Navigating cannabinoid choices for chronic neuropathic pain in older adults
Associate Clinical Professor for Academic Family Medicine at the University of Saskatchewan in Regina.
Approximately 18% of Canadian adults use cannabis, which has increased from 14% since the legalization of recreational marijuana. 1 However, less than 2% of Canadians are registered medical cannabis users. 2 , 3 Chronic pain is a common reason for using cannabis. 4 , 5 Because neuropathic pain, a subset of chronic pain, affects approximately 8% of patients and is challenging for physicians and patients to manage adequately, an understanding of cannabinoid therapies (ie, prescription cannabinoids or cannabis) is important (Box 1). 6 – 9 This article will review the evidence for cannabinoids in refractory neuropathic pain and highlight tools to assist family physicians who seek practical guidance in advising, authorizing, prescribing, and monitoring cannabinoids. We acknowledge that there are various viewpoints on the role of cannabinoids and we offer multiple considerations.
Overview and definitions
The following provides an overview of relevant terminology
Cannabinoid: Any compound that activates a cannabinoid receptor (eg, prescription cannabinoid and cannabis). The most studied, although still poorly understood, are THC and CBD
Cannabinoid receptors: CB1 receptors (primarily in the central and peripheral nervous system) and CB2 receptors (primarily in the immune system) are part of the endocannabinoid system
Prescription cannabinoids: Nabilone or nabiximols (see Table 1 9 for details)
Comparison of cannabinoids for treating neuropathic pain: The full version of the RxFiles cannabinoid treatment chart is available online from CFPlus. *
Cannabis: Marijuana; available legally from a licensed producer or licensed retailer
Licensed producer: Regulated by Health Canada; requires prescribers to authorize medical cannabis via a medical document
Licensed retailer: A regulated retailer or licensed dispensary; regulated by each province and territory, as government-operated, privately licensed stores, or online. Medical oversight is not required
Case description: Mr Wilson
Mr Wilson, an 81-year-old who lives independently with his wife, has been a patient of yours for a long time. Three weeks ago he had an emergency department (ED) visit owing to dizziness and a near fall, and was told to follow up with his family physician if he continued to feel dizzy.
His medical history includes neuropathic pain secondary to long-standing type 2 diabetes mellitus, spinal osteoarthritis, and chronic insomnia. He is an ex-smoker. The discharge summary indicates that findings of the computed tomography scan of his brain were normal and that laboratory test results revealed that complete blood count, renal panel findings, extended electrolyte levels, and random blood glucose level were within normal range. His recent hemoglobin A1c measurement was 7.5%. His blood pressure was 128/84 mm Hg, with no orthostatic drop, and his heart rate was 72 beats/min. Neurologic and cardiac assessments were done, and no evidence of underlying disease was found. Findings of Dix-Hallpike maneuvers were negative.
According to your records, Mr Wilson is currently taking 75 mg of pregabalin twice daily, 60 mg of duloxetine daily, 850 mg of metformin twice daily, 40 units of insulin glargine at night, 20 mg of rosuvastatin daily, 5 mg of ramipril daily, 7.5 mg of zopiclone at night as required (2 or 3 times per week), and 1000 units of vitamin D daily. You recall that nortriptyline was trialed without success a few years ago (it had caused drowsiness and constipation at a dose of 100 mg at night), but after he was switched to pregabalin, Mr Wilson reported some improvement. About a year ago, duloxetine was added, and Mr Wilson reported further improvements in his diabetic neuropathy. Furthermore, Mr Wilson has previously expressed that he wants to avoid opioids “at all costs.”
Mr Wilson is still experiencing dizziness, and on today’s examination, his blood pressure and heart rate are 120/70 mm Hg and 68 beats/min, respectively, with no orthostasis. You confirm his current medication regimen, with no changes made over the past several months. However, upon routine cannabinoid screening, you discover that Mr Wilson was given cannabidiol (CBD) oil 3 months ago by his son to try to help with his nerve pain. You ask Mr Wilson to complete a Cannabis Use Disorder Identification Test–Revised (https://bpac.org.nz/BPJ/2010/June/docs/addiction_CUDIT-R.pdf), on which he scores 4, indicating no hazardous cannabis use. 10
Importance of cannabinoid screening
Screening for cannabinoid use, even in older adults, is important given the prevalence of cannabis use. Patients might contemplate self-medicating with cannabis for various reasons, including viewing cannabis as a “natural” (and therefore “safe”) alternative, or for managing medical conditions not adequately controlled by their current drug therapy. 9 Prescription cannabinoids (ie, nabiximols and nabilone), when dispensed by a community pharmacy, are captured by provincial or territorial electronic prescription databases. Cannabis is not captured by these databases, which makes it easy to miss unless it is specifically asked about, as was the case with Mr Wilson. When screening, it might be helpful to ask patients separately about medical and recreational (or nonmedical) cannabis or marijuana. Also, prompting patients by asking about specific products such as “CBD oil” or “topical cannabis” might be useful, as these products are not always viewed as medications by patients.
Back to Mr Wilson
Physician: I’m sorry that your nerve pain is still causing problems. I didn’t realize how much it was bothering you. Thank you for sharing about your CBD oil though, as it is helpful for your assessment. Did you bring the CBD oil with you?
Mr Wilson: I have a picture of it on my phone. It’s really helping me. I started at 1 drop at night and now I take 16 drops. I think my son said it was safe to go up to 40 drops, but I didn’t need that much. He picked this one because it just has CBD in it. (The label reads CBD 100 mg/mL.)
Physician: May I make a suggestion about what I think could be the possible cause of your dizziness? [Mr Wilson nods.] I’m concerned that this CBD oil might be contributing to this.
Mr Wilson: But I thought CBD is safe because it doesn’t get you high.
Bringing evidence to practice: cannabinoid adverse effects
Cannabinoids can cause many adverse effects that are often underappreciated by patients or their families, such as with Mr Wilson and his son ( Table 2 ). 9 Most cannabinoid trials enrol experienced users and exclude older adults and those with comorbidities common among aging patients. 11 , 12 Interestingly, the risk of adverse effects might even be higher in older adults owing to greater cannabinoid exposure (eg, slower cannabis metabolism and increased fat tissue) compared with younger adults. 11 Cannabis also appears to increase the risk of ED visits. A survey of 14 715 individuals aged 50 years or older found that 30.9% of cannabis users visited the ED compared with 23.5% of nonusers (P < .001). 13 Patients, especially older adults, are at risk of cannabinoid-related adverse effects and should be educated about and monitored for these effects.
Adverse effects of cannabinoids to assess or monitor
|ADVERSE EFFECT||CANNABINOID EVENT RATE, %||PLACEBO EVENT RATE, %||NUMBER NEEDED TO HARM|
|Overall adverse effects||81||62||6|
|Withdrawal due to adverse effects||11||Approximately 3||14|
|Ataxia or muscle twitching||30||11||6|
Data from Allan et al. 9
Cannabinoid therapies can cause dizziness. A systematic review found 3 systematic reviews of cannabinoids versus placebo assessing this adverse effect. 12 The largest systematic review included 41 randomized controlled trials (RCTs) comprising 4243 participants and found an increased risk of dizziness (odds ratio of 5.09, 95% CI 4.10 to 6.32). 14 Increased dizziness with cannabinoid therapy was also found by Wade et al (3 RCTs including 666 participants; 32% vs 11% experienced dizziness; number needed to harm of 5) and by Mücke et al (4 RCTs including 823 patients), who found a numerical, although not statistical, increase in dizziness (risk difference of 3%, 95% CI −2% to 8%). 15 , 16 Furthermore, cannabinoid therapy is active in the central nervous system (CNS) and it can interact with other CNS-active drugs. The American Geriatric Society Beers criteria recommend avoiding the use of 3 or more CNS-active drugs. 17 Mr Wilson is currently taking 4 CNS-active drugs (ie, pregabalin, zopiclone, duloxetine, cannabis oil), which increases his risk of harm, including dizziness.
Whether CBD alone causes dizziness is unstudied; however, all cannabis oil purchased from a legal source in Canada (ie, licensed producers or licensed retailers) will provide labeled concentrations for both CBD and tetrahydrocannabinol (THC) (see Box 2 for cannabis oil considerations). 18 Therefore, it is likely that Mr Wilson was given illegal cannabis oil, as the label only listed the concentration for CBD, and that Mr Wilson’s cannabis oil does contain an unspecified amount of THC despite no labeled concentration. In addition, products purchased from a legal source will have an excise stamp on the packaging and a standardized cannabis symbol (if the product contains greater than 10 μg of THC per gram), which can be another clue about the source of cannabis. 19 , 20 To date, all legal cannabis products in Canada contain both CBD and THC.
Cannabis oil considerations
Most patients will report cannabis oil dose in drops or millilitres per day. However, it is important to know the milligram dose of CBD and THC. The concentration (ie, mg/mL) of CBD and THC should be reported on the product’s label
Cannabis dose calculation using Mr Wilson as an example:
– Cannabis oil bottle label reads CBD 100 mg/mL; THC concentration is not reported
– Mr Wilson is taking 16 drops per day, which is about 0.8 mL/d (rule of thumb: approximately 20 drops per mL)
– Mr Wilson is taking approximately 80 mg of CBD per day
Back to Mr Wilson
Physician: There really is no such thing as a safe type of cannabis. In fact, about 1 in 5 patients taking a cannabinoid medication will become dizzy. I am especially concerned when the cannabis is combined with your other medications that put you at risk of falling.
Mr Wilson: So, you want me to stop the CBD oil? But, won’t my pain come back? I don’t feel very good about that.
Bringing evidence to practice: diabetic neuropathic pain management and cannabinoid therapy
Before considering cannabinoid therapy, it is important to discuss goals of therapy with Mr Wilson and assess his previous medication trials. An understanding of Mr Wilson’s perceived benefit with cannabis oil is essential. Focusing on functional goals—that is, goals where success is measured by improvements in activities of daily life (eg, ability to play with grandchildren, garden, get groceries)—versus relying solely on pain scores is central to managing chronic pain. 6 , 21 It is also important to set realistic expectations regarding benefits that can be achieved pharmacologically. For example, a 30% or 50% reduction in pain are common efficacy outcomes assessed in chronic pain RCTs to indicate success; however, some patients might believe that drug therapy will reduce their pain to zero. Because Mr Wilson reported some improvement with both pregabalin and duloxetine, but still pursued self-medicating with cannabis, it would be worthwhile to discuss and set functional goals while emphasizing that complete elimination of pain is unrealistic. In addition, even for patients who might feel as though they have “tried everything,” there is often still an opportunity to optimize therapies. Guidelines recommend nonpharmacologic treatment such as exercise, physiotherapy, and psychological therapies in all patients. 7 Furthermore, many patients perceive a drug therapy to have failed, but have not undergone an adequate trial. For example, most medications need to be titrated to an effective dose and used for at least 6 weeks (and likely 3 months) to realize benefit. 9 Of note, older adults usually require lower doses and slower medication titration than younger adults do (see Geri-RxFiles available at www.RxFiles.ca for further dosing information). 22
Currently, cannabinoids are considered a third- or fourth-line treatment alternative for chronic neuropathic pain after patients fail tricyclic antidepressants, gabapentinoids, and selective norepinephrine reuptake inhibitor antidepressants. 7 , 9 For Mr Wilson, cannabinoids might be a reasonable alternative, as he has trialed nortriptyline, pregabalin, and duloxetine. A 2018 Cochrane meta-analysis of 10 RCTs of patients (1586 participants) experiencing chronic neuropathic pain found that cannabinoids compared with placebo increased the number of patients achieving a 30% or greater reduction in pain with a number needed to treat of 11 (moderate quality of evidence). 23 However, there was no difference in patients with diabetic neuropathy based on a subgroup analysis of 2 RCTs (327 participants). 23 In addition, the review attempted to meta-analyze a functional outcome—patient reported global impression of pain—but the quality of evidence was low and further study is required. 23
Although cannabinoids have been studied in chronic neuropathic pain as outlined above, important limitations exist. Most RCTs included fewer than 100 participants (range 20 to 339), between the ages of approximately 25 to 60 years (up to 70 years), and assessed the prescription cannabinoid nabiximols. 23 None of the RCTs assessed cannabis oil. 23 Two RCTs assessed nabilone (but were not included in the meta-analysis). 23 Most RCTs were 12 weeks in duration (up to 26 weeks), and long-term benefit is unknown. 23 This was further assessed in a systematic review by Allan et al, in which short RCTs (up to 5 weeks) found positive results and longer RCTs (9 to 15 weeks) found neutral results. 12 Thus, cannabinoid effects, especially long-term, remain unknown in older adults, such as Mr Wilson.
Potential management approaches for Mr Wilson
Managing refractory chronic neuropathic pain is challenging; however, there are a few interventions that Mr Wilson would likely benefit from. Goals of care, with an emphasis on function, should be discussed, and Mr Wilson should be reminded that drug therapy is unlikely to reduce his pain level to zero. Nonpharmacologic therapy is helpful and should be explored (eg, psychotherapy, physiotherapy, supervised activity program). An outline of many nonpharmacologic therapies is available online at www.RxFiles.ca/painlinks.
Various drug therapy approaches for refractory chronic neuropathic pain are reasonable and depend on many variables such as patient characteristics and values. For Mr Wilson, it might be reasonable to trial an increased dose of either 90 mg of duloxetine daily or 75 mg of pregabalin in the morning and 150 mg at night for 3 months while weighing the potential for benefits and adverse effects. 24 , 25
Given that Mr Wilson’s cannabis oil is likely illicit and associated with the onset of his dizziness, he should be encouraged to stop using it, or at least to decrease the dose (although it is important to note that Mr Wilson might not follow medical advice). Tapering is advised when stopping, as withdrawal symptoms (eg, anxiety, sweating, and sleep disturbances) have been reported when cannabinoids are used daily for a few weeks to months. 26 While the optimal tapering regimen is unknown, in non-frail elderly patients like Mr Wilson, decreasing the dose by 25% every 1 to 2 weeks as tolerated is reasonable while monitoring for dizziness resolution, cannabis withdrawal symptoms, and effects on function. 27 You might choose to provide Mr Wilson with a cannabis patient booklet, which highlights some cannabis myths and adverse effects (available at www.RxFiles.ca). 28
If alternative cannabinoid therapy is explored (see Table 1 for cannabinoid product details 9 and the full version of the RxFiles cannabinoid treatment chart available online from CFPlus * ), Mr Wilson should likely be titrated off or given a reduced dose of duloxetine or pregabalin to minimize additive CNS adverse effects. 9 Prescription cannabinoids are preferred over cannabis, as most RCTs assessed these products, dosing guidance is available, provincial and territorial electronic prescription databases capture these products aiding in cannabinoid screening, and the products meet prescription-level quality standards. However, cost might be prohibitive, especially with nabiximols. It would be important to initiate the cannabinoid at a low dose and increase it every few days or weekly, and a reasonable trial duration would be approximately 3 months. In general, the best approach will be patient-centred.
Overall, there are many unknowns and uncertainties about the optimal role of cannabinoids in older adults for refractory neuropathic pain. Until more robust data are available, ensure other nonpharmacologic and pharmacologic therapies are optimized and that patients have failed at least 3 other agents before initiating cannabinoid therapy. Patients might be curious and want to explore cannabinoid therapy, so it is important to screen for cannabinoid use, monitor for potential adverse effects, and engage with patients. In addition, cannabinoid-related tools for practice exist to assist family physicians who seek practical guidance for delivering patient care.
We thank Lynette Kosar and Loren Regier for their review of this article.
* The RxFiles Cannabinoid Drug Comparison Chart is available at www.cfp.ca. Go to the full text of the article online and click on the CFPlus tab.
RxFiles and contributing authors do not have any commercial competing interests. RxFiles Academic Detailing Program is funded through a grant from Saskatchewan Health to the University of Saskatchewan; additional “not for profit; not for loss” revenue is obtained from sales of books and online subscriptions. No financial assistance was obtained for this publication.
This article is eligible for Mainpro+ certified Self-Learning credits. To earn credits, go to www.cfp.ca and click on the Mainpro+ link.
La traduction en français de cet article se trouve à www.cfp.ca dans la table des matières du numéro de novembre 2019 à la page e469.
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Articles from Canadian Family Physician are provided here courtesy of College of Family Physicians of Canada
10 Best CBD Oils for Migraines
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CBD oil is becoming an increasingly popular treatment for migraines, and there are several reasons why it might work well for this condition. Today we’re sharing the 10 best CBD oils for migraines and tips to help keep your migraines at bay.
8. Nuleaf Naturals
9. Charlotte’s Web
Migraines are one of the most common neurological disorders in the world. An estimated 38 million Americans suffer from migraines, according to the Migraine Research Foundation. And while there are many different treatments available for migraines, finding the right one can be a challenge.
Some people find relief with over-the-counter medications, while others need prescription medication to get relief. But for some people, prescription medications don’t work at all and they’re looking for an alternative treatment.
How do I know if I have a migraine or headache?
Migraine headaches are characterized by throbbing or pulsing pain that often can worsen with activity. They typically affect only one side of the head and may be accompanied by nausea, vomiting, light sensitivity, and noise sensitivity.
What is CBD?
CBD, short for cannabidiol, is one of the active cannabinoids found in cannabis sativa. This compound can influence how we feel, think, and react. It does not produce a “high” feeling or psychoactive effects because it binds to other receptors in our bodies rather than those in the brain. People have been using CBD for a variety of conditions, including migraines and other types of pain.
CBD Oil for Migraines
When it comes to CBD oil, there are so many different brands to choose from that choosing the right one can be confusing. Some people have concerns over whether or not CBD oil is legal in their state. Others might be wondering how much they should take or which brand may be most effective.
If you’re considering trying CBD oil for your migraines, we want to make it easy for you by sharing a few tips and reviews of some of the best brands on the market.
How did we choose the best CBD oils for migraines?
When it comes to choosing the best CBD oil for migraines, we based our list on customer reviews and third-party lab tests. We also considered the price per milligram of CBD oil plus any discounts or coupons available.
Price and Discounts Available
One of the first things we considered when compiling our list is how much a company charges per milligram of CBD oil. A higher price point doesn’t necessarily mean a better product, but knowing available pricing and discounts can help if you’re on a budget.
Luckily, several of the companies on this list have discounts or coupons available on their websites that you can use for a better deal. It’s important to note that some of these discounts may have an expiration date, so be sure to check the company website for more information.
CBD Oil Reviews and Best Brands
We also considered customer reviews when compiling this list. CBD oil is a relatively new product and there aren’t many third-party lab tests available, so customer reviews are an important part of finding the best CBD oils on the market.
Finally, we also took into consideration any available third-party lab tests for any potential contaminants in the product. While some companies perform their own tests to ensure their products are clean, others rely on third parties to test their products. If you’re looking for a pure product, you’ll want to buy from a company that independently tests their products.
3 Tips for Finding the Best CBD Oils for Migraines
If you’re looking for the best CBD oils to ease your migraines, here are three tips to get started.
Tip 1: Choose Low or Full Spectrum CBD Oil
If you’re new to CBD oil, you might not know about full spectrum or broad spectrum CBD oils. There are several benefits of full spectrum CBD over regular hemp oil, but it’s especially helpful when treating migraines.
The main difference between the two is that full spectrum CBD oil contains other compounds found in hemp plants, not just CBD. These additional compounds are known as cannabinoids and terpenes. They contain antioxidants and help ease inflammation in addition to easing pain from migraines or headaches.
In order to get the most benefit from a full spectrum CBD oil, look for a product that’s high in both CBD and THCa or CBDa. Most full spectrum oils will also be broad spectrum, so consider this when deciding on a company.
Tip 2: Consider Third Party Lab Tests
If you’re new to CBD oil products, you might not know about third-party lab tests. Third-party lab tests are a good way to ensure that you’re getting a product that’s free from pesticides or any other harmful substances.
There are a few different places where you can find these test results, but many of the best CBD oil companies will have their results listed on their websites. This is also a good place to look if you’re concerned about whether or not the product is legal in your state.
Tip 3: Look for Coupons and Discounts
Did you know that many CBD oil companies offer coupons and discounts? If you’re on a budget, consider looking for a coupon before making a purchase.
What are the benefits of CBD oils for migraines?
There are many benefits of CBD oil and it might be one of the best ways for you to ease your migraine symptoms.
To start, CBD oil is a great alternative to western medicine. Migraine sufferers have been shown to benefit from the use of CBD oil and other cannabinoids. As with any natural product, it might take a little trial and error before you find a product that works best for you.
If you’re new to CBD oils, there are several benefits you might want to consider.
Improves Mood and Eases Depression
CBD oil is also a natural mood booster that helps ease depression in addition to the pain from migraines. It’s important to note that this may not work for everyone, but it can be an excellent option for some people.
One of the best ways that CBD oil helps ease migraines is by reducing anxiety. CBD oil contains terpenes that are known to help fight stress and decrease anxiety, which can help reduce your migraine symptoms.
CBD oils for migraines may also stimulate the appetite and help prevent nausea and vomiting related to migraines. This can be a great benefit if you’re going through treatment and struggling with food aversions or nausea.
Addresses Neuropathic Pain
CBD oil is also helpful for people who suffer from neuropathic pain related to migraine symptoms. This can be an excellent option if you’re dealing with head pain, neck pain, face numbness, dizziness, or any other type of symptom.
What are the side effects of CBD oils for migraines?
It’s important to know about all of the side effects before trying anything new.
Many people report feeling drowsy or groggy when taking CBD oil that contains higher levels of THC. If you’re new to CBD products, you should always start with a low dose and see how it affects you.
If the side effects are too much for you, it might be time to switch to an all CBD oil or full spectrum CBD oil product instead. This way, you won’t have any THC in the product and can still get all of the benefits of CBD.
How much CBD oils for migraines should I take?
The best CBD oils for migraines don’t come with dosing instructions, so you’ll need to do a little research before trying anything new.
It’s always best to start small and see how it impacts your overall migraine symptoms, including pain levels. If you find that you have a good experience with the product, there’s no need to increase your dosage.
You can always take more CBD oil as well if you’re struggling with pain and really want to get relief right away. Be sure not to take too much though as this can cause drowsiness or other side effects that go along with high doses of CBD oil.
What are the best CBD oils for migraines?
There are many benefits to using CBD oil and it might be the perfect natural alternative for you when dealing with migraine symptoms.
One thing that makes CBD oils great is that they’re natural, making them an excellent choice when looking at your overall health and wellness.
Another thing to consider when selecting CBD oils is the THC content if you’re looking for a more psychoactive product. If the CBD oil you choose has too much THC in it, make sure to purchase a CBD oil with less than 0.3 percent THC in order to avoid any unwanted side effects.
As you look through our top 10 list, keep in mind that your experience with CBD oil may be different than someone else’s. Everyone responds to CBD oil differently, so you might need to try a few brands before finding the best one for you.
With that in mind, let’s dive deeper into our top 10 list!
1. Penguin CBD Oil
Image courtesy Penguin CBD
Penguin CBD oil is the perfect addition to anyone seeking migraine relief from CBD oils! Made with Oregon-grown hemp, this supplement is a great way to rejuvenate your body and mind. Their fan-favorite mint, citrus, natural, strawberry, and cookies & cream flavors are sure to please.
Image courtesy Everest
Looking for an ultra-potent CBD oil that’s also vegan and non-GMO? Look no further than Everest CBD’s Delta-8 THC oils. High-grade, naturally grown hemp provides a potent dose of CBD (1,000 mg), while the mint flavor is refreshing and delicious.
3. R+R Medicinals
R+R boasts impressive levels of CBD, CBG, CBC, CBN, CBL, and more in their products so you can truly feel the entourage effect. Their 1000mg Fresh Mint Tincture is their best seller and of incredible value for a Full-Spectrum product at $46.99.
4. BATCH CBD
BATCH CBD is committed to creating natural and effective CBD products that you can rely on. All of BATCH’s products are rigorously tested to ensure the quality and potency of their organic ingredients. BATCH’s Original CBD Oil Tincture is infused with their premium full-spectrum hemp extract and a unique terpene blend of limonene, caryophyllene, and linalool so that you can effectively treat migraine pain, reduce tension, and ultimately find relief.
5. Verma Farms
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For a gentle CBD option that still delivers powerful results, look no further than Verma Farms. Their CBD products are made with your comfort and needs in mind, so you can find the right solution for you. Whether you want to use edibles, tinctures, topicals, or a combination, they have the best CBD oils for migraines.
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Hemp Bombs carry a huge range of CBD products, from oils and topicals to edibles and vape products. Hemp Bombs extracts are made with the highest quality ingredients and are rigorously tested for purity and potency. Plus, they offer great discounts on bulk orders!
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With options for every type of user, CBDistillery offers a range of extracts with different potencies to suit your needs. Plus, their products are always made with the highest quality ingredients and backed by a commitment to customer satisfaction.
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Nuleaf Naturals’ potent full-spectrum extracts provide the benefits of the entourage effect, while high quality hemp ensures that your oil is pesticide and herbicide free. Plus, their affordable prices make Nuleaf Naturals a great choice for anyone on a budget.
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Charlotte’s Web hemp extract is a natural dietary supplement that helps support your health and wellness. Made from the finest organic hemp, Charlotte’s Web extract is CO2 extracted to ensure the highest quality. It’s non-GMO, gluten-free, and vegan friendly.
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Looking to boost your CBD intake with a high-quality oil? cbdMD has you covered, with up to 7,500 mg of CBD in each bottle. Choose from three delicious flavor options, or go for the unflavored version for a pure CBD hit. Thanks to the MCT oil base, this CBD oil is easy to absorb and has a smooth flavor.
How does CBD help with migraines?
One of the main components of marijuana that delivers many of its effects is CBD. This non-psychoactive cannabinoid not only alleviates pain but can also reduce anxiety.
CBD interacts with certain serotonin receptors in the human brain and immune system, acting as a natural anti-inflammatory substance that reduces pain and inflammation.
CBD can help relieve migraines by affecting serotonin signals in the brain. One study found this effect to be effective on chronic migraine patients. CBD also works to reduce inflammation in the brain, which is known to exacerbate migraines.
CBD oil for pain relief is becoming one of the most popular health topics on search engines. With more people turning to alternative medicine as a solution for their ailments, it only makes sense that CBD has become so popular among those who are in pain.
Here are some potential side effects to be aware of if you’re thinking about trying CBD for your migraines:
CBD can make users feel tired or groggy, especially after taking a large dose. If you have to go to work or school soon after taking CBD, it might be best to take the product in smaller amounts throughout the day so you don’t fall asleep at your desk.
If you don’t already have migraines, CBD can actually cause them to develop over time. If you start feeling pressure around your temples or the back of your head after taking CBD, it might be due to a headache.
CBD acts on cannabinoid receptors that are found throughout the body, including saliva glands. When activated, these receptors can lead to dry mouth, which can cause difficulties eating or drinking.
Nausea and Vomiting
Again, CBD acts on cannabinoid receptors throughout the body, including those in the digestive tracts. If you feel sick after taking CBD oil for migraines, it could be because of your digestive system.
What are some other common migraine treatment options?
There are other prescription drugs that can help treat the symptoms of migraines. For example, some people opt to take sumatriptan (Imitrex), which narrows blood vessels and limits the pain signal sent to the brain.
A medication called propranolol (Inderal) is also prescribed for migraine relief and comes in several forms, including capsules, tablets that dissolve under the tongue, and injections.
Side effects of some prescription migraine treatments can include insomnia, restlessness, dizziness, lightheadedness, dry mouth, nausea, and vomiting.
There are also natural remedies people can try out for migraines before seeing a doctor or trying pharmaceutical drugs. Here are some options that might help:
· Hot or cold packs on the head
What foods can trigger a migraine?
Foods can trigger migraines in different ways, depending on the individual. Some foods are said to cause certain chemicals in the human body to change, which can lead to a migraine.
Some common migraine-triggering foods include:
· Monosodium glutamate (MSG)
· Bananas, citrus fruits, and other foods containing tyramine
· Fermented or pickled foods (such as vinegar-based salad dressings)
What are some of the best CBD oils for migraines?
There are many retailers online that sell high-quality CBD products. Again, here are the best we chose:
8. Nuleaf Naturals
9. Charlotte’s Web
Why would CBD oils for migraines work?
All of the products featured above are made with high-quality CBD that can help treat symptoms associated with migraines.
CBD oil can also help prevent future migraines and lessen the number of attacks a person experiences. If you’re still on the fence about using CBD oils for migraines, just select the best CBD oils for migraines out of our list above, give a low dosage a try, and see how your body responds.
CBD is an effective way to treat migraines and other conditions without the harsh side effects of prescription medications. Whether you’re looking for CBD oil drops with a specific CBD:THC ratio or trying out full-spectrum products with a variety of cannabinoids, our list above has plenty of options that you can order online and start using right away.