A Guide to Multiple Sclerosis and Cannabis | cannabisMD

The Complete Guide to Multiple Sclerosis and Cannabis

Multiple Sclerosis and Cannabis

Multiple sclerosis (MS) is a neurodegenerative disease characterized by the destruction of fatty insulating covers of cells in the central nervous system. Its name comes from the term sclerae, which refers to the scarring, plaques, or lesions that build up on the white matter of the brain, brainstem, spinal cord tissue, and basal ganglia. One prevalent potential explanation for its origin is that it is caused by a misdirected immune system attacking the protective, insulating myelin sheaths of otherwise healthy neurons in the central nervous system. Another theory is that is caused by a virus. Genetics has also been suggested as a factor, but no gene has been isolated as its cause. Women are twice as likely as men to be diagnosed with MS.

People who live far away from the equator, especially people with Scandinavian heritage, are generally more likely to be diagnosed with MS than people who live closer to the equator. Vitamin D deficiency as a result of low sunlight and genetics have been hypothesized as contributing to this. While many approved pharmaceutical treatments are available for the disease and its various symptoms, none of these treatments are cures. In some cases, patients do not take medicine because they feel the side effects outweigh the benefits. It has been observed that many MS patients self-medicate with marijuana, and patients who do this have reported that their symptoms of pain, anxiety, depression, and muscle spasticity are relieved by marijuana use. The National Multiple Sclerosis Society supports medical cannabis research and patients’ right to use medical marijuana if they so choose.

In the past few years, more and more evidence for cannabis’s potential efficacy in treating MS has emerged. This article will provide an overview of some neurological diseases, explain MS and outline some of its symptoms and approved treatments, give examples of some treatments including alternative and complementary therapies, and finally, show how medical cannabis is gaining traction as one treatment of the disease and its symptoms.

Multiple Sclerosis and Other Neurological Diseases

Multiple sclerosis is one of over 600 neurological disorders, diseases that affect the central nervous system. Other diseases in this category are the following:

  • Genetic disorders such as Huntington’s disease and muscular dystrophy
  • Developmental diseases such as spina bifida
  • Neurodegenerative diseases including Parkinson’s disease and Alzheimer’s disease
  • Cardiovascular diseases that affect the brain, such as stroke
  • Spinal cord and brain injuries
  • Disorders characterized by seizures like epilepsy
  • Cancers that affect the central nervous system like brain cancer
  • Diseases characterized by infection such as meningitis

Neurological disorders are complex and can cause problems in many systems of the body. Often, people who have such disorders exhibit problems with some of the following body functions:

  • Moving, coordination, and motor control
  • Speaking, forming sentences, and verbal reasoning skills
  • Swallowing, which is the first step of digestion
  • Respiratory problems: Both Parkinson’s and MS can cause pulmonary complications.
  • Learning: Autism spectrum disorder and other neurological diseases cause learning disabilities.
  • Memory: Alzheimer’s and other forms of dementia cause memory loss.
  • Senses: As mentioned elsewhere in this article, blindness is a symptom of MS.
  • Mood: The prevailing theory for mood disorders involves improper serotonin levels in the brain.

From this list, one can see that the effect of neurological diseases is not just confined to what is normally thought of as cognitive functioning. Rather, because the brain regulates virtually everything in the body including involuntary processes, neurological disorders can have a vast effect on one’s body and, by extension, health and quality of life. Let us examine three common neurological disorders other than MS:

First, Huntington’s disease (HD) is a genetic disease usually inherited. It happens when a mutated protein known as Huntingtin interacts with brain tissue and causes neurodegeneration, or the death of brain cells. This brain cell death and resulting memory loss puts it into a category with Alzheimer’s, Lewy body, and other diseases that have dementia as a symptom. Changes in mood and personality are often the first signs of the disease, which then progresses to cause a loss in motor functioning. Eventually, the patient can no longer speak and loses memory. Like MS, Huntington’s disease is not yet fully understood by researchers and has no known cure. It can also cause depression and anxiety like MS. Unlike MS, Huntington’s disease can be detected by genetic counseling early on, and some therapies and medications have been shown to be promising in treating symptoms and enhancing quality of life. The prognosis for HD is 20 years. The three leading causes of death for people who have the disease are pneumonia, heart disease, and suicide. The cognitive decline associated with HD generally progresses faster than in MS.

Second, Parkinson’s disease (PD) is another common neurodegenerative disease. It is not fatal, but its complications can be. PD, whose causes are not known, affects dopamine-producing parts of the brain called substantia nigra, causing the brain to produce less dopamine which helps control movement. Its hallmark symptoms have to do with motor control:

  • Tremor of muscles at rest.
  • Trouble with walking and balance.
  • Rigidity of arms and legs.
  • Bradykinesia (slowness of movement).

People who have PD can have a good or even great quality of life if they understand and manage the disease. Following the advice of a doctor is essential. Medicines that treat the symptoms are available, but these medicines do not slow or halt the progression of the disease, which is generally slow and variable. Some symptoms of PD and MS are the same or similar. However, the damage they do to the brain and nerves is quite different. Also, the age at which people start to exhibit symptoms is normally different for each disease. In MS, people usually start to deteriorate between 20 and 50, while in Parkinson’s, people usually start to exhibit symptoms at age 60 or later.

A third neurodegenerative disease that is somewhat similar to MS is Alzheimer’s disease (AD). Here, too, there are important distinctions. AD is caused by a buildup of plaque between brain cells and primarily affects cognition. The differences here are twofold. First, the neural damage in MS is associated with a deterioration of the myelin sheaths of nerves in certain parts of the brain. Second, while AD can lead to problems with physical health, especially in the later stages of the disease, its main effect is cognitive, while MS’s effects are more wide-ranging, including other parts of the body. MS also has a much better prognosis than AD. Less than 3% of people diagnosed with AD live more than 15 years after their diagnosis, while 40% of MS-diagnosed people live well into their 70s.

As can be seen from these comparisons, each of these four diseases has its own unique profile, patterns, and prognosis. Understanding the complex differences between them can help patients understand that neurological diseases are complicated and that the diagnosis of a neurological disease is not necessarily a death sentence. Of all of these diseases, MS is associated with the slowest decline in cognitive functioning and memory recall. A diagnosis of MS is life-changing but far from a death sentence.

Click here to learn more about The Positive Effects Of Weed on the Brain.

What exactly is Multiple Sclerosis?

To understand MS, let us examine a quote from the Belgian Society of Radiology:

“Multiple sclerosis (MS) is a progressive inflammatory, demyelinating and neurodegenerative autoimmune disease of the central nervous system, which leads to chronic progressive and irreversible disability in most patients.”

Let’s break that quote down. First, MS is progressive. This means it gets steadily worse over time. The next word is inflammatory, which refers to an overactive immune response. In the final section of this article, I will discuss the role of inflammation in helping readers understand the potential efficacy of cannabis (an anti-inflammatory) in treating MS. Demyelinating refers to the destruction of fatty myelin sheaths that insulate the neurons and causes the cognitive decline and loss of motor function of MS. Neurodegenerative refers to nerve damage. Autoimmune means MS is the result of a malfunctioning immune system that attacks the body’s cells instead of protecting the body from invading pathogens. It is a complex disease, and it is often hard to predict how fast it will progress.

These are common symptoms of MS:

  • Blindness in one eye
  • Paralysis
  • Cognitive decline
  • Loss of coordination
  • Muscle weakness
  • Spasticity

MS’s causes are not well understood, even by experts. It is recognized that MS symptoms can be either relapsing (cycle of flare-ups and remissions), progressive (steadily worsening), or a combination of both. In neurons that have lost their myelin sheaths, electrical signals take a longer time to get where they need to go or simply don’t reach their destinations. This would seem to explain the loss of motor functioning as occurs when the brain sends a signal telling the hand to move, but the signal just never makes it there. Also, unmyelinated neurons (neurons what have lost their myelin) do not regenerate. This is why the damage caused by MS is irreversible. The National MS Society has published a page on their website explaining theories for the cause of MS.

Click here to Learn More about Dispelling Myths and Stereotypes of Multiple Sclerosis and Cannabis

Medical, Complementary, and Alternative treatments for MS

If you are diagnosed with MS, your doctor may or may not prescribe pharmaceutical medicines to treat symptoms. According to a 2009 article by Dr. Jeffrey Cohen, “although these agents are effective and generally safe, some patients have continued disease activity or adverse effects.” Nevertheless, follow your doctor’s advice in every instance. Communicate with him or her if you experience side effects. In the same article, Dr. Cohen lists pharmaceutical medicines for MS including the following:

  • Alemtuzumab
  • Daclizumab
  • Rituximab
  • Dirucotide
  • Bht-3009
  • Cladribine
  • Dimethyl
  • Estriol
  • Fingolimod
  • Laquinimod
  • Minocycline
  • Statins
  • Temsirolimus
  • Teriflunomide

These drugs all work in various different ways to combat MS symptoms or slow the progression of the progressive form of the disease. Some are synthetically produced antibodies. Others are DNA vaccines or antibiotics.

New medicines show promise. Dr. Su Metcalfe, a British scientist, and her company LIFNano, are working on a cure for MS. The idea is to activate a stem cell particle called a LIF that regulates the immune system and controls whether it attacks dangerous cells or ignores healthy cells. The LIF are transported into the body inside nanoparticles that slowly dissolve in the body over a period of five days. The company intends to begin clinical trials in 2020.

Another very encouraging bit of news is that in 2017 the U.S. Food and Drug Administration approved a drug called Ocrevus to treat severe MS. The Swiss company Genentech chose to sell the drug at a 25% discount compared to its inferior competitor Rebif. The reason Genentech management gave for this pricing choice was that they felt the trend of skyrocketing medicine costs needed to be reversed.

If you want to try natural, alternative, or complementary treatments for MS, caveat emptor. Some treatments like chelation (chemical removal of heavy metals from the body) were believed to be effective in the past but are now known to be dangerous and ineffective. If someone tries to to sell you this treatment, that person is unethical. Stay away. Other proposed treatments like removing metal dental fillings are not harmful but are a waste of money. Many patients find complementary and alternative medicine to be effective in palliative care. In many cases, more research is needed. Proposed alternative or complementary treatments include tai chi, alternative diets, exercise, stress management, and acupuncture. There is some evidence in favor of some forms of some of these. In the next section, cannabis will be discussed as a alternative or complementary treatment.

Want to learn more about the possibility of an MS cure? Read Effectiveness of Cannabis Treatment on Multiple Sclerosis

Cannabis: an Emerging Key Player in MS Treatment

In recent decades, much has been made of the discovery and increased understanding of the human endocannabinoid system, which is a system of enzyme receptors that interact with cannabinoids, chemical substances similar to those found in the Cannabis sativa plant. More and more evidence is emerging that this system performs important regulatory functions in the body by aiding homeostasis. Cannabinoid receptors are found both in the central nervous system and elsewhere in the body.

It is especially relevant to the topic of MS that the non-psychotropic compound cannabidiol (CBD), the second most prevalent compound in cannabis, possesses potent anti-inflammatory properties that have been shown to be effective in preclinical trials in treating many inflammatory diseases. Also, CBD and the most prevalent compound in cannabis, delta 9-tetrahydrocannabinol (THC), are neuroprotective antioxidants that can reduce toxicity in neurons. A 2017 Colorado State University study showed that cannabis helps MS patients with physical activity. It is approved in Germany to treat MS spasticity. Nabiximols (Sativex), an oral spray whose active ingredients are a 50/50 blend of THC and CBD, was developed by the British biopharmaceutical company GW Pharmaceuticals and is approved in 30 countries outside the US for treating symptoms of MS. Unfortunately, the US federal government lags behind other countries in changing outdated and cruel criminal laws to make medical marijuana research convenient and cost-effective. As of the writing of this article in early 2018, the political situation around this issue can hardly be said to be improving, at the federal level, anyway. States continue to legalize marijuana for medical and recreational use. In 2017, Hawaii further liberalized its medical marijuana laws and approved its use for a number of diseases, specifically approving it for MS. Let us end on that high note and hope the day will soon come when sick people all over the world can legally seek evidence-based cannabis treatment for their debilitating diseases.

Click here to learn about 6 MS Symptoms That You Didn’t Know Could Be Cured With Cannabis.

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