Migraines and Headaches – Does CBD help?

When talking about the therapeutic effects of CBD, it’s often the cannabinoid’s analgesic effect that is mentioned. As headaches are the most common source of pain in the general population, it would make sense then that CBD for migraines is an obvious therapeutic target.

Migraines and headaches are a bit of a medical mystery but are usually credited to dysfunctional brainstem centres. So far, the only treatment for headaches and migraines have been painkillers such as paracetamol or ibuprofen, as well as Triptans that constrict the blood vessels and block pain pathways in the brain. But perhaps there is a better way to treat headaches and migraines.

Cannabinoids – a long history of treating headaches

CBD oil for headaches is not a recent therapy as you’d suppose. The hemp plant is mentioned as a treatment for headaches in ancient texts dating back thousands of years, though its use only became commonplace in the west during the 19th century when it was prescribed by many doctors as a tincture.

These days, aside from the multitude of anecdotal reports relating to CBD and hemp oil for headaches, the conclusive clinical evidence is lacking. But what scientists do know is that when it comes to CBD oil for headache disorders such as migraines, the endocannabinoid system is inherently linked.

Migraines and the Endocannabinoid System

One theory posited about a possible contributing cause of migraines is a dysregulation in the endocannabinoid system (ECS) – the body’s complex network of receptors that act to modulate pain, the immune system, mood, sleep, appetite and memory.

Scientists have observed several ECS mechanisms that may have an implication in migraine attacks. Anandamide (AEA) one of the prime endocannabinoids in the body, is both analgesic and has been found to potentiate the serotonin 5-HT1A receptors. Studies also suggest that endocannabinoids inhibit the trigeminovascular system.  

But perhaps the clearest indication of endocannabinoid dysfunction contributing to migraines is a study carried out in 2007 at the University of Perugia and published in the Journal of Neuropsychopharmacology. Researchers measured endocannabinoid levels in the cerebrospinal fluid of patients with chronic migraines finding significantly lower amounts Anandamide, concluding that this “may reflect an impairment of the endocannabinoid system in these patients, which may contribute to chronic head pain.”

Are migraines a sign of Clinical Endocannabinoid Deficiency?

This link between lower levels of endocannabinoids in migraine patients has contributed to the formulation of what has been termed Clinical Endocannabinoid Deficiency, a theory developed by Neurologist and Cannabinoid Researcher Dr Ethan Russo.

Based on the idea that many brain disorders are associated with a lack of certain neurotransmitters such as acetylcholine, Russo has suggested that “a comparable deficiency in endocannabinoid levels might manifest similarly in certain disorders that display predictable clinical features as sequelae of this deficiency.”

Russo says that this deficiency can be addressed by introducing plant cannabinoids, which act much like those found in the body by stimulating the endocannabinoid receptors. While CB1 agonists such as Marinol and Nabilone have been tested for migraines.

So how can CBD for migraines be of any help?

CBD oil for migraines

Russo in particular singles out CBD (Cannabidiol) as bringing balance to the endocannabinoid system. In his interview with Martin Lee from Project CBD he says, “cannabidiol is an endocannabinoid modulator, in other words, when given chronically it actually increases the gain of the system…. So, if there’s too much activity in a system, homeostasis requires that it be brought back down. If there’s too little, it’s got to come up. And that’s what cannabidiol can do as a promoter of endocannabinoid tone.”

Scientists are still unsure exactly how CBD interacts with the endocannabinoid system, it doesn’t bind directly to any of the endocannabinoid receptors. Instead, it activates many other non-endocannabinoid receptors, some of which are implicated in the development and treatment of migraines, such as the 5-HT1A serotonin and TRPV-1 receptors, the latter mediating pain perception.

One other possible explanation is CBD’s role as a fatty acid amide hydrolase (FAAH) inhibitor.

This enzyme breaks down anandamide in the body, so by inhibiting its production scientists theorize that it could lead to higher levels of the pain-relieving endocannabinoid; something that would potentially be of benefit to migraine sufferers.

Certainly, some migraine patients are finding that when using CBD for headaches or migraines it has helped reduce incidences of attacks.

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