CBD Oil For Trigeminal Neuralgia

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Trigeminal Neuralgia (TN) is a chronic pain condition that affects the trigeminal nerve, which carries sensation from your face to your brain. Trigeminal Neuralgia (TN) is caused by damage or dysfunction in the trigeminal nerve, resulting in severe pain on the face.

Trigeminal neuralgia: How cannabis can help with the excruciating pain

Although it is rare, approximately 1 in 10,000 people develop this condition each year.

The main symptom of trigeminal neuralgia is a sudden attack of severe, sharp, shooting facial pain. The pain may last only a few seconds to a few minutes, but can occur repeatedly, during an attack. The pain is often described as excruciating, like an electric shock. The attacks can be so severe that you’re unable to move while they’re happening. Pain can also arise in other areas that are supplied by the trigeminal nerve, such as the cheek, jaw, eye and forehead.

Initially, it can present itself as short, slight pain, but TN can develop and have more enduring impacts, which can take the form of longer-lasting, more intense pain. The condition affects more women than men and is more likely to affect people who are over 50.

Helen, a patient at Integro Medical Cannabis Clinics, recounts her story from first using conventional medicines to receiving her medical cannabis prescription. Since then, she has seen a significant improvement in her quality of life.

At Integro Clinics, our doctors have seen the positive benefits that cannabis medicines can have in managing our patient’s symptoms of trigeminal neuralgia.

Trigeminal Neuralgia: Helen’s Story

Helen began to suffer from TN 15 years ago, which has meant that she has been unable to work since completing her master’s degree at university. Chronic back pain, which then spread up to her neck, triggered Helen’s TN, which began with agonising migraines.

Helen describes her pain as always starting on the left side of her face.

“Trigeminal neuralgia comes as a permanent headache around my left eye, it feels like I actually have pain in my eye. The pain spreads into my forehead and my jaw as well. It is a constant, mild pain, but if my neck gets stiff, or if I get stressed, it becomes a more severe pain. My TN means I’m light sensitive and I can only use the computer for short periods at a time. If I am looking at the screen for too long, my headaches get worse, and then as a result the pain in my face flares up.” – Helen

Helen was prescribed anticonvulsants by her doctor, such as pregabalin. She did not find that they eased the pain and they caused short term memory loss.

She added: “When I came off the pregabalin tablets, I realised that they had not actually helped me. I was still feeling the same pain as when I was on the medicine. The only thing that changed was that my short term memory started to get better.”

Helen wanted to find an alternative way to manage her pain but did not want to suffer the side effects of using conventional medicines again. After searching through Facebook pages on TN, Helen found out that medical cannabis was legal and available on prescription and could actually help her without any horrible side effects.

“I eventually discovered that cannabis clinics existed on Facebook. I started as a patient at one clinic, but I soon realised that the oil they prescribed wasn’t working for me. So, I then became a patient at Integro and this is where I started to see the benefits of medical cannabis. The team at Integro really helped me to find the best combination of THC and CBD that works for me. I felt like I was listened to and they wanted to help me, rather than just seeing me as being a fussy patient.

The CBMP’s that I’m taking now has made a huge difference in my life. They relax the muscles in my neck which means that my TN is triggered far less than before. I also get a better night’s sleep which in turn reduces the symptoms of my TN. Even though the pain is still there, it’s much less severe, I can actually read a book or look at my computer screen for longer than I could before. Cannabis has really given me my life back.” – Helen

Chornic pain and cannabis

Dr Anthony Ordman, Senior Consultant at Integro Medical Clinics, has seen how cannabis medicines can help patients suffering from TN. The cannabis helps them to manage their symptoms and relieve their pain so they can get on with activities such as reading, or working on a computer screen

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“In trigeminal neuralgia, nerve cells fire off in an uncontrolled way which sends pain signals to the brain, experienced as severe pain in the face and mouth.

“Only one conventional medicine will help, carbamazepine, which doesn’t always help completely. Cannabis medicines help to settle down the over-excited nerves and to dampen down their excessive firing. But then it also helps with the secondary effects of TN such as muscle tension, low mood, poor sleep and so on.”

He added: “At Integro Clinics, we aim to never cause any adverse effects or dependency, but the same can’t be said for conventional medicines. Integro Medical Clinics Ltd always recommends remaining under the care and treatment of your GP and specialist for your condition, while using cannabis-based medicines, and the Integro clinical team would always prefer to work in collaboration with them.”

If you would like further information or to speak to Dr Anthony Ordman please contact Integro Clinics:

CBD Oil for Trigeminal Neuralgia – August 2022

Trigeminal neuralgia (TN) is a form of neuropathic pain condition caused by dysfunction in the trigeminal nerve, or fifth cranial nerve . The nerve is responsible for carrying sensation signals from the face to the brain.

TN pain has been reported to be so severe that it has been called the “ suicide disease ” (5) .

Slight stimulations on the face, such as touching, brushing, and washing may cause severe facial pain . TN may also cause muscle spasms, feelings of electric shock , and burning sensation .

TN treatments include anticonvulsant agents, antispasmodic agents, and potentially invasive surgical procedures.

Antiepileptic medications, such as gabapentin and carbamazepine, have been used to treat TN (6) . However, the lack of intolerability and efficacy has been observed among these medications after prolonged use (7) .

CBD is a proven antiepileptic treatment (8) . A recent study posted in Molecules mentioned evidence of CBD ’s anticonvulsant and neuroprotective properties. These actions might help reduce spasms and nerve pain (9) .

Studies have not investigated CBD ’s efficacy on spasms caused by TN. However, CBD might have therapeutic benefits for treating chronic pain caused by TN (10) .

A review shared that cannabinoids , such as CBD , might help alleviate neuropathic pain and hyperalgesia (pain sensitivity). The review mentioned that there is evidence that cannabinoids might block the pain pathway ’s neural transmission (11) .

The authors added that the nociceptive effects produced by cannabinoids might be a potential therapeutic approach to the management of trigeminal neuralgia (12) .

The analgesic and anti-hyperalgesic effects of CBD were supported by an animal study published in the Journal of Experimental Medicine (13) .

The study mentioned that CBD possesses therapeutic benefits that might reduce pain and inflammation that causes neuropathy (14) .

Neuropathy is dysfunction or damage in the nerves that may cause pain, tingling and burning sensations , numbness, or muscle weakness.

Moreover, the authors added that CBD was able to mitigate hyperalgesia in mice models. The study concluded that CBD reduced persistent inflammation and neuropathic pain (15) .

Another study shared in the European Journal of Pharmacology demonstrated that CBD may possess potent anti-inflammatory and immunomodulatory effects (16) .

In the study, oral CBD was administered on rat models with induced sciatic nerve compression. Researchers found that CBD treatment reduced hyperalgesia and reduced inflammation (17) .

According to experts, trigeminal nerve pain can be caused by a blood vessel pressing on the trigeminal nerve . This compression causes damage to the trigeminal’s protective coating (myelin sheath) (18) . In severe cases, this vessel may need to be surgically separated from the trigeminal nerve.

Moreover, researchers observed that high blood pressure increases the risk for TN (19) .

A preclinical study acknowledged that CBD has cardiovascular benefits (20) . The authors mentioned that healthy volunteers (age 21-29) whose hypertension is triggered by stress displayed a lower resting blood pressure after taking CBD .

Clinical studies without limitations are needed to confirm CBD ’s potential ability to reduce blood pressure in older individuals.

Most of the studies mentioned have shown results using animals as test subjects. More clinical studies are needed to prove CBD ’s efficacy in alleviating nerve pain .

How CBD Oil Works to Help With Trigeminal Neuralgia

The endocannabinoid system (ECS) is essential in maintaining homeostasis in the central nervous system , peripheral nervous system , immune system, and organs.

The ECS is composed of receptors that are spread across the human body. These receptors include the cannabinoid receptors (CB1 and CB2) and glycine receptor (GLyR) (21) .

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Studies acknowledged that modulating the receptors in the ECS might influence bodily functions, resulting in several therapeutic benefits (22) .

Modulatory effects can be triggered or stimulated by cannabinoids , such as cannabidiol ( CBD) , tetrahydrocannabinol ( THC ), cannabichromene (CBC), cannabinol (CBN), and cannabigerol (CBG) (23) .

A study posted by the Journal of Experimental Medicine suggested that modulating the ECS might have therapeutic effects in pain management (24) .

Moreover, the authors mentioned that glycine receptors in the central nervous system are an essential target for alleviating neuropathic pain (25) .

The authors added that cannabinoids , such as THC and CBD , might strengthen nerve impulses in the glycine receptors, resulting in analgesic potency (26) .

Glycine receptors are ion channels that are responsible for neurotransmission.

The study found that oral CBD treatment provided a binding glycine activity that reduced hyperalgesia and neuropathic pain in mice models.

The Pros and Cons of CBD Oil for Trigeminal Neuralgia

The Pros
  • Studies demonstrated that CBD might have therapeutic effects in pain management by modulating receptors in the ECS (27) .
  • Researchers acknowledged that CBD might strengthen nerve impulses in the ECS receptors, resulting in analgesic potency (28) .
  • Animal studies have shown that oral CBD treatment might be useful in alleviating neuropathic pain and hyperalgesia (pain sensitivity) (29) .
  • Studies have shown that CBD might reduce blood pressure . High blood pressure might increase the risk for TN (30) .
  • Researchers acknowledge that CBD is well-tolerated and has an excellent safety profile (31) .
The Cons
  • There are not enough clinical studies that support CBD ’s efficacy in treating trigeminal neuralgia .
  • Studies mentioned that CBD might cause adverse effects, such as dry mouth, diarrhea, drowsiness, loss of appetite, and CBD -induced drug interactions (32) .
  • An animal study has shown that CBD might cause hepatotoxicity (liver damage) when taken in extremely high doses. This hypothesis is supported by the US Food and Drug Administration (FDA) (33) .

How CBD Oil Compares to Alternative Treatments for Trigeminal Neuralgia

There are not many alternative treatment options for painful conditions, like TN. The efficacy of alternative anticonvulsants for treating TN is currently not supported by scientific studies.

A popular alternative treatment for TN is acupuncture. A review mentioned that a 66-year woman suffering from TN believed that she was successfully treated by acupuncture (34) .

Acupuncture is a Chinese tradition that uses microneedles to balance the energy in the body.

Researchers mention that acupuncture may help maintain homeostasis in the ECS and must be investigated. So far, no direct studies have been made on how acupuncture might trigger the cannabinoid receptors (35) .

A study published in Frontiers of Molecular Neuroscience has found that electroacupuncture on osteoarthritis rats was able to increase receptor activity, resulting in reduced chronic pain (36) .

Electroacupuncture is conducted by sending electrical signals through acupuncture needles.

CBD has somewhat similar characteristics to electroacupuncture. A study discussed that CBD ’s modulation of adenosine receptors resulted in reduced pain and inflammation in rheumatoid arthritis mice (37) .

Another alternative treatment for TN is vitamin B12. Studies have shown that vitamin B12 has analgesic properties that might be useful for treating neuropathic pain (38) .

A review from Neural Plasticity cited clinical studies that produced positive results from neuropathic patients following treatments of methylcobalamin (MeCbl), a form of B12. These clinical studies included patients with neuropathic health conditions, such as TN and diabetic neuropathy (39) .

Clinical studies have yet to test CBD ’s efficacy on TN and diabetic neuropathy. However, a study acknowledged that CBD might also possess therapeutic benefits for neuropathic conditions.

CBD ’s modulation of glycine receptors resulted in alleviating chronic pain and hyperalgesia in mice models (40) .

How to Choose the Best CBD Oil for Trigeminal Neuralgia

Full-spectrum CBD oil carries all the major cannabinoids found in hemp plants, such as CBD , CBG, CBC, and 0.3% THC .

Full-spectrum CBD is recommended for treating neuropathic pain . A study posted in Therapeutics and Clinical Risk Management acknowledged the analgesic effects of other cannabinoids present in hemp (41) .

Broad-spectrum CBD contains the same cannabinoids in full-spectrum without THC . Broad-spectrum is recommended for individuals who do not want traces of THC in their system.

Full-spectrum and broad-spectrum types provide individuals with the “entourage effect.” The entourage effect means that all the cannabinoids are working in synergy.

Individuals who cannot tolerate other cannabinoids may opt for CBD isolate. This concentration contains 90% CBD .

Additional tips to consider before buying CBD :

  • Customers may check for cannabinoid concentration in the product by referring to the certificate of analysis (COA).
  • Checking testimonials and reviews from other customers is helpful.
  • Consulting with a neurologist before taking CBD is important.
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CBD Dosage for Trigeminal Neuralgia

More clinical trials are crucial in determining the correct CBD dose for health conditions.

The British Journal of Pharmacology published a study that recommended a low dose of less than 1 to 50 milligrams kilograms per day (

Individuals may increase their dose once their bodies get used to having CBD in their system.

Moreover, a clinical study published by the Brazilian Journal of Psychiatry mentioned that a dose-response curve was observed with CBD (43) .

The authors explained that 300mg pure CBD treatment produced positive results, while 150mg and 600mg did not produce any changes.

Also, a high dosage of CBD is not recommended. A study released by Molecules observed that extremely high doses of CBD caused hepatotoxicity in rat models (44) .

How to Take CBD Oil for Trigeminal Neuralgia

CBD oil may be taken orally in forms of capsules, softgels, and gummies. Individuals may also take CBD capsules , gummies, and other edibles with a glass of water.

A study observed that CBD remained in the system three to four hours after oral intake (45) .

Individuals who want a higher potency of CBD may opt for sublingual administration. CBD tinctures may be taken by using an applicator to drop CBD under the tongue.

More studies are needed to determine absorption speed and plasma concentrations for sublingual delivery.

The half-life of sublingual CBD administration has been observed to be dose-dependent. Nevertheless, researchers observed that plasma concentrations are faster when individuals are in a fasted state (empty stomach) (46) .

CBD tinctures may have an earthy taste due to the presence of terpenes. Terpenes are aromatic compounds found in the plants.

Some individuals may want the fastest method for pain relief . Thus, CBD vape pens and cartridges may be recommended.

Studies have shown that the lungs can be very efficient in delivering CBD into the bloodstream (47) . The authors explained that inhaling CBD through vaporization could deliver plasma concentrations to the body in less than 10 minutes.

However, another study reported that vaping might cause side effects , such as chest pain, shortness of breath, allergic reactions, and chemical irritation (48) .

Are CBD Oil and Medical Marijuana the Same?

Some individuals may mistake CBD for medical marijuana . However, these compounds differ in cultivation and concentration.

Medical marijuana or medical cannabis can come from several cannabis strains. The cannabis plant is harvested for its flowers and leaves, after which they are cured and dried for consumption.

CBD is usually extracted from Cannabis sativa, particularly hemp, using CO2 extraction, solvent extraction, or steam distillation.

The extraction method creates a more concentrated version of hemp. The cannabinoids are manufactured into carrier oils, capsules, edibles, vape juice, and other products.

CBD and medical marijuana also differ in terms of THC content.

CBD contains only 0.3% THC or less, making it legal in all 50 US states and territories (49) . Meanwhile, some dispensaries sell cannabis products that may contain up to 25-28% THC (50) .

Recreational and medical use of marijuana is illegal in the US, except for 11 states. These states may require consumers to procure a medical marijuana card (51) .

Although CBD products are legal, the CBD market remains highly unregulated.

Individuals are advised to always look for the certificate of analysis (COA) before buying the product. The COA is a third-party lab test result from ISO-certified laboratories.

These labs test for cannabinoid concentration and harmful chemicals, such as heavy metals, pesticides, and other contaminants.

The COA allows consumers to know that the product is high-quality and safe for humans or pets.

Conclusion

Studies have shown that CBD might be useful in alleviating neuropathic pain and hyperalgesia . This mechanism is due to CBD’s ability to block neural transmission in the pain receptors (52) .

Researchers also acknowledged that CBD might produce analgesic potency by strengthening nerve impulses in glycine receptors (53) .

Moreover, studies have shown that CBD might indirectly reduce TN pain by lowering blood pressure (54) .

More direct studies are needed to prove CBD ’s efficacy in alleviating neuropathic pain .

However, researchers mention that CBD ’s therapeutic potentials showed promise in improving the quality of life of individuals with TN (55) .

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