Dosage of cbd oil for trigeminal neuralgia

Best CBD Oil For Nerve Pain: Benefits & Dosage For Neuropathic Pain

Only 40% to 60% of patients able to find partial relief from their symptoms with conventional treatments.

Recent evidence suggests CBD oil may be a powerful natural treatment option for nerve-related pain.

Learn how it works & how to use it.

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The human body is full of sensors leading to the brain. They sense temperature, touch, and tissue damage, and relay that information back to the brain for processing.

Neuropathic pain can be the result of damage to the nerves or pain sensors.

Learn what makes CBD so useful for treating neuropathic pain, how to use it effectively, and what other measures you can do to get the best chances of finding relief from your pain.

So, without further ado, let’s get into it.

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Updated on October 20, 2021

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Can CBD Oil Help With Neuropathic (Nerve) Pain?

CBD and other cannabinoids offer relief from various causes of neuropathic pain in humans [2, 3].

It offers most of these benefits through its ability to interact with the endocannabinoid system (ECS).

The ECS consists of a series of receptors and eicosanoids (called endocannabinoids) that regulate homeostasis (balance) throughout the body. There are endocannabinoid receptors found on virtually every organ in the human body, with the highest concentration in the central nervous system.

The endocannabinoid system functions like “read receipts” used in text messages.

When the nerves send a message, the receiving nerve cell uses the endocannabinoid system to tell the sending nerve that the message was received.

This system keeps the entire nervous system in constant feedback with itself and prevents sending the same message more than once — which is essentially what happens when we experience neuropathic pain.

CBD also supports nerve pain by reducing inflammation, activating the vanilloid pain receptors, and alleviating many of the common side effects of nerve pain.

The benefits of CBD oil for neuropathic pain include:
  • Protects the nerve cells & brain
  • Supports nerve cell regeneration
  • Blocks pain transmission
  • Regulates electrical activity in the brain
  • Alleviates anxiety & depression
  • Supports sleep

What’s The Effective Dose of CBD For Neuropathic Pain?

When it comes to treating neuropathic pain — a notoriously difficult type of pain to alleviate — a higher strength of CBD is generally recommended. Most of the research showing benefits from CBD noted an abnormally large dose of the compound to achieve this success.

For this reason, it’s a good idea to work out the dose yourself to find out what’s best for you and your symptoms.

You can use our CBD oil dosage calculator to find the best dose based on your weight and desired level of effects.

Start small and increase the dose every day until you either experience relief from symptoms — meaning you’ve found your dose — or experience side effects. If you experience side effects, you may need to dial the dose back to the last side-effect-free dose.

If you’re still not getting any reduction in pain symptoms with this dose, you may need to combine CBD with other forms of pain management — after consulting with a doctor, of course.

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What Are The Side-Effects of CBD?

Although CBD has been proven to be highly safe many times over, it’s important to know about the potential side effects it may produce.

Everybody is different, and what works for one person doesn’t always work the same way for another.

Here are some of the most common side-effects of CBD:

Which Type of CBD Should I Use?

CBD comes in all different forms — not all are going to work for every condition.

1. CBD Oils & Tinctures

CBD oils and tinctures provide the easiest methods of taking CBD. All you need to do is measure out the desired dose (more on this later) and pop it into your mouth. You can choose to hold the oil/tincture under your tongue for faster absorption or swallow it right away — both will work well.

2. CBD Capsules

CBD capsules are another excellent dosing option you can employ. Capsules are small and easy to carry, deliver standardized CBD doses, and have great bioavailability. They’re also an excellent option for people who don’t want to taste the CBD oil — which can have an earthy, undesirable taste in some cases.

3. Topical CBD Products

Topical CBD is another good option, but only if the source of your neuropathic pain is close to the surface of the skin. It’s recommended that you use it alongside internal forms of CBD, such as capsules, edibles, or oils. This is because the cannabinoids in topical CBD products won’t reach the spinal cord and brain where most of the pain relief comes from when treating neuropathic pain.

4. CBD Edibles

CBD Edibles, including gummies or baked goods, are certainly a fun way of taking CBD — but they’re often inconsistent with dosing (with the exception of gummies). The dosages listed are estimates, and the actual CBD content inside can vary significantly.

For this reason, we don’t recommend relying on CBD edibles as your everyday maintenance dose of CBD for neuropathic pain.

What is Neuropathic Pain?

Neuropathic pain is a type of pain involving damage to or dysfunction of the nerves and somatic sensors found throughout the body.

Any damage to or dysfunction of the nerves and sensory tissues can send pain signals to the brain. These signals warn the body of real damage or dysfunction, but they can also be caused by false messages sent to the brain.

These messages warn the brain of damage that may or may not exist. This makes neuropathic pain difficult to treat, especially when the underlying cause can’t be identified.

1. Central Neuropathic Pain

The central nervous system is any part of the nervous system inside the brain and spinal cord. This is separated from the peripheral nervous system by a semipermeable barrier called the blood-brain barrier.

Central neuropathic pain, therefore, involves pain originating from nerves located inside the central nervous system.

It’s caused by conditions such as:

2. Peripheral Neuropathic Pain

The peripheral nervous system involves any part of the nervous system outside of the brain and spinal cord. This includes all the nerves in the limbs, abdominal cavity, legs, and face.

Often, when a nerve becomes damaged, the repair process may not go as planned. Instead of returning the nerve to the way it was before the damage, the nerve becomes unusually sensitive and will send pain signals to the brain when it shouldn’t.

The original damage can happen from many different causes, primarily traumatic injuries or specific viruses that target the nerve cells directly — such as herpes virus or shingles.

This type of pain is caused by conditions such as:

3. Mixed — Peripheral and Central Neuropathic Pain

Mixed neuropathic pain involves pain stemming from nerves found both inside the central nervous system and inside the peripheral nervous system.

Causes for mixed neuropathic pain include:

  • Cancer
  • Chemotherapy treatments
  • HIV and other viral infections
  • Heavy metal toxicity

What Are The Causes of Neuropathic (Nerve) Pain?

Neuropathic pain is caused by damage or dysfunction of the nerve cells. There are many causes for nerve damage in the body, such as:

Treatments for Neuropathic Pain

  • Antidepressants (SSRIs, SNRIs, and tricyclic antidepressants)
  • Opiate pain medications (morphine, fentanyl, tramadol, and methadone)
  • Surgical nerve blocks (severe cases only)
  • Capsaicin
  • Topical analgesics (lidocaine)

CBD For Spinal Cord Injury

Spinal cord injuries can have debilitating and life-altering consequences. Injuries can cause varying levels of paralysis, spasticity, loss of sensation, muscle weakness, and nerve pain that can persist for the rest of that person’s life.

There are some treatments available for this condition, most of which are supportive — helping those affected manage pain, depression, and other side-effects of the condition.

CBD cannot cure a spinal cord injury — however, it does likely offer a great deal of support for those affected by managing symptoms and promoting the repair of nerve cells in the damaged areas of the spinal cord.

There’s also some indication that CBD can support the recovery process — lowering the severity of side effects and improving motor function in the affected nerves [5].

The Benefits of CBD Oil For Spinal Cord Injury Includes:
  • Managing chronic pain
  • Relieving symptoms of mild to moderate depression
  • Adjunctive treatment to prevent antibiotic resistance during lung infection
  • Alleviating insomnia
  • Promoting nerve regeneration
  • Possibly reducing the extent of nerve damage from the incident

What is a Spinal Cord Injury?

The spinal cord is an extension of the brain. It contains high concentrations of nerve cell tracts that send and receive messages between the body and the brain. Any damage to the spinal cord can result in serious consequences, including paralysis, spasms, neuropathic pain, or loss of organ function.

The spinal cord contains millions of nerve “intersections” that distribute signals to every part of the body. The area of the spinal cord that is damaged will determine what side-effects develop and where.

For example, if the region of the spine containing the nerves that control leg muscles is damaged, it means that there will be a weakness or complete loss of function in those muscles and sensory deficits in one or both legs.

Spinal Cord Injury Symptoms
Types of Spinal Cord Injury

Depending on how severe the injury is, there are three main classifications that doctors use to describe the condition:

  1. Incomplete spinal cord injury — involves damage that hasn’t completely inhibited nerve transmission past the site of injury.
  2. Complete spinal cord injury — damage to the spinal cord is severe enough that no nerve signals can pass across the site of injury.
  3. Brown Séquard Syndrome— damage to exactly one half section of the cord, either left or right hemisection.

There are also several other types of spinal cord injury such as dorsal column lesion, irregular lesions, small or large central lesion, tumor of the dorsal root, or tumor of the meninges or bone.

The Location of the Spinal Cord Injury Matters

Nerves leave the brain and head down the spinal cord in bundles and pairs. They branch off at various points along the way to go to their target organs, and some tracts will cross sides.

The location of the damage to the spinal cord will determine which areas of the body are affected.

Complete damage of the spinal cord will prevent all nerves below the damaged point to stop receiving or sending messages. Therefore, to classify the level of injury, doctors will assess the lowest levels of different sensations and functions of the nerves in the spinal cord.

There are four main divisions of the spinal cord — organized according to the vertebral column. The vertebral column starts at one at the base of the skull and goes all the way to the coccyx. The spinal cord, in fact, actually ends between vertebrae L1-L2, and is followed by a bundle of nerves called the cauda equina the rest of the way down.

Causes of Spinal Cord Injuries

What the Research Says

In 2012, researchers conducted a study on the use of CBD for spinal cord injuries in rats [5]. Rats were either placed in the treatment group and given CBD, or into the control group where no treatment was given. At the end of the six-day study, rats in the CBD treatment group had significant improvements in motor function and reduced injury side-effects than rats in the no-treatment group. Therefore, the researchers conducting this study concluded that CBD might be a useful treatment option for spinal cord lesions (injuries).

Another study used a survey that was handed out to 10 spinal cord injury patients at the Spinal Cord Injury ward of the Miami V.A. Hospital who were using marijuana to treat their symptoms. The survey was kept confidential and involved questions about the most common symptoms of the condition and how marijuana use affected them.

Results of This Survey Listed:
Symptoms Made Worse Made Better No Effect Distraction Not Applicable
Phantom Pain 1 4 2 2 1
Muscle Spasticity 0 5 3 0 2
Bladder Spasms 1 1 7 0 1
Urinary Retention 2 0 8 0 1
Headaches 0 5 4 0 1

THC has also offered benefits for spinal cord injuries. For this reason, a full-spectrum cannabis extract containing both CBD and THC is considered the best option.

Potential Benefits of THC for Spinal Cord Injuries
  • Reduces muscle spasms involved with spinal cord injuries [6]
  • Improves bladder control in spinal cord injuries [7]
  • Reduces pain associated with spinal cord injuries [8]

THC remains illegal throughout most of the world, so it may be difficult to find products containing more than 0.3% THC concentration. Further robust studies will be needed to better characterize standard effects and determine efficacy.

Key Takeaways: Does CBD Oil Work For Neuropathic Pain?

The causes of neuropathic pain can range from neurological issues such as multiple sclerosis or a stroke to nutritional deficiencies and diabetes.

No matter what’s causing neuropathic pain, the benefits of CBD remain much the same.

CBD can support neuropathic pain in the following ways:

  • Increases anandamide levels
  • Activates the vanilloid receptors
  • Inhibits inflammation that may be causing neuropathic pain
  • Mildly activates the opioid receptors in the spinal cord and brain

When it comes to treating neuropathic pain, a higher dose is usually recommended — however, this can vary from person to person. Whenever using CBD for the first time, it’s wise to start low and increase slowly over time until you receive the benefits you’re looking for.

CBD Oil for Trigeminal Neuralgia: Is Cannabis a Viable Approach?

Neuropathic pain has many faces, one of which includes trigeminal neuralgia. This condition affects the nerves that transmit sensation from the face to the brain, causing severe discomfort comparable to an electric shock. The TN pain can be triggered by the slightest movement or touch anywhere on the face, commonly affecting the lips, gums, jaw, and cheeks.

People with trigeminal neuralgia usually suffer from flare-ups affecting one side of the face at a time. Although short-lived at the beginning, the episodes of burning sensation may become chronic, lasting for weeks or longer.

CBD has been mentioned by researchers as a potentially viable remedy for pain that is difficult to treat. Trigeminal neuralgia fits within this definition like a glove.

Today we’ll elaborate on the problem of TN pain and how to treat it with natural resources.

CBD Oil for Trigeminal Neuralgia: Highlights

  • Trigeminal Neuralgia (TN) develops as a result of the damage caused to the trigeminal nerve, causing severe pain on the face.
  • CBD’s interaction with the endocannabinoid system (ECS) may provide relief from neuropathic pain by mitigating the pain signals. According to a study published in Pharmacological Reviews, CBD strengthens nerve impulses in the ECS receptors, producing analgesic effects (1).
  • A review of studies concluded that CBD might be useful in reducing neuropathic pain and sensitivity to pain signals (hyperalgesia) (2).
  • Researchers have reported that hypertension (high blood pressure) increases the risk of trigeminal neuralgia. In a 2017 study, subjects who received CBD showed reduced resting blood pressure (3).
  • More clinical studies on humans are needed to support the preclinical findings of CBD’s benefits for people with trigeminal neuralgia.

Why People Are Turning to CBD for Trigeminal Neuralgia?

The dysfunction of the trigeminal nerve can have debilitating consequences for the sufferers. It causes severe pain on the face that occurs upon even the slightest movement, such as touching, scratching, or rubbing. The condition may also cause muscle spasms and burning sensations on top of the shock-like pain.

The treatment of trigeminal neuralgia usually involves anticonvulsant medications, antispasmodic agents, surgery, and other procedures involving the trigeminal nerve. Antiepileptic drugs, such as carbamazepine and gabapentin have been used with some success, although they lack efficacy and intolerability with prolonged use.

This is where CBD starts to shine.

Studies on CBD and Trigeminal Neuralgia

CBD is an acknowledged antiepileptic treatment. Its anticonvulsant and neuroprotective properties have been recently posted in a study from the journal Molecules. These actions might be useful in reducing muscle spasms in TN patients (4).

Although studies haven’t analyzed the efficacy of CBD on spasms caused by TN, there is evidence that CBD may have significant benefits for treating chronic pain caused by the condition.

One review has pointed to CBD as the potential reliever of hyperalgesia (pain sensitivity). The review mentioned that CBD can effectively block the pain pathway’s neural transmission. The authors also highlighted the nociceptive effects of cannabinoids, describing them as the potential therapeutic approach to the management of TN pain.

The painkilling and anti-hyperalgesia effects of CBD were supported by an animal study published in the Journal of Experimental Medicine. The study suggested that CBD reduced pain and inflammation caused by neuropathy.

Neuropathy stems from dysfunction or damage in the nerves that may trigger pain, tingling sensation, muscle weakness, and numbness.

On top of the above findings, the authors of the study added that CBD was able to curb hyperalgesia in mice models. There was a conclusion that CBD reduced persistent inflammation and neuropathic pain.

Another paper from the European Journal of Pharmacology demonstrated remarkable anti-inflammatory and immunomodulatory effects of CBD. Cannabidiol was administered to rats with induced sciatic nerve pain. The research team found that CBD treatment lowered inflammation and reduced hyperalgesia (5).

Experts hypothesize that trigeminal nerve pain can be caused by the contraction of blood vessels in the trigeminal nerve. This contraction damages the trigeminal protective tissue. Furthermore, researchers noticed that high blood pressure contributes to the development of trigeminal neuralgia (6).

A 2017 preclinical study found that CBD has benefits for the cardiovascular system. The authors reported that healthy individuals (age 21–29) with hypertension caused by a stressful event showed lower blood pressure after taking CBD (7).

Since the majority of the studies on CBD and trigeminal neuralgia have been conducted on animal models and preclinical human samples, longitudinal clinical studies are needed to further prove CBD’s ability to treat the condition.

How Does CBD Oil Work for Trigeminal Neuralgia?

The benefits of CBD for trigeminal neuralgia are attributed to the human endocannabinoid system (ECS). The ECS is the major regulatory network engaged in maintaining homeostasis in the central nervous system, peripheral nervous system, immune system, and organs. The ECS contains receptors that are found throughout the body, including CB1, CB2, and glycine receptors.

Studies have found that the modulation of the ECS might promote the healthy functioning of biological processes, providing a wide range of therapeutic benefits.

For example, a study published in the Journal of Experimental Medicine found that modulating the ECS translates into therapeutic effects for pain management. The authors also mentioned that glycine receptors in the central nervous system are important targets for reducing neuropathic pain. According to the study, cannabinoids such as THC and CBD might enhance the activity of the glycine receptors, resulting in analgesic effects.

Glycine receptors are ion channels that control the transmission of pain signals from the nerve to the brain.

The study found that oral CBD products resulted in a binding glycine activity that lowered neuropathic pain and hyperalgesia in animal models.

The Pros and Cons of CBD Oil for Trigeminal Neuralgia

The Pros

  • Numerous studies have demonstrated the therapeutic potential of CBD in pain management thanks to its ability to modulate receptors in the ECS.
  • Researchers agree that CBD might strengthen nerve impulses and increase pain resistance.
  • Animal studies have found that oral CBD solutions might be useful in lowering one’s sensitivity to pain.
  • CBD can reduce blood pressure in healthy volunteers, indirectly reducing the risk of trigeminal neuralgia
  • Many international medical organizations agree that CBD is well-tolerated in humans and has a high safety profile.

The Cons

  • There is not enough clinical evidence to support CBD’s efficacy in treating trigeminal neuralgia
  • CBD has a few mild side effects, including dry mouth, reduced appetite, drowsiness, and CBD-induced drug interactions
  • According to one animal study, extremely high doses of CBD can cause liver toxicity. However, these results haven’t been confirmed on human subjects.

CBD vs. Alternative Treatments for Trigeminal Neuralgia

There are limited options when it comes to alternative treatments for trigeminal neuralgia. The alternative anticonvulsants, except for CBD, aren’t supported by scientific studies. Recently, acupuncture has been touted for its effectiveness in treating neuropathic pain. There are lots of reports from TN patients who claim to have successfully treated TN with acupuncture.

Acupuncture is part of traditional Chinese medicine that uses tiny needles to balance the energy flow within the body. Studies also mention acupuncture’s ability to support homeostasis in the ECS. However, direct studies are needed to find out how acupuncture affects cannabinoid receptors.

One study from Frontiers of Molecular Neuroscience has found that electroacupuncture increased receptor activity in the rat models of osteoarthritis, resulting in reduced pain. Electroacupuncture is performed by sending electric signals through the microneedles (8).

Weird as it may sound, CBD has similar effects on the body to electroacupuncture. One study has found that the modulation of adenosine receptors resulted in mitigated pain and lower inflammation in mice after they took CBD (9).

Vitamin B12 is another alternative for trigeminal neuralgia. Research shows that vitamin B12 has painkilling properties that may aid patients in managing neuropathic pain.

Several clinical studies have reported positive results after treating patients with methylcobalamin, a form of B12. These studies examined patients with different types of neuropathy, such as trigeminal neuralgia and diabetic neuropathy (10).

How to Take CBD Oil for Trigeminal Neuralgia?

CBD comes in different forms, concentrations, and formulas. It may be taken orally in the forms of capsules or gummies, or sublingually as oil drops. Some people vape CBD, while others use it topically for localized relief. The choice of the product boils down to your individual situation.

CBD oil is the most common format. It contains a hemp extract infused into an inert oil, such as MCT oil or olive oil. CBD oil comes with a dropper for easier and more accurate dosing. You just squeeze the preferred amount using the dropper, place a few drops under your tongue, and wait for up to 60 minutes until it absorbs through tiny capillaries in your mouth. The calming effects of CBD should be felt within 15–20 minutes.

If you don’t like the taste of CBD oil, capsules and edibles are a good alternative. CBD capsules are available in the form of soft gels, providing a fixed dose of CBD per serving. They are better suited for busy people who take their CBD on the go. Since the CBD needs to pass through the digestive system before absorbing into the bloodstream, capsules have a delayed onset, usually around 40–90 minutes depending on your metabolism and whether or not you’re taking CBD oil on an empty stomach.

Edibles work in a similar fashion, but they are made with fun flavors that make the whole experience more enjoyable. The most popular forms of CBD edibles are gummies and honey sticks.

If you’re looking for the most effective way to deliver CBD to your system, CBD vape pens will be your best bet. Vaporized CBD gets into the bloodstream through the lung tissue, producing its effects within minutes after inhalation. CBD vapes also offer the highest bioavailability of all consumption methods, ensuring that up to 56% of the ingested substance is absorbed.

Finally, you may try a topical formulation, such as CBD creams for localized relief. Topicals work best for flare-ups because they address inflammation by interacting with the CB2 receptors in the skin’s endocannabinoid system. The absorption rate and duration of CBD topicals vary between products; you may need to reapply the dose after a few hours for consistent results.

Dosage of CBD Oil for Trigeminal Neuralgia

There are not enough clinical trials to determine the effective CBD dosage for specific health conditions.

According to a study published in the British Journal of Pharmacology, a low dose may vary from less than 1 to 50 milligrams per one kilogram per day. Everybody is different, and factors like your age, gender, metabolism, weight, overall health, and prior experience with CBD will affect your optimal dosage range.

It will take some experimentation until you find out what works for you. It is recommended to start with a low dose, say, 10 mg of CBD once or twice daily for one week — and observe the results. If you don’t feel any pain relief after that time, add another 10 mg to the dosage and continue for another week. Once you’ve found an effective dose, you can stick to it — people don’t build a tolerance to CBD.

If you’re thinking about adding CBD oil to your trigeminal neuralgia treatment, consult a holistic doctor experienced in CBD and cannabis therapies in general. Doing so will help you determine the right dosage range for your condition on top of avoiding potential negative CBD-induced drug interactions.

Summarizing the use of CBD for Trigeminal Neuralgia

Studies support CBD’s therapeutic effects in a range of painful conditions, including neuropathic pain. CBD modulates the activity of the cannabinoid receptors in the ECS, mitigating pain signals and reducing inflammation throughout the body. Moreover, CBD has been found to reduce blood pressure when administered under stressful conditions. All these effects can have a positive impact on the symptoms of trigeminal neuralgia. CBD is also an acknowledged anticonvulsant and neuroprotectant, so it can prevent further damage to the trigeminal nerve.

More direct clinical trials are needed to prove CBD’s efficacy specifically in alleviating TN pain. However, current findings, as well as reports from patients, are very encouraging.

Do you take CBD for trigeminal nerve pain? What products work best for you? Share your thoughts in the comment section!

Literature:

  1. Pacher, Pál et al. “The endocannabinoid system as an emerging target of pharmacotherapy.” Pharmacological reviews vol. 58,3 (2006): 389-462. doi:10.1124/pr.58.3.2
  2. Liang, Ying-Ching et al. “Therapeutic potential of cannabinoids in trigeminal neuralgia.” Current drug targets. CNS and neurological disorders vol. 3,6 (2004): 507-14. doi:10.2174/1568007043336833
  3. Turner, C L et al. “Measurement of pulse pressure profiles in patients with trigeminal neuralgia.” Journal of neurology, neurosurgery, and psychiatry vol. 74,4 (2003): 533-5. doi:10.1136/jnnp.74.4.533
  4. The U.S. Food and Drug Administration. The FDA Approves First Drug Comprised of Cannabidiol.
  5. Costa, Barbara et al. “The non-psychoactive cannabis constituent cannabidiol is an orally effective therapeutic agent in rat chronic inflammatory and neuropathic pain.” European journal of pharmacology vol. 556,1-3 (2007): 75-83. doi:10.1016/j.ejphar.2006.11.006
  6. Trigeminal Neuralgia Overview.
  7. Jadoon, Khalid A et al. “A single dose of cannabidiol reduces blood pressure in healthy volunteers in a randomized crossover study.” JCI insight vol. 2,12 e93760. 15 Jun. 2017, doi:10.1172/jci.insight.93760
  8. Yuan, Xiao-Cui et al. “Electroacupuncture Potentiates Cannabinoid Receptor-Mediated Descending Inhibitory Control in a Mouse Model of Knee Osteoarthritis.” Frontiers in molecular neuroscience vol. 11 112. 6 Apr. 2018, doi:10.3389/fnmol.2018.00112
  9. Russo, Ethan B. “Cannabinoids in the management of difficult to treat pain.” Therapeutics and clinical risk management vol. 4,1 (2008): 245-59. doi:10.2147/term.s1928
  10. Zhang, Ming et al. “Methylcobalamin: a potential vitamin of pain killer.” Neural plasticity vol. 2013 (2013): 424651. doi:10.1155/2013/424651
Livvy Ashton

Livvy is a registered nurse (RN) and board-certified nurse midwife (CNM) in the state of New Jersey. After giving birth to her newborn daughter, Livvy stepped down from her full-time position at the Children’s Hospital of New Jersey. This gave her the opportunity to spend more time writing articles on all topics related to pregnancy and prenatal care.

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