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Hemp and Concussions

According to the Center for Disease Control and Prevention, Traumatic Brain Injury (TBI) is a major cause of death and disability in the United States.  In 2013 approximately 2.5 million emergency room visits were for TBIs and in 2012 approximately 329,290 children were treated in emergency departments for sports and recreation-related concussions or TBIs.  A TBI is an injury to the head that can cause mild, temporary brain dysfunction, or it can cause severe, permanent and even deadly brain injury.   A mild TBI is often classified as a concussion.  Concussions are also categorized as Grade I, Grade II or Grade III. 

A Grade I concussion often goes undiagnosed.  It is a blow the body or head that causes temporary confusion with no amnesia (permanent loss of memory for a period of time) or loss of consciousness.  The symptoms of a Grade I concussion usually fully resolve within 15 minutes but may be transient. Headaches and confusion may temporarily return for short periods of time during physical and mental strain for several days after the injury occurs. 

With a Grade II concussion there is still no loss of consciousness, but there is amnesia and symptoms take longer than 15 minutes to resolve.  The symptoms of a Grade II concussion may also be transient for several days to weeks after the injury and are usually triggered by either physical or mental strain.

A Grade III concussion is a blow to the body or head that causes any loss of consciousness.  Just like a Grade I or Grade II concussion, headaches and confusion often come and go for the days and weeks after the injury. 

The transient symptoms of concussion are thought to be caused by an inflammatory response in the brain causing damage to neurons in brain tissue.  The only treatment for concussion is physical and cognitive rest and the use of safe anti-inflammatories that do not increase the risk of bleeding.  With a concussion there is no bleeding in the brain.  However, a severe TBI with bleeding can often initially present as a concussion and initial imaging may not show mild bleeding.  If the symptoms of a concussion worsen in the first 15 minutes then a severe TBI with bleeding should be ruled out immediately. 

We know that many of the phytonutrients from hemp including CBD and others, work as anti-inflammatories and immune response regulators.  CBD and other cannabinoids from hemp bind to receptors in our endocannabinoid system called CB1 and CB2 receptors. CB1 receptors are primarily located in the brain and central nervous system as well as in the peripheral nervous system, organs and tissues.  CB1 receptors are reactive to anandamide (a naturally occurring cannabinoid we produce in our bodies similar to THC), 2‑arachidonylglycerol or 2‑AG (a naturally occurring cannabinoid we produce in our bodies similar to CBD), THC, CBD, and all other cannabinoids, terpenes and flavonoids.  CB2 receptors are primarily located on white blood cells, tonsils, spleen and other organs of the endocrine system, as well as the central and peripheral nervous systems.  They regulate the release of pro-inflammatory cytokines, which signal the immune system to increase an inflammatory response.  CB2 receptors are reactive to 2-AG and CBD, terpenes, flavonoids, CBD, terpenes, flavonoids, as well as other beneficial cannabinoids from the hemp plant, but they are not reactive to THC. 

A study done in Isreal on mice and rats showed promising results with post concussion treatment of CBD.  It was recognized that the levels of 2-AG dramatically increased post TBI.  A group of mice and rats were then given CBD, while a control group was not.  The mice given the CBD recovered much faster than the ones who were not given CBD.  CB1 receptors on the neuronal mitochondria play a role in neuronal protection post TBI through the regulation of apoptosis.  2-AG has been proven to also decrease neuronal damage post TBI by regulating the pro-inflammatory cytokines at the blood brain barrier.  The first ever clinical trial on the use of cannabinoids in the treatment of TBI is currently being done by the University of Miami.  It is a five year, three phase study. 

Hemp extract high in CBD and low in THC (less than .3%) is a safe product to take after an injury to help regulate inflammation and immune response without the risk of bleeding.  It should be taken immediately after injury in either a tincture or capsule form in order to enter the blood stream.  Serving size should start around 10-15 mg 3x/day for young patients.  Adults can start with a serving size around 25-35 mg 3x/day. 


Pub Med:

Zhen Xu1, Xiao-Ai Lv2, Qun Dai3 , Yu-Qing Ge3 and Jie Xu4. Molecular Brain. Acute upregulation of neuronal mitochondrial type-1 cannabinoid receptor and it’s role in metabolic defects and neuronal apoptosis after TBI. (2016) 9:75

David Panikashvili, Constantina Simeonidou, Shimon Ben-Shabat, LumõÂr HanusÏ, Aviva Breuer, Raphael Mechoulam & Esther Shohami. Nature. Volume 413. October 2001. An endogenous cannabinoid (2-AG) is neuroprotective after brain injury.

David Panikashvili,a,b,1 Na’ama A. Shein,a,1 Raphael Mechoulam,b Victoria Trembovler, a Ron Kohen,c Alexander Alexandrovich,a and Esther Shohami a. Neurobiology of Disease. The endocannabinoid 2-AG protects the blood–brain barrier after closed head injury and inhibits mRNA expression of proinflammatory cytokines. 22 (2006) 257 – 264

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