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
Get our printable guide for your next doctor’s appointment to help you ask the right questions.
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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.
Marijuana for Chronic Fatigue Syndrome (CFS)
Chronic Fatigue Syndrome (CFS), less-commonly known as myalgic encephalomyelitis (ME), is a medical condition with a variety of debilitating symptoms. The most common symptom is extreme fatigue, a problem which is difficult to manage and can have a major impact on the sufferer’s quality of life.
With a lack of effective conventional treatment options available, more and more people with CFS are now turning to medical marijuana for help. But is cannabis good for chronic fatigue or is this just a fad?
Keep reading to find out more about cannabis for chronic fatigue syndrome, plus some of the best cannabis strains for CFS that are available from your local dispensary.
What is Chronic Fatigue Syndrome?
CFS is a long-term health condition with no known cure. The exact cause of CFS is still unclear, although it is thought to be triggered by several different factors including:
- A viral or bacterial infection
- A problem with the immune system
- Hormonal imbalance
- Emotional trauma or extreme stress
It also seems likely that there is a genetic factor as CFS appears to run in families to some extent. CFS is more likely to affect women than men, and it usually develops between the mid-twenties and mid-forties.
Chronic Fatigue Syndrome Symptoms
CFS has a variety of symptoms which can get better or worse on a daily basis. People with CFS may suffer from relapses or ‘setbacks’ where their symptoms become significantly worse for some time.
The most common symptoms of CFS include:
- Overwhelming physical or mental tiredness
- Muscle and joint pain
- Poor memory or difficulty concentrating
- Sore throat or glands
- Flu-like symptoms
These unpleasant symptoms can range from mild to severe and can vary greatly from person to person. They often become worse following over-exercising or physical or mental exertion.
Chronic Fatigue Syndrome Treatments
Since the exact cause of CFS is a mystery, treatment options for the condition are very limited.
Medication can be used to manage symptoms such as headaches and muscle pain, and some common drugs include painkillers and antidepressants. While these treatments can offer some relief, they do carry the risk of side effects, especially strong analgesics such as opioids.
Talking therapies such as CBT (cognitive behavioral therapy) may also be useful for people with CFS. They can help patients to come to terms with their diagnosis, and assist them in developing coping strategies and staying mentally well.
Another good option is graded exercise therapy or activity management. This involves slowly increasing activity levels over time, allowing CFS patients to build up to milestones such as completing household chores or going shopping without triggering a relapse.
In addition to these treatment options, there are also several lifestyle changes which may help to manage CFS symptoms. These include eating a well-balanced, nutritious diet, maintaining good sleeping habits, and finding an appropriate balance between activity and rest.
Although many people with CFS find supplements and complementary therapies such as acupuncture helpful, there is little scientific evidence that these treatments for CFS work.
With such a lack of viable treatment options, it is little wonder that many CFS patients are now turning to medical marijuana to find some relief.
Medical Cannabis and Chronic Fatigue Syndrome
Since marijuana has been illegal for so many years, there is a lack of research specifically regarding cannabis and chronic fatigue syndrome. However, there is plentiful anecdotal evidence that the herb can provide some relief.
Furthermore, a 2011 study into cannabis for fibromyalgia, a condition with many similar symptoms to CFS, found that after using marijuana, patients experienced improvements in pain and stiffness, relaxation, sleepiness, and perceived general wellbeing. The patients who used cannabis also scored significantly higher for mental health compared with those who did not.
It seems the potential benefits of cannabis for CFS patients are numerous. The herb is well-known for its ability to relieve pain, provide relaxation, aid sleep, and help with various emotional issues such as anxiety and depression. But can cannabis relieve the extreme tiredness that makes CFS such a debilitating condition?
The answer is not straightforward, unfortunately, and will depend a lot on the strain of cannabis that you choose. Indica strains are generally associated with relaxation and pain relief but may cause unwanted side effects such as increased tiredness if used during the day. Sativa strains, conversely, are associated with more uplifting, cerebral effects and may help improve energy and mental focus as well as offering relief from depression.
Therefore, if you are looking for a cannabis strain to help you sleep better at night, a potent indica such as the legendary Northern Lights is a good choice. However, if you are suffering from fatigue, a more sativa-leaning strain may be more appropriate.
The Best Cannabis Strains for Chronic Fatigue Syndrome
Most of the cannabis strains that you encounter these days are hybrids, with a mix of indica and sativa heritage. Although pure sativa strains can be hard to find, there are plenty of sativa-dominant hybrids that could offer a burst of energy and potentially provide some relief from CFS symptoms.
Here are some of our favorite cannabis strains for CFS:
Jack Herer is a classic strain which is known for its powerful high and energizing effects. With a THC content of 18–24%, this sativa-leaning hybrid is often used to treat fatigue as well as mental health issues like anxiety and depression.
Super Silver Haze
Another sativa-dominant strain (70%), Super Silver Haze is a great medicinal strain containing 18–23% THC. One of the most sought-after benefits of this strain is to provide a much-needed energy boost and help to relieve fatigue.
As the name suggests, Green Crack is another powerfully energizing strain. With a THC content of 15–20%, Green Crack is also often used to relieve stress, anxiety, and depression.
Durban Poison is a landrace cannabis strain from South Africa, meaning that it is as close to a pure sativa strain as you will find these days. With a generous THC content of 17–26%, Durban Poison should improve your physical and mental energy and help you to power through the day.
Sour Diesel is a popular strain which has been used for breeding a variety of others with similarly energizing effects. It is 90% sativa-dominant and has a THC content of 18–26%, making it useful in the treatment of fatigue, depression, stress, and pain.
Just the name Jet Fuel says a lot about this strain’s potent, energizing effects. This 70% sativa-dominant hybrid is a descendant of Sour Diesel and contains 17–24% THC. As well as relieving fatigue, this cannabis strain may also be useful for those suffering from headaches and depression.
No list of medicinal strains would be complete without mentioning the ever-popular Blue Dream. This 60% sativa-dominant strain can contain as much as 25% THC, and as well as relieving fatigue, it may also be useful in the treatment of stress and pain.
Although these cannabis strains for CFS are not yet scientifically proven to work, with so few treatment options available, they could well be worth a try.
Using Cannabis for Chronic Fatigue Syndrome
While many people choose to smoke or vaporize their marijuana, there are plenty of other options available too. Although smoking and vaping offer the fastest relief, the effects of edibles may last longer due to the way that cannabinoids are metabolized after oral ingestion.
If you do decide to take the edibles route, you should be cautious as they may take one or two hours to take effect. On some occasions, this has led people to think that their marijuana-infused treats are ineffective and take a second dose, leading to them having a very bad time once they do kick in.
Other options include cannabis oils and tinctures which can be held under the tongue before swallowing. This means that the cannabinoids enter the bloodstream more quickly than they would with edibles, but not rapidly as smoking or vaping.
If you do decide to vape your cannabis for CFS, be sure to set your vaporizer to the right temperature to ensure that you benefit from the full range of cannabinoids and therapeutic terpenes.
And last but not least, a quick word of caution. If you do feel a sudden increase in energy after using cannabis for CFS, don’t be tempted to overdo it. You may feel like you can conquer the world for a few hours, but after the effects have worn off, you could end up feeling a whole lot worse.
Cannabis for Chronic Fatigue Syndrome: Final Thoughts
CFS is a condition which is both difficult to live with and challenging to treat. Although using marijuana for CFS may provide some relief, there is a lack of research into the subject, and it may work better for some people than others.
Here at WayofLeaf, we believe in the healing powers of cannabis, but we are not doctors. If you plan to use medical marijuana for CFS or any other condition, consult a qualified physician for further advice.
We take a look at cannabis for chronic fatigue syndrome, how it works, and some of the best marijuana strains for this medical condition.