Yale Medicine doctor investigates whether a synthetically created molecule that mimics properties and effects of CBD could treat diseases. Numerous studies suggest that a dysfunctional endocannabinoid system is involved in autoimmune diseases. Is it possible that CBD, a potent inflammatory and modulator of the immune system, can effectively treat autoimmune conditions? While advancements in science have enabled a greater understanding of our health, getting to the root cause of a chronic disease can be challenging. Autoimmune conditions are an area of medicine that remain largely misunderstood. Presently, there are more than 80 registered autoimmune disorders, affecting various parts of the body. More conditions may also turn out to be
Can Cannabinoids Help Lupus and Other Diseases?
A lupus diagnosis can be devastating. The disease causes the body’s immune system to attack its own tissues and can affect internal organs—including the brain, heart, and lungs—which can start to deteriorate. Lupus flare-ups can leave patients so fatigued and in pain that they’re unable to do the simplest of things, such as walk, cook, or read. Many can’t go outdoors without layers of sunscreen, because the disease can make them extremely susceptible to sunburn.
Lupus affects approximately 240,000 people in the United States, and yet at present doctors neither know the exact cause nor have a cure. Instead, current treatments focus on improving quality of life by controlling symptoms and minimizing flare-ups to reduce risk of organ damage.
“The landscape for treatment of lupus is a bit bleak,” says Fotios Koumpouras, MD, a rheumatologist and director of the Lupus Program at Yale Medicine. “A multitude of drugs have failed in the last 10 to 15 years. Most of the drugs we use are being repurposed from other conditions and are not unique to lupus. Many of them can’t be used during pregnancy, which is a problem because lupus mostly affects young women. All of these issues create the impetus to find new and more effective therapies.”
This is why he’s exploring a candidate for a new lupus treatment option: a molecule with a cannabinoid template structure that binds to cannabinoid receptors, the same receptors involved in the chemicals found in the marijuana plant.
What is CBD?
CBD is a form of cannabinoid called “cannabidiol.” Cannabinoids are a type of chemical that binds to CB1 and CB2 receptors found throughout the body. CB1 receptors are mostly located in the nervous system, connective tissues, gonads, glands, and organs; CB2 receptors are primarily found in the immune system, along with the spleen, liver, heart, kidneys, bones, blood vessels, lymph cells, endocrine glands, and reproductive organs. (Collectively this is called the endocannabinoid system.)
What these cannabinoids do when they bind to the receptors depends on which receptor is activated, and thus can produce effects ranging from the firing of neurotransmitters (the chemical messengers sent from the brain to the rest of the body) that alter mood, to reducing inflammation and promoting digestion.
So, our bodies have their own endocannabinoid system, but cannabinoids can also be found in nature, most abundantly in the marijuana plant. The two most well-known types of cannabinoids in the marijuana plant are THC (tetrahydrocannabinol) and CBD (cannabidiol). THC binds to both the CB1 and CB2 receptors, but the CB1 receptor seems to be responsible for many of the well-known psychoactive effects of marijuana, such as euphoria, increased heart rate, slower reaction times, and red eyes. CB2 receptor binding results in the production of a series of proteins that reduce inflammation. (These proteins are called “resolvins” because they appear to resolve inflammation.) The pharmacology of CBD at cannabinoid receptors is complex and highly variable, but CBD has been shown to activate the endocannabinoid system.
Fotios Koumpouras, MD, is researching a synthetically created cannabinoid molecule that binds preferentially to CB2 receptors (called Lenabasum) to see if it can help ease pain and inflammation in patients with lupus.
Dr. Koumpouras learned from a colleague of ajulemic acid, a side-chain analog of Δ8-THC-11-oic acid, which was designed as a potent therapeutic agent free of the psychotropic adverse effects typical of most cannabinoids. This molecule may help relieve pain and reduce inflammation in systemic lupus erythematosus (SLE), the most common type of lupus. “Reducing inflammation is crucial for patients with lupus because it is what causes the buildup of scar tissue in vital organs that can eventually lead to their deterioration and malfunction,” he says. This cannabinoid molecule was already in study for other diseases, including systemic sclerosis and dermatomyositis.
In 2018, Dr. Koumpouras joined a multi-site randomized clinical trial that aims to recruit 100 participants to examine whether a drug using a synthetically created cannabinoid molecule that binds preferentially to CB2 receptors (called Lenabasum) can help ease pain and inflammation in patients with lupus. Participants will receive Lenabasum or a placebo for almost three months and will continue to be monitored for pain and inflammation levels, as well as lupus disease activity. The study is ongoing, but Dr. Koumpouras anticipates that it will wrap up by early next year.
From “miracle drug” to medicine?
Dr. Koumpouras’ excitement over the new drug comes at a time when products containing CBD have flooded supermarkets, labeled with claims that they treat everything from back pain to insomnia. Although CBD is not yet approved by the FDA, the hype around it stems from the popularity of the marijuana plant it is derived from.
But whether CBD actually provides those benefits in a significant way remains to be seen. Only a few studies—small ones—have definitively proven the effectiveness of medicines that involve the endocannabinoid system. To date, the only FDA-approved medication containing CBD is Epidiolex, a medication used to treat two rare forms of severe epilepsy—Lennox-Gastaut syndrome and Dravet syndrome, both which begin mostly in infancy and early childhood. In a group of three clinical trials, Epidiolex seemed to reduce the number of seizures significantly. And yet, Vinita Knight, MD, a Yale Medicine pediatric neurologist, says her patients who take Epidiolex have had mixed results. Some have had reductions in seizures and others haven’t shown much improvement. “We’re not seeing as much success as what’s been reported on Facebook and Twitter,” she says, but adds that so far it has only been prescribed for children with the most debilitating and difficult-to-treat seizures. In addition, some researchers believe that CBD works most effectively in combination with other cannabinoids and compounds found in the marijuana plant, in what is known as the “entourage effect.” Thus, it would be less effective as an isolated chemical in pill form, but that, too, remains unproven.
But these questions are why Dr. Koumpouras is focusing on a compound that, until recently, few have studied.
His research is one of many new studies at Yale and elsewhere looking at the endocannabinoid system and molecules related to CBD action for use in treating everything from Crohn’s disease to psoriatic arthritis, and he hopes that this new data will be used to help paint a more complete picture about the chemical for future treatment options.
“The more data the better,” he says. “The more we’re able to make informed decisions.”
CBD Oil for Autoimmune Diseases: Benefits, Dosage, & How to Use?
Getting to the underlying cause of a chronic disease can be difficult despite advancements in science and a better understanding of our health. Autoimmune diseases are still largely misunderstood. Worse yet, there are over 80 registered autoimmune conditions (still counting), affecting various regions of the body.
According to medical researchers, the immune system is interconnected with the endocannabinoid system, which response to cannabis compounds such as CBD and THC. These two molecules have been identified as potent anti-inflammatories with the ability to modulate the communication of the immune system cells. There’s also a clear link between the onset of autoimmune diseases and a condition known as clinical endocannabinoid deficiency (CECD).
Several clinical trials have investigated the efficacy of CBD in the treatment of chronic conditions, including chronic pain, inflammatory bowel disease, epilepsy, autism, and arthritis. Despite minor differences in the consistency of its effects, scientists agree that CBD is the potential therapeutic agent for the management of autoimmune diseases.
Today we explain the mechanism of action behind CBD’s benefits for autoimmune conditions.
Why People Are Turning to CBD for Autoimmune Diseases?
Autoimmune diseases develop when the immune system gets triggered and mistakenly treats the body’s healthy tissues as the potential threat. The immune system is mediated by various cells — including T-cells, which are in charge of protecting our body against foreign invaders. When these cells go out of whack, they take action as if the body’s own cells were those invaders. This results in chronic inflammation, the root of any autoimmune condition.
Autoimmunity is both difficult to diagnose and treat. The reason why the self-attack happens is still unknown. Some researchers argue that autoimmunity derives from hereditary factors, while others turn to events like parasites, infection, traumatic experiences, and leaky gut syndrome. When it comes to treatment options, doctors typically go with immunosuppressants, which — in simple terms — shut down the immune system to prevent the auto-aggressive response.
However, immunosuppressants can weaken the immune system over time, making it more susceptible to infections, which can further deteriorate an autoimmune disease.
And the blind circle continues to spin.
This is where CBD steps in.
The Link Between the Endocannabinoid System and Immune System
Despite being a relatively new discovery, the endocannabinoid system (ECS) has been confirmed to play an important role in the regulation of many biological processes, including brain functions and immune response. Endocannabinoid receptors (CB1 and CB2) are found throughout the central nervous system, as well as in the immune system and other organ systems. The ECS produces its own chemical messengers (endocannabinoids) that interact with these receptors (1).
The main role of the ECS is to help the body maintain homeostasis — the internal balance between the said functions. The ECS controls mood, emotions, pain perception, memory, appetite, reproduction, body temperature, and hormone secretion on top of other physiological and psychological processes.
The ECS works ‘on-demand,’ meaning it only gets activated when the body needs its assistance. The endocannabinoids are available for use only for a short span, and worse yet, the ECS doesn’t store them for later. The system depends on its own ability to produce more cannabinoids “here and now.”
At some point, the ECS becomes deficient in cannabinoids, compromising the activity of other systems and organs (2).
When you take CBD, it indirectly interacts with your endocannabinoid system, signaling it to produce more of its natural cannabinoids. It also inhibits the enzyme that breaks them down, so you end up with more endocannabinoids circulating in the body for a longer duration. Your body can use them more efficiently and return to homeostasis.
On top of that, CBD has over 65 molecular targets, which makes it a versatile tool for the management of many health concerns.
Let’s see how CBD may address the underlying cause of autoimmune conditions.
How Does CBD Help Manage Autoimmune Diseases?
The clinical endocannabinoid deficiency has been mentioned as the potential root cause of many chronic conditions, including chronic pain, migraines, type 1 diabetes, Crohn’s disease, fibromyalgia, arthritis, and mental disorders such as depression, schizophrenia, and post-traumatic stress disorder (PTSD).
CBD can help the ECS fix these deficiencies by interacting with the CB1 and CB2 receptors in the affected parts of the body. Since cannabinoid receptors are present in the immune system, CBD can have a positive effect on its functioning.
Below we explain how CBD may correct your body’s immune response.
Immunomodulatory Effects of CBD
Clinical dieticians recommend herbs and foods that produce modulatory effects in the immune system for people with autoimmune diseases. Cannabis therapy and dietary changes appear to be less expensive, safer, and possibly more effective for treating the symptoms and addressing the root cause than pharmaceutical medications.
Cannabis compounds such as CBD are known to modulate the immune system. They act as regulators, bringing an over or under-reacting immune system back on track. However, it’s difficult to tell the difference between “immune-modulating” and “immune-boosting.” It’s commonly agreed that people with autoimmune conditions are better off without taking anything which boosts the immune system.
According to researchers from the National University of Natural Medicine, cannabinoids offer a beneficial strategy to treat autoimmune disorders. Immunomodulation is known for its biphasic nature. For example, if your immune system’s response is exaggerated, an immunomodulatory compound will downregulate it. On the other hand, if your immune system has problems identifying potential threats, it will increase immune activity to fix the deficient response (3).
Cannabinoid receptors type 2 (CB2) regulate many pathways of the immune system. CBD is the agonist of the CB2 receptors; studies have shown that activating CB2 receptors can suppress the immune response, which can be helpful for those with autoimmunity. CB2 can also block the release of pro-inflammatory cytokines and boost the secretion of anti-inflammatory cytokines, balancing the immune system (4).
CBD has been found to modulate the immune system in autoimmunity disease models. CBD also suppresses immune system memory and slows down T-cell production, meaning that it could reduce the likelihood of future autoimmune flare-ups.
On top of that, CBD can increase the expression of genes that combat oxidative stress, reducing cell damage from autoimmune attacks. Unlike THC, CBD doesn’t require high doses to produce immunosuppressive effects.
Terpenes found in CBD oil, such as beta-caryophyllene, decrease inflammation through its interaction with the CB2 receptor. Myrcene, another terpene, is known for anti-inflammatory effects (5–6).
Long story short, CBD can help the immune system return to homeostasis, provide protection against damage from AI attacks, slow down excess T-cell production, and prevent future attacks.
Anti-Inflammatory Effects of CBD
Inflammation is the trigger of many illnesses, and autoimmunity falls into that bracket. Medical researchers have broadly described the anti-inflammatory properties of CBD and other cannabis ingredients. Regulating inflammation reduces the likelihood of an autoimmune attack. Cannabis therapies are known to assist people with autoimmune conditions by curbing inflammation with little to no adverse reactions. According to preclinical studies, CBD can attenuate autoimmune response on top of decreasing the gene transcription that promotes inflammation.
Although there’s a lack of specific human clinical trials, patients with autoimmune diseases report that they have been able to improve their condition by incorporating cannabis-based medicine into their regime. According to Dr. Bonni Goldstein, cannabinoids like CBD could be useful for people who demonstrate symptoms of arthritis and lupus. Goldstein reported that a two-month treatment with cannabis allowed her patients to participate in their life again, encouraging more people to try various CBD/THC ratios.
Cannabinoids are described in scientific literature as novel anti-inflammatory drugs based on preclinical evidence (7). But in order to benefit from cannabinoids, you need to choose a product from the right source.
Hemp vs Marijuana-derived CBD for Autoimmunity: Know the Difference
CBD is found both in hemp and marijuana. These two names refer to plants that are members of the Cannabis genus. Despite coming from the same family of plants, hemp and marijuana have a different chemical makeup.
Marijuana is known for its high THC content, ranging anywhere between 5–35%, and they’re bored with the intoxicating effects in mind. Hemp, on the other hand, contains only traces of THC (less than 0.3%) — nowhere near to get anybody high. It also has a higher concentration of CBD, the non-intoxicating compound.
If you’re looking for a federally legal CBD product for autoimmune conditions, hemp-derived CBD oil will be your best. But if you have the opportunity to try a medical-grade CBD from marijuana, feel free to experiment with different ratios under the supervision of your doctor.
You don’t need a prescription to buy hemp-derived CBD oil; it’s widely available over-the-counter in organic health stores, dispensaries, head shops, and online.
Keep in mind that CBD oil isn’t the same as hemp seed oil. The latter comes from the seeds and despite being a rich source of nutrients, it is devoid of cannabinoids. CBD oil should always be labeled as CBD oil, not ‘hemp oil’ or other umbrella terms.
CBD Dosage for Autoimmune Diseases
Everybody is different, and considering the nature of autoimmune disorders, the effective dosage range varies greatly between individuals. It will take some experimenting to find the best dose for you. If you want to get a better understanding of CBD dosage, consult your doctor; doing so will also help you avoid potential interactions with other medications.
The general recommendation is to start low and slow. Take the minimum dose based on your weight — 2–6 mg per every 10 pounds of your body weight — and observe the effects over the course of one week. Adjust the dosage as needed and continue for another week. Once you’ve found the sweet spot, you can lock that dosage in and stick to it, as people don’t build a tolerance to CBD.
CBD is well tolerated in doses as high as 1,500 mg. That being said, there are a few mild side effects that might occur when you take too much of it at a time. These include dry mouth, appetite fluctuation, lowered blood pressure, fatigue, and diarrhea.
Fortunately, since cannabinoid receptors aren’t found in the brain stem area that controls respiratory function, it’s impossible to fatally overdose on CBD.
CBD Oil Options for Autoimmune Diseases
- CBD Oil – most CBD is sold as a liquid extract suspended in an inert oil for better absorption. You take this sublingually, placing the desired dose under the tongue and holding them there for up to 60 seconds to enhance bioavailability.
- CBD Capsules – if you dislike the flavor of CBD oil, capsules are a good alternative. They have no odor, no taste, and can be easily swallowed down with water. Most capsules come in the form of small, convenient soft gels, providing a fixed dose of CBD per serving. It will take longer to experience the effects of CBD when you take it this way, as capsules need to pass through the digestive system before they make it to the bloodstream.
- CBD Edibles – CBD is infused into lots of foods and drinks to make the supplementation more enjoyable. The most popular formats are gummies and honey sticks which are often referred to as honey straws. When looking for the best CBD edibles for autoimmune disorders, make sure to carefully read the list of ingredients; adding CBD to food doesn’t make it healthy.
- CBD Vape Pens – vaping provides the fastest way to feel the effects of CBD. It also delivers more CBD to your system than other forms, although studies have yet to analyze the safety of long-term vaping for the lungs.
- Topicals – topical products such as CBD creams are formulated to address localized problems. If you suffer from an autoimmune skin condition, topicals combined with a sublingual or oral form of CBD should provide relief from flare-ups while modulating the activity of the immune system from within.
Always make sure to check the potency of your CBD oil. Look at the label to see the total amount of CBD and the amount you’re getting with each serving. A high-potency CBD product will contain more servings per container than a lower-potency option of the same size.
How to Find a Trustworthy CBD Brand?
- Hemp farming methods – choose a brand that sources its hemp from local organic farms. This will greatly narrow down your options. Plants grown with natural methods contain higher levels of CBD and are free of common contaminants from the soil and the plant’s environment.
- Extraction method – getting the CBD out of the plant involves some work. The most common technology is CO2 extraction due to the lack of additional heat and solvents involved in the process.
- Ingredients – the best CBD products for autoimmune diseases should have a very short list of ingredients: CBD extract and a quality carrier oil such as MCT oil. Flavored CBD oils may contain natural terpenes or other flavorings. Steer clear of companies using artificial sweeteners, flavorings, or emulsifiers in their products.
- Certificates of Analysis (COA) – the CBD market is booming and unregulated, which provides opportunities for many fly-by-night vendors to churn out poor-quality products and label them as “premium.” The best way to find out whether or not you’re buying from a trusted provider is to check if they provide third-party lab testing reports. The testing should be multifaceted, informing the user about potency and the lack of potential contaminants such as pesticides, heavy metals, and mycotoxins.
CBD vs. Immunosuppressants for Autoimmune Diseases
The reason why people are turning to CBD for autoimmune diseases lies in its high safety profile. Unlike conventional immunosuppressants, CBD doesn’t shut down the immune system. Instead, it reduces inflammation while modulating the communication between the system’s cells. In other words, CBD helps the body fix the immune response without harming it — something which pharmaceutical medications fail to achieve.
Still, if you’re considering taking CBD for your autoimmune condition, consult the idea with a holistic doctor experienced in cannabis therapies. Only then will you be able to determine if CBD oil will be safe for your situation.
Does CBD Interact with Medications for Autoimmune Diseases?
CBD is known for interacting with a wide range of medications. It uses the same mechanism as grapefruit juice, so any medication with a grapefruit warning on it shouldn’t be taken along with CBD oil. CBD inhibits the cytochrome p450 system, a group of enzymes that metabolize active ingredients in drugs. Taking CBD with other medications can result in a subtherapeutic effect or, on the contrary, substance toxicity — none of which are good for your health.
Summarizing the use of CBD for Autoimmune Conditions
Autoimmunity may be a challenging situation that requires a multifaceted approach due to its complex nature. Hopefully, there are holistic approaches you can take to address your symptoms and manage the condition. Coping with an autoimmune disease puts much burden on the sufferer, but it can also be a chance to get back in touch with your body.
On top of supplementation with CBD oil, you can incorporate some lifestyle changes, such as a nutrient-rich diet, exercise, sufficient sleep, herbal medicine, and probiotics to support your immune system from many angles.
Many pieces of research have been made to confirm the preclinical findings on CBD and autoimmune conditions like systemic lupus erythematosus, diabetes, migraines, and more, but what we’ve learned so far is very promising. Again, we recommend that you consult a doctor before buying any CBD product to avoid potentially negative interactions with your medications and establish the right dosage.
- Campbell, Andrew W. “Autoimmunity and the gut.” Autoimmune diseases vol. 2014 (2014): 152428. doi:10.1155/2014/152428
- Russo, Ethan B. “Clinical Endocannabinoid Deficiency Reconsidered: Current Research Supports the Theory in Migraine, Fibromyalgia, Irritable Bowel, and Other Treatment-Resistant Syndromes.” Cannabis and cannabinoid research vol. 1,1 154-165. 1 Jul. 2016, doi:10.1089/can.2016.0009
- Lee, Wen-Shin et al. “Cannabidiol Limits T Cell-Mediated Chronic Autoimmune Myocarditis: Implications to Autoimmune Disorders and Organ Transplantation.” Molecular medicine (Cambridge, Mass.) vol. 22 (2016): 136-146. doi:10.2119/molmed.2016.00007
- Turcotte, Caroline et al. “The CB2 receptor and its role as a regulator of inflammation.” Cellular and molecular life sciences: CMLS vol. 73,23 (2016): 4449-4470. doi:10.1007/s00018-016-2300-4
- El-Sheikh, Sawsan M A et al. “Anti-arthritic effect of β-caryophyllene and its ameliorative role on methotrexate and/or leflunomide-induced side effects in arthritic rats.” Life sciences vol. 233 (2019): 116750. doi:10.1016/j.lfs.2019.116750
- Rufino, Ana Teresa et al. “Evaluation of the anti-inflammatory, anti-catabolic and pro-anabolic effects of E-caryophyllene, myrcene, and limonene in a cell model of osteoarthritis.” European journal of pharmacology vol. 750 (2015): 141-50. doi:10.1016/j.ejphar.2015.01.018
Livvy is a registered nurse (RN) and board-certified nurse midwife (CNM) in the state of New Jersey. After giving birth to her newborn daughter, Livvy stepped down from her full-time position at the Children’s Hospital of New Jersey. This gave her the opportunity to spend more time writing articles on all topics related to pregnancy and prenatal care.
Molecular Mimicry: The Role of Cannabis in Healing Autoimmune Disease
Sarah Russo is a writer, cannabis consultant, and a social media and content manager. She got her degree in environmental studies and social justice, with a focus in plant medicine from the Evergreen State College. She has previously worked for Project CBD and the Society of Cannabis Clinicians. She has also acted as an herbal medicine educator in natural remedy apothecary shops. Some of her main goals are diversifying the cannabis movement by integrating the plant into the greater herbal medicine compendium as well as encouraging sustainable agricultural practices.
While advancements in science have enabled a greater understanding of our health, getting to the root cause of a chronic disease can be challenging. Autoimmune conditions are an area of medicine that remain largely misunderstood. Presently, there are more than 80 registered autoimmune disorders, affecting various parts of the body. More conditions may also turn out to be autoimmune related.
Autoimmunity (AI) is an “attack on self”, where the immune system gets triggered and thinks that the body’s healthy tissues are invaders. Our immune system is mediated by beta cells which produce antibodies to foreign invaders. Beta cells produce antibodies to prevent infection or fend off bacterial and viral pathogens. T-cells are in charge of cell-mediated immunity are derived from the thymus and other immune tissues. They attack foreign invaders in the body. In an autoimmune response, T-cells take action as if the body’s own cells were foreign in order to bring the body back into homeostasis. This self-attack is known as “molecular mimicry” and is the root of any autoimmune disease.
The location of the autoimmune attack will vary based on the condition. For example, if there is autoimmunity in the joints, rheumatoid arthritis may result. If molecular mimicry occurs in the thyroid, it may lead to Hashimoto’s. For skin disorders like psoriasis, the dermal layer is the target. Autoimmune conditions may attack more than one part of the body at the same time. Lupus can manifest in the skin, digestive system, joints, and the brain.
The reason why the self-attack switch is turned on is relatively unknown. Common consensus is that those with autoimmunity have a genetic predisposition for these types of conditions. Then a particular event like an infection, parasite, leaky gut syndrome, or a traumatic experience sets off the autoimmune reaction.
The triangle of autoimmune triggers. Gut dysbiosis and genetic and environmental factors play mayor roles in the development of autoimmune diseases.
AI can remain latent in the body, resulting in ailments that have not been properly pinpointed. Autoimmune related situations can linger in the body unexposed for many years, which can result in digestive complaints and various associated problems. Frequently, autoimmune diseases are misdiagnosed because their symptoms can mimic other ailments.
There has been a dramatic increase in the prevalence of autoimmune diseases since World War 2. Autoimmune conditions more commonly affect women than men. The National Institute of Health estimates that 23.5 million people in the USA have an autoimmune disease, while cancer affects 13 million in the country. The true number of those affected by autoimmunity is likely higher, due to misdiagnosis and general lack of understanding about the complexity of AI related conditions.
Conventional medicine ideology believes that the immune system cannot be controlled and once the autoimmunity switch has been triggered, it is impossible to revert back to the body’s normal state. However, many alternative medical professionals feel that autoimmune conditions may be reversed or greatly resolved. In typical treatment protocols, patients are not given information about dietary changes and are generally told that pharmaceutical medications are required to get better.
Conventional treatments for autoimmune disorders
Currently, prescription medication for autoimmune diseases aim to “turn off” the immune system all together. Immunosuppressive drugs are synthetically created antibodies which attack the autoimmune antibodies. Immunosuppressive drugs can create many potential side effects. These medications may make someone more susceptible to infection, and may lead to the development of cancer. According to Dr. Bonni Goldstein, a cannabis friendly doctor in Southern California, many patients who try immunosuppressive medications end up discontinuing them due to unfavorable side effects. In her experience, patients seek holistic treatment options for autoimmune diseases.
Steroids are a commonly prescribed medication for autoimmunity to lower inflammation and suppress the immune system. They are meant to be taken on the short term. Julie Holland, a pro-cannabis psychiatrist based in New York, says that the goal shouldn’t be to be globally immunosuppressed, “With steroids, you are sweeping the dirt under the carpet. You’re not getting to the root cause at all. It’s as if you’re hitting mute on the alarm, but the alarm is going off for a reason.” Steroids may decrease blood supply to various parts of the body, and create fat deposits in the face or other areas. If someone has autoimmunity and chronic pain, steroids may not help address the root of the discomfort.
In general, immunosuppressive therapy is incredibly expensive and not always effective. The aim should be to modulate the immune system and bring it back into balance, not to turn it off completely.
What options exist for someone with an autoimmune condition if they do not wish to use traditional medications? Holistic approaches for autoimmune conditions are to decrease inflammation, repair the digestive tract, and regulate the immune system. This includes getting rid of stressors and sensitivities on the broad spectrum, including environmental, food, chemical, and others. Managing autoimmune disease requires dietary and lifestyle changes, which have been reported to help reverse these conditions.
Someone with an autoimmune disease may consider cannabinoid therapies for their ability to decrease inflammation, modulate the immune system, and help to bring the system back into balance.
Immune system modulation
The immune system is a delicate balancing act and deeper investigation is needed to better understand the mechanisms of how it works. Herbs and foods that work to modulate the immune system are ideal for someone dealing with an autoimmune condition. Cannabis therapy and dietary changes seem to be safer, cheaper, and possibly more effective for combating autoimmune conditions than pharmaceutical medications.
Cannabis and other adaptogenic herbs are known to be immune modulating. They act as a regulating tool: they can bring an over or under-reacting immune system back into balance. However, the difference between “immune modulating” and “immune boosting” can be tricky to decipher. It is generally felt that someone with autoimmunity would not want to take anything which boosts the immune system, but this is a point of contention among practitioners.
According to Kevin Spelman, faculty member in Botanical Medicine at National University of Natural Medicine, the definition of immune modulatory is the biphasic effect of an herbal medicine. “Immunomodulatory herbs offer a very beneficial strategy to treat autoimmune conditions. The category of immunomodulation rests on biphasic activity. If someone’s immune response is overly vigilant, there would be a down regulation of immune response. If someone’s immune response is ‘deficient’ there would be an increase of immune activity.” Spelman explained that a patient’s therapeutic response is dependent on how their individual molecular environment is behaving.
Cannabis is a unique biphasic botanical remedy that can bring the system back into balance in numerous regards. Based on current research, cannabis therapies may provide benefit for autoimmune disease in three basic ways: modulation of the immune system, decreasing general inflammation, and helping to assist the digestive system. Cannabis medicine may also treat symptoms of specific autoimmune diseases like ALS, rheumatoid arthritis, ulcerative colitis and Crohn’s, fibromyalgia, Huntington disease, multiple sclerosis, and others. The plant may decrease chronic pain, inflammation, and spasms associated with some of these conditions. There have been few specific investigations on cannabinoid treatment for AI, due to federal prohibition on human clinical trials. However, extensive studies in test-tubes and in animals have reported the anti-inflammatory benefits of cannabinoids for specific AI conditions like multiple sclerosis and rheumatoid arthritis.
Investigation has demonstrated that CB2 receptors regulate many complex pathways of the immune system. Preclinical studies show that triggering CB2 receptors can suppress immune response, which can be beneficial for those suffering with AI. CB2 can also inhibit production of pro-inflammatory cytokines and enhance anti-inflammatory cytokines, which helps to restore a balanced state. However, there are conflicting reports as research has shown that CB2 activation, under certain conditions, may aggravate inflammation.
There has been some preclinical investigation focusing on the role of particular cannabinoids in AI disease models. CBD has been found to modulate the immune system instead of suppressing it. Cannabidiol also slows down T-cell production and suppresses immune system memory, meaning that CBD could cut down on the likelihood of future autoimmune attacks. CBD has also been found to increase the expression of genes that deal with oxidative stress, which may reduce cell damage from autoimmune attacks. As for THC, this cannabinoid is immunosuppressive only at very high doses. In low doses can be helpful as an analgesic and anti-inflammatory. Its ability to activate CB2 receptors may down regulate T cell function and decrease the harmful effects of immune cells.
The role of cannabis terpenes for autoimmunity deserve further investigation as well. The terpene beta-caryophyllene, found in certain strains of cannabis and black pepper, is known to decrease inflammation through its ability to stimulate the CB2 receptor. Myrcene, another terpene, also has antiinflammatory properties.
Based on preclinical evidence, cannabinoids may help bring the system back into homeostasis, protect against damage from AI attacks within the body, slow down overactive T-cell production, and prevent the immune system from being triggered.
Inflammation is the root cause of many illnesses, and autoimmunity is no exception. Extensive research has been performed on the anti-inflammatory properties of THC, CBD, and other cannabis components. If inflammation response is regulated, there will be less likelihood of an autoimmune attack. More investigation is needed to examine the particular role of cannabinoids for autoimmune disorders.
Cannabinoid therapy has the potential to assist those with autoimmune conditions by decreasing systemic inflammation, with little to no side effects. Preclinical evidence has found that cannabinoids can attenuate autoimmune inflammatory response. In an animal model of multiple sclerosis, CBD decreased the gene transcription that promoted inflammation.
Despite a scarcity of specific human based studies, patients with autoimmune disorders have been able to improve their situation by integrating cannabis medicine into their lifestyle. Dr. Bonni Goldstein has seen a number of patients with lupus and rheumatoid arthritis wean off pharmaceuticals and control their symptoms with cannabis, dietary changes, exercise, and stress reduction. Goldstein gave the example of a young patient with ankylosing spondylitis. Goldstein reported that after two months on cannabis the patient discontinued three of the pharmaceuticals, experienced a significant improvement in her pain symptoms, and was “able to participate in her life again”. Dr. Goldstein encourages patients to try various CBD/THC ratios, and to experiment with raw cannabinoids such as THCA and CBDA. Trial and error is required to find what works best for an individual’s unique situation.
Additional approaches one can take to lower inflammation:
- A nutrient rich diet: a whole food diet, devoid of processed foods, will naturally decrease inflammation.
- Exercise: active movement increases circulation of anti-inflammatory cytokines from the skeletal muscles.
- Sufficient sleep: your body naturally lowers inflammation while you get shut eye.
- Herbal medicine: turmeric, ginger, cinnamon, nettle, and various medicinal mushrooms can help decrease inflammation throughout the body.
- Probiotics & Prebiotics: these supplements promote healthy bacteria in the gut, which lowers inflammation and promotes healthy immune response.
While autoimmunity may be a complex and challenging situation in need of deeper investigation, there are holistic approaches one can take to manage their condition. Coping with an autoimmune disease may feel burdensome, but it can also be an opportunity to get back in touch with your body. Aim to treat it in the best way possible. Nature can be your guide.
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