Can CBD Help Your Multiple Sclerosis?
When you’re living with multiple sclerosis (MS), it’s wise to have a range of tools in your arsenal to manage symptoms. CBD, a.k.a. cannabidiol, is chemical compound from the cannabis plant that is becoming more widely available as a method for dealing with chronic pain. You may have heard about it, and if you have, you’re probably wondering if it’s worth a shot to help manage your MS symptoms. So, is it? This is what experts currently say about CBD and its effectiveness for MS.
What Is CBD?
There are many compounds found in the cannabis plant. The two we know the most about are CBD and THC, says Kathy Costello, associate vice president of clinical care at the National Multiple Sclerosis Society. “THC is a psychoactive compound found in the plant—it makes people feel high,” she says. “CBD does not have psychoactive properties, but it’s believed to have other useful properties,” such as relieving anxiety, insomnia, and, yes, chronic pain.
Know Your CBD Sources
CBD products are either made from hemp or marijuana, says Ben Thrower, M.D., medical director of the Andrew C. Carlos MS Institute at the Shepherd Center in Atlanta, GA, and senior medical adviser for the Multiple Sclerosis Foundation. Both are types of cannabis, but CBD products from hemp contains only trace amounts of THC, while CBD from marijuana—only legal in some states—can contain higher amounts of THC.
Can CBD Relieve MS Symptoms?
Researchers have been studying the effects of cannabinoids like CBD on MS for years. The bottom line? CBD likely does help reduce pain and spasticity, as well as symptoms such as fatigue, anxiety, and urinary issues, but more studies are needed. One major catch: Most research has been done using nabiximols (Sativex), an oral spray that contains a 1:1 CBD-to-THC ratio and is not currently available in the U.S. because it is not approved by the Federal Drug Administration, says Costello.
Not All CBD Is the Same
CBD products are not well-regulated in the U.S., making the decision to use them a little tricky. Depending on the laws in your state, you might be able to buy CBD at your local health food store or dispensary, but beware: “You may not get the amount of CBD stated on the label because each batch is not regulated the same way as a pharmaceutical, so it may or may not be effective,” Costello says. There could also be toxins like pesticides in some hemp-derived CBD products.
How Is It Supposed to Work?
It’s not entirely understood how CBD reduces MS symptoms, says Costello. Here's what we do know: Your body naturally produces its own cannabinoids—called endocannabinoids—and has receptors for these, mainly in the central nervous system (CNS) and immune system cells. The CNS comes under attack by the immune system when you have MS. The theory is that CBD interacts with CNS receptors, changing how they respond to various stimuli.
How CBD May Relieve Pain
Pain affects about two-thirds of people with MS. The most common type is known as central neuropathic pain, a.k.a. nerve pain. This type of pain is often felt as sharp stinging or burning sensation, and research suggests that some cannabinoid receptors in the CNS play a role in the processing of these sensations. For that reason, if you’re looking to relieve MS pain, “the interaction between CBD and those receptors may lead to a reduction in discomfort,” Costello says.
CBD May Decrease Spasticity
Muscle tightness and involuntary spasms are other common symptoms caused, in part, by the pathways to the brain and spinal cord being compromised. “Spasticity in MS occurs because of issues in the CNS, not in the muscles,” says Costello. “So if you alter the pathways in the brain and spinal cord with CBD, then may you alter the pathways that control muscle as well.” Those changes in the CNS pathways may reduce spasticity—and in turn, help increase mobility.
What Type of CBD Is Best?
If you’re looking to treat MS symptoms, certain types of CBD may be more helpful for certain symptoms, says Dr. Thrower. “I have found oral hemp-based CBD oils to be helpful for sleep and anxiety in MS. Topical CBD may help with joint pain and muscle tightness,” he says. “If we want to manage more severe spasticity or burning pain in MS, I find that we need to use oil containing higher amounts of THC.” (Remember—THC products aren’t legal in every state.)
Risks of Using CBD for MS
In general, the chance of side effects with hemp-based CBD is low, says Dr. Thrower. If you’re taking CBD with more THC in it, side effects like cognitive changes, drowsiness, and less often, nausea and vomiting are possible, he says. Beyond that, though, the main thing to be aware of is how CBD may affect other drugs you’re taking. “I advise people to speak with their pharmacist about any potential interactions between CBD oil and their prescription medications,” says Dr. Thrower.
Talk to Your Doctor
You’ve got the facts, and you’re interested in trying CBD for your MS symptoms. What now? Check with your doctor, says Dr. Thrower. “Patients should discuss all complementary therapies with their health care team,” he explains. That way, everyone is in the know. But keep in mind: “Health care providers have varying comfort levels and knowledge about the use of cannabis products in MS,” Dr. Thrower says. “Reputable stores selling CBD products may be able to help with product selection and dosing.”
The Bottom Line
When it comes to CBD’s effectiveness for MS symptoms, it’s safe to say it might be helpful, especially for pain and spasticity. That said, more research will give us a clearer picture. And while the risks of CBD appear limited, it’s best to talk with your doctor before starting any new therapy—and keep in mind that not all CBD products are created equal. “We are just starting to understand the complex nature of cannabis,” says Dr. Thrower.
Cannabis for MS Evidence: National MS Society. (2017). “Cannabis for Multiple Sclerosis Symptoms.” nationalmssociety.org/NationalMSSociety/media/MSNationalFiles/Professionals/Cannabis-and-Multiple-Sclerosis.pdf
Medical Marijuana and MS: The National MS Society. (2020). “Medical Marijuana (Cannabis) and MS FAQS.” nationalmssociety.org/Treating-MS/Complementary-Alternative-Medicines/Marijuana/Marijuana-FAQs
CBD for Health Conditions Info: Harvard Health. (2018). “Cannabidiol (CBD) — what we know and what we don’t.” health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont-2018082414476