Can you use CBD oil for gout pain relief? With research supporting CBD’s anti-inflammatory and pain-relieving properties, the outlook is promising. Dr Frankel talks about his personal experience with gout and treating it with CBD. People with arthritis may consider CBD products for pain relief. Learn what science and experts say about CBD’s benefits, risks, different ways the product can be used and how to be a smart shopper.
CBD Oil for Gout Pain Relief
We all know that western diets, which are notoriously low in vegetables and high in red meat, cause numerous adverse health outcomes such as diabetes and obesity. However, our diets also play a role in another condition, which causes extreme episodes of joint pain—gout.
Gout is a type of inflammatory arthritis that most commonly affects the big toe and can be a source of chronic pain. It develops due to deposits of uric acid crystals in the joints, which are sharp and, when jostled, cause excruciating pain.
The body naturally creates uric acid from the breakdown of purines. Purines are found in foods such as red meat, alcohol, and foods containing fructose. It is only when the body produces more uric acid than it excretes, and levels become too high, that gout occurs. In 90% of cases, gout occurs when the kidneys cannot excrete uric acid adequately.
Gout used to be known as the “disease of kings,” as kings were known for indulging in rich foods and drink. Today, gout is much more common among the general public, due to our “standard American diets.”
Table of Contents
- CBD Oil for Gout: Just the Facts
- Risk Factors for Gout Attacks
- Experiencing Gout
- Common Characteristics of Gout
- Conventional Treatment of Gout
- How to Use CBD Oil for Gout
- Endocannabinoid System and Pain
- Inflammation and Pain
- What the Research Says
- Additional CBD Resources on Pain
CBD Oil for Gout: Just the Facts
Gout is a painful condition that most often affects the joint at the base of the big toe, but can affect any of the body’s joints. Many people are turning to CBD oil to treat their gout pain due to its anti-inflammatory and pain-relieving properties. Although there are few studies exploring the effectiveness of using CBD oil for gout pain relief, research shows CBD products are useful in relieving pain related to other arthritic conditions. Therefore, using CBD oil for gout makes sense.
Risk Factors for Gout Attacks
- Diets high in purines (red meat, fructose, beer)
- Being male
- Some medications, such as diuretics for high blood pressure
- Family history of gout
- Kidney disease
- Recent surgery
- Recent trauma to a joint
Gout typically begins with an acute attack of severe pain in a joint, lasting 12 hours or so. After the acute gout flare-up, there is often still severe pain in the joint, which can last for several days or even a couple weeks. In addition, a person often feels tired, may have a fever, and may experience high blood pressure from the level of pain.
Common Characteristics of Gout
- Most common in the joint at the base of the big toe
- Red, swollen, warm joint
- Severe pain that is worse with movement
- High fever
Conventional Treatment of Gout
In most cases, medications for pain management are first-line therapy for an acute attack. These medications include pain relievers such as Naproxen or Ibuprofen. In some cases, corticosteroids are also prescribed to help with the inflammation.
In most people, gout can be avoided by simple lifestyle changes. Helpful dietary changes include decreasing the intake of high purine foods (red meat, alcohol, and some types of seafood) and increasing the intake of antioxidant-rich foods such as vegetables. Also, drinking lots of water helps the kidneys flush out accumulated uric acid. Limiting alcohol and drinks that are sweetened with fructose is beneficial, as is exercising regularly and maintaining a healthy weight.
Some people are more prone to gout, especially those who have a history of gout attacks, a genetic predisposition, or an underlying health issue such as kidney disease. In these cases, long-term medications that decrease the levels of uric acid in the blood, like Allopurinol, may be necessary. However, it is recommended to always consult with your doctor.
CBD and Gout
Many people report only some relief of their gout pain with painkillers. In addition, these drugs have several side effects, such as increasing the risk of gastric ulcers or perforation in the gut. For these reasons, people are turning to CBD oil for gout pain, for its cannabinoids content—which has anti-inflammatory and pain-relieving abilities.
How to Use CBD Oil for Gout
Cannabis’s use as an analgesic for pain in dates back to 2800 B.C. CBD, which is derived from the Cannabis Sativa (or industrial hemp) plant, is emerging as a go-to for many types of pain conditions. CBD products do not contain THC, the psychoactive component of cannabis. You can ingest CBD oil orally or use it through topical application for joint pain.
Endocannabinoid System and Pain
The endocannabinoid system is a signaling system within the nervous system, and it modulates the levels of pain we feel. Cannabinoids, including the cannabidiol that’s found in CBD products, stimulate cannabinoid receptors (cb2 receptors) within the endocannabinoid system. As a result, this can help reduce the perception of pain signals in the body. It can also reduce inflammation.
Inflammation and Pain
Research has shown that CBD has potent anti-inflammatory properties. In other words, CBD is effective at reducing inflammatory chemicals, such as TNF and IL-12, in the joints. Furthermore, it has also been shown to modulate the immune system, which is responsible for creating inflammation.
Inflammation is a major component of pain, especially in gout. Therefore, it is reasonable to assume that using CBD oil for gout pain may be helpful.
What Research Has Been Done?
Currently, there are no studies on the efficacy of CBD oil and pain relief of gout in humans. However, there is good evidence to support CBD use in the treatment of other forms of arthritis. Multiple studies have shown that CBD is an effective treatment for reducing pain in other forms of arthritis—so it only makes sense that using CBD oil for gout (and the pain related to it) could be beneficial.
A recent study assessed whether a whole-plant medicine made from the cannabis plant (Sativex) is effective in treating rheumatoid arthritis pain. It found that there were significant improvements in pain on movement and pain at rest, as well as the quality of sleep of the study participants. Keep in mind that this study used a cannabis whole-plant medicine, which contains more active constituents than just CBD alone, including THC.
Animal studies have shown that topical application of CBD oil is effective in reducing pain levels. This study also found that CBD oil did work as an anti-inflammatory and reported a reduction in the number of inflammatory mediators in the affected joints.
What the Research Says
Given that gout causes inflammation, which is responsible for some of gout’s symptoms, CBD is a promising treatment due to its anti-inflammatory properties and stimulation of the endocannabinoid system.
To date, there have not been any research studies on using CBD for gout, specifically. However, research into CBD’s effects on other types of arthritis pain has shown it to be an effective treatment, so its efficacy in using it for gout is promising.
Research supports that whole-plant cannabis supplements, which contain CBD, help manage joint pain in other inflammatory conditions such as rheumatoid arthritis.
Animal studies show that topical CBD is effective for reducing joint pain and inflammation.
Our Thoughts On Using CBD Oil for Gout Pain
If you suffer from gout and are considering trying CBD oil for gout pain relief, it is recommended that you always speak with your physician first. And it should be noted that CBD oil alone will not prevent gout flare-ups from occurring, especially in those with kidney disease or other predisposing factors. This is because gout is due to an excessive build-up of uric acid in the blood, which is then converted into painful urate crystals.
CBD oil and other CBD products are not regulated by the United States FDA. Therefore, make sure you purchase any CBD products through a reputable source with third-party testing. This helps ensure both the quality and safety of the products.
Gout is a type of arthritis that causes extremely painful inflammation in the joints, which can be disabling. There are certain dietary choices, such as the consumption of large amounts of red meat or fructose, which may lead to developing gout. Also, genetics, kidney health, and other medical conditions are a factor.
Because many medications to treat gout come with side effects and risks, people are turning to alternative approaches like CBD oil to manage their gout symptoms.
Research indicates that the cannabinoids in CBD are a potent anti-inflammatory and effectively relieve pain related to rheumatoid arthritis, another type of arthritis. Although there has not been much research conducted regarding using CBD oil for gout directly, its use as a treatment for gout pain (both orally and topically) is promising and warrants further investigation.
Always consult your physician before beginning any new medications or supplements, including CBD products.
GOUT PREVENTION AND TREATMENT WITH CANNABIDIOL
Just about five years ago, as I was enjoying some leisure time relaxing and reading a book, I suddenly felt some tingling in the big toe of my left foot. Naturally, I attributed it to a new pair of shoes I had recently purchased which were a bit tight. However, within a few hours, I was in a considerable amount of pain, so I began noting the swelling and erythema (redness) around that area.
It wasn’t long before I was certain that I was experiencing my first episode of Gout. The symptoms? It was unusually painful. Walking, and even working, were challenging. Sleeping was very difficult as well, as the pain awakened me if the sheets merely grazed my toe.
Being a trained physician, you’d think I would seek medical advice. Did I?
Of course not! Doctors rarely properly care for themselves. Like most people, I took over-the-counter anti-inflammatory tablets (think: “Advil”) and several days later the pain and swelling subsided. Within a week I was fine… enough.
The Road Less Traveled
What if I had chosen the conventional medical route? Since uric acid is drawn from the blood into the joint during an attack, it often reads low anyway, so I never actually bothered checking my uric acid levels. I had no interest in starting medically prescribed Allopurinol to lower my uric acid.
For about one year I was just reactive, so I relied on NSAIDs every time I had an attack, which commonly occurred every 3-4 months.
Over time, as I continued to learn more about the benefits of CBD, it came to mind that the daily doses of Whole Plant CBD that I had been taking for my overall health and well-being may very well have been a potential preventive therapy for gout. Given the potential health costs of long term overuse of NSAIDs, Whole Plant CBD seemed like a great alternative.
By the end of that first year, unbeknownst to me, I had experienced my last episode! It has been about four years since my last flare-up, and even the tiny amount of swelling that remained after my first episode has resolved. Gout… GONE.
Cannabis as a Therapeutic Alternative
Over the past four years or so I have seen several patients with gout, and I have recommended a combination of both systemic CBD for prevention, along with a transdermal CBD/THC formulation for acute attacks. With attention to symptoms, the preventive CBD alone may be all we’ll need to stay one step ahead.
There are currently about 8 million patients afflicted with gout in the United States, which is clearly a significant number, so further studies are certainly needed to determine the best and most effective Cannabis treatments for this condition.
Let’s give CBD a chance.
Let’s advocate for more research.
Allan Frankel, MD Dr Allan Frankel is one of the few physicians in the US who truly understands Cannabis as a medicine. All treatments suggested have been well studied. Every patient seen by Dr Frankel is given a personally created Treatment Plan created with the patient’s specific issues defined. Plant medicine requires “tuning” of the dosing. Dr Frankel works with his patients thru a messaging portal. The use of this portal, allows quick and simple follow up contact with Dr Frankel. Patients are not charged for these messages, as this is how Dr Frankel has learned what he has learned. Follow up appointments in person or by phone/video are also available when needed
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CBD Oil For Gout
Online resource that helps patients better understand health coverage options, choose the right coverage, manage the denial process and reduce health care costs.
CBD for Arthritis Pain: What You Should Know
Learn what the science says about the risks and benefits of CBD use for arthritis and what to shop for.
What is CBD? CBD, short for cannabidiol, is an active compound found in the cannabis plant. CBD is not intoxicating but may cause some drowsiness. The CBD in most products is extracted from hemp, a variety of cannabis that has only traces (up to 0.3%) of THC, the active compound that gets people high.
Does CBD work for arthritis? Animal studies have suggested that CBD has pain-relieving and anti-inflammatory properties, but these effects have not been validated in quality studies in humans. Anecdotally, some people with arthritis who have tried CBD, but not all, report noticeable pain relief, sleep improvement and/or anxiety reduction.
Is CBD safe to use? Research evaluating the safety of CBD is underway. At this point very little is known. So far, no serious safety concerns have been associated with moderate doses. CBD is thought to have the potential to interact with some drugs commonly taken by people with arthritis. Talk to your doctor before trying CBD if you take any of the following: corticosteroids (such as prednisone), tofacitinib (Xeljanz), naproxen (Aleve), celecoxib (Celebrex), tramadol (Ultram), certain antidepressants, including amitriptyline (Elavil), citalopram (Celexa), fluoxetine (Prozac), mirtazapine (Remeron), paroxetine (Paxil), sertraline (Zoloft), and certain medications for fibromyalgia, including gabapentin (Neurontin) and pregabalin (Lyrica).
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 state laws.
Taking the First Step
Should I give CBD a try? Without quality clinical studies on CBD and arthritis, doctors have not been able to say who might benefit from CBD, at what dose and in which form, who likely won’t benefit and who should avoid it. Still, there is agreement on several points:
- CBD is not a substitute for disease-modifying treatment for inflammatory arthritis.
- Patients who are interested in trying CBD should first talk to the health care provider who treats their arthritis before trying CBD. Together, they can review what has worked or not worked in the past, whether there are other options to try first, how to do a trial run, what to watch for and when to return for a follow-up visit to evaluate the results. Keep a symptom and dose diary to track effects.
- Quality CBD products can be expensive, especially when used for prolonged periods. To avoid wasting money, be completely sure that the product is truly having a positive effect on symptoms.
What type of product should I consider? CBD-based products can be taken orally, applied to the skin or inhaled. There are pros and cons for each.
By mouth. CBD that is swallowed, whether in capsules, food or liquid, is absorbed through the digestive tract. Absorption is slow and dosing is tricky due to the delayed onset of effect (one to two hours), unknown effects of stomach acids, recent meals and other factors.
Capsules can work for daily use after a safe, effective capsule dose has been established. Experts discourage taking CBD via edibles, like gummies and cookies, because dosing is unreliable, and they are appealing to children but do not come in childproof containers. Like any medicine, edibles should be secured out of sight and reach of children.
CBD can also be absorbed directly into the bloodstream by holding liquid from a spray or tincture (a liquid dosed by a dropper) under the tongue (sublingual) for 60 to 120 seconds. The taste may not be pleasant. Effects may be felt within 15 to 45 minutes.
On the skin. Topical products, like lotions and balms, are applied to the skin over a painful joint. Whether these products deliver CBD below the skin is unknown. Topical products may also include common over-the-counter ingredients such as menthol, capsaicin or camphor, making it difficult to determine if a positive effect is due to the CBD or another ingredient.
Inhaled. CBD can be inhaled via a vaporizing, or vape, pen. However, inhalation of vapor oils and chemical byproducts carry unknown risks, particularly for people with inflammatory arthritis. For this reason and because the Centers for Disease Control and Prevention is investigating vaping in association with widespread hospitalizations and deaths from severe pulmonary disease, vaping is not recommended.
How much CBD should I use? While there are no established clinical guidelines, the medical experts consulted by the Arthritis Foundation recommend the following for adults:
- When 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.
- Go low and slow. Start with just a few milligrams of CBD in sublingual form twice a day. If relief is inadequate after one week, increase the dose by that same amount. If needed, go up in small increments over several weeks. If you find relief, continue taking that dose twice daily to maintain a stable level of CBD in the blood.
- If CBD alone doesn’t work and you are in a state where medical or recreational marijuana is legal, talk to your doctor about taking CBD with a very low-dose THC product. Be aware that THC, even at low levels, may get you high, creating cognitive, motor and balance issues. Try THC-containing products at home or at night first, so you can sleep off any unwanted effects.
- After several weeks, if you don’t find relief with CBD alone or with a combination of CBD and very low THC, CBD may not be right for you.
- If you experience any unwanted side effects when using a CBD product, immediately discontinue use and inform your doctor.
What to Look for When Shopping
There is good reason to be a cautious shopper. CBD products are largely unregulated in the U.S. market. Independent testing has shown mislabeling and lack of quality control. The biggest issues are strength of CBD (significantly more or less than the label says), the presence of undeclared THC, and contamination with pesticides, metals and solvents. Here’s what to look for:
- Find products manufactured in the U.S. with ingredients grown domestically.
- Choose products made by companies that follow good manufacturing practices established by the FDA for pharmaceuticals or dietary supplements (a voluntary quality standard because CBD products are not federally regulated under either category) or required by the state where they are manufactured.
- Buy 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 benefits.
- Be aware that marketers and people behind retail counters are not health professionals; they are salespeople. That’s why your doctor is your best source for guidance and monitoring when using an unregulated product.
Our gratitude to the following experts for their guidance and review:
Kevin Boehnke, PhD, a researcher at the Chronic Pain and Fatigue Research Center at the University of Michigan, focuses on medical cannabis as an analgesic and opioid substitute in chronic pain.
Daniel Clauw, MD, a professor of anesthesiology, rheumatology and psychiatry at the University of Michigan and director of the Chronic Pain and Fatigue Research Center, leads research on arthritis pain and fibromyalgia, and the effects of cannabis, particularly CBD, in pain.
Mary-Ann Fitzcharles, MD, an associate professor of medicine in the Division of Rheumatology at McGill University in Montreal, Quebec, conducts research on pain and rheumatic diseases. She is the lead author of the 2019 Canadian Rheumatology Association (CRA) position statement for medical cannabis.
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