Imagine a life constantly in pain. Throw in some extreme tiredness, plus feeling like your whole body is on fire, and that is a roundabout description of fibromyalgia. Not surprisingly many sufferers also experience low mood, depression and anxiety as their once active lives become a living hell. More often than not the cocktail of drugs prescribed fail to keep symptoms in check and are accompanied by hard to bear side effects. So increasingly, many fibromyalgia patients are turning to medical cannabis, in particular CBD.
Fibromyalgia a mysterious, modern disease
Twenty years fibromyalgia was almost unheard of, but now it’s the most common diagnosis in American rheumatology practices affecting roughly 10 million people in the US alone. The disease is more prevalent in women, although why, nobody really knows. Nor is it clear why fibromyalgia comes on in the first place. A link between stress has been suggested, but hasn’t been proven. So on the whole the condition remains a mystery, with the medical profession rather fumbling around in the dark.
A common consensus is that fibromyalgia patients share an oversensitivity to pain, because of increased sensory processing. Many also suffer from other conditions such as migraines, IBS and chronic fatigue. So, while getting a fibromyalgia diagnosis is not exactly a death sentence, it could be considered more like life imprisonment, with the odds of early release fairly low.
CBD – creating a stir in fibromyalgia forums
But enter any fibromyalgia forum and one natural therapy is causing quite a stir. CBD, otherwise known as Cannabidiol, is generating a lot of attention, with some patients saying they’ve managed to come off all their meds thanks to the non-psychoactive cannabinoid.
Reducing pain and inflammation are two of the more accepted therapeutic benefits of CBD, but to really get to grips with why CBD is causing such as ripple of excitement, we must look towards the body’s endocannabinoid system, the homeostatic regulator that keeps us in balance.
Can a deficient endocannabinoid system explain fibromyalgia?
The endocannabinoid system (ECS) is a complex network of receptors and cannabis-like chemicals that when functioning optimally regulate sleep, pain and inflammation, appetite, our immune system, mood, and reproduction. It’s been likened to a dimmer switch, upregulating and downregulating the body’s biological activity in order maintain equilibrium and health.
As with other systems in the body, our ECS doesn’t always operate like a well oiled machine. Researchers have observed both excessive and depleted endocannabinoids levels associated with certain pathologies. Although in the case of increased endocannabinoid activity, it isn’t always clear whether it is the cause of a disease or the body acting to heal itself.
But it’s a theory called ‘Clinical Endocannabinoid Deficiency’ that’s being posited as a possible explanation for many difficult to explain illnesses such as fibromyalgia. Developed by neurologist and psychopharmacology researcher Dr Ethan Russo, he suggests that in the same way that other diseases like Parkinson’s and Alzheimer’s are attributed to neurotransmitter deficiencies, so a lack of sufficient endocannabinoids can also cause certain clinical disorders with ‘predictable clinical features’.
In an interview with Project CBD Russo says, “it occurred to me that a number of very common diseases seem to fit a pattern that would be consistent with an endocannabinoid deficiency, especially these are migraine, irritable bowel syndrome, and fibromyalgia. They have some things in common. They’re all hyper-algesic syndromes, meaning that there seems to be pain out of proportion to what should be going on.”
Testing endocannabinoid levels – not so easy
While the symptoms of fibromyalgia patients seem to fit Russo’s endocannabinoid hypothesis, one study published in Psychoneuroendocrinology found that fibromyalgia patients actually had higher plasma levels of the endocannabinoid anandamide, as well as the stress hormone norepinephrine.
One obvious method to test the veracity of the Endocannabinoid Deficiency theory in Fibromyalgia would be to check patients’ endocannabinoid levels. However, right now the process is fairly invasive involving lumbar punctures or taking tissue samples. Plus, because endocannabinoids are produced locally and broken down rapidly in the body, getting an overall reading of endocannabinoid levels is next to impossible.
What does research tell us?
This does not take away from the growing body of evidence, both anecdotal and scientific, to suggest that phytocannabinoids found in the cannabis plant do have a therapeutic effect on symptoms of fibromyalgia. One questionnaire based study published in 2011 compared the experiences of fibromyalgia patients who were regular cannabis users with those who didn’t use the plant. The study found “a statistically significant reduction of pain and stiffness, enhancement of relaxation, and an increase in somnolence and feeling of well being.”
A further survey from the National Pain Foundation which interviewed over 1,300 fibromyalgia patients, found that “medical marijuana is far more effective at treating symptoms of fibromyalgia than any of the three prescription drugs approved by the Food and Drug Administration to treat the disorder,” with 62% of patients who’d tried cannabis saying it was effective at treating their symptoms.
In a scientific paper published in the British Journal of clinical Pharmacology entitled “Cannabinoids for treatment of chronic non-cancer pain; a systematic review of randomized trials,” the authors found that “fifteen of the eighteen trials that met the inclusion criteria demonstrated a significant analgesic effect of cannabinoid as compared with placebo and several reported significant improvements in sleep.”
A further randomized, double-blind, placebo-controlled trial testing the use of the synthetic THC drug Nabilone on 40 fibromyalgia patients concluded that “Nabilone appears to be a beneficial, well-tolerated treatment option for fibromyalgia patients, with significant benefits in pain relief and functional improvement.”
What fibromyalgia patients say about CBD
But what about patients who do not live in a country where medical cannabis is legal or fibromyalgia a qualifying condition? Many are finding relief from taking the non-psychoactive cannabinoid Cannabidiol, otherwise known as CBD.
Fibromyalgia blogger Donna Gregory shares her experience of trying CBD. “When I received my oil, I used it sublingually every 6-8 hours. I was surprised by what happened over the next 24 hours. After my third dose of CBD oil I noticed the pain in my lower extremities greatly reduced. I continued putting the drops under my tongue for the next week and as I did so, it relieved the majority of my pain. I have other fibro friends who report similar results.”
Jo Allen, a British former intensive care nurse who now has to use a wheelchair for anything more than short distances, has found CBD to work on subtler level. “CBD has definitely helped,” says Jo. “I’m now off my sleeping tablets. It helped me through withdrawals from Oxynorm and has since helped me reduce them significantly. It is a gentle effect and it’s only when you look back you can say ohh right yes that is better.”
Time for more research into CBD and fibromyalgia?
It is surprising then despite the amount of anecdotal accounts reporting CBD’s effectiveness for improving fibromyalgia symptoms, that so far only randomised clinical trials using THC based drugs have been conducted. Surely it is time to officially prove once and for all what many patients have found through personal experience: that cannabis oil abundant in CBD can effectively reduce fibromyalgia pain, with the added benefit of allowing patients to cut down on potentially harmful and addictive opioid based medication.
If you are a fibromyalgia sufferer and have used CBD, we would love to know about your experience. Please share your story in the comments section below.