Amyotrophic Lateral Sclerosis ALS , also known as Lou Gehrig’s Disease, affects the motor neurons of the spinal cord, which causes progressive weakness and atrophy of muscles. ALS & Some evidence suggests CBD can slow the progression of ALS through its anti-inflammatory, antioxidant, and neuroprotective benefits. In recent years, cannabis, or marijuana, has been assessed in amyotrophic lateral sclerosis (ALS) and has shown some beneficial effects for patients.
Amyotrophic Lateral Sclerosis
ALS , also known as Lou Gehrig’s Disease, affects the motor neurons of the spinal cord, which causes progressive weakness and atrophy of muscles.
ALS & Cannabinoids
Cannabis Patient with ALS Outlives Her Doctors
Cathy Jordan she was diagnosed with ALS in 1986. Decades later she is still alive thanks to cannabis.
Science abstracts on CBD and Amyotrophic Lateral Sclerosis
- Cannabis and amyotrophic lateral sclerosis
- Self-medication with cannabidiol oil in a patient with primary lateral sclerosis
- Neurological aspects of medical use of CBD
These links are from third-party sites and are provided as a courtesy to the reader.
CBD for ALS Patients: Effectiveness, Dosage, & How to Use
Amyotrophic lateral sclerosis (ALS) and CBD — how it works, how to get started, how to dose effectively, and what the current research says.
Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder affecting the nerves responsible for muscle control.
Consequently, those affected are left unable to move, talk, and, eventually, breathe.
Stephen Hawking had the condition for most of his life but ultimately passed away at the age of 76.
No cure exists for this condition.
There are medications available that may slow neuronal cell death and improve daily functioning. But the majority of treatment is purely supportive — addressing significant symptoms and providing increased levels of support as those affected lose their ability to walk, talk, and take care of themselves.
Rapidly emerging evidence is suggesting cannabinoids such as CBD and THC may reduce neurological and oxidative damage associated with ALS.
Here, we’ll explore the potential use of CBD in ALS and offer some insight into how you can get the most out of your CBD supplementation.
MEDICALLY REVIEWED BY
Updated on January 12, 2022
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Summary: Using CBD for ALS
CBD may be useful for a range of other neurodegenerative disorders, including Alzheimer’s disease , Parkinson’s disease , and multiple sclerosis . Current CBD research related to these conditions is limited, but promising enough to be looked into further.
These conditions are independent of each other but have similar underlying mechanisms.
They all involve some degree of inflammation and oxidative damage in the brain that either causes the breakdown of nerves directly or serves as sustaining factors for the condition.
CBD produces well-known anti-inflammatory, antispasmodic, neuroprotective, and antioxidant effects within the body. It’s through these effects that CBD is, therefore, thought to be useful for a spectrum of neurological disorders — including ALS.
However, aside from a clinical report on spasticity , there are unfortunately no clinical trials involving the use of CBD for ALS to confirm these effects conclusively. Therefore, all we have to go off at the moment are case studies, animal studies, in vitro research, and correlation studies.
A review of CBD and ALS was recently published  calling for more research in this area.
The study highlighted a list of hypothetical benefits CBD is believed to offer ALS patients, including:
Tips to Getting the Most Out of Your CBD
- Look for full-spectrum CBD extracts. This is because other cannabinoids in the plant have also shown benefit toward neuroinflammation and side-effects of the condition.
- Always choose high-quality CBD products. This is because any contaminants in poor-quality CBD products can cause new problems or possibly make ALS progress even faster.
- Use the CBD consistently. This is because any benefits from CBD regarding ALS will likely take several weeks to develop. Be patient and persistent with CBD supplementation.
- Use CBD alongside other treatments, not all by itself. This is because ALS is a complex disorder involving many different factors. Therefore, it’s wise to use multiple forms of treatment to get the best results possible.
- Speak with your doctor before using CBD alongside other ALS medications. This is because some medications may interact negatively with CBD or the other cannabinoids in the bottle. Your doctor should continue monitoring your liver enzymes due to the standard ALS treatments.
What is ALS?
Amyotrophic lateral sclerosis, or ALS, is also referred to as Lou Gehrig’s Disease because of the famous baseball player who was forced to retire from the sport in 1939 after being diagnosed with the condition.
The disease involves gradual muscle paralysis as the neurons controlling the muscles break down. We each have millions of specialized nerve cells — called motor neurons — tasked with transmitting messages from the brain to the muscles and back again.
Eventually, as these motor neurons are destroyed, those affected are no longer able to walk, talk, eat, or drink. The disease ultimately becomes fatal when the motor neurons controlling the lungs fail.
Symptoms of ALS
- Dropping things
- Slurred speech
- Difficulty swallowing
- Weight loss
- Decreased muscle tone
- Shortness of breath
- Increased or decreased reflexes
- Uncontrollable periods of laughing or crying
- Feeling weak
- Muscle cramping or twitching
- Muscle stiffness or rigidity
- Poor concentration
- Mood changes
There Are Two Different Types of ALS
1. Sporadic ALS
This form of ALS can affect anybody — regardless of their gender, ethnicity, or age. However, it is more common in men, caucasian people, and persons older than 60 years, with peak onset around 58 to 63 years.
2. Familial ALS
Familial ALS is an inherited form of the disease. It accounts for 5% to 10% of cases. Peak age at onset is 47 to 52 years.
Another Manifestation of ALS: Bulbar ALS
Bulbar ALS refers to the starting point for the neurons affected. People with both familial or sporadic ALS can have the bulbar form of ALS. With this type, the motor neurons in the corticobulbar region of the brainstem are affected first. Therefore, the muscles in the face, neck, and head to become paralyzed before other areas of the body. This is as opposed to limb onset ALS or respiratory onset ALS that begin in the limbs or diaphragm, respectively.
What Causes ALS?
The exact cause is unknown, but there are a few theories for contributing factors for the disease, including:
- Environmental factors, such as tobacco use and formaldehyde exposure
- Heavy metal exposure
- Genetic predisposition, such as superoxide dismutase (SOD1) mutation
Common Medications for ALS
There is no cure for ALS but there are a few treatments available, such as FDA-approved riluzole and edaravone. Riluzole, a glutamatergic neurotransmission inhibitor, does not provide relief from the symptoms of ALS, but it can extend life expectancy by two to three months.
Edaravone, an antioxidant drug, can slow the decline of daily functions and halt the progression of ALS. CBD interacts with some medications, so always check with your doctor before using it.
Other treatments for ALS include:
- Physical therapy
- Occupational therapy
- Anti-depressants (fluoxetine, sertraline, citalopram)
- Anxiolytics (alprazolam, diazepam, lorazepam)
- Pain relievers (acetaminophen, asprin, ibuprofen)
Guide to Using CBD for ALS
It’s clear that more research is needed to investigate the effects of CBD on ALS in human subjects. However, the research we do have is very promising.
CBD and many of the other cannabinoids, including delta 9 THC and CBG, have been shown to offer significant benefits toward many of the uncomfortable symptoms involved with the condition. Therefore, they have been implicated as a potentially effective adjunct treatment for a series of other, related neurodegenerative disorders.
Both CBD and THC could offer support for the condition. Most of the case studies showing improvements in lifespan and symptoms were using marijuana containing both THC and CBD.
Therefore, we recommend opting for a full-spectrum CBD oil rather than a purified CBD extract with all other cannabinoids and terpenes removed. But depending on where you live, you may or may not have access to CBD products that contain THC in concentrations higher than about 0.3%.
In some places, patients with ALS can apply through a medical marijuana program to receive oils, tinctures, concentrates, or raw cannabis buds that contain high levels of both CBD and THC. The current research to date suggests this is the best option for ALS sufferers.
However, if you’re unable to get any hemp or marijuana products that contain THC, that’s okay. CBD is still likely to be effective for this condition and is generally better for relieving muscle tremors, insomnia, and anxiety than products containing THC.
However, as with any neurodegenerative disorder, it’s wise to speak with your physician before trying CBD or marijuana products for ALS symptoms because, in rare cases, CBD oils may have a negative interaction with other medication you might be taking, and you may also require liver enzyme monitoring . Therefore, it’s better to ask your doctor before assuming it’s 100% safe.
What the Research Says
Unfortunately, there are no clinical studies investigating the effects of CBD for ALS sufferers, despite years of case studies and promising research on related neurological disorders. However, there are a lot of case studies showing positive anecdotal impacts with both legal and illegal cannabis and CBD use .
Additionally, there is a growing body of evidence to suggest that THC is also beneficial for ALS.
An animal study published in 2004 investigated the role of THC — the primary psychoactive cannabinoid in the cannabis plant — on mice with ALS to measure any changes . The results of this study reported that the mice who were given THC had significantly less severity with their symptoms than mice not given the THC treatments.
Other studies have found that THC protects the motor neurons in the spinal cord , which are critically involved with the development of ALS.
THC has also been shown to be “extremely effective” at reducing oxidative damage induced by a known neurotoxic oxidative compound known as tert-butyl hydroperoxide .
What’s the Recommended Dose of CBD?
Because there are no good clinical trials involving CBD for ALS, there are no specific dosages identified nor characteristic results to be expected. However, studies involving CBD and other neurodegenerative disorders often report that high dosages are needed to receive benefits. Therefore, it’s likely to assume that the dose for ALS is also higher than average.
We recommend starting with a low dose and building up gradually by adding 2 mg to 5 mg of CBD each day.
Once symptoms are alleviated, you’ve found the right dose. According to case reports, CBD can relieve symptoms such as insomnia, pain, and muscle tremors almost immediately, while the longevity-enhancing effects of the compound would take much longer and won’t be as noticeable. Further research would be needed to confirm these kinds of effects.
Therefore, for best results, it’s recommended that you aim for the high-strength dose of CBD, and take this dose consistently over the long term.
However, always consult with your doctor before taking CBD for ALS and always take your routine prescriptions as directed, never stop on your own.
Amyotrophic lateral sclerosis (ALS) is a disease characterized by extensive damage over time to motor neurons in the brain and spinal cord. Motor neurons are nerve cells that are responsible for the communication, the signals, taking place between the brain and the muscles.
Due to this damage, the brain is increasingly unable to control muscle movement, and patients progressively loses the ability to easily do activities that most people take for granted, like walk, swallow, or speak. There is currently no cure for ALS, but treatments can help manage its symptoms.
One potential treatment is cannabis sativa, otherwise known as marijuana. Cannabis, as medical marijuana, is being assessed in its various forms for its potential in easing ALS symptoms.
How cannabis works
The active ingredients in cannabis — tetrahydrocannabinol (THC) and cannabidiol (CBD) — are called cannabinoids. They are believed to work as antioxidants and as anti-inflammatory and neuroprotective agents, and for these reason might slow or prevent further damage to nerve cells in ALS.
Both CBD and THC mainly function by binding to the cannabinoid receptor proteins CB1 and CB2 of the endocannabinoid system. The endocannabinoid system is responsible for regulating brain function, hormone secretion, and the immune system. CB1 receptors are present on the surface of nerve cells in the brain and spinal cord, and regulate neurodevelopmental activities; CB2 receptors are predominantly present in immune cells, and modulate inflammation and immune cell function.
Binding of THC to the CB1 receptor activates the receptor’s anti-glutamatergic action, meaning it inhibits the release of excess glutamate by nerve cells. Glutamate is a neurotransmitter, and in excess can cause nerve cell damage or excitotoxicity. In ALS, excitotoxicity is thought to compound nerve cell damage and increase neurodegeneration.
Since THC prevents excitotoxicity via the CB1 receptors, treatment with THC may be neuroprotective for ALS patients. A study showed that neuronal cells obtained from the spinal cord of ALS mouse models and treated with THC were protected from induced excitotoxicity.
The cannabinoids exert an anti-inflammatory effect through the CB2 receptors, which regulate immune cells and the production of inflammatory proteins. In this way, they might slow further tissue damage.
Cannabinoids also function as an antioxidant, but in a CB receptor-independent manner. Other receptors, such as the transient receptor potential vanilloid receptor 1, have been found to be involved, but how they work in ALS is still unclear.
Medical marijuana in clinical trials
Cannabis-derived products are being, or were, evaluated for their potential in treating ALS in various clinical trials.
Sativex (nabiximols), being developed by GW Pharmaceuticals, is an oral spray containing the two active components of cannabis. A Phase 2 trial (NCT01776970) in Italy, called CANALS, evaluated the safety, efficacy, and tolerability of Sativex in ALS patients affected by spasticity, or muscle stiffness. A total of 59 patients, ages 18 to 80, were included in the study. Patients were randomly assigned to receive either Sativex (29 patients) or placebo (30 patients). The study’s findings showed that Sativex was well-tolerated with no serious side effects. Spasticity was significantly reduced in treated patients compared to those given the placebo, whose symptoms continued to worsen.
An earlier single-site study (NCT00812851) tested the efficacy of oral THC in alleviating cramps in ALS patients. This was a crossover study, meaning that all 27 patients enrolled, (mean age 57; with moderate to severe cramps) were given THC at some point during the trial. They were randomly divided into two groups, one receiving 5 mg THC twice daily for two weeks, followed by a placebo; and the other receiving placebo first followed by THC for two weeks. A two-week treatment-free, or washout, period preceded changes in treatment status, and patients were evaluated two weeks after their treatment period.
This trial’s primary goal was changes in cramp intensity. The number of cramps per day, the intensity of muscle twitches, change in appetite, depression, and patient’s quality of life and sleep were measured as secondary goals. Study findings failed to show effectiveness in these measures; THC at 5 mg did did not alleviate cramps in ALS patients, and no significant changes were observed in the secondary outcomes, its researchers reported.
An ongoing Phase 3 study (NCT03690791) is testing the effects of CBD oil capsules by CannTrust on slowing disease progression in ALS patients. The study aims to enroll 30 patients, ages 25 to 75, who will be randomly grouped to receive either the CBD oil capsules or a placebo. In this six-month study, changes in a patient’s motor abilities, lung function, pain and spasticity levels, and quality of life will be assessed to evaluate the efficacy of CBD capsules. Enrollment at this trial’s single site, the Gold Coast Hospital and Health Service in Australia, may still be underway; contact information is available here.
In an observational study (NCT03886753), researchers at Children’s Hospital of Philadelphia are evaluating the effects of four formulations of cannabis-based products — the medical marijuana products Dream, Soothe, Shine, and Ease — by Ilera Healthcare used as standard therapy by people with multiple diseases, including ALS. How this therapeutic moves within the body (its pharmacokinetics) and its chemical interaction in the body (pharmacodynamics) will be monitored, and reports of relief of symptoms collected. The study is enrolling patients, ages 2 and older.
Another large and observational study (NCT03944447) in people with multiple diseases, including ALS, aim to assess the safety and efficacy of cannabis use by up to 10,000 people in the more than 38 states that have legalized medical marijuana. As an observational study, medical cannabis as part of person’s standard therapy — regular use — is being evaluated through patient reporting of perceived relief and findings of side effects.
Called OMNI-Can, the study and its investigators will use an anonymous online questionnaire to assess the potential benefits and side effects of medical cannabis on participants, most of whom are expected to be current users. A separate cannabis-naive group, defined as no use in the past year, will also be enrolled. Participants will first be given the survey at a visit with a physician to establish their baseline (start of the study) characteristics. Subsequent surveys will be given follow-up visits every three months for up to five years.
The study’s primary goal is the perceived benefits of cannabis in treating chronic pain, and the safety of its use via reporting of adverse events. Its impact on patients’ quality of life will be also be recorded, as will preferences such as favored type for use (route of administration, like vaping or eating as a candy) and its formulation (THC/CBD ratio). Contact information is available here.
Cannabis use should be in consultation with a treating physician, who can monitor patients for behaviors that may indicate dependence.
CBD, one of the more than 100 pharmacologically active compounds (cannabinoids) that can be retrieved from the cannabis plant, is thought to hold the greatest therapeutic potential. This is largely because it does not have the psychoactive properties common to other cannabis-related compounds. psychoactive properties
In addition to dependence, side effects attributed to medical marijuana use include lung irritation (smoking or vaping), low or elevated blood pressure, anxiety, dry mouth, changes in appetite, and nausea.
ALS News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.