Essential Tremor Research Program: Cannabidiol Anti-Tremor Action and Mechanisms
“People tend to think of medical marijuana as a single substance; a substance that may have beneficial effects but also causes mood- and mind-altering effects,” explains Dr. Adrian Handforth, Assistant Chief of Neurology at VA Greater Los Angeles Healthcare System in California, “But that is not the case at all. Actually, marijuana is made up of many related chemicals, called cannabinoids.”
Dr. Handforth is the lead researcher of an upcoming IETF funded study that will explore the effects of a particular cannabinoid known as “CBD” (cannabidiol) on essential tremor. Unlike the well-known cannabinoid “THC” (tetrahydrocannabinol), which has mind- and mood-altering effects, CBD does not alter the mind, the emotions, or one’s judgment. Although its long-term safety remains to be thoroughly studied, CBD has already shown some promising initial results in the treatment of epilepsy, pain, anxiety, and other disorders. Dr. Handforth and his team will try to find out whether CBD can suppress essential tremor in an animal model. And if it does, he will take the next step and try to understand how it works.
This is exactly why the IETF is so pleased to support Dr. Handforth and this cutting-edge research with a nearly $20,000 grant. “The significance of this work is two-fold,” says Dr. Handforth. “First, finding that CBD suppresses tremor in an animal model may provide justification for a clinical trial of CBD for essential tremor in humans. Second and more importantly, if we can understand how CBD stops the tremor, what mechanisms are at work, then an ET-specific medication could be developed that would be better-tolerated and more effective than what it available today.”
An ET-specific medication would impact millions of people around the world who have this life-altering condition but who don’t respond to the medications that are currently available. An ET-specific medication would be a life-changer for millions of men, women and children today and for generations to come.
Cannabidiol Anti-Tremor Action & Mechanisms – Conclusion
Principle Investigator: Adrian Handforth, MD
Cannabis, also known as marijuana, has been used for medicinal purposes for thousands of years. However, by federal law, the possession of cannabis is illegal in the United States, except within approved research settings; however, a growing number of states, territories, and the District of Columbia have enacted laws to legalize its medical use.
The U.S. Food and Drug Administration (FDA) has not approved cannabis as a treatment for any medical condition. However, the chemical components in cannabis are being studied. It is well known that certain chemicals in cannabis activate specific receptors throughout the body and these chemicals may be useful in treating neurological conditions, like ET. In this study, Dr. Handforth is looking at a specific chemical called Cannabidiol. Cannabidiol (CBD) is one of at least 113 active chemicals (also known as cannabinoids) identified in cannabis. However, CBD does not produce any intoxicating effects or alteration in mood. For years it was thought to be a benign and unimportant part of the plant. Now it is being investigated as a possible treatment option for ET.
In this study, Dr. Handforth aimed to show CBD can suppress tremor in animal models. If successful, it would offer justification for further study of CBD in humans. First, the study had to determine what effects CBD would have on mice impacted with harmaline–induced tremor. Then, if reduced, the team had to discover how CBD suppressed the tremor.
Testing a variety of doses, Dr. Handforth was able to note a robust suppression of tremor in the mice given CBD, without the animals showing any signs of impairment or sedation. Next, the team worked to discover what receptors in the brain might be involved in the noted effects. After looking at several options the information suggests that CBD activates the 5HT1a receptors to suppress tremor by activating the TRPV1 receptor.
Although the finding is clear with this model in mice, the extrapolation to human ET is tentative and would ultimately require validation in trials with the suggested therapies. So the findings are only suggestive at this time.
Does CBD Oil Help with Essential Tremors?
Tremors can be caused by various factors, from neurodegenerative diseases to anxiety, brain damage, aging, and withdrawal symptoms from addiction.
Scientists have been examining the health benefits of CBD for quite some time now, with great effort being fueled into research on how CBD may affect tremors.
The endocannabinoid system (ECS) controls an array of essential physiological processes, including motor functions and movement. Since tremors are muscle movements that involve back and forth rhythmic swaying, they perfectly fall into that bracket.
In turn, this suggests that the ECS can be a therapeutic target for people looking for effective tremor management.
CBD oil is the modulator of the ECS, but can it help with tremors?
This article explores how CBD affects tremors and what science says about its therapeutic potential in this subject.
Common Causes of Tremors
Tremors are involuntary movements of the body and can impact the hands, arms, head, face, legs, and voice. More often than not, tremors are caused by neurological disorders in the brain regions that control movement. Conditions that destroy or degrade the brain cells, like Alzheimer’s disease, Parkinson’s disease, or stroke, can trigger tremors.
However, they can also appear as a result of drug withdrawal or as the side effect of certain prescription medications. Tremors often appear during a stressful event when a person is going through anxiety.
So, while temporary tremors aren’t an alarming sign, chronic episodes may indicate a serious disease requiring medical attention.
Does CBD Help with Tremors?
Researchers have yet to find out how CBD affects tremors. CBD is widely studied for its ability to reduce the symptoms of movement disorders. So far, we know that CBD can reduce muscle spasms, convulsions, and tremors associated with conditions like epilepsy, Parkinson’s Disease (PD) , and Multiple Sclerosis (MS ). One study actually found that CBD reduced the intensity of tremors in patients with PD during their REM sleep stage.
The mechanism behind the potential positive effect of CBD on tremors isn’t well-known yet. However, scientists speculate that the ECS is the major therapeutic target in this relationship.
By indirectly acting on the cannabinoid receptors in the central and peripheral nervous system, CBD can ensure proper muscle movement and prevent tremors — at least hypothetically.
Let’s elaborate on that mechanism using the examples of different types of tremors.
Does CBD Oil Help with Hand Tremors?
As mentioned, CBD interacts with the ECS, which is a broad system of receptors and neurotransmitters that work to maintain homeostasis between essential bodily functions — including muscle movement.
When CBD regulates these receptors, it produces relaxing and antispasmodic effects; it can also block the release of pro-inflammatory proteins known to damage the nervous system.
Through these pathways, CBD can ease symptoms of tremors on top of effectively acting as a neuroprotectant.
One study on mice showed that CBD produced superior results in tremor relief without showing any life-threatening side effects or causing impairment. The authors also determine what receptors may be involved in these effects, suggesting that CBD engages with the 5-HT1A receptor to prevent tremors by activating the TRPV1 receptor .
Many of the prescription drugs that people usually take for tremors carry a risk of dangerous side effects. CBD, in turn, comes with anti-tremor properties and has a good safety profile with only minor side effects when overdosed.
CBD Oil Effects on Parkinson’s Disease Tremors
As mentioned earlier, tremors generally result from neurodegenerative diseases, such as Parkinson’s Disease (PD). This non-reversible disorder of the central nervous system causes people to experience impaired posture, uncontrolled muscle movements, rigid muscles, and hand tremors.
In 2015, Neurotherapeutics published a study that examined the efficacy of medical cannabis for PD symptoms, concluding that the majority of the subjects showed significant improvements at the end of the treatment .
Patients from the Prague Movement Disorder Centre also reported improved quality of life due to significant symptom relief after using cannabis .
That being said, medical cannabis isn’t the same as hemp-derived CBD oil. The former may contain higher amounts of THC on top of CBD and other cannabinoids, while the latter only comes with 0.3% of THC or less — meaning the effects of cannabis-derived CBD oil may not be replicated with hemp-derived extracts.
CBD Oil for Elderly Tremors
More studies are needed to determine if CBD can be used as monotherapy to manage tremors and other symptoms among the elderly and patients with PD.
However, some neuroscientists acknowledge that CBD may act as a neuroprotectant that helps with PD. A study published in the British Pharmacological Society mentioned that CBD could modulate neurotransmission and prompt neurogenesis (formation of new brain cells) .
These effects were tested as a monotherapy, and in conjunction with other cannabinoids, among patients with Huntington’s disease, multiple sclerosis, and Parkinson’s Disease.
Other Types of Tremors that CBD Oil Can Help With
Aging and neurodegenerative disorders are just two causes of tremors that CBD might help with. But can it also relieve tremors induced by stress or brain injuries?
CBD Oil for Anxiety Tremors
In a recent study published by the Journal of Psychopharmacology, the authors found that CBD reduced anxiety and tremor amplitude among PD patients. The research team used a dose of 300 mg CBD/day, which provided significant benefits for heart rate, blood pressure, and frequency of tremors among the subjects .
The scientists also noted a reduction in anxiety-related tremors during a simulated public speaking test.
Other studies implicate that CBD can have therapeutic benefits for people with anxiety disorders and neuropsychiatric conditions.
CBD Oil vs. Brain Damage Tremors
An animal study from Pharmaceuticals found that CBD may positively affect brain regeneration after an injury and ischemic stroke (one caused by the blockage of blood flow) .
The study found that CBD exerted neuroprotective actions and assisted in repairing communication between neurons in the brain. The researchers administered 3mg/kg of CBD per day to mice models with cerebral ischemia — reporting improved motor coordination and neurological scores.
The authors concluded that more research would help establish CBD’s clinical value on brain injury and stroke.
Best Type of CBD to Use for Tremors
There are three main types of CBD you can choose from: full-spectrum CBD, broad-spectrum CBD, and CBD isolate.
Full-spectrum CBD is made from the whole hemp plant, and as such, it contains all the cannabinoids present in hemps, such as CBD, CBN, CBG, CBC, and trace amounts of THC. It also contains a lot of terpenes, which are volatile molecules that modulate the activity of cannabinoids.
These compounds create a unique synergy known as the entourage effect. This concept was brought up in 1988 and further elaborated on in 2011 by E.B. Russo, an esteemed neuroscientist and cannabis expert. In the entourage effect, the sum of all active ingredients in the plant is more potent therapeutically than each compound in isolation.
Therefore, if you want to reap the most benefits of your CBD oil, opt for full-spectrum extracts.
Broad-spectrum CBD is very similar to its full-spectrum counterpart, but it doesn’t contain any THC. The intoxicating ingredient has been removed after initial extraction so that the user can benefit from some of the entourage effects without worrying about failing a drug test.
You can also choose CBD isolate, which is pure CBD that has been crystallized and infused into the same product formats as the other types of CBD. The advantage of CBD isolates over other types of CBD oils is the lack of flavor and aroma; that being said, there’s also an obvious downside — the lack of entourage effect.
Once you know your desired type of CBD, it’s time to consider the best form for your tremors. Here we’ll explore the two basic formats of CBD: oils and capsules.
CBD Oil vs. Capsules for Essential Tremors
Choosing between CBD oil and capsules for tremors boils down to mapping out your needs and knowing the pros and cons of both products.
CBD oil is administered under the tongue. From there, it absorbs through tiny blood vessels in the mouth, reaching the bloodstream. The effects of CBD oil are usually noticeable within 15-30 minutes after administration, lasting for up to 6 hours. The peak concentration levels of CBD oil are usually reached after 1.5 hours. The bioavailability of CBD oil is around 35%, meaning that slightly over one-third of the ingested content ends up in your system.
With CBD capsules , the route of administration causes a delay in effects. Since CBD needs to pass through the digestive system, the effects may need about 30 to 90 minutes to take hold, depending on your metabolism and whether you take CBD on a full or empty stomach. While CBD capsules offer lower bioavailability — up to 20% — they last longer than oils because CBD is released gradually from the liver.
If you’re looking for more pronounced and faster-acting effects, CBD oil is a better option. Capsules come in handy if you have your supplementation scheduled up and don’t mind the delay. CBD capsules also mask the earthy flavor of CBD oil because the extract is contained in a soft gel shell, which is another argument in their favor.
CBD Oil Dosage for Tremors
Dosing CBD depends on a range of individual factors, including your weight, metabolism, age, the severity of tremors, and unique body chemistry.
According to a review of studies evaluating the effects of different CBD doses in clinical populations, an effective dose can range from 1 to 50 milligrams per day. The dosage can be increased when you don’t feel any difference after, say, one week. From there, you can gradually adjust the amount of CBD to the point where it effectively reduces tremors.
When you use CBD for tremors, taking high doses may cause a few mild side effects , such as:
- Dry mouth
- Appetite fluctuation
CBD can also interact with many pharmaceutical substances , so consult your doctor before adding CBD to your daily routine if you take any medications.
Bottom Line: How Can You Use CBD to Help with Tremors?
CBD’s potential in reducing different types of tremors is, without a doubt, promising. Several studies have already shown that it has the ability to improve primary motor symptoms of neurological conditions such as Parkinson’s Disease.
These positive results from the aforementioned studies shed new light on the therapeutic use of CBD for tremors. Products like CBD oil can significantly improve motor disorders without the dangerous side effects associated with pharmaceuticals.
Tremor sufferers can also adjust their lifestyle to naturally improve their lives, mainly by exercising, reducing alcohol, practicing meditation, and avoiding caffeine.
A consultation with a holistic or integrative neurologist should help you find the right set of remedies and adjustments to help you cope with tremors without frustration.
- IETF. (2015). ESSENTIAL TREMOR RESEARCH PROGRAM: CANNABIDIOL ANTI-TREMOR ACTION AND MECHANISMS. Retrieved June 8th, 2020, from essentialtremor.org
- Arjmand, S., Vaziri, Z., Behzadi, M., Abbassian, H., Stephens, G. J., & Shabani, M. (2015). Cannabinoids and Tremor Induced by Motor-related Disorders: Friend or Foe?. Neurotherapeutics: the journal of the American Society for Experimental NeuroTherapeutics , 12 (4), 778–787. 
- Venderová, K., Růzicka, E., Vorísek, V., & Visnovský, P. (2004). Survey on cannabis use in Parkinson’s disease: subjective improvement of motor symptoms. Movement disorders: official journal of the Movement Disorder Society , 19 (9), 1102–1106.
- Fernández-Ruiz, J., Sagredo, O., Pazos, M. R., García, C., Pertwee, R., Mechoulam, R., & Martínez-Orgado, J. (2013). Cannabidiol for neurodegenerative disorders: important new clinical applications for this phytocannabinoid?. British journal of clinical pharmacology , 75 (2), 323–333. 
- de Faria, S. M., de Morais Fabrício, D., Tumas, V., Castro, P. C., Ponti, M. A., Hallak, J. E., Zuardi, A. W., Crippa, J., & Chagas, M. (2020). Effects of acute cannabidiol administration on anxiety and tremors induced by a Simulated Public Speaking Test in patients with Parkinson’s disease. Journal of psychopharmacology (Oxford, England) , 34 (2), 189–196.  
- Hayakawa, K., Mishima, K., & Fujiwara, M. (2010). Therapeutic Potential of Non-Psychotropic Cannabidiol in Ischemic Stroke. Pharmaceuticals (Basel, Switzerland) , 3 (7), 2197–2212.
Nina created CFAH.org following the birth of her second child. She was a science and math teacher for 6 years prior to becoming a parent — teaching in schools in White Plains, New York and later in Paterson, New Jersey.
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CBD Oil for Essential Tremor: How Can It Help?
Essential tremor, sometimes referred to as ET, is a condition that affects around 7 million Americans and millions globally. ET affects up to 1% of the general population and up to 5% of people aged over 65.
Despite how common ET is, there is no cure, and there are currently very few treatment options available.
Despite how common ET is, there is no cure, and there are currently very few treatment options available. Some have proposed that CBD oil could offer potential relief to those suffering from essential tremor. This article will explore this possibility in-depth.
What Is an Essential Tremor?
Essential tremor is a nervous system (neurological) disorder. It is characterized by involuntary and rhythmic shaking, which can occur in any part of the body. It most commonly occurs in the hands when performing simple tasks like drinking from a glass or tying shoelaces.
The tremors are similar to Parkinson’s disease symptoms, leading to ET being confused with Parkinson’s. Here are some of the key differences between the two conditions.
The Timing of the Tremors
With ET, the tremors usually occur when the affected person is using their hands. However, with Parkinson’s disease, these tremors or shakes arise when they are inactive. For example, Parkinson’s hand tremors are most prominent when they are by the person’s side or resting on their lap.
Posture and Movement
Some people with ET develop ataxia, which means that they no longer have full control over their bodily movements. As a result, people with ataxia often have an unsteady gait. On the other hand, people with Parkinson’s disease often have a shuffling gait. Other associated symptoms of Parkinson’s disease include slow motion and having a stooped posture.
Parts of the Body Affected
ET mainly affects the hands, head, voice, and legs. With Parkinson’s disease, these tremors usually start in the hands. However, they can also impact the legs and chin.
Marijuana is the future. …
Symptoms of Essential Tremor
Essential tremor signs and symptoms include:
- Beginning gradually, usually more prominently on one side of the body
- Worsening with movement
- Occurrence in the hands first, affecting one or both hands
- A possible “yes-yes” or “no-no” motion of the head
Upward and downward movements characterize ET in the hands. These tremors can also affect the arms, head, eyelids, and larynx (voice box), which results in a shaky voice.
Essential tremor symptoms can be challenging to detect, as they tend to start discreetly and worsen over time.
Emotional stress, fatigue, caffeine, or temperature extremes may aggravate this condition. However, people should not confuse essential tremor with what doctors consider to be physiologic tremor.
Many people have a slight tremor only when performing specific tasks, which is entirely reasonable and nothing of concern. Factors such as caffeine, stress, smoking, and tiredness can bring on a physiologic tremor.
What Causes an Essential Tremor?
One risk factor for ET is age. Essential tremor is much more common in people aged 40 and older. Remember, ET affects up to 5% of people aged over 65.
The other main risk factor is a genetic mutation. The inherited cause of ET is due to it being an autosomal dominant disorder. This means only one parent needs to have the defective gene for their children to inherit it. Research shows that if one parent has the defective gene, children have a 50% chance of developing the condition.
Can CBD Help with Essential Tremor? Current Research
There is plenty of encouraging research into CBD for other conditions with similar symptoms. However, experts are no closer to adding essential tremor to the qualifying conditions for medical marijuana.
However, there was a recent breakthrough for the industry as researchers at the University of California San Diego are currently investigating the effect of cannabinoids on ET. They are conducting a study that will look at the effectiveness and safety of a cannabis formulation for helping ET.
The researchers estimate that approximately sixteen participants with ET will take part in the study. All participants undergo a complete neurological examination and psychological testing as part of the study.
The participants take an oral cannabis formulation with a CBD to THC ratio of 20:1. Upon completion of a particular dosage of the cannabis formulation for two weeks, participants taper off. After a washout period, they then cross to an alternate study arm.
The study will take approximately one year to complete. The researchers will use various types of validated tremor rating measures in the study. As well as quantifying tremor severity, the researchers will assess the safety and tolerability of the cannabis formulation.
Dr. Adrian Handforth is the Chief of Neurology at VA Greater LA Healthcare System. He is the lead researcher of an IETF-funded study that explores the effects of CBD on essential tremor. Dr. Handforth and his team seek to determine whether CBD can suppress ET in an animal model.
He says that finding positive results could justify a human clinical trial. Also, Dr. Handforth hopes to understand how CBD stops the tremor. If his team can achieve this, their findings could help develop an ET-specific medication.
Are There Any Research Results?
Yes. A recent study published in May 2021 offered hope for ET patients. Researchers from the University of Copenhagen looked into the effect of medical cannabis on essential tremor. An injection with a synthetic cannabinoid into the spinal cord turned on the astrocytes located there. This process resulted in the release of adenosine, a substance that reduces nerve activity and shaking.
According to researchers, this new approach avoids affecting the neurons in the brain responsible for our cognitive abilities and memory. Therefore, it is possible to provide patients with involuntary shaking an effective treatment that doesn’t lead to certain marijuana side effects. The next step is to perform clinical trials on patients with ET to see if this approach has the same impact on humans.
While it is exciting news, the results of such research are probably years from being published.
What Treatments Are Available to Those with Essential Tremor?
There is currently no cure for essential tremors. Treatment is limited to medication or deep brain stimulation surgery in extreme cases. Here is what’s available right now.
While there is no medication capable of completely removing the symptoms of essential tremor, some can reduce their severity. In general, doctors prescribe drugs for oral consumption. Some commonly prescribed medications include:
- Primidone (anti-seizure drug)
- Benzodiazepines (e.g. lorazepam)
Another option is to undergo deep brain stimulation (DBS). This is a procedure that involves implanting electrical leads in the brain’s thalamus. The thalamus is associated with muscle control and coordination. Many experts believe it is responsible for the tremors experienced by people with ET.
MRI-Guided Focused High-Intensity Ultrasound
One final treatment method revolves around the use of MRI to focus ultrasound. The idea is to destroy the tissue located in the thalamus. One significant downside is that patients stay awake during the procedure, which isn’t a pleasant experience.
Could CBD Oil Help Reduce an Essential Tremor?
Cannabis research is ongoing and focuses on the plant’s potential to address a plethora of medical symptoms. Many states across America now have laws allowing cannabis use in some form.
Cannabidiol, or CBD, is one of the most heavily researched compounds of the marijuana plant. CBD could potentially be hugely significant in mitigating a host of disease-related symptoms in the future.
Research has shown that CBD has anti-inflammatory properties and is a patented neuroprotectant. It also displays other promising benefits.
The FDA has also acknowledged CBD’s medicinal benefits for certain types of seizures. The epilepsy drug Epidiolex is the first-ever CBD-based drug the administration has approved.
Despite the level of research into CBD, there is still minimal research into cannabis for essential tremor.
Despite the level of research into CBD, there is still minimal research into cannabis for essential tremor. Nonetheless, the lack of treatment options for ET means that a growing number of patients are looking into CBD oil to help.
In theory, cannabidiol targets and regulates the endocannabinoid system (ECS) receptors, CB1 and CB2. These are found in the brain and throughout the body and help regulate bodily functions such as muscle movement.
CBD could potentially enable muscle relaxation and ease the symptoms of ET. Studies into CBD for Parkinson’s have proven fruitful, and it is hoped this will be the case with essential tremor research.
As an interesting aside, one experienced doctor claims that THCV helped a patient with a severe ET case. According to the physician, it was the worst case of essential tremor he had seen in almost 40 years. The patient could hardly walk, write her name, or swallow food.
Yet, within 24 hours of using THCV, she could eat, control her tremors, and her speech was almost normal. This is a fascinating tale as it shows the potential power of cannabinoids for patients with ET.
Using CBD for Tremors (Dosage and Use)
Patients that use CBD for tremors tend to consume it sublingually or via a vaporizer. As everyone reacts differently to the cannabinoid, it is best to begin with just a single drop 2-3 times a day. Increase the dosage once you’re comfortable that there are no side effects. As a rule of thumb, up to 25mg of CBD a day is sufficient for someone with a mild to moderate ET case.
Please note that vaping provides a faster effect and has a higher absorption rate than sublingually consumed CBD. Also, individuals with a hand tremor may find it difficult to hold the CBD oil dropper. It could take a while to determine the right amount of cannabidiol for you, so be patient!
Shopping Tips for Best CBD for Essential Tremor
Finding the best CBD for essential tremors isn’t as easy as one might hope. The cannabidiol market is unregulated federally in the United States. As a result, there are lots of low-quality products around. Here are a few tips to ensure you get the best from your CBD experience.
- Stick with tried and trusted brands. Read the reviews published on WayofLeaf to determine if a company is trustworthy.
- Make sure the CBD comes from industrial hemp with a maximum of 0.3% THC.
- As a combination of CBD and THC potentially works best, opt for full-spectrum products.
- Don’t buy from any brand that doesn’t provide third-party lab reports.
- It is best if you only choose CBD oil where CO2 extraction is used.
- When it comes to CBD vape products, avoid ones with thinning agents such as PG and PEG.
- Patients with essential tremor should focus on oral CBD products.
- Make sure the label clearly outlines the ingredients and has a batch number and manufacturing date.
- Steer clear of products that say the CBD comes from the stalk or seeds of the hemp plant. Those parts of the plant have minimal CBD.
Final Thoughts on CBD Oil for Essential Tremor
The clinical trials occurring right now are crucial for sufferers of ET and the cannabis industry as a whole. This will be the first time scientists have looked to the plant to calm essential tremor symptoms effectively.
The results of this research could potentially have a life-changing impact on people with ET. A positive outcome would likely pave the way for further clinical studies using cannabinoids.