Can medical marijuana help treat Lyme disease? A doctor’s perspective.
by Daniel A. Kinderlehrer, M.D.
I have a confession to make. I proposed a talk on medical marijuana at ILADS because it would force me to learn everything I could on the topic. I live in Colorado where it seems there is a dispensary on every corner, and many of my patients have been using medical cannabis. But the huge assortment of products is confusing, and I wanted to give specific recommendations to help patients get the most benefit. Here is what I learned.
Marijuana has 483 phytocannabanoids, which are naturally occurring compounds that can affect many body processes such as appetite, mood and sleep. Most people have heard of one of them—THC, or tetrahydrocannabinol—the psychoactive component of marijuana. THC can make you high, giddy, or euphoric, and provide seemingly awesome universal insights that may appear quite trivial the next day.
Some strains of marijuana now available are not your father’s weed—they have a much higher THC content. It’s important to choose the appropriate strain for your needs, and some people may want to avoid THC entirely. However, it has been clearly established that THC is quite beneficial for pain, sleep, nausea, appetite, and PTSD, so there are medically valid reasons for choosing it.
Most of the non-THC phytocannabanoids fall into the category of cannabidiols, or CBDs. CBDs were once considered to be physiologically inactive unless paired with THC, but it turns out that is not the case. There is compelling scientific research documenting its independent activity, and now there is extensive clinical experience as well.
Did you know that we make our own CBDs? All vertebrates going back 600 million years on the evolutionary tree have an endocannabanoid system, which modulates immune and nervous system function. CBDs are potent anti-inflammatory agents, they regulate neurotransmitters, and they may enhance immune competence. CBDs decrease neuroinflammation and are neuroprotective. They can significantly reduce pain and anxiety.
Marijuana is not the only product that supplies CBDs. Hemp, a variety of cannabis that is used to make rope, fabric and paper, contains CBDs. Hemp has less than 0.3% THC, and is not psychoactive.
There are two strains of cannabis: indica and sativa. Indica is great for pain but is sedating, so it is best used in nighttime. Sativa is activating, can increase energy, and is better suited for daytime use. The difference between indica and sativa is another ingredient, terpenes. Terpenes modify the activity of CBD and THC. There are also a number of hybrid strains now available that essentially cross categories.
If your problem is pain, consider taking CBDs in the form of hemp oil in the daytime. My patients have had excellent responses to a liposomal sublingual extract (taken under the tongue), and it is activating, not sedating. In the evening, you can take a marijuana extract with equal parts THC and CBD, since these together will have additive pain-relieving effects. There are a number of delivery systems available, including smoking, vaping, edibles and sublingual extracts. I recommend the extracts since the onset is reasonably quick, usually in about 30 minutes, and the dose can be easily titrated by adjusting the number of drops under the tongue.
Both hemp-derived CBD and marijuana are available as balms that can be applied topically to relieve pain. Whether taken systemically or applied locally, these products can help many patients significantly decrease their need for pain medication. In fact, states that have legalized medical marijuana have experienced a 25% decrease in opiate overdose deaths. That’s right. This scourge, which took 42,000 lives in 2016 (66,000 including all drug overdose deaths), was significantly reduced by the availability of marijuana.
For sleep, take a THC-dominant indica strain. THC is not only sedating, it increases the time spent in the deeper stages of sleep, so sleep is more restorative. If your problem is difficulty falling asleep, use a short-acting vehicle like vaping, which kicks in within 15 minutes. Vaping is high-tech smoking without the ill effects of the smoke. Alternatively, use a sublingual extract, which has an onset within 30 minutes. Both of these will hang around for up to an hour.
If your problem is staying asleep, then take an edible. It takes 60-90 minutes to get into the circulation, and hangs around for an average of 3-4 hours. I don’t recommend cookies or candy, as they usually have a lot of junk in them—you can take pure THC tablets. The average dose is 10mg, but start with 2.5mg to see how well you tolerate it.
If you have problems with both sleep initiation and maintenance, you can take sublingual extract or vape to fall asleep, and a THC tablet to stay asleep. The table below includes some considerations for choosing among the available options.
|Daytime||CBD from hemp oil||Pain|
|THC can cause sedation and alter cognition|
|Evening||Marijuana with THC:CBD ratio around 1:1||Pain|
|THC and CBD combination yield optimal analgesic benefits|
|Night||THC dominant indica strain or edible THC||Sedation|
Improved sleep architecture
|Vape or SL extract for sleep initiation;|
Edible for sleep maintenance
While THC is only available in states that have legalized medical marijuana, CBD from hemp oil is available everywhere—although the attorney general in Nebraska seems to be confused about that. You can buy it on the Internet, travel across state lines, and I have even taken it out of the country when I traveled to Israel to visit my daughter.
CBD can lessen anxiety, without any of the psychoactive giddiness of THC. CBD is anti-inflammatory—it not only decreases pain, it can improve energy, cognitive function and general well being. When I started selling it in my office, it went flying off the shelf. The full effects of CBD from hemp oil do not kick in for two to three weeks.
While properly administered marijuana has been extremely effective in helping people with PTSD, in some people it will make anxiety worse. Similarly, THC can help depression in some people, but in others can make depression worse, particularly if it is abused by chronic users. If you develop tolerance to the benefits of cannabis because of chronic use, it is important to take a drug holiday. Pregnant women should not take marijuana.
The legal status of marijuana is dicey. It is unjustifiably classified as a Class I controlled substance by the Food and Drug Administration, in the same category as heroin, and the Obama administration declined to enforce federal laws regarding marijuana in states where it was legalized and properly regulated. The current administration is trying to change that, but I predict it will be like trying to put toothpaste back in the tube.
The analgesic, anti-inflammatory and neuroprotective properties of cannabis make it extremely valuable as an adjunct to the treatment of tick-borne diseases. There is a lot of research available on the medical uses of cannabis. A couple of good resources are listed below.
Kowal MA et al. Review on clinical studies with cannabis and cannabinoids 2010-2014. Cannabinoids 2016;11(special issue):1-18
Project CBD, User’s Manual: https://www.projectcbd.org/guidance/cbd-users-manual
Dr. Daniel Kinderlehrer specializes in the treatment of tick-borne disease in Denver, Colorado. He has found that properly administered medical marijuana and CBD from hemp oil have been extremely beneficial for many of his patients.
- January 24, 2018 at 6:49 am
Is it a cure or just pain management?
- January 24, 2018 at 6:51 am
I have been researching CBD oil for a few months and asked my doctor about it last week. I was told that there is a compounding pharmacist in my area in VA that will prepare a formulation for me if a doctor sends my vital info to them. However, I’ve not been able to locate the pharmacist and my doctor said that she was not legally allowed to ‘prescribe’ or recommend CBD. I can’t tolerate any THC and would like to try the CBD but there are so many online companies and their formulations in different units are confusing…6x, 1500mg, etc..and what about quality control? I don’t want to waste my money (100 plus dollars) on a bottle of cold-pressed hemp oil. Can anyone recommend a few reputable companies?
- January 29, 2018 at 10:15 am
Hi Liz! I was finally able to get CBD oil when I started seeing an acupuncturist. Evidently CBD oil is a known method of pain management in Chinese medicine. My acupuncturist orders it from LuZa and the oil is certified organic. You can choose the potency as well. The more potent, the more expensive it is; however, I find I need less of it throughout the day so it lasts longer. Also, getting my CBD oil from my acupuncturist turned out to be cheaper than any other option available to me. I hope this helps and good luck!
- January 29, 2018 at 11:27 am
Here in NY, (still behind the times, but not that much), I purchased CBD capsules at my a food co-op. Though I no very little regarding dosage, this bottle has 600mg capsules. I would think that the co-op would only use a reputable company. This company’s website is… greenmountaincbd.com. Good luck all.
Currently in my 8th month of Anaplasmosis treatment. (I have no clue how long I had the it, at least 7 years)…
My boyfriend has chronic back pain. He began using marijuana, both what they offer in NYS (expensive, cheaper to stay on the nasty opiates and such!!) legally, and other cannabis we aquired. His need for pills lessened so fast! He could sleep at night! But, it was so dramatic, he started to detox from the pain meds… such a f-d up world
and is B13 a real thing
- March 13, 2018 at 9:29 am
I use Isodiol extend caps. It was recommended by my Dr. The CBD is in crystalline form. According to my Dr., it is the best and safest on the market. I live in Pennsylvania where it is legal to use CBD’s.
- January 24, 2018 at 9:16 am
Great article Dan! Thanks for sharing your expertise on this topic.
- January 24, 2018 at 12:03 pm
We have just heard of a CBD oil intramuscular injection. Is this safe and effective? What sort of preparation is used for this? What does the consumer look for to assure safety for this type of application?
- January 25, 2018 at 10:32 am
Thank you for all this valuable information. My daughter has been suffering from Chronic Lyme that has gone to the brain. (Since the age of 15, she is now 29)
Her insomnia, anxiety and pain control is out of control. I feel that she can benefit from some forms of Cannabis but unfortunately we live in the backward state of Florida.
- January 26, 2018 at 1:05 pm
I suffer from neuro lyme disease, anxiety, depression and insomnia. I know that several issues start from inflammation and I believe that CBD / cannabis would be very beneficial in the healing process. Would like to know more about strains and ratios that would work best for me. Thank you for your support
- January 27, 2018 at 2:48 pm
Hi, Just skimmed article. 13.5 years w lyme disease and cured using RSO . RSO is Rick Simpson Oil. Made from cannabis. It worked for me and hope others with lyme will try it. Thanks for this article
- January 27, 2018 at 3:40 pm
Rick Simpson Oil is the “cure for cancer” discussed in the documentary film “Run From The Cure.” The dosage for curing cancer is to wean up to a gram a day for 6 weeks, or until the cancer is gone for more advanced cases. The THC and CBD doses discussed here are for treating symptoms. Is there any study of Rick Simpson Oil and whether or not it can cure Lyme?
- January 29, 2018 at 8:20 am
Great article! I’ve been running a Lyme healing with cannabis group for almost four years and I agree with most of what you have stated, except for the fact that hemp for cbd which we do not recommend due to hemp being absorbent to pesticides and toxins from the soil. That’s the last thing a Lyme patient needs introduced to their system. Better to advise on a strain of cannabis which has been hybrid and removed most thc to .03 in the legal limit. A good example of this is Charlottes Web hybrid which was discussed in CNN’s Weed documentary and is even suitable for children as well. I’ve been in remission from Lyme for 4 years, thank you for spreading the word! It’s not a cure, but better than years of abx which did not help me.
- January 29, 2018 at 3:41 pm
I moved to Washington after learning about the healing powers of cannabis. 4 years later, I feel great. My symptoms are down, and my pain is almost non-existent. It is a life changer.
- January 29, 2018 at 8:13 pm
There have been studies at British Columbia University that have proven cannabis will kill Lyme in vitro. I believe in vitro studies are going to be done.
- February 1, 2018 at 5:37 pm
I bought my CBD oil in olive oil from Luckypharmacy.com. Just be aware they automatically set you up on auto ship and charge. I stopped it. Will continue to order from them.
Great info from this article.
- March 11, 2018 at 4:02 pm
The hardest part of marijuana is finding a strain that works for you. Some states list the amount of THC and CBD in a strain, but where I am from it is hit or miss. I have my med. marijuana card but don’t get fooled into thinking the first thing you try is going to be it. I would love to hear from folks about strains they may be using, forms they use it in and what does/doesn’t work. I am a12 year neuro/pain/cognition lyme sufferer that can’t function without tramadol many a day. CBD oil alone does not work for me. Too much THC and it alters my mind, which I don’t like but I know there is something out there.
The cure? If someone finds out that marijuana is it I would love to hear dosages, etc….. I am always hopeful…….but sure have gone through many different regimes and still am infected.
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