Does Medical Marijuana Help in Treating Cachexia?
Understandably, being diagnosed with cachexia can cause you to worry. After all, the disorder is often associated with the late stages of severe illness.
Also known as wasting syndrome, cachexia is common in patients in the late stages of chronic progressive illness – such as cancer, HIV/AIDs, COPD, kidney disease, and congestive heart failure.
In the latter stages of such illnesses, many patients find themselves lacking appetite and energy. Their physical condition starts to deteriorate with extreme weight loss and muscle-wasting.
A cachexia diagnosis will probably leave you with a lot of questions. What exactly does cachexia mean? What causes cachexia? What are the symptoms of cachexia? How is cachexia treated? And most importantly, can medical marijuana help with cachexia?
In this article, we will answer all these questions and explore how medical marijuana can help in treating cachexia.
What is Cachexia?
Cachexia is a wasting disorder that causes one to experience extreme weight loss, muscle depletion, and loss of body fat.
Cachexia medical definition is where a patient loses more than 5 per cent of their body weight over 12 months or less. This weight loss occurs when you are not trying to lose weight through diet or exercise and you have a known illness or disease.
Cachexia is a term that is derived from the Greek words “kakos” and “hexis” which mean “bad condition.”
Why is Cachexia Weight Loss Different?
Unlike other types of weight loss, losing weight due to cachexia is involuntary. People suffering from cachexia are not actively trying to trim their waistlines through diet and exercise. Rather, cachexia patients lose weight due to lack of appetite, metabolic imbalances, and inflammation associated with their illness.
Researchers have theorized that cachexia is one of the body’s natural responses to fighting disease. When you can’t provide your body with adequate nutrition due to illness, it starts breaking down muscle and stored fat for fuel.
Unlike normal weight loss, cachexia patients don’t simply lose weight. They also get weak and frail, which makes them more vulnerable to infections, which may lead to death.
Cachexia is commonly seen in patients suffering from:
- Rheumatoid arthritis
- Chronic renal failure
- Multiple sclerosis
- Celiac disease
- Congestive heart failure
- Chronic obstructive pulmonary disease (COPD)
- Cystic fibrosis
- Severe sepsis
- Mercury poisoning
Note: Cachexia is also common in the elderly, where it may happen without any underlying cause.
What Causes Cachexia?
Cachexia is a multifactorial, complex syndrome. The exact causes of cachexia vary from patient to patient depending on their physiology and underlying illness.
Cachexia was largely overlooked by physicians and researchers, who disagreed on its classification, diagnostic criteria, and treatment approaches.
Fortunately, understanding of the condition has improved considerably over the years. It is now recognized by doctors and scientists as a distinct condition that is treatable with the right approach.
Scientists have found that cachexia patients have incorrect levels of some substances in their bodies. Such imbalances are responsible for wasting syndrome.
For instance, a 2015 study by La Trobe University in Melbourne discovered that the fibroblast growth factor-inducible 14 (Fn14) receptor found on the membrane of cancer cells leads to cachexia in cancer patients.
The scientists found that blocking the Fn14 receptor can help reverse cachexia, regardless of the presence or stage of a tumour.
What are the Common Cachexia Symptoms?
Although emaciation is one of the most prominent cachexia symptoms, research suggests that the wasting syndrome starts even before any weight loss occurs.
In 2006, a group of international experts met in Washington DC and reached a consensus on diagnosing cachexia.
For you to be diagnosed as cachectic, they agreed, have to have lost at least 5% weight in 12 months or less in the presence of underlying illness.
Additionally, you must have at least three of these other symptoms:
- Decreased muscle strength
- Low fat-free mass index
- Abnormal biochemistry – (such as increased inflammatory markers, elevated cytokines, anaemia, and low serum albumin)
Besides that criteria, another symptom to look out for is decreased physical performance, which leads to lowered quality of life for the patient.
It is estimated that more than 160,000 people are hospitalized with cachexia diagnosis annually in the United States.
According to data from the Nationwide Inpatient Sample, the median duration of hospital stay for patients with cachexia is 6 days, compared with 3 days for non-cachexia admissions.
Cachexia patients also experience greater loss of function than those admitted with other conditions.
The global prevalence of cachexia is around 1% of the patient population – around 9 million people are affected.
Cachexia prevalence in various illnesses is as follows:
- 5-15% in people with congestive heart failure or chronic obstructive pulmonary disease (COPD)
- Up to 60% of people with lung cancer
- Up to 80% of people with stomach and other upper GI cancers
- 60% of people with chronic kidney disease
Focus on Cancer Cachexia
Various forms of cancer present with a complex metabolic profile that is characterised by loss of lean body mass. This syndrome is known as cancer cachexia, or cancer anorexia cachexia syndrome (CACS).
Cancer cells release substances that deplete muscles and reduce appetite. The situation is exacerbated by cancer treatments that can cause nausea or damage the digestive tract, making it harder to eat and absorb nutrients.
As your body gets less nutrition, it turns to fat and muscle for fuel. Cancer cells also use the limited nutrients to survive and multiply.
The wasting syndrome occurs in up to 80% of cancer patients, and in at least 50% of people with advanced cancer.
Cancer cachexia is thought to be directly responsible for 20-30% of cancer deaths in the US.
There are 3 stages of cancer cachexia:
- Pre-cachexia: Where the patient has less than 5 per cent weight loss along with other symptoms such as impaired glucose tolerance and anorexia.
- Cachexia: Where the patient has more than 5 per cent weight loss along with other symptoms associated with the syndrome.
- Refractory cachexia: Where patients diagnosed with cachexia are no longer responsive to cancer treatment. At this stage, patients have low performance scores and a life expectancy of less than 3 months.
How is Cachexia Treated?
Unfortunately, there’s no definitive treatment for cachexia.
Currently, treatment options for cachexia include:
- Appetite stimulants such as megestrol acetate (Megace)
- Drugs to improve nausea, appetite, and mood such as dronabinol (Marinol)
- Human growth hormone (HGH) treatments
- Medication to reduce inflammation
- Diet changes and nutritional supplements
- Adapted exercise
Researchers are learning more about cachexia and the processes that cause it. With new discoveries, there is hope that drugs will be developed to effectively combat the wasting process.
Most of the currently available treatment options for the syndrome are costly and have significant downsides.
For instance, human growth hormone treatments can cost more than $40,000 annually. Somatropin, a human growth hormone that helps patients build muscle and gain weight, is also known to cause joint and muscle pain and high blood sugar.
Dronabinol, which improves mood and stabilises weight, is a man-made form of an active ingredient in cannabis. Unfortunately, it isn’t covered by insurance.
Without a reliable treatment option for cachexia, many patients turn to medical marijuana to manage their symptoms.
Can Medical Marijuana be Used to Treat Cachexia?
Yes. Medical marijuana can bring some relief to people suffering from cachexia. It can help in improving appetite, reducing nausea, improving mood, and decreasing pain.
However, cannabis isn’t a cure for the wasting syndrome.
Here’s a summary of how medical cannabis helps with cachexia:
- Increasing appetite and relieving nausea: Medical cannabis has been shown to help boost appetite and relieve nausea in patients suffering from an array of illnesses. Tetrahydrocannabinol (THC), in particular, helps increase hunger signals to the brain and promote a positive emotional association with eating.
- Reducing pain: Cannabis can induce relaxation and even euphoria. This helps reduce pain during late-state illness. With reduced pain and a more positive mental outlook, cannabis has also been attributed to increased physical activity. This helps slow down muscle atrophy.
- Boosting mental outlook and comfort: Cannabis has also been shown to improve mental outlook and comfort in cachexia patients. In a 2007 study by Columbia University, HIV patients reported positive effects from using medical marijuana, with no discomfort or impairment in cognitive performance. The patients also reported improvements in sleep – a benefit they lacked in prescription appetite drugs such as dronabinol.
The Best Cannabis Strains for Cachexia
Several cannabis strains have been found to be effective in managing cachexia. Generally, THC-dominant strains seem to be the most effective for treating cachexia.
That said, here is a summary of the best cannabis strains for managing different cachexia symptoms:
To improve your appetite, try strains that are dominant with appetite-stimulating THC and CBG. If you would like to avoid the psychoactive, go for CBG-dominant strains.
THC stimulates ghrelin production to make you feel hungry. Additionally, it acts on the olfactory bulb to make food tastier and its smell more appealing.
THC also triggers the release of dopamine, helping increase the satisfaction you get from eating.
CBG also acts as an appetite stimulant by stimulating hormones such as endorphin.
While it doesn’t directly stimulate appetite, CBD can also be helpful. It improves mood, relieves pain, and eases nausea – all of which can help boost a patient’s desire to eat.
Try these cannabis strains to boost appetite: Sonoma Coma, Orange Skunk, Caramelo, White Fire OG, Grapefruit Haze, Sour Willie, Nepalese, and Santa Sativa.
For Nausea and Vomiting
Medicinal use of cannabis in alleviating nausea is quite well-documented and established. Whether one is experiencing nausea due to pregnancy or chemotherapy treatment, cannabis has been found to be an effective, natural remedy that gives instant relief.
Both THC and CBD strains have properties that can provide relief from nausea. However, consuming edibles isn’t advisable if you are taking medical marijuana for nausea. Edibles can take 30-45 minutes to have any noticeable effect.
You can also use medical marijuana to prevent and treat nausea caused by motion sickness. If you are prone to motion sickness, medicate before boarding.
Drugs commonly prescribed for nausea and vomiting such as promethazine and metoclopramide come with worrying side effects. The side effects include dizziness, shortness of breath, increased heartbeat, fever, headaches, and weakness.
Unlike these drugs, medical cannabis doesn’t come with a laundry list of side effects.
Patients who have used cannabis for nausea and vomiting say that CBD-dominant strains provide the most relief. Look for strains with high CBD and low THC amounts. Research has found that combining the non-intoxicating effects of CBD with low levels of THC can provide relief for nausea and vomiting.
The best strains for treating nausea and vomiting include Sour Willie, Good Medicine, Durban Poison, Mango Kush, and Sour Diesel.
Research shows that cannabis can be an effective remedy for depression, one of the symptoms of cachexia.
A 2015 study from the University of Buffalo’s Research Institute on Addictions found that endocannabinoids in the brain activate the same receptors as many active compounds in marijuana. Endocannabinoids are linked to feelings of happiness and general well-being, activate
Another study published in the Journal of Affective Disorders found that smoking marijuana helps to significantly reduce self-reported levels of depression in the short term.
The best cannabis strains for treating depression in cachexia patients include:
- Granddaddy Purple – an Indica strain that is known to be mentally stimulating.
- Blue Dream – a Sativa-dominant hybrid that will leave you feeling relaxed, euphoric, and creative.
- Chocolope – a pain-relieving Sativa strain that also alleviates depression.
With the depletion of fat and muscle, patients suffering from cachexia find themselves feeling constantly fatigued.
Fortunately, marijuana can give patients an energy boost. This can enable them to have more physical activity and improve their quality of life.
Generally, Sativa and Sativa-dominant hybrid strains are the best for fatigue as they have energizing and mentally stimulating effects.
The best strains for energizing cachexia patients include:
- Jack Herer – a Sativa strain that is known to boost energy.
- OG Kush – a potent THC-dominant strain that will leave you feeling happy and relaxed.
- Green Crack – a Sativa dominant hybrid that will give you enough energy to go through the day but won’t keep you up at night.
Super Silver Haze – a strain that will make you feel energized and focused throughout the day.