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Use of cbd oil in reatment for arthrythis

Does CBD Oil Help With RA?

People with rheumatoid arthritis and other pain conditions are trying cannabinoids to alleviate their symptoms. Here’s what you need to know.

There was a time in Ron Lev’s life when the pain from his rheumatoid arthritis (RA) was so bad that he felt like nothing could help him.

“You just sit still because it’s too painful to stand,” says Lev, 44. “Everything you can imagine doing is painful. Even eating is painful. Driving a car, opening a door, turning the ignition.”

After decades of treating his RA with biologic drugs and steroids, Lev was on the verge of accepting the pain as his “new normal.” However, he’d heard of other people with the condition using cannabinoids (CBD) to alleviate their pain and, four years ago, he decided to give it a try, too.

“At that time, I’d been on steroids for 23 years,” he says. Some of the long-term side effects he’d experienced from the medication included thinned skin, bloating, and weight gain, among others. “I tried unsuccessfully to wean off the steroids, but the pain was so bad… that I just kept using them.”

Within months of starting on cannabinoids, with guidance and direction from his rheumatologist, Lev not only weaned himself off the steroids, he was also able to spread out his biologic infusions from every couple of months to every 6 months. Now, he only gets infusions once a year.

After seeing the tremendous pain relief CBD offered him personally, Lev started his own CBD company, Reclaim Labs, in 2018.

Stories like Lev’s are becoming more and more common among people with RA and other autoimmune disorders. According to a 2019 poll from the Arthritis Foundation, 29 percent of people with arthritis report currently using CBD — mainly in liquid or topical form — while nearly 80 percent were either using CBD, had used it in the past, or were thinking about using it.

There’s also growing scientific evidence, including a study published in September 2020 in the journal Cell Disease & Death, that cannabinoids can alleviate pain from RA and act as an effective anti-inflammatory agent, with few, if any, side effects — unlike anti-inflammatory drugs such as steroids or biologics options.

“We’re seeing more organized and well-done research on the benefits of cannabinoids and CBD when treating RA,” explains Anca Askanase, MD, a rheumatologist and associate professor of medicine and director of rheumatology clinical trials at Columbia University Medical Center in New York City. “As a culture we’ve embraced both medicinal and recreational use of marijuana, and we’re seeing that it does help alleviate pain, especially with RA patients.”

Research on CBD in RA Needed

Positive news aside, Dr. Askanase cautions that more studies doesn’t necessarily mean enough studies.

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“We’re going about things backwards — it’s been approved before we have all the research there to support it,” she says. “My biggest concern is that we need to understand and use cannabinoids in a more organized and mindful way as opposed to just saying, ‘It’s legal, it sounds like it works, just take some.’”

One reason for the hesitation on the part of Askanase and her fellow rheumatologists is that while cannabinoids may significantly reduce pain and inflammation, they can also trigger other side effects when smoked. For example, people who have RA can have a greater risk of developing lung and heart issues, which can be exacerbated by smoking marijuana, according to the Centers for Disease Control and Prevention.

Another concern, says Askanase, is the potential addictive nature of the drug. “We’ve learned that most of the things that act on the brain like cannabinoids do have some addictive potential,” she explains. “This is something that needs to be further researched.”

The Truth About CBD Oil and RA

Still, there’s no denying that despite the lack of research, people with RA report that CBD has significantly lessened their pain.

A survey published in November 2019 in the Journal of Psychoactive Drugs found that, of the respondents taking legalized cannabis for pain relief, 80 percent described it as “very or extremely helpful.” Among respondents taking over-the-counter pain medications, 82 percent reported reducing or stopping use of those medications. Among respondents taking opioid analgesics, 88 percent reported reducing or stopping use of those medications.

“I tried for years to stop taking steroids and it’s incredibly difficult to do,” explains Lev. “CBD is the only thing that has helped get me off steroids and relieve my pain.”

Additionally, there’s research that shows cannabis has a powerful anti-inflammatory effect, which can help address the inflammation behind RA. According to a review published in May 2019 by the journal Current Opinion in Rheumatology, researchers have found that “cannabinoids show anti-inflammatory effects by activating cannabinoid type 2 receptors, which decrease cytokine production” (cytokines are proteins known to be involved in inflammation).

The authors concluded that cannabis may be a suitable option for treating RA.

While Askanase is among a growing number of rheumatologists who are interested in seeing more research on CBD in RA, she also cautions that it shouldn’t be used as a stand-alone treatment.

“We need to very clearly make an effort to say that cannabinoids are supplementary interventions but should not replace the traditional disease-modifying therapies we currently have available,” she explains. If you’re considering using CBD as a complementary treatment option, she says, you should seek out medical marijuana dispensaries, which have some medical supervision and control over the products and the amount being used.

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Complementary treatments and arthritis – from turmeric to cannabis oil

People use complementary medicine for many different reasons, including:

  • wanting to use more natural treatments
  • their symptoms aren’t fully controlled by conventional medicine.

Read more about complementary therapies which can help to ease the symptoms of arthritis, from yoga to meditation.

Are they right for me?

As with all complementary treatments, different things work for different people and it isn’t possible to predict which might be the most useful or effective.

There are some key points to consider if you’re thinking about using any complementary treatments.

  • What are you hoping to achieve? Pain relief? More energy? Better sleep? Reduction in medication?
  • What are the financial costs?
  • Is there any evidence for their effectiveness?

Are complementary medicines safe?

Complementary medicines are relatively safe, although you should always talk to your doctor before you start any new treatment.

In specific cases they may not be recommended, for example, if you are pregnant or breastfeeding, or they may interact with certain medication.

A starter for five

Here we share a spotlight on the most popular complementary medicines that people call our helpline about.

Turmeric

It’s thought that turmeric can possibly reduce inflammation, which could help people with arthritis.

People with knee osteoarthritis who took part in a research trial reported improvements to their pain levels after taking turmeric. The evidence is limited however, as it is from just one trial. What evidence there is suggested that people only had minor side-effects after taking turmeric.

Turmeric can be bought from health food shops, pharmacies and supermarkets in the form of powder.

Glucosamine

Glucosamine sulphate and glucosamine hydrochloride are nutritional supplements. Animal studies have found that glucosamine can both delay the breakdown of and repair damaged cartilage.

The results for the use of glucosamine for osteoarthritis are mixed and the size of the effect is modest. There’s some evidence that more recent trials and those using higher-quality methods are less likely to show a benefit.

Capsaicin

Capsaicin is taken from chilli peppers. It works mainly by reducing Substance P, a pain transmitter in your nerves. Results from randomised controlled trials assessing its role in treating osteoarthritis suggest that it can be effective in reducing pain and tenderness in affected joints, and it has no major safety problems. Evidence for its effectiveness for fibromyalgia is related to a single trial.

Other names: Axsain®, Zacin®, chilli, pepper gel, cayenne

Capsaicin is licensed in the UK for osteoarthritis and you can get it on prescription in the form of gels, creams and plasters.

There are no major safety concerns in applying capsaicin gel/cream. A review of capsaicin applied to the skin to treat chronic pain (not specifically related to osteoarthritis, rheumatoid arthritis or fibromyalgia) concluded that around one third of people experience a reaction around the area where the treatment is applied. It’s important to keep capsaicin away from your eyes, mouth and open wounds because it will cause irritation. There have been no reported drug interactions.

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Fish oils

Fish oils are rich in omega-3 essential fatty acids, which have strong anti-inflammatory properties. Fish liver oil is also a rich source of vitamin A (a strong antioxidant) and vitamin D (which is important for maintaining healthy joints).

Evidence suggests that fish body oil can improve the symptoms of rheumatoid arthritis. Unconfirmed evidence also suggests a combination of fish body and liver oils might also be useful in the long term, particularly in reducing the use of non-steroidal anti-inflammatory drugs (NSAIDs). There isn’t enough evidence for the use of fish liver oil for osteoarthritis.

Omega-3 fatty acids also play a role in lowering cholesterol and triglyceride levels in your blood, so they can reduce the risk of heart disease and stroke in people with inflammatory arthritis.

In the UK, dietary guidelines recommend eating two portions of fish a week, including one oily. Fish oil is considered to be well tolerated at this dose.

At the correct doses, side-effects are usually minor and uncommon.

Cannabis oil (CBD)

CBD is type of cannabinoid – a natural substance extracted from the cannabis plant and often mixed with an oil (such as coconut or hemp) to create CBD oil. It does not contain the psychoactive compound called tetrahydrocannabidiol (THC) which is associated with the feeling of being ‘high’.

Research in cannabinoids over the years suggests that they can be effective in treating certain types of chronic pain such as pain from nerve injury, but there is currently not enough evidence to support using cannabinoids in reducing musculoskeletal pain. We welcome further research to better understand its impact and are intently following developments internationally.

CBD oil can be legally bought as a food supplement in the UK from heath food shops and some pharmacies. However, CBD products are not licensed as a medicine for use in arthritis by MHRA (Medicines and Healthcare products Regulatory Authority) or approved by NICE (National Institute for Health and Care Excellence) or the SMC (Scottish Medicines consortium).

We know anecdotally from some people with arthritis, that CBD has reduced their symptoms. If you’re considering using CBD to manage the pain of your arthritis, it’s important to remember it cannot replace your current medicines, and it may interact with them, so please do not stop/start taking anything without speaking to a healthcare professional.

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