerebri) also presents with increased ICP and can be difficult to treat. In a case report, a woman with medically refractory pseudotumor cerebri had complete resolution of headache within 5 minutes of smoking marijuana once a week, without recurrence that day. Cannabis may not be the best treatment choice for individuals with pseudotumor cerebri who are overweight, however, because of appetite-stimulating effects. 21

Migraine

The number of patients asking about the use of Cannabis for treatment of headache is increasing, especially for treatment of migraine. Even 30 years ago, a survey study showed participants were commonly using Cannabis to self-treat migraine. 22 In a 2018 electronic survey study on patterns of medicinal Cannabis use among persons with a variety of illnesses, including chronic pain, headache, and migraine, 24.9% (505 of 2,032 participants) used Cannabis to treat headache. Across all individuals with pain, hybrid Cannabis strains were preferred; specifically, the most preferred strain was “OG Shark.” The most common methods of use were vaporizing and smoking. 5

There is a a single abstract presented from a double-blind, placebo-controlled study that suggests cannabinoids can be suitable for prophylaxis of chronic migraine and acute treatment of cluster headache in patients with a history of migraine. 29 In a case series of 3 persons with chronic headache, relief of symptoms occurred after smoking Cannabis similar to that seen after taking ergotamine and aspirin. 30 In a different series of 3 individuals, migraine attacks occurred after abruptly stopping long-term daily marijuana use. 22 A 2002 survey of 2,480 participants from the Oakland Cannabis Buyers’ club found that 5% of patients used Cannabis to treat migraine. 31

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Medication Overuse Headache

Prevalence of medication overuse headache (MOH) is 1% to 2%; prevalence at tertiary headache centers is estimated at 30% to 50% of patients. 33 Persons with MOH often do not respond to prophylactic treatment in the setting of ongoing medication overuse. Tapering and discontinuing medication overuse is integral to the treatment of MOH but can be challenging because of the initial increase in pain and other withdrawal side effects. In the first and only randomized double-blind active-controlled crossover study investigating efficacy of the synthetic cannabinoid nabilone (a CB1 receptor agonist) in 26 individuals with long-standing intractable medication overuse headache, nabilone was more effective than ibuprofen at reducing pain intensity and daily analgesic intake (P < .05). 34

Cannabinoids hold promise for reducing opioid use as well. Over 50% of emergency department visits for migraine result in treatment with opioids, despite this treatment not being recommended for treatment of any primary headache disorder. 35 There is strong preclinical data indicating that coadministration of cannabinoids and opioids may result in reduced opioid doses without loss of analgesic efficacy. 36 There is, however, still a lack of prospective, controlled clinical trials and conflicting evidence. Some data suggest that medical marijuana use may reduce opioid prescriptions for patients with pain 37,38 ; however, other data suggest Cannabis use may increase the risk of developing an opioid-use disorder. 39

Adverse Effects

The safety of Cannabis and cannabinoid treatments is a concern because of the heterogeneity of unregulated products on the market. Individuals usually access these products without the guidance and recommendation of a physician. It is important to consider the ratio between Δ 9 -THC and CBD, because most of the known adverse effects of Cannabis can be attributed to Δ 9 -THC. 40

Commonly known side effects of Cannabis often come from studies that primarily evaluated recreational users and cannot be assumed to be universal; therefore, it is important to correlate Cannabis side effects to specific phytocannabinoids, phytocannabinoid ratios, sterility of growing conditions, contaminations with pesticides, fungal and bacterial microbes, dosing, and patient characteristics. 6 Until more strict product regulations are enforced, it is essential to educate patients on potential adverse effects. Neurologic side effects of Cannabis and cannabinoid treatments are shown in Table 2. 4 Whether or not long-term Cannabis use can lead to more permanent cognitive deficits is controversial and requires more research. 4,41 Rare side effects include reversible cerebral vasoconstriction syndrome (RCVS), which could be triggered potentially by daily use of marijuana. 42,43 Dependency occurs in 9% of marijuana users (compared to 32% in tobacco users and 23% in heroin users). 6 Cannabinoid hyperemesis syndrome (CHS) is thought to be a variant of cyclic vomiting syndrome secondary to chronic Cannabis use for which discontinuing use is the only assured cure. Other potential treatments include antipsychotics, benzodiazepines, and possibly topical capsaicin. 44 Precaution should be taken, or use avoided, in persons with a history of substance abuse, concurrent usage of other sedative or hypnotic medications, and psychiatric disease (specifically schizophrenia and patients with mood disorders). 6

8 Best CBD Oils for High Blood Pressure

This article contains affiliate links to products. We may receive a commission for purchases made through these links.

High blood pressure, or hypertension, is a serious medical condition that can lead to heart disease, stroke, and other health problems. If you have high blood pressure, it’s important to take steps to lower your blood pressure and improve your health.

One way to do this is by using CBD oil. CBD oil has been shown to help lower blood pressure and improve heart health. Here are the eight best CBD oils for high blood pressure.

7. Charlotte’s Web

High blood pressure can be debilitating to live with. It puts unnecessary strain on the heart and the body’s other muscles. This often leads to stiffening of the arteries, which can lead to heart attack or stroke if not addressed immediately. Fortunately, CBD oil comes in to save the day.

What is high blood pressure?

High blood pressure is a type of chronic medical condition in which the force of blood pumping through your arteries is too high. This puts an excess burden on your heart and increases the risk for various health problems.

What are the symptoms of high blood pressure?

The most common symptoms may include:

● Frequent, sharp chest pain that may extend to your neck, jaw, back or stomach.

● Shortness of breath

● Nausea and vomiting

● Heart palpitations (feel like your heart is skipping beats)

You may also experience pain in your arms or legs when resting or exercising. This is a sign of other serious medical problems and should be checked by a doctor as soon as possible.

The cause of high blood pressure is usually unknown and can include:

● High salt intake or other conditions that increase sodium retention in your body, such as kidney disease or hormonal problems like Cushing’s syndrome.

● Stress and anxiety

● Lack of exercise and a sedentary lifestyle

● Smoking and alcohol use

● Family history of hypertension

How is high blood pressure diagnosed?

High blood pressure can be diagnosed with an at-home blood pressure test that you can do yourself. These are inexpensive and easy to use, but it’s important to remember that this is just a quick tool to help you figure out if you should talk to a doctor. If your blood pressure is high, it’s important to have yourself checked by a professional as soon as possible.

What is CBD?

CBD is an abbreviation for cannabidiol, a compound found in marijuana plants along with its psychoactive counterpart, THC. CBD oils are popularly utilized by medical patients for several purposes, one of which is helping reduce blood pressure levels naturally through its natural effects on the body.

What are CBD’s Effects on Blood Pressure?

CBD acts as a vasodilator. This basically means that it works to expand the diameter of arteries, allowing the heart to work less while still maintaining an appropriate blood pressure level.

What does CBD oil do to your blood pressure?

CBD, when consumed in the form of oils or tinctures with high concentrations, works directly on the endocannabinoid system (ECS). The ECS is responsible for regulating blood pressure levels.

When CBD enters the body, it stimulates CB-1 cannabinoid receptors which are found throughout the body. This stimulates vasodilation, allowing for more blood flow and circulation, lowering high blood pressure levels.

Is CBD Oil Safe?

CBD is considered completely safe to use with no negative side effects by most users of the product. However, only buy from a reputable brand and make sure you consume it in small doses prior to using it. This way you can monitor your body’s reaction to CBD, spotting anything unusual for future reference.

When should I take CBD oil to lower my blood pressure?

You can use CBD oil safely at any time to help control your blood pressure. However, it’s recommended that you opt for this method of treatment only if the other options available, such as over-the-counter medication or prescription drugs, have proven ineffective or caused complications during treatment.

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If you are currently taking medication for high blood pressure, consult with your doctor before using CBD oil as a replacement treatment or in conjunction with medication.

You can opt to use CBD oils sublingually by applying them under the tongue. This allows your body to absorb CBD faster and more easily than if you were to consume it.

In what forms can I take CBD Oil?

CBD oil is available in a variety of different product forms, some of which include:

Tinctures

These come in small bottles and are usually mixed with glycerin or alcohol before being applied under the tongue using a dropper for faster absorption into the body.

Creams

These are often used on top of skin irritations and are applied directly to the skin for fast absorption. These topical CBD oil creams aren’t useful for high blood pressure, as the problem is internal. Topical CBD creams help with surface or nerve level pain and ailments easier than other methods of CBD oil.

Suppositories

These are often used by people who have problems swallowing pills or wish to avoid an unpleasant taste while taking CBD oil orally. These tend to be more effective on a cellular level, therefore allowing them to work faster against blood pressure disorders.

How much CBD oil should I take to regulate my blood pressure levels?

The answer will depend on a variety of factors including your weight and the severity of your high blood pressure. These factors, combined with the type and concentration of CBD you’re using, will determine how much CBD oil is needed for you to see results.

It’s best to start with a smaller dose, then gradually increase it over time until you see the desired effects or are satisfied with what works best for your body’s needs.

The Criteria We Used to Determine The 8 Best CBD Oils for High Blood Pressure

Just to help you understand how we concluded that these are the best CBD oils for high blood pressure, we wanted to share what criteria we considered for this list:

Is the CBD Oil from a trustworthy manufacturer?

Popular brands that have been in business for a while have proven themselves to be reliable and trustworthy. These manufacturers take great care when sourcing their products, creating safe and beautiful packaging, and strictly testing all of their products before going on sale.

Are the CBD oils lab tested?

Any CBD oils we recommend on this list will be lab tested and third-party verified to ensure the highest quality CBD oils available. This means you can rest easy knowing that what you’re using is safe for your body and manufactured responsibly, without any harmful chemicals or toxins that could cause harm in the long run.

Are high standards of the CBD Oil Manufacturer enforced?

To ensure the highest quality CBD oils on the market, manufacturers must adhere to strict criteria that is enforced by independent laboratories. This includes testing for any contaminants or toxins that could be harmful for human health and operating responsibly according to state regulations.

Are the CBD oils free of any unwanted ingredients or substances?

CBD oils that are manufactured responsibly will be completely free of additives and allergens. We also considered what type of concentration was available for each product. This is because different concentrations can work differently depending on the person using them and the intended purpose.

We wanted to be sure that the CBD oils on this list are high quality and reliable, so we made sure to include companies that have earned trust in the industry by providing safe products.

How well will it work for my intended purpose?

Each product may vary depending on what you’re wanting to use them for. For example, if you’re wanting to use CBD oil for pain or to lower your blood pressure, then it’s best to find a concentration that works well with the condition you’re attempting to treat.

How does the taste of the product compare to other CBD oils?

As each person has different tastes in what they enjoy using, one thing you should consider is if the CBD oil tastes good before purchasing it. Some CBD oils may be more potent than others and also may taste more like you’d expect it to, such as an earthy taste which is more common with hemp-based products.

Do they have a money back guarantee?

To ensure that customers are getting high-quality CBD oil, manufacturers should offer a guarantee that’s easy to follow. Whether it involves returning the product or getting your money back, you can trust that these companies will do what they can to ensure your satisfaction.

8 Best CBD Oils for High Blood Pressure

Choosing the best CBD oil for high blood pressure may not be as easy as one would like. There are many different brands out there, all boasting their own unique benefits and claims.

We’ve taken the time to do the research for you and provide you with this list of high-quality CBD oils that can help lower blood pressure levels without any negative effects.

1. Penguin CBD

Image courtesy Penguin CBD

Looking for a CBD oil that is grown and made in the USA? Look no further than Penguin CBD. Their oil is extracted from Oregon-grown hemp, making it a safe and reliable choice. Plus, their broad-spectrum extract ensures you get all the possible benefits of CBD.

2. Everest

Image courtesy Everest.

Achieve the ultimate summit of CBD satisfaction with Everest. Their full-spectrum CBD oil is rich in terpenes and cannabinoids, providing a well-rounded experience and relief from a variety of conditions. Whether you’re a beginner or an experienced mountaineer, their CBD oil will take you to new heights.

3. Verma Farms

Image courtesy Verma Farms

Looking for a pure and organic CBD brand? Look no further than Verma Farms. Our cannabis plants are grown without pesticides or GMOs, and all of our formulas are THC-free and non-toxic. Whether you’re looking for oils, creams, gummies, or capsules, Verma Farms has you covered.

4. R+R Medicinals

R+R Medicinals is quickly becoming one of the most trusted and popular CBD brands by proving one thing – they make the CBD that works. Using supercritical CO2 extraction on their proprietary Cherry strain of USDA Certified Organic hemp, they yield an unparalleled profile of cannabinoids, terpenes, and other phytonutrients in their products that translate into guaranteed performance. Their 1000mg Fresh Mint Tincture is their best seller and of incredible value for a Full-Spectrum product at $46.99. R+R boasts impressive levels of CBD, CBG, CBC, CBN, CBL, and more in their products so you can truly feel the entourage effect. They also publish third party certificates of analysis on their site for every batch they make. In addition to being USDA Organic Certified, they are also US Hemp Authority Certified, and they have hundreds of 5-star ratings on Google, so you can take comfort in knowing they do things with the highest standards of safety and quality in mind.

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5.Spruce

Image courtesy Spruce

Add Spruce CBD to your daily routine for a more balanced life. This pure, organic CBD oil is lab-grade and helps support the health of both you and your furry friend. With no added flavors, this oil is perfect for those who want the therapeutic benefits of CBD with nothing else getting in the way.

6.Joy Organics

Image courtesy Joy Organics

Are you looking for a CBD oil that is high in quality and potency? Look no further than Joy Organics. Their products are organic and lab-grade, and they strive for no-frills, just quality. If you’re looking for an unflavored or peppermint CBD oil, Joy Organics is the perfect choice.

7.Charlotte’s Web

Image courtesy Charlotte’s Web

Charlotte’s Web offers a variety of potencies to find the perfect CBD oil for you. Whether you’re new to CBD or have experience, they have a product that will work for you. Gummies and capsules provide 10-25 mg per serving while topicals range from 100-750 mg per container.

8.Aspen Green

Image courtesy Aspen Green

Looking for an intense high? Aspen Green has you covered with their powerful full-spectrum products. Flavorful and potent, these products are sure to give you the lift you need. Whether you’re looking for discontinued items or reformulated strains, Aspen Green is the place to go.

What does the research say about CBD oils for high blood pressure?

CBD has been known to reduce stress and anxiety, which plays a huge role in high blood pressure. Research has also proven CBD to be an anti-inflammatory agent, which makes it the perfect treatment for hypertension.

In fact, evidence suggests that CBD may even help with cholesterol reduction and atherosclerosis!

How do I use CBD oil for high blood pressure?

There are a number of ways you can take CBD oils depending on what works best for you. They can be taken orally, sublingually, or even through aromatherapy.

What are the side effects of CBD oils for high blood pressure?

Since CBD is a natural and organic product, there aren’t many, if any, side effects. A small percentage of people experience drowsiness or tiredness after taking CBD oil which can be remedied by taking another dose before bed or moving to a lower potency.

What should I consider before taking CBD oils for high blood pressure?

If you are considering adding CBD oil to your daily routine to help treat high blood pressure, it is important to consult with your primary care physician first. CBD is still relatively new to the market, so it’s important to make sure it will not interact with any medications you are currently taking.

Additionally, start with a low dosage of CBD oil and increase gradually until you find the amount that works best for you. Some people experience a “high” feeling with full-spectrum CBD oils, so it’s important to start slowly until you know how the oil will affect you.

Why Buy CBD Oils Online?

There are many reasons why buying CBD oils online is beneficial compared to buying in-person.

First, you don’t have to drive around town looking for the best CBD oils on the market. Instead, just hop online and do some research to find what works best for you.

Additionally, you can easily compare prices and shop around to find the right CBD oil for you. All in all, shopping online is a great option when it comes to buying CBD oils because it allows the freedom to shop without salespeople being too pushy, or someone seeing you venture inside those shops that sell CBD oils for high blood pressure.

Why is CBD Oil good for high blood pressure?

CBD oil is a promising new treatment for high blood pressure. So far, the research shows that it can be effective in some people and not others – but we’re still waiting on more studies before making any official conclusions about its usefulness!

In order to help reduce your high blood pressure, it’s important to start a CBD oil regimen as well as make diet and lifestyle changes. Although everyone is different, a good starting dosage for most is around 10mg-50mg and you can slowly increase the dosage until you find what works best for you.

Here are some conclusions that research has come to regarding the use of CBD oils for high blood pressure:

● CBD has been shown to help reduce blood pressure in mice.

● CBD oils can be used to treat anxiety, which is a huge contributor to high blood pressure.

● CBD oils are anti-inflammatory, which means they can help hypertension by reducing inflammation.

Other Things You Should Know About High Blood Pressure:

High blood pressure is a common disorder that affects around 1 in 3 adults. When you have high blood pressure, your heart is working too hard and your arteries are under too much strain from the additional pressure which can lead to issues like heart attack, stroke, kidney damage, or blindness.

There are many risk factors for high blood pressure such as family history, obesity, tobacco use, lack of physical activity, and high sodium intake.

It’s important to manage these risk factors in order to reduce your chance of developing hypertension or worsening your blood pressure if you already have it.

Fortunately, with the help of CBD oils for high blood pressure along with making healthy lifestyle changes – you can live a longer and better life!

What are the best CBD oils for high blood pressure?

Purchasing CBD oils online is an excellent way to find whatever benefits you most. We put together a list of our favorites based on what current research has found, which is that full-spectrum CBD oil is most effective at treating high blood pressure.

8 Best CBD Oils for High Blood Pressure

7. Charlotte’s Web

How to effectively use CBD oils for high blood pressure?

Any CBD oils that are full-spectrum will be your best bet because they contain the most cannabinoids and terpenes: things like THC, caryophyllene, and limonene.

Start with a low dosage of around 10 mg and slowly increase to find what works best for you. Everyone is different and it’s important to take into account all other medications you’re taking, your weight, age, gender, and current health.

Some people experience an “entourage effect” which means the cannabinoids work better together than they do on their own. You can take CBD oils orally or apply them topically. For high blood pressure, it is typically dosed as 10 mg-50 mg orally or topically twice a day.

CBD oil is a promising new treatment for high blood pressure. So far, the research shows that it can be effective in some people and not others. As always, discuss this option of using CBD oils for high blood pressure with your doctor before buying any of the best CBD oils for high blood pressure on our list.

Lastly, in order to help reduce your high blood pressure, it’s important to start a CBD oil regimen as well as make diet and lifestyle changes. Although everyone is different, a good starting dosage for most is around 10 mg-50 mg and you can slowly increase the dosage until you find what works best for you.