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Long Covid: Experts explore the role of cannabinoids in treatment

Experts have explored the idea of cannabinoid therapy in the treatment of long Covid.

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Experts explored the idea of cannabinoid therapy in the treatment of long Covid, in a one-off webinar hosted by the Medical Cannabis Clinicians Society.

Professor Mike Barnes, neurologist and director of the Medical Cannabis Clinicians Society (MCCS), was joined by Dr Anjali Didi, a general practitioner based in Australia and Dr Hosseini, chief scientific officer at BOD pharmaceuticals, to explore the role that cannabinoids could play in treating long Covid.

The webinar, which took place on Tuesday 30 November, was aimed at clinicians who may be treating patients experiencing long Covid patients and are keen to learn about alternative therapies or treatments.

It could not have been more timely, following the emergence of a new concerning variant in the UK, Omicron.

Dr Anjali Didi explained the importance that the endocannabinoid system (ECS) has in the body and how this interacts with different cannabinoids, focusing on CBD, THC, CBG, CBC and CBDV. She highlighted the important role of the CB1 and CB2 receptors throughout the body.

Long covid: A banner advert for the medical cannabis clinics

Different cannabinoids may have different benefits associated with them. Studies have shown that CBG may produce a response in skin tumours, while CBC and CBDVA may potentially reduce seizures by up to 40 per cent.

Dr Didi said that although doctors can often feel nervous about prescribing cannabinoids such as THC, they needn’t be worried.

Dr Didi: “THC interacts with the CB1 receptor as an agonist. It’s responsible for intoxicating effects in high doses and that’s important to know when you prescribe. CBD is known to counteract that intoxicating effect, so even though that is something people worry about when they first start to prescribe in low or 50:50 doses, it’s unlikely. The rule is always start low, go slow.”

Dr Didi, who was originally based in the UK before relocating to Australia, has treated both British and Australian patients.

When she began to see long Covid patients at her clinic, she noted a particular set of symptoms occurring in patients around two months post-infection.

“Long Covid was something I was labelling a set of symptoms as, that I had seen in people typically around two months post the acute infection,” she explained.

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“The World Health Organisation is now calling it post Covid-19 syndrome or post-acute sequelae Covid (PASC). Some of the symptoms that have appeared in reports and my practice include insomnia, depression, anxiety, fatigue both mental and physical, shortness of breath and cough.”

Her patients also report pain in different places, including the joints, headaches, chest pain, myalgia, neurocognitive dysfunction, involuntary movement and anosmia that persists. Case reports also show repeated pyrexia, fever and dizziness.

It was original research on CBD and sleep that convinced Dr Didi to try prescribing cannabinoids for the treatment of long Covid. She explained her experience with prescribing cannabis for one of her patients.

Long Covid case study

The patient that Dr Didi chose to present was a 42-year-old British male patient who contacted Covid in March. He was diagnosed after losing his sense of smell.

“His initial infection was in another country in March, with an acute loss of smell when he couldn’t smell his coffee. He was quite well for three or four days with just that. He [then] started to present with a lot of diarrhoea and his acute infection with myalgia changed from day 10 to headaches, night sweats and breathlessness with a cough,” she said.

“The biggest thing was that it got worse when he was lying down, so he was sleeping on two or three pillows. He worked quite hard in the finance industry but he has never been well since the infection.”

Dr Didi explained that her patient experienced a lot of disturbance with muscle fasciculations [twitching] in the body which caused a lot of anxiety, resulting in an insomnia pattern that stopped him from being able to sleep.

While her patient was healthy with no chronic conditions, he had mentioned he had asthma and allergies as a child. He came to see the doctor after struggling for nine months after his initial infection. He had also been off work for some months as a result of the illness.

“He had some pill rolling tremors that were worrying him and he had learned to sit holding his right hand to prevent the fasciculations taking over from his thought process. He felt he couldn’t think as well as he used to be able to, but I had no way to measure that and neither did he. He was fatigued enough to not be able to walk his daughter to school which was around a 10 – 15-minute walk.”

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As well as brain fog and tiredness, Dr Didi’s patient also reported feeling pain in his muscles and stabbing chest pains which were quite debilitating. However, his biggest issue was lack of sleep and he had tried using prescription medication or alcohol to help.

Dr Didi said: “Since the PASC had started, he hadn’t been able to sleep, sometimes all night. He felt, looking back, that it was the fasciculations but also the speed of thoughts in his head, whether that was caused by lockdown or his worry about his symptoms. It could have been an amalgamation of things.”

Long COVID crash

In April, her patient experienced what he described as a ‘Covid crash.’

Dr Didi outlined the different medications that he had tried but it was after this that she suggested they discuss medical cannabis.

She explained: “He was able to walk a little bit but was very fatigued. In September, he had a two week period where he was unable to get out of bed, enough that his wife was bringing him makeshift bedpans. When he wakes up, he finds that his joints ache and he doesn’t have any balance.”

The doctor started him on a small dose of Seroquel to help improve his sleep, before starting him on a tiny dose of a BOD medical cannabis product with a ratio of 20mg of CBD and less than two per cent THC.

He began to feel less anxious but felt he wanted to reduce the SSRI due to experiencing issues with his libido. Dr Didi increased the medical cannabis but he began to feel increasingly sleepy. He found success with 20mg of Medcabilis [the BOD product] but felt the 40mg was too strong for him.

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“I wanted to try to support him in his decision to go back to work,” she added.

“I asked him to try a new SSRI but continue with the CBD which is something he never stopped. He felt that the one or two days he stopped it, he didn’t feel well in terms of fatigue. He was also able to complete 10-minute walks where he could take his daughter to school.”

Dr Didi also presented another case study of a woman with long Covid who struggled to sleep. She was prescribed a 50:50 ratio of THC and CBD. She reported that it helped her daytime anxiety so has been kept on her dose.

Dr Hosseini from BOD Medical Cannabis explained more about the two products used in both case studies.

“The two case studies mentioned included the Medicabilis five per cent, which is a pharmaceutical-grade product available in the UK by prescription,” she said.

“It has 50mg per ml of CBD but in addition, it does have other minor cannabinoids as well. It has less than 2mg per ml of THC which makes it relatively safe for prescribing to manage symptoms related to neurological or psychological effects such as anxiety.”

So can cannabinoids treat Covid-19?

Prof Barnes concluded the panel by touching on the recent research which suggests cannabinoids may help with lung inflammation experienced by Covid patients.

study from early 2021 revealed that some cannabis strains could potentially help to reduce a type of inflammatory distress referred to as a ‘cytokine storm’.

He suggested that as long Covid is sometimes caused by the cytokine storm, an overreaction of the immune system, through cannabinoids we may be able to reduce the numbers of patients suffering from symptoms.

“Cannabinoids – generally CBD – being anti-inflammatory may reduce the incidence of long Covid,” commented Prof Barnes.

“There are some early indicators from Israel and Canada, so people are looking around that more definitively.”

He added: “It’s a really important question for global health but we still can’t answer it yet.”

 

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Mental health

Can CBD help with feelings of sadness on blue Monday?

Blue Monday may or may not be a real thing, but feelings of sadness, anxiety and stress are.

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Blue Monday: A woman sitting on the floor with a jumble of thoughts.

The third Monday in January is often referred to as ‘blue Monday.’ But what is it and could taking CBD help with feelings of depression, stress or anxiety?

What is blue Monday?

Blue Monday is thought to be the most depressing day of the year.

It was created after psychologist Cliff Arnall was asked to create a formula for the holiday blues. It falls on the third Monday of January each year. While there is a lot of debate as to whether it is real or not, depression and anxiety can be difficult to cope with.

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January can be a really hard time of year for those with seasonal affective disorder (SAD). It may be due to the increase in cold weather, post-holiday sadness and credit card statements.

Real or not, it can be an opportunity to start talking about how depression or anxiety affect us all.

Could CBD help to lift our mood during this difficult month?

CBD for depression

Symptoms of depression can include a persistent low mood, unhappiness, low self-esteem or feeling tearful. It can cause a loss of interest in things you used to enjoy, withdrawal, tiredness or sleep issues. In severe forms, it may also cause suicidal thoughts.

CBD may have a positive interaction with the hormone, serotonin in our brains. Serotonin is involved with different functions in our bodies but it can impact a person’s happiness or emotional well-being. Low serotonin levels are associated with depression.

A study examined how CBD could make a difference to people who struggle with seasonal depression. Participants in the study were given 400mg of CBD or a placebo. Researchers reported those given the CBD reported less anxiety than those on the placebo.

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CBD for anxiety

Anxiety is a reaction to stress creating an apprehensive feeling about what may happen. Some people struggle with strong feelings of anxiety every day. These feelings of anxiety can be a symptom of post-traumatic stress disorder (PTSD), generalised anxiety disorder (GAD) or social anxiety disorder.

A study on CBD and sleep quality also found it may reduce anxiety. It involved 72 participants with 47 experiencing anxiety and 25 with poor quality sleep. Each participant was given a daily dose of 25mg of CBD then asked to report how they felt afterwards. The researchers recorded that 79.2 per cent recorded reduced anxiety and 66.7 per cent said their sleep had improved after the first month.

CBD for stress

Our bodies naturally produce a hormone called cortisol which is responsible for our feelings of stress. When we encounter fear or a stressful situation, our brain signals our nerve and hormone systems. Adrenaline and cortisol rush into our body causing a spike in blood pressure and heart rate.

Cortisol increases the glucose in the bloodstream and increases the availability of substances that can repair tissue. It controls mood, motivation and fear.

In one study, male participants with Parkinson’s disease were given CBD then asked to undergo a simulated public speaking test. Researchers reported that an oral dose of 300 mg of CBD given 90 minutes before the test reduce the participant’s anxiety and stress.

The best way to take CBD

There is no right or wrong way to take CBD if you are feeling blue.

The most common ways to take CBD are oils or tinctures, edibles or vaping. Each person may have an individual preference for one method over another. Oils or tinctures can be great if you need a quick, easy way to take a dose but vaping helps the CBD to reach the system faster. This could be a great choice if you are struggling with panic attacks and need a faster dose.

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Edibles are a discreet way to take CBD and they also taste nicer than some oils. The best way to decide what is right for you is to try different methods until you find the one you prefer.

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Mental health

Could CBD be the key to a healthier 2022?

We explore the myriad of ways CBD could help you have a healthy 2022.

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CBD 2022
The start of a new year is always the time for making changes.

The start of a new year is always the time for making changes, setting goals and new promises, could CBD help you make some positive changes this year?

At the end of 2020, 43 per cent of one survey’s participants resolved to eat healthier, while 50 per cent aimed to exercise more. And that was after one year of a pandemic; as we now enter the third, Cannabis Health looks at how CBD could be the key to a healthier 2022 for you. 

What is CBD?

Its official name is cannabidiol and is the second most prevalent active ingredient in cannabis.

Unlike its cousin tetrahydrocannabinol (THC), CBD doesn’t have any psychoactive enzymes and therefore does not cause a ‘high’.

Although studies are continually ongoing, it has not yet been found to have any effects indicative of abuse or dependence. 

Here are just a few of the ways CBD can help you feel healthier this year. 

Anxiety: A banner advert for the medical cannabis clinics

Period pain 

We thought we’d start with the big guns; period pain. Something almost every woman suffers from to some degree, the monthly cramps can have a huge impact on your mood and lifestyle. 

With its soothing and anti-inflammatory properties, CBD is a perfect remedy for menstrual difficulty – and there are so many ways you could take it! 

While oils and edibles are perfect for a quick fix, there are other methods that can be more enjoyable and direct. 

Craving chocolate during your period is totally normal, so why not mix a few drops of CBD oil to a soothing mug of hot chocolate?

Or if you prefer lounging in the bath, throw in a CBD bath bomb to help you fizz away to your happy place feeling relaxed and calm (they’ll even help with lower back pain too).

Want a more direct route? You can’t get more precise than CBD tampons. Vaginal absorption is one of the fastest ways to get a dose into the system, as the walls of the vagina absorb the CBD immediately into the bloodstream where it can get to work. 

New year’s diet

We’ve all been there – pledging to eat well, maybe even lose a few pounds, but how can CBD help you eat healthier?

Adding hemp (the plant from which CBD hails) can have numerous benefits – it’s considered a superfood after all. 

A great source of Omega 3 and 6, polyunsaturated fats that cannot be manufactured by the body, hemp is thought to help reduce cholesterol, and be associated with improvements in skin, heart health and mental health. 

Hemp seeds are also a fantastic, complete protein source so if you’re a gym-goer, athlete or body builder looking to improve their macros, a sprinkling could work wonders! 

A good night’s sleep 

It’s no secret that good health starts when you’re not even awake. A bad night’s sleep can cause a ripple effect of unhealthy decisions. But CBD can help. 

study from 2019 with 72 patients, 25 of whom experienced poor sleep, looked at whether CBD could improve sleep. The participants were given a capsule containing 25 milligrams of CBD and in the first month, 66.7 per cent reported better sleep.

With several methods available, there’s no right or wrong way to take CBD for sleep, but many find oils and edibles work best, although it entirely depends on your own endocannabinoid system. 

Avoiding anxiety and burnout

The added pressure we put on ourselves at this time of year, not to mention the current climate we’re living in, can leave us feeling frazzled and burnt out. This is where CBD could come into its own.

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In 2021, a review of all the research so far found that CBD can have a positive impact on anxiety and stress. Scientists believe that CBD works by interacting with receptors in the brain to potential sending signals to the neurotransmitter, serotonin.

While more research is needed to uncover how precisely the two react, what we do know is that serotonin is the neurotransmitter responsible for mental health and that lower levels are sometimes associated with depression or anxiety, which why the medicinal treatment for anxiety is usually selective serotonin reuptake inhibitors (SSRIs).

Whatever you’re using CBD for, and however you choose to take it, the advice from professionals is always to start low and go slow, upping the dose only once you’re sure of the effects – and always speak to your doctor before making changes to your medication.

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Mental health

Yoga and CBD – how a new event hopes to combine benefits of both

If you have ever been curious about cannabinoids or yoga, then this is could be the event for you.

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Yoga: Two people practising yoga on a mat

Practising yoga is perfect for connecting the body, while CBD may help you to deal with stress and anxiety.

After the stress of the past two years, we could all do with making relaxation and unwinding one of our new year’s resolutions. Taking up yoga or introducing CBD could be a great start to 2022.

A new event, Yoga & CBD:  a sensory workshop, aims to combine the two, offering an evening of yoga, conscious movement and plant education. It will be held on the 20 January at Core Clapton

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The yoga will be led by Victoria Logan, who has been working in the cannabis space for three years, alongside teaching yoga. Roísín Delaney of cannabis consultancy firm, Neon Green, will provide information on the endocannabinoid system while Herbotany Health will be providing CBD products for attendees.

Victoria has been teaching yoga for around four years after completing her teacher training in India, and is passionate about mental health, CBD and reconnecting with the body.

Victoria said: “I came to the cannabis space through the medical route instead of wellness. I’ve been working for the Centre for Medical Cannabis for about three years now trying to change policy around prescriptions. I’ve also been using cannabis myself for a long time as well so I was able to cross over into the CBD market.”

She added: “I understood that people were quite curious about using CBD as a supplement. I met a lot of interesting patients who were using it as part of their daily rituals, especially if they have members of their family who are quite sick. They use CBD as a supplement to help them manage that situation as well. It seemed like a really natural progression to start talking about CBD and introducing it into my practice.”

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Yoga: Victoria Logan performing a yoga pose

Yoga and mental health

Yoga and CBD share a lot in common when it comes to the health benefits they could offer. This is especially true when it comes to helping with mental health conditions.

“It slows everything [down] and allows you to connect the mind and body,” explained Victoria.

“CBD is a natural product that shares a lot of the sort of healing and calming aspects that yoga does. It allows you to come into a correct headspace while giving you the space to manage things. It melts away a lot of mental health issues especially with meditation and pranayama which is a breathing technique we use in yoga.”

Victoria stressed that the session will involve a gentle vinyasa practice, with attendees at the event led through breathing techniques and given CBD to sample. The variation on each pose will allow beginners and experts alike to tailor the event to their experience level.

Although yoga is often associated with flexibility, it isn’t a requirement to get started. There are many different physical and mental health conditions that can benefit from taking part or introducing a regular yoga routine.

“You hear people saying, oh no, I can’t do that as I’m too stiff. You are too stiff because the body is holding on to that trauma or illness, grief or anger, whatever situation has happened to you,” said Victoria.

“With yoga practise, it really works on those areas. Especially a practice called Yin yoga which holds postures for three to five breaths. It’s very floor-based and restorative while also being calming and passive. You may find it a bit uncomfortable to begin with, but the longer you sit in the posture, you learn that it’s actually really beneficial as you are melting away the stress.

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“You are opening the body, allowing it that little bit of space and recovery. Then with the CBD, it’s a lovely extra thing to have in the practise. It can help with stiffness in the body and help with holding the poses for longer.”

Endocannabinoid system education

The event will begin with an introduction to the endocannabinoid system (ECS).

Victoria said: “I think it’s really fundamental that people understand that we have it in our bodies. A lot of people don’t actually know it’s there and that comes down to education. We will introduce the ECS, receptors and how the plant interacts with that.

“We will also have a bit of pranayama which is a breathing technique and w will all take some of the Herbotany CBD. There will also be little pots of ointment for self-massage too. We invite people to smell the product and consciously use it, to take time to appreciate it and nourish the body.”

Yoga events

The event is hoped to be the first of many, with plans to develop a series that can be held across the UK, in person and online.

“Yoga workshops are a really nice thing to attend. It’s a nice environment where you meet lots of lovely people who are on similar journeys or paths. If people are dealing with things, especially at the moment, or something traumatic has happened then it can create a safe space to go and release some of that stress or tension,” added Victoria.

“I love organising events and wellness workshops which bring people together while creating community vibes. I think people would really respond to it at the moment because of the last couple of years. It feels like the next natural thing for us to do is to step outside of this little Covid bubble to create some wellness events and help people move back to whatever normal life is.”

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For more information on the event, click here

 

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