cbd oil for mast cell activation

Cbd oil for mast cell activation

To understand how Medical Cannabis works in the body as a mast cell stabilizer we must first understand how our Endocannabinoid system works.

What is the Endocannabinoid system (ECS)?

The endocannabinoid system (ECS) refers to a collection of cell receptors and corresponding molecules. You can think of cell receptors like little locks on the surface of your cells. The keys to these locks are chemical molecules called agonists. Each time an agonist binds to a cell it relays a message, causing a cascade of chemical effects.

The endocannabinoid system is the name for a series of cell receptors that respond to certain kinds of agonists. Two primary cell receptors make up the ECS, Cannabinoid Receptor 1 (CB1) and Cannabinoid Receptor 2 (CB2). The keys to these receptors are called endocannabinoids.

Endocannabinoids are like the body’s natural THC. In fact, endocannabinoids got their name from cannabis. Plant cannabinoids were discovered first. Endo means within, and cannabinoid referring to a compound that fits into cannabinoid receptors.

Cannabinoid Receptors

The cannabinoid receptors are found on the surface of the cells. Think of these receptors like a keyhole that will only function if the right key is inserted into it.

There are many types of cannabinoid receptors but only two of them have been widely studied and researched. They are CB1 and CB2.

Each receptor responds to different kinds of cannabinoids, but there are some cannabinoids that don’t distinguish between the two and can interact with both.

The distribution of these receptors within the body system explains why cannabinoids have certain profound effects on us.

CB1 receptors are abundantly present in the brain and spinal cord. They are found in exceedingly high concentration in the parts of the brain that are associated with the behaviors they influence.

Most importantly, they are found in the hypothalamus and the amygdala, which are responsible for appetite regulation, control of stress and anxiety, reducing nausea as well as for memory and emotional processing.

CB1 receptors are also present in nerve endings where they act to reduce sensations of pain (one major reason why cannabis is used as a pain killer).

CB2 receptors are usually located in the immune cells of the peripheral nervous system. Once activated, they trigger an immune response to reduce inflammation, a role that is important in treating many chronic diseases.

The presence of CB2 (and CB1) in immune system cells strongly suggests that endocannabinoids are immunomodulators.

CB1 and CB2 Suppress Mast Cells

Mast cells contain CB1 and CB2 receptors, which when activated inhibit mast cell release (R).

Research shows that cannabinoids can suppress mast cell degranulation.

“Cannabinoids are broadly immunosuppressive, and anti-inflammatory properties have been reported for certain marijuana constituents and endogenously produced cannabinoids. The CB2 cannabinoid receptor is an established constituent of immune system cells, and we have recently established that the CB1 cannabinoid receptor is expressed in mast cells. In the present study, we sought to define a role for CB1 in mast cells and to identify the signalling pathways that may mediate the suppressive effects of CB1 ligation on mast cell activation. Our results show that CB1 and CB2 mediate diametrically opposed effects on cAMP levels in mast cells. The observed long-term stimulation of cAMP levels by the Gαi/o-coupled CB1 is paradoxical, and our results indicate that it may be attributed to CB1-mediated transcriptional regulation of specific adenylate cyclase isoenzymes that exhibit superactivatable kinetics. Taken together, these results reveal the complexity in signalling of natively co-expressed cannabinoid receptors and suggest that some anti-inflammatory effects of CB1 ligands may be attributable to sustained cAMP elevation that, in turn, causes suppression of mast cell degranulation.“

A leading Mast Cell Activation Syndrome expert Dr. Afrin shares his experience with patients who use Medical Cannabis to help with their mast cell disease symptoms in his book Never Bet Against Occam.

“The mast cell surface features (inhibitory) cannabinoid receptors, making me wonder whether at least some of the chronically ill patients out there who claim that the only thing that makes them feel better is marijuana might be unrecognized MCAS patients in whom THC’s binding with the cannabinoid receptors on their dysfunctional mast cells leads to a quieting of the activity of those cells and thus a lessening of symptoms.“

*CBD alone without THC maybe ineffective at treating dysfunctional mast cells because THC has a strong binding affinity for both CB1 and CB2 receptors, cannabidiol (CBD) has no particular binding affinity. Instead, many of the therapeutic benefits of CBD are created through indirect actions.

In another research article,
“Cannabinomimetic Control of Mast Cell Mediator Release: New Perspective in Chronic Inflammation” published in the Journal of Neuroendocrinology provides detailed evidence backing up the fact that Medical Cannabis can suppress mast cell degranulation and help alleviate pain and inflammation in patients.

What Is the Best Way to Use Cannabis When You Have MCAS?

*Consult your doctor before making any change in your medical care. When trying Medical Cannabis remember that there are different strains of medical cannabis, one strain may give you great relief vs another may not.

If you’re considering using Medical Cannabis for Mast Cell Activation Syndrome you’re probably wondering how to take it. There are many Medical Cannabis treatment options available such as: Cannabis Edibles, Topical Ointments, Cannabis Oil, Smoking the Cannabis flower. However, when it comes to MCAS patients who are more severe, they tend to not tolerate ingesting the Medical Cannabis oil or edibles but may can inhale the actual Organic Medical Cannabis Flower and find great relief from MCAS symptoms.

“In the context of smoked marijuana, cannabinoids gain access to the systemic circulation within minutes of inhalation. However, airways and the gastrointestinal tract are immediate points of contact for cannabinoids constituents, and the resident mast cells in these areas will be impacted by marijuana smoke. Mast cells express CB2 cannabinoid receptors and a variety of responses to cannabinoid application have been described in these cells. In vitro, suppression of mast cell proinflammatory mediator release by both marijuana constituents and endocannabinoids has been described. The marijuana constituent tetrahydrocannabinol (THC) is highly suppressive in in vivo models of mast cell proinflammatory function.

It is recommended that MCAS patients only try organic medical cannabis as different pesticides and fertilizers can cause an allergic response. As with any medication there is a risk of an allergic reaction, so we encourage you to speak with your doctor.

Hemp Oil VS Medical Cannabis Oil

When trying Medical Cannabis Oil it is recommended to only use CBD/THC oils made strictly from medical marijuana for MCAS patients because of safety and superior medicinal benefits vs hemp.

CBD products made from hemp potentially have several problems:

Hemp contains less cannabidiol than CBD-rich cannabis strains so it takes a large amount of industrial hemp to extract a small amount of CBD. Hemp is also a “bio-accumulator” meaning the plant naturally drawns toxins from the soil which can cause issues in a MCAS patient.

Hemp-derived CBD and refined CBD powder lack critical medicinal terpenes and secondary cannabinoids found in cannabis oil. These compounds interact with CBD and THC to enhance their medicinal benefits.

MCAS patients want to make sure that the Medical Cannabis oil is CO2 derived as the other extraction process uses Ethanol (High-grade grain alcohol) and will likely cause anaphylaxis in Mast Cell Patients because Ethanol/Alcohol is known to cause mast cell degranalation.

MCAS and Cannabidiol (CBD)

Endocannabinoids are naturally-occurring substances found within the body. Endocannabinoids are found in breast milk and have also been linked as the source of the “runners high” one can get with exercise. Endocannabinoids are part of a neurotransmitter system that promotes relaxation and regulates other body functions like sleep, hunger, memory, and even aspects of the immune system. They have been touted as big players in the maintenance of homeostasis in the body.

Phytocannabinoids are very similar to endocannabinoids and come from plants. One of the more common and potent sources on the market comes from the hemp plant. Cannabidiol (known as “CBD”) is the non-psychoactive component of the cannabis plant that stimulates cannabinoid activity. Due to the stigma associated with the psychoactive tetrahydrocannabinol (THC) ingredient in marijuana, CBD oil has unjustly received a bad rap based on association by those who are not aware that the two compounds operate distinctly.

A 2015 peer-reviewed review article in Neurotherapeutics noted that THC can be addictive, while “cannabidiol (CBD), in contrast, appears to have low reinforcing properties with limited abuse potential” and that it appears to inhibit drug-seeking behavior. 1 However, it may take a while for American mainstream medicine to jump on board fully with the use of CBD, in-part due to its stigma but also due to the limited research studies conducted in the U.S. (thus far).

That being said, more and more peer-reviewed research articles on CBD use in other countries are coming back with some astonishing results. According to the 2015 review, “Human studies on CBD corroborate preclinical findings on its therapeutic effects on nausea, inflammation, and cerebral ischemia.” 1 Epilepsy, anxiety and depression, cardiovascular disease, endometrial inflammation, neurological conditions, and atopic dermatitis are a small example of the conditions that show promising results in CBD research. 1,2,3,4 CBD has promising initial research into potential use for patients with addictions and opioid abuse. 1 Its use has also been associated with a reduction in allergy symptoms, and cannabis appears to have a bronchodilating effect in the asthmatic population. 3,4 CBD appears to decrease autonomic nervous system activation 1 and it would be interesting to study its effects in a population of patients who present with MCAS and hyperadrenergic POTS.

It appears that to date there is no high-quality research evaluating CBD use in patients with MCAS or mastocytosis. Ständer and colleagues evaluated the role of cannabinoid receptors (CB1 and CB2) in human cutaneous mast cells including one patient with mastocytosis. The authors concluded that “The abundant distribution of cannabinoid receptors on skin nerve fibers and mast cells provides implications for an anti-inflammatory, anti-nociceptive action of cannabinoid receptor agonists and suggests their putatively broad therapeutic potential.” 5

Additional sources support that CBD appears to have a therapeutic impact on mast cell activation. CBD use reduces the production of cytokines (such as interleukins released by mast cells) in human subjects. 6 An Italian research team conducted a review of studies examining CBD and mast cell activation in 2008. They noted evidence of in vitro animal and human prevention of mast cell activation via different pathways following cannabinol exposure. 3 The authors concluded that “cannabinomimetic compounds, including PEA and its congeners, act to control MC (mast cell) activation and degranulation early during the inflammatory response, thus leading to a swift resolution and preventing the development of chronic inflammatory disease.” 3

Furthermore, a 2017 review of pain management in the MCAS patient by Wirz and Molderings concluded that CBD offers a promising future for analgesic therapeutic options for patients with MCAD. 7 While the research is somewhat preliminary, it appears that CBD has tremendous neuroprotective, anti-inflammatory, antimicrobial, and antioxidant effects on the human body and offer a promising potential for patients with mast cell overactivation and allergic disease. CBD oil does not contain THC and it appears that it has been approved in all 50 U.S. states. 8

Anecdotally in the online MCAS community it seems to be helpful for some patients, particular those with high pain levels, inflammation, and insomnia. CBD may have potential side effects, depending on the dosage. Patients have reported GI issues, tiredness, lightheadedness, and low blood pressure. 1 Patients with MCAS may need to factor these possibilities into their decision to use CBD, as they are often already prone to these symptoms. Many patients find that using CBD oil at bedtime is most optimal to prevent side effects and assist with symptoms of insomnia. However, studies have noted both sleep-inducing and wakefulness characteristics with CBD use, so it’s not certain that it assists with insomnia. 1

Initial caution may be needed as CBD oil, like any new medication or supplement, could in theory cause reactivity in patients with MCAS. Long-term effects are currently unknown, and CBD is metabolized in the liver and could in theory interact with other drugs metabolized in the same area, such as pain medications and steroids. 1 CBD oil can also interact with certain medications such as tricyclic antidepressants and anti-anxiety meds, so it’s another topic to discuss with one’s medical team. 1