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What is cbd hemp oil dosage for ms patients

CBD for MS (Multiple Sclerosis) – May 2022

According to The National Multiple Sclerosis Society, approximately 85% of people with MS are initially diagnosed with relapsing-remitting MS (RRMS) (5 ) .

RRMS is a type of MS characterized by inflammatory attacks on the nerve fibers and myelin, the layers of insulating membranes surrounding nerve fibers in the central nervous system (CNS).

While RRMS is defined by attacks or relapses of new MS symptoms, progressive forms of MS involve fewer attacks.

The progressive types of MS are secondary-progressive MS (SPMS), primary-progressive MS (PPMS), and progressive-relapsing MS (PRMS).

The symptoms of MS vary, but they often include pain, inflammation, muscle spasticity, MS fatigue, and depression.

Spasticity is a condition characterized by an abnormal increase in muscle tone or stiffness of muscle, which might interfere with movement.

MS symptoms can reduce physical activity, negatively impact functional mobility, and have a detrimental effect on a person’s quality of life (6) .

Although there have been recent significant advances in disease-modifying therapy, none of the current treatments stops or cures MS-related symptoms (7 ) .

Thus, many people with MS look for alternative and complementary therapies, such as cannabis plants and their derivatives.

CBD for Multiple Sclerosis: What The Research Says

Sativex is a cannabis-based prescription medicine that contains a 1:1 CBD (cannabidiol)-THC (delta-9-tetrahydrocannabinol) ratio.

Approved as an additional treatment for nerve pain and spasticity in multiple sclerosis patients, Sativex is administered as a mouth spray (oromucosal) (8 ) .

In a 2005 study published in Issues in Emerging Health Technologies , 368 patients with various neurological conditions, including MS, were given the THC:CBD spray (9 ) .

Results showed that the spray significantly reduced nerve pain, spasticity, muscle spasms, and sleep disturbances among the human subjects.

However, the researchers observed adverse events, like dizziness, sleepiness, fatigue, feeling of intoxication, and experiencing an unpleasant taste.

A 2016 study in Therapeutic Advances in Neurological Disorders summarized the evidence for the efficacy and effectiveness of THC-CBD oromucosal spray in symptom management for those experiencing spasticity due to MS (10 ) .

Researchers believe that for individuals with resistant moderate to severe MS-induced spasticity, THC-CBD spray can be a treatment option.

It was only in 2017 when a pre-clinical study on CBD alone was conducted. The study, published in CNS and Neurological Disorders – Drug Targets, showed that CBD could produce beneficial effects in individuals with MS (11 ) .

How CBD Oil Works to Help With Multiple Sclerosis

The two primary cannabinoid receptors are CB1 and CB2. CB1 receptors are found in the CNS (the brain and spinal cord), intestines, connective tissues, and other glands.

CB2 receptors are mostly located in the spleen, tonsils, and immune cells. Only a few are in the brain.

Data suggests that CBD does bind to the receptors but does not directly activate them. Instead, it appears to adjust how the receptors respond to stimulation from other compounds, such as THC (12 ) .

The authors of a study, published in the British Journal of Pharmacology in 2010, noted there had been anecdotal and scientific evidence of cannabis providing symptomatic relief in neurodegenerative disorders, including MS (13 ) .

The study results implied that the endocannabinoid system (ECS) impairment might be responsible for some disease symptoms.

The ECS plays an active role in regulating a wide range of body functions, including pain sensation, immune response, anxiety , mood, appetite, sleep, metabolism, and memory.

The CBD-THC spray, Sativex, acts via cannabinoid receptors distributed throughout the CNS and in immune cells (14 ) .

CB2 is involved in weakening inflammatory immune cell response to disease.

Meanwhile, the activation of CB1 receptors has been shown to block the release of glutamate, a chemical transmitter released by nerve cells in the brain (15 ) .

Abnormal or excessive glutamate levels and signaling in the nervous system can contribute to MS (16 ) .

The Pros and Cons of CBD Oil for Multiple Sclerosis

Pros
  • Evidence suggests that CBD may reduce MS symptoms, such as MS fatigue, pain, and spasticity, and ultimately improve mobility (17 ) .
  • The 2018 Farm Bill has legalized CBD products derived from hemp. However, individual states in the United States have their legislation (18 ) .
  • The American Academy of Neurology has highlighted the safety profile and benefits of cannabis in a review of medical marijuana (medical cannabis).
  • No studies have investigated the effects of cannabis oil on mobility in individuals with MS. However, some studies have suggested that CBD may exert positive effects on health by reducing inflammation and relieving pain (20 ) .
Cons
  • Studies are too limited to determine if CBD is an effective treatment for conditions other than those approved by the US Food and Drug Administration (FDA).
  • There are risks in using CBD. Possible side effects include dry mouth, drowsiness, diarrhea, fatigue, and reduced appetite (21 ) .
  • CBD can interact with other drugs and alter how the body metabolizes certain medications, as a 2017 research noted (22 ) .
    • A 2017 review revealed labeling inaccuracies in some CBD products. Some products had less CBD than stated in the label, while others had more (23 ) .

    How CBD Oil Compares to Alternative Treatments for Multiple Sclerosis

    Some of the alternative or complementary therapy options for MS include massage and a healthy, well-balanced diet with linoleic acid supplementation (24 ) .

    Regular massage therapy can help MS patients relax and reduce stress and depression, which can exacerbate the disease.

    CBD oil tinctures can be combined with massage oils. Like massage oils, CBD-infused bath bombs can help provide relaxation and relief from physical tension and emotional stress.

    A study published in the journal CNS and Neurological Disorders – Drug Targets noted that CBD had therapeutic uses as an anti-anxiety-like and an antidepressant-like compound (25 ) .

    There is also evidence that taking an oral supplement of linoleic acid (found in evening primrose oil) may improve MS symptoms.

    Researchers of a 2019 study found that higher levels of α-linolenic acid (ALA) were associated with lower disease activity in MS patients (26 ) .

    Meanwhile, cannabis extracts from Sativa cultivars (Cannabaceae) are rich in linoleic acid (57.1%), according to researchers of a 2012 study published in the European Journal of Lipid Science and Technology (27 ) .

    How to Choose the Right CBD

        1. Research on the legal stipulations applicable to CBD in the area where it would be bought and used.
        2. Read product reviews before buying from an online store. Check if the store is authorized by the government to sell CBD.
        3. Look for the certificate of analysis (COA) of the CBD product. A COA is a laboratory report that includes cannabinoid content and other tested compounds.
        4. Compare company claims with that of third-party lab testing reports.

      CBD Dosage for Multiple Sclerosis

      The appropriate dose of cannabinoids for specific medical conditions is not known . However, there are suggested doses for some multiple sclerosis symptoms, like pain and spasticity.

      A 2011 systematic review that examined the effects of cannabinoids of any type (smoked cannabis, oral extracts, nabilone, synthetic THC, nabiximols) showed that cannabinoids provided pain relief (28 ) .

      When using Sativex for the first time for MS-related pain and spasticity, follow the number of sprays on the days and times in the table below as reference (29 ) .

      A 2011 study noted that high doses of 1,500 mg CBD a day is well-tolerated by humans (30 ) . Still, always consult with a doctor before taking any CBD products.

      How to Take CBD Oil for Multiple Sclerosis

      A topical CBD cream or patch is ideal to use for inflammation or pain in a specific area. The CBD can target localized clusters of cannabinoid receptors, rather than interacting with the entire endocannabinoid system (ECS).

      CBD oil capsules and edibles, such as gummies , brownies, and lozenges, are a convenient and straightforward way to take CBD oil, especially for beginners.

      Meanwhile, CBD oil tinctures and sprays may be practical options for those who seek fast results and maximum dosage control.

      Conclusion

      CBD alone or its combination with another cannabinoid, like THC, may help alleviate many common MS symptoms.

      Unfortunately, studies on the use of CBD for specific medical conditions in humans are limited, and CBD’s long-term effects remain unknown.

      More longitudinal research is required to gather more scientific evidence and validate results from previous studies.

      What Are the Benefits of CBD for Multiple Sclerosis?

      Research on CBD for MS is limited, but shows it might reduce pain and spasticity

      Kelly Burch is a freelance journalist who has covered health topics for more than 10 years. Her writing has appeared in The Washington Post, The Chicago Tribune, and more.

      Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more.

      Emily Dashiell, ND, is a licensed naturopathic doctor who has worked in group and private practice settings over the last 15 years. She is in private practice in Santa Monica, California.

      Multiple sclerosis (MS) is an autoimmune disease that causes a range of symptoms, including fatigue, cognitive impairment, and muscle weakness. MS can manifest in many ways, but patients have one thing in common: the symptoms of MS have a big impact on their quality of life.

      To manage symptoms, some MS patients turn to cannabidiol, or CBD, a non-psychoactive compound found in the cannabis plant. Scientists are still researching the benefits of CBD for people with MS, but early indications show that CBD might help control some MS symptoms, such as pain and muscle stiffness.

      This article will review what you should know about CBD and multiple sclerosis, including the potential benefits, safety concerns, and optimal dosage.

      Verywell / Michela Buttignol

      Immune System and Multiple Sclerosis

      Multiple sclerosis is an autoimmune disease. That means that the symptoms of the disease occur because the immune system is attacking healthy cells in the way that it’s supposed to attack viruses and other pathogens.

      In MS, the immune system targets the myelin sheath, a protective coating that wraps around nerve cells in the spinal cord and brain. When the immune system attacks this barrier, it causes inflammation and damage, which can impair the nerve signaling that facilitates movement, breathing, thinking, and more.

      The severity of MS symptoms varies, depending on the location of the attack and the extent of the damage to the myelin sheath, but they most often include fatigue, muscle weakness or stiffness, and cognitive dysfunction.

      Cannabinoids and the Immune System

      Cannabinoids are a group of compounds found in the cannabis plant. The two main cannabinoids are THC (the psychoactive ingredients in marijuana) and CBD (which does not have a psychoactive component).

      The body processes cannabinoids via cannabinoid receptors, which are found in the brain and in immune cells. This is all part of the endocannabinoid system, which regulates inflammation, immune function, motor control, pain, and other bodily functions commonly affected by MS.

      This connection helps explain why CBD can be beneficial for MS. Cannabinoids have been shown to reduce inflammation and regulate immune response. CBD does this without mind-altering properties, making it appealing to people looking for relief from MS symptoms without the “high” of marijuana.

      Benefits of CBD for MS

      In a recent meta-analysis, researchers concluded that cannabinoids, including CBD, are “probably effective” at alleviating certain symptoms of MS, including pain and abnormal muscle tightness (spasticity), but “probably not effective” for treating muscle tremors or incontinence.

      Additional research supported using CBD for MS. Here are some key findings:

      • A 2018 scientific review found that CBD supplementation reduced pain, fatigue, inflammation, depression, and spasticity in people with MS, while improving mobility. The authors concluded that recommending CBD supplementation for people with MS would be advisable.
      • A 2014 scientific review found that Sativex (nabiximols), a CBD nasal spray, can help reduce pain, spasticity, and frequent urination in patients with MS.
      • Two different 2021 medical reviews found that in animal models, CBD helps regulate the immune system, reducing the autoimmune response that causes MS symptoms. More research is needed, but in the future this may mean that cannabis-derived medications and CBD could be used to treat the progression of MS, not just the symptoms.

      Are There Any Side Effects?

      CBD is generally considered safe, and it does not have mind-altering properties. A dose of up to 300 mg daily of CBD is safe for up to six months. Higher doses are safe for a shorter amount of time.

      However, like any other supplements or medication, CBD may have side effects in some individuals. These may include:

      • Drowsiness
      • Lightheadedness
      • Low blood pressure
      • Damage to the liver

      In addition, CBD may interact with many other prescription drugs. It’s best to speak with your healthcare provider before supplementing with CBD, especially if you are pregnant or breastfeeding. Most doctors who treat MS are familiar with CBD, since at least 20% of MS patients are currently using CBD.

      CBD is legal for consumption in the United States, but cannabis products that contain THC are illegal at the federal level. Be sure to understand the legal and professional implications of using CBD, especially if you are regularly screened for drug use.

      Keep in mind that the Food and Drug Administration does not oversee or regulate any CBD supplements, so it’s important to purchase CBD products from a reputable source.

      How to Use CBD for MS

      CBD is available in many different forms, including topicals, tinctures, edibles, and nasal sprays.

      You’ll also have to decide whether you want to take a full or broad-spectrum CBD, which contains other cannabinoids, or a CBD isolate, which contains just cannabidiol. Limited research suggests there may be a benefit to the “entourage effect”: It’s believed that having other cannabinoids present may make CBD more effective.

      Consulting your healthcare provider can help you decide where to start with CBD supplementation. They can offer insight as to what has worked for other patients and guide you toward an appropriate dose of CBD.

      How to Buy CBD for MS

      It’s important to deal with reputable dispensaries when purchasing CBD for MS. Here’s what you should consider when buying CBD to treat MS:

      • The legal status of CBD in your state, including whether you need a medical cannabis card
      • The possible impact of taking CBD on your professional licenses or other areas in your life
      • Your goals in taking CBD, and the symptoms you would most like to address
      • Whether you would like a CBD isolate or a full-spectrum product that contains other cannabinoids
      • Whether the retailer is licensed in your state
      • Where the product was sourced (grown)
      • Whether the product has a COA, or certificate of analysis, which shows the chemical composition of a substance

      A Word from Verywell

      MS can have a huge impact on your quality of life, which is why so many people look for relief from MS symptoms. The research around CBD and MS is very promising: It shows that some people experience reduced pain and spasticity when they use CBD supplements.

      In the future, CBD-derived medication may even be used to control the progression of the disease by reducing inflammation.

      Unfortunately, use of CBD for MS is still in its infancy, and there’s a clear need for more research. For now, it’s best to talk with your doctor and trusted peers when deciding whether CBD is right for you. Don’t be shy about speaking up: Research has shown that up to 60% of MS patients are currently using cannabis and 90% would consider it.

      You shouldn’t feel any shame or hesitation about investigating this treatment option. However, it’s important to understand any legal and professional implications for where you live, especially if you use a product containing THC.

      Although there is a lot of promise for CBD to treat MS, there is no FDA-approved treatment. Using it in combination with more traditional medically sanctioned treatment is likely a good course of action.

      Frequently Asked Questions

      Research indicates that CBD likely helps with muscle spasticity in people with MS. A UK-based study found that physicians did not measure a large improvement in spasticity in people taking CBD versus a supplement. However, the people taking CBD reported a reduction in spasticity compared with those taking a placebo. Because of that, the Multiple Sclerosis Society says that CBD is likely effective for spasticity.

      CBD is generally considered safe, and some research shows that it likely helps treat pain and spasticity caused by MS. However, CBD is not FDA approved for treating MS or its symptoms. You should speak with your healthcare provider about using CBD to treat MS.

      Much of the research on using CBD for MS pain has been done using oral supplements and nasal sprays. Some people also report benefits from smoking CBD flowers or cannabis. It’s best to speak with your healthcare provider and consider the legal standing of CBD and cannabis in your state as you decide how best to use CBD to treat MS pain.

      CBD for Multiple Sclerosis (MS)

      Multiple Sclerosis (MS) is a neurological autoimmune disease which affects the central nervous system. This chronic and progressively debilitating disease is one of the most common of the autoimmune diseases, affecting young adults and middle-aged people.

      The way in which this disease progressively attacks the body makes it really difficult for patients to live a normal life. It isn’t long before they are unable to work and need constant help and care. For many MS patients, spasticity further impairs their quality of life, with debilitating muscle spasms and rigidity of limbs.

      Common Symptoms of Multiple Sclerosis

      • restricted mobility
      • fatigue
      • pain
      • sensory deficits
      • palsy
      • bladder dysfunction
      • spasticity

      How can CBD Help Treat Multiple Sclerosis?

      CBD and THC are the two biologically active chemicals in Cannabinoids. THC is the psychotropic chemical found in cannabis. CBD is not psychotropic, therefore does not make you feel “high”. It is (in most countries) a legal substance that has been helping patients with MS and other diseases.

      CBD and THC are believed to have therapeutic properties in regards to multiple sclerosis 1 2 . These properties can help improve mobility and pain reduction. CBD is shown to be anti-inflammatory and antipsychotic 3 4 . This can help with the pain as well as the depression brought on by MS. CBD treatment can also help with abdominal discomfort and muscle spasticity.

      MS patient and American TV personality Montel Williams uses medical cannabis to manage his MS symptoms. He is a prominent medical cannabis advocate and has been speaking about the legalization and acceptance of CBD for decades. It’s a movement that is gaining momentum in the MS community in recent years.

      What are The Benefits of Using CBD for Multiple Sclerosis?

      Using CBD to treat symptoms of Multiple Sclerosis can improve the quality of life of most patients. A study published in 2013 in the journal “Neurobiology of Disease” addresses this topic. It confirms cannabidiol (CBD) long-lasting protection against harmful effects of inflammation in a viral model of multiple sclerosis 5 . With regular use, spasms could be reduced by an antispasmodic effect of CBD.

      The use of CBD in Multiple Sclerosis is growing in popularity due to how patients generally feel better by using it. Many countries around the world have made the use of medicinal CBD legal and controlled.

      Are There any Side Effects with the use of CBD for Multiple Sclerosis?

      CBD is a safe natural chemical substance with little side effects. However, like any treatment, some patients feel side effects 6 . Some of these include dry mouth, low blood pressure, lightheadedness, and drowsiness.
      Thankfully, drinking plenty of water can help with the dry mouth situation. At high doses, CBD can hinder the productivity of other medicines by affecting the liver enzymes. This is considered a side effect but can be avoided or easily reversed by adjusting dosages.

      What is the usual dosage of CBD for Multiple Sclerosis?

      Every person is unique and everyone’s reaction to CBD is different.

      Based on the guide in the book by Leinow & Birnbaum “CBD: A patient’s guide to Medical Cannabis” 7 we recommend the Step-Up method, where you gradually increase the dose until the desired results are achieved. Leinow & Birnbaum recommend to start with a standard dose for multiple sclerosis. Carefully the dosage can be increased to a macro dose. To learn more about the differen doses and how to correctly take your CBD oil, please read our CBD dosage guide.

      How can CBD be administered?

      There are quite a few ways that CBD can be administered. The most common is CBD oil with a dropper but there are also CBD extracts and pills. Some patients prefer to vape or inhale liquid CBD in electronic cigarettes. There are also creams and balms which contain CBD oil in them to help with muscular and joint pain.

      What does Research say About Using CBD for MS?

      A wealth of preclinical and clinical data shows that cannabinoid-based drugs reduce spasticity symptoms in MS and other neurodegenerative diseases 8

      Another study 9 was conducted to investigate the effects of cannabis treatment on neuropathic pain. Patients in both groups received oral sprays as placebos or CBD for several weeks. Most patients who received CBD had less pain than the others.

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