CBD Oil & Headaches

Today we are going to discover how CBD can be a good therapeutic option for all those who suffer from headaches. Thanks to its analgesic, anti-inflammatory and soothing properties on both physical and mental levels. CBD can be of great help not only to alleviate the symptoms associated with headaches, but also to reduce their frequency and/or intensity in a stable way and significantly improve the quality of life.

Types of headaches

Headache is a common and complex disorder of the nervous system that chronically affects between 4 and 12% (1)(2)(3) of the world's population, and can occur episodically to almost anyone throughout life.
There are several types of headache with different symptoms, the most common of which are:

As can be seen, both the symptomatology and the causes of headaches and migraines are quite different, thus implying a different therapeutic approach.

In addition to the two main ones, there are different headaches related to flu and ailments, premenstrual syndrome, dental problems, intoxications (also excess of analgesics)... (3)

Cannabis and headaches

A very thorough study by Ethan Russo (4) on the history of Cannabis use for headaches describes and documents how this plant has been used for centuries as a symptomatic treatment for migraines and headaches in all cultures, from Islamic, Indian and Chinese to Greek and Roman. In particular, between 1842 and 1942, it was part of Western pharmacopoeia, being the treatment most commonly prescribed by leading doctors to treat migraine symptoms.

Today, recent discoveries about the Endocannabinoid System have made it possible to understand more about the mechanisms involved in headaches and the role that phytocannabinoids, in particular CBD, can play in each specific case.

Although much remains to be discovered, it is being hypothesized that complex disorders such as migraine, fibromyalgia and irritable bowel syndrome (characterised by chronic inflammatory states that cause pain and other associated symptoms), could be caused by a deficiency of the Endocannabinoid System. A good response to cannabinoid treatment can therefore be confirmed (5).

Thanks to scientific discoveries made in recent years (6), it has been possible to establish a close relationship between the mechanisms that can cause headaches and migraines and the Endocannabinoid System (ECS):

• Stimulation of cannabinoid (CB1 and CB2) and vanilloid (TRPV) receptors activates the body's anti-inflammatory mechanisms and produces an analgesic effect.
• ECS modulates the serotonergic (serotonin) and dopaminergic (dopamine) systems and interacts with the mechanisms of action of triptans and opioid pathways, playing a fundamental role in the neuronal transmission of pain.
• People who suffer from chronic migraines show a significant reduction in levels of Anandamide and 2-AG (the main endocannabinoids) and also a significant increase in FAAH enzymes (those that degrade endocannabinoids) (7)(8).

To learn more about this system read our article on the Endocannabinoid System.

These studies seem to confirm the hypothesis that disorders such as migraines may have their origin in ECS dysfunction(9), showing how a therapy based on indirect stimulation of endocannabinoids (through inhibition of FAAH) seems to be very promising (10) and, consequently, placing the use of CBD in a fundamental position.

CBD effects for headaches

Although there are still no clinical trials on the use of Cannabis for migraines, most of the clinical evidence in humans can be seen in single case or small group studies, as well as anecdotal cases and surveys (6). These studies show positive results in the use of THC (11). Most of them refer to self-administrated use of inhaled Cannabis or through medication, with its synthetic counterpart. Thanks to current advances in studies on the properties of CBD and the link between ECS and the mechanisms of action of migraines and headaches, it has been found that the use of Cannabidiol could be much more effective.

In particular, a study presented in 2017 at the 3rd Congress of the European Academy of Neurology showed the effectiveness of a combination of THC and CBD in 40% of the cases studied. More recent research has demonstrated the effectiveness of the use of Cannabis in different disorders characterised by chronic pain, showing good results especially with the use of CBD-rich products (12).

According to Dr. Peyarube in an article in the Canna Foundation:

"My clinical experience with these patients is in line with these findings and has allowed me to confirm a very good response to treatment with repeated doses of CBD, requiring very low doses of THC, so that their adverse effects are almost non-existent, and if they do occur, they tend to disappear by lowering the doses of THC. After a treatment with cannabinoids, the frequency of migraine attacks tends to be considerably reduced. In some cases I have even observed their extinction, at least during the time of clinical follow-up".

Effects of CBD on headaches/migraines

We have seen that CBD can be a very valuable tool for treating headaches and associated symptoms, thanks to its properties:

• Anti-inflammatory and analgesic
• Relaxing on a physical and especially muscular level.
• Relaxing on a mental level, helping to improve mood.
• ECS modulatory, indirectly increasing the level of our own endocannabinoids.

Although headaches and migraines share the same main symptomatology (headache), they are usually caused by different mechanisms and therefore recommendations and routes of administration may vary.

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"It's the best thing I have tried, both for pain and migraines. Without a doubt today, it is my choice, to enjoy life."

-María

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How to take Cannabis oil for headaches

Dosage

It is important to remember that CBD is a natural compound that modulates other physiological systems, i.e. it is made "available" as needed in order to restore the body's balance in a natural and stable way. This means, above all, that the assumption of a higher quantity does not correspond to a greater or better effect.

Therefore, there is an optimal dose for each person to take, and the way to get to know it is to start with a minimum amount (about 10 mg of CBD distributed in 3 daily intakes) and gradually increase it (for example, about 10 mg of CBD every 2 or 3 days depending on the response) until the effect is noticed. Once the dosage has been found, it will remain relatively stable over time, as CBD does not cause tolerance (i.e. it is not necessary to increase the dosage over time to obtain the same effects).
In any case, it is always best to consult a specialist who can accompany you in the follow-up, advise you on a quality product (as the market is not regulated in Spain) and also know the legal regularization framework in your country of residence.

Routes of administration

For headaches

As we have seen, headaches are caused by muscle tension related to bad posture and/or emotional stress, so CBD could be useful especially with sublingual and/or topical administration.

• Topical use: apply to the cervical area, forehead and temples as needed or preventively up to 3-4 times per day. It has a local action and can mainly provide symptom relief and promote muscle relaxation.
• Sublingual use (not regulated in Spain): depending on the frequency of the episodes, use 2 or 3 times a day continuously in order to reduce their frequency and/or intensity. It can also be used on demand to obtain symptom relief, similar to inhaled use.

For migraines

Migraines, unlike headaches, usually involve more complex physiological mechanisms that lead to a release of inflammatory substances and also to an associated symptomatology that is highly incapacitating, therefore CBD could be useful especially with sublingual administration and/or inhalation.

• Topical use: Although in this case it is not the best option, as the cause is internal, it can provide relief in terms of muscle relaxation and local analgesia.
• Sublingual use (not regulated in Spain): use continuously 2 or 3 times a day to reduce the frequency and intensity of episodes through a stable improvement in the physiological processes that lead to inflammatory states. In this case, action would be taken directly on the causes of the migraine and not only at the symptomatological level.
• Inhaled use (not regulated in Spain): can provide maximum and immediate relief of both acute pain and associated symptoms (nausea, hypersensitivity), especially when they occur abruptly and particularly intensely.

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¿Es seguro tomarlo?

Según los estudios realizados hasta hoy en día, el CBD no es una sustancia tóxica ni siquiera si es administrado de forma crónica o en altas dosis. Si quieres saber más consulta nuestro artículo sobre el report de la OMS sobre el uso de Cannabidiol.

Posibles efectos adversos

Los efectos adversos suelen ser de intensidad moderada-leve e incluyen: cansancio, somnolencia, sequedad de boca, mareos y disminución del apetito

Precauciones si vas a tomarlo

Hay que tener precaución especial en caso de combinarlo fármacos analgésicos, antiinflamatorios o hipotensores, tanto si el CBD es administrado de forma sublingual o inhalada. En cambio el uso tópico es seguro, ya que su acción es local y externa. Tampoco es apropiado utilizarlo en personas embarazadas o en etapa de lactancia.

Bibliografía:

1. Goldstein, B.. Cannabis Revealed. (2017)
2. Cefaleas o Migrañas. Artículo del blog del Colegio Oficial de Farmacéuticos. (2017)
3. Cefaleas. Artículo de la Organización Mundial de Salud. (2016)
4. Russo, E.  Hemp for headache: An in-depth historical and scientific review of cannabis in migraine treatment. Journal of Cannabis Therapeutics, 1(2), 21-92. (2001)
5. Russo EB. Clinical endocannabinoid deficiency (CECD): can this concept explain therapeutic benefits of cannabis in migraine, fibromyalgia, irritable bowel syndrome and other treatment-resistant conditions? Neuroendocrinol Lett. 2004;25:31–39. (2018)
6. Baron, E. P. Comprehensive review of medicinal marijuana, cannabinoids, and therapeutic implications in medicine and headache: What a long strange trip it’s been…. Headache: The Journal of Head and Face Pain, 55(6), 885-916. (2015)
7. Cupini LM, Costa C, Sarchielli P, et al. Degradation of endocannabinoids in chronic migraine and medication overuse headache. Neurobiol Dis.;30:186-189. (2008)
8. Rossi C, Pini LA, Cupini ML, Calabresi P, Sarchielli P. Endocannabinoids in platelets of chronic migraine patients and medication-overuse headache patients: Relation with serotonin levels. Eur J Clin Pharmacol ;64:1-8. (2008)
9. Sarchielli P, Pini LA, Coppola F, et al. Endocannabinoids in chronic migraine: CSF findings suggest a system failure. Neuropsychopharmacology;32:1384–1390. (2007)
10. Greco, R., Demartini, C., Zanaboni, A. M., Piomelli, D., & Tassorelli, C.. Endocannabinoid System and Migraine Pain: An Update. Frontiers in neuroscience, 12, 172. (2018)
11. Rhyne DN, Anderson SL, Gedde M, Borgelt LM. Effects of Medical Marijuana on Migraine Headache Frequency in an Adult Population. Pharmacotherapy. (2016)
12. Baron, E.P., Lucas, P., Eades, J. et al. Patterns of medicinal cannabis use, strain analysis, and substitution effect among patients with migraine, headache, arthritis, and chronic pain in a medicinal cannabis cohort. J Headache Pain 19, 37 (2018)