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Can CBD Help with Multiple Sclerosis? Multiple sclerosis (MS) symptoms often include pain, inflammation, muscle spasticity, MS fatigue, and depression. A drug called Sativex® (CBD & THC) has been approved for the treatment of multiple sclerosis. Learn how CBD oil can be used to support MS.

CBD for MS (Multiple Sclerosis) – August 2022

According to The National Multiple Sclerosis Society, approximately 85% of people with MS are initially diagnosed with relapsing-remitting MS (RRMS) (5 ) .

RRMS is a type of MS characterized by inflammatory attacks on the nerve fibers and myelin, the layers of insulating membranes surrounding nerve fibers in the central nervous system (CNS).

While RRMS is defined by attacks or relapses of new MS symptoms, progressive forms of MS involve fewer attacks.

The progressive types of MS are secondary-progressive MS (SPMS), primary-progressive MS (PPMS), and progressive-relapsing MS (PRMS).

The symptoms of MS vary, but they often include pain, inflammation, muscle spasticity, MS fatigue, and depression.

Spasticity is a condition characterized by an abnormal increase in muscle tone or stiffness of muscle, which might interfere with movement.

MS symptoms can reduce physical activity, negatively impact functional mobility, and have a detrimental effect on a person’s quality of life (6) .

Although there have been recent significant advances in disease-modifying therapy, none of the current treatments stops or cures MS-related symptoms (7 ) .

Thus, many people with MS look for alternative and complementary therapies, such as cannabis plants and their derivatives.

CBD for Multiple Sclerosis: What The Research Says

Sativex is a cannabis-based prescription medicine that contains a 1:1 CBD (cannabidiol)-THC (delta-9-tetrahydrocannabinol) ratio.

Approved as an additional treatment for nerve pain and spasticity in multiple sclerosis patients, Sativex is administered as a mouth spray (oromucosal) (8 ) .

In a 2005 study published in Issues in Emerging Health Technologies , 368 patients with various neurological conditions, including MS, were given the THC:CBD spray (9 ) .

Results showed that the spray significantly reduced nerve pain, spasticity, muscle spasms, and sleep disturbances among the human subjects.

However, the researchers observed adverse events, like dizziness, sleepiness, fatigue, feeling of intoxication, and experiencing an unpleasant taste.

A 2016 study in Therapeutic Advances in Neurological Disorders summarized the evidence for the efficacy and effectiveness of THC-CBD oromucosal spray in symptom management for those experiencing spasticity due to MS (10 ) .

Researchers believe that for individuals with resistant moderate to severe MS-induced spasticity, THC-CBD spray can be a treatment option.

It was only in 2017 when a pre-clinical study on CBD alone was conducted. The study, published in CNS and Neurological Disorders – Drug Targets, showed that CBD could produce beneficial effects in individuals with MS (11 ) .

How CBD Oil Works to Help With Multiple Sclerosis

The two primary cannabinoid receptors are CB1 and CB2. CB1 receptors are found in the CNS (the brain and spinal cord), intestines, connective tissues, and other glands.

CB2 receptors are mostly located in the spleen, tonsils, and immune cells. Only a few are in the brain.

Data suggests that CBD does bind to the receptors but does not directly activate them. Instead, it appears to adjust how the receptors respond to stimulation from other compounds, such as THC (12 ) .

The authors of a study, published in the British Journal of Pharmacology in 2010, noted there had been anecdotal and scientific evidence of cannabis providing symptomatic relief in neurodegenerative disorders, including MS (13 ) .

The study results implied that the endocannabinoid system (ECS) impairment might be responsible for some disease symptoms.

The ECS plays an active role in regulating a wide range of body functions, including pain sensation, immune response, anxiety , mood, appetite, sleep, metabolism, and memory.

The CBD-THC spray, Sativex, acts via cannabinoid receptors distributed throughout the CNS and in immune cells (14 ) .

CB2 is involved in weakening inflammatory immune cell response to disease.

Meanwhile, the activation of CB1 receptors has been shown to block the release of glutamate, a chemical transmitter released by nerve cells in the brain (15 ) .

Abnormal or excessive glutamate levels and signaling in the nervous system can contribute to MS (16 ) .

The Pros and Cons of CBD Oil for Multiple Sclerosis

Pros
  • Evidence suggests that CBD may reduce MS symptoms, such as MS fatigue, pain, and spasticity, and ultimately improve mobility (17 ) .
  • The 2018 Farm Bill has legalized CBD products derived from hemp. However, individual states in the United States have their legislation (18 ) .
  • The American Academy of Neurology has highlighted the safety profile and benefits of cannabis in a review of medical marijuana (medical cannabis).

The review was conducted to address the treatment of symptoms of MS, epilepsy, and movement disorders (19 ) .

  • No studies have investigated the effects of cannabis oil on mobility in individuals with MS. However, some studies have suggested that CBD may exert positive effects on health by reducing inflammation and relieving pain (20 ) .
Cons
  • Studies are too limited to determine if CBD is an effective treatment for conditions other than those approved by the US Food and Drug Administration (FDA).
  • There are risks in using CBD. Possible side effects include dry mouth, drowsiness, diarrhea, fatigue, and reduced appetite (21 ) .
  • CBD can interact with other drugs and alter how the body metabolizes certain medications, as a 2017 research noted (22 ) .
    • A 2017 review revealed labeling inaccuracies in some CBD products. Some products had less CBD than stated in the label, while others had more (23 ) .

    How CBD Oil Compares to Alternative Treatments for Multiple Sclerosis

    Some of the alternative or complementary therapy options for MS include massage and a healthy, well-balanced diet with linoleic acid supplementation (24 ) .

    Regular massage therapy can help MS patients relax and reduce stress and depression, which can exacerbate the disease.

    CBD oil tinctures can be combined with massage oils. Like massage oils, CBD-infused bath bombs can help provide relaxation and relief from physical tension and emotional stress.

    A study published in the journal CNS and Neurological Disorders – Drug Targets noted that CBD had therapeutic uses as an anti-anxiety-like and an antidepressant-like compound (25 ) .

    There is also evidence that taking an oral supplement of linoleic acid (found in evening primrose oil) may improve MS symptoms.

    Researchers of a 2019 study found that higher levels of α-linolenic acid (ALA) were associated with lower disease activity in MS patients (26 ) .

    Meanwhile, cannabis extracts from Sativa cultivars (Cannabaceae) are rich in linoleic acid (57.1%), according to researchers of a 2012 study published in the European Journal of Lipid Science and Technology (27 ) .

    How to Choose the Right CBD

    Consider the following to ensure the reliability and safety of the CBD products purchased.

        1. Research on the legal stipulations applicable to CBD in the area where it would be bought and used.
        2. Read product reviews before buying from an online store. Check if the store is authorized by the government to sell CBD.
        3. Look for the certificate of analysis (COA) of the CBD product. A COA is a laboratory report that includes cannabinoid content and other tested compounds.
        4. Compare company claims with that of third-party lab testing reports.

      CBD Dosage for Multiple Sclerosis

      The appropriate dose of cannabinoids for specific medical conditions is not known . However, there are suggested doses for some multiple sclerosis symptoms, like pain and spasticity.

      A 2011 systematic review that examined the effects of cannabinoids of any type (smoked cannabis, oral extracts, nabilone, synthetic THC, nabiximols) showed that cannabinoids provided pain relief (28 ) .

      When using Sativex for the first time for MS-related pain and spasticity, follow the number of sprays on the days and times in the table below as reference (29 ) .

      Each 100 microlitre spray contains 2.7 mg THC and 2.5 mg CBD.

      (Between waking up and noon)

      (Between 4 pm and bedtime)

      A 2011 study noted that high doses of 1,500 mg CBD a day is well-tolerated by humans (30 ) . Still, always consult with a doctor before taking any CBD products.

      How to Take CBD Oil for Multiple Sclerosis

      A topical CBD cream or patch is ideal to use for inflammation or pain in a specific area. The CBD can target localized clusters of cannabinoid receptors, rather than interacting with the entire endocannabinoid system (ECS).

      CBD oil capsules and edibles, such as gummies , brownies, and lozenges, are a convenient and straightforward way to take CBD oil, especially for beginners.

      Meanwhile, CBD oil tinctures and sprays may be practical options for those who seek fast results and maximum dosage control.

      Conclusion

      CBD alone or its combination with another cannabinoid, like THC, may help alleviate many common MS symptoms.

      Unfortunately, studies on the use of CBD for specific medical conditions in humans are limited, and CBD’s long-term effects remain unknown.

      More longitudinal research is required to gather more scientific evidence and validate results from previous studies.

      Consulting with a doctor experienced in CBD use is ideal before using CBD or any cannabis products.

      CBD for MS (Multiple Sclerosis): What The Research Says

      MS is a disorder involving the loss of insulation around the nerve fibers.

      Learn how CBD can support symptoms & may be able to slow the progression of the disease.

      Article By

      Multiple sclerosis (MS) is a debilitating neurodegenerative disorder affecting two and a half million people around the world.

      Cannabis extracts have recently been investigated for their potential role in treating the disease and its symptoms — and the results are promising.

      In this article, you’ll learn how CBD and THC are used as a treatment for MS and its symptoms, and the limitations of this all-natural approach.

      MEDICALLY REVIEWED BY

      Carlos G. Aguirre, M.D., Pediatric Neurologist

      Updated on November 14, 2021

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      Can CBD Oil Help With MS? What Are The Benefits?

      A pharmaceutical preparation of CBD (cannabidiol) and THC (delta-9-tetrahydrocannabinol) — Sativex® — was approved by the FDA in 2018 as a treatment for multiple sclerosis.

      Sativex® (a pharmaceutical combination of CBD and THC) was shown to improve muscle spasms [7, 8, 9], bladder dysfunction [10], and nerve pain [11] — all of which are common symptoms of MS.

      CBD has also been shown to inhibit the ability for immune cells to attack the myelin sheathing on our nerve cells — which is the primary cause for MS.

      It’s important to remember that there is still no cure for MS — CBD and other medications may help slow the progression of the disease and manage individual symptoms.

      Benefits of Using CBD for MS
      • Reduces neuroinflammation
      • Reduces muscle spasms
      • Prevents T-cell infiltration & slow disease progression
      • Alleviates nerve pain
      • Resists the development of autoimmunity
      • Supports bladder control

      1. Inhibits Brain Inflammation

      MS, like many other medical conditions, is characterized by underlying inflammation in the brain and spinal cord. Inflammation itself is extremely complex, often involving dozens of inflammatory messengers each interacting differently with each other.

      Researchers have highlighted key inflammatory messengers involved with MS — this is used to drive the development of new treatment options.

      In the case of MS, the primary inflammatory markers involved include TNFα, IL-1β, IL-2, IL-6, IL-12, and IFN-γ. CBD has been shown to reduce the activity of all of these inflammatory markers and activate other inflammatory processes in the microglial cells that are found abundantly in the human brain [4, 5, 6].

      The overall effect is a reduction in neuroinflammation driving the destruction of the myelin — the primary cause for disease progression.

      2. Reduces Muscle Spasticity

      A 2012 meta-analysis analyzed a series of clinical trials from 1980 to 2012 to review the effects of CBD and THC on muscle spasticity associated with MS [13].

      They found that, overall, CBD and THC extracts were well tolerated and offered improvement in symptoms even in patients who were unable to find relief with conventional anticonvulsant medications.

      3. May Prevent T-Cell Infiltration & Slow Disease Progression

      MS begins with low-grade inflammation in the brain. Specialized cells known as T-cells pass through the blood-brain barrier and congregate around the nerve fibers.

      These T-cells are one of the main components of our immune system. Think of them as our immune soldiers, deployed to fight infection.

      In the case of MS, these T-cells decide to attack the myelin sheath around the nerve fibers — destroying and scaring them in the process.

      One of the primary aims of treatment is stopping these T-cells from going rogue and attacking the body, and preventing them from being passing the blood-brain barrier.

      CBD has been shown to slow the movement of T-cells across the blood-brain barrier and limit the inflammatory reaction involved with the disease [4, 5, 6].

      4. Alleviates Nerve Pain

      Sativex® was involved in a series of clinical studies to determine its effects on the various symptoms of MS, including nerve pain [12]. This study found that those taking Sativex® had significantly reduced pain scores in the final week of treatment.

      In other studies, CBD was demonstrated to be beneficial for various types of pain, including neuropathic pain [14], cancer pain [15], and arthritic pain [16].

      Guide to Using CBD for Multiple Sclerosis

      CBD is a useful supplement for alleviating symptoms of MS and may even be able to slow the progression of the disease.

      Most of the research involving CBD for MS used a combination of CBD and THC at a 1:1 ratio. It appears these two cannabinoids work synergistically together to provide relief from symptoms.

      In many countries, products containing THC are illegal. However, MS is one of the few conditions that medical cannabis is generally prescribed for — but this can vary according to your country.

      Tips for Getting the Most from CBD for Multiple Sclerosis
      1. Make sure to check the quality of CBD products before buying — poor-quality products often contain contaminants that can make the condition worse. Look for certificates of analysis and companies that use organic hemp.
      2. Avoid relying on CBD gummies for your daily dose of CBD — gummies are high in sugar, which has been linked with MS. Oils, tinctures, or capsules are better options.
      3. Combine CBD supplementation with other diet and lifestyle modifications conducive to alleviating MS symptoms.
      4. Always speak with your doctor before taking CBD or other cannabis products — especially if taking other medications.

      Even if you can’t find products containing both THC and CBD, or don’t want the psychoactive effects from the THC, you can still use most CBD products. CBD will provide relief from several key symptoms of MS.

      What Type of CBD Products Are Best For MS?

      The best option is to source a CBD product made with a full-spectrum extract.

      These products include an array of cannabinoids, terpenes, and other phytochemicals from the cannabis plant. Each of these compounds work together to produce the overall effects of CBD oil.

      With MS, it’s especially important to find oils that have third-party testing to prove they’re contaminant-free. Contaminants like arsenic, mercury, or cadmium can worsen the condition by causing further damage to the neurons.

      There are a few products people with MS are using to support symptoms:

      • CBD Oils — this is the most common form of CBD supplement for MS
      • CBD Capsules — offer the same benefits of CBD oil without the need to do any measuring
      • CBD Gummies — similar to CBD capsules, but rarely available in full-spectrum forms
      • CBD Concentrates — shatters, waxes, and dabs deliver heavy doses of CBD in a small volume
      • CBD Vape Pens — these offer the fastest onset of effects, but have the shortest duration

      What’s The Dose of CBD For Multiple Sclerosis?

      The dose of CBD can vary from one person to another, so it’s important you take some time to see what works best for you.

      With that said, most MS patients, and MS research, used a heavier dose than usual (around 2 mg per kg or more).

      Use our CBD oil dosage calculator to help find the optimal dose based on your weight and desired strength of effects.

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      What is Multiple Sclerosis (MS)?

      MS is an autoimmune condition affecting the myelin insulation around nerve cells.

      Without myelin, the nerves can’t transmit messages to the rest of the body or the brain.

      The cause of MS is hard to determine in most cases but usually involves underlying autoimmune conditions. Autoimmunity happens when the body’s immune system begins attacking and destroying myelin on the nerve cells in the brain.

      There is no cure for MS — most of the treatment options are aimed at slowing progression and easing symptoms.

      MS can have different levels of severity from one person to the next — symptoms can be anywhere from mild to severe. However, the lifespan of those affected is generally the same as those without the disease. Some reports suggest a six-year difference between people with MS and those without.

      What Are The Symptoms of MS?

      What Causes MS?

      Roughly 1 in 700 people in the United States will be diagnosed with MS at some point in their lives. These figures are similar in other developed regions of the world. Twin studies on the condition have shown that although there are genetic components to the disease, it goes much deeper than that. With identical twins, if one has MS, the other only has a 30% chance of developing the condition — this is much lower than with other genetic disorders.

      It’s hard to determine the individual causes of MS — it’s more than likely the condition is a combination of many different factors.

      There are some factors that medical researchers have determined to be related to those affected. We call these risk factors for the condition. The more risk factors are present, the higher the chances of developing MS.

      Risk Factors for MS
      • Age(most common between the ages of 20 and 50)
      • Gender(women are more than twice as likely to develop MS than men)
      • Ethnicity(European descent has the highest rate of MS)
      • Genetics(HLA-DR2 gene mutations may develop MS)
      • Vitamin D deficiency
      • Viral infection (EBV, cytomegalovirus, varicella zoster)
      • Other autoimmune conditions or atopy
      • Exposure to heavy metals

      Four Different Types of MS

      1. Clinically Isolated Syndrome

      This is the first episode of MS symptoms. Usually, the first sign of the disease is a sudden onset of symptoms that last more than 24 hours. When this happens only once, it’s referred to as clinically isolated. When these symptoms return, we can begin classifying them as a specific form of MS listed below.

      2. Relapse-Remitting MS

      This form of MS is characterized by bursts of intense symptoms followed by periods of remission. The condition gets gradually worse over time — often, over many years.

      Roughly 85% of people with MS experience this form of the disease.

      3. Primary-Progressive MS

      This form of MS involves a steady progression of symptoms without remissions. It affects about 15% of MS cases on average.

      Primary progressive MS involves a steady attack on myelin, producing a predictable worsening of symptoms over time.

      Plateaus may occur from time to time, during which symptoms appear to remain the same for long periods. However, it’s unclear why some cases plateau for a while before continuing their progression. Good MS management will promote plateaus more often, but this isn’t always possible.

      4. Secondary-Progressive MS

      This is a hybrid of relapse-remitting and primary progressive MS. Symptoms generally start with initial episodes of relapse or remission before transitioning into something with a more steady progression of symptoms.

      How Is MS Treated?

      The most debilitating symptoms of MS are fatigue, muscle spasms/weakness, and nerve pain. Therefore, the primary treatment aim, aside from slowing the progression of the disease, is to address these symptoms as necessary.

      Opiate and corticosteroid analgesics are often used to treat severe cases of pain. Otherwise, other analgesics such as acetaminophen are preferred because they produce fewer side effects and less potential for addiction.

      Cannabis extracts — including CBD and THC — are also popular treatments for the pain associated with MS.

      Emotional changes are common with the condition, so antidepressants and mood stabilizers are often prescribed.

      There’s a chance CBD can interact with certain medications, so always check with your doctor before using it.

      Common Medications for Multiple Sclerosis:
      1. Antidepressants — to treat depression as a symptom of the condition.
      2. Anti-inflammatories — TNF-a, NF-kB, eicosanoid synthesis modulators, and glucocorticoids.
      3. Aubagio (Teriflunomide) — used for relapse-remitting MS.
      4. Cannabis extract (CBD) — helps relieve symptoms of MS and may slow the progression of the disease.
      5. Copaxone (Glatiramer) — stops the immune system from attacking myelin.
      6. Corticosteroids — used for acute flare-ups of symptoms.
      7. Interferon beta 1a or 1b — slow the progression of the condition but may cause liver damage.
      8. Mitoxantrone (Novantrone) — suppresses the immune system to stop attacks but can damage the heart.
      9. Tysabri (Natalizumab) — last-resort medication as it can lead to infection in the brain.
      10. Vitamin D — often given because vitamin D deficiency is considered a risk factor.

      Final Verdict: Can CBD Help With Multiple Sclerosis?

      MS is a slow-progressing neurodegenerative disorder affecting the myelin sheath on the neuron cells. As the myelin breaks down, the neurons lose their ability to transmit electrical signals to other areas of the brain and body.

      CBD and THC have both been extensively tested to establish their role in alleviating symptoms of this condition. It appears that an even ratio of the two compounds is going to offer the most benefit, but products containing a high CBD content still have positive effects.

      We recommend using a full-spectrum product at the higher end of the dosage scale for this condition. It’s also critically important that your doctor monitors your CBD use to avoid negative interactions with other medications and to ensure the best possible outcome.

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