Myasthenia gravis (MG) is a chronic disease that causes severe weakness of the muscles. New research suggests that cannabis may help, but few medical marijuana programs list MG as a qualifying condition. In fact, only Illinois currently allows registered patients to use cannabis for myasthenia gravis.
In this article, we explore how cannabis could help MG and why more states need to follow Illinois’ example.
What Is Myasthenia Gravis?
Myasthenia gravis causes weakness in the skeletal muscles. These include the muscles of the face, arms, legs, and chest. It produces a variety of symptoms, including:
- Drooping eyelids (ptosis)
- Blurred vision
- Abnormal facial expressions
- Difficulty swallowing (dysphagia)
- Impaired speech (dysarthria)
- Shortness of breath
- Weak neck, limbs, and extremities
Approximately 15–20% of people with MG may suffer from something known as a ‘myasthenic crisis.’ This is a medical emergency in which the patient becomes unable to breathe due to muscle weakness in the chest.
What Causes Myasthenia Gravis?
Myasthenia gravis is an autoimmune disorder, meaning that the immune system becomes confused and begins to attack the body’s tissues. In the case of MG, the immune system attacks the space between the nerve cells and the muscles. This area is known as the neuromuscular junction (NMJ).
In healthy people, the NMJ is where nerve cells stimulate the muscles to contract. They do this by releasing a neurotransmitter called acetylcholine. Acetylcholine travels across the NMJ and binds with receptors on the muscles.
However, in people with myasthenia gravis, the immune system attacks these receptors. It causes damage, which means that acetylcholine is no longer able to bind effectively. This means that the muscles are unable to contract normally, leading to the symptoms of MG.
Scientists are still unsure exactly why some people develop myasthenia gravis. However, some believe that it is due to a dysfunction of the thymus gland, which produces immune cells known as T-cells.
Myasthenia Gravis Treatment
Fortunately, it is now possible to control MG using medication or surgery. For some people, removing the thymus gland can have significant benefits. Others find that medication helps.
One of the most common treatments for MG is a class of drugs known as anticholinesterase medications. They work by slowing the breakdown of acetylcholine in the NMJ to improve muscle function. Side effects include gastrointestinal upsets, excessive tearing, and saliva overproduction.
Another type of treatment that may help to relieve myasthenia gravis symptoms is immunosuppressant drugs. These dampen down the immune response to reduce damage to the acetylcholine receptors on muscle cells. The main downside is that they suppress the whole immune system, making patients more vulnerable to infections.
So, how about cannabis? Could it offer a more natural treatment for myasthenia gravis?
Can Cannabis Help Myasthenia Gravis?
Humans have used cannabis as a medicine for thousands of years. However, it became illegal during the 20th century and is just beginning to regain its reputation as a healing herb. Proponents claim that cannabis can help with a wide range of physical and psychological complaints. One of these is myasthenia gravis.
It appears that cannabis could help myasthenia gravis by regulating activity in the nervous system. It does this by producing compounds known as cannabinoids, including THC and CBD. Both THC and CBD have beneficial properties. They influence a physiological system known as the endocannabinoid system (ECS) to produce various effects on the body and mind.
However, THC and CBD both affect the ECS in very different ways. THC primarily binds with receptors called CB1 receptors, which are prominent in the brain and nervous system. CBD, on the other hand, exerts most of its effects on CB2 receptors, which are highly concentrated in immune cells.
Studies have shown that when THC binds with CB1 receptors, it modulates the release of several different neurotransmitters. The long list of neurotransmitters that THC affects includes acetylcholine, the chemical involved in myasthenia gravis. For example, this study for the journal Alcohol and Drug Research found that THC increased acetylcholine levels in several areas of the brain.
Another study for the European Journal of Pharmacology explored this phenomenon further. Its authors suggested that THC exerts its effects not only at cannabinoid receptors but other sites in the nervous system too.
More research is required to understand precisely how cannabis could impact acetylcholine levels and myasthenia gravis. However, many scientists are now becoming interested in this relationship, leading to the publication of further studies.
Research on Cannabis for Myasthenia Gravis
One such study appeared in the journal Scientific Reports in 2018. The authors investigated the effects of a cannabinoid receptor agonist called WIN 55,212 on a mouse model of myasthenia gravis. They found that treatment with the compound led to restored neuromuscular transmission. The authors suggest that the mechanism behind this is an increase in acetylcholine levels in nerve cells.
The results of this study suggest that cannabinoids could offer a promising treatment for myasthenia gravis in the future. However, it is essential to note that this study utilized a synthetic cannabinoid agonist rather than natural cannabis. Further studies are also necessary to confirm whether these effects would be replicated in human subjects.
THC or CBD for Myasthenia Gravis?
To date, most of the research on cannabis for MG has focused on THC and its effects on acetylcholine. However, it’s possible that CBD could offer some benefits too. While THC primarily affects the central nervous system, CBD has a greater influence on the immune system.
Research suggests that CBD could suppress the immune system to help with autoimmune conditions such as MG. No studies currently exist on CBD for myasthenia gravis, specifically. However, the cannabinoid does appear to have a positive effect on other autoimmune disorders such as type I diabetes.
Another significant benefit of CBD is that, unlike THC, it is available in the majority of places. The Hemp Farming Act of 2018 made it legal to grow CBD-rich hemp plants containing less than 0.3% THC. Since then, the CBD market has exploded, and you can now find this cannabinoid in everything from ice cream to bath bombs.
However, the most popular way of taking CBD is in the form of CBD oil. People use this oil by placing a few drops under their tongues and holding it there for up to 90 seconds. This allows the CBD to diffuse into the bloodstream and bypass the digestive system, allowing for better absorption. It is also available in the form of capsules, edibles, and topical creams.
One of the biggest issues with using CBD for myasthenia gravis is that the market is not well regulated. This means that many of the products that you find online or in stores are of poor quality. It is essential to conduct comprehensive research before choosing a CBD product to ensure that you purchase an item that is both effective and safe.
Can Cannabis Help Myasthenia Gravis? Final Thoughts
Although most states with medical marijuana programs have not yet caught on, it seems that cannabis could offer some benefit for patients with myasthenia gravis. Residents of Illinois can apply for an MMJ card if they suffer from this debilitating condition. However, those living in other states will either have to rely on recreational cannabis laws or consider using CBD instead.
If you decide to use cannabis or CBD oil to treat myasthenia gravis, you should consult your physician first. While these natural remedies may act as a helpful adjunctive treatment, they are not a substitute for proper medical care. Never stop taking any prescribed medication without your physician’s consent, and be sure to monitor your condition carefully if you do make any changes.
You should also be aware that cannabis and CBD could interact with other medications you may be taking. Your doctor will be able to advise you on whether these products are safe for you and how much you should use.