Evidence based

CBD and Inflammation: Current Research & Understanding

Inflammation is at the root of many medical conditions. CBD and other cannabinoids offer powerful benefits for the underlying causes of inflammation by targeting the inflammatory messengers directly. Here’s how it works.

Article By
Justin Cooke , posted 2 months ago

Cannabidiol (CBD) — a non-psychoactive and highly medicinal cannabinoid found in the cannabis plant — is used to treat a wide range of health conditions.

There are thousands of studies coming out every year describing the use of CBD for various health conditions. It seems like we’re adding new medical conditions to the list of uses for CBD each year.

How can a single compound be so useful for so many different medical issues?

CBD uses a wide range of mechanisms to treat ailments. By far, the most impressive benefit it offers is its anti-inflammatory effects.

The anti-inflammatory effects of CBD are extremely powerful — involving dozens of separate inflammatory processes simultaneously.

  • Table of Contents

Summary: Using CBD for Inflammation

There are dozens of chemical messengers and enzymes working together to produce inflammation in the body.

Blocking one pathway may prove useful for certain types of inflammation, but it’s not the most effective method treatment.

CBD is an excellent anti-inflammatory because it works through multiple pathways. By doing this, CBD halts the inflammatory process at several different points in the process.

Compared with common anti-inflammatory drugs such as Aspirin — which inhibits only one enzyme involved in the inflammatory process — we find CBD more effective for combating inflammation.

Inflammation 101

The human body is made up of trillions of individual cells, all working together. Therefore, the cells need to be able to communicate with each other.

We use our nervous system to send messages in the form of electrical impulses to and from our brain, and we use chemical messengers to send signals around the body via the blood.

The process of inflammation relies heavily on these chemical messengers to signal the immune system and regulate blood flow to damaged areas of the body.

There are dozens of inflammatory messengers, each sending a particular type of message — some call immune cells to an area to help clean out the infection, others tell the cardiovascular system to start pooling blood in a damaged area.

Allergic reactions, for example, rely on the activation of the mast cells — which wait patiently until an allergen floats nearby. When exposed to an allergen, the cell releases a potent dose of inflammatory markers (such as histamine) that cause the cascade of inflammatory reactions that we know as an allergic reaction (for example, hives, runny nose, puffy eyes, or scratchy throat).

Here’s a map of the inflammatory process. Complicated, isn’t it?

(Source: Cavaillon et al., 2002)

You may be thinking, “I have no idea what all of this means.”

Well, you’re not alone.

Researchers are still uncovering new information about inflammation, and there are some forms of inflammation that we don’t yet understand (such as interstitial cystitis and irritable bowel syndrome, for example).

The best treatment for inflammation considers the type of inflammation.

We need to consider whether the inflammation is acute (short-lived) or chronic (long-lived). We also need to take into account whether the inflammation is caused by physical damage or an allergic or autoimmune reaction. These are essential steps to consider because each of these forms of inflammation involves different chemical messengers.

Stopping inflammation means blocking these chemical messengers.

Types of Inflammation

Inflammation comes in all different forms depending on the cause — autoimmunity, allergic reactions, traumatic injuries, and infection.

The most important distinction to make is whether the inflammation is acute (short-term) or chronic (long-term).

1. Acute Inflammation

Acute inflammation refers to short-term inflammation — typically less than six months in duration. When we get cuts in the skin or stub our toe, we experience acute inflammation. It appears very fast and leaves once the injury has healed.

Acute inflammation can lead to chronic inflammation if the irritant persists (such as eating inflammatory foods on a regular basis).

Common causes of acute inflammation include:

  • Allergic reactions
  • Asthma attacks
  • Traumatic injuries
  • Eczema (can also become chronic)
  • Early stages of arthritis
  • Early stages of depression

The most critical messengers involved with acute inflammation are histamine, nitric oxide, and inflammatory enzymes such as COX or 5-LOX. Aspirin, for example, works by blocking the COX enzyme.

CBD inhibits the COX enzymes (both COX-1 and COX-2) responsible for producing inflammatory messengers such as leukotrienes and prostaglandins — known as key mediators in both acute and chronic inflammation [10].

2. Chronic Inflammation

Inflammation is categorized as chronic when symptoms continue for longer than six months.

Prolonged inflammation can cause severe damage to the systems affected.

In a nutshell, chronic inflammation works like this:

  1. Inflammation damages the tissue.
  2. The tissue releases new inflammatory messengers to fix the damage.
  3. The new inflammation causes further damage to the tissue.
  4. The process repeats.

Chronic inflammation can continue for many years with a wide range of medical conditions, including:

  • Depression
  • Parkinson’s disease
  • Multiple sclerosis
  • Osteoarthritis
  • Rheumatoid arthritis
  • Inflammatory bowel disease
  • Psoriasis
  • Hepatitis

Some of the critical inflammatory messengers involved with chronic inflammation are TNF-a, NF-kB, IL-6, and IFN-y. CBD has been shown to inhibit all of these inflammatory messengers.

Treatment Options for Inflammation

Inflammation is very common — as a result, we’ve developed many different approaches to treating inflammation over the years.

Some common forms of inflammation treatment include:

1. Dietary Changes

  • Eliminate inflammatory-causing foods
  • Identify and eliminate sources of food allergies
  • Increase fiber and antioxidant-rich foods
  • Increase anti-inflammatory foods (such as turmeric or ginger)

2. Anti-inflammatory Medications

  • Corticosteroids
  • NSAIDs (Aspirin, Ibuprofen, and Acetaminophen)
  • TNF inhibitors (Adalimumab, and Etanercept)

3. Herbal Supplements

  • Cannabis extracts (CBD, CBN, and THC)
  • Ginger root (Zingiber officinalis)
  • Frankincense resin (Boswellia serrata)
  • Turmeric root (Curcuma longa)
  • Aloe (Aloe vera)

4. Lifestyle Changes

  • Gentle aerobic exercise
  • Stress reduction techniques
  • Yoga/meditation
  • Sleep hygiene

Guide to Using CBD for Inflammation

CBD is a potent anti-inflammatory — interfering with inflammatory messengers at almost every level of the inflammatory response.

There are a few reasons why CBD can infiltrate and halt inflammation at so many levels:

  1. It stops the breakdown of anandamide — a powerful regulator of inflammation throughout the body.
  2. CBD (and other cannabinoids) are structurally similar to many of our inflammatory messengers (similar to our prostaglandins and leukotrienes).
  3. CBD activates the vanilloid receptors — responsible for regulating a different set of inflammatory messengers (TNF-a, IL-4, IL-12) [2].
  4. It slows the activation of immune cells such as T and B cells [1] — responsible for maintaining autoimmune-related inflammation.
  5. CBD triggers apoptosis (programmed cell death) in the immune cells involved with chronic inflammation [1]

What Inflammatory Messengers Does CBD Interact With?

Unlike most anti-inflammatory compounds that inhibit a select few of the inflammatory messengers driving inflammation, CBD stops almost all of them.

This makes it useful for many different types of inflammation — from allergic reactions and autoimmunity to sprains and strains.

Inflammatory Messengers Affected by CBD

Inflammatory MessengerRole in InflammationInhibiting Cannabinoids
HistamineInvolved in allergic reactions and triggers rapid inflammationTHC [6]
IFN-γHeavily involved in sustaining chronic inflammationCBD [5]
NF-kBOne of the key sustaining factors for psoriasis and involved with cancer growthCBD [7]
TNF-αTriggers systemic (whole-body) inflammationCBD [8]THC [2]
IL-2Involved with inflammation related to cancer and autoimmune diseaseTHC
CBN [4]
IL-4Regulates conversion of T-helper cells to Th2 cells and is heavily involved with autoimmunityCBD [8]THC [2]CBN [4]
IL-6Triggers inflammatory cascade in acute inflammation and is a sustaining factor in chronic inflammation and autoimmunityCBD [8]
IL-8Involved in acute inflammation from infectious diseases (viruses or bacteria)CBD [9]
IL-12Involved in autoimmune conditions, including rheumatoid arthritisCBD [2]
IL-13Both inflammatory and anti-inflammatory depending on the other messengers involvedTHC
CBN [4]CBD [8]
ProstaglandinsOne of the key regulators in starting and maintaining the inflammatory responseCBD [10]
LeukotrienesOne of the key regulators in starting and maintaining the inflammatory responseCBD [10]

As you can see, CBD and many of the other cannabinoids have a lot to offer regarding inflammation — for a variety of different types of inflammation.

Because there are other cannabinoids with their specific anti-inflammatory effects, it’s best to find a full-spectrum extract for treating inflammatory conditions rather than a pure CBD extract.

Best Form of CBD For Inflammation

CBD comes in all different forms — but not all are appropriate for every condition. When it comes to inflammation specifically, there are a few types of CBD that work better than others.

Let’s cover the main types of CBD you’re likely to find and discuss their advantages and disadvantages for reducing inflammation.

1. CBD Oils and Tinctures

CBD oils are the most common form of CBD that people are using today. They allow for simple, effective dosing, and have a long shelf-life. CBD tinctures are very similar to oils, but use alcohol as the carrier instead of oils. This gives them a longer shelf-life and it makes it easier for herbalists and naturopaths to mix other anti-inflammatory herbs into the formula — however, the taste is unpleasant.

To take CBD oils and tinctures, measure out the intended dose using the supplied dropper and place under the tongue for fast onset of effects, or swallow for a slower onset of effects.

2. CBD Capsules

CBD capsules provide another popular method of consuming CBD. They take away a lot of the guesswork when it comes to dosing and make it easy to take your CBD on the go.

3. CBD Suppositories

CBD suppositories are not popular, but they’re an excellent option for addressing inflammation in the digestive tract by delivering the cannabinoids directly to the problematic site.

4. Topical CBD Products

Any inflammation involving the skin can be relieved by taking CBD internally. However, the best treatment for these conditions is usually topical. This allows the cannabinoids to concentrate effects on the inflamed local tissues.

When to Use Topical CBD:

  • Psoriasis
  • Eczema
  • Allergic dermatitis
  • Acne
  • Muscle injuries
  • Tendonitis
  • Skin infections

5. CBD Edibles

Edibles — including gummies, cookies, or cooking oils — also provide useful ways of getting CBD into the body. They taste great without compromising potency. The only downside is that, with the exception of standardized gummies, it can be challenging to gauge the strength of edibles. Eating too many edibles can have other negative long-term side-effects due to the high sugar content.

Therefore, edibles are better for spot treatment rather than a daily source of CBD.

6. CBD E-Liquids and Vape Oils

Vaping CBD is the most efficient of all the dosage forms because bioavailability through the lungs is much higher than it is through the digestive tract.

However, the cost to start vaping can be steep as you’ll need to buy a vaporizer, and the duration of effects tends to be shorter than that of CBD consumed orally.

Vaping is ideal for delivering CBD to the lungs and is, therefore, a good option for lung inflammation. However, it may or may not make conditions such as asthma worse — so always use CBD vape oils with caution.

How Much CBD Should I Take?

When it comes to inflammation, the more CBD, the better. Most of the research on using cannabinoids for inflammation indicates a dose-dependent response. This means that the more you take, the stronger the anti-inflammatory effect it produces.

Therefore, the recommended dose will vary according to the level of inflammation.

For low-grade inflammation — such as early stages of arthritis — a low strength may achieve the results you’re looking for.

To treat severe inflammation — such as inflammatory bowel disease or autoimmune diseases — you may need to opt for a medium or high strength instead.

General Dosage Guidelines for Inflammatory Conditions

Low-Strength CBDMedium-Strength CBDHigh-Strength CBD
• Early stages of arthritis    
• Post-viral infection  
• Low-grade traumatic injury
• Mild allergies    
• Arthritis  
• Mild depression
• Multiple sclerosis    
• Atherosclerosis  
• Hepatitis  
• Severe allergies  
• Moderate depression  
• Parkinson’s disease

Calculating CBD Dosage Strengths By Weight

Unit of MeasureLow StrengthMedium StrengthHigh Strength
Imperial (pounds)1 mg for every 10 lbs3 mg for every 10 lbs6 mg for every 10 lbs
Metric (kilograms)1 mg for every 4.5 kg3 mg for every 4.5 kg6 mg for every 4.5 kg

By consulting these general guidelines, you can determine roughly what dose you can expect to need to get the level of inflammatory support you’re looking for.

It’s important to note that these are merely recommendations, and your dose may vary.

Therefore, these guidelines are designed to provide a rough estimate of the dose you need.

After determining the strength you’re likely to require, use your weight to calculate how much CBD you may need per day (in mg).

Remember, these doses are in pure CBD — use these numbers to determine how much CBD oil, capsules, or edibles you should take to get the right amount of CBD.

Daily Doses of CBD by Weight and Strength (in mg)

Weight (lbs)Low StrengthMedium StrengthHigh Strength

100 lbs

10 mg

30 mg

60 mg

125 lbs

13 mg

38 mg

75 mg

150 lbs

15 mg

45 mg

90 mg

175 lbs

17 mg

52 mg

105 mg

200 lbs

20 mg

60 mg

120 mg

225 lbs

22 mg

67 mg

135 mg

250 lbs

25 mg

75 mg

150 mg

Potential Side-Effects of CBD

Although CBD is proven to be highly safe in terms of toxicity, it’s important to know about the potential side-effects. Everybody is different, and what works in one person doesn’t always work the same way in another.

Here are some of the most common side-effects of CBD:

  • Appetite suppression
  • Diarrhea
  • Drowsiness
  • Dry mouth
  • Lightheadedness
  • Lower heart rate
  • Sedation

Final Verdict: Using CBD for Inflammation

CBD is an excellent anti-inflammatory supplement — and as a result, it is used for many different types of inflammation.

Types of inflammation CBD works for:

  • Autoimmunity
  • Allergic reactions
  • Traumatic soft tissue injuries
  • Muscle strains
  • Inflammatory bowel disease
  • Atherosclerosis
  • Post-surgery inflammation

The key to using CBD effectively for inflammation is to ensure you’re only using high-quality, full-spectrum extracts that have been confirmed to be free from contaminants through third-party testing.

You can use virtually any form of CBD to get anti-inflammatory benefits, but we recommend finding a high-potency oil due to the simplicity of use, cost-effectiveness, and long shelf-life.


References

  1. Nagarkatti, P., Pandey, R., Rieder, S. A., Hegde, V. L., & Nagarkatti, M. (2009). Cannabinoids as novel anti-inflammatory drugs. Future medicinal chemistry, 1(7), 1333-1349.
  2. Tsuji, F., Murai, M., Oki, K., Inoue, H., Sasano, M., Tanaka, H., … & Aono, H. (2010). Effects of SA13353, a transient receptor potential vanilloid 1 agonist, on leukocyte infiltration in lipopolysaccharide-induced acute lung injury and ovalbumin-induced allergic airway inflammation. Journal of pharmacological sciences, 112(4), 487-490.
  3. Derocq, J. M., Jbilo, O., Bouaboula, M., Ségui, M., Clère, C., & Casellas, P. (2000). Genomic and Functional Changes Induced by the Activation of the Peripheral Cannabinoid Receptor CB2 in the Promyelocytic Cells HL-60 POSSIBLE INVOLVEMENT OF THE CB2 RECEPTOR IN CELL DIFFERENTIATION. Journal of Biological Chemistry, 275(21), 15621-15628.
  4. Jan, T. R., Farraj, A. K., Harkema, J. R., & Kaminski, N. E. (2003). Attenuation of the ovalbumin-induced allergic airway response by cannabinoid treatment in A/J mice☆. Toxicology and applied pharmacology, 188(1), 24-35.
  5. Srivastava, M. D., Srivastava, B. I. S., & Brouhard, B. (1998). Δ9 tetrahydrocannabinol and cannabidiol alter cytokine production by human immune cells. Immunopharmacology, 40(3), 179-185.
  6. Dvorak, M., Watkinson, A., McGlone, F., & Rukwied, R. (2003). Histamine induced responses are attenuated by a cannabinoid receptor agonist in human skin. Inflammation research, 52(6), 238-245.
  7. Kozela, E., Pietr, M., Juknat, A., Rimmerman, N., Levy, R., & Vogel, Z. (2010). Cannabinoids Δ9-tetrahydrocannabinol and cannabidiol differentially inhibit the lipopolysaccharide-activated NF-κB and interferon-β/STAT proinflammatory pathways in BV-2 microglial cells. Journal of biological chemistry, 285(3), 1616-1626.
  8. Vuolo, F., Petronilho, F., Sonai, B., Ritter, C., Hallak, J. E., Zuardi, A. W., … & Dal-Pizzol, F. (2015). Evaluation of serum cytokines levels and the role of cannabidiol treatment in animal model of asthma. Mediators of inflammation, 2015.
  9. Kaplan, B. L., Springs, A. E., & Kaminski, N. E. (2008). The profile of immune modulation by cannabidiol (CBD) involves deregulation of nuclear factor of activated T cells (NFAT). Biochemical pharmacology, 76(6), 726-737.
  10. Ruhaak, L. R., Felth, J., Karlsson, P. C., Rafter, J. J., Verpoorte, R., & Bohlin, L. (2011). Evaluation of the cyclooxygenase inhibiting effects of six major cannabinoids isolated from Cannabis sativa. Biological and Pharmaceutical Bulletin, 34(5), 774-778.

Conditions that May Respond to Cannabidiol