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CBD Oil for Chronic Fatigue Syndrome

Claudia Chaves, MD, is board-certified in cerebrovascular disease and neurology with a subspecialty certification in vascular neurology. She is an associate professor of neurology at Tufts Medical School and medical director of the Lahey Clinic Multiple Sclerosis Center in Lexington, Massachusetts.

Chronic fatigue syndrome (CFS or ME/CFS) is an extremely difficult illness to treat. It features dozens of symptoms believed to stem from the dysregulation of multiple systems throughout the body. Cannabidiol (CBD) oil is a hot, up-and-coming treatment right now that’s being touted as a fix for all kinds of diseases. It’s only natural that a lot of people with ME/CFS would develop an interest in CBD oil as a possible treatment.

But is CBD a safe and effective treatment for this complex and debilitating disease? Thus far, we have no specific research on CBD for ME/CFS, so it’s too early to have an answer to that question.

Another possible deterrent for people considering this treatment is that CBD oil—which comes from hemp—gets wrapped up in the controversy over medical marijuana. That may make some people hesitant to try it. Additionally, it’s been hard to find a straight answer about whether it’s legal, but that concern should be going away soon.

What Is CBD Oil?

CBD stands for “cannabidiol,” which comes from the cannabis plant. That’s the same plant that gives us marijuana. However, CBD—as an oil or in other forms—doesn’t have psychoactive properties. That means it doesn’t provide the “high” associated with marijuana.  

The substance in marijuana that gets you high is called THC (tetrahydrocannabinol).   Growers who want to maximize the plant’s psychoactive effect use breeds and techniques that result in higher levels of THC. On the other hand, cannabis that’s grown for hemp is generally richer in CBD than THC, and that’s where CBD comes from.

CBD oil can be used in several different ways. You can smoke it (typically in vape pens), take it in capsule form, use it sublingually (under the tongue), use oral sprays or drops, or apply it topically to your skin. A crystalline form of pure CBD is also available, which is generally taken sublingually.

CBD products that are extracted from cannabis are being used for a lot of medical purposes, and you can find many claims online about miraculous results.

But are these claims true? And would it work as well for you? From a scientific standpoint, the answers are more like “we don’t know” and “possibly” and “some claims appear to be true” than a firm “yes,” and it depends on which claims you’re looking at.

People are using CBD oil for a whole lot of different medical purposes, including:

  • Chronic pain and inflammation, including neuroinflammation (a suspected feature of ME/CFS)
  • Social anxiety disorder
  • Insomnia
  • Halting the growth of cancerous tumors
  • The pain of glaucoma
  • Epilepsy, especially in children
  • Bipolar disorder
  • Multiple sclerosis
  • Parkinson’s disease
  • Schizophrenia
  • Movement problems caused by Huntington’s disease
  • Help with smoking cessation

As of June 25, 2018, CBD oil has been approved by the U.S. FDA as an oral solution (Epidiolex) for the treatment of seizures associated with two very severe forms of epilepsy that usually affect children: Lennox-Gaustaut and Dravet syndromes.  

Research in the United States for other diseases is still in the early stages. That’s because legal restrictions have for decades made it extremely difficult to study the medical benefits of marijuana or any of its components, which are called cannabinoids. Promising research is being done, though, on multiple conditions. Down the road, it’s likely that we’ll eventually see many applications submitted to the FDA.

CBD Research and ME/CFS

Anyone who’s studied ME/CFS for very long will not be shocked to hear that, so far, we don’t have any research done on CBD oil as a treatment for this disease. That doesn’t mean we don’t know anything, though.

CBD is being researched for numerous conditions, and many of those conditions share features with ME/CFS. While we can’t say for certain that those results apply to similar conditions, they provide some basis for informed speculation.

Also, we’re likely to see CBD investigated for ME/CFS before long, for several reasons.

First, we just don’t have good treatments for ME/CFS. In fact, none are FDA approved. And while dozens of different medications and other interventions are used to help lessen the symptoms, many of them are only marginally effective and only help a fraction of those with the condition. Side effects tend to be a problem for this group, as well.

Second, we have a pain epidemic in the U.S. While not all ME/CFS involves pain, many cases do. Current treatments are inadequate, though, so there’s a big financial incentive to find something that’s better at relieving ME/CFS pain.

Third, we’re currently struggling with an opioid addiction and overdose epidemic in the U.S. Several studies have shown that when a state legalizes marijuana, either medicinally or recreationally, the number of opioid prescriptions drops. That’s good news for doctors looking for safer pain treatments, for law enforcement agencies struggling to control the tide of illegal use, and for lawmakers trying to find solutions.

Fourth, CBD oil is believed to be effective against pain and inflammation, and, in its pure form, it’s generally regarded as safe. Especially in light of the theory that ME/CFS is related to neuroinflammation, and the wealth of evidence pointing to it being an inflammatory disease, it’s pretty obvious that there’s a potential benefit that should be explored.

Finally, while anecdotal evidence isn’t proof of anything, we already have an abundance of it from people with ME/CFS. When patients with difficult-to-treat conditions tell their doctors something works, you can bet it gets them interested.

A 2017 ​paper   published in Expert Opinion on Therapeutic Targets suggested CBD as a possible way to diminish the activity of brain cells called glia that can lead to central sensitization. That’s a hypersensitive central nervous system and a major feature of ME/CFS and other central sensitivity syndromes such as fibromyalgia, irritable bowel syndrome, and migraine.

CBD is believed to help with your body’s homeostasis, which is keeping things like temperature, respiration, and blood flow in proper balance. Homeostasis tends to be out of balance in ME/CFS.  

While it’s less well documented in ME/CFS, a condition called endocannabinoids deficiency, characterized by lower amounts of naturally produced endocannabinoids in certain individuals, has been linked to fibromyalgia, making cannabis products a promising treatment.  

A 2016 review   published in Cannabis and Cannabinoid Research found evidence that CBD is effective in treating migraine and irritable bowel syndrome, which are related to ME/CFS. It also stated that some cannabis-based treatments appeared effective for fibromyalgia. The authors stated that CBD is often preferable to patients because it doesn’t include the high and other effects of THC.

As mentioned earlier, several studies have suggested that CBD can fight inflammation.   That’s a big deal for a disease that research links to chronic inflammation, and possibly to neuroinflammation as an underlying cause.

A 2017 French study   on Alzheimer’s disease suggests that CBD lessens oxidative stress, diminishes mitochondrial dysfunction, and suppresses pro-inflammatory activity. All of those things could prove helpful against known and suspected dysfunctions associated with ME/CFS.

A 2011 study out of Italy   suggested that CBD may lower intestinal inflammation via control of the neuro-immune axis. While that study was on inflammatory bowel disease, changes to the neuro-immune axis could be beneficial in ME/CFS, as well.

Side Effects

We don’t have a full picture of the possible side effects of CBD. Some reported side effects include:  

  • Changes to liver enzymes used to process drugs
  • Dry mouth
  • Low blood pressure
  • Lightheadedness
  • Drowsiness
  • Increased tremor in Parkinson’s disease, at high doses

The following effects are possible but require more study, according to the World Health Organization:

  • Alteration of hormonal levels
  • Immune system stimulation at low levels, and immune suppression at higher levels

The immune system effects will be especially important for ME/CFS, which is believed to involve a chronically overactive immune system.

Addiction and abuse don’t appear to be problems with CBD, and it appears to have a low toxicity level, which means that it takes a lot to overdose.

Is It Legal?

When the 2018 Farm Bill was signed into law, it made hemp an agricultural product. That means products made from hemp—including CBD—are legal at the federal level.

However, some states and municipalities have passed laws specifically banning hemp products or CBD. Technically, federal law overrides state law. That doesn’t mean, though, that your state or town will automatically stop making arrests and pressing charges under its CBD laws.

If you’re in an area with laws prohibiting CBD, you may want to consult a legal expert on whether it could be a problem for you. Better safe than sorry.

The website ProCon.org has information about which states have laws specific to CBD oil. A site called Governing maintains a map of where marijuana is legal in some form.

A Word from Verywell

You have a lot to consider when it comes to any form of treatment, and even more when it comes to CBD. Be sure to consider the pros and cons, including the legal ones. Discuss this option with your doctor to make sure you’re not endangering your health. As with any treatment, watch for side effects.

With legal changes in-store and more research coming, things may change rapidly when it comes to CBD oil and other cannabis-based treatments. It’s likely that we’ll know a great deal more about the effectiveness and safety of these products a few years from now.

Chronic Fatigue Syndrome Doctor Discussion Guide

Get our printable guide for your next doctor’s appointment to help you ask the right questions.

Khan MI, Sobocińska AA, Czarnecka AM, Król M, Botta B, Szczylik C. The Therapeutic Aspects of the Endocannabinoid System (ECS) for Cancer and their Development: From Nature to Laboratory. Curr Pharm Des. 2016;22(12):1756-66. doi:10.2174/1381612822666151211094901

Nagarkatti P, Pandey R, Rieder SA, Hegde VL, Nagarkatti M. Cannabinoids as novel anti-inflammatory drugs. Future Med Chem. 2009;1(7):1333-49. doi:10.4155/fmc.09.93

Burstein SH, Zurier RB. Cannabinoids, endocannabinoids, and related analogs in inflammation. The AAPS Journal. 2009 Mar;11(1):109-19. DOI: 10.1208/s12248-009-9084-5.

De Filippis D, Esposito G, Cirillo C, et al. Cannabidiol reduces intestinal inflammation through the control of neuroimmune axis. PLoS One. 2011;6(12):e28159. DOI: 10.1371/journal.pone.0028159.

Hill KP, Saxon AJ. The role of cannabis legalization in the opioid crisis. JAMA internal medicine. 2018 May 1;178(5):679-680. DOI: 10.1001/jamainternmed.2018.0254.

Nijs J, Loggia ML, Polli A, et al. Sleep disturbances and severe stress as glial activators: key targets for treating central sensitization in chronic pain patients? Expert opinion on therapeutic targets. 2017 Aug;21(8):817-826. DOI: 10.1080/14728222.2017.1353603.

Piomelli D, Weiss S, Boyd G, Pacula RL, Cooper Z. Cannabis and the opioid crisis. Cannabis and cannabinoid research. 2018 Apr 1;3(1):108-116. DOI: 10.1089/can.2018.29011.rtl.

Russo EB. Clinical endocannabinoid deficiency reconsidered: current research supports the theory in migraine, fibromyalgia, irritable bowel, and other treatment-resistant syndromes. Cannabis and cannabinoid research. 2016 Jul 1;1(1):154-165. DOI: 10.1089/can.2016.0009.

Silvestri C, Di Marzo V. The endocannabinoid system in energy homeostasis and the etiopathology of metabolic disorders. Cell metabolism. 2013 Apr 2;17(4):475-90. DOI: 10.1016/j.cmet.2013.03.001.

Vallee A, Lecarpentier Y, Guillevin R, Vallee JN. Effects of cannabidiol interactions with Wnt/B-catenin pathway and PPARy on oxidative stress and neuroinflammation in Alzheimer’s disease. Acta biochimica et biophysica Sinica. 2017 Oct 1;49(10):853-866. DOI: 10.1093/abbs/gmx073.

You hear a lot of hype about CBD oil for treatment ME/CFS, but what's the truth? See what the science says, and find out about CBD's legal status.

CBD Picks for Fibromyalgia

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Cannabidiol (CBD) is a type of cannabinoid, a chemical compound naturally found in cannabis. Unlike tetrahydrocannabinol (THC), another type of cannabinoid, CBD doesn’t cause a feeling of being “high.”

Since 2018, when a federal bill legalized hemp cultivation and sales across the country, the availability of CBD products has increased dramatically. Some state laws still forbid the sale of hemp products, but many have adopted the federal government’s policy of legalization.

For decades, research into CBD and other cannabinoids has been limited because of these federal restrictions on hemp and cannabis. Research into CBD’s benefits is still new, but early studies show promising results. This is especially true for issues like sleep, anxiety, and pain.

But as with many health and wellness products, the market for CBD is largely unregulated.

The Food and Drug Administration (FDA) doesn’t approve or police CBD products. It also doesn’t have specific guidelines for claims or terminology used by CBD companies.

Governance of CBD products, what little there is, remains largely up to the manufacturers themselves.

That makes it all the more important you do your own research before purchasing any CBD products. Understanding the markers of good CBD products can help you bypass inferior products and save money.

For people with fibromyalgia, a condition causing chronic pain and fatigue, CBD can be a helpful tool in a battery of treatment options.

While there’s no current cure for fibromyalgia, some lifestyle adjustments and self-care techniques may go a long way to alleviating symptoms of the condition. CBD may be a part of that treatment strategy.

Keep reading to learn about five CBD products that may be a good pick for people with fibromyalgia, and how you can use CBD for symptoms of this condition.

To look at CBD for fibromyalgia, let’s start with the basics of the condition and current medical treatments.

Fibromyalgia is a chronic condition that causes pain all over the body. It can also cause:

  • fatigue
  • tenderness
  • sleep problems
  • cognitive disturbances

Treatment focuses on easing or reducing symptoms, and managing pain. These treatments include:

  • medications, such as prescription and over-the-counter pain medications
  • self-care strategies, including stress reduction and aerobic exercise
  • lifestyle changes, such as adjustments to diet and sleep patterns

Researchers have looked at cannabis as a possible treatment for fibromyalgia symptoms.

Several studies have examined the effect cannabis (THC strains and hemp plants) has on fibromyalgia broadly and on symptoms of the condition more specifically.

CBD can help fibromyalgia, but research includes other cannabinoids, too

Most of the studies that have looked at managing fibromyalgia with cannabinoids have included THC in the dose. THC, or the active ingredient in cannabis that causes a “high,” isn’t legal in all U.S. states.

These studies have found that people with fibromyalgia experience some improvements in pain when taking CBD combined with THC.

But because the doses given to study participants have included THC, it’s not possible to say yet what effect CBD alone might have.

CBD, like THC, interacts with the body’s endocannabinoid system (ECS). This is a complex system responsible for signaling cells throughout the body.

Cannabinoids like THC and CBD can interact with your ECS. When they do, research tells us the ECS sends out signals that work to decrease inflammation and reduce feelings of pain and discomfort. Both of these benefits could help people with fibromyalgia.

For that reason, it may be more beneficial to look at CBD usage as a way to help some symptoms of fibromyalgia instead of treating the whole condition broadly.

In that regard, we see a number of successful studies already.

Research on CBD benefits

  • Chronic pain. A 2018 research review reported that CBD may be able to treat chronic pain, such as what people with fibromyalgia experience.
  • Sleep quality. A small 2019 study found that people who took CBD daily reported better sleep and less anxiety.
  • Depression. Another 2018 research review found that CBD usage may benefit conditions like depression, which do occur in people with fibromyalgia frequently.

Most of these studies also reported few, if any, adverse effects or problems with CBD usage. That may be reason enough for people living with fibromyalgia to try out CBD and see whether it helps.

CBD oil may help best for fibromyalgia symptoms like pain and insomnia. Here’s what to know.