Rheumatoid Arthritis CBD Oil Nhs

Find out more about complementary medicines and the top five that people contact us about. You may be wondering if marijuana may ease the pain and discomfort from rheumatoid arthritis. Here’s what to know. Some people with moderate to severe rheumatoid arthritis (RA) are using cannabinoids to relieve pain. Do they work?

Complementary treatments and arthritis – from turmeric to cannabis oil

People use complementary medicine for many different reasons, including:

  • wanting to use more natural treatments
  • their symptoms aren’t fully controlled by conventional medicine.

Read more about complementary therapies which can help to ease the symptoms of arthritis, from yoga to meditation.

Are they right for me?

As with all complementary treatments, different things work for different people and it isn’t possible to predict which might be the most useful or effective.

There are some key points to consider if you’re thinking about using any complementary treatments.

  • What are you hoping to achieve? Pain relief? More energy? Better sleep? Reduction in medication?
  • What are the financial costs?
  • Is there any evidence for their effectiveness?

Are complementary medicines safe?

Complementary medicines are relatively safe, although you should always talk to your doctor before you start any new treatment.

In specific cases they may not be recommended, for example, if you are pregnant or breastfeeding, or they may interact with certain medication.

A starter for five

Here we share a spotlight on the most popular complementary medicines that people call our helpline about.

Turmeric

It’s thought that turmeric can possibly reduce inflammation, which could help people with arthritis.

People with knee osteoarthritis who took part in a research trial reported improvements to their pain levels after taking turmeric. The evidence is limited however, as it is from just one trial. What evidence there is suggested that people only had minor side-effects after taking turmeric.

Turmeric can be bought from health food shops, pharmacies and supermarkets in the form of powder.

Glucosamine

Glucosamine sulphate and glucosamine hydrochloride are nutritional supplements. Animal studies have found that glucosamine can both delay the breakdown of and repair damaged cartilage.

The results for the use of glucosamine for osteoarthritis are mixed and the size of the effect is modest. There’s some evidence that more recent trials and those using higher-quality methods are less likely to show a benefit.

Capsaicin

Capsaicin is taken from chilli peppers. It works mainly by reducing Substance P, a pain transmitter in your nerves. Results from randomised controlled trials assessing its role in treating osteoarthritis suggest that it can be effective in reducing pain and tenderness in affected joints, and it has no major safety problems. Evidence for its effectiveness for fibromyalgia is related to a single trial.

Other names: Axsain®, Zacin®, chilli, pepper gel, cayenne

Capsaicin is licensed in the UK for osteoarthritis and you can get it on prescription in the form of gels, creams and plasters.

There are no major safety concerns in applying capsaicin gel/cream. A review of capsaicin applied to the skin to treat chronic pain (not specifically related to osteoarthritis, rheumatoid arthritis or fibromyalgia) concluded that around one third of people experience a reaction around the area where the treatment is applied. It’s important to keep capsaicin away from your eyes, mouth and open wounds because it will cause irritation. There have been no reported drug interactions.

Fish oils

Fish oils are rich in omega-3 essential fatty acids, which have strong anti-inflammatory properties. Fish liver oil is also a rich source of vitamin A (a strong antioxidant) and vitamin D (which is important for maintaining healthy joints).

Evidence suggests that fish body oil can improve the symptoms of rheumatoid arthritis. Unconfirmed evidence also suggests a combination of fish body and liver oils might also be useful in the long term, particularly in reducing the use of non-steroidal anti-inflammatory drugs (NSAIDs). There isn’t enough evidence for the use of fish liver oil for osteoarthritis.

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Omega-3 fatty acids also play a role in lowering cholesterol and triglyceride levels in your blood, so they can reduce the risk of heart disease and stroke in people with inflammatory arthritis.

In the UK, dietary guidelines recommend eating two portions of fish a week, including one oily. Fish oil is considered to be well tolerated at this dose.

At the correct doses, side-effects are usually minor and uncommon.

Cannabis oil (CBD)

CBD is type of cannabinoid – a natural substance extracted from the cannabis plant and often mixed with an oil (such as coconut or hemp) to create CBD oil. It does not contain the psychoactive compound called tetrahydrocannabidiol (THC) which is associated with the feeling of being ‘high’.

Research in cannabinoids over the years suggests that they can be effective in treating certain types of chronic pain such as pain from nerve injury, but there is currently not enough evidence to support using cannabinoids in reducing musculoskeletal pain. We welcome further research to better understand its impact and are intently following developments internationally.

CBD oil can be legally bought as a food supplement in the UK from heath food shops and some pharmacies. However, CBD products are not licensed as a medicine for use in arthritis by MHRA (Medicines and Healthcare products Regulatory Authority) or approved by NICE (National Institute for Health and Care Excellence) or the SMC (Scottish Medicines consortium).

We know anecdotally from some people with arthritis, that CBD has reduced their symptoms. If you’re considering using CBD to manage the pain of your arthritis, it’s important to remember it cannot replace your current medicines, and it may interact with them, so please do not stop/start taking anything without speaking to a healthcare professional.

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Medical Marijuana, CBD Oil, and Rheumatoid Arthritis

Researchers still don’t know a lot about how marijuana affects your body. But there is substantial evidence that it can help relieve long-term pain. And pain is a major symptom of rheumatoid arthritis (RA).

Here’s what’s known so far about how medical marijuana and a marijuana extract called CBD (cannabidiol) might affect RA.

Benefits for RA

The Cannabis sativa plant has more than 100 chemicals that can affect your body and mind. The two that scientists know the most about are THC and CBD.

THC, or delta-9-tetrahydrocannabinol, is what gets you high when you smoke, vape, or eat marijuana. CBD doesn’t affect your brain that way. For that reason, some people prefer CBD for medical uses.

Rheumatoid arthritis is an autoimmune disease that can make your joints stiff, tender, and painful. RA also can affect your lungs, eyes, skin, and other body parts.

The federal ban on marijuana and CBD means studies on humans have been few. So researchers don’t know for sure that cannabis eases RA symptoms. But the results from several very small studies suggest that in people with rheumatic diseases, including RA and osteoarthritis, it may help:

  • Curb morning pain (but not the overall level of pain)
  • Improve sleep
  • Lower inflammation in joints (but not joint stiffness)

Unproven Therapy

Some lab testing suggests that cannabinoids may help tamp down the body’s immune response. But the studies have been limited to animals, not humans.

Doctors will need more proof before they can recommend cannabis products to treat rheumatic diseases. For example, we know very little about the effects on RA from smoking marijuana or other uses of herbal marijuana.

Is Cannabis Right for You?

The best way to answer this is to ask your doctor. They can tell you about possible side effects and drug interactions, legal considerations, and which form and at which dose may help you the most.

More than half of the states have legalized marijuana for medical use. More than a dozen other states allow limited medical uses of CBD.

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The FDA doesn’t regulate marijuana or CBD, so you might not know exactly what’s in the products you buy. One batch of pot or edible marijuana may have a much higher or lower amount of THC than another, or affect you differently. CBD also can be unpredictable.

Side Effects

Cannabis can affect you mentally and physically. THC can impair driving, so you shouldn’t get behind the wheel for at least 8 hours after you take it. Smoking or vaping (inhaling) marijuana will hit you more quickly than if you eat it. It’s also not good for your lungs or respiratory system.

If you use marijuana regularly, it could make you more likely to get anxiety, depression, and other mental illnesses.

CBD side effects are usually mild or moderate. They can include:

Medical marijuana has similar side effects, that may include:

Where to Get It

Depending on your state, you may need to buy medical marijuana and CBD at specific dispensaries or pharmacies from approved vendors. Your doctor may need to certify that you have a condition that may benefit from marijuana.

Marijuana is available in many forms, like pills, prepared foods, teas, nasal sprays, and as something you smoke or vape.

In some states, CBD is sold at many all-natural food stores and online. It can be taken by mouth as oil or extracts, or applied to your skin.

Show Sources

Chemistry & Biochemistry: “History of Cannabis and Its Preparations in Saga, Science, and Sobriquet.”

Mayo Clinic: “Mayo Clinic Q and A: Treatment with medical cannabis,” “Marijuana,” “What are the benefits of CBD — and is it safe to use?” “Rheumatoid arthritis.”

News release, The National Academies of Sciences, Engineering, and Medicine: “The Health Effects of Cannabis and Cannabinoids.”

Dialogues in Clinical Neuroscience: “Cannabis, Cannabinoids, and Health.”

Arthritis Care & Research: “Efficacy, Tolerability, and Safety of Cannabinoid Treatments in the Rheumatic Diseases: A Systematic Review of Randomized Controlled Trials.”

Nature Reviews Rheumatology: “Cannabinoids for the treatment of rheumatic diseases — where do we stand?”

U.S. Drug Enforcement Administration: “Drug Scheduling.”

Cannabis and Cannabinoid Research: “Cannabis and Pain: A Clinical Review.”

Journal of Medical Toxicology: “Medical Marijuana and Driving: A Review.”

National Center for Complementary and Integrative Health: “Marijuana and Cannabinoids.”

Does CBD Oil Help With RA?

People with rheumatoid arthritis and other pain conditions are trying cannabinoids to alleviate their symptoms. Here’s what you need to know.

There was a time in Ron Lev’s life when the pain from his rheumatoid arthritis (RA) was so bad that he felt like nothing could help him.

“You just sit still because it’s too painful to stand,” says Lev, 44. “Everything you can imagine doing is painful. Even eating is painful. Driving a car, opening a door, turning the ignition.”

After decades of treating his RA with biologic drugs and steroids, Lev was on the verge of accepting the pain as his “new normal.” However, he’d heard of other people with the condition using cannabinoids (CBD) to alleviate their pain and, four years ago, he decided to give it a try, too.

“At that time, I’d been on steroids for 23 years,” he says. Some of the long-term side effects he’d experienced from the medication included thinned skin, bloating, and weight gain, among others. “I tried unsuccessfully to wean off the steroids, but the pain was so bad… that I just kept using them.”

Within months of starting on cannabinoids, with guidance and direction from his rheumatologist, Lev not only weaned himself off the steroids, he was also able to spread out his biologic infusions from every couple of months to every 6 months. Now, he only gets infusions once a year.

After seeing the tremendous pain relief CBD offered him personally, Lev started his own CBD company, Reclaim Labs, in 2018.

Stories like Lev’s are becoming more and more common among people with RA and other autoimmune disorders. According to a 2019 poll from the Arthritis Foundation, 29 percent of people with arthritis report currently using CBD — mainly in liquid or topical form — while nearly 80 percent were either using CBD, had used it in the past, or were thinking about using it.

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There’s also growing scientific evidence, including a study published in September 2020 in the journal Cell Disease & Death, that cannabinoids can alleviate pain from RA and act as an effective anti-inflammatory agent, with few, if any, side effects — unlike anti-inflammatory drugs such as steroids or biologics options.

“We’re seeing more organized and well-done research on the benefits of cannabinoids and CBD when treating RA,” explains Anca Askanase, MD, a rheumatologist and associate professor of medicine and director of rheumatology clinical trials at Columbia University Medical Center in New York City. “As a culture we’ve embraced both medicinal and recreational use of marijuana, and we’re seeing that it does help alleviate pain, especially with RA patients.”

Research on CBD in RA Needed

Positive news aside, Dr. Askanase cautions that more studies doesn’t necessarily mean enough studies.

“We’re going about things backwards — it’s been approved before we have all the research there to support it,” she says. “My biggest concern is that we need to understand and use cannabinoids in a more organized and mindful way as opposed to just saying, ‘It’s legal, it sounds like it works, just take some.’”

One reason for the hesitation on the part of Askanase and her fellow rheumatologists is that while cannabinoids may significantly reduce pain and inflammation, they can also trigger other side effects when smoked. For example, people who have RA can have a greater risk of developing lung and heart issues, which can be exacerbated by smoking marijuana, according to the Centers for Disease Control and Prevention.

Another concern, says Askanase, is the potential addictive nature of the drug. “We’ve learned that most of the things that act on the brain like cannabinoids do have some addictive potential,” she explains. “This is something that needs to be further researched.”

The Truth About CBD Oil and RA

Still, there’s no denying that despite the lack of research, people with RA report that CBD has significantly lessened their pain.

A survey published in November 2019 in the Journal of Psychoactive Drugs found that, of the respondents taking legalized cannabis for pain relief, 80 percent described it as “very or extremely helpful.” Among respondents taking over-the-counter pain medications, 82 percent reported reducing or stopping use of those medications. Among respondents taking opioid analgesics, 88 percent reported reducing or stopping use of those medications.

“I tried for years to stop taking steroids and it’s incredibly difficult to do,” explains Lev. “CBD is the only thing that has helped get me off steroids and relieve my pain.”

Additionally, there’s research that shows cannabis has a powerful anti-inflammatory effect, which can help address the inflammation behind RA. According to a review published in May 2019 by the journal Current Opinion in Rheumatology, researchers have found that “cannabinoids show anti-inflammatory effects by activating cannabinoid type 2 receptors, which decrease cytokine production” (cytokines are proteins known to be involved in inflammation).

The authors concluded that cannabis may be a suitable option for treating RA.

While Askanase is among a growing number of rheumatologists who are interested in seeing more research on CBD in RA, she also cautions that it shouldn’t be used as a stand-alone treatment.

“We need to very clearly make an effort to say that cannabinoids are supplementary interventions but should not replace the traditional disease-modifying therapies we currently have available,” she explains. If you’re considering using CBD as a complementary treatment option, she says, you should seek out medical marijuana dispensaries, which have some medical supervision and control over the products and the amount being used.