5 Best Cannabis Strains for Cystic Fibrosis
Cystic fibrosis is a life-threatening genetic disease with no cure. However, cannabis may help some patients with cystic fibrosis address their symptoms and improve their overall quality of life.
There is much talk about medical marijuana and the variety of chronic illnesses that it can help to manage. At present, medical cannabis is legal in more than two-thirds of the states throughout America. According to the Lung Institute, medical cannabis is effective at reducing inflammation, easing pain, improving sleep, reducing phlegm, and supporting the immune system. While research into the use of cannabis to treat cystic fibrosis is limited, this natural option shows much promise in addressing some of the condition’s symptoms.
This article will discuss what cystic fibrosis is, what some of the conventional treatment options are, and what studies have been published regarding cannabis and cystic fibrosis. And of course, we’ll list five strains that may help address some of the symptoms of cystic fibrosis.
What Is Cystic Fibrosis (CF)?
Cystic fibrosis is a genetic condition that affects more than 30,000 people in the United States. People who suffer from the disease are born with it – it is not a condition that a person develops or contracts later on in life.
To be diagnosed with cystic fibrosis, the person must have inherited two copies of a particular gene – one from each parent. Since many different gene mutations cause CF, people who suffer from the disease can have very different symptoms, depending on the two genes that they carry.
Cystic fibrosis causes a wide range of challenging symptoms that affect the entire body.
Estimates suggest that one in 25 people carries the gene that causes CF, and many people who carry it do so without ever knowing.
On a molecular level, the gene affected by CF controls the movement of water and salt in and out of cells. As such, people who suffer from cystic fibrosis experience a buildup of thick, sticky mucus on the lungs, digestive system, and other organs. This buildup of mucus causes a wide range of challenging symptoms that affect the entire body. Let’s take a look at the two of the most common ones:
A buildup of mucus in the lungs causes chronic infections, which means that people with CF struggle with reduced lung function. CF patients sometimes have to take hours out of each day to do physiotherapy and take nebulizer treatments. The sudden worsening of health can lead to frequent hospitalization, often for weeks at a time.
Some of the effects of the respiratory system due to CF can include:
- Sinus infection
- Stuffy nose
- Sinus pain
- Mucus-filled cough
- Frequent lung infections
- Inability to exercise
Digestive and Endocrine Systems
CF can cause the pancreas to get blocked with mucus, and when this happens, the enzymes required for digesting food can’t reach the stomach. As such, people with this disease often need to take more than 50 tablets a day to help digest food and keep respiratory problems in check.
When it comes to digestive symptoms, those with this disease often suffer from:
- Poor growth
- Lack of appetite
- Intestinal blockage
- Abdominal pain
CF also causes additional problems. For instance, men with the disease are usually infertile, and pregnancy can put a lot of stress on the body of a woman who suffers from the condition. Additional complications include bone disease, bowel obstructions, and CF-related diabetes, amongst other things.
Conventional Treatment for Cystic Fibrosis
As we mentioned previously, there is currently no cure for cystic fibrosis. Medical professionals tend to treat the symptoms of CF on a case-by-case basis, as the effects often differ from one person to the next.
Conventional treatment aims to relieve the symptoms and reduce any complications that may occur as a result of cystic fibrosis.
Treatment aims to relieve the symptoms and reduce any complications that may occur as a result of this disease. Moreover, doctors look to prevent and treat intestinal blockages and infections and loosen and remove mucus from the lungs. Good nutrition is a vital part of the treatment plan.
Also, since there are various symptoms associated with cystic fibrosis, there are several different treatment methods, some of which we will take a closer look at below.
Chest Physical Therapy
The loosening up of mucus in the lungs makes it easier to cough up and expel from the body. Chest physical therapy helps to loosen mucus, and usually, CF patients will do this one to four times a day. A common technique is to clap with cupped hands on the front and back of the chest. There are also breathing techniques that CF patients can use to loosen mucus.
Medical professionals might recommend a long-term program that could improve lung function and overall well-being. Pulmonary rehabilitation is typically done on an outpatient basis and might include physical exercise, counseling and support, breathing techniques to loosen mucus, nutritional counseling, and education about the condition.
Surgical and Other Procedures
There are also a few invasive and non-invasive procedures that health professionals might carry out to treat this condition:
Feeding tubes: Because CF interferes with digestion, people with this condition can’t absorb nutrients from food very well. Therefore, doctors might suggest using a feeding tube while the CF patient is asleep to deliver extra nutrition.
Nasal polyp removal: This refers to surgery to remove nasal polyps that obstruct breathing
Bowel surgery: If the bowel becomes blocked, the patient may need surgery to remove the obstruction(s). When a section of the bowel folds in on itself (known as intussusception), it may also require surgical repair.
Lung transplant: In severe cases, if the patient has problems breathing, increased resistance to antibiotics, or life-threatening lung complications, a lung transplant may be necessary.
Oxygen therapy: If the patient experiences a decline in blood oxygen levels, they may need to breathe pure oxygen to prevent high blood pressure in the lungs.
Studies on Cannabis and Cystic Fibrosis
It seems that very few medical scientists have delved into research concerning cannabis and cystic fibrosis. Hopefully, this will change with the methods of medical cannabis delivery and synthetic derivatives of marijuana being developed more rapidly than in previous years.
Although there is a lack of research in this area, some studies have been conducted. For example, a 2002 review article by Esther Fride discussed the possibility of marijuana as a potential medicine for cystic fibrosis. Fride’s paper concluded that cannabis could potentially alleviate many of the symptoms associated with CF.
Appetite, Nausea, and Vomiting
One of the symptoms that cannabis could potentially address is decreased appetite. Cannabis has been known for years to stimulate the appetite. THC is the cannabinoid thought to be effective in addressing this symptom.
Lack of appetite, which can result in malnutrition, is a contributing factor to the mortality of CF patients, and this is why some doctors have proposed giving THC to those suffering from the disease. They believe that THC will alleviate malnutrition, and therefore help to prevent chronic wasting in CF patients.
Cannabinoids could also potentially alleviate the nausea and vomiting that often accompanies appetite loss in CF.
Fatty Acid Imbalance and the Endocannabinoid System
Fride’s research suggests that a fatty acid imbalance is often observed in CF patients. This is relevant because fatty acids are precursors to endocannabinoids, cannabinoid-like compounds that the body produces naturally.
Endocannabinoids have various essential roles in our physiology. They influence many of the symptoms that occur in CF, such as lack of appetite, nausea, and lung pathology.
More evidence is needed, but Fride hypothesizes that an endocannabinoid deficiency could contribute to CF’s etiology. If this proves to be the case, cannabis-derived cannabinoids, such as THC and CBD, could help to restore balance.
Find out which is best…
A 2011 study by Fride and Bregman supports this theory. The researchers administered THC to young mice with CF. They found that, compared to controls, the treated animals had improved motor activity and anxiety in adulthood. Both of these features may be influenced by fatty acid imbalance and endocannabinoid deficiency.
In the same year, the duo also published a paper suggesting THC administration could counter infertility in male CF mice. Again, they attribute this effect to reversing endocannabinoid dysfunction.
However, while these results are promising, further research is necessary to determine whether they can be replicated in humans.
Rates of Cannabis Use Among Cystic Fibrosis Patients
According to a 2020 survey, 16.5% of CF patients used medical cannabis in their lifetime, with 15.4% using it in the previous year.
The most common reasons for using cannabis included:
- Pain relief
- Appetite stimulation
The most common consumption methods were edibles and vaping.
Of the 31 participants who had used cannabis, 28 found it “a great deal effective” for their symptoms. Furthermore, 21 rated it as very important or important to their health.
5 Best Cannabis Strains for Cystic Fibrosis
[It is crucial to understand that cannabis is not an FDA-recognized medicine or treatment option for cystic fibrosis or for any related symptoms. If you live in a state where medical marijuana is illegal, be advised that consuming marijuana may result in criminal penalties.
Of course, not every marijuana strain is created equally, which is why you need to find the best one for cystic fibrosis. We offer five possibilities below. Please note that these haven’t been proven to be the best strains for cystic fibrosis in any studies; they are merely our recommendations.]
1. Silver Haze
Silver Haze was the first seed strain to deliver the full-strength haze experience quickly and compactly. A combination of Haze and the non-dominant indica variety Northern Lights, Silver Haze has a strong but clear-headed sativa effect. Its name derives from the large number of shiny THC glands (trichomes) that cover the buds.
With its high THC content, Silver Haze packs a punch that can give users a long-lasting body high. Medical cannabis consumers often appreciate the high THC content of this strain, as it contains between 20 – 24% THC on average – all but ensuring that any tension or stress will float away.
Silver Haze is also one of the best strains for anyone who suffers from a loss of appetite, as it kickstarts the hunger hormones without leaving the user stuck on the couch. As we have discussed above, lack of appetite is one of the significant symptoms associated with cystic fibrosis.
Blueberry is another strain with a high THC content. It’s a three-way cross between the indica strain, Afghani, a Thai sativa, and a Purple Thai variant. This strain is renowned for its unmistakable fresh blueberry aroma and flavor, making it a favorite among cannabis enthusiasts.
Blueberry’s THC content ranges between 15% and 24%, which is likely why some people have had success addressing cystic fibrosis symptoms. It leaves users feeling nicely relaxed, with a lasting feeling of peace and euphoria.
While appealing flavors and a great look are a bonus, this strain has achieved much hype for its potent medical benefits. Along with some incredible results for addressing anxiety, the deep bodily relaxation of Blueberry also may provide relief from pain, rigidity, and muscle spasms.
3. Blue Blood
A cross between Blueberry and OG Kush, Blue Blood can have a THC content of up to 20%. It carries the potent legacy of Blueberry and adds a sweet berry flavor to its diesel and pine undertones. Blue Blood users have described the high as slow-building, with a gradual feeling of euphoria and a high level of pain relief. For these reasons, Blue Blood may help some patients with chronic pain, muscle spasms, insomnia, and MS.
It’s also rated as one of the top strains used to address digestive problems, which is why it may be beneficial for some users with cystic fibrosis. Although this is quite a potent strain, it has a fairly high CBD content. Therefore, while it does offer a rewarding head and body high, it doesn’t leave the user feeling too sedated.
4. Black Widow
The name of this strain says it all – with THC levels that can go above 24%, Black Widow is one of the most potent cannabis strains of all time. It is only suitable for patients who have experience using cannabis because it is so intense that it could trigger panic attacks and THC-induced paranoia. However, for those who can tolerate it, this is an incredible strain to address physical pain, muscle spasms, depression, headaches, and everyday stress.
It has also shown promise in inducing hunger in patients with wasting syndrome, which is one of the big problems for CF. It’s a hybrid strain with an outstanding balance of both indica and sativa genetics. It delivers a forceful cerebral high with a fast onset that is highly intense and blissful, followed by laziness and couch lock. It’s best for evening and nighttime use because of its sedative effects.
Tangerine is a sativa-dominant hybrid with a fruity aroma and mango-like tropical flavors. It offers a euphoric and positive buzz while providing relief from stomach pain, headaches, and anxiety. Stomach pain is often a symptom of cystic fibrosis, which is why this strain may have the potential for managing this aspect of the condition.
Users state that the tangerine high is just as pleasant as the taste and is perfect for daytime use when a short-term energy boost is required. Consumers typically experience a strong euphoric onset that initially leaves them feeling energized, followed by a deep, happy relaxation through the body and mind that isn’t sedative but rather pain and tension-reducing.
Because of its powerful effects, its high average CBD level of 2%, and its THC level of up to 18%, this is a great strain for addressing chronic pain, inflammation, depression, and muscle spasms.
Final Thoughts on the Best Cannabis Strains for Cystic Fibrosis
Cystic fibrosis is an incurable disease, but thankfully some cannabis strains could help address some of its symptoms. Since THC is thought to be the most effective cannabinoid at alleviating some CF symptoms, we have chosen cannabis strains with a high THC content.
Of course, very little research has been conducted on cannabis for cystic fibrosis. We can only hope that as an increasing number of states legalize cannabis across the United States, more research will look into cannabis for cystic fibrosis.
Use of medical marijuana in cystic fibrosis patients
The usage and attitudes towards medical marijuana in Cystic Fibrosis (CF) patients is unknown. Through the use of a survey we aim to clarify rates and reasons for use.
An anonymous survey was sent out to six centers in the Mid-Atlantic region of the United States. Use of and reason for medical marijuana was assessed, along with attitudes of the perceived utility of medical marijuana.
A total of 637 surveys were sent out, and 193 surveys were returned (30.3% return rate). Three did not give consent, and one was empty, for a total of 189 completed surveys. 31 subjects (16.5%) reported having used marijuana for medical purposes in their lifetime, with 29 (15.4%) of these in the past year. The most used forms were edible and vaporized. The most common indications for usage were pain and stress. 28 out of 31 found marijuana to be a great deal effective for their symptoms. 21 of the 31 rated marijuana very important or important to their health. There were two reported side effects, both mild. Of 156 subjects who responded to the question if they would be interested in medical marijuana if available, 72 (46.2%) replied yes.
The use of marijuana for medical reasons was 15.4% in the past year in this sample CF population, although more expressed interest if it was available through prescription. Side effects were rare. CF physicians are going to have to familiarize themselves with advantages and disadvantages of medical marijuana as there is a great deal of interest within the community, and legalization becomes more common.
The availability of and belief in medical marijuana have recently increased dramatically in the United States. Today, 33 states and the District of Columbia have laws permitting its use, giving 63% of the population access . The evidence for the utility of medical marijuana, however, is limited to moderate-quality evidence for chronic pain and spasticity and low-quality evidence for Tourette syndrome, sleep disorders, weight gain in HIV infection and nausea and vomiting due to chemotherapy .
Cystic fibrosis (CF) is a genetic disorder most commonly diagnosed at birth. The lungs are the cause of mortality in 90% of patients, but morbidity from chronic pain, depression, and anxiety are becoming more common as lifespan has recently increased . Treatment of CF with marijuana is complicated by the fact that marijuana is often smoked or vaporised, and inhalation from any source by somebody with a chronic lung disease is discouraged. There is no evidence that alternative delivery systems such as vaporisation are safer than smoking . Drug interactions, especially with new CF transmembrane modulator therapies, are areas of concern as the chemically active components of marijuana, cannabinoids, have the potential to induce the liver enzyme CYP1A2 .
The current rates and reasons for use of medical marijuana are unknown in the CF population. Only two studies assessing usage rates specifically in CF could be identified in PubMed, both older. The first, published in 1987 by Stern et al., surveyed 173 CF patients and found a 20% marijuana-usage rate .
The other study, published in 1998 by Britto et al., showed a 9.7% prevalence in the 115 CF patients surveyed . This study is an attempt to assess current usage rates and to discern the intake route and reasons for medical marijuana usage in a CF population.
An electronic survey entitled ‘An Anonymous Survey of Alternative and Complimentary Therapies in Cystic Fibrosis’ was sent via email to patients 16 and older in six CF centres in New Jersey and Pennsylvania. Institutional Review Board approval was obtained at all sites, and the survey was earlier tested on medical residents. The survey was without compensation. Data were collected from March 2017 through February 2018, during which period there were no legal medical marijuana laws for CF patients in either Pennsylvania or New Jersey. Electronic consent outlined the study length, principle investigator and purpose of the survey. Medical marijuana questions were one part of an overall assessment of the use of alternative medicines. Forty-one questions were asked, all on a single page. RedCap, a secure HIPAA compliant data collection tool, was used to collect and store data.
The data were analyzed using SAS version 9.4 (SAS Institute Inc., Cary, NC). Wilcoxon two-sample tests were used to determine whether age group, lung health, or overall health influenced current use of medical marijuana or the use of medical marijuana if it were made legal. A continuity-adjusted chi-squared test was used to determine if gender impacted current or future use of medical marijuana.
Surveys were sent to 637 subjects, with a total return of 193 surveys, for a return rate of 30.3%. Three subjects refused consent, and one subject left the survey completely blank, leaving 189 surveys for analysis. Baseline characteristics, which overall appear to reflect an average adult CF population, are shown in Table 1. Not all questions were answered by all subjects, so the number of responses is slightly variable by question.
Of the 189 survey completions, 31 subjects (16.5%) reported having used marijuana for medical reasons, and 29 subjects (15.4%) reported having done so in the past 12 months. The route of administration used by subjects was diverse, with 90% reporting edible use, 48% vaporised, 38% smoked, 25% oil, 6% tea, and 6% topical. Edible was the preferred method of 48% of the subjects, while vaporized was preferred by 32%, smoked by 13%, and oil by 6%. Reasons for use are listed in Table 2.
Of the 31 subjects who had used marijuana for medical issues, 28 (90.3%) stated that it was highly effective for their symptoms, with one subject each indicating that it was somewhat, only a little, or not at all effective. Of this same group of 31, 21 thought medical marijuana was either important or very important to their health, while six stated that it was somewhat important and four said that it was not at all important. Two subjects of the 31 reported side effects, with one citing drowsiness and the other reporting fatigue, dizziness, and cold hands and feet.
In response to whether they would be interested in trying medical marijuana if it were available, 72 of the 156 subjects who answered the question responded yes (46%). A text response box was provided for giving a reason as to why they would want to try medical marijuana. In the 44 responses from those who had not tried marijuana previously, 10 reported that they would do so for anxiety, nine for musculoskeletal pain, six for appetite stimulation, four for improved breathing, three for sleep aid and one each for coughing, Parkinson’s tremor, bipolar disorder and to expand consciousness.
The Wilcoxon two-sample test used to determine whether age, lung health, or overall health influenced current or future use of medical marijuana did not achieve significance for any variable. There was a trend for current use among younger subjects, which achieved a p-value of 0.062. The continuity-adjusted chi-squared test also showed no significance in the analysis of gender on the current or possible future use of medical marijuana.
Cystic fibrosis is a chronic lung disease that can commonly cause pain, anxiety, depression and insomnia as well as chronic dyspnoea. One study demonstrated that 32.6% of CF patients regularly experience intense to severe pain, while the average rates in adults with CF of anxiety and depression are 21.8 and 27.2% respectively [3, 8]. Medical marijuana has been proposed as a possible treatment for these conditions.
No study has ever documented the usage rates of marijuana specifically for medical use in the CF population. Two prior studies did evaluate the use of recreational marijuana, with a rate of 20% in the study by Stern et al. in 1987, while in 1998 Britto found a rate of 9.7% [6, 7]. In this study, we found a rate of medical marijuana use of 15.4% in the year prior. The reasons for usage in this CF population were varied, with anxiety, musculoskeletal pain and appetite stimulation the most common. Those who used it overwhelmingly found it to be very effective, and adverse events were rare although controlled studies are lacking.
The incidence of medical marijuana use in CF has the potential to increase as this survey was done prior to a legal indication for CF in the states of residence of those surveyed. As reported in this study, 46% of subjects indicated they would be interested in trying marijuana if it were legally available. This would be a substantial rise from the current 15.4% who have used it in the past year.
Use of marijuana has been overall increasing in the U.S. recently, and current rates in the general population mirror usage in this CF population. In a poll conducted in 2018, 14.6% of adults in the U.S. had used marijuana in the past year . In a 2012—2013 poll, the rate of adults in the U.S. who had used marijuana in the past year was 9.5%, while in 2001–2002 the rate was 4.1% .
In comparison to CF and the general usage frequency in the U.S. of about 15%, other disease-specific studies have shown variable, but generally higher, rates. One study in the U.S. analysed utilisation in orthopaedic surgery patients, with 34% of patients using marijuana out of a total of 275 completed surveys . Another study in the U.S., analysing a population with gynaecological cancer, showed a rate of 26.7% of 225 surveys analzyed . A 2004 Canadian study found that 28.8% of 104 patients with HIV reported use . In multiple sclerosis, a Spanish study of 175 patients showed a rate of 17.1%, while in the U.K. in 254 surveys the rate was 30% [14, 15]. A large 2019 study demonstrated a higher usage rate of medical marijuana in younger patients, a trend that was also seen in this study .
It is possible that the somewhat lower rates seen in our survey compared to other chronic diseases is related to the presence of lung disease, which creates a perceived barrier to either smoking or vaporisation. The cigarette smoking rate in the CF population is 2.1%, much lower than 16.9% in 2017 in the general population . This perceived barrier would potentially disappear with legalized medical marijuana as alternative regulated forms like tinctures and creams would be available.
The use of marijuana does not come without potential for side effects, both short and long term. In a 2015 meta-analysis of 79 medical marijuana studies, overall as well as serious adverse events were greater in the marijuana group . Common short-term adverse events were dizziness, dry mouth, nausea, fatigue, loss of balance and hallucination. A 2010 meta-analysis noted a consistent association between marijuana use and psychotic episodes . Neurocognitive issues, motor vehicle accidents and emergency department visits may also be increased with marijuana use . Deleterious lung effects documented include an increased prevalence of chronic cough, sputum production, wheezing, shortness of breath as well as episodes of acute bronchitis . This lung morbidity could be more deleterious in the CF population which already has underlying pulmonary disease.
Given this, physicians will need to discuss marijuana use with their CF patients and counsel them on the potential for side effects. As importantly, the route of use should be discussed. In this study, vaporisation or smoking marijuana was the preferred delivery for 45% of subjects. In light of their pre-existing lung disease as well as the recent crisis of severe disease with vaporisation, inhalation of marijuana from any delivery system should be discouraged .
A limitation of the study was a somewhat low survey return rate, which could imply bias, but overall the cohort was broad based, with 79% reporting pancreatic insufficiency and 74% perceiving either fair or good lung function, both of which are typical of an adult CF population. The data do capture what a substantial segment of CF patients think about medical marijuana. Questions on medical marijuana use were also part of a larger questionnaire on alternative medicine use, so the results would not have been biased by those specifically interested in the subject.
Compared to the current usage rate in the general U.S. population, the utilisation of marijuana for medicinal purposes was comparable in this specific CF cohort. With increased availability and a patient population that is expected to live longer, usage may increase. Based on this study, CF physicians are going to have to begin incorporating discussions about potential usage of medical marijuana in their patient panels, and concerns about side effects as well as the potential for toxicity with inhalation should be part of that discussion.
Availability of data and materials
The entire data set is kept in RedCap, a secure online electronic database which is password protected. The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.
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