Arthritis Rheumatoid Arthritis CBD For Rheumatoid Arthritis By Kimberly Charleson Kimberly Charleson Kimberly is a health and wellness writer with 8 years of experience in healthcare and a special passion for mental health awareness. Learn about our editorial process Updated on April 05, 2021 Medically reviewed by Scott Zashin, MD Medically reviewed by Scott Zashin, MD LinkedIn Scott J. Zashin, MD, specializes in the treatment of rheumatologic and musculoskeletal conditions using both traditional and alternative therapies. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Benefits for RA Benefits for Arthritis Possible Side Effects Warnings Preparation and Dosage What to Look For As cannabidiol (CBD) has grown in popularity over the years, major organizations like the Arthritis Foundation have released guidelines pertaining to its use in the treatment of rheumatoid arthritis (RA). CBD is a non-psychoactive component of cannabis. The CBD in most products is extracted from hemp, a variety of cannabis that only has traces (up to 0.3%) of THC, the active compound that gets people high. Studies have shown CBD can help reduce chronic pain by impacting endocannabinoid receptor activity, which may also reduce inflammation. CBD comes in different forms, including oil, vape, edible, and topical. Oils, vapes, and edibles are taken orally, while topical CBD lotions can be applied to the skin. CBD dosage varies depending on the form, the indication, and other treatments being used. What Is Rheumatoid Arthritis? RA is an autoimmune inflammatory disease, in which the immune system attacks healthy cells in the body and causes inflammation. RA commonly affects joints in the hands, wrists, and knees, causing the joint lining to become inflamed and damaging the tissue. This causes chronic joint pain and leads to deformity. RA can also affect other tissues throughout the body, such as the lungs, heart, and eyes. Causes of Rheumatoid Arthritis Pain and Treatment Options Vera Livchak / Getty Images Health Benefits of CBD for RA Animal studies have suggested that CBD has pain-relieving and anti-inflammatory properties, but these effects have not been validated with quality studies in humans. Anecdotally, some people who have tried CBD for treatment of arthritis symptoms report noticeable pain relief, improved sleep improvement, and reduced anxiety. The trials that have been conducted in humans have not yielded strong evidence for the use of CBD in managing arthritic pain. A randomized trial of topical CBD for treatment of knee osteoarthritis lasted only 12 weeks, and results were mixed.One of the largest reviews examining the health effects of cannabis and CBD concluded that there is substantial evidence that cannabis is an effective treatment for chronic pain in adults. There was, however, no specific conclusion regarding CBD, as definitive studies were not available.More recently, a new study showed that CBD can potentially help alleviate RA pain and inflammation by acting on immune cells that are attacking healthy cells in the body. It's important to note that this study was also not conducted with human subjects. Research in this area is ongoing. If you are interested in trying CBD for RA pain management, be sure to talk to your healthcare provider first before using any CBD products. Rising Popularity of CBD for RA Based on a 2019 national survey of 2,600 people conducted by the Arthritis Foundation, 79% of respondents said they were using CBD, have used it in the past, or were considering using it to help with their arthritis pain. What Is CBD Oil? Health Benefits Related to Arthritis Given the lack of strong scientific evidence supporting the use of CBD, it is not recommended as the first choice for pain relief in RA. If you have RA, you should not stop taking your prescribed medications that may be protecting your joints from future damage. You should discuss any changes you want to make to your medication regimen with your healthcare provider. Additional Health Benefits The strongest scientific evidence for effectiveness of CBD as a medical treatment is for seizure prevention in Dravet syndrome and Lennox-Gastaut syndrome, which are severe childhood epilepsy disorders that typically don’t respond to antiseizure medications. Several years ago, the FDA approved the first cannabis-derived medicine for these conditions, Epidiolex, which contains CBD. Other potential health benefits of CBD include: Reduce anxiety, insomnia, and depression Relieve cancer or cancer treatment symptoms Clear acne Slow the progress of neurologic disease like Alzheimer's disease Can CBD Oil Treat a Migraine? Possible Side Effects Treatment with CBD should be started slowly and under the supervision of a healthcare provider, who will oversee its effectiveness and side effects. There have been reports of mild side effects of CBD. The most common side effects include: Nausea Fatigue Irritability Diarrhea Dry mouth Lightheadedness Sleepiness Low blood pressure Appetite changes It's important to note that CBD may interact with other drugs, including some of the medications that are prescribed for the treatment of RA. Warnings and Interactions There are some warnings and adverse drug interactions to be aware of before beginning using CBD for management of RA-associated pain. Warnings Do not stop taking any other treatments without consulting your healthcare provider. Additionally, CBD shouldn't be a replacement for other therapies you are using. Pregnant people and children should consult a healthcare provider before using CBD since there isn't enough research on the effects of CBD on these populations. There has been concern about a possible link between inhaled cannabis and lower-birthweight babies, but it’s not clear if this applies to CBD. Currently, the U.S. Food and Drug Administration (FDA) does not regulate the safety and purity of CBD products, so you cannot know for sure that the product you buy has active ingredients at the dose listed on the label. The product may contain other unknown elements. The most effective therapeutic dose of CBD for any particular medical condition has not been established. Are CBD Products Legal? CBD products derived from hemp are no longer considered schedule I drugs under the federal Controlled Substances Act, but they still remain in a legal gray zone. There are changes underway on federal and state levels that will ultimately clarify the laws and regulations related to CBD-based products and sales. Despite that, they’re widely available in nearly every state and online. People who want to use CBD should check their own state laws. Interactions Studies have found moderate interactions between CBD and medications commonly prescribed for treating RA. Interactions can occur with these medications: Corticosteroids Tofacitinib Naproxen Celecoxib Tramadol Some antidepressants, including amitriptyline, citalopram, fluoxetine, mirtazapine, paroxetine, and sertraline Some medications used for treating fibromyalgia, including gabapentin and pregabalin CBD can increase your level of coumadin, a blood thinner. CBD may also raise levels of other medications in your blood by the same mechanism that grapefruit juice does. Medications that interact with grapefruit juice can potentially interact with CBD, including: Cholesterol medicationsHigh blood pressure medicationsOrgan-rejection medicationsAnti-anxiety medicationsCorticosteroidsHeart medicationsSome antihistamines Which Medications Interact With Grapefruit Juice? Preparation and Dosage If you've decided to try CBD for treating your RA pain, the next step is figuring out how much to take. Your dosage depends on a number of factors: Body weightMedical indicationThe concentration and form of CBD that you're taking You will likely need to start with a low dose and find what works for you. Studies have found extreme differences in dosages, with some people using 5 milligrams (mg) and others as much as 600 mg. Your healthcare provider may direct you to start with 20-40 mg per day and increase slowly each day until you feel the relief you're looking for. To ensure that you are using CBD safely and effectively for pain management, you should: Choose an oral treatment (rather than inhaled products) and start with a low doseEstablish initial goals of treatment within a realistic period of time. For example, a reduction in knee pain that allows you to walk around the block within two weeks of starting treatment; later, if improved, the goals can be adjustedTell your healthcare provider(s) about your planned and current CBD treatment; monitor your pain and adjust medications with your medical providers, rather than with non-medical practitionersWhen preparing to take a liquid form, be aware that the CBD extract is mixed with a carrier oil, so there are two measures to know: the amount of the liquid product to take (the dose) and the amount of CBD in each dose If CBD alone doesn’t work and you are in a state where medical or recreational marijuana is legal, you could consider talking to your healthcare provider about taking CBD with a very low-dose THC product. Be aware that even at low levels, THC may make you feel high, resulting in cognitive, motor, and balance impairment. If you experience any unwanted side effects when using a CBD product, immediately discontinue use and inform your healthcare provider. What Is CBD Oil? What To Look For Look for the following when choosing a CBD product: Look for products manufactured in the United States with ingredients grown domesticallyChoose products made by companies that follow good manufacturing practices established by the FDA for pharmaceuticals or dietary supplements or required by the state where they are manufacturedBuy from companies that test each batch and provide a certificate of analysis from an independent lab that uses validated standardized testing methods approved by the American Herbal Pharmacopoeia (AHP), the U.S. Pharmacopeia (USP), or the Association of Official Agricultural Chemists (AOAC)Avoid companies that claim their products have disease benefitsBe aware that marketers and people behind retail counters are not health professionals. Your healthcare provider is your best source for guidance and monitoring when using an unregulated product How to Pick the Best CBD Oil for You A Word From Verywell CBD may sound like an appealing option for pain relief, but do your due diligence before jumping on the bandwagon. A lot of people say CBD can help reduce pain and inflammation for those with RA, but not a lot of strong scientific data have substantiated that claim. That said, serious effects are not commonly associated with CBD use. If this is something you are interested in, you can work with your healthcare provider to figure out whether CBD is something you can try safely. Remember that CBD should not be used as a first-line treatment for RA pain and that it's not advisable to stop taking disease-modifying treatments for RA. 15 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Arthritis Foundation. CBD for Arthritis Pain: What You Should Know. Xiong W, Cui T, Cheng K, et al. Cannabinoids suppress inflammatory and neuropathic pain by targeting α3 glycine receptors. J Exp Med. 2012;209(6):1121-1134. doi: 10.1084/jem.20120242 Centers for Disease Control and Prevention. Rheumatic Arthritis (RA). Harvard Health Publishing. Does CBD help with arthritis pain? Lowin T, Tingting R, Zurmahr J, Classen T, Schneider M, Pongratz G. Cannabidiol (CBD): a killer for inflammatory rheumatoid arthritis synovial fibroblasts. Cell Death Dis. 2020 Sep 1;11(8):714. doi: 10.1038/s41419-020-02892-1 Arthritis Foundation. Arthritis Foundation Releases First CBD Guidance for Adults With Arthritis. Boehnke KF, Clauw DJ. Brief Commentary: Cannabinoid Dosing for Chronic Pain Management. Ann Intern Med. 2019 Jan 15;170(2):118. doi: 10.7326/M18-2972 Harvard Health Publishing. Cannabidiol — what we know and what we don't. Shannon S, Opila-Lehman J. Effectiveness of cannabidiol oil for pediatric anxiety and insomnia as part of posttraumatic stress disorder: a case report. Perm J. 2016;20(4). doi:10.7812/TPP/16-005 Dariš B, Tancer Verboten M, Knez Ž, Ferk P. Cannabinoids in cancer treatment: Therapeutic potential and legislation. Bosn J Basic Med Sci. 2019;19(1):14-23. doi:10.17305/bjbms.2018.3532 Oláh A, Tóth BI, Borbíró I, et al. Cannabidiol exerts sebostatic and antiinflammatory effects on human sebocytes. J Clin Invest. 2014;124(9):3713-3724. doi:10.1172/JCI64628 Watt G, Karl T. In vivo evidence for therapeutic properties of cannabidiol (Cbd) for alzheimer’s disease. Front Pharmacol. 2017;8:20. doi:10.3389/fphar.2017.00020 Wilson-Morkeh H, Al-Abdulla A, Sien L, Mohamed H, Youngstein T. Important drug interactions exist between cannabidiol oil and commonly prescribed drugs in rheumatology practice. Rheumatology (Oxford). 2020 Jan 1;59(1):249-251. doi: 10.1093/rheumatology/kez304 Zhornitsky S, Potvin S. Cannabidiol in humans—the quest for therapeutic targets. Pharmaceuticals. 2012;5(5):529-552. doi:10.3390/ph5050529 Bergamaschi MM, Queiroz RHC, Zuardi AW, Crippa JAS. Safety and side effects of cannabidiol, a Cannabis sativa constituent. Curr Drug Saf. 2011;6(4):237-249. doi:10.2174/157488611798280924 By Kimberly Charleson Kimberly is a health and wellness content writer crafting well-researched content that answers your health questions. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit