Cannabis & Migraines - Hope for a Debilitating Condition
Headaches are one of the most common symptoms that something is going wrong in our bodies. While almost every human has experienced a headache at some point, a sizeable percentage of the population is plagued by frequent headaches so severe that they disrupt daily life - the chronic migraine sufferers. Migraine has been identified as one of the 10 most debilitating illnesses by the World Health Organization, and it’s estimated that 12% of Americans, or over 37 million people in our country alone, are affected by these terrible symptoms regularly. Women are particularly susceptible to the illness, with estimates ranging between 1 in 5 and 1 in 3 women who will experience migraines in their lifetime. A vast majority of sufferers feel the devastating impacts of their pain in their social, professional, and emotional wellness. Unfortunately, treatments for migraine are not universally effective due to the mysterious nature of migraine causes, and many sufferers are not able to find relief in traditional medications.
With so many people suffering without relief from other sources, it’s no surprise that patients have turned to cannabis and its long history of pain relief for potential mitigation of symptoms. Based on anecdotal evidence and some emerging scientific research, we are beginning to understand the science behind how the active compounds in cannabis intercede on the pathways that trigger migraine pain, reducing their severity or even preventing their formation in some cases. These findings represent a promising new frontier for cannabis medicine, and a potential treatment source for migraine sufferers who have found little relief in the past.
We’ll discuss the science of how migraines are triggered & manifest as a wide range of symptoms, how cannabinoids and terpenes may be able to interfere with these migraine pathways to produce symptom relief, and the best types of cannabis products to try for potentially preventing & reducing the acute pain of a migraine.
The Science of Migraines - and How Our ECS May Be Able to Help
Let’s begin with a description of what migraines are exactly. If you’ve never experienced one, it’s easy to imagine a migraine as just a really intense headache, but this description doesn’t do the experience justice - two members of the [Pe] team actually suffer with migraine disorders themselves, and they experience visual disturbances, light & sound sensitivity, nausea & vomiting, neck & back pain, extremity tingling & bodily weakness, and other severe symptoms when a migraine sets in. Migraines are a type of chronically recurring headache with sensations of throbbing, pulsing, and extreme pain that are often centered on the temples or one side of the head. These symptoms can last for several hours to many days in extreme cases. They may include a warning sign, called an aura, that distorts the senses of perception and lets the person know migraine pain is imminent - however, more frequently, they set in with no warning at all. The severe symptoms of migraine make it hard for sufferers to work, maintain a social life, and if frequent, can cause depression due to the hopelessness sufferers feel.
No exact cause of migraine has been determined - in fact, migraine sufferers have identified a large number of triggers that can set off an attack, including hormonal changes, emotionally-charged experiences, environmental factors like the weather or allergen levels, diets or certain foods, prescription medication, and more. With so many triggers setting off migraines, and such a wide range of symptoms experienced from person to person, it has been extremely hard for science to identify a single pathway responsible for migraine pain in the brain. Researchers have not been able to narrow the root cause beyond “abnormal activity” in the brain - which could impact electrical communication between nervous system cells, chemical signaling pathways, and the transport of blood in the brain as well. Just one of these disturbances would be enough to result in a headache - the compounding of two or more such disturbances during migraine attacks makes the experience near unbearable for chronic sufferers.
In the face of such a diverse disease pathology that has long proven resistant to treatment, how does our Endocannabinoid System (ECS) come into play as a potential source of targeting to provide relief? For starters, our brains - especially the specific brain regions often identified in migraine pain - are thick in Endocannabinoid Receptors like CB1 & CB2. Activating these receptors has been shown to treat symptoms of migraine like nausea, convulsive electrical impulses, and acute pain in patients with cancer, AIDS, seizures, and other chronic illnesses. If you have some knowledge of the many applications of medical marijuana, it is likely no surprise that stimulation and regulation of our ECS is able to help migraine sufferers thanks to the system’s thermostat-like regulation of our bodily processes, allowing a multi-pronged approach to migraine relief. The whole-plant cannabis medicine that interacts most naturally with our ECS can then potentially be much more effective for a wider population suffering from a mix of migraine triggering pathways than a refined pharmaceutical that targets only a single pathway. We’ll examine this whole-plant medicine effect of cannabis on the symptom pathways of migraines in the next section.
How Cannabis Might Address the Symptoms of Migraine Conditions
Though anecdotal evidence that migraine sufferers can use cannabis to reduce and relieve symptoms has long been observed (and when we say long observed, we really mean it - Assyrian and Ayurvedic texts describe cannabis as a treatment for extreme headache as far back as 2,000 BCE!), scientists have only recently begun to examine the connections between cannabis compounds and migraine relief in the lab setting. Leading migraine researchers have indicated that cannabis and its constituent chemical compounds are able to modulate many pathways inherent to migraine signaling, effectively reducing the severity and/or frequency of migraine attacks. In fact, a 2016 study conducted by Colorado researchers found migraine prevention to be medical cannabis’s greatest benefit for chronic migraine patients, with inhaled cannabis able to abort active migraine pain in many patients studied.
Cannabis’s main mode of action against migraine - like most of the conditions for which it is medicinally valued - is through relieving our sensation of pain. Cannabis can have both analgesic (localized pain prevention) and anesthetic (nervous system-wide depression in sensation of any kind, including but not limited to pain) effects on our body, helping to quiet the pain and other negative feelings associated with migraine. However, the anti-inflammatory actions of THC, CBD, and many main cannabis terpenes can also fight pain by reducing inflammation in the brain that contributes to pain production in migraines. Cannabis compounds can quiet overexcitement of the trigeminal nerve, the main nerve cluster of the head that is often a source of the throbbing felt during migraine Cannabinoids may also be able to inhibit the downstream signaling of pain through the body, reducing body weakness, pain, and tingling in the arms and legs during attacks. A 2018 Study examined the effect of several cannabis strains in managing symptoms of several conditions, including pain and migraine, as well as general non-chronic headache. THC, CBD, and common cannabis terpenes were identified as potent pain relievers and anti-inflammatory agents that reduced headache pain in both condition types - so there is some early but promising scientific evidence of cannabis as a migraine pain reliever through this dual action.
CBD is able to up-regulate the action of our naturally produced endogenous cannabinoids, which can potentially help regulate the vascular structures of our brain and prevent dilation that contributes to pain, as well as chemical signal pathways that lead to migraine. Endocannabinoids also interact with our brainstem, the most core control system of our body, to modulate pain signaling - CBD’s ability to increase the available levels of Endocannabinoids can support this pain relief mechanism. In fact, it is now more increasingly theorized that depressed ECS “tone”, or baseline level of endocannabinoids available in the body at all times, might be partially responsible for chronic migraine syndromes. By using carefully dosed whole-plant cannabis or hemp medicine to support normal ECS operation, migraine sufferers may notice a decrease in the frequency and severity of the migraines they experience.
THC and CBD are not the only cannabinoids that may prove effective against migraine pain as cannabis medicine advances - there is some early buzz around the medicinal potential of CBG, or cannabigerol, a minor cannabinoid produced from the same pre-cursor molecule that develops into THC and CBD. Though usually only present in small concentrations in cannabis products unless refined out, CBG has been found to have many promising medicinal applications that could make it effective in migraine symptom management. In addition to powerful anti-inflammatory actions and control of pain signaling similar to THC and CBD, CBG has been found to reduce intraocular pressure - this makes it very interesting as a potential glaucoma treatment, but intraocular pressure has also been identified as a possible source of the localized pain felt during migraine and acute headache, so CBG intervention may prove helpful during migraine attack as well as for migraine prevention. Dr. Ethan Russo, a leading expert in cannabis science, points out in his revered “Taming THC” paper that CBG is able to work synergistically with several anti-inflammatory and pain relieving terpenes, including Limonene and Linalool, to induce greater pain relief and swelling reduction than either compound could alone. Cannabis and hemp breeders are currently working to produce plants with naturally higher percentages of CBG expressed to maximize the availability of this promising molecule, so we may see even more benefits from CBG and other minor cannabinoids as medical cannabis study advances.
Best Cannabis Product Types for Migraine Sufferers
As you can see from the science available, migraine is a very finicky disorder that has great variance in symptoms and unknown root causes. As such, any medical treatment of this disorder is somewhat mysterious, not guaranteed, and requires quite a bit of personal experimentation to dial in a solution that is helpful for you. Cannabis is never a guaranteed treatment for any illness, and expectations should be appropriately tempered. However, given the severity of migraine symptoms and the current dearth of other effective treatment options, any measure of relief provided by cannabis is likely to be appreciated by patients, and the side effects of cannabis consumption are typically so minimal and temporary as to present a very low barrier to trying a cannabis medicine.
Migraine sufferers report that smoked or vaporized cannabis products are most effective for short-term relief of pain, throbbing sensations, and nausea associated with migraine. However, migraineurs have also found that the extended metabolism of edible cannabis products helps to prevent the frequency and lessen severity of migraine attacks. Tinctures may have similar preventative effects if re-dosed at regular intervals. It’s likely that a combination of consumption methods will be most effective for tailoring your cannabis medicine needs to the time of day and your setting.
Considering the active compounds in your cannabis product is also very important in all medicinal applications. CBD to THC ratios are a matter of personal preference and application, and require some trial and error to dial in for your exact needs - ask your trusted budtender for advice on products to use for your use case. You should also experiment with terpene profiles to find the one that provides you the most relief. In general, it is probably best to avoid distillate products and stick to full-spectrum products for maximum migraine symptom relief, as distillate or isolate products are not as effective at producing the Entourage Effect impacts on our Endocannabinoid systems due to the lack of terpenes and minor cannabinoids.
It also critical to note that cannabis medicine can be very dose dependent. The actions of cannabis compounds, particularly THC and certain divergent terpenes, are often biphasic - meaning at a low dose, they can have a medicinally beneficial effect, but at high dose they can have almost an exact opposite action, and actually cause the symptom they were able to prevent at low doses. For example, too much THC can actually induce the dilation of blood vessels in the brain, leading to headache symptoms - so be sure to balance your THC dose, ratios of active compounds, and frequency of dosing to find a protocol that provides relief without crossing over into a negative place.
Most importantly, keep in mind that cannabis can only do so much to help with migraine symptoms, so it’s vitally important to make sure that you’re taking good care of your health in other ways to hedge your bets on reducing the occurrence of migraines. Physicians and neurologists recommend regular physical exercise, a sufficient sleep schedule, reducing and avoiding unnecessary stress, staying well hydrated, and avoiding foods that you find trigger migraine symptoms in your experience, to keep the body in an optimal state to avoid migraine and other illnesses.
We hope that this overview of the current science behind cannabis’s effect on migraine formation has empowered you to explore new options for managing your migraine pain. Again, if you’re interested in learning more about how cannabis works together with our bodies to support our health in many ways, check out our write-up on the Human Endocannabinoid System. If you’re nervous about experimenting with cannabis for the first time, especially edibles, read our blog post on preventing and combatting the negative side effects of THC overconsumption.
*DISCLAIMER: These opinion pieces are personal experiences of the individual authors, and are not medical recommendations, medical claims, or usage recommendations from the company. Our products are not approved by the FDA to treat, cure or prevent any diseases. Periodic edibles supports responsible cannabis use in accordance with all local laws.