Non cbd oil for vestibular migraines

The 5 Best Cannabis Strains if You Have Vertigo

Vertigo, dizziness and other balance-related conditions have an estimated lifetime prevalence between 20-56%, accounting for 2-3% of total consultations in emergency departments. Affected individuals often feel as if the room is spinning, which can cause intense nausea.

As a powerful antiemetic, cannabis presents itself as a potential therapeutic option for those trying to deal with vertigo-related nausea and vomiting. This article discusses what vertigo is and which strains patients may want to consider to find the most effective nausea-reducing effects.

Need a Medical Marijuana Card ?

What Is Vertigo? – The Symptoms

Vertigo is best defined as a sensation of dizziness that makes it feel as if the world is spinning. In a more general sense, vertigo can simply relate to any ongoing or temporary dizzy spell. The dizziness can result from various causes, such as a sudden drop in blood pressure or getting up too quickly from a seated or lying down position. Problems within the inner ear may also result in vertigo.

Symptoms of vertigo include:

  • Vomiting and nausea
  • Motion sickness
  • Difficulties with balance
  • Tinnitus (ringing in the ear)
  • Headaches
  • Nystagmus (eye movement disorder characterized by rapid, involuntary movement of the eye)
  • Lightheadedness
  • Sweating

The symptoms may last for minutes or persist for several hours.

Vertigo Causes

There are several possible reasons why a patient may experience vertigo. These include:

Benign Paroxysmal Positional Vertigo (BPPV): There are otolith organs in our inner ear that contain calcium carbonate crystals in fluid. In individuals with BPPV, the crystals become dislodged and end up in the ear’s semicircular canals. When a crystal touches sensory hair cells within the canals’ cupula, the brain sends false information about position and orientation, causing victims to feel dizzy.

Meniere’s Disease: It is a condition that causes a fluid build-up in the inner ear. Meniere’s can cause an attack of vertigo that results in hearing loss after ringing in the ears. It commonly impacts people aged 40-60.

Does it offer any relief? …

Labyrinthitis: This disorder occurs when an infection causes an inflamed inner ear labyrinth. The vestibulocochlear nerve is within this region and sends information to the brain regarding sound, position, and head motion.

Cholesteatoma: This is a noncancerous skin growth located in the middle ear. It grows behind the eardrum and may damage the bony structures of the middle ear.

Vestibular Neuritis: is inflammation of the vestibular nerve caused by an infection. It causes vertigo with symptoms such as severe nausea and blurred vision.

Other potential factors that could cause vertigo include:

Non-Cannabis Vertigo Treatments

There are several treatments for the condition, but they depend on what is causing it. Examples include:

  • Vestibular rehabilitation for vestibular neuritis.
  • Canalith repositioning maneuvers for BPPV.
  • Antibiotics (if the vertigo is caused by inflammation or an infection).
  • Diuretics for Meniere’s disease.
  • Surgery in extreme cases.

Can Medical Marijuana Help with Vertigo?

Cannabis should not be mistaken as a cure for vertigo. Remember, the condition is merely a symptom of something else. Therefore, patients need to manage their expectations and understand that MMJ may only help alleviate the issue – not get rid of it altogether. Of course, for those who regularly feel the room spinning, a reduction in symptoms is more than enough.

Over the years, research has brought to light how cannabis may potentially help with vertigo symptoms such as dizziness, headache, and nausea. Marijuana appears to activate specific endocannabinoid receptors in the body. CB1 and CB2 are the main receptors, with CB1 receptors primarily found in the central nervous system. The CB2 receptor is generally in immune cells. Both may also have downstream effects within the brain.

Several studies look at cannabis’s effects on patients with nausea, vomiting, and dizziness.

Unfortunately, there is limited research on marijuana and its therapeutic use in the pathophysiology of vertigo. However, several studies look at cannabis’s effects on patients with nausea, vomiting, and dizziness, which are the hallmark symptoms associated with vertigo. A study by Parker et al., published in the British Journal of Pharmacology in August 2011, looked at CBD’s impact on nausea and vomiting. The researchers found that CBD helped reduce those symptoms in patients undergoing chemotherapy.

A study by Pamplona et al. in Frontiers in Neurology in September 2018 also had interesting findings. The researchers discovered that consistent and continuous doses of CBD oil helped reduce dizziness over an extended period.

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What to Look for in a Marijuana Strain for Vertigo

The lack of clinical trials poses a problem. The vast majority of positive evidence is anecdotal. However, research seems to indicate that CBD has the most significant potential for helping with the dizziness and nausea associated with vertigo. Indeed, high doses of THC are likely to increase the sensation of dizziness.

However, the entourage effect suggests that cannabinoids work better together than in isolation. As a result, many choose to search for a strain with a low to moderate THC level and a high CBD level.

It is also prudent not to ignore the terpenes in any strain. For example, linalool has calming and sedating effects that may prove beneficial among those suffering from vertigo. Likewise, the stress relief and elevated mood caused by limonene should prove helpful. It only takes a little of a terpene to have a reasonable effect by all accounts.

If you are considering using cannabis for vertigo, here are five strains that we recommend:

1 – Charlotte’s Web

Charlotte’s Web is a hemp-derived strain with a CBD content of up to 17%. It does not cause an intoxicating high, which makes it a suitable option for patients with vertigo.

Users can seek out the actual CW strain in flower form (many dispensaries across the U.S. keep it in stock), or they can try hemp extract oils from the Charlotte’s Web CBD brand.

2 – Harle-Tsu

Harle-Tsu is another strain that offers a high level of CBD. It is a slightly indica-dominant strain that’s a cross between Sour Tsunami and Harlequin. Harle-Tsu has a CBD content of up to 24% and a THC level of just 1%. This is a fantastic ratio for vertigo patients aiming to benefit from the entourage effect.

Harle-Tsu is also a favorite amongst those wanting to re-energize after a long, stressful day. Users often say they feel relaxed all over the body while still having a desire to get things done. For those that experience vertigo, the strain could also help relieve the feelings of anxiety and nausea that come with it.

3 – Dancehall

Dancehall is another cannabis strain that offers an excellent CBD to THC ratio. It is a slightly sativa-dominant strain that’s a cross of Kalijah and Juanita La Lagrimosa genetics. The THC content here rarely exceeds 9%, while CBD levels often approach 16%. The strain’s most abundant terpenes are myrcene, beta-caryophyllene, and limonene.

On occasion, however, it’s possible to find Dancehall with a CBD to THC ratio of almost 1:1. For patients with vertigo, it’s essential not to nudge into THC dominance territory.

In terms of effects, Dancehall provides a clear-headed high that is a long way from being overwhelming. However, it’s likely not the best option for those that haven’t used cannabis before.

4 – Cannatonic

Cannatonic is a strain that’s gained near-legendary status. It boasts a THC content of 7-15%, with CBD levels up to 17%. Like Dancehall, the primary terpenes in Cannatonic are myrcene, beta-caryophyllene, and limonene. This combination can result in a smooth, relaxing, nausea-relieving experience.

That being said, there is enough THC in Cannatonic to warrant respect. While the intoxicating effects are typically gentle and pleasant, it will produce a high nonetheless.

5 – Valentine X

Valentine X is a somewhat rare strain that has its genetic origins in the famous ACDC strain. It is a balanced hybrid with a CBD content of up to 25% and a THC content of 1% or less. Valentine X’s main terpenes are beta-myrcene, caryophyllene oxide, pinene, and limonene.

Users say that Valentine X is outstanding when it comes to helping them attain a level of focus. As a result of its high CBD to THC ratio, it is also ideal for daytime use as users remain productive, with no intoxicating high. Users also may find that the strain provides a much-needed boost first thing in the morning, along with a rush of euphoria.

Final Thoughts on the Best Marijuana Strains for Vertigo

Again, we reiterate that there are no direct studies on the use of specific cannabis strains for vertigo. However, there is evidence that medical marijuana could reduce the impact of vertigo-related symptoms such as nausea, headaches, and dizziness.

There is evidence that medical marijuana could reduce the impact of vertigo-related symptoms.

Since high-THC strains may exacerbate unwanted effects, we recommend focusing on strains that offer more CBD than THC. It is also worth seeking strains with high levels of limonene and linalool terpenes.

In addition to flower, many vertigo sufferers find relief from cannabis or CBD products in tincture or edibles form. Many prefer taking a few drops of cannabis oil (or eating an edible) over smoking a joint.

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If you are a vertigo sufferer and are interested in learning more about medical cannabis in your state, be sure to read our informative state-by-state MMJ guide.

Cannabis (Marijuana) for dizziness, nausea or headache.

Marijuana is one of the most popular recreational drugs worldwide, and is the #1 illegal drug in the US (followed by cocaine). It is estimated that in the US, about 13.5% of the population uses it every year. (Zhang, 2019) As medical marijuana has become legal in many countries as well as about half of the states in the USA, it is now possible to discuss its use for treatment of common conditions such as dizziness, nausea and headache.

Cannabis is a generic term used for drugs produced from plants belong to the genus Cannabis (i.e. marijuana). Cannabis is not a single substance but rather is a mixture of up to roughly 60 compounds. Some of them, like THC (d-9-tetrahydrocannabinol), are psychoactive, and most others are not.

Prescription forms of cannabinoids include:

Cannabinoid formulations (Fife et al, 2015)

Name Constituents FDA approval Legal under federal/state laws
Marijuana THC, CBD, others No No/Yes
Dronabinol (Marinol) THC Yes yes/yes, was schedule I in 1971, but FDA indications suggest there i an accepted use.
Nabilone (Cesamet) Synthetic cannabinoid Yes Yes/yes
Nabiximole (Sativex) Oral spray mix of THC and CBD No No/no — available as of 2015 only in FDA approved clinical trials

What is in Cannabis ?

According to Fife et al, Marijuana is a plant of the species Cannabis sativa or Cannabis indica, and contains many chemical compounds. THC is the chief psychoactive component, while CBD (cannabidiol) has minimal or no psychoactive effects. Other cannabinoids without psychoactive properties include cannabigerol and cannabinol. THC can be measured in the blood, while carboxy THC is detected only in the urine. Hemp, made from the stem of the plant, contains only traces of THC. There are several strains of cannabis, mainly differentiated by the their psychoactive properties. “sativa’ is more stimulating. “indica” is more calming. “hemp” has low or absent THC.

A single dose of cannabis can be detected in the urine for 12 days. Thus someone who is involved in an auto-accident 10 days after using cannabis, could theoretically be cited for “DUI”.

One would think that it might be possible to use a non-psychoactive cannabinoid for a medical purpose, without running into issues with mental status. Nevertheless, due to the odd status in the US where research on cannabis has been suppressed by the government, we know little about the non-psychoactive components of Marijuana. We do not know, for example, if they cause cancer (just an example).

What does Cannabis do the brain ?

Rather astoundingly, Cannabis appears to activate specific endocannabinoid receptors, mainly in the CNS. There are two main cannabinoid receptors, CB1 and CB2. According to Baron (2018), CB1 is found mainly in the CNS. CB2 is more numerous in the peripheral tissues.

THC (tetrahydrocannabinol) is a partial agonist of CB1 (more so than CB2).

Cannabidiol (CBD) has no psychoactive properties, does not attach to CB1 or CB2, but functions as a noncompetitive antagonist at CB1.

The details of what it does to the brain are being worked out and are presently the subject of considerable controversy. While there are claims that cannabis reduces cognitive function, a recent study published in JAMA psychiatry, analyzing 69 studies, suggested that there is only a very small effect after 72 hours (Scott et al, 2018)

Possible indications for Cannabinoids

As of 2015, Fife et al (2015) summarized their conclusions regarding utility of Cannabis in neurological disorders.

There was evidence for effectiveness in spasticity, central pain in MS. Nabiximols was thought to be “probably effective” in reducing bladder spasms (this drug is also used to treat nausea, see below). In movement disorders such as tremor, Huntington disease, and dopamine related dyskinesias, it was thought either ineffective or unknown. For Epilepsy, as of 2015, it was unknown.

Nausea:

THC (brand name Dronabinol) has been extensively studied with placebo controlled trials for nausea. A similar drug called Nabilone is also available. Both of these have been approved by the FDA for treatment of nausea and vomiting associated with chemotherapy. Another substance called “Nabiximol” is not currently FDA approved for nausea, but it is licensed in other countries and appears to be similar.

Headache

McGeeney (2012) suggests that anecdotal evidence suggests that they “are used” by patients for migraine, including as an abortive, and for cluster headache. Baron (2015) also suggests that there is some evidence for a good effect in migraine. As there is some evidence for an effect in chronic pain, one would anticipate a positive effect also in chronic migraine. Thus evidence is currently extremely weak.

According to Baron (2018), a chemical called anandamide inhibits dilation of blood vessels, modulates CGRP, and cortical spreading depression. CB1 also inhibits pain responses. We consider this also anecdotal.

Vertigo and Dizziness

There are presently (in 2015) no studies of cannabis for treatment of dizziness, and dizziness appears to be more of a side effect than a therapeutic target (Grotenhermen et al, 2012). Smith (2006) suggested that there are cannabinoid receptors in the central vestibular system. More studies are needed.

We have had heard from our patients that they have sometimes had a good response to a non-mind altering component of cannabis (CBD). In theory, this might be related to the anti-seizure effects of some components of cannabis. At this date (early 2018), these are just anecdotes.

Products that we have been told were helpful are “Charlotte’s Web”, “Watermelon Pucks”, and “Anandahemp 200”. The first is CBD oil, and can easily be ordered from the internet. The second contains some THC, and is not as readily available. As noted above, THC is approved by the FDA for treatment of nausea and vomiting associated with chemotherapy, and thus it is not surprising that “Watermelon Pucks” might be helpful in some people with dizziness. To be very clear, I am not advocating for these products, but I am simply transmitting what patients are telling me.

Legal status of cannabis in Illinois.

As of 2019, cannabis is scheduled to be available for recreational use by early 2020. Presently, In Illinois, the Illinois Compassionate Use of Medical Cannabis Pilot Program requires physicians to certify the diagnosis of a debilitating condition or terminal illness for a qualifying patient seeking to apply for a medical cannabis registry identification card. Whether or not a physician chooses to provide a written physician certification is up to the health care practitioner. More information is here: https://www.dph.illinois.gov/topics-services/prevention-wellness/medical-cannabis/physician-information

According to Fife et al (2015), the system used in Illinois is the usual one used to handle the odd situation where the Federal government states that licensed physicians cannot legally prescribe herbal marijuana (although they may prescribe nabilone or dronabinol). Physicians can document that the patient has a medical condition that justifies the use of marijuana under that state’s law. Patients then may proceed to acquire the marijuana, under the particulars of the laws of their state. Nevertheless, certain institutions, including the Department of Veteran affairs, may have policies banning physicians from discussing medical marijuana with their patients.

Note that THC can be detected in the urine as long as 12 days after a single “dose”. This means that in Illinois, should one be involved in an auto accident, it is theoretically possible to be cited for DUI, 12 days after ingesting a small amount of medical marijuana.

Qualifying conditions for cannabis in Illinois:

An individual diagnosed with one or more debilitating conditions is eligible to apply for a medical cannabis registry identification card. The qualifying patient must obtain a written certification from a physician specifying their debilitating condition, unless they are a veteran receiving health services at a VA facility. Veterans must submit one year of medical records from the VA facility where they receive services. Effective January 1, 2015, the Act was amended to include eligibility for children under age 18 and to add seizure disorders to the list of debilitating conditions. On June 30, 2016, the Act was amended (Public Act 099-0519) to add Post-Traumatic Stress Disorder (PTSD) as a debilitating condition and to allow persons diagnosed with a terminal illness to apply for a medical cannabis registry identification card. The Act is effective until Jan, 1, 2020.

Qualifying patients must be diagnosed with a debilitating condition, as defined in the Compassionate Use of Medical Cannabis Pilot Program Act, to be eligible for a medical cannabis registry identification card in Illinois.

On this list, conditions that might cause or be associated with dizziness include Arnold-Chiari, Cancer, Hydrocephalus, MS, myoclonus, and TBI. Neither migraine nor intractable nausea are included here.