Scientific Confidence Grade	Effect Size Rating	Editorial Note
D	?	CBD might help with endocannabinoid deficiency — a condition that may cause migraines. However, CBD hasn’t been studied for migraines so there isn’t any solid evidence yet.
There’s no research looking specifically at CBD. However, studies have found that medical cannabis (which contains CBD, THC, and other cannabinoids) can reduce the number and severity of migraines.	There aren’t any studies of CBD for migraines.

 

CBD for Migraines: Can It Help? (April 2021)

There isn't any research looking at the use of CBD for migraines. However, mounting evidence suggests that a dysfunctional endocannabinoid system can be cause, which means CBD might help with migraine treatment.

 

Cannabis is a popular option for migraine sufferers looking for relief. As such, it’s not surprising that some turn to cannabidiol (CBD) products, which lack intoxicating effects.

 

While early research has shown that cannabis — which contains both THC, CBD, and other active compounds — can relieve migraines, there’s a lack of research looking specifically at CBD.

 

However, there’s growing evidence that a dysfunctional endocannabinoid system can be involved in migraines.

 

If this holds true, CBD could be beneficial for this and other difficult-to-treat conditions.

 

Migraines Overview

Migraine is a common disorder characterized by painful headaches that usually occur on one side of the head. It can also cause nausea, sensitivity to light, and other symptoms.

 

In some cases, migraines are preceded by or happen alongside aura symptoms, which include visual effects such as blind spots and other issues such as feeling tingling sensations and hearing noises.

 

Migraines typically come in the form of recurrent attacks that can last anywhere from a few hours to several days. They can be triggered by certain foods, weather, stress, caffeine, sleep disturbances, and other factors.^[1]

 

Researchers are not completely sure what causes migraines but genetics, neurochemical imbalances, and dysfunctions in certain parts of the brain appear to be involved.

 

Migraine Subtypes

Migraines can be divided into the following types:

 

• Common migraine: the most prevalent type of migraine that doesn’t involve aura symptoms.
   
• Classic migraine: migraine accompanied by aura symptoms for up to 30 minutes before headaches.
   
• Hemiplegic migraine: a more severe type of aura migraine with weakness on one side of the body.
   
• Ocular migraine: aura symptoms with partial or full loss of vision in one eye followed by migraine headaches.
   
• Menstrual migraine: migraines that occur days before, during, or after a woman’s period.
   
• Migraine equivalent: aura symptoms without any headaches.

 

Migraines Symptoms & Pathology

Although a throbbing or pulsating headache is the main symptom of migraines, you can also experience other issues.

 

Migraine attacks typically occur in phases, although not everyone experiences all four:

 

1. Prodromal phase (day or two before the headache), where people may have depression, irritability, neck stiffness, and food cravings.
    
2. About 25% of sufferers also experience aura, which can include visual, auditory, sensory, and other symptoms, such as bright lines, blind spots, hearing music and other noises, and feeling tingling or numbness. The aura phase typically occurs before or as the headache starts.
    
3. The headache phase, which can occur on one or both sides of the head and be accompanied by nausea, vomiting, and sensitivity to light and sound.
    
4. Postdromal phase, where you may experience short-lasting headaches when moving your head and feel tired.

 

Can CBD Help with Migraines?

Researchers hypothesize that CBD and other cannabinoids may relieve migraines by interacting with the body’s endocannabinoid system (ECS).

 

The ECS is composed of a network of cannabinoid receptors (CB1 & CB2), enzymes, and natural endocannabinoids made by the body to maintain a balanced state called homeostasis. To do so, the ECS regulates brain function, pain, immunity, metabolism, and many other processes.^[2]

 

In particular, researchers believe that a dysfunction of the ECS called clinical endocannabinoid deficiency (CED) may be linked to migraines.

 

First proposed by respected cannabis researcher Dr. Ethan Russo in 2001, this theory argues that deficient endocannabinoid levels could lead to certain health disorders.

 

Since then, researchers have been finding more support for the theory. There’s particularly strong evidence that a dysfunctional ECS is linked to irritable bowel syndrome, fibromyalgia, and migraines.^[3]

 

First off, studies show that endocannabinoids may be able to inhibit the brain’s trigeminovascular system, which is widely considered to play the central role in causing migraines.^[4]

 

Additionally, there’s evidence that the migraine-relieving effects of drugs called triptans are at least partially dependent on the ECS.^[5] Triptans include common drugs such as Imitrex, Amerge, Zomig, Maxalt, Axert, Frova, and Relpax.

 

Researchers also believe that a dysfunctional serotonin system may be involved in migraines. To illustrate this, one study looked at platelets, a type of blood cell which may play a role in migraines.

 

The scientists found that endocannabinoid and serotonin levels were significantly lower in the platelets of people with chronic migraines and medication overuse headaches (MOH) as compared to healthy individuals.^[6]

 

Another interesting link are the symptoms of migraines, which include sensitivity to light, touch, and nausea — all effects that the ECS is known to regulate.^[7]

 

Meanwhile, genetic studies suggest that certain endocannabinoid genes may be linked to migraines. For example, one study showed that specific variations of the CB1 receptor gene were associated with an increased risk of migraines.^[8]

 

There’s also ample evidence for the involvement of the natural endocannabinoid, anandamide, in migraines:

 

• One study found that chronic migraine sufferers had reduced cerebrospinal fluid anandamide levels compared to healthy individuals.^[9] This is considered the key piece of evidence that endocannabinoid deficiency could be a cause of migraines.
   
• Another study found that anandamide interacted with serotonin receptors in a similar way to drugs that relieve migraines.^[10]
   
• In an animal study, anandamide directly inhibited trigeminovascular neurons which when overstimulated may cause migraines. This suggests a mechanism by which endocannabinoids like anandamide can improve migraines.^[11]
   
• Researchers have used anandamide to reduce migraine-like pain in rats.^[12]

 

In summary, research findings indicate that a dysfunctional endocannabinoid system can be involved in migraines and that plant-derived cannabinoids may be able to help.

 

CBD is an especially promising candidate because one of its major effects is suppressing FAAH, the enzyme that breaks down the endocannabinoid, anandamide.^[13]

 

According to a review conducted by a team of Italian and American researchers, “inhibition of AEA degradation via FAAH is a promising therapeutic target for migraine pain.”^[14]

 

What Does the Research Say?

There are currently no studies on CBD for migraines.

 

However, we can gain some helpful insights from studies of whole-plant cannabis, which contains CBD as the second-most abundant active ingredient after THC. THC is the psychoactive cannabinoid often associated with the cannabis plant.

 

In one Colorado trial, medical cannabis use (smoking, vaping, edibles, or topicals) improved migraines in 85.1% of 121 participants. Interestingly, cannabis not only reduced the number of migraines but also stopped them when taken during an attack.^[15]

 

Another study found that when inhaled, whole-plant cannabis improved regular headaches and migraines in 94% of 699 study participants.^[16]

 

Similarly, a retrospective study of 316 people with chronic migraines found that 88.3% saw improvements from using medical cannabis. The study also noted that patients using cannabis with a higher THC to CBD ratio (20:1) reported greater improvements than those using a 1:1 ratio.^[17]

 

Another study found significant reductions in migraine and headache severity from inhaling cannabis, with concentrates being more effective than regular cannabis. In this case, CBD and THC content did not seem to influence the effectiveness of cannabis.^[18]

 

These findings support the idea that a combination of THC and CBD can reduce the number and severity of migraines.

 

However, there isn’t enough data to say whether THC is more effective than CBD for migraines or whether CBD-only preparations would produce similar effects.

 

Ultimately, human studies looking specifically at CBD for migraines are needed.

 

How Much CBD Should I Take for Migraines?

There isn’t enough evidence to suggest a CBD dosage for migraines.

 

Besides, the optimal dosage is different for everyone and depends on multiple factors, including body weight, genetics, migraine severity, and CBD product type.

 

Your best option is to follow the “start low and go slow” approach suggested by most health experts.^[19]

 

Ideally, you’ll want to take CBD when you feel a migraine coming on so you can see whether it helps.

 

Start with a small amount of CBD (10-15 mg) and assess how you feel. If you don’t notice any relief, raise the dose in small increments over time until you find one that provides the desired effects.

 

If you want to experience immediate effects, inhaling CBD by smoking or vaping is the best option. However, CBD oils, capsules, and edibles can be used as well.

 

Are There Any Side Effects?

According to decades of research, CBD is a generally safe, well-tolerated compound.^[20]

 

While some studies have reported that CBD can cause side effects, they were mostly considered mild and occurred only when using high doses of pure CBD.

 

The possible side effects of CBD include: ^[21]

 

• Tiredness
• Drowsiness
• Diarrhea
• Nausea
• Dry mouth
• Low blood pressure
• Lightheadedness
• Changes in appetite or weight

 

Since most people use smaller doses of CBD and often opt for whole-plant formulations rich in many other natural compounds, the chances of experiencing these side effects are slim.

 

However, it's important to note that CBD remains unapproved by the Food & Drug Administration (FDA). With that, it's unclear how safe it is for people of all categories to take. For example, pregnant women are advised to avoid CBD as there isn't enough research to suggest its safety.

 

Conclusion

At this time, there isn’t much evidence that CBD for migraines is beneficial.

 

The only studies completed so far used whole-plant cannabis, which includes high concentrations of THC and many other active compounds, so it’s difficult to determine the effects of CBD.

 

Still, there is some evidence that CBD can help from a theoretical standpoint. Researchers have uncovered more and more evidence that dysfunction in the endocannabinoid system is involved in migraines.

 

Since CBD can influence this system by reducing the breakdown of endocannabinoids, it may have a positive effect on the number and severity of migraine attacks. Not to mention, it may be able to be used for therapeutic purposes alongside migraine medication.

 

References