A new study, led by Southern Cross University in Australia, will research the efficacy of medicinal cannabis in the treatment of patients with fibromyalgia.
The project, which is expected to commence in early 2022, will assess the safety, tolerability and efficacy of medicinal cannabis in relieving pain and other symptoms in adult patients diagnosed with fibromyalgia syndrome (FMS)
FMS affects approximately 2.7 percent of the global population and is characterised by chronic widespread pain, sleep disturbances, morning stiffness, severe fatigue and cognitive dysfunction.
It is often accompanied by other somatic and psychological impairments including mood changes, depression, anxiety, irritable bowel syndrome, vulvodynia, interstitial cystitis, chronic prostatitis, temporomandibular joint dysfunction and headaches.
Treatment options are limited for people suffering FMS with previous studies demonstrating medicinal cannabis may be beneficial for some people suffering FMS.
Intended to run over a three-year period, the Southern Cross study will be conducted in three stages starting with a literature review and survey.
The final stage, a Phase 2 randomised controlled, double blinded, placebo-controlled clinical trial, is planned to begin recruitment in 2022 and uses medicinal cannabis in a 1 THC: 1 CBD ratio versus a placebo for a three-month period with follow-ups for a further six months post-trial.
The Principal Investigator for this research undertaken by Southern Cross University is Dr Janet Schloss, part of the National Centre for Naturopathic Medicine as the Clinical Research Fellow conducting clinical trials and has also been in private practice as a Naturopath and Nutritionist for over 20 years.
Australian medical cannabis company Little Green Pharma (LGP) will provide funding for the three-year PhD Scholarship and research supervision, as well as medicinal cannabis products in connection with the research project.
Commenting on the research program, LGP Head of Research and Innovation Dr Leon Warne said: “LGP is proud to be associated with Southern Cross University in this important research study. FMS is a debilitating disease and knowing that LGP is doing its part to assist in a clinical trial into the effectiveness of medicinal cannabis in treating FMS sufferers goes to the heart of our goal of providing a cost-effective therapy to enhance the quality of life of patients.”
Under the Scholarship grant agreement, LGP will provide scholarship funding to support PhD candidate Inna Kurlyandchik.
Kurlyandchik commented: “Fibromyalgia is a complex condition with limited treatment options available. Last year we undertook a systematic review and found that medicinal cannabis has potential to reduce pain and improve the quality of life in fibromyalgia patients. I would like to express my gratitude for the PhD scholarship provided to me by Little Green Pharma LTD and Southern Cross University, which will allow me to build upon previous research in this area and further understand safety and efficacy of medicinal cannabis in treatment of this complex disorder.”
CBD for fibromyalgia pain – where to start?
Studies are indicating that CBD could be a helpful tool in managing symptoms of fibromyalgia.
Increasing numbers of studies indicate that CBD could be a helpful tool in managing some of the symptoms of fibromyalgia, but knowing where to start can be daunting.
Fibromyalgia, a condition characterised by widespread pain, brain fog and sleeping issues, is notoriously difficult to treat.
Over-the-counter and prescription medications are often the first port of call, but these can be accompanied by unwanted side effects that may leave sufferers feeling worse.
Evidence is growing that cannabidiol (CBD) could be the answer to fibromyalgia patients’ prayers, with a number of studies into the effects of CBD showing a clear correlation between its use and a reduction in pain, along with improved sleep.
One such study, published in the Journal of Cannabis Research, clearly pointed to a reduction in pain and other symptoms in patients with fibromyalgia.
An Italian researcher explored the long-term use of various types of cannabis in 38 patients with treatment-resistant fibromyalgia. Participants consumed CBD for up to 12 months, in conjunction with their prescribed medications.
The author reported that “significant improvements were observed” following the initiation of cannabis therapy in most of the patients.
Anecdotally, too, increasing numbers of people are turning to CBD to ease their fibromyalgia symptoms, especially those for whom traditional treatments have failed, or who are uncomfortable being reliant on prescription medication.
A 2020 survey by the National Fibromyalgia Association found that more than a third of women with CPP, the pelvic pain common in fibromyalgia patients, used CBD for pain relief, better sleep and to treat anxiety.
A US study, meanwhile, discovered that more than 70 per cent of fibromyalgia patients were using CBD as an alternative to opioid medications.
How to use CBD for fibromyalgia
Nowadays, there are a variety of different ways to use CBD, from food and drinks to topical remedies, and even pillows, candles and make-up.
However, the most common (and practical) ways to take it to ease fibromyalgia symptoms are through edibles and tinctures.
Edibles are when CBD oil has been used as an ingredient in baked goods, gummies, drinks or chocolates.
They may take longer to take effect, but when they do, the effects tend to last longer, which may make them a popular choice for those suffering chronic pain.
However, some experts urge caution when it comes to taking CBD edibles because dosing can be unreliable.
Tinctures, on the other hand, are made by soaking cannabis flowers in alcohol for an extended period of time. This process extracts the CBD into a more concentrated form than found in most CBD oil products. Tinctures are taken by the drop, and can be used on their own or mixed with food or a drink.
CBD is also available in topical treatments, such as balms or creams, which may be beneficial if the pain is concentrated in a particular location. It can also be found in bathing products, which have the added benefit of relaxing the body ahead of bedtime, hopefully increasing the chances of a good night’s sleep.
Before taking CBD in whatever form, there are some things to be aware of.
Firstly, the advice is always to start low and go slow. This means taking a very small amount infrequently, gradually increasing it until you find what gives you the result you’re hoping for.
Secondly, as with all other natural products, there is the potential for adverse reactions when taken with other medications, especially those that come with grapefruit warnings, such as certain blood thinners. These warnings indicate that certain medications should not be taken with products containing grapefruit.
However, as long as guidance is followed, CBD, with its well-documented anti-inflammatory and calming properties, could be well worth trying to ease a number of debilitating fibromyalgia symptoms in one product.
CBD guides: Could CBD help the symptoms of long covid and fibromyalgia?
A study reported that 30 per cent of patients with Long Covid met the diagnosis criteria for fibromyalgia
The Office for National Statistics reveals that 1.3 million people in the UK are estimated to have Long Covid. We ask if CBD could help the symptoms.
Long Covid is a series of symptoms that persist for weeks after the initial infection. As part of the survey, 325,000 people were asked to record their own symptoms. The results recorded shortness of breath, extreme tiredness and brain fog among others. Fatigue was the most common symptom with 51 per cent of participants stating they were struggling with extreme tiredness.
Similar symptoms have also been noted in patients diagnosed with fibromyalgia.
In a study from late 2021, it was reported that 30 per cent of patients with Long Covid met the diagnosis criteria for fibromyalgia. The survey included responses from 600 patients who had recovered from COVID infection but were now struggling with their symptoms post-infection.
The survey was based on the American College of Rheumatology’s Survey Criteria for Fibromyalgia, as well as its Fibromyalgia Impact Questionnaire. It suggested that inflammation to the lining of the blood vessels or immune system post-infection could be the cause. Interestingly, the survey results revealed that men were more likely than women to develop symptoms in line with fibromyalgia. Fibromyalgia is thought to affect more women than men.
As Long Covid is a relatively new condition, there are not as many studies as there are for fibromyalgia. We ask if CBD could help the overlapping symptoms of both.
Inflammation is a response from the body when it is under extreme stress. Patients with Long Covid experience a cytokine storm which is an extreme inflammatory response. If the body releases too many cytokines into the system, it can lead to acute respiratory distress syndrome (ARDS).
This inflammation can lead to severe pneumonia making breathing difficult. Research has shown that CBD may reduce a number of the inflammatory cytokines associated with Covid such as IL-6 or interleukin (IL)-2.
A pre-Covid study on animals with asthma also showed that CBD could potentially reduce cytokine production making it easier for them to breathe. The same study also revealed that it had an effect on pulmonary fibrosis which is a thickening of the blood vessels and scarring leading to long term breathing complications.
Patients with fibromyalgia may also experience inflammation. Studies show CBD may help to reduce the level of painful inflammation. One study found that CBD may prevent the hypersensitivity of cells in the surrounding nerves for people experiencing chronic pain.
With both conditions, fatigue is reported to be one of the most common symptoms. Fatigue is a response to the body attempting to fight a viral infection such as Covid. In Fibromyalgia, this can range from mild tiredness to severe exhaustion with flu-like symptoms.
CBD may help with sleepiness or reduce anxiety or stress which may interfere with sleep.
A study examined if CBD could help sleep or anxiety. Researchers took 72 participants with anxiety and poor sleep. They were given 25 mg of CBD in a capsule daily. Within the first month, 79.2 per cent reported lower anxiety levels while 66.7 per cent reported better sleep as a result.
A lack of sleep, pain and fatigue can combine to create intense headaches. Migraine headaches can cause sensitivity to light, an upset stomach, loss of appetite and you may even feel sick. Viral infections such as Covid can make existing migraine attacks worse and they may be more frequent or last longer than usual.
Fibromyalgia may cause stiffness in the neck or shoulders which leads to headaches or migraines.
A study from 2016 found that CBD may help with migraine pain relief. The study took place at two medical cannabis clinics in Colorado. The patients used medical cannabis that had a percentage of CBD but also contained THC. The results showed that 48 patients reported that it had helped to reduce the number of headaches they experienced and the frequency. A further 24 patients found that it stopped their headaches.
Depression and anxiety are common with both conditions.
Coping with the long-term effects of a new diagnosis or worrying about what life may be like in the future.
CBD may have a positive interaction with the hormone, serotonin in our brains. Serotonin is involved with a lot of different functions in our bodies but it impacts a person’s happiness and emotional well-being. Low serotonin levels are associated with depression. A review of existing studies showed that CBD may have anti-stress effects that could reduce depression.
Some terpenes are also thought to have potential benefits for patients with Long Covid. Terpenes give plants their smell and taste. Different terpenes can be found in CBD or cannabis strains and are thought to be associated with certain health benefits. Pine needles are a great example of a terpene.
Beta-caryophyllene which can be found in hops, cloves and rosemary also interacts with the CB2 receptors in the body. Due to its interaction with this receptor, it may have anti-inflammatory, antiviral, and immunomodulatory properties.
As a result, it may help with infection, immunity, and inflammation. All of which are experienced by those with Long Covid.
Myrcene is another terpene commonly found in thyme and lemongrass that may be helpful for fibromyalgia. It is a powerful anti-inflammatory and also, may help with sleep issues.
Could medical cannabis help fibromyalgia?
We examine the science surrounding medical cannabis for fibromyalgia
Fibromyalgia can be a debilitating and extremely painful condition. We examine if medical cannabis could offer some help with symptoms.
Fibromyalgia is a condition that causes pain, fatigue brain fog and causes difficulty sleeping. It also causes memory problems and headaches. It is estimated that may be around 1.5 to 2 million people in the UK with the condition. It is thought to affect more women than men.
There is currently no cure for fibromyalgia but some patients have turned to CBD and cannabis for relief from their symptoms.
One study that tested Bediol, which contains both THC and CBD on patients with fibromyalgia reported a 30 per cent decrease in pain in comparison to those who took a placebo. Bediol is a high-THC variety of cannabis.
Chronic pain studies
A review of studies on THC and CBD for pain found that in twenty-eight trials that were mostly linked to multiple sclerosis, revealed it may help chronic pain.
One study reported the effects of cannabis in 56 participants, predominately women, with fibromyalgia. The group were split between those who did and did not use cannabis. After two hours of using cannabis, they reported a decrease in pain or stiffness and felt sleepier. There was also an improvement in mental health scores.
Fibromyalgia and inflammation
A new study on patients diagnosed with fibromyalgia and other inflammatory rheumatic diseases, reports a reduction in pain levels following medical cannabis use. The study surveyed 319 patients about their use of medical cannabis products. Those with fibromyalgia accounting for 82 per cent of the group, reported a mean pain level reduction of 77 per cent. They also reported sleep quality improvement of 78 per cent. According to the results, the THC concentration, duration of consumption, and dose had potentially significant effects on pain reduction. Only the duration of consumption had an independent significant effect on sleep quality improvement.
Whole plant cannabis
A new review suggests that whole-plant cannabis may provide relief or improve different symptoms experienced by fibromyalgia patients. Researchers examined scientific papers specific to either the use of cannabis or synthetic cannabinoids in fibromyalgia patients. They reported that cannabis or cannabinoids may help with various symptoms and are safe for use in treatment.
The research focused on 313 studies that investigated Nabilone, Dronabinol, Bedrocan, Bediol and Bedrolite.
How do I get medical cannabis?
In the UK, medical cannabis must be prescribed by a doctor. There are a number of clinics around the country that offer medical cannabis for fibromyalgia patients.
A person can self-refer themselves for a consultation at a clinic through the websites. Prior to the consultation, a patient will be asked to gather their notes and information from their GP about their condition which outlines their treatment. Clinics can offer in-person appointments or over Zoom. It may depend on distance or COVID-19 restrictions.
Once a person has been assessed by a doctor, their case is usually examined by a multi-disciplinary team who decide if cannabis may be the right option. If it is, the clinic will speak to the patient about the different options available before sending their prescription to a pharmacy.
The pharmacy will then post the cannabis to the patient. Follow-up appointments will be made at different intervals to discuss the effects of cannabis.
How much does medical cannabis cost?
The cost for a prescription will vary on what type of prescription it is and how much is ordered.
Different clinics or pharmacies may have varying prices for oils or flower. There will also be different prices for initial consultations and follow-up appointments. It is worth checking with the clinic how much they charge for all of these before committing to a consultation. Also, some clinics may have access programs in place to help patients on lower incomes.
Medical cannabis is not widely available on the NHS yet.
What is the best way to take medical cannabis?
This varies from person to person depending on a number of factors. Medical cannabis is usually available in flowers that can be vaped, oil that can be taken orally or topicals that are applied to the skin.
Personal preference may mean that a person prefers vaping to oils because of the taste or topicals rather than flower. For some, taking oral oils may be a problem or they dislike the taste. In selecting a product, it is worth noting what you prefer or switching to another method if the original doesn’t suit you.
Your doctor may also be able to advise you on methods and also what strength of product is needed.
How do I know if medical cannabis works for my fibromyalgia?
Keeping a journal can help with making any notes about changes you experience. It is also helpful to keep a record so that you can let your doctor know at a follow-up appointment if you have experienced anything negative.
Your follow-up appointments will usually involve speaking to a doctor about your cannabis journey. It may also include filling in questionnaires about how you feel physically or mentally. These are designed to highlight any changes which may require your medication to be adapted.
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