Cannabidiol – commonly known as CBD oil – has a number of proven health benefits. Along with treating pain, epilepsy and anxiety, anecdotal evidence has suggested that CBD oil my be helpful in alleviating multiple sclerosis (MS) symptoms.
But what exactly is CBD oil and could it be the solution for MS sufferers? We examine the research.
CBD is a cannabinoid – a naturally occurring chemical compound – which can be extracted from the cannabis plant. It is then mixed with a carrier oil (such as hemp), to create CBD oil.
Unlike the most well-known cannabinoid, tetrahydrocannabidiol (THC), CBD is not psychoactive, meaning that it won’t make you ‘high’. While the majority of cannabinoids are controlled substances under the Misuse of Drugs Act, CBD is legal across the UK, provided it has been derived from an industrial hemp strain that’s EU-approved.
These strains contain very little to no THC (the psychoactive cannabinoid). In fact, there are strict regulations in place with regard to CBD oil’s THC content, as well as the conditions of sale.
‘CBD oils can only be sold legally in the UK providing they contain negligible amounts of THC, do not make any claims for medical benefit and are not sold as medicines,’ explains Janice Sykes, Information Officer at MS Trust.
Multiple sclerosis (MS) is a condition that affects the brain and spinal cord, which occurs when your immune system starts to attack the myelin that coats and protects your nerve fibres.
MS symptoms differ for everyone, depending on the area and extent of the nerve damage, but they can include vision problems, numbness, tingling, muscle spasms and spasticity, pain, weakness, fatigue, and difficulty moving or walking. Symptoms can be unpredictable – for some, symptoms deteriorate over time, while for others they come and go in periods of relapse and remission.
How does CBD oil differ from medicinal cannabis?
Medicinal cannabis became legal for specialist doctors to prescribe from 1 November 2018. The term ‘medicinal’ simply means that it is used for medical, rather than recreational, use. Therefore, medicinal cannabis can refer to anything from raw herbal cannabis to a drug manufactured to pharmaceutical standards.
Sativex is one such licensed, cannabis-based medicine, which can be prescribed in the UK for the treatment of spasticity and spasms related to MS.
However, it can only be prescribed by a specialist doctor (not a GP), and only when the patient has not responded to other treatments first. Unlike CBD oil, Sativex contains equal proportions of both CBD and THC, and studies have shown that it can lessen symptoms of spacticity and spasms.
Other studies have investigated different preparations of medicinal cannabis containing both CBD and THC, and have found that it may help to treat other symptoms of MS as well as spasticity, including reduced central pain and frequent urination.
Does CBD oil work for MS?
An article published in the journal Frontiers in Neurology in 2018 discussed the fact that CDB has the potential to offer positive pharmacological effects, given that it is anti-inflammatory, antioxidative, antiemetic, antipsychotic and neuroprotective. It also cites the fact that CBD is safe, as it does not alter heart rate, blood pressure and body temperature, and psychomotor and psychological functions are not negatively affected.
However, when it comes to MS, only cannabis products that contain both CBD and THC have been subjected to clinical studies, and only cannabis with a 1:1 ratio of CBD:THC (or greater) has been shown to reduce muscle spasticity and pain in people with MS.
‘There have not been any clinical studies to demonstrate whether cannabis oils containing cannabidiol (CBD) alone have any benefits (or harms) in MS,’ reiterates Sykes. ‘All the studies have used preparations with different proportions of THC and CBD, or THC alone.’
Therefore, there is no conclusive evidence to suggest that CBD is beneficial to people with MS.
Despite the lack of empirical evidence, there does appear to be anecdotal evidence suggesting that CBD oil may improve MS symptoms in some people.
‘Anecdotally, some people with MS say they have found cannabis oils to be beneficial, while others have seen no effect,’ says Sykes. ‘While I couldn’t offer any explanation as to why this is the case, of course a placebo effect would need to be considered.’
What are the side effects?
While the majority of CBD users don’t experience any negative effects, as with any treatment there are of course possible side effects. These include nausea, vomiting, diarrhoea, bloating and dizziness.
CBD oil may also interact with common prescription medications, so it’s important you always seek the advice of your GP before giving it a go.
If you’re interested to see whether CBD oil may help alleviate your MS symptoms, it is available in the form of tinctures, sprays and gummy sweets, which can be ingested, as well as e-liquid for vape pens and creams for topical application. However, before trying, it’s important to consult your doctor.
‘It would be sensible to discuss your decision to try CBD oil with your GP, MS nurse or neurologist,’ advises Sykes. ‘As for where to purchase, we’re not aware of any independent guide to the quality or otherwise of the CBD oil products that are available, although there are plenty of anecdotal reports of benefits and websites selling a wide range of products. A number of CBD oil producers are members of the Cannabis Trades Association UK.’
If you are keen to give CBD oil a go, Sykes recommends the following:
- In an area with strong feelings on both sides of the argument, and little in the way of objective evidence, we would suggest that people ignore the hype from both sides and monitor any effects on their own symptoms in a diary.
- Listing the symptoms experienced – perhaps rated on a 1-5 scale to indicate severity – would give a picture of health over a period of time.
- If you start the diary a week or two before trying CBD oil, this will give you a baseline.
- It may help to record other medication and treatment/management for MS, as well as other lifestyle changes.
- Set a reasonable trial period (the research on Sativex saw a response to the drug in the first two or three weeks).
- Review your diary after the trial period.
- If it shows improvements, and cost and availability issues are not prohibitive, then you may choose to continue.
- If there is no change or a deterioration in symptoms, maybe you should stop and consider other approaches.