How CBD Helps With Essential Tremors
Cannabidiol (CBD) is a phytocannabinoid (plant-based cannabinoid) commonly found in cannabis plants that purportedly provide therapeutic relief for different medical conditions.
Findings suggested that CBD may help with essential tremors by interacting with the endocannabinoid system (ECS) to help modulate the motor function and potentially reduce symptoms of movement disorders(1).
According to studies, the ECS helps maintain body homeostasis or balance and ensures that different internal systems work correctly.
The ECS has cannabinoid receptors that are found throughout the body. These receptors help modulate different daily bodily functions, such as immune response, pain sensation, and anxiety(2).
Among the different ECS receptors, the CB1 and CB2 receptors are the most common(3).
These two receptors primarily mediate the effects of endocannabinoids (cannabinoids produced by the body)(4). Endocannabinoids bind to the receptors to activate them and influence the body’s functionality(5).
Phytocannabinoids, such as CBD and tetrahydrocannabinol (THC), may also influence CB1 and CB2 receptors to trigger specific responses.
CB1 receptors are primarily found in the brain and central nervous system(6). These receptors are especially abundant in the hippocampus, cerebellum, and basal ganglia regions of the brain(7).
The cerebellum and basal ganglia are the areas of the brain that control motor function.
A 2015 review noted that CBD’s interaction with CB1 receptors in basal ganglia and cerebellum may have therapeutic potential in managing tremors and symptoms of movement disorders in patients(8).
Moreover, findings suggest that CB1 receptors may be associated with neuroprotective responses and may help treat or prevent neurodegenerative or neurological disorders, such as Parkinson’s disease(9).
Essential tremor, a neurological disorder, shares symptoms and characteristics with Parkinson’s disease.
Both conditions cause involuntary and rhythmic shaking of different body parts, differing only in the timing of the tremors and parts affected(10). Meanwhile, Parkinson’s disease patients also show symptoms of other health problems, such as psychosis(11).
Researchers from the University of California San Diego conducted studies on how an oral formulation of cannabis can help with common movement disorders(12).
With the study’s target completion date set for Dec 2020, the clinical trials started in January 2019(13). The authors examined how a 20:1 ratio of high CBD and low-dose THC may affect and potentially treat essential tremors in adults.
Dr. Fatta Nahab, the lead researcher and a neurologist at UC San Diego Health, notes that, if successful, the study may provide both new treatment options for essential tremor patients and new insights into the condition(14).
CB2 receptors, abundant in the immune system, affect immune cell functions. When activated, CB2 receptors trigger anti-inflammatory responses(15).
A study hypothesized that activated CB2 receptors’ anti-inflammatory effects may also help reduce inflammation and improve neuron survival in the brain(16). The study suggested that CB2 receptors may provide potential therapeutic relief for neurodegenerative illnesses.
Additionally, the results indicated that cannabinoids, like CBD and THC, may offer therapeutic relief for multiple sclerosis symptoms and improve the overall quality of life. Tremors are also a common symptom of multiple sclerosis.
Individual states have recognized the potential therapeutic benefits of medical cannabis and have programs that allow patients with multiple sclerosis, chronic pain, and other severe conditions to access medical marijuana(17).
Benefits of Using CBD for Essential Tremors
The use of CBD for essential tremors presents patients with a potential non-invasive treatment option for alleviating debilitating or severe cases.
According to the National Institute of Neurological Disorders and Stroke (NINDS), deep brain stimulation (DBS), used to treat essential tremors, epilepsy, Parkinson’s disease, and other neurological movement disorders, is invasive.
DBS involves inserting an electrical probe into the part of the brain that causes tremors. The probe transmits electrical pulses to disrupt signals that may be causing the tremors(18).
Although studies on CBD’s benefits specifically for essential tremors are lacking, research suggests that CBD may reduce movement disorder among patients with Huntington’s disease(19).
Moreover, CBD is shown to be well-tolerated among patients. A study noted that high CBD doses of up to 1,500mg per day caused no observable adverse effects among clinical trial participants(20).
Risks of Using CBD for Essential Tremors
Possible side effects of taking CBD may include dry mouth, reduced appetite, diarrhea, drowsiness or fatigue, and weight fluctuations(21).
Despite its legality and alleged therapeutic benefits, CBD is still a highly unregulated product. The US Food and Drug Administration (FDA) is yet to approve of CBD as a treatment for any medical condition.
As of December 2020, the FDA has only approved one CBD-based medication, Epidiolex, to treat rare forms of epilepsy(22).
Moreover, the FDA cautions users that extremely high doses of CBD may cause liver damage(23).
CBD may also adversely interact with some drugs, such as blood pressure medications or blood thinners(24).
Thus, it is advisable to always seek medical advice from health care professionals familiar with CBD and its potential therapeutic benefits before buying or using CBD products.
How Soon CBD’s Effects Can Be Felt After Taking It
Vaping or inhaling CBD is the fastest delivery method for CBD. Inhaling CBD lets the compound enter the bloodstream in as fast as 30 seconds or less, allowing for a faster onset or start of effect(25).
Vaping also offers high CBD bioavailability. Up to 56% of CBD may be absorbed and transported around the body when vaping, making this method the most effective way to take CBD(26).
Bioavailability refers to the amount of the drug and the speed that it gets absorbed into the bloodstream.
Studies have noted that vaping may deliver peak CBD plasma concentrations in under 10 minutes(27). With this near-immediate onset or start of effects, some people feel the positive effects of CBD within seconds or a few minutes(28).
The effects of vaping or inhaling CBD may last anywhere between one to four hours, depending on the amount and potency of the CBD product taken(29).
However, studies suggest that vaping may be linked to lung issues or respiratory complications(30).
In fact, both the US Centers for Disease Control and Prevention (CDC) and the FDA advise against vaping, especially THC-containing products, while safety investigations are underway(31).
People with essential tremors may also choose oral or sublingual (under the tongue) CBD administration.
Users that let the CBD oil sit underneath their tongue for at least one minute may start to feel CBD’s effects within 15 to 45 minutes(32).
It may take up to an hour before one can experience the effects of sublingual use of CBD(33). The effects may last six to eight hours(34).
Swallowing the CBD oil right away or taking CBD edibles and capsules means the product will go through the digestive system, leading to a longer onset of effects.
It may take a couple of hours to feel the effects of orally ingested CBD on an empty stomach or up to three hours when taken with a meal(35).
A study showed that taking CBD capsules with high-fat or high-calorie foods may increase the amount of CBD absorbed into the body by up to four times(36).
The effects of CBD edibles, capsules, and orally ingested tinctures may be felt for about six to twelve hours(37). The extended duration of effects makes oral CBD ingestion ideal for people with chronic medical conditions.
Take note that the CBD potencies and carrier oils used in different products may also affect CBD bioavailability.
It is recommended to approach a certified medical doctor familiar with CBD usage before using CBD to help ensure optimal effectiveness and overall wellness.
How to Buy the Best CBD Oil for Essential Tremors
CBD has three different types: full-spectrum CBD, broad-spectrum CBD, and CBD isolates.
Full-spectrum CBD oil contains a complete range of phytocannabinoids naturally found in cannabis plants, including CBD, THC, terpenes, flavonoids, and fatty acids.
Terpenes are aromatic compounds that may provide additional relaxation and therapeutic benefits(38). Flavonoids are plant chemicals that may offer antioxidant and anti-inflammatory relief(39).
Together, these compounds produce the entourage effect, wherein they work together in synergy to magnify each others’ therapeutic benefits. Thus, users can take in all the purported benefits of CBD and other cannabinoids.
Full-spectrum CBD oil and products are recommended for people with essential tremors who want to get the maximum therapeutic benefits from their CBD intake.
Broad-spectrum CBD products are ideal for essential tremors patients that are not comfortable with even trace amounts of THC yet still want to take advantage of the full range of phytocannabinoids and other compounds.
Researchers hypothesized that the cannabinoids and terpenes in broad-spectrum CBD may still trigger an entourage effect(40).
Meanwhile, CBD isolates are made of pure CBD. These are free from THC and other phytocannabinoids.
Here are other factors to consider when trying to buy the best CBD oil for essential tremors:
- Check the kind of ingredients used in the product. If possible, choose products whose ingredients are organic, all-natural, and non-GMO (genetically modified organism), particularly the hemp plants.
- Go for brands that are transparent about their hemp farming practices, CBD extraction process, and third-party lab testing.
- Always make sure the products have certificates of analysis (COAs) or lab test results to verify the CBD potency and cannabinoid content.
- The products should also be tested for harmful contaminants and toxins, such as residual solvents, pesticides, and heavy metals.
CBD Oil Dosage for Essential Tremors
The rule of thumb for first-time CBD users is to start with a low concentration and dosage of CBD. Users may slowly increase the dosing until their desired effects are achieved.
CBD is not an FDA-approved medication. As such, there are no established or official dosage recommendations.
CBD oils and tinctures often come with graduated or marked droppers for ease of administration and accurate dosage measurement.
Individuals with essential tremors are advised to talk with a physician or neurologist knowledgeable on CBD use for a more precise dosage recommendation.
How to Take CBD Oil for Essential Tremors
Inhalation or vaping is the fastest acting method for taking CBD, though it is also the method that offers the shortest effect duration(41).
The fast onset and high bioavailability makes vaping CBD ideal for patients with acute medical conditions or in need of immediate therapeutic relief(42).
Take note, though, that not all CBD oils and tinctures are safe for vaping. A study suggested that vaping CBD products with medium-chain triglyceride (MCT) oil may cause acute lung injury and inflammation(43).
The FDA and CDC also advise people not to vape CBD products that contain THC(44). Vaping has been linked to over 2,800 lung injury cases or deaths in the US, as of February 2020.
Taking CBD sublingually is a popular method among experienced users. This method requires holding the CBD oil under the tongue for at least 60 seconds before swallowing it.
Holding drops of CBD tinctures or oils under the tongue allows the blood vessels in the area to absorb CBD directly(45). This method allows for optimal absorption and a better bioavailability rate than CBD edibles(46).
People with essential tremors may also ingest CBD orally by taking CBD edibles, such as capsules, softgels, and gummies.
Oral ingestion is the slowest acting CBD delivery method. However, CBD edibles have a longer-lasting effect (up to 12 hours)(47).
The effect onset takes longer as the ingested CBD goes through the digestive system and gets metabolized in the liver. This process is known as “first-pass metabolism.”
Consult a medical doctor familiar with CBD use before buying and taking any CBD product, especially if you are taking other seizure prescription drugs, like primidone.
CBD topicals are also available, although these products may be more suitable for targeted joint pain relief rather than essential tremors(48).
CBD may cause contraindications with other medications, so it is highly recommended to get your doctor’s consent before using CBD.
Legality of CBD
CBD was legalized by federal law when the United States passed the 2018 Farm Bill or the Agriculture Improvement Act of 2018(49).
The bill permits the cultivation, processing, manufacture, handling, and selling of hemp and hemp derivatives, including CBD products(50).
The legality of hemp and hemp-based CBD hinges on its THC content. As per the 2018 Farm Bill, Cannabis sativa plants are considered as industrial hemp and federally legal as long as they have no more than 0.3% THC on a dry weight basis(51).
Any cannabis plant or product whose THC concentration exceeds the 0.3% federal limit is recognized as marijuana, which is still illegal in most parts of the US.
The 2018 Farm Bill also removed industrial hemp from the Schedule I drugs category(52). Schedule I drugs are substances with no approved medical use and a high potential for abuse(53).
Although CBD is no longer a Schedule I substance, it is still not an FDA-approved drug or supplement. The FDA has only approved one CBD-based medication, Epidiolex, for treating seizures caused by rare forms of epilepsy(54).
Additionally, the FDA regulations restrict the sale of any food or beverages with added CBD(55).
States may impose their own rules and regulations regarding CBD, with some states passing less restricting CBD laws than others.
Colorado, for instance, allows the manufacture and sale of CBD-infused food and drinks and does not have any age restrictions on who can buy CBD products unless CBD is added to alcohol(56).
In contrast, South Dakota continues to consider all forms of industrial hemp and CBD oil illegal(57).
Meanwhile, New York abides by the FDA’s regulations and does not permit the sale of food products with CBD additives has similar restrictions. However, the state has recently proposed regulations to amend this rule(58).