What is cachexia?
Millions of people around the world suffer from chronic conditions such as cancer or HIV/AIDS, significantly impairing their quality of life. Both of these conditions are notorious for manifesting, at least partially, in the form of severe weight loss, decreased appetite, fatigue, depression, and weakness.
So much so, that individuals suffering from these conditions may often not be able to lead a normal life after diagnosis, even when they are receiving treatment. This state of illness that comes in the presence of conditions such as cancer is known as cachexia or wasting syndrome.
Although treatment can efficiently take care of the underlying cause of the symptoms (in the case of cancer, the cancerous cells), it does not always do a great job at treating the symptoms themselves. In fact, treatments such as chemotherapy greatly exacerbate this state of illness in cancer patients and may worsen the common symptoms of cachexia syndrome.
Cachexia syndrome tends to have a shaky definition and no therapeutic treatment is available at the moment. This is mainly because cachexia syndrome is not necessarily a disease, but rather a state of illness that comes as a consequence of another more severe condition.
Because no therapeutic treatment is available, physicians usually resort to weight gain regimens and suggesting supplements or activities that may raise energy levels in the patient. Of course, this approach is not always efficient and is highly variable amongst physicians. Additionally, there is truly no “one size fits all” approach for weight gain or increasing energy levels in patients suffering from cachexia syndrome.
How does CBD improve the symptoms of Cachexia?
Although cachexia is accompanied by other symptoms such as fatigue and muscle weakness, one of the main identifiers of the syndrome is extreme weight loss. Weight loss can come from two factors: anorexia or an abnormal increase in energy expenditure and metabolism.
When the weight loss in cachexia is caused by anorexia, the whole syndrome is referred to as cachexia-anorexia syndrome. Anorexia usually presents itself as a lack of appetite at meal times, loss of taste for food or even loss of enjoyment for food.
On the other hand, when the weight loss in cachexia is not caused by anorexia, it is caused by an increase in the levels of inflammatory cytokines and energy expenditure. This state of chronic inflammation is seen predominantly in patients with advanced stages of cancer. Even if the patient has not lost appetite and is eating on a regular schedule, they will lose weight due to this abnormally increased metabolism. The patient will lose weight in both adipose tissue (fat) and muscle tissue.
Anecdotally, the recreational use of cannabis leads to an increased appetite in users. This is colloquially known as “the munchies”. Because of this, researchers have been interested in understanding the mechanisms that lead to this increase in appetite. Furthermore, they have been even more interested in understanding how cannabis and its extracts (cannabinoids) could be used for conditions characterized by weight loss and loss of appetite.
In current clinical practice, there exists therapeutic agents that can help with both HIV/AIDS and cancer-related cachexia. For example, some current cancer-cachexia treatments include synthetic cannabinoids like dronabinol, progestins, corticosteroids and anabolic steroids. These, however, have been deemed insufficiently effective and carry with them various severe side effects such as muscle pain or increased risk for blood clots.
So coming back to our original question, can CBD help with cachexia syndrome?
As you may or may not be aware, this is an extremely complex question… That is simply because there actually have not been any studies regarding up to this date that have looked at the implications of CBD use in cachexia syndrome.
Other studies looking at the use of CBD for conditions such as inflammatory bowel syndrome (IBS), obesity and cardiovascular disease have yielded relatively satisfactory results. These satisfactory results have been mainly due to the fact that CBD is known to have anti-inflammatory properties. As mentioned in our previous articles, CBD is thought to confer these anti-inflammatory properties through its interactions with CB2 receptors on immune cells and gut epithelia.
Even though the use of CBD for anti-inflammatory purposes in other conditions shows promising results, both experimentally and anecdotally, its use for cachexia may not provide the same effects. The main problem with cachexia syndrome is that it predominantly affects patients suffering from cancer or HIV. These types of patients possess extremely weak immune system and may not respond to a CBD treatment the same as an otherwise healthy patient would.
However, CBD has been previously used by cachexia syndrome patients to relieve the common symptoms of the condition. Then again, this is purely anecdotal and there are no studies that provide convincing evidence of such benefits. Moreover, it is THC in cannabis, not CBD, that has been shown to increase appetite levels in its recreational users. Therefore, nothing points to the idea that CBD in particular would be helpful for this condition.
Initially it was thought that THC could be part of the solution because of its ability to increase appetite in cannabis recreational users. However, many studies comparing THC against control-placebos have demonstrated that no significant weight gain is achieved by using THC.
In addition, because THC possesses psychoactive effects, it is heavily contraindicated by physicians. This is simply because the use of THC may induce a state of paranoia, cognitive disorientation or other common side effects of a “high”, which may increase anxiety in patients. Subsequently, anxiety could worsen the loss of appetite rather than improve it.