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
- Halting the growth of cancerous tumors
- The pain of glaucoma
- Epilepsy, especially in children
- Bipolar disorder
- Multiple sclerosis
- Parkinson’s disease
- 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.
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
- 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
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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.
Living with chronic fatigue – my CBD story
26th November 2020
Emma Franklin, who lives with chronic fatigue syndrome (CFS), on how cannabidoil changed her life.
CFS is like having the worst flu of your life ALL the time so your energy is very limited and you are debilitated (there are different severities). You only have so much energy each day almost like a battery that goes flat really quickly and you have to wait until the next day until it’s charged again.
For example, with my current energy levels I have a few hours each day where I can ‘do’ things – they include making food / eating / showering / watching tv / replying to emails / any work etc / meeting a friend / having conversations then once that energy is gone it’s gone.
So it’s hard for me to do ‘extra’ things like reply to emails when I only just have enough energy to look after myself, there isn’t much spare! Most people with CFS also have other symptoms like joint and muscle pain – which can be so debilitating – and cognitive problems like memory loss and poor concentration, which is partly why I’m limited in the amount and type of work I can do.
Sore throat and enlarged lymph nodes are also common, The point being it does affect my life still every day but I’m so grateful for how much progress I’ve made and continue to make.
I believe CBD oil has been a really important part of my recovery. I was diagnosed with CFS aged 19 – eight years ago – and spent about five years prior to the diagnosis seeing numerous GPs and specialists on the NHS doing a lot of different tests. None of them could find out what 35 was wrong with me until, eventually, an immunologist diagnosed me with CFS.
It was actually my mum who first knew something was wrong. She was the one who started taking me to the doctors because I was coming home from school going straight to bed, getting up to eat then going back to bed until the next day. Fatigue is different to tiredness; it’s debilitating where you physically cannot do things no matter how hard you try.
Imagine the worst flu of your life multiplied by 100. You just physically can’t get out of bed. With CFS your body is like this ALL the time it doesn’t come and go. I didn’t realise something was wrong though I assumed everyone was like this because I was so young!
Just before I was diagnosed with CFS I was working part time at Topshop as a personal shopper and I had to quit my job because I couldn’t stand up enough to work. I used to go to the toilet every hour and lie down on the floor because I wasn’t able to be up and about. I still had no idea what was wrong with me.
I had to quit and soon after I was diagnosed. I was out of work from the age of 19 until last year aged 26 when I started to work from home as a part-time freelancer. I had managed to go to uni for two years to study Fashion Communications and Journalism in London and Sydney, Australia.
But by the end of the 2nd year I was in a wheelchair, had to return home from Australia and couldn’t go back to uni after that. When I was bedridden I didn’t have a routine. I was paralysed of the arms and legs, unable to eat, walk, stand or talk, and my mum used to spoon feed me puréed food.
Then every two weeks she’d lift me out of the bed into the bath, wash me, change my pyjamas and put me back in bed. I couldn’t tolerate any light or noise so I lived in silence and black out for seven months.
I didn’t have much feeling I was so unwell; it was like I wasn’t there and you couldn’t communicate with me. My mum was forced to give up work when I needed 24 -hour care. She gave up her entire life to look after me and help me get better. She couldn’t even leave the house or see family or friends for a year because I needed round-the-clock care.
My dad financially supported my treatment during this time. I wouldn’t be here today without them! I have struggled with depression from the trauma I experienced and being so debilitated and limited. My life hasn’t exactly been ‘normal’. I also have anxiety and fear of ending up like that again from post traumatic stress.
I see a psychologist though who is amazing and helps me a lot. Sadly I lost a lot of friends from being ill. I went from being the fun outgoing person who lived life to the full 36 to not being able to go out so much or have much energy to maintain friendships.
Thankfully I’ve made many new friends who I wouldn’t have met if I hadn’t become ill, which I’m really grateful for. I’ve faced a lot of judgement and criticism over the years because I don’t look sick and I’m generally a happy, upbeat, optimistic person so people wonder ‘how can she feel so bad when she’s like that?’
People just don’t understand when you have a chronic illness those symptoms aren’t going to be going anywhere anytime soon so you either make the most of the situation and what you can do despite how bad you feel or you just give up, which wasn’t an option for me.
I’ve learnt to not care what other people think though. As long as I’m happy with where I’m at and what I’m doing, that’s all that matters! Last year I tried CBD for the first time.
I had seen many different types of CBD advertised but found it overwhelming with so many different types and so much information to process and understand. But I chose Hapi Hemp. It appealed to me because it’s an independent British business which I always love to support.
I also really liked their ethics; they felt much more approachable, friendly and family orientated than other CBD brands available. I began to take the CBD to help with CFS and anxiety and depression. Over a period of a few weeks I began sleeping more easily. Prior to this I used to stay awake for hours each night unable to sleep.
These sleep improvements have meant I’ve been able to return to work after seven years out of work. I’ve also seen huge improvements in activity levels as my pain levels have reduced. I’ve taken CBD every day for nearly nine months now and will continue to take it as part of my daily routine.
My doctor believes CBD is a really important part of recovery for anyone who has CFS / ME! It’s wonderful to have my doctor’s encouragement and support. Taking Hapi Hemp CBD oil fits perfectly with my routine health limitations
As time goes on I hope it will allow me to work more and more, growing my freelance social media business and my online community to help as many people as possible with the information and knowledge I’ve learnt over the years so they don’t have to go through what I’ve been through.
I would also like to spend more time with friends, family and travel more which I’ve not been able to do as much as I like. I feel like social media is a very important tool because without it I wouldn’t have discovered Hapi Hemp or CBD generally.
Living with chronic fatigue – my CBD story 26th November 2020 Emma Franklin, who lives with chronic fatigue syndrome (CFS), on how cannabidoil changed her life. CFS is like having the