CBD and Inflammation

We often hear of how inflammation is bad for our bodies and how we need to consider taking anti-inflammatory agents or include anti-inflammatory foods in our diets. But why is inflammation a problem? And can CBD be an answer to it? In this article, we will find out.

What is Inflammation?

First, we should discuss what inflammation does to the body. In general, inflammation is not always a bad thing. It actually helps your body to heal and fight infections in small doses. According to the Institute for Quality and Efficiency in Health Care (IQWiG), inflammation is the result of your immune system fighting something that the body thinks might be harmful to you. Common symptoms of inflammation include swelling, redness, soreness, pain, or localized heat. Sometimes these symptoms do not occur, so you might not even notice when you have inflammation.

It is usually caused by some sort of bacteria or virus, or from an injury either from exercise, scratches and/or scrapes, or external objects such as a splinter getting stuck in your hand. Basically, it is your body’s natural way of defending itself against illness and injury. However, sometimes the body can actually have too much inflammation for too long – this is where the problem starts. The body can start to use inflammation to fight and damage its own healthy cells, destroying them and causing all sorts of health issues. Examples of this include auto-immune diseases or cancers. More specifically these are diseases such as Rheumatoid Arthritis (RA), Lupus, Psoriasis, Celiac Disease, or Inflammatory Bowel Disease (IBD). These are referred to as chronic inflammatory diseases and patients can suffer with them for their whole lives. Mostly, it is these chronic conditions that worry people and make them look for medications, supplements, or foods that are anti-inflammatory.

How Does Inflammation Work?

Inflammation releases certain mediators and hormones in the body to the area that it is fighting and trying to keep healthy. It causes the blood vessels in that area to widen – which allows more blood to rush to the site, leading to the redness and heat associated with inflammation. The blood helps carry the mediators, such as histamine and bradykinin, that help fight the harmful agents and heal the body. Sometimes these mediators can irritate the area and it can cause pain signals to be sent to the brain, which is why we feel pain with inflammation. These mediators also help make the vessels more permeable, meaning that things can go in and out the vessels easier, to allow more of these defense agents to help. They often bring fluid with them which is where the swelling comes from. Extra fluid can also help flush toxins out of your body (like when you have a runny nose).

Why Do We Want Anti-Inflammatory Agents?

As stated above, long-term inflammation can cause serious damage to organs and the body in general. It can contribute to auto-immune diseases, cancers, pain, heart disease, and even nervous system illnesses like Alzheimer’s Disease. This long-term inflammation can be caused by a variety of reasons such as environmental factors, stress, not exercising, or even certain foods in our diet. Dr. Andrew Weil states that anti-inflammatory foods include broccoli, cauliflower, kale, spinach, squash, berries, peaches, oranges, chickpeas, and much more. It can even include spices such as turmeric and ginger. Anti-inflammatory foods and supplements may help lower our risk of getting these diseases. It also helps us maintain a healthier diet if we choose to include more anti-inflammatory foods to our daily meals.

Is CBD Anti-Inflammatory?

The short answer is – we think so. It has been shown back in the 90’s that CBD has more antioxidant activity than traditional antioxidants like vitamin C and vitamin E. Antioxidants help fight inflammation by decreasing the number of free radicals in the body that can cause damage. CBD was also shown to reduce TNFα in mice. TNFα is a protein that stimulates inflammation in the body. It is often used as a marker to measure for inflammation in the body. Therefore, if it is decreased, so is inflammation.

How Does CBD Fight Inflammation?

Typically, when thinking of anti-inflammatory agents we think of the drug class called NSAIDs (non-steroidal anti-inflammatory drugs). Examples of these drugs include ibuprofen (Advil), naproxen (Aleve), celecoxib (Celebrex), and others. They work by inhibiting cyclooxygenase (COX) enzymes in our body to help relieve pain and inflammation. However, they have their fair share of side effects. For example, agents that inhibit COX-1 (one type of COX enzyme) can possibly cause ulcers in the gastrointestinal (GI) tract and even GI bleeding with prolonged use.

This is why they came up with drugs like celecoxib which inhibit more COX-2 (another type of COX enzymes) than COX-1. Although this causes less GI side effects, it can cause more heart-related side effects such as having heart attacks and strokes. So even though NSAIDs are great for inflammation – the long-term side effects are not favorable.

It turns out that CBD does not work the same way these drugs do at all. CBD does not inhibit either COX enzyme at pharmacologically appropriate doses. This means CBD may produce anti-inflammatory effects without causing the harmful side effects associated with NSAIDs.

inflammation

Although the mechanism behind the anti-inflammatory effects is still being researched, one theory is that CBD exerts its effects through the A2A receptor. A2A is an adenosine receptor in the body and adenosine is an agent that already exists in our body and promotes anti-inflammatory actions. CBD is thought to inhibit a transporter of adenosine which in turn promotes the signaling of the A2A receptor. This simply means it increases the effects of adenosine in the body, which increases anti-inflammation. Another study in mice suggests that the anti-inflammation and pain relief mechanism for CBD could be through glycine receptors. Glycine receptors are important for pain sensation in the spine and usually relates to pain and inflammation that deals with your nerves. This is the type of pain that feels like burning, tingling, or shooting pain. One of the causes of this type of pain is thought to be inflammation around the nerves.

What Does the Research Say?

An interesting note, a drug from GW Pharmaceuticals called Sativex, was approved for symptoms related to moderate to severe Multiple Sclerosis (MS) in patients who have not adequately responded to other anti-spasmodic MS medications. One of the causes of MS symptoms is inflammation. Sativex contains both THC (the part of marijuana that makes you feel high) and CBD. Some think that its effectiveness may be due to the anti-inflammation effects of THC and CBD.

One study, completed in 2011, showed how CBD could also be a potential treatment for IBD. This study was done on intestinal biopsies from humans with Ulcerative Colitis (a form of IBD) and intestinal segments that were inflamed from mice. CBD reduced inflammation in the cells and decreased the amount of intestinal damage.

A more recent study from 2016 suggested the use of CBD to help with arthritis. Arthritis pain can be related to inflammation around the joints. This study used a transdermal CBD gel on rats to see if it would help with reducing inflammation and pain. They found that CBD reduced joint swelling and pain in a dose-dependent manner. They also used pro-inflammatory markers (like the TNFα mentioned above) to measure inflammation. It was noted that CBD also reduced inflammation in a dose-dependent manner. This just means that the higher the CBD dose was, the lower the levels of inflammation were.

So far, as with the studies listed above, the research has been done in animals or cell cultures. Research with humans are mostly case reports, meaning they are based off of situations that occurred in one person and not in many people like with clinical trials. Therefore, we cannot say definitively that CBD will help with inflammation in humans and we will have to wait for more data. However, it does have an excellent safety profile and the research does seem to support CBD having anti-inflammatory actions.

Final Take-Away Points

All in all, CBD is beginning to become an exciting new supplement in the medical world. Research seems to be expanding as the world is seeing the health benefits CBD might have. We do have to wait for more clinical studies to be completed in larger amounts of people, and for there to be reproducible results. Despite this, CBD may help with inflammation based off the data we have so far. It also does not have harmful side effects, unlike traditional anti-inflammatory agents. So, it might be worth talking to a health care professional about to see if it is right for you. If you have any health issues that are due to chronic inflammation, it could be a nice add-on to your medications that are treating your condition. It may even help to lower your doses of these medications and potentially decrease the side effects from them. It should not be used as your sole treatment for these conditions however, unless your physician states otherwise.

References:

  1. https://www.ncbi.nlm.nih.gov/books/NBK279298/
  2. https://www.drweil.com/diet-nutrition/anti-inflammatory-diet-pyramid/dr-weils-anti-inflammatory-diet/
  3. https://www.ncbi.nlm.nih.gov/pubmed/9653176/
  4. https://www.ncbi.nlm.nih.gov/pubmed/10920191/
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5022003/
  6. https://www.ncbi.nlm.nih.gov/pubmed/16672367/
  7. https://www.ncbi.nlm.nih.gov/pubmed/22585736
  8. https://www.medicines.org.uk/emc/product/602/smpc
  9. https://www.ncbi.nlm.nih.gov/pubmed/22163000
  10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4851925/

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Dr. Harry Zollars (Pharm D)

Harry, COO of Skollarz LLC, is a practicing Pharmacist with over 5 years of experience in the community setting. He graduated highest honors with a Doctor of Pharmacy and a Specialization in Pharmacy Education and a Certificate in Pharmacy Informatics. In addition to his academic career, he was an integral part of several research labs that studied organic chemistry synthesis modifications as well as analyzing and defining structural activity relationship maps of somatostatin derivatives. Harry is currently a Pharmacy Manager, Secretary of the Illinois Pharmacist Association Executive Board, Lead Luminary of the Illinois Community Pharmacy Enhanced Network, Adjunct Pharmacy School Professor, and Pharmacy School Advisory Board Member. He recently was awarded the IPhA Distinguished Young Pharmacist Award.

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