The Increased Interest In Cbd Products As Supplemental Treatment
There is also a very confusing array of CBD products that are available for purchase. These vary in:
- What the manufacturers state is in the product. That is, some formulations of CBD will state on their label that they also contain a small amount of THC or that they contain other cannabis-derived compounds, but not THC. Others state that they are pure CBD.
- The formulation. CBD is available in oils, creams, pills, inhalants and more.
It is not just the Parkinsons disease community that has taken an interest in CBD. There are countless health claims that CBD is helpful for a whole host of conditions. Clinical trial evidence to support the use of CBD however, is minimal. The only FDA-approved indication for CBD is to reduce seizure frequency in certain rare and severe forms of childhood epilepsy. A purified form of CBD, sold under the brand name Epidiolex® was tested in a well-designed clinical trial in order to gain this approval. .
For all the other health claims, there is not enough clinical trial data to allow the FDA to state whether or not CBD is effective. And there definitely is not enough data to support the use of one type or formulation of CBD over another.
This has not dimmed the enthusiasm of millions of CBD users for a wide range of medical conditions.
Over Half Of Cannabis Users With Parkinson’s Disease Report Clinical Benefits
A survey in Germany found over 8% of patients with Parkinson’s disease are using cannabis products and more than half experienced beneficial clinical effects, reports the Journal of Parkinson’s Disease
Amsterdam, NL, January 26, 2021 – With medicinal cannabis now legalized in many parts of the world, there is growing interest in its use to alleviate symptoms of many illnesses including Parkinson’s disease . According to results of a survey of PD patients in Germany in the Journal of Parkinson’s Disease, over 8% of patients with PD reported using cannabis products and more than half of those users reported a beneficial clinical effect.
Cannabis products containing THC can be prescribed in Germany when previous therapies are unsuccessful or not tolerated, and where cannabis can be expected with not a very unlikely chance to relieve disabling symptoms. CBD is available without a prescription from pharmacies and on the internet.
Investigators aimed to assess patient perceptions of medicinal cannabis as well as evaluate the experiences of patients already using cannabis products. They performed a nationwide, cross-sectional, questionnaire-based survey among members of the German Parkinson Association , which is the largest consortium of PD patients in German-speaking countries with nearly 21,000 members. Questionnaires were sent out in April 2019 with the association’s membership journal and were also distributed in the investigators’ clinic.
Cannabis Shown To Relieve Parkinson Disease Symptoms
A recent survey found that patients experienced relief of certain motor and nonmotor symptoms of Parkinson disease from using cannabis.
A recent survey on community perceptions of cannabis use in patients with Parkinson disease found that patients reported cannabis to be effective at reducing symptom severity.
Results also show a lack of knowledge on the different types and administration routes among patients. Researchers said that this is the largest study analyzing the view of patients on cannabis therapy in PD.
The study, published in Journal of Parkinsons Disease, took place in Germany, which in 2017 approved medical cannabis as a therapy for patients with severe symptoms of PD when other therapies were unsuccessful or not tolerable. MC is eligible for reimbursement in these cases.
Although many cannabis products and formulations are available to patients, there is a lack of controlled clinical studies addressing MC effectiveness on PD symptoms. Its also unclear which PD symptoms would be best treated with MC, whether certain cannabis formulations are more effective, or which routes of administration patients would prefer most. Further, the prevalence of MC use and patient opinion on its use for PD symptoms relief are unknowns.
Cannabis users made up 15% of participants, of which 13.9% were regular users, 32.2% were occasional users, and 42.6% had tried it once 11.4% did not answer. Users were on average 5.6 years younger than nonusers.
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Best Cbd Oil For Treating Parkinsons
Which CBD oil is best for Parkinsons disease depends on several factors. The only way you can make sure that you buy a high-quality CBD product is to shop smart.
- Read the label. Check how much CBD and THC the product contains.
- Check for third-party testing. Companies with independent evaluation facilities that test their products usually provide higher quality.
- Check online reviews to make an informed and educated decision.
- Check the sourcing location. Knowing where the product comes from and how the plant is grown is essential. Namely, some states require growers to adhere to stricter quality assurance regulations regarding the use of pesticides or chemicals.
- Check the oil type. Full or broad-spectrum CBD oil will probably be better than an isolate.
- Choose where you buy CBD. The best place to find CBD oil is from licensed dispensaries.
Cbd Improves The Quality Of Life For Pd Patients
Living with Parkinsons isnt easy. This disease, which only gets worse with time, can seriously jeopardize a persons ability to lead a normal life. Luckily, studies show that CBD treatment can offer some relief:
- A study of 21 PD patients that used CBD and a placebo found that the participants who received CBD experienced improvements in their quality of life after just six weeks.
- Another study on CBD oil and Parkinsonsthat included 119 patients also pointed out that CBD plays a significant role in the patients well-being and quality of life. And even though motor and general symptoms did not improve, findings showed a higher quality of life score.
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No Easy Task To Launch Cbd And Parkinsons Study
With marijuana legalized, Leehey began hearing from a number of her patients that cannabis, especially products high in CBD, helped them cope with the debilitating symptoms of Parkinsons disease. CBD made for an attractive study target. Unlike its cannabis cousin THC, CBD doesnt get its users high an essential consideration for those persons with Parkinsons that struggle with thinking, gait and balance problems. In addition, pre-clinical animal studies showed promise for CBD in reducing Parkinsons symptoms.
Leehey found that getting a study of CBD with human subjects wasnt easy. The barriers included simply obtaining CBD for a small pilot study and meeting a host of regulatory requirements for administering it. She finally found a flavored oral CBD solution to use in the pilot, which 10 patients completed.
In addition, the pilot study showed the CBD caused side effects, especially diarrhea, dizziness and daytime sleepiness. In some patients taking the CBD solution, there was also concern about liver dysfunction.
The pilot study had helped Leehey settle on a proper dose of CBD for the next study step, a randomized trial in which neither she nor her patients would know whether they were getting the drug or a placebo.
But Leehey and her team also needed to monitor patients for side effects while protecting their identities. Bainbridge and a study biostatistician provided lists of patients receiving medication or placebo, with their identities removed.
What Evidence Is Available For The Use Of Cbd For Pd
The FDA is aware that patients are frustrated that our understanding of how best to use CBD remains minimal because of the lack of clinical trials. In 2015, the FDA changed some of their regulations to make it easier to study CBD in clinical trials.
There have been a few studies of CBD for various symptoms of PD which have generally involved a small number of patients. Many have been open-label trials, in which the doctor and patient are both aware that the patient is receiving treatment and there is no control group that received a placebo.
- In one, an open label study of CBD was conducted on six patients with psychosis. Psychotic symptoms decreased.
- In a second trial, an open-label study of CBD was conducted on four patients with REM behavior sleep disorder. Symptoms decreased.
- A third trial was conducted on 21 patients with PD and was double blinded, meaning neither patient nor doctor knew who received treatment and who received a placebo. Motor scores did not improve, but quality of life scores did.
Additionally, three more recent trials of CBD for PD were conducted.
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Uncertain Responses To Cbd
Both men completed the CBD trial. Neither felt any positive effects after taking the drug, although their experiences were different.
Mullen thinks he got the placebo. I kept wanting to feel something different, he said, but I didnt feel anything. He is anxious to see the results of the trial and added that he would still be willing to take CBD to treat his Parkinsons disease symptoms.
Preusser is convinced that he did get the CBD, explaining that after the first administration he felt lightheaded. Things werent quite as concrete and were more ethereal than how I commonly perceive my surroundings, he said.
The dizziness forced him to go to another room at the clinic to lie down. He said at his second visit, he got half the dose, which seemed to diminish the side effect.
But like Mullen, Preusser said he derived no benefit from whatever he took. I didnt notice any diminishment of my tremor or change in my level of cognition, he said. He remains open, however, to the idea that CBD could help some people with Parkinsons disease.
I understand that every patient is different, he said. It may work miracles for the next guy. For me, not so, but there may be a point when I might reconsider or something may prompt a different assessment.
Lessons Ive Learned On My Parkinsons Journey
Cannabis has two main active components: tetrahydrocannabinol , which is the main chemical that induces a high, and cannabidiol , which doesnt induce a high but may have numbing or anti-inflammatory properties.
Cannabis has not been rigorously studied in Parkinsons, but many patients are interested in its potential benefits, and with increasing availability of a number of cannabis-based products, many have tried them. In lieu of scientific studies, learning from these patients experiences could help patients and clinicians to understand the potential benefits and risks of using various cannabis products for Parkinsons patients.
To this end, researchers at the University of Colorado conducted a survey through Fox Insight, an online platform run by the Michael J. Fox Foundation for Parkinsons Research.
The survey was answered by 1,881 people with Parkinsons who reported having used cannabis products since they were diagnosed. Most respondents were men , and more than half had been diagnosed with Parkinsons for less than three years. The vast majority were white , and the respondents generally were highly educated, with nearly two-thirds having at least a college degree and 33.6% with graduate or professional degrees.
In general, the overall magnitude of both positive and negative effects was small, the researchers noted. Notably, patients who took a product with high THC were generally more likely to experience an effect whether positive or negative.
Anecdotal Evidence Surrounding Parkinsons Disease
No large, placebo-controlled, randomized, double-blinded clinical trials have been conducted on the effect of whole-plant cannabis on patients with Parkinsons Disease, meaning that there is no evidence that a cause-effect relationship exists showing that cannabis use improves symptoms or slows progression for patients with Parkinsons Disease.
When the evidence on cannabis in relation to a certain disorder is limited, we can turn to patient stories for anecdotal evidence that medical marijuana may provide relief for some patients, especially those with symptoms uncontrolled by standard therapies. A recent blog post, The goal of medicine is to balance evidence with stories highlights the important point which is its title. Given the favorable safety profile of medical cannabis and potential for low-risk experimentation for most patients, patient stories help in guiding healthcare professionals to which symptoms/disorders may be alleviated by the use or study of cannabinoid medicine.
According to David Esparza, a patient who has lived with Parkinsons Disease for over 13 years and has experienced negative side effects from standard therapy, helps me with my attitude, it helps me with my shaking, it helps me deal with my new life I dont know how I look to other people but I know what I feel like I feel good. He shares his story here.
How To Administer Cbd Oil For Parkinsonsdisease
There are several ways that one can take CBD:
- CBD oils and tinctures can be used sublingually where a few drops are placed under the tongue and absorbed quickly into the bloodstream. You can also add them to food and beverages or apply them to the skin. Highly recommended for PD patients suffering from localized pain and muscle stiffness.
- Capsules and pills are beneficial to PD patients who cannot correctly dose liquids due to tremors. When taking CBD oil with pills and capsules, the effect is a bit delayed. Nevertheless, the effects are felt for 4 hours or longer once it kicks in.
- Edibles. Although they can be effective, edibles are not recommended for people with Parkinsons due to inaccurate precise dosage compared to other administration methods.
- Smoking cannabis cannabis can be smoked, vaped, or inhaled. However, experts advise PD patients to avoid smoking as it may cause damage to the lungs or throat.
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Legal Status Of Cbd In The Us
To understand the legality of CBD, you have to know the difference between hemp-derived CBD and marijuana-derived CBD. As previously mentioned, CBD is derived from both marijuana plants and hemp plants. Marijuana plants can contain as much as 30% THC, while hemp plants do not contain more than 0.3% THC. The percentage of THC in hemp plants is so low that it is impossible for one to get high. In 2018, the U.S. legalized CBD through the Farm Bill. That gave a national legal standard with guidelines dictating it contains less than 0.3% THC and made from hemp . Because of differences between state and federal laws, each state can have their own requirements on its legality.
A table below breaks down the different requirements by state to CDBs legality.
|Legality of CBD by State|
|Conditions of Legality|
Using Cbd For Treating Parkinsons Disease Symptoms
Without clinical trial data however, we do not know whether CBD is safe and effective for a particular symptom, and if it is, what CBD formulation and dosage is best to be used for a particular symptom.
We also dont know the side effect profile of CBD in people with PD. At baseline, people with PD may have various non-motor symptoms that may make them more prone to side effects from CBD, including fatigue and nausea.
If you would like to try CBD for one of your PD symptoms, have a conversation with your movement disorders specialist about it. Your doctor may be willing to oversee your trying it, or may feel that it is too risky for you without evidence that it will help. At the very least, he/she can make sure that there are no drug interactions between CBD and anything else that you take and discuss with you any potential side effects that you need to be aware of.
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Insurance Coverage Of Cbd
Unfortunately, private health insurance companies will not cover the cost of CBD products with the exception of Epidiolex, which is FDA-approved for epilepsy. Some Parkinsons patients and their caretakers may find that high-CBD strains of medical marijuana arent overly expensive and are safer compared to medications prescribed for Parkinsons disease.
People frequently want to know if Medicare covers the cost of CBD products. CBD does not have FDA approval, so it is still classified as a Schedule 1 drug. Because of this, Medicare does not cover the cost of any CBD product. In addition, it cannot be used towards a drug plan deductible .
As with Medicare, Medicaid will not cover the cost of CBD products because of lack of FDA approval.
The VA will not directly cover the cost of products containing CBD. However, there are VA pensions, such as the basic pension and Aid & Attendance Pension from which veterans or surviving spouses receive a monthly monetary benefit. Recipients of these pensions are able to use the money as they see fit, which means theoretically that one could use it towards purchasing CBD products. Learn more about these pensions here.
Many CBD retailers provide discounts to veterans who might need help covering the costs of their products. It is possible for active duty and military veterans to receive savings of more than 50% from companies that deliver CBD nationwide.
Can Cbd Oil Prevent Parkinsons Disease
Parkinsons is a neurodegenerative disease primarily in the elderly when neurons get prone to break down in the brain. As a result, the brain fails to send proper signals to the body, leading to Parkinsons symptoms. Cannabidiol may operate as a neuroprotection due to its antioxidant and anti-inflammatory properties. It may help activate the protective tissues stopping neurons from degenerating. The FDA-approved Epidiolex, a CBD drug for epilepsy and seizures, is proof of its therapeutic effects on neurons. This suggests that if we use CBD oil every day as a preventive measure, it will likely improve the health of our neurons while reducing the odds of a degenerative breakdown.
Dr. Bradley E. Alger from Harvard University stated that the chemical connection between the brain and the body contributes to the medical cannabinoid treatment. He also noted that CBD engages a chemical mechanism that helps a healthy symbiosis between brain activity and bodily homeostasis.
Having said that, we have to add that theres no scientific basis that a specific strategy can prevent the onset of Parkinsons.
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