There’s a great deal that we don’t know about whether medical marijuana can help people with lupus. Research is just starting to study how it might help manage or treat lupus.
Products that contain natural or synthetic THC or CBD come in many forms. These include the dried plant (herb or flower), edibles (brownies, cookies, candy), drinkables (coffee, tea, lemonade, soda), oils, tinctures (which are taken orally), sprays, and topical creams and gels.
Here’s what you need to know about medical marijuana.
Marijuana contains active chemicals called “cannabinoids.” The main cannabinoid is commonly known as THC, which gives users a “high.” Another often used cannabinoid is known as CBD, which doesn’t produce a high and may relieve pain and inflammation. There are also hundreds of synthetic cannabinoid chemicals – chemicals that are created in the laboratory that mimic natural cannabinoids.
People have used medical marijuana for a variety of health conditions. But the FDA hasn’t approved medical marijuana as a safe and effective treatment for lupus – or for any medical condition or symptoms.
The FDA has approved one drug that contains CBD to treat seizures associated with two severe forms of childhood epilepsy. It has also approved three medications containing synthetic cannabinoids that may help treat cancer symptoms or the side effects of cancer therapies.
But whether CBD actually provides those benefits in a significant way remains to be seen. Only a few studies—small ones—have definitively proven the effectiveness of medicines that involve the endocannabinoid system. To date, the only FDA-approved medication containing CBD is Epidiolex, a medication used to treat two rare forms of severe epilepsy—Lennox-Gastaut syndrome and Dravet syndrome, both which begin mostly in infancy and early childhood. In a group of three clinical trials, Epidiolex seemed to reduce the number of seizures significantly. And yet, Vinita Knight, MD, a Yale Medicine pediatric neurologist, says her patients who take Epidiolex have had mixed results. Some have had reductions in seizures and others haven’t shown much improvement. “We’re not seeing as much success as what’s been reported on Facebook and Twitter,” she says, but adds that so far it has only been prescribed for children with the most debilitating and difficult-to-treat seizures. In addition, some researchers believe that CBD works most effectively in combination with other cannabinoids and compounds found in the marijuana plant, in what is known as the “entourage effect.” Thus, it would be less effective as an isolated chemical in pill form, but that, too, remains unproven.
In 2018, Dr. Koumpouras joined a multi-site randomized clinical trial that aims to recruit 100 participants to examine whether a drug using a synthetically created cannabinoid molecule that binds preferentially to CB2 receptors (called Lenabasum) can help ease pain and inflammation in patients with lupus. Participants will receive Lenabasum or a placebo for almost three months and will continue to be monitored for pain and inflammation levels, as well as lupus disease activity. The study is ongoing, but Dr. Koumpouras anticipates that it will wrap up by early next year.
“The landscape for treatment of lupus is a bit bleak,” says Fotios Koumpouras, MD, a rheumatologist and director of the Lupus Program at Yale Medicine. “A multitude of drugs have failed in the last 10 to 15 years. Most of the drugs we use are being repurposed from other conditions and are not unique to lupus. Many of them can’t be used during pregnancy, which is a problem because lupus mostly affects young women. All of these issues create the impetus to find new and more effective therapies.”
What is CBD?
His research is one of many new studies at Yale and elsewhere looking at the endocannabinoid system and molecules related to CBD action for use in treating everything from Crohn’s disease to psoriatic arthritis, and he hopes that this new data will be used to help paint a more complete picture about the chemical for future treatment options.
This is why he’s exploring a candidate for a new lupus treatment option: a molecule with a cannabinoid template structure that binds to cannabinoid receptors, the same receptors involved in the chemicals found in the marijuana plant.
Lupus affects approximately 240,000 people in the United States, and yet at present doctors neither know the exact cause nor have a cure. Instead, current treatments focus on improving quality of life by controlling symptoms and minimizing flare-ups to reduce risk of organ damage.
CBD is a form of cannabinoid called “cannabidiol.” Cannabinoids are a type of chemical that binds to CB1 and CB2 receptors found throughout the body. CB1 receptors are mostly located in the nervous system, connective tissues, gonads, glands, and organs; CB2 receptors are primarily found in the immune system, along with the spleen, liver, heart, kidneys, bones, blood vessels, lymph cells, endocrine glands, and reproductive organs. (Collectively this is called the endocannabinoid system.)
Did you know CBD can be derived from different sources too?? Well, get into that.
If you have any medical questions or concerns, please talk to your healthcare provider. The articles here are written by a Functional Medicine Holistic Nutritionist. However, they are not a substitute for professional medical advice, diagnosis, or treatment.
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