Is Fibromyalgia a deficiency of Cannabinoids?
Treating the Disease With Cannabis
Fibromyalgia is a chronic pain disorder that manifests itself in a number of ways including widespread pain in the muscles and joints, fatigue, and tender or burning areas throughout the body. The condition is known to affect sleep, memory, mood and energy levels. Unlike arthritis, which affects the joints, fibromyalgia painfully affects the soft tissue of the body.
Over ten million people in the US, and up to 6% of the female population in Canada, suffer from Fibromyalgia—according to the National Fibromyalgia Association. Curiously, it is estimated that 75 to 90 percent of fibro sufferers are women. The exact cause of the condition is unknown and is often misdiagnosed, because the presenting symptoms are similar to many other conditions like arthritis and chronic fatigue syndrome. There appears to be a strong genetic component to the disorder that runs in families, among siblings, and between mothers and children.
There is no known cure for fibromyalgia, so treatment focuses on trying to alleviate the presenting symptoms. The pharmaceuticals most commonly used to treat fibromyalgia—Lyrica and Cymbalta—are often ineffective and frequently cause a host of unpleasant side effects. Patients frequently report feelings of brain fog on these medicines, as well as side effects like nausea, constipation, fatigue, disrupted sleep patterns and more. Cannabis is proving to be a safe and effective treatment for fibromyalgia sufferers with few side effects.
Dr. Ethan Russo, a well-respected neurologist and pharmacologist, has proposed a theory based on his extensive career studying the endocannabinoid system. The endocannabinoid system is a network that communicates between one’s brain, organs, cells, glands, and connective tissues. The system works to keep the internal environment stable and constant by circulating naturally produced cannabinoids throughout our body. Dr. Russo postulates that the cause of fibromyalgia may be related to a deficiency within the endocannabinoid system. He has termed the phenomenon Clinical Endocannabinoid Deficiency (CECD). Under this theory, the endocannabinoid system fails to naturally produce cannabinoids and maintain balance. This would explain the high success rate treating fibromyalgia with cannabis.
In 2014, the National Pain Foundation in the U.S., conducted a survey of over 1300 fibromyalgia patients. About one-third reported having used medical cannabis. 62% of them reported cannabis was very effective in treating their symptoms. 33% of the remaining patients said it helped a little. Only 5% said it didn’t help at all. Conversely, only between 8 and 10% reported Lyrica or Cymbalta as very effective. Over 60% reported the pharmaceuticals did not help at all.
Both CBD and THC are sometimes used to treat fibromyalgia—depending on the patient’s symptoms. Frequently, they are used in tandem. CBD, the non-psychoactive type of cannabis medicine, is often used twice during the day—in the morning or afternoon. A third dose is sometimes added in the evening and that dose is sometimes blended with THC to help sleep or nighttime pain. By consuming two to three doses of cannabis daily, the patient is able to keep the medicine circulating in the bloodstream. Dr. Russo would contend these cannabinoids are substituting for the ones that the fibromyalgia patient’s faulty endocannabinoid system is failing to produce. The circulation brings homeostatic balance back to the body and therefore, alleviates the patient’s pain and other symptoms.
A clinical study by Drs. Habib and Artul, conducted in Israel and published last August, concluded that all 26 participating fibromyalgia patients reported significant improvement using medical cannabis. Furthermore, half of the patients studied had such significant improvement that they were able to successfully discontinue the pharmaceuticals they were taking for fibro. In our clinic, where I counsel fibromyalgia patients on a daily basis, we also see a high correlation of success using cannabis for fibromyalgia. Granted, different patients are able to achieve various levels of relief, but almost all of them get some degree of improvement.
Fibromyalgia remains a medical enigma. Doctors are still at a loss to explain both the origin and the mechanics of the disorder. There appears to be a hereditary component—suggesting a genetic mutation of some sort. Women are particularly vulnerable to fibro. The medicines prescribed to treat fibromyalgia are often ineffective and frequently have unpleasant side effects. Fibromyalgia may be the result of a defective endocannabinoid system. Cannabis seems to be the most effective treatment for fibromyalgia, lending some credibility to that theory.