Gout is a painful joint disease that grips millions across the world. It affects men more than women.
A 2019 study estimated that “in 2015-2016, the prevalence of gout was 3.9% among adults in the US (9.2 million people), with 5.2% [5.9 million] in men and 2.7% [3.3 million] in women”.
Cannabidiol (CBD) may be used to manage the symptoms of gout and other forms of arthritis. The debilitating pain and inflammation persuades one to look at CBD as a potential treatment option.
If you are considering CBD for pain relief, read what the researchers and medical experts have to say about it.
What is Gout?
Gout is a type of arthritis that causes severe pain, swelling, and inflammation in the joints. It often affects the joint of the big toe. It may also attack your knees, elbows, ankles, thumbs, and fingers. This happens when too much uric acid gets deposited in the joints.
The patient may experience a gout attack at night with intense pain in the joints. The condition is also characterized by sudden flares when the symptoms get worse.
It is of two types: Acute gout and Chronic gout.
Acute gout: It is a condition that affects only one joint, more often the big toe.
Acute gout attack: According to John Hopkins Arthritis Centre, “a typical gout attack is characterized by the sudden onset of severe pain, swelling, warmth, and redness of a joint”.
The pain reaches its peak within 12-24 hours of onset and remits in 7-14 days.
Chronic gout: In this condition, more than one joint is affected. The patient may experience multiple severe attacks in short time intervals.
What are the Symptoms of Gout?
Gout flares can last from a few days to weeks and they may not happen for months or years. It affects only one joint at a time. One may experience symptoms like:
- Intense pain
If left untreated, the increased urate crystals can gather into nodules called “tophi.” This can worsen the pain and lead to permanent damage to joints.
Causes of Gout
According to the Centre for Disease Control and Prevention, Gout happens when there’s too much build-up of uric acid in the body. This condition is known as hyperuricemia.
The body produces uric acid when it breaks down to purines present inside the body and in the foods you eat. The crystals of uric acid (monosodium urate) can get deposited in the joints, tissues and fluids in the body.
Until a flare-up, the person lives a normal life for years; it is known as asymptomatic hyperuricemia.
It is important to note that hyperuricemia does not always lead to Gout.
Other causes of gout disease are:
- Eating acid-forming foods (purine and sugar-rich)
- Excessive alcohol intake
- Having hypertension, insulin resistance, diabetes, metabolic syndrome, and poor kidney function
Treatment for Gout
As of now, there’s no cure for Gout. But there are treatments to relieve the symptoms and attacks caused during this condition. Then, there are drugs that either improve uric acid removal or help prevent the production of excess uric acid in the body.
For alleviating symptoms:
- Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, and naproxen.
- Colchicine drug
To prevent gout-related complications:
- xanthine oxidase inhibitors like allopurinol and febuxostat
CBD and Gout
Cannabidiol (CBD) is a compound of the Cannabis plant derived typically from Sativa species. Over the years, it has proved to be beneficial in treating pain and inflammation in conditions like gout arthritis.
Unlike Tetrahydrocannabinol (THC), the psychoactive (mind-altering) compound of Cannabis, CBD works without making the user ‘high’.
With the use of the aforementioned drugs, there is always a high risk of side effects.
- NSAIDs can cause bleeding, stomach pain, and ulcers.
- Colchicine use can cause vomiting, nausea, and diarrhea.
- Corticosteroids can lead to sudden mood swings, increased blood sugar, and high blood pressure.
Owing to this, many patients are turning to the natural alternative of CBD.
We have compiled the studies and researchers till date that talk about the use of CBD for gout.
The endocannabinoid system (ECS) in the body regulates our sleep, pain, memory, stress, and immune function. The cannabinoids in CBD interact with the endocannabinoid receptors of the ECS.
CBD helps improve the functions of the ECS by inhibiting the breakdown of endocannabinoids by the enzymes. It also increases the production of endocannabinoids.
This helps in maintaining homeostasis (balance) in the body and reducing the pain signals during conditions like gout.
A 2014 review established the involvement of the endocannabinoid system in Osteoarthritis pain, a degenerative joint disease.
How does CBD help Gout?
There are no researches available specifically for CBD as a potential treatment for Gout. But there are several evidences to prove its effect on the other forms of arthritis. CBD may be used to relieve gout symptoms like pain and inflammation.
In a 2000 study on murine (mice) with collagen-induced arthritis (CIA), CBD was administered after the first clinical signs of arthritis. The researchers noticed that CBD treatment blocked the progression of arthritis effectively.
They concluded the study by saying that: “…these data show that CBD, through its combined immunosuppressive and anti-inflammatory actions, has a potent anti-arthritic effect in CIA”.
The results of the researches performed up till now are promising and are paving a way for CBD as a potential treatment option for Gout as well.
Here’s how CBD can help alleviate gout symptoms:
Inflammation occurs when the body tries to fight infection. A Gout is a form of inflammatory arthritis. In this condition, the affected area swells up and turns red.
CBD has anti-inflammatory properties which can be effective in treating arthritis-related inflammation. It does so by suppressing cytokine production at the inflammatory sites. Cytokines are a group of proteins that regulate the immune function and inflammation in the body.
A 2011 study revealed that cannabinoids can help reduce inflammatory pain in rats by affecting the endocannabinoid receptors in their body.
Hervé Damas, MD, a Miami-based physician says that “Cannabinoids can inhibit or excite the release of neurotransmitters [brain chemicals] and play a role in modulating the body’s natural inflammatory response, which are the two things we’re concerned about when talking about CBD for arthritis”.
Pain is another major symptom of Gout that CBD can help with. The pain becomes so intense at times that the patient may wake up in the middle of the night. CBD has analgesic properties, meaning it helps in relieving pain.
The aforementioned 2014 review showing involvement of the ECS in OA pain also hinted on the therapeutic role of cannabinoids in pain management.
A 2017 study in a rat model of osteoarthritis showed that inhibition of inflammation by CBD can prevent the development of OA pain and nerve damage.
Other than this, a recent study of 2016 on patients with rheumatoid arthritis showed that they experienced an improvement in joint pain, sleep quality, and the quality of life.
Pros and Cons of using CBD for Gout
The best way of deciding if CBD is worth it is by weighing its pros and cons. Take a look:
- Helps alleviate pain and inflammation symptoms of gout and other forms of arthritis.
- According to the World Health Organization (WHO), “CBD is generally well-tolerated with a good safety profile”.
- The user cannot develop tolerance or get addicted to CBD. It delivers therapeutic benefits without causing the ‘high’.
- CBD can be a natural alternative to medication drugs.
- There is a lack of research related to the efficacy of CBD on gout specifically.
- CBD may interact with gout medications and drugs for other diseases.
- CBD is not regulated by the Food and Drug Administration (FDA) except in the case of epilepsy.
- There’s no established dosage of CBD for gout.
CBD and other treatments for Gout
Other than the aforementioned treatments for gout, making changes in your lifestyle has proven to be effective.
We know Gout as the “disease of kings” as it happens due to the overindulgence in rich foods like the royalty. A major change in eating and exercise habits can help you reduce the gout attacks and even prevent them.
Studies show the intake of Vitamin C for gout. It may either reduce the uric acid levels or prevent the development of gout in the body. The results of different studies are confusing but are overall in favor of Vitamin C supplementation for gout.
A 2012 study revealed that consumption of cherry can also decrease the risk of recurrent gout attacks.
These treatments can be used in combination with CBD. The patient should also indulge in light exercise to lose weight and ensure the proper movement of your joints.
Other than this, try eating healthy and avoid purine-rich foods (red meat, organ meat, and seafood).
How to choose the right CBD for Gout
There are three types of CBD: Full-spectrum, Broad-spectrum, and CBD Isolate.
The Full-spectrum CBD, also known as whole plant CBD, contains terpenes, flavonoids, and other cannabinoids. These compounds enhance the properties of CBD and produce an ‘entourage effect’. The THC content in this CBD should be less than 0.3%.
CBD Isolate is a single molecule cannabinoid with 99% pure CBD. This doesn’t contain any THC, the psychoactive compound of Cannabis.
Broad-spectrum CBD is a mix between full-spectrum and CBD Isolates. It has multiple cannabinoids that produce an entourage effect but without THC Content.
The Full-spectrum CBD is considered more effective for clinical and medical purposes due to the presence of multiple cannabinoids. As per a 2015 research, this whole plant extract can help in the reduction of pain and inflammation of the user.
But gout patients who don’t want THC in their system can use the broad-spectrum CBD.
How to Take CBD for Gout
CBD is available in many forms for the user to consume. Although the right way to ingest CBD is topically, we will be suggesting you other methods as well. Here’s how you can use CBD for gout:
For gout, using CBD topically is probably the best option. CBD Topicals are available in the form of lotions, ointments, and salves. These CBD infused topicals are said to have healing properties and get absorbed into the skin to reach the painful areas.
A 2016 study showed that the application of CBD Topicals can help in reducing arthritis-induced pain and inflammation. It also reduces joint swelling.
Here, applying 6.2 mg – 62 mg of CBD gel every day consecutively for four days helped treat arthritis in rats.
- How to use: Before applying the cream, wash the affected area with soapy water and pat dry.
- Now, apply generously on the areas and where you feel the pain. You will experience a cooling sensation right after the application.
- It will show effects in 15-20 minutes that usually last for 3-4 hours. You can apply the topical 2-3 times daily.
CBD can be taken in the form of oil tinctures, gel caps, pills to reduce the pain and inflammation caused by gout.
As oils are molecular carriers, they hold more cannabinoids than other forms of CBD products. This helps them get easily absorbed in the body and get transferred into the blood.
You need to take it sublingually and the effects will appear in 15 to 45 minutes.
How to use: You can take the CBD oil as it is by putting it under your tongue using a dropper. Let it be there for 90 seconds to allow it to get absorbed in the bloodstream.
You can also consume the oil in the form of capsules. But as these capsules have to pass through the digestive tract, they take longer to show effects.
This is the easiest way to take CBD. The edibles are available in the form of gummies, brownies, cookies, etc. They work to reduce swelling and inflammation and help provide comfort.
Another way of taking CBD is through vaping, inhaling of CBD vapors.
This can be done through vape pens, cartridges, and e-cigarettes.
Although one can get instant effects with vaping, it can harm your lungs and cause pulmonary health risks.
Interesting fact: Sativex is a marijuana-based mouth spray prepared using THC and CBD. Tests and studies on this Sativex showed that it can help reduce pain and improve sleep quality in the patients.
CBD Dosage for Gout
There is no recommended CBD dosage for Gout. You will have to find the right dosage for yourself.
Start from the lowest dosage and slowly work your way up as required. Use the same dosage for a week or two to notice the difference. When you find the right dosage, stick to it.
If consuming CBD sublingually, use twice a day. Take it at the same time every day, so that there is a proper flow of CBD in your system.
Dr. Daniel Clauw, professor and an expert in chronic pain stated that; one can take a dose of 5 to 10 milligrams of CBD twice daily and move to the higher doses of 50 to 100 milligrams per day if needed.
To be on the safer side, consult your healthcare provider before using CBD. They will let you know if it is safe for you provided your current medical condition.
In case you experience any unwanted side effects, immediately discontinue the use.
Does CBD interact with Gout medication?
Yes, CBD may interact with the present treatments for Gout. The patients use corticosteroids, a drug that lowers inflammation in the body to control the acute gout attacks. These medications are metabolized by the cytochrome P450, a superfamily of liver enzymes.
CBD inhibits the action of cytochrome P450. This slows down the breakdown of the corticosteroids and therefore increases the risk of side effects in the body.
Hence, it is not recommended to take CBD along with other gout medications. Speak to your doctor if you are considering using CBD while on other medications.
To avoid this, look for the grapefruit warning on the CBD label. Grapefruit inhibits the action of the CYP3A4 enzyme, so it’s better to not buy such CBD products.
Side Effects of CBD
Although there are no reported side effects of CBD for out, the results may vary from person to person.
In rare cases, the patient may experience tiredness, nausea, or diarrhea. These are relatively less harmful than the side effects of gout medications.
There is a need for gout-specific research to unravel the full potencies of CBD. It can be a new natural alternative to steroid-filled drugs used to treat gout presently.
It is important to take low doses of CBD to avoid any harmful effects. Although you cannot develop a tolerance to CBD, consuming it in high amounts may cause mild side effects.
We hope we helped you understand the efficacy of CBD for Gout. We recommend you to cross-check with your doctor before using it. Stay fit, stay healthy!.