A healthy, natural alternative to traditional medications is becoming more and more accessible for persons suffering the effects of Parkinson’s disease. Studies show that CBD, a Cannabidiol also referred to as CBD-rich cannabis, may offer much-needed relief for the debilitating symptoms of Parkinson’s. CBD is a natural compound found in cannabis sativa plants, with none of the adverse side effects of prescription medications and without the “high” effect from THC in marijuana. And while traditional medications may become less effective over time, or stop working completely, CBD users are hailing long-lasting benefits. Parkinson’s disease (PD) is a neurological disorder that affects one’s nervous stem, with the average age on onset at 60 years old. Simply stated, brain cells that produce the neurotransmitter, dopamine, which are responsible for transmitting messages to the body in relation to movement, become damaged and die. This results in a variety of movement issues, which may include tremors, lack of facial expression, difficulty balancing, and stiffness of muscles. In addition, PD may develop into Parkinson’s disease dementia (PDD), which impacts one’s cognitive functioning, such as the ability to remember things, make good decisions, and pay attention.

Initially, symptoms of PD may be nearly unnoticeable and may include difficulty standing after sitting, lack of facial emotion, or tremors (a slight shakiness of one’s hands.) As mentioned previously, PD is a progressive disease, and the symptoms become more pronounced over time. In addition to tremors of one’s limbs, hands, head, and jaw and stiffness/inflexibility of arms, legs, neck, and torso, one may experience a slowness of movement called bradykinesia, as well as balance issues. One’s manner of walking changes as PD progresses. In fact, it is a gait so commonly seen that it has its own name: Parkinson’s (or Parkinsonian) gait. This is often characterized by a stooped posture, a short step that is more a shuffling of the feet, as if the individual is dragging them, and reduced arm movement or arms that do not swing when one walking.

Persons with PD may experience other issues, including loss of smell, constipation, trouble swallowing, slurred speech, delusions, visual hallucinations, lack of judgment, difficulty concentrating, and memory loss. Persons with PD may also suffer from depression, anxiety, apathy, irritability, pain, and difficulty sleeping. As mentioned previously, many people with Parkinson’s disease go on to develop Parkinson’s disease dementia.

Persons with PD and PDD often seek treatment in the form of prescription medications to alleviate the symptoms, frequently with adverse side effects including dizziness, drowsiness, blurred vision, nausea, diarrhea, vomiting, dry mouth, loss of appetite, heartburn, and more.

Before getting into the various uses of CBD Oil, it is important to explain the difference between FDA approved indications (or uses) and unapproved indications. FDA approved indications are medical uses that are accepted by the FDA. For this to happen, there are multiple phases of testing that drugs must complete before being approved. First, drugs go through pre-clinical trials in animals or cell cultures to determine if it may work in humans. Next, they go through Phase 1 which is done in a small group of healthy people to determine safety and dosages. Then, it goes through Phase 2 testing in a larger group of people with the disease they want to treat to test for efficacy and possible side effects. This is followed by Phase 3 testing in an even larger group of people with the disease to test for efficacy again and monitor any side effects. Phase 3 testing usually lasts longer than the other phases to help gather more long-term data. When it passes all these phases to prove safety and efficacy, the drug gets approved by the FDA and goes on to Phase 4 testing. This is monitoring that is done by health care professionals. If patients have side effects or reactions to drugs, health care professionals can report these to programs like MedWatch. If drugs get too many complaints, they can be taken off the market. As for unapproved indications, these are reasons why people take drugs even if it is not the official use for them.

CBD, or cannabidiol, is one of the cannabinoids (or chemical compounds) found in Cannabis sativa plants. Therefore, it can be derived from either hemp or marijuana plants. It does not have the psychoactive properties that THC exhibits.

It is also safe and non-addictive. There are few side effects, if any. The most reported side effects are tiredness, diarrhea, and nausea. Many people take CBD for its numerous proposed health benefits. It is available in many different forms, such as tinctures, gel capsules, gummies, and topical products such as creams or salves.

Most of the research is in animal models and examines the effects of CBD in the hippocampus region of the brain. This area of the brain is thought to deal with emotions, learning, memory, and coordination. Therefore, changes in the hippocampus could affect any one of these processes. Most of the studies found that CBD did impact neuroplasticity. Most of them showed that CBD increased the creation of nerve cells or the remodeling of nerve cells in the hippocampus of the brain. Many of them concluded that this was one of the reasons for how CBD can cause anxiety relief or antidepressant-like effects. Others mentioned this was how CBD could impact coordination and movement or even how it helps with memory loss.

There also were a couple of studies in humans that showed positive neuroplasticity changes as well, however this was in small groups. There is not a lot of human data out there that supports CBD and neuroplasticity. As it turns out, there might be a reason for this.

In 1998, an article was published in the Proceedings of the National Academy of Sciences that discussed how the cannabinoids CBD and THC are antioxidants and neuroprotective. The authors suggested that because of their antioxidant properties, they would have therapeutic uses as neuroprotective agents, making them ideal candidates for drug targets for certain diseases.

Due to this revolutionary report, the U.S. government issued a patent on “Cannabinoids as antioxidants and neuroprotectants”. The patent states:

“The cannabinoids are found to have particular application as neuroprotectants, for example in limiting neurological damage following ischemic insults, such as stroke and trauma, or in the treatment of neurodegenerative diseases, such as Alzheimer’s disease, Parkinson’s disease and HIV dementia. Non-psychoactive cannabinoids, such as cannabidiol, are particularly advantageous to use because they avoid toxicity that is encountered with psychoactive cannabinoids at high doses useful in the method of the present invention.”

It is important to keep in mind that, as with most topics surrounding CBD, most of this research is pre-clinical or anecdotal evidence due to it being performed in animal models or small groups of humans. This means that it is not definitive by any means but is hypothesis-generating. It allows for more specific research to be conducted and eventually clinical trials to be completed.

Therefore, currently professional judgement can be used when deciding if the data is “good” or not, and that varies from person to person based on their diverse experiences.

Recent studies demonstrating the therapeutic effects of CBD for persons with PD abound. Because PD affects the brain’s ability to produce dopamine, researchers Alyssa S. Laun and Zhao-Hui Song from the University of Louisville, Kentucky, made an important discovery when they found that CBD acts as an “inverse agonist” on CPR6 receptors found predominantly in the basal ganglia region of the brain, which connects to the cerebral cortex and brainstem, driving functions in our bodies including movement, learning, and emotion. This means CBD potentially responds within the receptors to provide therapeutic effects against the symptoms of PD. Any increase in dopamine levels would counteract the steady decrease of dopaminergic neurons experienced by those afflicted with PD.

Cannabinoid receptors run throughout our body as part of the endocannabinoid system regulating physiological operations including hunger, pain sensitivity, temperament, and memory. These natural receptors are affected in patients with PD. As analyses continue, CDB is demonstrating relief for tremors, psychosis, and problems sleeping. CBD may also reduce depression, anxiety, and relieve pain. A study at the Colorado School of Medicine has demonstrated relief of issues including tremors and difficulty sleeping. CBD studies are also showing it as effective in treating the psychosis that comes with PDD (Parkinson’s disease dementia). So far, patients are tolerant of low doses of CBD oil and report positive effects.

Numerous studies echo CBD’s benefits. Researchers in Brazil have noted “Our findings point to a possible effect of CBD in improving quality of life measure in PD patients with no psychiatric comorbidities.” (Study) 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 PD.” (Study) And a different Colorado study concluded: “Cannabis was rarely used in our population but users reported high efficacy, mainly for nonmotor symptoms.”

These more recent revelations come on the back of federally funded preclinical studies published in 1998 documenting strong antioxidant and neuroprotective properties in CDB and THC, particularly in treating “neurodegenerative diseases, such as Alzheimer’s disease, Parkinson’s disease, and HIV dementia.” These promising findings led to a U.S. government patent on cannabinoids as antioxidants and neuroprotectants.

In June of 2018, the first FDA-approved CBD medication, Epidiolex, was approved to treat two rare types of epilepsy. While there are currently no CBD medications approved by the FDA specifically for Parkinson’s disease, one should not be discouraged, as research is ongoing. In 2017, the Salk University in California found that THC and other compounds found in cannabis, such as CBD, reduce the amount of amyloid beta, a plaque protein that is toxic in the brains of persons with Alzheimer’s disease. This is great news for persons with dementia because the removal of amyloid beta allows brain cells to survive. Amyloid beta not only causes neuron death, but also causes inflammation and contributes to memory loss and other cognitive issues. This type of plaque is also found in the brains of some persons with Parkinson’s disease dementia. In addition, some animal studies suggest that CBD might protect one against developing neurological disorders, such as Parkinson’s disease, in the first place.

Forms of CBD Administration

CBD can come in a variety of forms. This includes tinctures, gel capsules, topical products such as creams, gummies, beauty products, and even in drinks such as CBD water or CBD seltzer. The actual amount of CBD varies from product to product and brand to brand. In general, the forms with the highest concentrations include tinctures because they have a higher bioavailability than the other products. The most popular CBD oil product is tinctures. Most tinctures are usually a great way to take different complementary and alternative medications (aka CAM) because of their ability to easily dissolve a good majority of active chemicals into an oil carrier. These carrier oils can range from coconut oil, olive oil, grape seed oil, and even hemp seed oil. The carrier oils that companies use vary depending on which oil they find to be the most appropriate choice. However, the variance between the carrier oils usually do not affect how to use CBD oil. If companies are looking to try CBD isolates or finding a cost-effective way to create tinctures, then they may give olive oil a try as a carrier oil. Olive oil has a mild taste, a low cost, and has a high potential for absorption. However, coconut oil is also a good option. Generally, people like the taste of coconut oil and it may help balance out the natural taste of the CBD oil. It also contains medium chain triglycerides (aka MCT), which are thought to help with absorption and offer additional health benefits on their own. Another option is hemp seed oil, it also has its own health benefits as well. It depends on how the company labels their products, but hemp seed oil generally only comes from the seed of the hemp plant whereas hemp oil comes from the whole plant and contains the additional cannabinoids that hemp seed oil lacks. Depending on which one they use, you may get the entourage effect benefit of the additional cannabinoids. This may be a more expensive option for carrier oil of CBD oil tinctures, but it allows them to get a full spectrum product – which many consumers are looking for. Regardless of the carrier that is chosen, many tinctures will contain oils because they are easier to dissolve CBD than water-based carriers such as vinegar or ethanol.

Depending on the experience of the CBD customer, the variability of CBD oil products can either be appealing or just plain confusing. Especially with the wide availability of oral options such as gel capsules and edibles to topical products such as creams, it is easy to feel overcome. When deciding how to use CBD oil and which form to choose and how much of it gets absorbed can be a big factor in the decision.

Tinctures

Tinctures have a big difference in terms of absorption when comparing them to oral and topical CBD forms. The best advice for how to use CBD oil tinctures is to take it sublingually (aka under the tongue). This means that you place the drops under your tongue, let the CBD absorb (usually around 30 seconds), and then swallow. A lot of medications and supplements use this dosage form for absorption whenever their active ingredient is able to absorb through the tissue under the tongue. CBD is already naturally able to be absorbed there and can reach the blood vessels under the tongue.

Oral Products

Generally, the oral options have a lower absorption because CBD (and the other cannabinoids) have a low bioavailability when absorbing through the digestive tract. Bioavailability is the amount of drug or chemical that gets into the blood to act on the body. Even then, when CBD is absorbed, the liver quickly breaks down a good majority of the CBD.

Topical Products

On the other hand, topical products are also an option for those looking to use CBD oil to help with pain relief on a certain part of their body – such as the joints. However, these products have an even lower bioavailability than the oral products. The products that are oil-based, such as ointments and salves usually penetrate the outer layers of the skin, whereas the water-based products such as creams and lotions, may penetrate into the deeper layers of the skin where the blood vessels are located. This means that in order to get larger amounts of CBD absorbed into the body through topical products, you would have to place a larger amount of CBD cream over a large area of the body. Additionally, absorbing CBD through this topical method would allow the CBD to not get broken down through the liver, which would be an advantage when comparing them to oral CBD products.

Final Thoughts

It is always best practice to talk with a health-care professional before using CBD to help with any health conditions you may have. They can help you evaluate the research and decide if it is the best option for you. They can also help you determine if any drug interactions exist with any current medications you might be taking and give suggestions for how to avoid them.