Inflammation is not a condition. It's better described as an adjective to describe a response your body undergoes when it detects something (anything) wrong.
It could be anything from a paper-cut to arthritis - the steps your body takes to repair the damage or kill the invaders leads to the symptoms of acute inflammation.
An inflammatory response turns into a condition of it's own when it doesn't stop after doing it's job, or engages in inflammatory activities for no good reason, thereby throwing your body into chaos.
Inflammation then, in essence, is your body's response to disruptions in your body's homeostasis. But, it can also be the disruptor if not functioning properly.
Knowing all of this, and knowing that cannabis in general, and CBD in particular, is so effective as a medicine because it acts on multiple systems to return your body to homeostasis, using CBD for inflammation (or any type of cannabis to treat your symptoms) makes sense.
Inflammation is at the root of, or involved in, most (if not all) acute and chronic illness (source).
This includes cancer, neurological diseases, cardiovascular disease, metabolic disorders, and more as seen in the image to the right (source).
For this reason, among many others, there's a sense of urgency to find a safe and reliable treatment.
This article covers the basic science of inflammation in the body, how the endocannabinoid system is involved in inflammatory responses, and how we can use cannabis to take advantage of that.
Feel free to skip ahead if you know where you want to go using the table of contents below.
The inflammatory response is extremely complicated, and involves many different types of immune cells. These many different cells release meany different molecules that mediate the inflammation response. These molecules dilate the blood vessels around the affected tissue. This part of the inflammation response allows more blood to reach the affected area. This is why your skin turns all red and gets hot when you're injured.
Additionally, these mediators increase the permeability of your blood vessels so that more healing and defense cells can enter the area to do their thing. All of these molecules are tasked with either destroying, diluting, or walling off the injured site, as well as walling off the cause of the injury (if still present).
Along with this extra blood comes more and more cells that are designed to help with the healing process in different ways. Sometimes the influx of cells irritates nerves around the area causing pain.
This massive influx of cells causes the tissue to swell up due to the additional liquid in the tissue. On top of this, mucous membranes involved in the affected area will release more fluid during inflammation to flush your body of toxins and compounds left-over from the destruction of injured cells (think of runny noses during allergies, or phlegm during a chest-cold).
The liquid is then removed by another step in the inflammatory process. The official term for this is 'exudation.' The extra white blood cells (leukocytes) that were introduced to help in healing your tissue are removed, causing the swelling to go down and the inflammation response to end.
Most Common Sources of Acute Inflammation
The most common causes for an acute inflammation process are as follows: .
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These are just the most common sources of acute inflammation. Additionally, diseases or conditions that cause inflammation often have a name ending in “-itis.” For example:
- Cystitis, an inflammation of the bladder
- Bronchitis, an inflammation of the bronchi
- Otitis media, a middle ear infection
- Dermatitis, a disease where the skin is inflamed
Symptoms of Acute Inflammation
The above section is a very basic and simple explanation of the acute inflammation process. Acute inflammation is a normal and healthy response of the body to foreign, harmful, or misplaced tissue/substances introduced to your body. During this response, you will experience the following classic symptoms of inflammation:
- Redness
- Heat
- Swelling
- Pain
- Loss of function
An individual undergoing an acute inflammation response that follows a normal progression will see their symptoms disappear as the body takes care of business.
If, however, an individual continues to be exposed to the source of their inflammation response, or if the inflammation response goes awry, chronic inflammation is developed.
Developing Chronic Inflammation
As mentioned above, an inflammation response is not always a helpful response of the body.
For example, in certain autoimmune diseases, the immune system will identify normal cells as harmful or foreign and initiate an inflammatory response that's unnecessary. Diseases like these include:
- Rheumatoid arthritis
- Psoriasis
- IBD, Crohn's disease, and ulcerative colitis
These diseases are classified as chronic inflammatory diseases and they last for the patient's lifetime, or at the very least, for years depending on the severity of the condition (source).
Another way the inflammatory response can be harmful, is if your exposure to the source of inflammation is continued, forcing your body to continuously undergo the inflammatory cycle.
This is the case for you if you cant pinpoint the reason for your inflammation symptoms.
If you think that your inflammation comes from out of nowhere, that means there's an aspect of your everyday life that's causing the response. Next, we'll go over the most common sources for non-pathological chronic inflammation.
Most Common Symptoms of Chronic Inflammation
If you are experiencing chronic inflammation you may not know it if due to daily exposure to common inflammatory agents.
Here's a list of a few signs that you've developed chronic inflammation (source):
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Here's a great infographic from Healtheo 360 with tips for mitigating the list of symptoms above.
Chances are if you're experiencing these symptoms, you've developed a case of chronic inflammation, and you'll need to do your due diligence to identify the source and take actions to eliminate it and mitigate current symptoms.
Most Common Sources of Chronic Inflammation
The most common causes for chronic inflammation process are as follows (source):
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These are just the most common sources of chronic inflammation, and not an exhaustive list. However, there's a good chance the source for your chronic, non-pathological inflammation is on this list.
The Research: Cannabinoids & Inflammation
The endocannabinoid system is well-known to reduce inflammation. Here are a few of the studies.
In a 2015 study, the efficacy of transdermal CBD for inflammation and pain in an arthritic knee joint model. Transdermal CBD gels were applied for 4 consecutive days after arthritis induction. The results showed that the CBD gel significantly reduced joint swelling, limb posture scores as a rating of spontaneous pain, immune cell infiltration, and thickening of the synovial membrane in a dose-dependent manner (study).
A 2007 study shows that cannabinoids are effective at suppressing immune and inflammation functions in leukocytes in vitro, and in animal models of acute inflammation, such as the mouse hind paw, ear and air pouch models, as well as gastrointestinal, pulmonary, myocardial, vascular, periodontal, neural, hepatic, pancreatic and arthritic inflammation models. It also suggests that the non-psychoactive cannabinoid receptor CB2 is emerging as a critical target for cannabinoid regulation of inflammation, and thus CB2-selective agonists are undergoing intense investigation and research (study).
This 2009 study showed that the manipulation of endocannabinoids and/or use of exogenous cannabinoids in vivo can constitute a potent treatment modality against inflammatory disorders. For example, administration of endocannabinoids or use of inhibitors of enzymes that break down the endocannabinoids, led to immunosuppression and recovery from immune-mediated injury to organs such as the liver (study).
Additionally, as we know that cannabinoids profoundly affect the immune system. Evidence suggests that CB receptor agonists (natural and synthetic), as well as drugs that indirectly modulate the ECS, can induce the down-regulation of a number of cytokines, chemokines as well arachidonic acid metabolites and also reduce nitric oxide overproduction during an inflammatory assault (study).
Another study goes as far as hypothesizing that cannabinomimetic compounds act to control mast cell activation and degranulation early during the inflammatory response, thus leading to a swift resolution and preventing the development of chronic inflammation (study).
These are just a few of the dozens of studies showing that cannabinoids have anti-inflammatory properties and are effective at treating conditions resulting from chronic inflammation.
How Cannabis Hemp/CBD Compares to Modern Medicine
In a moment, we're going to talk specifically about using cannabis to treat chronic inflammation, but first I'd like to do a review of current approved treatments so you have a full picture of your options.
It's important to note that unless you have an actual disease resulting from chronic inflammation (such as Rheumatoid Arthritis), you should treat the source of your inflammation first, or in parallel with treating your symptoms. For example, make sure you're breathing clean air, eating whole foods, getting sleep, and exercising; not just taking medication.
If you do want more in-depth information about treatments for a particular pathological disease (such as arthritis, IBD, Crohn's disease, etc), visit that diseases topic page.
There are a few current treatments including medication and natural herbal supplementation that we will go over in order.
Medication
First let's go over medication commonly used to treat chronic inflammation symptoms (source). These medications can come in oral form, or topical forms. Here are the most commonly used agents to treat inflammation:
- Metformin is commonly used in the treatment of type II diabetic patients with dyslipidemia and low-grade inflammation. The anti-inflammatory activity of Metformin is evident by reductions in circulating TNF-alpha, IL-1beta, CRP, and fibrinogen in these patients.
- Non-steroidal anti-inflammatory drugs (NSAIDs) like naproxen, ibuprofen, and aspirin acts by inhibiting an enzyme cyclooxygenase (COX) that contributes to inflammation and are mostly used to alleviate the pain caused by inflammation in patients with arthritis.
- Statins are anti-inflammatory as they reduce multiple circulating and cellular biomediators of inflammation. This pleiotropic effect appears to contribute in part to the reduction in cardiovascular events.
- Corticosteroids also prevent several mechanisms involved in inflammation. Glucocorticoids are prescribed for inflammatory conditions including inflammatory arthritis, systemic lupus, sarcoidosis, and asthma.
- Herbal supplements like ginger, turmeric, cannabis, hyssop, cannabis, and Harpagophytum procumbens are shown to have anti-inflammatory properties.
Other Treatments
Chronic inflammation, especially non-pathological chronic inflammation, is best treated by incorporating lifestyle and diet changes in conjunction with a cannabis-based supplement. It's important to complete these steps in addition to taking CBD or THC, as it's likely the source of your inflammation.
Here's a list of the major steps you can take to reduce inflammation without introducing a medication or supplement to your diet.
- Eat anti-inflammatory foods: Avoid eating simple sugars, refined carbohydrates, high-glycemic foods, trans fats, and hydrogenated oils. Instead, eat whole grains, natural foods, plenty of vegetables and fruits such as avocados, cherries, kale, and fatty fish like salmon.
- Reduce use of antibiotics and NSAIDs: Antibiotics, antacids, and NSAIDs should be avoided. These medicines harm the microbiome in the gut causing inflammation in intestinal walls known as leaky gut which in turn releases toxins and triggers chronic, body-wide inflammation.
- Get more exercise: Adipose tissue in obese or overweight individuals induces low-grade systemic inflammation. Exercising helps you lose weight and is also a stress reducer.
- Get more sleep: Your body needs 7-8 hours to rebuild and reset. There's no getting around this.
- Minimize stress: Chronic psychological stress is linked to greater risk for depression, heart disease and the loss of your ability to regulate the inflammatory response. Tactics such as yoga and meditation are helpful in alleviating stress-induced inflammation.
The Verdict
For chronic inflammation that's not a disease, the best course of action seems to be introducing healthier lifestyle habits into your daily routine while also supplementing with an anti-inflammatory agent. We think this agent should be a cannabinoid of your choosing.
Cannabinoids apparently act on inflammation through mechanisms different from those of agents such as non-steroidal anti-inflammatory drugs (NSAIDs). As a class, the cannabinoids are generally free from the adverse effects associated with NSAIDs. That's why we recommend using an herbal supplement like cannabis and CBD instead of an NSAID.
Tips For Using Cannabis & CBD for Chronic Inflammation
Choosing a cannabis-based medication for inflammation can be a challenge, especially considering the different ways chronic inflammation can present in a patient.
More details for specific diseases are provided on their individual topic pages, but for now, we're going to go over general best practices for treating inflammation, and especially chronic inflammation with no apparent source or underlying disease.
Strains, Terpenoids, & Cannabinoids For Inflammation
CBD and THC both act as powerful anti-inflammatory agents. Additionally, the terpene beta-caryophyllene has been found to activate CB2 receptors with a potent anti-inflammatory response.
THC is said to be twice as effective as hydrocortisone at reducing inflammation (source), so you if you can introduce it into your regimen, that would be best.
If you can't introduce THC into your life, CBD still has powerful anti-inflammatory properties. There's a large body of preclinical and animal studies that document the anti-inflammatory effect of CBD and its analogs (source) (source).
In addition to the major cannabinoids and the terpene beta-caryophyllene, cannabis varieties high in other terpenes such as myrcene, limonene, and/or linalool at night, and Terpinolene during the day may add synergistic effects.
Best Delivery Methods For Inflammation Patients
For chronic inflammation, the recommended delivery methods are oral and topical.
For oral administration, both THC and CBD are indicated, depending on your needs and preferences. Inhalation is not recommended unless inflammation is accompanied by pain.
CBD Dosage For Inflammation
As with all cannabinoid treatments, dosage is essential. Unlike some other conditions cannabis can treat, dosing for inflammation is still being studied. Therefore, we recommend going with the standard micro-dose and working your way up.
Let's go over dosing CBD for inflammation in terms of oral cannabis first. Then we will talk about topical cannabis and CBD dosing for inflammation.
Oral Cannabis
We recommend starting out with 1 mg to 5 mg of THC orally every three to four hours to manage low level inflammation. If you aren't a fan of THC, adding an additional 2.5 mg to 10mg of CBD to the THC dose reduces THC psychoactivity and providing a measure of neuroprotection. If you're omitting the THC entirely, take 2.5 to 7.5 mg of CBD and work your way up.
Topical Cannabis
Topicals can be applied as often as desired, but usually the recommendation is to apply liberally once every 2-4 hours, or as pain symptoms occur with inflammation. For topical applications to work, the inflamed area needs to be localized (usually to a joint or muscle). We recommend topicals with higher levels of THC if possible.
Recommended Hemp/CBD Products for Inflammation
Since THC-dominant cannabis products can't be sold online, I'm going to just recommend products that are CBD-dominant and have been reported to relieve inflammation in consumers. Below you'll find a product recommendation for each delivery method recommended above.
We are only going to show one optimal recommendation for each delivery category. For more products, see our recommended products page.
CBD Drip makes gel capsules they call 'EcoGels'. It's a full-spectrum product with Vitamin E intact along with essential terpenes. Each pill has 25 mg of CBD, and can be taken apart for titration.
Endoca's hemp oil can be used as a sublingual tincture, or can be ingested like an edible. Indeed, even when used sublingually, at least some CBD oil is ingested.
Elixinol's CBD cream is a topical balm made using full-spectrum hemp oil. It's a great moisturizer, safe for all skin types and made without any synthetic chemicals.
More Posts About Cannabis Hemp/CBD & Inflammation
Want more? See the list below for more posts about using CBD for inflammation.
CBD and Inflammation: The Anti-Inflammatory Benefits Of Hemp Oil
In this post I’m going to outline the collective body of current research on CBD and Hemp Extract with relation to Inflammation. There is a decent amount of research to this point, all indicating pretty impressive benefits of CBD for inflammation, typically looking at inflammation biomarkers (indicators) and positive improvements when subjects use CBD or … Continue reading “CBD and Inflammation: The Anti-Inflammatory Benefits Of Hemp Oil”
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