Does cannabis offer anti-inflammatory properties?

We all know the class of diseases that end in 'itis' right? Well, these conditions (such as dermatitis, tonsillitis, cystitis, arthritis, bronchitis, appendicitis, etc.) are certain to cause an inflammatory response from the body in the fight to overcome the issue. Contact with pathogens will also cause an inflammatory reaction, as well as external injury and exposure to certain chemicals and radiation.

And while inflammation hits for a reason, it can sometimes lead to more severe issues down the line. Autoimmune diseases, and chronic inflammatory issues, such as psoriasis, rheumatoid arthritis, and Crohn's disease are caused by the body's own immune system going into overdrive and attacking healthy tissues, resulting in heavy internal inflammation.

So where does cannabis come into the equation?

Long heralded for its ability to potentially help the body reduce a range of inflammation issues, cannabis has played a somewhat surprising role throughout world history as a medicinal relief option for inflammation – but it is only recently that the plant has been able to be legally and thoroughly studied.

Before we dive into the recent science, let's take a step back and have a quick look at the history of cannabis…

Understanding cannabis and cannabinoids

The medicinal value of cannabis has been anecdotally quoted for thousands of years. The first piece of solid historical evidence that is available is Emperor Shen Nung's pharmacopoeia (one of the first Chinese medical texts) from 2800 BC, where the plant was lauded for its possible ability to help the body heal from a range of issues, inflammation included.

From there, we find it pops up in texts from ancient Indian Hindus, where the legends tell of Shiva being bestowed with the title "The Lord Of The Bhang” (referring to his love of cannabis in food). The writing credits the setting in of a fever as ‘the hot breath of the gods”, who had been displeased by the feverish individual's behaviour. Indulging in cannabis eased the god's wrath, who then softened the fever in return. Fast-forward to a few thousand years (129-200 AD), where Roman physician and surgeon Claudius Galen described administering dried cannabis flowers for not only potential therapeutic applications but also recreational endeavours.

And then we get to more modern times. In 1841, Irish-born Dr William Brooke O’Shaughnessy travelled throughout India where he wrote of seeing cannabis being administered in many curative situations, including the reduction of convulsions in a child.

It was only in the last 130 years that the first cannabinoids were isolated, with CBN being the first in 1898 and CBD following in early 1940. It was around this time (1937) that the prohibition on cannabis came into effect in the USA, with many countries following suit in quick succession, effectively banning almost all in-depth studies of the plant. 

Thankfully, these Draconian laws have started to be repealed in the last two decades, opening the door for researchers to once again delve into the medicinal properties of cannabis, leading us to present-day breakthroughs and its role in reducing and controlling the inflammatory response.

Before we go any further, we should point out that the research into weed and its medicinal qualities is still in its infancy. However, what we are seeing is encouraging, and further research is likely to provide us with a greater insight into the potential of cannabis for treating inflammation.

How cannabinoids reduce inflammation and the role of the endocannabinoid system (ECS)

While more than 110 separate cannabinoids have been isolated at the time of writing, we are just going to look at the primary two, THC or delta-9-tetrahydrocannabinol, and CBD or cannabidiol – and how they interact with the endocannabinoid system (ECS).

The Endocannabinoid System (ECS)

First identified in the early 1990s while researchers were looking into the effects of THC on the body, the endocannabinoid system (ECS) is made up of a vast interconnected network of receptors and signalling chemicals within the human body. It is made up of three main components -

• Cannabinoid receptors – CB1 which mostly interacts with the central nervous system, and CB2 which are more commonly found in the peripheral nervous system (immune cells in particular)
• Endocannabinoid signalling molecules
• Enzymes

The receptors are responsible for many roles. They can be thought of as the traffic lights in the ECS system, and are directly responsible for determining the activity levels of the majority of our neurotransmitters. It is through this function that the ECS is able to modulate not only pain and inflammation within the body, but also temperature, hunger, memory, mood, and even fertility.

Our bodies produce what are known as endocannabinoids, or endogenous cannabinoids, which work in similar ways to the (phyto)cannabinoids contained in cannabis. They interact with the receptors, telling them to start or stop certain processes. These endocannabinoids are vital in keeping the body in homeostasis.

The enzymes then break down the endocannabinoids once they have fulfilled their role.

Essentially, phytocannabinoids (THC & CBD) bind to the cannabinoid receptors and hijack the system, which allows for the modulation of the bodily process.

How Does THC Affect The ECS?

A study from 2013 set out to see if THC could be administered to control the symptoms of Crohn's disease in patients that had not responded to traditional steroid therapy. Each participant inhaled 115 mg of THC per day during an eight-week period, with ten of the eleven participants in the non-control group reporting significant clinical, steroid-free benefits – five of whom achieved complete remission. Although this study only involved a small sample size, the results point to the possibility that THC could have a huge impact on the reduction of Crohn’s related inflammation.

There have also been several studies in the recent past that show that THC may play a role in upregulating T-regulatory cells (Tregs) and reducing cytokine and chemokine production, which leads to the suppression of inflammatory responses.

It is important to remember that THC is a psychoactive cannabinoid. It has the potential to cause psychological effects such as paranoia and anxiety when taken in large doses, although these side effects do not impact the majority of medical cannabis patients.

How Does CBD Affect The ECS?

While the need for more in-depth study on CBD and inflammation is needed before we make any sweeping statements regarding its efficacy, the currently available science certainly points in the way of it being a potentially viable anti-inflammatory option.

In one study from 2020 titled 'Cannabidiol (CBD): a killer for inflammatory rheumatoid arthritis synovial fibroblasts', researchers were able to show that CBD treatment could hold the potential to drastically increase intracellular calcium levels while also possibly reducing the production of rheumatoid arthritis synovial fibroblasts (RASF) in rodents with rheumatoid arthritis. This combination of effects decreased the inflammation in the affected joints, suggesting that CBD possibly targets activated, pro-inflammatory RASF.

CBD binds weakly to CB2 receptors, which are believed to potentially reduce inflammation in the body as well as modulate pain and reduce the severity of seizures. 

CBD has also been shown to reduce the enzymatic breakdown of our endocannabinoids, which is thought to lead to longer interactions with both the CB1 and CB2 receptors. This may increase the strength and efficiency that our own cannabinoids have when interacting with the ECS receptors.

There is also evidence to propose that CBD may help in reducing anxiety, stress, and other related mental health issues.

Unlike THC, CBD is non-intoxicating and therefore can be administered in larger doses without the risk of any negative reactions. When mixed at a 1:1 ratio with THC, CBD seems to reduce any chance of the negative side effect of THC, while still retaining the therapeutic properties of both cannabinoids.

Types of Cannabis Products for Inflammation

In this brave new world of cannabis legality, the range of treatment options available to patients suffering from inflammation-related issues and looking for a natural and safe alternative to pharmaceuticals is ever-growing. No longer is cannabis administration restricted to simply inhalation (although this is a viable treatment option); nowadays, a wealth of alternatives exists, which can be tailored to the needs and preferences of every patient.

For people new to the world of medicinal cannabis, the vast array of options can be overwhelming and the terminology confusing. Let's quickly breeze over the most important terms to be familiar with.

Term	Explanation
Isolate	Isolates are pure extracts containing just the cannabinoid listed
Broad-spectrum	Broad-spectrum products contain the target cannabinoid, along with all the other compounds and chemicals such as terpenes and non-psychoactive cannabinoids contained in the source plant, except THC
Full-spectrum	Full-spectrum products contain all the naturally occurring compounds found in the cannabis plant, including THC. The THC level is capped at 0.3% which ensures no impairment when administered
Terpenes	Terpenes are the aromatic compounds found within cannabis (and any other plants) that provide the distinct flavour and aroma associated with the plant, and the different strains. Recent research suggests that terpenes play a role in modifying the effects of cannabis, and can therefore be applied to customize a treatment plan.

Now, before we dive into the product options that are available, we need to stress that not all cannabis products are created equally. If you are considering taking cannabis as part of your treatment regimen, it is essential that you do your due diligence and research the product thoroughly before making a purchase.

Flower

The buds of the female cannabis plant are where the highest concentrations of cannabinoids are found, and in the past decade, we have seen a huge increase in the levels of CBD (and THC, for that matter) available. From pure CBD flowers to balanced options with even percentages of both THD and CBD or pretty much anything in between – the availability of cannabis flowers with varying cannabinoid concentrations is almost never-ending.

Tinctures

Cannabis tinctures are an increasingly popular way of dosing and administering cannabis for medicinal purposes. They allow for precise measurements and can be consumed discreetly, and with ease. Tinctures are made by soaking cannabis in high-proof alcohol to extract the cannabinoids and terpenes, and come in a range of cannabinoid options. Tinctures are taken sublingually (under the tongue), and so they bypass the digestive system by soaking directly into the bloodstream. This allows for a much faster onset of effects when compared to edibles or ingestibles. 

Cannabis Oils

CBD oil was among the first medicinal cannabis treatment options available, and remains among the most popular. Cannabis oils are typically made from raw cannabis material and then processed with a carrier oil, most often medium-chain triglyceride (MCT) coconut oil. The cannabinoid content of cannabis oils can vary greatly, and it's important to check the label for cannabinoid percentages before purchase.

Topicals

Cannabis-infused topicals are able to be applied to the inflammation-affected area, and there is anecdotal evidence to suggest that they can help with localized pain and inflammation. Cannabis topicals come in a variety of forms, such as balms, lotions, ointments, sprays, and massage oils.

Edibles

Cannabis edibles are extremely popular and come in such a ridiculously wide variety of forms, it’s almost hard to keep up. These may be a good option for people who don't want to inhale smoke or vapour, but make sure to check the THC dosage before diving in. 

Conclusion

The current research points to CBD and THC both being more than worthy candidates for improving your body's response to inflammation-related issues, but we do stress that more work needs to be done before definitive conclusions can be made.

As always, you should seek professional advice and consult with your doctor before making any changes or additions to your current treatment plan, and make sure to only purchase from reputable sources for your CBD and THC products.

At Releaf, we believe that access to medical cannabis is important. That's why we offer tailored monthly packages based on your cannabis prescription, specialist consultations for medical cannabis, and a unique medical cannabis card for protection.