Trigeminal Neuralgia (TN) is caused by damage or dysfunction in the trigeminal nerve, resulting in severe pain on the face. Dr Frankel talks about Trigeminal Neuralgia and the positive effect he has seen cannabis have on patients dealing with it. Some feedback received by three recen
CBD Oil for Trigeminal Neuralgia – August 2022
Trigeminal neuralgia (TN) is a form of neuropathic pain condition caused by dysfunction in the trigeminal nerve, or fifth cranial nerve . The nerve is responsible for carrying sensation signals from the face to the brain.
TN pain has been reported to be so severe that it has been called the “ suicide disease ” (5) .
Slight stimulations on the face, such as touching, brushing, and washing may cause severe facial pain . TN may also cause muscle spasms, feelings of electric shock , and burning sensation .
TN treatments include anticonvulsant agents, antispasmodic agents, and potentially invasive surgical procedures.
Antiepileptic medications, such as gabapentin and carbamazepine, have been used to treat TN (6) . However, the lack of intolerability and efficacy has been observed among these medications after prolonged use (7) .
CBD is a proven antiepileptic treatment (8) . A recent study posted in Molecules mentioned evidence of CBD ’s anticonvulsant and neuroprotective properties. These actions might help reduce spasms and nerve pain (9) .
Studies have not investigated CBD ’s efficacy on spasms caused by TN. However, CBD might have therapeutic benefits for treating chronic pain caused by TN (10) .
A review shared that cannabinoids , such as CBD , might help alleviate neuropathic pain and hyperalgesia (pain sensitivity). The review mentioned that there is evidence that cannabinoids might block the pain pathway ’s neural transmission (11) .
The authors added that the nociceptive effects produced by cannabinoids might be a potential therapeutic approach to the management of trigeminal neuralgia (12) .
The analgesic and anti-hyperalgesic effects of CBD were supported by an animal study published in the Journal of Experimental Medicine (13) .
The study mentioned that CBD possesses therapeutic benefits that might reduce pain and inflammation that causes neuropathy (14) .
Neuropathy is dysfunction or damage in the nerves that may cause pain, tingling and burning sensations , numbness, or muscle weakness.
Moreover, the authors added that CBD was able to mitigate hyperalgesia in mice models. The study concluded that CBD reduced persistent inflammation and neuropathic pain (15) .
Another study shared in the European Journal of Pharmacology demonstrated that CBD may possess potent anti-inflammatory and immunomodulatory effects (16) .
In the study, oral CBD was administered on rat models with induced sciatic nerve compression. Researchers found that CBD treatment reduced hyperalgesia and reduced inflammation (17) .
According to experts, trigeminal nerve pain can be caused by a blood vessel pressing on the trigeminal nerve . This compression causes damage to the trigeminal’s protective coating (myelin sheath) (18) . In severe cases, this vessel may need to be surgically separated from the trigeminal nerve.
Moreover, researchers observed that high blood pressure increases the risk for TN (19) .
A preclinical study acknowledged that CBD has cardiovascular benefits (20) . The authors mentioned that healthy volunteers (age 21-29) whose hypertension is triggered by stress displayed a lower resting blood pressure after taking CBD .
Clinical studies without limitations are needed to confirm CBD ’s potential ability to reduce blood pressure in older individuals.
Most of the studies mentioned have shown results using animals as test subjects. More clinical studies are needed to prove CBD ’s efficacy in alleviating nerve pain .
How CBD Oil Works to Help With Trigeminal Neuralgia
The endocannabinoid system (ECS) is essential in maintaining homeostasis in the central nervous system , peripheral nervous system , immune system, and organs.
The ECS is composed of receptors that are spread across the human body. These receptors include the cannabinoid receptors (CB1 and CB2) and glycine receptor (GLyR) (21) .
Studies acknowledged that modulating the receptors in the ECS might influence bodily functions, resulting in several therapeutic benefits (22) .
Modulatory effects can be triggered or stimulated by cannabinoids , such as cannabidiol ( CBD) , tetrahydrocannabinol ( THC ), cannabichromene (CBC), cannabinol (CBN), and cannabigerol (CBG) (23) .
A study posted by the Journal of Experimental Medicine suggested that modulating the ECS might have therapeutic effects in pain management (24) .
Moreover, the authors mentioned that glycine receptors in the central nervous system are an essential target for alleviating neuropathic pain (25) .
The authors added that cannabinoids , such as THC and CBD , might strengthen nerve impulses in the glycine receptors, resulting in analgesic potency (26) .
Glycine receptors are ion channels that are responsible for neurotransmission.
The study found that oral CBD treatment provided a binding glycine activity that reduced hyperalgesia and neuropathic pain in mice models.
The Pros and Cons of CBD Oil for Trigeminal Neuralgia
- Studies demonstrated that CBD might have therapeutic effects in pain management by modulating receptors in the ECS (27) .
- Researchers acknowledged that CBD might strengthen nerve impulses in the ECS receptors, resulting in analgesic potency (28) .
- Animal studies have shown that oral CBD treatment might be useful in alleviating neuropathic pain and hyperalgesia (pain sensitivity) (29) .
- Studies have shown that CBD might reduce blood pressure . High blood pressure might increase the risk for TN (30) .
- Researchers acknowledge that CBD is well-tolerated and has an excellent safety profile (31) .
- There are not enough clinical studies that support CBD ’s efficacy in treating trigeminal neuralgia .
- Studies mentioned that CBD might cause adverse effects, such as dry mouth, diarrhea, drowsiness, loss of appetite, and CBD -induced drug interactions (32) .
- An animal study has shown that CBD might cause hepatotoxicity (liver damage) when taken in extremely high doses. This hypothesis is supported by the US Food and Drug Administration (FDA) (33) .
How CBD Oil Compares to Alternative Treatments for Trigeminal Neuralgia
There are not many alternative treatment options for painful conditions, like TN. The efficacy of alternative anticonvulsants for treating TN is currently not supported by scientific studies.
A popular alternative treatment for TN is acupuncture. A review mentioned that a 66-year woman suffering from TN believed that she was successfully treated by acupuncture (34) .
Acupuncture is a Chinese tradition that uses microneedles to balance the energy in the body.
Researchers mention that acupuncture may help maintain homeostasis in the ECS and must be investigated. So far, no direct studies have been made on how acupuncture might trigger the cannabinoid receptors (35) .
A study published in Frontiers of Molecular Neuroscience has found that electroacupuncture on osteoarthritis rats was able to increase receptor activity, resulting in reduced chronic pain (36) .
Electroacupuncture is conducted by sending electrical signals through acupuncture needles.
CBD has somewhat similar characteristics to electroacupuncture. A study discussed that CBD ’s modulation of adenosine receptors resulted in reduced pain and inflammation in rheumatoid arthritis mice (37) .
Another alternative treatment for TN is vitamin B12. Studies have shown that vitamin B12 has analgesic properties that might be useful for treating neuropathic pain (38) .
A review from Neural Plasticity cited clinical studies that produced positive results from neuropathic patients following treatments of methylcobalamin (MeCbl), a form of B12. These clinical studies included patients with neuropathic health conditions, such as TN and diabetic neuropathy (39) .
Clinical studies have yet to test CBD ’s efficacy on TN and diabetic neuropathy. However, a study acknowledged that CBD might also possess therapeutic benefits for neuropathic conditions.
CBD ’s modulation of glycine receptors resulted in alleviating chronic pain and hyperalgesia in mice models (40) .
How to Choose the Best CBD Oil for Trigeminal Neuralgia
Full-spectrum CBD oil carries all the major cannabinoids found in hemp plants, such as CBD , CBG, CBC, and 0.3% THC .
Full-spectrum CBD is recommended for treating neuropathic pain . A study posted in Therapeutics and Clinical Risk Management acknowledged the analgesic effects of other cannabinoids present in hemp (41) .
Broad-spectrum CBD contains the same cannabinoids in full-spectrum without THC . Broad-spectrum is recommended for individuals who do not want traces of THC in their system.
Full-spectrum and broad-spectrum types provide individuals with the “entourage effect.” The entourage effect means that all the cannabinoids are working in synergy.
Individuals who cannot tolerate other cannabinoids may opt for CBD isolate. This concentration contains 90% CBD .
Additional tips to consider before buying CBD :
- Customers may check for cannabinoid concentration in the product by referring to the certificate of analysis (COA).
- Checking testimonials and reviews from other customers is helpful.
- Consulting with a neurologist before taking CBD is important.
CBD Dosage for Trigeminal Neuralgia
More clinical trials are crucial in determining the correct CBD dose for health conditions.
The British Journal of Pharmacology published a study that recommended a low dose of less than 1 to 50 milligrams kilograms per day (
Individuals may increase their dose once their bodies get used to having CBD in their system.
Moreover, a clinical study published by the Brazilian Journal of Psychiatry mentioned that a dose-response curve was observed with CBD (43) .
The authors explained that 300mg pure CBD treatment produced positive results, while 150mg and 600mg did not produce any changes.
Also, a high dosage of CBD is not recommended. A study released by Molecules observed that extremely high doses of CBD caused hepatotoxicity in rat models (44) .
How to Take CBD Oil for Trigeminal Neuralgia
CBD oil may be taken orally in forms of capsules, softgels, and gummies. Individuals may also take CBD capsules , gummies, and other edibles with a glass of water.
A study observed that CBD remained in the system three to four hours after oral intake (45) .
Individuals who want a higher potency of CBD may opt for sublingual administration. CBD tinctures may be taken by using an applicator to drop CBD under the tongue.
More studies are needed to determine absorption speed and plasma concentrations for sublingual delivery.
The half-life of sublingual CBD administration has been observed to be dose-dependent. Nevertheless, researchers observed that plasma concentrations are faster when individuals are in a fasted state (empty stomach) (46) .
CBD tinctures may have an earthy taste due to the presence of terpenes. Terpenes are aromatic compounds found in the plants.
Some individuals may want the fastest method for pain relief . Thus, CBD vape pens and cartridges may be recommended.
Studies have shown that the lungs can be very efficient in delivering CBD into the bloodstream (47) . The authors explained that inhaling CBD through vaporization could deliver plasma concentrations to the body in less than 10 minutes.
However, another study reported that vaping might cause side effects , such as chest pain, shortness of breath, allergic reactions, and chemical irritation (48) .
Are CBD Oil and Medical Marijuana the Same?
Some individuals may mistake CBD for medical marijuana . However, these compounds differ in cultivation and concentration.
Medical marijuana or medical cannabis can come from several cannabis strains. The cannabis plant is harvested for its flowers and leaves, after which they are cured and dried for consumption.
CBD is usually extracted from Cannabis sativa, particularly hemp, using CO2 extraction, solvent extraction, or steam distillation.
The extraction method creates a more concentrated version of hemp. The cannabinoids are manufactured into carrier oils, capsules, edibles, vape juice, and other products.
CBD and medical marijuana also differ in terms of THC content.
CBD contains only 0.3% THC or less, making it legal in all 50 US states and territories (49) . Meanwhile, some dispensaries sell cannabis products that may contain up to 25-28% THC (50) .
Recreational and medical use of marijuana is illegal in the US, except for 11 states. These states may require consumers to procure a medical marijuana card (51) .
Although CBD products are legal, the CBD market remains highly unregulated.
Individuals are advised to always look for the certificate of analysis (COA) before buying the product. The COA is a third-party lab test result from ISO-certified laboratories.
These labs test for cannabinoid concentration and harmful chemicals, such as heavy metals, pesticides, and other contaminants.
The COA allows consumers to know that the product is high-quality and safe for humans or pets.
Studies have shown that CBD might be useful in alleviating neuropathic pain and hyperalgesia . This mechanism is due to CBD’s ability to block neural transmission in the pain receptors (52) .
Researchers also acknowledged that CBD might produce analgesic potency by strengthening nerve impulses in glycine receptors (53) .
Moreover, studies have shown that CBD might indirectly reduce TN pain by lowering blood pressure (54) .
More direct studies are needed to prove CBD ’s efficacy in alleviating neuropathic pain .
However, researchers mention that CBD ’s therapeutic potentials showed promise in improving the quality of life of individuals with TN (55) .
Trigeminal Neuralgia Or Neuropathy treated using CBD and THCa
Trigeminal Neuralgia is a specific variant of neuropathy that primarily effects the Fifth Cranial or facial nerve.
Trigeminal Neuralgia is often seen after facial or facial nerve trauma. The pain is neuropathic in nature, meaning it is severe, burning and often “suicidal” in nature. Neuropathic pain is often described as “suicidal” as it is often so severe, the patients will often consider suicide as a way out of this very severe neuropathic disorder.
The patients treated, generally are taking moderate doses of narcotics and often are being treated with acupuncture as well as other modalities in attempts to relieve the pain.
In recent months, we have tried using combinations of CBD and THC-Acid as treatment for neuropathic pain and in particular Trigeminal Neuralgia.
We have also found that THC-Acid is a very good therapy for neuropathic or neuralgic pain. Combining THC-Acid with CBD generally gives very good results in treating neuropathic or neuralgic pain.
THC-Varin is also therapeutic in the treatment of neuropathic or neuralgic pain. Combining THC-V and THC-A should give patients relief as well.
1. “For several years, I was taking medication for my trigeminal neuralgia that had severe side effects. Since Dr. Frankel prescribed cannabis medication, my pain has been under control with no side effects. Because of my very positive experience, I recommend that patients with trigeminal neuralgia to try cannabis-based medication instead of the standard treatment.”
2. “i do not have any more pain in my face and the swelling of my gums is almost normal. Can’t tell you how happy that makes me. I am very please with the outcome. “
Allan Frankel, MD Dr Allan Frankel is one of the few physicians in the US who truly understands Cannabis as a medicine. All treatments suggested have been well studied. Every patient seen by Dr Frankel is given a personally created Treatment Plan created with the patient’s specific issues defined. Plant medicine requires “tuning” of the dosing. Dr Frankel works with his patients thru a messaging portal. The use of this portal, allows quick and simple follow up contact with Dr Frankel. Patients are not charged for these messages, as this is how Dr Frankel has learned what he has learned. Follow up appointments in person or by phone/video are also available when needed
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