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Cystic Fibrosis and Medical Cannabis

Cystic Fibrosis and Medical Cannabis/Marijuana

 

Definition

General Cystic Fibrosis (CF) is a genetic disorder that mostly affects the lungs and causes abnormal amounts of viscous mucus production. Other symptoms include frequent chest infections, poor growth & weight gain, clubbed fingers and toes, shortness of breath and salty-tasting skin. CF also affects the pancreas, liver, kidneys and intestines.

 

Potential Efficacy / Quality of Evidence (Low, Average, High) of Medical Marijuana for Cystic Fibrosis (CF)

 

Average

 

Cannabinoids, Terpenes/Terpenoids, Strains and Ratios that May Help

 

Cannabis is not necessarily a “cure” for CF per sé, but could well be a form of palliative care. However, there are several areas where cannabinoid treatment may be very useful for those with CF. One is the cirrhosis of the liver that often occurs with CF – CBD could well help prevent inflammation of the liver [1] in moderate doses. Another is insulin regulation – again, CBD can potentially help against neuropathic pain associated with diabetes, and THCV may well help regulate insulin. [2] Pinene, limonene and THC may help clear the airways and help with breathing. [3] [4] The antiemetic effects of THC and CBD could also prove to be beneficial for those with CF.

 

Smoking cannabis flower should be avoided for those with CF. Vaporizing with a quality vaporizer, edibles and tinctures are the preferred method of ingestion for CF patients. As with all cannabinoid medications regardless of one’s health state and conditions, care must be taken to ensure it is clean and free of pathogens. Strains and products high in THCV, CBD and pinene may potentially help those with CF, but again, until we have the definitive research stating so, we can only theorize.

 

Medical Cannabis Pros

 

• Many strains of cannabis have high amounts of limonene, borneol and eucalyptol – all bronchodilators that can help ease breathing.

THC is also a potential bronchodilator – see the Asthma section.

• Cannabis can help manage the aches and pains associated with CF and the effects of regular chest percussion.

• Medicine that targets the endocannabinoid receptors may help prevent coughing.

• Help increase appetite and decrease nausea.

• Help reduce inflammation.

• May help defeat superbugs like MRSA [5] that have developed due to antibiotic resistance.

 

Medical Cannabis Cons

 

• Smoking cannabis may make things worse for those with CF – there has been note of a condition named “bong lung” for [6] cannabis users with CF.

• Important that the cannabis is free of pathogens (e.g. moulds, bacteria etc.) that may harm those with a suppressed immune system.

• CBD may interact with the immune system, so care must be taken if a CF patient has had a transplant and is on anti-rejection medication.

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More About Cystic Fibrosis

 

CF is most common amongst people of Northern European ancestry, and affects around 1 in every 3,000 newborns. There are approximately 30,000 people in the U.S. [7] who suffer from CF. The average life expectancy for those with CF is 42 – 50 years old, and there is no known cure for CF.

CF is caused by mutations in the gene for the cystic fibrosis transmembrane conductance regulator (CFTR) protein. [8] People can be carriers if they have a single working copy of the gene. People with CF are often on one or more antibiotics at all times in order to prevent infection. There are also relationships between CF and diabetes, as both conditions affect the islets of Langerhans in the pancreas, which is an endocrine cell responsible for the production of insulin. [9] Poor vitamin D uptake also leads to osteoporosis.

Though many antibiotics are generally safe, antibiotics in the aminoglycoside class can cause hearing loss, loss of balance and renal failure with long-term use. Antibiotics may also become ineffective over time due to resistance. Other treatments for CF include vitamin supplements, pancreatic enzyme replacement, lung transplantation if lung function continues to worsen, high protein diets, chest percussion and postural drainage to help keep the airways clear for more short-term relief.

Suffering from CF means an increased likelihood of developing bowel problems, diabetes, infertility, respiratory problems, pneumonia, arthritis, sinusitis and lots more. Though a relatively rare disease, CF is one of the most common life-shortening inherited diseases.

 

Quotes from the Experts

 

“Lack of appetite resulting in malnutrition is a contributing factor to mortality in many Cystic Fibrosis (CF) patients. It is proposed here for the first time, to administer THC to CF patients. It is hoped that the cannabinoid will alleviate malnutrition and thus help prevent wasting in CF patients. Recent findings suggest that a lipid imbalance (high arachidonic acid/low DHA) is a primary factor in the etiology of CF and that defective CFTR (CF transmembrane conductor regulator) that characterizes the CF condition is responsible for the dysregulation.

Endocannabinoids are all fatty acid derivatives. Therefore, it is further proposed here that the CFTR gene product also modulates endocannabinoid synthesis, through regulation of fatty acid biosynthesis. According to this hypothesis, CF patients display decreased levels of endocannabinoids and by elevating these levels, symptoms may improve. Indeed, a number of physiological mechanisms of cannabinoids and endocannabinoids coincide with the pathology of CF. Thus it is suggested that potential benefits from THC treatment, in addition to appetite stimulation, will include antiemetic, bronchodilating, anti-inflammatory, anti-diarrheal and hypoalgesic effects.”  Ester Fride, Cannabinoids and Cystic Fibrosis:
A Novel Approach to Etiology and Therapy https://www.cannabis-med.org/data/pdf/2002-01-2.pdf [10]

 

Case Studies

 

Let’s Talk About Marijuana

References

 

[1] https://www.fasebj.org/doi/full/10.1096/fj.201600646r

 

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3671751/

 

[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5796802/

 

[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1429361/

 

[5] https://www.sciencedaily.com/releases/2020/02/200226130527.htm

 

[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2998526/

 

[7] https://www.cff.org/What-is-CF/About-Cystic-Fibrosis/

 

[8] https://ghr.nlm.nih.gov/gene/CFTR

 

[9] https://www.diabetes.co.uk/cystic-fibrosis.html

 

[10] https://www.cannabis-med.org/data/pdf/2002-01-2.pdf

 

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Featured Image: Own work , and this is a derivative work from this file that was originally made by User: Mikael Häggström

Nelson essentials, text book of pediatrics [1]

↑ Kliegman, Robert; Richard M Kliegman (2006) Nelson essentials of pediatrics, St. Louis, Mo: Elsevier Saunders ISBN: 0-8089-2325-0.

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