CBD Oil for Chronic Fatigue Syndrome

How This Condition Can Be Treated

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Cannabidiol (CBD) oil is talked about as a possible treatment chronic fatigue syndrome (CFS or ME/CFS). However, whether it is safe and/or effective for this purpose is yet unknown. Thus far, there is no specific research on CBD for chronic fatigue.

But as CBD products become more and more mainstream, the interest in the use of CBD oil for ME/CFS will, no doubt, remain. This is largely because chronic fatigue is an extremely difficult illness to manage, and many patients continue to live with dozens of symptoms despite trying conventional treatment options.

ME/CFS symptoms are believed to stem from the dysregulation of multiple systems throughout the body. They are similar to those of influenza, and can include weakness and fatigue, headache, tender lymph nodes, joint pain, and an inability to concentrate.

This article explains how CBD differs from marijuana, what is known about any benefit for ME/CFS, possible side effects, and more.

What Is CBD Oil?

CBD stands for cannabidiol, which comes from the cannabis plant. That's the same plant that gives us marijuana. However, CBD—as an oil or in other forms—doesn't have psychoactive properties. That means it doesn't provide the "high" associated with marijuana.

The substance in marijuana that gets you high is called THC (tetrahydrocannabinol). Growers who want to maximize the plant's psychoactive effect use breeds and techniques that result in higher levels of THC. On the other hand, cannabis that's grown for hemp is generally richer in CBD than THC, and that's where CBD comes from.

CBD oil can be used in several different ways. You can smoke it (typically in vape pens), take it in capsule form, use it sublingually (under the tongue), use oral sprays or drops, or apply it topically to your skin. A crystalline form of pure CBD is also available, which is generally taken sublingually.

CBD products that are extracted from cannabis are being used for a lot of medical purposes, and you can find many claims online about miraculous results.

But are these claims true? And would it work as well for you? From a scientific standpoint, the answers are more like "we don't know" and "possibly" and "some claims appear to be true" than a firm "yes," and it depends on which claims you're looking at.

People are using CBD oil for a whole lot of different medical purposes, including:

As of June 25, 2018, CBD oil has been approved by the Food and Drug Administration (FDA) as an oral solution (Epidiolex) for the treatment of seizures associated with two very severe forms of epilepsy that usually affect children: Lennox-Gaustaut and Dravet syndromes.

Research in the United States for other diseases is still in the early stages. That's because legal restrictions have for decades made it extremely difficult to study the medical benefits of marijuana or any of its components, which are called cannabinoids. Promising research is being done, though, on multiple conditions. Down the road, it's likely that we'll eventually see many applications submitted to the FDA.

CBD Research and ME/CFS

Anyone who's studied ME/CFS for very long will not be shocked to hear that, so far, we don't have any research done on CBD oil as a treatment for this disease. That doesn't mean we don't know anything, though.

CBD is being researched for numerous conditions, and many of those conditions share features with ME/CFS. While we can't say for certain that those results apply to similar conditions, they provide some basis for informed speculation.

Also, we're likely to see CBD investigated for ME/CFS before long for several reasons.

First, we just don't have good treatments for ME/CFS. In fact, none are FDA-approved. And while dozens of different medications and other interventions are used to help lessen the symptoms, many of them are only marginally effective and only help a fraction of those with the condition. Side effects tend to be a problem for this group, as well.

Second, we have a pain epidemic in the U.S. While not all ME/CFS involves pain, many cases do. Current treatments are inadequate, though, so there's a big financial incentive to find something that's better at relieving ME/CFS pain.

Third, we're currently struggling with an opioid addiction and overdose epidemic in the United States. Several studies have shown that when a state legalizes marijuana, either medicinally or recreationally, the number of opioid prescriptions drops. That's good news for healthcare providers looking for safer pain treatments, for law enforcement agencies struggling to control the tide of illegal use, and for lawmakers trying to find solutions.

Fourth, CBD oil is believed to be effective against pain and inflammation, and, in its pure form, it's generally regarded as safe. Especially in light of the theory that ME/CFS is related to neuroinflammation, and the wealth of evidence pointing to it being an inflammatory disease, it's pretty obvious that CBD could help with chronic fatigue.

Finally, while anecdotal evidence isn't proof of anything, we already have an abundance of it from people with ME/CFS. When patients with difficult-to-treat conditions tell their healthcare providers something works, you can bet it gets them interested.

A 2017 ​paper published in Expert Opinion on Therapeutic Targets suggested CBD as a possible way to diminish the activity of brain cells called glia that can lead to central sensitization. That's a hypersensitive central nervous system and a major feature of ME/CFS and other central sensitivity syndromes such as fibromyalgia, irritable bowel syndrome, and migraine.

CBD is believed to help with your body's homeostasis, which is keeping things like temperature, respiration, and blood flow in proper balance. Homeostasis tends to be out of balance in ME/CFS.

While it's less well documented in ME/CFS, a condition called endocannabinoids deficiency, characterized by lower amounts of naturally produced endocannabinoids in certain individuals, has been linked to fibromyalgia, making cannabis products a promising treatment.

A 2016 review published in Cannabis and Cannabinoid Research found evidence that CBD is effective in treating migraine and irritable bowel syndrome, which are related to ME/CFS. It also stated that some cannabis-based treatments appeared effective for fibromyalgia. The authors stated that CBD is often preferable to patients because it doesn't include the high and other effects of THC.

As mentioned earlier, several studies have suggested that CBD can fight inflammation. That's a big deal for a disease that research links to chronic inflammation, and possibly to neuroinflammation as an underlying cause.

A 2017 French study on Alzheimer's disease suggests that CBD lessens oxidative stress, diminishes mitochondrial dysfunction, and suppresses pro-inflammatory activity. All of those things could prove helpful against known and suspected dysfunctions associated with ME/CFS.

A 2011 study out of Italy suggested that CBD may lower intestinal inflammation via control of the neuro-immune axis. While that study was on inflammatory bowel disease, changes to the neuro-immune axis could be beneficial in ME/CFS, as well.

Side Effects

Reported Side Effects of CBD Oil

Nusha Ashjaee / Verywell

We don't have a full picture of the possible side effects of CBD. Some reported side effects include:

  • Changes to liver enzymes used to process drugs
  • Dry mouth
  • Low blood pressure
  • Lightheadedness
  • Drowsiness
  • Increased tremor in Parkinson's disease, at high doses

The following effects are possible but require more study, according to the World Health Organization:

  • Alteration of hormonal levels
  • Immune system stimulation at low levels, and immune suppression at higher levels

The immune system effects will be especially important for ME/CFS, which is believed to involve a chronically overactive immune system.

Addiction and abuse don't appear to be problems with CBD, and it appears to have a low toxicity level, which means that it takes a lot to overdose.

Is It Legal?

When the 2018 Farm Bill was signed into law, it made hemp an agricultural product. That means products made from hemp—including CBD—are legal at the federal level.

However, some states and municipalities have passed laws specifically banning hemp products or CBD. Technically, federal law overrides state law. That doesn't mean, though, that your state or town will automatically stop making arrests and pressing charges under its CBD laws.

If you're in an area with laws prohibiting CBD, you may want to consult a legal expert on whether it could be a problem for you. Better safe than sorry.

The website ProCon.org has information about which states have laws specific to CBD oil. A site called Governing maintains a map of where marijuana is legal in some form.

A Word From Verywell

You have a lot to consider when it comes to any form of treatment, and even more when it comes to CBD for chronic fatigue. Be sure to consider the pros and cons, including the legal ones. Discuss this option with your healthcare provider to make sure you're not endangering your health. As with any treatment, watch for side effects.

With legal changes in-store and more research coming, things may change rapidly when it comes to CBD oil and other cannabis-based treatments. It's likely that we'll know a great deal more about the effectiveness and safety of these products a few years from now.

Chronic Fatigue Syndrome Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

Doctor Discussion Guide Woman

Frequently Asked Questions

  • For how long does CBD make you drowsy?

    Drowsiness is one of the possible side effects of CBD oil. This can compound the fatigue due to CFS. How long drowsiness lasts varies. Talk to your healthcare provider if drowsiness impacts your daily activities and avoid driving or operating machinery if CBD makes you sleepy.

  • Does CBD raise dopamine?

    Early research has shown that CBD has the potential to increase levels of dopamine. This is a key brain chemical that plays a role in how your body interprets fatigue.

  • Does CBD increase serotonin?

    Research about the impact of CBD on serotonin levels is limited, but it is generally understood that it does not increase levels of this important pain neurotransmitter. However, research has indicated that CBD may play a role in how your brain processes serotonin, which may be why it reduces pain symptoms.

  • Can CBD affect thinking?

    CFS can cause low levels of serotonin, which can impact how the brain functions. CBD can help clear brain fog and help with attention and memory because of its ability improve how your body processes serotonin.

13 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.
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  5. Khan MI, Sobocińska AA, Czarnecka AM, Król M, Botta B, Szczylik C. The Therapeutic Aspects of the Endocannabinoid System (ECS) for Cancer and their Development: From Nature to Laboratory. Curr Pharm Des. 2016;22(12):1756-66. doi:10.2174/1381612822666151211094901

  6. Russo EB. Clinical Endocannabinoid Deficiency Reconsidered: Current Research Supports the Theory in Migraine, Fibromyalgia, Irritable Bowel, and Other Treatment-Resistant Syndromes. Cannabis Cannabinoid Res. 2016;1(1):154-165. doi:10.1089/can.2016.0009

  7. Nagarkatti P, Pandey R, Rieder SA, Hegde VL, Nagarkatti M. Cannabinoids as novel anti-inflammatory drugs. Future Med Chem. 2009;1(7):1333-49. doi:10.4155/fmc.09.93

  8. Watt G, Karl T. Evidence for Therapeutic Properties of Cannabidiol (CBD) for Alzheimer's Disease. Front Pharmacol. 2017;8:20. doi:10.3389/fphar.2017.00020

  9. De filippis D, Esposito G, Cirillo C, et al. Cannabidiol reduces intestinal inflammation through the control of neuroimmune axis. PLoS ONE. 2011;6(12):e28159. doi:10.1371/journal.pone.0028159

  10. Oleson EB, Cheer JF. A brain on cannabinoids: the role of dopamine release in reward seeking. Cold Spring Harbor Perspectives in Medicine. 2012;2(8):a012229-a012229. doi:10.1101/cshperspect.a012229

  11. De Gregorio D, McLaughlin RJ, Posa L, et al. Cannabidiol modulates serotonergic transmission and reverses both allodynia and anxiety-like behavior in a model of neuropathic painPain. 2019;160(1):136-150. doi:10.1097%2Fj.pain.0000000000001386

  12. Švob Štrac D, Pivac N, Mück-Šeler D. The serotonergic system and cognitive functionTranslational Neuroscience. 2016;7(1):35-49. doi:10.1515/tnsci-2016-0007

  13. Healy D. Serotonin and depression. BMJ. 2015;350(apr21 7):h1771-h1771. doi:10.1136/bmj.h1771

Additional Reading
  • Burstein SH, Zurier RB. Cannabinoids, endocannabinoids, and related analogs in inflammation. The AAPS Journal. 2009;11(1):109-19. doi:10.1208/s12248-009-9084-5.

  • De Filippis D, Esposito G, Cirillo C, et al. Cannabidiol reduces intestinal inflammation through the control of neuroimmune axis. PLoS One. 2011;6(12):e28159. doi:10.1371/journal.pone.0028159.

  • Hill KP, Saxon AJ. The role of cannabis legalization in the opioid crisis. JAMA internal medicine. 2018;178(5):679-680. doi:10.1001/jamainternmed.2018.0254.

  • Nijs J, Loggia ML, Polli A, et al. Sleep disturbances and severe stress as glial activators: key targets for treating central sensitization in chronic pain patients? Expert opinion on therapeutic targets. 2017;21(8):817-826. doi:10.1080/14728222.2017.1353603

  • Piomelli D, Weiss S, Boyd G, Pacula RL, Cooper Z. Cannabis and the opioid crisis. Cannabis and cannabinoid research. 2018;3(1):108-116. doi:10.1089/can.2018.29011.rtl

  • Russo EB. Clinical endocannabinoid deficiency reconsidered: current research supports the theory in migraine, fibromyalgia, irritable bowel, and other treatment-resistant syndromes. Cannabis and cannabinoid research. 2016;1(1):154-165. doi:10.1089/can.2016.0009

  • Silvestri C, Di Marzo V. The endocannabinoid system in energy homeostasis and the etiopathology of metabolic disorders. Cell metabolism. 2013;17(4):475-90. doi:10.1016/j.cmet.2013.03.001

  • Vallee A, Lecarpentier Y, Guillevin R, Vallee JN. Effects of cannabidiol interactions with Wnt/B-catenin pathway and PPARy on oxidative stress and neuroinflammation in Alzheimer's disease. Acta biochimica et biophysica Sinica. 2017;49(10):853-866. doi:10.1093/abbs/gmx073

By Adrienne Dellwo
Adrienne Dellwo is an experienced journalist who was diagnosed with fibromyalgia and has written extensively on the topic.