In just over an hour, someone will be diagnosed with amyotrophic lateral sclerosis (ALS), and then every hour after that. This is a disease of the nerve cells in the spinal cord and brain that control voluntary muscle movement. (1) The condition is also known as Lou Gehrig’s disease, and disease progression can be rapid. Life expectancy following a diagnosis is just 2-5 years, though a small percentage live a lot longer. There are currently only a few medical options used to treat the disease, and only one drug that can slow the progression by just a few months on average. The need for treatment options is very high, but the availability is extremely low. Over the past several years, there has been significant progress made in both understanding the disease, and in public awareness, though this hasn’t translated into effective medical treatments.
Cannabidiol (CBD) assists in relieving muscle spasm and is a powerful anti-inflammatory, and has significantly more antioxidant activity than vitamins C or E. CBD has been found to have advantageous effects on all diseases involving basal ganglia and mitochondrial portions of the brain and has a neuroprotective effect that can increase neuron cell survival. (2) But it’s not just the cannabinoid CBD from the hemp plant that can assist with ALS, other cannabinoids such as the anticonvulsant cannabinol (CBN), antiinflammatory and analgesic (pain killing) cannabichromene (CBC) that promotes brain growth, anti-inflammatory tetrahydrocannabivarin (THCV), and the analgesic cannabicyclol (CBL). (3)
You’ll notice we use the terms “cannabis”, “hemp”, and “marijuana” sometimes interchangeably in this post and other articles. This is because cannabis is the genus of plant, with both hemp and marijuana being varieties of that plant, just like macintosh and granny smith are to apples. Hemp is considered the low-THC variety (0.3%), whereas marijuana is the high-THC variety (10-15%). Hemp products containing a full spectrum of cannabinoids are the ideal solution for those wishing to avoid the psychoactive effects of THC while taking advantage of a very low profile of side effects, if any. You can learn more about hemp in our article, What is Hemp.
Properties of marijuana for symptoms of ALS: (4)
It is recommended that before making any changes to your lifestyle or treatment plan that you consult with a licenced medical professional on the best dosage and ratio of CBD or medicinal cannabis for your particular condition. This article is for informational purposes only, and should not be taken as medical advice. If one has taken the time to educate themselves by doing their due diligence on the effects and options of cannabinoids for ALS, they can become aware and responsible health consultants taking measures into their own hands, though, we restate, under the guidance of a medical professional is advised.
When it comes to cannabis, you can always take more, but you can’t take less. Remember that as you explore your options. Always start with a micro dose to test for sensitivity, and titrate up as needed until symptoms subside.
The general dosage for ALS is usually found in the macro range, with a suggested dose of 1-2 mg/lb of cannabinoids per day. Commonly, the most suggested ratio is 1:1, due to the fact it has been most widely studied in clinical trials involving the pharmaceutical Sativex, which has a CBD:THC ratio of 1:1. If the high-THC ratio is too difficult to tolerate, one could utilize ratios higher in CBD during the day, with more THC added at night (generally, indica-dominant, or sedating strains are recommended).
When higher doses are needed, there are concentrated forms of cannabis oil that can be taken orally under the tongue, in a capsule form, or by adding to foods such as nut butters. The most potent and purest concentrates are made using a CO2-extraction process.
For immediate symptoms such as drooling, quick and highly effective relief can be found by smoking or vaporising cannabis. This is also a favored method to relieve pain immediately. The current pharmaceutical options available last just one to three hours, whereas cannabis products that can be ingested take thirty to sixty minutes to take effect and last six to eight hours. Vaporizers that use a cartridge filled with the CO2 concentrate are very effective, and these are available in various ratios of CBD to THC pending the country and legal status of cannabis where you live. Herbal vaporizers with a full spectrum of cannabinoids from the whole plant are also an effective and potent delivery method.
Based on the Cannabis Health Index, ALS scores in the possible-to-probable range of efficacy for treatment based on the currently twelve available studies.
Although studies on ALS and cannabis is relatively scarce, there is a lot of discussion going on recently of its anecdotal effectiveness, with a number of research papers in medical journals of successful case studies containing comments that more work needs to be done in this area. In a research paper from 2010, the potential applications were discussed with a previous animal trial being referenced in which cannabis showed a slowing of the progression of the disease calling for clinical trials and concluding, “it is reasonable to think that cannabis might significantly slow the progression of ALS, potentially extending life expectancy and substantially reducing the overall burden of the disease.” (5) Further research showed that CBD when combined with THC lengthened life expectancy more than THC alone. (6)
One of the understood causes of the degeneration of motor neurons in the central nervous system and spines of ALS sufferers is the disappearance of an enzyme called superoxide dismutase (SOD1), a strong antioxidant that protects the human body from damage caused by destructive free radicals. The antioxidant properties of CBD are, however, just one of its potentially beneficial aspects when it comes to ALS. The authors of the 2010 paper state:
“It appears that a number of abnormal physiological processes occur simultaneously in this devastating disease. Ideally, a multidrug regimen, including glutamate antagonists, antioxidants, a centrally acting antiinflammatory agent, microglial cell modulators (including tumor necrosis factor alpha [TNF-α] inhibitors), an antiapoptotic agent, 1 or more neurotrophic growth factors, and a mitochondrial function-enhancing agent would be required to comprehensively address the known pathophysiology of ALS. Remarkably, cannabis appears to have activity in all of those areas.” (6)
Furthermore, in 2016, a meta-analysis was conducted by researchers from the Journal of Neural Regeneration Research, which involved the study of the current available literature at the time, authors found that “in light of the above findings, there is a valid rationale to propose the use of cannabinoid compounds in the pharmacological management of ALS patients. Cannabinoids indeed are able to delay ALS progression and prolong survival.” (7)
In 2019 a study was published in BMC Neurology, where patients showing high spasticity symptomology reporting a “high recommendation rate” for CBD:THC treatment. Researchers applied the cannabis treatment on an individual basis with results interestingly proving more advantageous in those with high spasticity versus low, concluding that, “these results suggest that THC:CBD may serve as a valuable addition in the spectrum of symptomatic therapy in ALS.”
A study in Current Pharmaceutical Design had researchers find, “there is increasing evidence that cannabinoids and manipulation of the endocannabinoid system may have therapeutic value in ALS, in addition to other neurodegenerative conditions. Cannabinoids exert anti-glutamatergic and antiinflammatory actions,” and concluding with, “the ability of cannabinoids to target multiple neurotoxic pathways in different cell populations may increase their therapeutic potential in the treatment of ALS.” (8)
Important note on the endocannabinoid system (ECS). As researchers mentioned above, the endocannabinoid system may have therapeutic value in the treatment of ALS. This is due to the fact that there are cannabinoid receptors right across the entire body from the organs and skin to the brain stem and central nervous system that are designed to take endo-cannabinoids such as AEA and 2-AG, and phyto-cannabinoids such as CBD, CBG, CBN, THCA and so on. What this means is that plants can help re-balance or “supplement” our bodies own supply of cannabinoids, to help restore order and balance to a system in disarray and out of order. We encourage you to learn more about the ECS by reading our article, The Endocannabinoid System Explained.
Another study from 2019 involving the use of both cannabidiol (CBD) and cannabigerol (CBG) found that both exert powerful antioxidant, anti-inflammatory, and anti-apoptotic effects relating to ALS with researchers supporting further clinical work to be undertaken in this area. (9)
There are currently several clinical studies in the works on humans evaluating the clinical effects of cannabinoids on ALS, through both high-CBD low-THC products, and balanced CBD:THC ratios, with many researchers patiently awaiting the results. (10)
We also encourage readers of this article to check out our investigation on cannabinoids and multiple sclerosis (MS). The research surrounding MS is quite extensive and promising. It is another condition that involves demyelination of nerve cells and may assist in your quest to learn more about potential side effects of cannabis use and its efficacy.
If you found this article of value, consider reading others just like it over on our blog, where we cover the latest research surrounding all things hemp, cannabinoids, and the endocannabinoid system for conditions like anxiety, arthritis, endometriosis and many more.
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