Why cannabis for migraine?
If you’ve ever suffered from a migraine, you know that moment. The moment when you’ve waited too long to treat it and no matter what you do, nothing will work – or, what you try might even make it worse. Instead, you dim the lights, lay down, and hope it dissipates sooner than it did the last time. You may have tried countless remedies but may not have found what effectively works, and as a last resort, perhaps you’re wondering if cannabis might just work for you.
Cannabis, considered a novel therapeutic despite its long history of use for medicinal purposes, is making lots of headway in the health and wellness industry in recent years due to advances in research and subsequent changes in law. The interesting thing about cannabis is that is does help not just migraines, but also many other imbalances in the body.
There may, however, be some trial and error involved when using cannabis in order to get the relief you are looking for, partly due to the plant itself – and its complexity in nature – as well as the complexity of an individual’s body. Therefore, we must consider the bio-individuality, or the uniqueness, of both the plant and the individual using it. To help you understand if cannabis is an effective remedy for you in preventing and treating migraines, the following provides a basic explanation of how it works and how to use it.
Cannabis is known for its two major cannabinoids: delta-9 tetrahydrocannabinol (THC), which has psychotropic effects that allow for the high associated with cannabis, and cannabidiol (CBD), considered to be psychoactive but non-psychotropic. However, the plant itself is much more complex.
Plus, if you are curious about its efficacy in treating migraines, it’s not as simple as selecting CBD over THC to avoid the psychotropic effects. Besides these two big players, there are 144 known phytocannabinoids, over 150 terpenes, plus other components that are potentially beneficial for health including but not limited to flavonoids, phenols, and fatty acids.
Scientists like Dr. Dedi Meiri are working diligently to understand what these components are capable of in isolation as well as when combined. When dealing with either specific cultivars (strains) in flower form or extracted cannabinoids from the plant, such as a tincture of CBD, there is potential for a more targeted treatment to a specific condition. But before we get into the “magic” of the cannabinoids, let’s first understand how cannabis works.
How cannabis works
Our bodies have an endocannabinoid system. This is a self-regulatory system found at the cellular level throughout the body including the central and peripheral nervous system. This system acts like a smart thermostat in the body. When a response is needed, the system upregulates, or increases the availability of receptors and endocannabinoids, and when less is needed, those receptors and endocannabinoids reduce activity and return the body to a state of equilibrium.
The system is comprised of cellular receptors, endocannabinoids (lipid messengers), and enzymes to keep the system in check. Its main function is to keep balance, or homeostasis, in many regulatory functions such as inflammation, immunity, mood, and memory. In simple terms, this system functions through its ability to act in a retrograde messaging fashion to help regulate chemicals such as hormones, cytokines, and neurotransmitters. Retrograde signaling means that there is communication from neurons in a reverse fashion, from postsynaptic to presynaptic. The retrograde signalers are called endocannabinoids, and these are counterparts to the phytocannabinoids found in the cannabis plant, which bind not just to receptors of the endocannabinoid system (CB1 and CB2) but other receptors including TRPV, 5-HT, PPAR, GPR receptors.
Ethan Russo proposed that some inflammatory conditions (or chronic illnesses), including migraines, are actually an indication that there is a clinical endocannabinoid deficiency in the body. Consider the fact that we need to consume essential fatty acids, like fish oil, since the body doesn’t produce them on its own. Endocannabinoids are in fact synthesized from the essential fatty acids omega-3 and omega-6. For those who may be deficient, the consumption of cannabinoids from the cannabis plant can compensate for this deficiency.
A deficiency can also be related to a dysregulation of the system, specifically in the enzymatic activity involved in the metabolism of endocannabinoids. Phytocannabinoids like CBD inhibit the enzymes that degrade endocannabinoids, allowing for further circulation and increasing their presence in the body, of which the most well-known is anandamide (AEA). It is in this production or inhibition of degradation where we may find a reliable means to fighting migraines.
Possible causes of migraines and how cannabis helps
Often migraine sufferers report that headaches begin in response to a trigger, such as bright light, hunger, hormonal shifts like “that time of the month,” certain smells like gasoline, or foods like ones containing MSG. The triggering event causes an imbalance in the brain, which should then trigger the production of endocannabinoids to maintain homeostasis. If one is deficient in endocannabinoids or has a dysregulation of the system, the imbalance continues, leading to the development of a migraine and accompanying inflammation. One way that CBD can help is to mediate the triggers through the regulatory effects of the endocannabinoids.
Let’s take MSG for example. MSG is derived from glutamates, which are excitatory neurotransmitters. Glutamate and GABA have an opposing relationship. While glutamate is stimulating, GABA is calming. Endocannabinoids work at cellular receptor sites to help regulate their transmission. As a result, this activity might make the trigger of something like MSG less reactive to the person who consumed it.
Another way CBD and THC contribute to maintaining homeostasis in the body is to regulate the inflammatory expression of cytokines. This is why consistent use can prevent frequent occurrences of migraines or diminish the severity.
In functional medicine, the philosophy is that treatment is best preceded by the identification of the root cause of symptoms. Despite the challenge of this approach, knowing the root cause could help determine the best course of action to take for treatment. Ultimately, though not well understood, endocannabinoids have the potential to modulate migraine pain through different systems in the body including the trigeminovascular and serotonergic systems as well as various areas of the brain.
Another known trigger for migraines is oxidative stress. This is stress that results from a lack of antioxidants to match the hard work our body is doing at a cellular level. Oxidative stress can present as migraines, memory loss, brain fog, decreased vision, wrinkles, or grey hair. Certain receptors detect oxidative stress in the body, particularly, the TRP receptors, which act as sensors in pain regulation and are often easily recognized for how certain flavorful foods like vanilla and chili powder can affect them.
Interestingly, these receptors are activated by THC and CBD, as well as by two phytocannabinoid not yet mentioned:cannabigerol (CBG) and cannabichromene (CBC).Through this interaction, endocannabinoids are more available to reduce oxidative stress.
Let’s examine two more cannabinoids: CBG and CBC
Another less commonly known phytocannabinoid, cannabigerol (CBG), is considered as the mother of all cannabinoids, as it’s the precursor to the main cannabinoids THC and CBD. What I love about CBG is that it works like CBD by supporting the presence of endocannabinoids in the body and similarly to THC because of the receptors it binds to for pain relief but without the high. THC primarily binds to receptors in the central nervous system including serotonin receptors, which have long been a focal point of research for migraines due their role in vasodilation and vasoconstriction; CBG can do this as well.
As for the treatment of migraines, CBG can be effective in various ways. It has the potential to reduce the severity of neurological pain, specifically radicular pain, where the pain stems from a pinched or damaged nerve. In addition to its pain modulating properties, CBG can decrease blood pressure via vasodilation, which in turn can relieve intraocular pressure, another possible cause of migraines.
CBC, or cannabichromene, is one of the other majorly researched cannabinoids, and like CBD and THC it is derived from the same precursor — CBG (cannabigerol). This is another non-intoxicating cannabinoid and one that binds not only to receptors in the endocannabinoid system but also to TRPV1 and TRPA1. Through this action, CBC impacts pain perception experienced during a migraine. When these receptors are activated by CBC, there is a greater concentration of endocannabinoids present to help bring the body back into balance.
How to use cannabis for migraines
When clients approach me about where to start in treating their migraines, I generally steer them toward CBG. Those new to cannabis often prefer to start with CBD or CBG, known for their anti-inflammatory, analgesic, and anti-nociceptive properties without the mind-altering effects. CBG can generally be tolerated at higher amounts than CBD without side effects such as sleepiness or anxiousness, which could happen for some when taking high amounts of CBD.
As for CBD, I find it can be more effective when combined with THC, that is if the client lives in a state where it is legal to have a medical marijuana card. Due to their complementary actions, one can try a ratio of THC:CBD. When used together, CBD mediates the psychoactivity of THC, making it more tolerable in most cases. Tolerance is a factor when using cannabis to alleviate symptoms. If you are not familiar with the potential effects of cannabis, then you should follow this basic rule of thumb: start low and go slow. Start with CBD and gradually titrate up with THC until you find a ratio that hits your sweet spot, where the dose is both tolerable and provides migraine relief. Keep in mind, with this system, balance is key. Taking too little may not have any effect, whereas taking too much can make things worse.
The best way to find a ratio that fits your needs is to purchase a tincture, an oil or alcohol-based preparation. Some companies offer different cannabinoid oils, such as a CBD oil or a CBG oil though there are generally other cannabinoids present to some amount unless it is an isolate from. When purchasing a full-spectrum oil, you can see what levels of cannabinoids are present by examining a Certificate of Analysis, also referred to as a COA. Other methods include vape oil cartridges and strains of flower that combine a greater array of cannabinoids than mentioned here, both of which would offer acute relief. Alternatively, there are balms or lotions for topical use and transdermal patches for a steady method of administration, where effects can be felt for several hours.
There is often trial and error in finding what works best based on the root of your migraines as well as your bioindividuality. Everyone’s experience can vary. Long story short: cannabis can be effective in treating migraines, and if you are willing to give it a try, be patient and experiment to find the treatment that’s right for you.
Alicia Salazar is a Functional Nutrition and Cannabinoid Coach. Alicia has completed training through the Functional Nutrition Alliance, Holistic Cannabis Academy, and Institute for Integrative Nutrition. With her practice, Stay Balanced, she works with people seeking dietary and lifestyle support through a compassionate approach. She supports clients in implementing changes for a sustainable, healthy way of living with an emphasis on ways to balance the endocannabinoid system. What Alicia enjoys most is educating her local community on the uses, benefits, and precautions of cannabis for well-being and holistic health. Follow her @staybalancedwithalicia on Instagram and Facebook as well as @StayBalanced3_6 on Twitter.
