Studies have found moderate interactions between CBD and medications commonly prescribed for treating RA.
Medications that interact with grapefruit juice can potentially interact with CBD, including:
Scott J. Zashin, MD, is board-certified in internal medicine and rheumatology. He was a volunteer clinical professor of internal medicine at the University of Texas Southwestern Medical School Dallas.
Given the lack of strong scientific evidence supporting the use of CBD, it is not recommended as the first choice for pain relief in RA.
CBD products derived from hemp are no longer considered schedule I drugs under the federal Controlled Substances Act, but they still remain in a legal gray zone. There are changes underway on federal and state levels that will ultimately clarify the laws and regulations related to CBD-based products and sales. Despite that, they’re widely available in nearly every state and online. People who want to use CBD should check their own state laws.
Your healthcare provider may direct you to start with 20-40 mg per day and increase slowly each day until you feel the relief you’re looking for.
There are some warnings and adverse drug interactions to be aware of before beginning using CBD for management of RA-associated pain.
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In addition, individuals experience pain and respond to treatment in different ways. As a result, it’s highly unlikely that there is a single CBD-containing product that works for all people with all types of arthritis.
Until recently, little guidance has been available for people with arthritis pain who were interested in CBD treatment. Depending on availability and interest, patients and their doctors had to decide on their own whether CBD was a reasonable option in each specific case. To a large degree that’s still true, but some guidelines have been published. Here’s one set of guidelines for people pursuing treatment with CBD that I find quite reasonable (based on recommendations from the Arthritis Foundation and a recent commentary published in the medical journal Arthritis Care & Research):
There’s a good chance you’ve tried it already: according to a Gallup poll in August of 2019, about 14% of Americans report using CBD products, and the number one reason is pain. The Arthritis Foundation conducted its own poll and found that 29% reported current use of CBD (mostly in liquid or topical form), and nearly 80% of respondents were either using it, had used it in the past, or were considering it. Of those using it, most reported improvement in physical function, sleep, and well-being; of note, a minority reported improvement in pain or stiffness.
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We may not have all the evidence we’d like, but if CBD can safely improve your symptoms, it may be worth considering.
Dialogues in Clinical Neuroscience: “Cannabis, Cannabinoids, and Health.”
The best way to answer this is to ask your doctor. They can tell you about possible side effects and drug interactions, legal considerations, and which form and at which dose may help you the most.
Medical marijuana has similar side effects, that may include:
Where to Get It
The Cannabis sativa plant has more than 100 chemicals that can affect your body and mind. The two that scientists know the most about are THC and CBD.
Nature Reviews Rheumatology: “Cannabinoids for the treatment of rheumatic diseases — where do we stand?”
Chemistry & Biochemistry: “History of Cannabis and Its Preparations in Saga, Science, and Sobriquet.”
News release, The National Academies of Sciences, Engineering, and Medicine: “The Health Effects of Cannabis and Cannabinoids.”