CBD for Migraine Headaches

Migraines

Migraines are defined as severe pain in the head, neck and facial areas that is usually described as one sided and throbbing. Migraines are usually partnered with nausea, vomiting and sensitivity to light and/or sound. These attacks can last for hours– or they can last for days. Some people may experience an aura a relatively short time before the migraine begins– this aura can be visual (flashing lights, blind spots) or may be sensory (tingling in an arm, leg or part of the face). Some people also experience what is known as a prodrome– a period one or two days before a migraine appears that may include changes in bowel movement, changes in mood for no apparent reason, cravings for some types of foods and for some, frequent yawns!

We don’t know what causes migraine, but they are more common in women and often associated with hormonal changes. They can also be associated with caffeine and alcohol use, stress, changes in weather, some foods and some food additives.

Migraines are usually diagnosed by a history and physical and treatment is by medications such as OTC pain relievers and drugs including triptans, opioids, and drugs like Lasmiditan and Ubrogepant. Sometimes preventive medications have been useful– these include medications to lower blood pressure, antidepressants and botox injections.

What is the Evidence that CBD Might Help Reduce Migraine Pain?

A recent important paper published in The Journal of Pain indicated that headaches and migraines were “reduced by nearly 50% after using cannabis.”  In this study, it did not appear to matter how much CBD versus THC was in medical cannabis. However, the study does point out that cannabis was effective in reducing headache and migraine pain, with men showing a greater response as compared to women. Other studies have shown similar results for medical cannabis.

There are still no controlled studies on how CBD alone might affect headaches and migraines– however, there are some theoretical reasons to think that the anecdotal evidence is real. For example, some researchers believe that migraine headaches may be the result of endocannabinoid deficiency. The endocannabinoids are the natural system regulating pain, sleep, appetite and other systems– CBD and other cannabinoids bind to the same receptors as endocannabinoids do. If the endocannabinoid system is deficient and that is one cause of migraines, it is thought that CBD (and other cannabinoids) may help reduce migraine pain by relieving that deficiency. [4]

One way CBD may work to relieve migraines is to prevent the degradation of a major endocannabinoid, anandamide thus keeping the levels of this pain-regulating substance high.[5] This possibility is currently being actively researched.

What is CBD?

CBD (cannabidiol) is the non-intoxicating cannabinoid found at high levels of certain strains of hemp. It will not get you high, but has been found to be effective for a number of different pain conditions. It has been found to have anti-inflammatory, anti-pain and immune-modulating actions. [6]

In 2018, the US Congress passed a Farm Bill which legalized hemp and removed CBD from the DEA’s controlled substance list as long as CBD products contained less than 0.3% THC. The FDA has not yet made recommendations concerning the sale or use of CBD however, leaving it is a slightly grey area. CBD is legal in most states– you have to check the laws in your own state to be certain.

How to Use CBD for Migraines

If you want to try CBD for migraines, there are several different approaches to consider– but always talk to your healthcare professional first! CBD can interact with a number of prescription medications and while there are no absolute contraindications for CBD, everyone is different– and you and your healthcare professional know the details of your health condition.

Whenever you use CBD, the best advice is to start low and go slow– in other words, start with a low dose such as 5, 10 or 25 mg and wait for a bit to see if it works. If needed, slowly increase the dose until you achieve your goal. Edibles like gummies and capsules can take 40 or more minutes to begin to be felt. Tinctures if taken under the tongue are the fastest– those effects can often be felt within 10-30 minutes. The fastest route is by inhalation, but this is generally only recommended for acute pain– vaping effects can be felt within minutes.

There is no recommended dosage– you will have to determine that by a process of trial and error– many people report some relief around 50-100 mg of CBD, but that is very individualized.

So, choose your delivery method and start with the lowest dose you can easily measure out. Gummies and tinctures are often best suited for this because gummies are easy to cut into halves or quarters and half a dropperful of tincture is relatively easy to determine. (about 15-17 drops for most droppers)

If you don’t get any relief, start increasing the dose every two hours or so– for most delivery methods, you may start to feel the effects as described, but about 2 hours is needed for full effect. And– while CBD is very safe with only relatively mild side effects including fatigue, drowsiness and nausea– it is never a good idea to take more than what you need.

As mentioned, there are currently few studies on cannabinoids and migraines– and all of those have used mixtures of THC and CBD. This may be one reason to look into full-spectrum CBD products because the full spectrum products do contain a very small amount of THC. THC does in some cases appear to work synergistically with CBD in pain management, so there is a good reason to at least try the full spectrum products.

Always buy your CBD carefully from reputable companies. Here at LeafReport, we have looked at many different products and companies– take a look! Always, though, check the 3rd party lab results for the product you choose– that will give you a much better idea of exactly how much CBD you need plus it ensures that you are getting what you expect in every dose!

References:

1. Cuttler, C., Spradlin, A., Cleveland,MJ., Craft, RM. Short- and Long-Term Effects of Cannabis on Headache and Migraine, The Journal of Pain, Volume 21, Issues 5–6, 2020.
2. Kim PS, Fishman MA. Cannabis for Pain and Headaches: Primer. Curr Pain Headache Rep. 2017 Apr;21(4):19. doi: 10.1007/s11916-017-0619-7. PMID: 28281107.
3. Tassorelli, Cristinaa,b; Greco, Rosariaa; Silberstein, Stephen D.c The endocannabinoid system in migraine: from bench to pharmacy and back, Current Opinion in Neurology: June 2019 – Volume 32 – Issue 3 – p 405-412 doi: 10.1097/WCO.0000000000000688
4. Russo EB. Clinical Endocannabinoid Deficiency Reconsidered: Current Research Supports the Theory in Migraine, Fibromyalgia, Irritable Bowel, and Other Treatment-Resistant Syndromes. Cannabis Cannabinoid Res. 2016 Jul 1;1(1):154-165. doi: 10.1089/can.2016.0009. PMID: 28861491; PMCID: PMC5576607.
5. Fine PG, Rosenfeld MJ. The endocannabinoid system, cannabinoids, and pain. Rambam Maimonides Med J. 2013 Oct 29;4(4):e0022. doi: 10.5041/RMMJ.10129. PMID: 24228165; PMCID: PMC3820295.
6. Baron EP. Medicinal properties of cannabinoids, terpenes, and flavonoids in cannabis, and benefits in migraine, headache, and pain: an update on current evidence and cannabis science. Headache 2018; 58:1139–1186.