Is Fibromyalgia Caused by an Insufficiency of the Endocannabinoid System?

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Cannabis could be the only treatment necessary to alleviate the symptoms associated with fibromyalgia syndrome.

What is Fibromyalgia Syndrome (FMS)?

That definition or diagnosis varies depending on the type of practitioner you ask and their belief of what this condition truly is. The reason for this is the fact that there is no “golden standard” for diagnosing FMS. The general conscious is that FMS is the presence of chronic, widespread musculoskeletal pain, that may be accompanied with migraines, insomnia, irritable bowel syndrome (IBS), memory problems, mood swings, and fatigue, just to name a few. Recent research has shown that individuals diagnosed with FMS have abnormal pain perception processing. This condition primarily affects women and is typically diagnosed between the ages of 20-40 +/-.  According to the Centers for Disease Control and Prevention (CDC), approximately 4 million adults in the US are affected by fibromyalgia (CDC, 2017).

If you are currently experiencing symptoms that fall within the diagnosis of FMS, you know yourself, that your own symptoms might vary from day to day. The most frustrating thing about it though, is that many patients never find substantial relief from these symptoms despite the use of multiple prescribed medications. Others seeking treatment may even be undiagnosed or misdiagnosed. At Nature’s Way Medicine, we provide comprehensive assessments for patients interested in treating FMS, or other medical conditions through the use of medical marijuana.

New information related to FMS and the endocannabinoid system

The Endocannabinoid System

The endocannabinoid system is a recently discovered system within the human body. In the early 1990s, several researchers discovered this system (Alger, 2103), including the receptors that are located in the central nervous system (CB1), in the peripheral nervous system and organs related to immunity (CB2). With the discovery of these receptors came the knowledge of naturally occurring neurotransmitters called endocannabinoids (endo- internal or within).  Without getting into the chemistry of the system, these receptors respond to the cannabinoids made by the body as well as those found in Cannabis. So, one might ask themselves… Why do we have these receptors in our body, if we were not meant to use Cannabis to treat ailments?

Endocannabinoid Deficiency and Fibromyalgia

Today, more information about FMS and its possible connection to the endocannabinoid system (ECS) is available, and the research is showing a potential link to the cause of the symptoms being associated with a deficiency in this system. The theory is that the ECS has the ability to regulate and balance the systems within the body. It is believed that in certain conditions, whether congenital or acquired, the function of the ECS becomes deficient and causes various syndromes. Fibromyalgia may be one of those syndromes; yet, there is still inconclusive evidence on this topic (Habib & Artul, 2018).

If we look at the main complaints associated with FMS, we find significant proof of the efficacy of Cannabis to treat these individual symptoms.

  • Chronic Pain (CP) — The ECS is now known to be one of the key systems that regulate pain sensation, with distinct actions at all stages of pain processing pathways (Woodhams et al., 2015). So, if the pain regulation within the ECS is not working correctly, this could, in turn, cause the pain associated with FMS. A study published in The Journal of Pain stated that their findings suggest that many CP patients are essentially substituting medical Cannabis for opioids and other medications for CP treatment and finding the benefits of Cannabis to be greater than these other classes of medications (Boehnke et al., 2016).
  • Insomnia — Preliminary research into Cannabis and insomnia suggests that CBD may have therapeutic potential for the treatment of insomnia, while THC may decrease sleep latency (the time it takes to fall asleep). A recent study used a popular app to determine the efficacy of Cannabis when used to relieve insomnia. They found that the consumption of medical Cannabis flower among their participants was associated with significant improvements in perceived insomnia. There was, however, a difference in the effectiveness and side effects, depending on the product they used and how it was administered (Vigil et al., 2018).
  • Migraines — Traditionally, migraines have been treated with calcium channel blockers, beta-blockers, and topiramate in a prophylactic manner. They can cause some unwanted side effects though. Research has shown that Cannabis appears to alter the nociceptive (pain from nerve cells) processes in the brain and can function via serotonergic (nerve ending stimulated by serotonin) and other pathways involved in migraines. When inhaled, it’s rapidly activated and skips the digestive system. This is a huge benefit because intestinal absorption is markedly decreased during a migraine and that many migraine patients experience nausea and vomiting as a common symptom. It should be noted that Cannabis is a highly effective antiemetic as well (Chirchiglia et al., 2017).

One common problem that we see today with validating the use of Cannabis is that it is still a Schedule 1 drug in the United States. Despite the fact that all but 19 states have legalized the use of medical Cannabis or Cannabis use for recreational use, it is still illegal to possess, use and grow Cannabis in the US. This archaic law impedes the progress of research to would enable additional studies to determine the full medicinal benefits of Cannabis.

Nature’s Way Medicine provides medical marijuana cards for patients looking to relieve symptoms of FMS and other medical conditions in an effective manner. Our physicians conduct thorough medical marijuana assessments to ensure our patients are aware of all risks and benefits of treating their medical condition with cannabis. To schedule a consultation, please contact us at 855-420-3627. For questions or inquiries, you may fill out our contact form.

References

Alger, B. E. (2013, November). Getting high on the endocannabinoid system. In Cerebrum: the Dana forum on brain science (Vol. 2013). Dana Foundation. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3997295/.

Boehnke, K. F., Litinas, E., & Clauw, D. J. (2016). Medical Cannabis use is associated with decreased opiate medication use in a retrospective cross-sectional survey of patients with chronic pain. The Journal of Pain, 17(6), 739-744. doi.org/10.1016/j.jpain.2016.03.002

Centers for Disease Control and Prevention (CDC). National Center for Chronic Disease Prevention and Health Promotion , Division of Population Health. (2017). Fibromyalgia. Retrieved from https://www.cdc.gov/arthritis/basics/fibromyalgia.htm

Chirchiglia, D., Della Torre, A., & Chirchiglia, P. (2017). Focus on the endogenous cannabinoid system in migraine. EMJ Neurology, 5(1), 88-91. Retrieved from https://www.researchgate.net/profile/Domenico_Chirchiglia/publication/318878241_Focus_on_the_endogenous_cannabinoid_system_in_migraine/links/598c2467458515c333a69f4c/Focus-on-the-endogenous-cannabinoid-system-in-migraine.pdf

Habib, G., & Artul, S. (2018). Medical Cannabis for the treatment of fibromyalgia. JCR: Journal of Clinical Rheumatology, 24(5), 255–258. doi:10.1097/RHU.0000000000000702

Vigil, J.M., Stith, S.S., Diviant, J.P., Brockelman, F., Keeling, K., & Hall, B. (2018). Effectiveness of raw, natural medical Cannabis flower for treating insomnia under naturalistic conditions. Medicines, 5(3), 75. doi.org/10.3390/medicines5030075

Woodhams, S. G., Sagar, D. R., Burston, J. J., & Chapman, V. (2015). The role of the endocannabinoid system in pain. In Pain control (pp. 119-143). Springer, Berlin, Heidelberg. doi.org/10.1007/978-3-662-46450-2_7



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