Medical Marijuana, Cannabis, & CBD for Lyme
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Medical Marijuana and CBD Can Help Lyme
I lived in Washington state until late 2018 where state law provides for both medicinal and recreational use of marijuana. Federal law does not allow for medical marijuana, but it allows for the unrestricted sale of products derived from hemp. Hemp and marijuana are forms of cannabis. I recommended medical cannabis in my Seattle practice from marijuana or hemp for some of my Lyme disease patients based on the limited science available and based on the positive responses I witness. In this article I review
- how medical cannabis and medical marijuana works,
- CBD and THC,
- conditions cannabis and marijuana helps,
- how to take medical cannabis and medical marijuana,
- starting doses, and
- possible safety concerns.
Note:This is a long article with a lot of background. Skip to the bottom to see the conditions medical marijuana helps and information on how to take it.
Marty Ross MD on CBD and Marijuana in Lyme Disease
The Politics of Medical Marijuana
As I write this article twenty five states in the USA allow medical marijuana use and eight all marijuana recreational use. USA federal law currently allows for the use of CBD derived from hemp in all 50 states. Unfortunately the federal government, under the Trump administration, has put out some worrisome writings that it thinks hemp should be regulated the same as marijuana. In addition, US Attorney General Sessions calls for the federal government through US Attorneys at their discretion to enforce federal marijuana laws putting an end to state recreation and medical marijuana usage.
Cannabis, Marijuana, Hemp, CBD, THC
There are two varieties of cannabis plants. They differ in their appearance and chemical make up. The two plants are Cannabis Indica and Cannabis Sativa. Both of these plants are called marijuana. Hemp is a variety of Cannabis Sativa that has less than .3% delta-9-tetrahydrocannabinol (THC). THC is the psychoactive component of cannabis that gets people high. Both Indica and Sativa that have more than .3% THC are regulated as illegal drugs by the US government. Federal courts have ruled that industrial hemp, cannabis sativa with less than .3% THC, cannot be regulated as a drug. Thus cannabidiol (CBD) derived from hemp can be sold as a supplement across state lines and through the internet.
Cannabinoids & The Endocannabinoid System
There are over 400 chemicals called cannabinoids in cannabis that interact with the body’s natural cannabis system. Our natural marijuana/cannabis system is called the endocannabinoid system. The two main cannabis chemicals are delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). These chemicals interact with our endocannabinoid system in a variety of ways. In addition to cannabinoids, cannabis has terpenes. Terpenes give the flavor and aroma to cannabis. They also change the absorption and effects of CBD and THC.
The endocannabinoid system is distributed throughout the entire body with receptors found in the brain and many major organ systems. There are two major chemical receptors called cannabinoid receptor 1 (CB1) and cannabinoid receptor 2 (CB2). in addition to CB1 and CB2 there are some other minor receptors.
CB1 receptors are found on many organs including the brain and nervous system. They regulate the release of neurotransmitters in the brain and are psychoactive. CB1 regulates the heart and blood vessels, energy, thinking, memory, emotions, pain, muscle control, sensory regulation, the intestinal system, and much more.
CB2 is primarily anti-inflammatory and regulates the immune system. These receptors are found on a variety of white blood cells including B cells that make antibodies, T cells that fight Lyme, bacteria, and viruses, and macrophages that fight viruses. In addition to fighting infections, T cells release inflammatory cytokines that cause most Lyme symptoms. So regulating CB2 can lead to improvements in most of these symptoms.
The endocannabinoid system produces a number of chemicals that bind to the CB1, CB2 and minor receptors. The two major known ones are anandamide and 2-arachidonoylglycerol (2-AG). These two chemicals are broken down by a number of enzymes.
THC works by binding directly to CB1 and CB2 receptors. CBD works indirectly by limiting the destruction of 2-AG and anandamide. This leaves more of these chemicals available to bind to CB1 and CB2 receptors. In addition to indirectly raising anandamide and 2-AG, CBD may bind to minor receptors exerting a direct influence on the organs and the nervous system.
THC is also psychoactive. This is what gives a person the high of smoking or eating THC. CBD does not have this effect. CBD is thought to decrease the psychoactive effect of THC. Because it is psychoactive, THC can cause some thinking impairment which could be a draw back for people in Lyme who have difficult thinking. By comparison, CBD does not seem to give thinking problems.
One other major difference of THC and CBD is that THC produces more sleepiness while CBD is more upping. Thus THC is better for night use compared to CBD which is better for day use.
THC can cause psychosis. And CBD and THC can lower blood pressure and even cause heart attacks. So THC should not be used in people with psychotic mental health conditions. And both CBD and THC should be avoided in someone with low blood pressure or at risk for a heart attack. For instance someone with Lyme and paroxysmal orthostatic hypotension syndrome (POTS) should not use medical cannabis. And if a person has cognitive impairment on either CBD or THC, he or she should not drive.
What Does Medical Marijuana Help?
The research data base for medical cannabis is very limited due to US federal law that limits research on marijuana. Below I detail what is known through research on various medical conditions. However, there has not been any specific research on cannabis and someone with Lyme disease.
In 2016 the National Academy of Sciences published a review of the science and medical cannabis. Here is a list of its findings supported by research:
- Prevents chemotherapy induced peripheral neuropathy in animal studies,
- Inhaled cannabis reduces pain in HIV related neuropathy,
- Can help with pain through a helpful interaction with opioid receptors (animal studies) and can help reduce pain for patients on narcotics,
- Helps chemotherapy induced vomiting and nausea,
- Decreases anorexia and wasting in HIV,
- Reduces muscle spasticity in ALS and MS,
- Decreases saliva production in ALS,
- Reduces symptoms of depression in ALS,
- Anecdotal reports shows help with depression, anxiety and stress,
- CB1 receptor binders decrease seizures (in mice anandamide levels rise after seizures which stops the seizure),
- THC in some animal studies decreases seizures,
- CBD lowers seizures too through a number of proposed mechanisms by increasing anandamide levels, blocking enzymes that lower 2-AG and anandamide, or lowering glutamate levels,
- Limited human experiments shows lower seizure thresholds,
- Open label CBD studies show can lower seizures in humans,
- THC can help HIV cachexia and wasting syndrome,
- In HIV inhaled cannabis alleviates nerve pain,
- In HIV can help with nausea,
- Cannabis can alleviate symptoms of Chron’s and Ulcerative colitis like abdominal pain, nausea, and diarreha,
- Decreases MS muscle spasm and pain,
- Reduces pain,
- In Parkinsons, decreases tremors, and stiffness like bradykinesia, and dyskinesia, and
- In Post Traumatic Stress Disorder (PTSD) can help alleviate the hyperarousal state and insomnia.
Kills Lyme:In Canada, Dr. Erni Murakami did laboratory experiments showing CBD kills Lyme spirochetes. However there are no human experiments that show this to occur.
Medical Cannabis Benefits in Lyme
Based on the above research and what I see in my patients I recommend medical marijuana and medical cannabis for people with Lyme for the following reasons or conditions:
- As an anti-inflammatory working through CB2 receptors it protects the health of the nervous system and brain,
- Anxiety (I prefer CBD over THC),
- Depression (I prefer THC over CBD),
- Nerve pain,
- Muscle and joint pain,
- Insomnia (THC, not CBD),
- Stomach and Intestinal dysfunction like diarrhea and cramping,
- Seizures or seizure-like symptoms,
- Difficulty maintaining weight,
- Muscle spasms
- Muscle stiffness,
- Improve immune function by lowering inflammatory cytokines, and
- To decrease narcotics or to enhance their effect for pain control.
Kills Lyme?I am skeptical that it actually kills Lyme in any meaningful way in humans, although I am interested in this potential based on Dr. Murakami’s experiments. I have not seen improved killing of Lyme in my patients who use medical cannabis.
How to Take Medical Marijuana and CBD in Lyme
Medical cannabis comes in a variety of forms. Loose plant and oils can be inhaled either by using a vaporizer or directly smoking (plant). Of the inhaled methods, I prefer the vaporizer to limit harmful chemicals and irritants entering the lungs through smoking. Edible forms come in pills, drops, or in food. Also drops and sprays can be used in the mouth. There are creams and lotions which may have an effect where they are placed, but not throughout the body. The delivery method determines how quickly the effect will occur and how long it will last.
|Delivery Method||Time to Feel Effect||Time of Peak Effect||Length of Effect|
|Vapor or Smoke||90 sec||15 – 30 min||2 – 3 hours|
|Edibles/Pills/Drops||90 min||2 – 6 hours||4 – 12 hours|
|Mouth Sprays||.5 – 2.5 hour||1.5 – 4.25 hours|
Note: There is a lot of dfference in effects between different people.
Starting Dose: For someone who is new to cannabis and marijuana a good starting dose is 5 mgto see what the effect is. Based on that add more or less. Be careful with edibles because it could take 90 minutes or more to feel the effect.
CBD versus THC: CBD tends to be more activating and generally is good for daytime use. THC is more psychoactive creating sleepiness and the high; so it is better for before bed time use.
With CBD and THC from marijuana, there are products that are higher or lower in THC to CBD ratios. For instance a high THC product could have THC:CBD of 10:1. This type of product is good for night use. On the other hand a product of THC:CBD of 1:10 is good for day use.
Dose Frequency: Take high CBD ratio products up to 2 times during the day and high THC products before bed.
Experiment with Ratios: For some people THC works better for symptom management than CBD does. So for daytime use a person may need to find a higher THC:CBD ratio that works for that person.
How to Limit the High: Vaporizing or smoking high THC products gives less of a high than edible forms. THC from edible forms is altered by the liver into a more psychoactive substance giving a greater high. Also CBD can lower the high too.
Talk to The Bud Keeper: Medical marijuana stores have bud keepers. Good ones know the products in the store. Talk with them before you purchase to help find the best product for your situation. There is a lot of variation in products including mixes of THC, CBD, other cannabanoids in the products, and terpenes that effect how any given product works.
In Washington State, medical marijuana stores were combined with recreational stores in 2017. In my experience, the bud keepers in recreational shops are generally not as skilled at finding the right medical product as bud keepers in medical marijuana stores. Fortunately, in Washington state, some stores have certification in medical marijuana. These medical certified stores tend to have bud keepers who know the medical properties of there products.
The ideas and recommendations on this website and in this article are for informational purposes only. For more information about this, see the sitewide Terms & Conditions.
Medical marijuana/cannabis including CBD & THC helps many Lyme symptoms. Marty Ross MD LLMD reviews how and why to use it in a Lyme disease treatment.
Hemp oil and lyme disease
When I was diagnosed with chronic Lyme disease at 12-years-old, an unexpected emotion of relief coincided with it.
It was an experience that I later learned was far too common among women and girls, where the questioning and disbelief of our symptoms leads to months or years of undiagnosed and misdiagnosed health problems. At the time, my diagnosis offered hope that I would be able to get better. I was suffering from debilitating fatigue, muscle and joint pain, chest pain, headaches, cognitive difficulties, dizziness, trouble sleeping, and other symptoms that doctors struggled to put a name to. But, after trying a range of treatments, including antibiotics, supplements, and homeopathy, I found that sense of relief deteriorating into frustration and hopelessness.
Nine years later, the discovery of medical cannabis would reignite the feeling that maybe I really would be able to get better. If only I had known about it sooner.
My experience navigating doctors and searching for treatment was, unfortunately, not unique. Not only were other girls and women across the world finding themselves bedridden with a range of similar symptoms, but their doctors were telling them their symptoms were “all in their head,” too; that they were really “just depressed” and “should try to get out of the house more.” It was as if medical professionals across the globe were reading from the same script: How to Dismiss Women and Girls Who Are in Pain.
I subsequently learned, however, that this has been going on for centuries.
As early as the 1600s, women were being diagnosed with medically-unexplained “hysteria,” with symptoms ranging from paralysis and hallucinations to insomnia and shortness of breath. Women were advised treatments as outrageous as sexual stimulation and marriage, and by the 1800s it was regarded as a psychological disorder. As Maya Dusenbery explains in her 2018 book Doing Harm, many women were given this diagnosis because their doctors were unable to measure a cause for their symptoms, and even with all of the technological advances and scientific discoveries made over time, this is still happening today.
“The terminology has morphed — from hysteria to ‘somatization,’ and from conversion disorders to ‘medically unexplained symptoms’ — but the idea has remained remarkably unchanged. And the idea that women are especially prone to such psychogenic symptoms has endured too,” writes Dusenbery.
In more recent years, many alarming studies have shown a striking difference in how men and women are treated when it comes to health concerns and doctors visits. Multiple studies have found that men are prescribed painkillers more often than women, and a 1982 study found that women were in pain for a longer period of time than men before being referred to a specialist. A 2001 study in the Journal of Law, Medicine & Ethics concluded that women’s reports of pain are taken less seriously than men, that women are more likely to have their symptoms deemed emotional or psychogenic, and that women are more likely to be assumed to not be in pain if they are more physically attractive.
When it comes to illnesses that are difficult to diagnose, the gender bias can have an even more harmful impact. If you have a widely-recognized and easily-detectable disease, for example, it’s more likely that you will receive a diagnosis, because there is already-established diagnostic criteria in place. But if you have a condition that is not yet well understood and that doctors aren’t as educated on, you are often left with nowhere to turn when doctor after doctor assures you there is nothing physically wrong. In these instances, many women are left with no choice but to take their treatment into their own hands.
That is exactly where I found myself after years of battling Lyme disease. I had exhausted all of my immediate options and ended up sitting in small offices with naturopaths or homeopaths that I was skeptical of, but who guaranteed they would have me symptom-free within a few months. When I read about CBD helping relieve the symptoms of chronic Lyme disease, I was inclined to try it, since smoking marijuana had already helped with my muscle and joint pain.
My nutritionist recommended CBD oil liposomes, which act as carriers that transport CBD efficiently throughout the body. At first, I didn’t feel any effect, but I continued to increase the dose until I felt a difference. Once I found my dose, I couldn’t believe the results. I had the energy to go for walks, get out of the house more, and I didn’t feel my fatigue dramatically increase throughout the day. I was full of motivation and excitement. I felt like I could see everything a little clearer.
It’s unfortunate that many patients have to take treatment into their own hands when they are already dealing with the stress of navigating life with a complex chronic illness. K. Leonard, 44, said she had to push her doctor to even test her for Lyme disease. When she finally tested positive two months after first getting sick, she was put on long-term oral antibiotics that did not seem to help. Leonard was luckily able to see a Lyme literate doctor three years later. “[She] encouraged me to research various treatments. Although she understood the basics of Lyme disease, she also knew that it was under-researched, and that many Lyme patients were finding success with extra-medical or alternative treatments.”
After coming across CBD in her research, Leonard spoke to her neurologist, who encouraged her to give it a try. She then went to a medical marijuana dispensary in Colorado for advice on what to take. “While I couldn’t get a prescription because I wasn’t a Colorado resident, the dispensary staff were very thorough in going over my Lyme disease symptoms and my [treatment] options. I had not previously tried any other form of cannabis,” she says.
Leonard now takes 10mg of CBD oil twice daily. “It completely eliminates the low-to-medium grade nausea I often have early in the day, and helps reduce inflammation-caused pain in my joints, back, and chest,” she says. “I had been taking a lot of painkillers before sleeping at night, but then I began taking the oil before bedtime, and now I don’t need the painkillers as often to sleep comfortably.”
Dr. Marty Ross, who has been working with medical marijuana since the late 1990s and has been treating Lyme disease since 2004, explains that cannabis works by interacting with our body’s natural ‘marijuana system,’ known as the endocannabinoid system. The endocannabinoid system is distributed throughout our body and has ‘receptors’ (molecules that are activated by CBD) in the brain and organ systems, with the two major chemical receptors being CB1 and CB2.
“CB1 receptors are found on many organs, including the brain and the nervous system. They regulate the release of neurotransmitters in the brain,” Dr. Ross says. CB1 receptors are also responsible for psychoactive effects of marijuana, such as euphoria, and impaired memory. “CB1 [helps] regulate the heart and blood vessels, energy, thinking, memory, emotions, pain, muscle control, sensory regulation, the intestinal system, and much more.”
CB2, on the other hand, is primarily anti-inflammatory, and regulates the immune system. “These receptors are found on a variety of white blood cells including B cells that make antibodies, T cells that fight Lyme disease, and on macrophages that fight viruses.” Dr. Ross says that regulating CB2 (which you can do with a cannabinoid receptor antagonist, meaning a drug that prevents CB2 receptors from being activated) can lead to the improvement of Lyme symptoms. This is because T cell receptors have been found to interact with molecules of Lyme disease, causing an activation of T-cells that produces inflammatory molecules, resulting in joint pain. Regulating CB2 can therefore regulate pain by reducing that inflammation.
In his practice, Dr. Ross found that patients’ responses to medical marijuana can vary, but he has seen mainly positive reactions when cannabis was used to treat nausea, tremors, anxiety, depression, and stiff muscles, among other conditions. The best improvements he’s seen, however, have been with pain control, treatment of insomnia, and seizure management. “In these situations, I tend to find products [with] higher THC content work better than those higher in CBD,” he says.
Susan Pogorzelski, 35, added CBD oil to her regimen of oral antibiotics and supplements, which had previously helped her reach remission for Lyme. After relapsing, she hoped CBD oil would help relieve her brain fog — a common symptom of the disease.
“I soon noticed that the physical pain had lessened, my sleep was more restful, and I had improved mental clarity,” she says of her experience. Pogozelski had to try a few different types of oil before finding one that worked for her, which turned out to be from Complete Body Defense, a company run by her friend, Nick Risden, who also has Lyme disease. “It hasn’t let me down,” she says. “I notice a difference in my symptoms when I don’t take it versus when I do.”
There are countless different types of cannabis oils on the market, and I’ve also benefited from hemp tea for relaxation and sleep, hemp massage oils and salves for painful joints, and CBD pre-rolls to help fall asleep and relieve pain. There are many other products worth researching if you’re interested in how CBD or medical marijuana can make a difference in your life.
“It’s unfortunate but true that women really must become their own best advocates for their health,” says Leonard. “We need to do research, talk with specialists in ‘alternative’ therapies, vote for the legalization of cannabis and the funding of cannabis-related medical research, and educate ourselves and our doctors.”
There is currently no treatment for chronic Lyme disease that is proven to work for every patient, but CBD and medical marijuana can offer a significant step in the right direction. And as marijuana legalization increases across the US and globally, hopefully more people will have access to this powerful, life-changing medicine.
"I couldn’t believe the results. I had the energy to go for walks, get out of the house more, and I didn’t feel my fatigue dramatically increase throughout the day. I felt like I could see everything a little clearer."