CBD: A Natural Remedy that Decreases Parkinson’s Disease Symptoms?

Introduction: CBD as an Alternative to Pharmaceuticals

Natural alternatives to traditional medicine is becoming more and more accessible for people suffering the effects of Parkinson’s disease. Studies show that cannabidiol, also known as CBD, may relieve tremors and other symptoms of Parkinson’s. CBD is a compound found in cannabis plants but is free of the high effect of THC in marijuana. And while traditional medications may become less effective over time, CBD users are finding long-lasting benefits, with many giving up their pharmaceuticals for good.

CBD is also gaining momentum as a treatment for Alzheimer’s disease, epilepsy, anxiety, and chronic pain. Studies are ongoing, but data indicates CBD has more potential positive effects than we knew.

Parkinson’s Symptoms

Parkinson’s disease is a disorder that affects the nervous system. The average age of its onset is typically in patients in their 60s. Simply stated, brain cells that produce the neurotransmitter dopamine, responsible for sending messages to the body about movement are damaged and die. This results in a variety of movement issues including tremors, lack of facial expression, difficulty balancing, and stiff muscles. In addition, patients may develop Parkinson’s disease dementia. The effects impacts their cognitive functioning, such as the ability to remember things, make good decisions and pay attention.

Parkinson’s disease dementia and Alzheimer’s disease differ by Alzheimer’s directly targets a person’s memory and ability to communicate. On the other hand, Parkinson’s disease dementia is often associated with deteriorating problem-solving skills and thinking speed. Another rare form of dementia is Lewy-body dementia, which has symptoms closer to Parkinson’s disease dementia. More on Parkinson’s disease dementia is available here.

Initial symptoms of Parkinson’s disease may be nearly unnoticeable and can include:

– Difficulty standing

– Lack of facial emotion

– Tremors (shakiness of one’s hands)

– Bradykinesia (slow movement)

– Balance issues

Problems walking are commonly seen and have developed their name: Parkinson’s gait. This is often characterized by a stooped posture, short steps that are more like shuffling of the feet (as if the individual is dragging them), and reduced arm movement or arms that do not swing when one is walking.

Patients with Parkinson’s may experience other issues over time that can include:

– Loss of smell

– Constipation

– Trouble swallowing

– Slurred speech

– Delusions

– Visual hallucinations

– Lack of judgment

– Difficulty concentrating

– Memory loss

People with Parkinson’s disease may also suffer additionally from depression, anxiety, apathy, irritability, pain, and difficulty sleeping. This transitions for many patients with Parkinson’s disease as they develop Parkinson’s disease dementia.

People with Parkinson’s disease and Parkinson’s disease dementia often seek treatment via prescription medications to alleviate the symptoms. Frequently this causes dizziness, drowsiness, blurred vision, nausea, diarrhea, vomiting, dry mouth, loss of appetite, heartburn, and more.

Potential Benefits of CBD

Many therapeutic benefits have been found as more research on CBD is done. CBD has anti-inflammatory and antioxidant properties that make it a neuroprotective agent, meaning it can help with specific neurological disorders like Parkinson’s disease. When nerve cells in the brain and body are protected, problems with movement and thinking problems are less pronounced and get worse at a slower rate.

CBD can help alleviate anxiety symptoms tied to tremors. A published study from Brazilian researchers showed that CBD reduced anxiety and tremors that occurred during a public speaking test for people over 60 with Parkinson’s disease. Subjects who took 300 milligrams of CBD before giving a speech (public speaking is a classic anxiety inducer) had fewer symptoms than a control group who were given a placebo.

This has led to researchers studying how Parkinson’s disease affects the brain’s ability to produce dopamine. They made an important discovery linking CBD to increased dopamine levels, which counteract the decrease of dopaminergic nerve cells that happens with Parkinson’s disease.

Cannabinoid receptors run throughout our body as part of the endocannabinoid system regulating hunger, pain sensitivity, temperament, memory, and more. These natural receptors are affected in patients with Parkinson’s disease. As research continues, CDB is showing relief for tremors, psychosis, and problems sleeping. CBD may also reduce depression, anxiety, and pain. Studies have shown relief from tremors, difficulty sleeping and treating psychosis that comes with Parkinson’s disease dementia. Patients who used low doses of CBD oil showed positive effects.

– Researchers in Brazil had previously noted “Our findings point to a possible effect of CBD in improving quality of life measure in Parkinson’s disease patients.”

– Researchers with the Department of Neuroscience and Behavior there concluded “preliminary data suggest that CBD may be effective, safe, and well tolerated for the treatment of the psychosis in Parkinson’s disease.”

– In Colorado, it was concluded that: “Cannabis was rarely used in our population but users reported high efficacy, mainly for nonmotor symptoms.”

– 1998 federally funded preclinical study showed strong antioxidant and neuroprotective properties in CBD and THC. These findings led to a U.S. patent on cannabinoids as antioxidants and neuroprotectants.

THC and CBD products are becoming more mainstream as an increasing number of states legalize cannabis for medicinal and recreational use. For more on legalized CBD, see below. In June 2018, the first FDA-approved CBD medication, Epidiolex, was approved to treat two rare types of epilepsy. Epidiolex has the possibility of treating other diseases including Parkinson’s after a study released in 2020 showed that most participants with Parkinson’s saw improvements in motor function after taking the drug. Nighttime sleep and issues with emotions and behavior improved significantly as well.

CBD and Better Brain Cells
While there are currently no CBD medications approved by the FDA for Parkinson’s disease, it is continued to be studied. In 2017, Salk University in California found that THC and other compounds found in cannabis, like CBD, reduce the amount of amyloid beta. This is a protein that is toxic in the brains of people with Alzheimer’s disease and dementia. CBD helped in the removal of amyloid beta proteins in order to preserve brain cells. These harmful proteins also kill neurons, cause inflammation and contribute to memory loss and other cognitive issues. This type of protein is also found in the brains of patients with Parkinson’s disease dementia.

FDA Approval Under Consideration

Because there is no federal approval of CBD, lawmakers wrote a bill that would force the FDA to do so. Introduced in early 2021, H.R.841 would make hemp and its byproducts legal and labeled as a dietary supplement under the FDA’s protection and jurisdiction.

This potential law is important for two major reasons. First, FDA approval is the key to making it more accessible to patients in all states and care facilities. In addition, this leads to being potentially covered by insurance. Medicare and Medicaid have set the precedence that they normally approve coverage for all FDA-approved medicines.

At this point, it is unknown if this Bill will make a difference. H.R.841 has a long time before it will be signed into law; it is estimated at two years before the FDA is forced to decide on CBD’s legality.

Misperceptions & Myths

CBD Makes You Feel High

The effects of CBD and THC (Tetrahydrocannabinol), both cannabinoids that are extracted from cannabis plants, are often mixed up. Both CBD and THC are known to have healing properties, and some researchers believe a combination of the two is very effective as a means of treatment. However, only THC produces a feeling of being high or stoned. CBD-rich cannabis usage does not have any mind-altering effects. This makes CBD a desirable option for those that do not want to feel high from THC or certain prescription drugs.

CBD is a Regulated Product

Due to a lack of regulation when it comes to CBD products, there is no guarantee that a product labeled as containing a certain amount of CBD mg actually has that amount. A researcher at Penn Medicine in Philadelphia discovered that almost 70% of CBD products sold on the internet are under-labeled or over-labeled when it comes to the concentration of CBD within the product. Just 30% of the products bought contained a concentration of CBD within 10% of what the label indicated. For the best and most consistently produced CBD products, locally sourced medical CBD is recommended. These products are held to a higher level of lab testing for strength and impurities.

CBD has Sedative Properties

While some people may believe that CBD is a sedative, the truth is that it actually produces alertness without negatively impacting one’s sleep. Even if one takes a dose of 600mg of pure CBD, which is a very high dose, it still does not produce a sedating effect. However, one may take a CBD with a terpene (fragrant and flavorful essential oils found in plants) called myrcene, which is produced by several cannabis strains and has sedating properties.

CBD is Legal in All States

CBD is sold in lots of stores and online because it has been legalized in the United States since 2018 because of the Farm Bill. It is important to note that CBD-rich medical cannabis does not have the same protection. Hemp-based CBD (containing less than 0.3% THC) is the legal standard in all states minus South Dakota and Idaho. In these two states, CBD is only legal with zero THC. Regardless of specific local laws, CBD can be purchased legally online and delivered to all states. One can do so here.

Potential Risks of Use

Studies have shown that CBD treatment is usually tolerated well by patients and is regarded as safe. There has also been no evidence of potential abuse and/or addiction. A few side effects have been that are: diarrhea, appetite changes, and tiredness. The FDA also warns that CBD can cause liver injury (as shown in some animal experiments with high doses). The agency also says that long-term side effects remain unknown. It is crucial that one consults with their physician prior to adding CBD to any medication regimen. In addition, monitor side effects after starting.

Forms of CBD Administration

There are a variety of options when it comes to administering CBD. The main difference is that each form takes a different amount of time to work and lasts differently in the body. They are:

– Ingestible CBD, which commonly includes oils (CBD is mixed with what is called a carrier oil, such as hemp seed, coconut, and olive oil) and tinctures (CBD is in an alcohol solution).

– Sublingual consumption, which is a few drops of oil or tincture placed under the tongue for a few minutes. It is often suggested because the oil is absorbed quickly into the bloodstream and is generally effective within a few minutes. One can also digest the oil or tincture directly or add it to food.

– Oil capsules that can be taken like pills.

– CBD edibles, like gummies, can take an hour before they start working. The effects can be felt for 4 hours or longer.

– Oils and tinctures can also be applied topically, meaning they can be applied to the skin. Like digesting CBD, it can take an hour or so for the effects to be felt and will last for a few hours. This method of use is good for people suffering from localized pain.

– One can also opt for CBD vape products (vaporizer pens), CBD inhalers, or smoke high-CBD hemp strains. This method of inhalation allows users to feel the effects of CBD almost immediately and generally lasts a couple of hours.

There is no preferred method of CBD administration for patients with Parkinson’s Disease. Methods should be chosen that are most comfortable for your loved one. If success with CBD is found, users should choose an administration method that can accommodate frequent and ongoing usage.

Legal Status of CBD in the U.S.

The key to understanding the legality of CBD is to know which plant it was sourced from. The difference is between hemp-derived CBD and marijuana-derived CBD. As previously mentioned, CBD is derived from both marijuana plants and hemp plants. Marijuana plants can contain as much as 30% THC, while hemp plants do not contain more than 0.3% THC. The percentage of THC in hemp plants is so low that one can’t get high. In 2018, the U.S. legalized CBD through the Farm Bill. That gave a national legal standard with guidelines dictating that CBD containing less than 0.3% THC and produced from hemp (not marijuana) is legal. Because of differences between state and federal laws, each state has its requirements on legality.

The table below breaks down the different requirements by state (as of Nov. 2022) for CDB’s legality.

How to Obtain CBD

The best place to buy CBD-rich medical cannabis is from state-licensed medical (and in some states, recreational) dispensaries. Alternatively, CBD can be purchased legally online here.

For convenience, many dispensaries also provide delivery services. Unfortunately, dispensaries are not legal in every state. Oftentimes one can find hemp-derived CBD in local health stores. If taken once daily, a continuous supply of CBD would cost approximately $2-$3 per day. As detailed in the following section, insurance will not cover the cost, and the daily cost would be out-of-pocket.

Insurance Coverage of CBD

Unfortunately, private health insurance companies will not cover the cost of CBD products. The only exception of Epidiolex, which is FDA-approved for epilepsy. Some Parkinson’s patients and their caretakers may find that high-CBD strains of medical marijuana aren’t overly expensive and are safer with fewer harmful side effects. This is compared to traditional medications prescribed for Parkinson’s disease.

Medicare’s Policy

People frequently want to know if Medicare covers the cost of CBD products. CBD does not have FDA approval because it is still classified as a Schedule 1 drug. Due to this, Medicare does not cover the cost of any CBD product. In addition, it cannot be used towards a drug plan deductible (like Medicare Part B).

Medicaid Policy

As with Medicare, Medicaid will not cover the cost of CBD products because of a lack of FDA approval.

Veterans Benefits

The VA will not directly cover the cost of products containing CBD. However, there are VA pensions, such as the Basic Pension and Aid & Attendance (A&A) Pension from which veterans or surviving spouses receive monthly monetary benefits. Recipients of these pensions can use the money as they see fit, which means theoretically that one could use it towards purchasing CBD products. Learn more about these pensions here.

Many CBD retailers provide discounts to veterans who might need help covering the costs of their products. It is possible for active duty and military veterans to receive savings of more than 50% from companies that deliver CBD nationwide.