Medical marijuana and the treatment of Cachexia (Wasting Syndrome)

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Cachexia is a complex condition associated with a variety of chronic diseases such as cancer, AIDS, and Tuberculosis. It is usually characterized by rapid, unintentional weight loss and muscle wasting.

There is no straight cure for cachexia, and treatment of the disease usually varies based on the individual and the underlying condition that causes it. However, new evidence suggests that cannabis may help, seeing as cannabinoids like THC are known to be very effective at improving appetite.

UNDERSTANDING CACHEXIA:

Cachexia, or wasting syndrome, is a condition characterized by severe weight loss and muscle wasting in people who are not actively trying to lose weight. It is usually accompanied by a severe loss of appetite and causes weakness, fatigue, and a variety of other effects in a patient.

The weight loss caused by cachexia is different from regular weight loss caused by starvation or conditions like anorexia. In long-term starvation, for example, the body begins to use fat as a fuel source, which eventually leads to a loss of body fat.

In cachexia, however, patients experience a loss of lean body mass, or muscle mass. This is an important difference and is usually one of the key factors that differentiates cachexia from other conditions that produce similar symptoms, like anorexia.

WHAT CAUSES CACHEXIA?

The exact causes of cachexia aren’t clear, but the condition is usually associated with other chronic illnesses or diseases.

Cachexia is most commonly associated with cancer and it affects between 50-80% of cancer patients, usually in the final stages of the disease. However, it is also associated with other conditions, including:

  • HIV/AIDS
  • Celiac disease
  • Multiple sclerosis
  • Tuberculosis
  • Crohn’s disease
  • Rheumatoid arthritis
  • Kidney disease

It has been observed that conditions like cancer create a unique inflammatory response in a patient’s body. This inflammation can cause a unique neuroendocrine response which ultimately results in lowered appetite, as well as metabolic changes which contribute to the loss of lean body mass.

The weight loss and muscle wasting associated with cachexia in this case is typically caused by a combination of lowered nutrient intake and abnormal metabolism.

Some researchers suggest that the chronic inflammation that so many cancer patients experience can cause changes to the storage of fat tissue around the body.

The human body is known to produce 2 kinds of fat; white and brown. White fat is the most common type of fat and is created for the purpose of storing energy for later use. This is essentially what happens to the calories that you do not burn during the day.

Brown fat, on the other hand, isn’t so common and is mostly found in babies and hibernating animals. This type of fat is usually burned in order to generate heat in the body.

Many cancer patients are believed to experience a unique change in their body that turns white fat stores into brown fat and ultimately leads to the wasting, weight loss, and cachexia.

UNDERSTANDING THE IMPACT OF CACHEXIA

Cachexia has severe effects on patients and is often described as a severely debilitating and demoralising condition.

When experienced in conjunction with another chronic illness, cachexia has a huge effect on the effectiveness of treatment and the progress of a patient.

In cancer patients, for example, cachexia can reduce a patient’s tolerance and response to treatment or therapy. As the disease progress, a patient’s muscles literally waste away, sometimes to the point where they become immobile.

The wasting caused by cachexia also creates other complications for patients, including fatigue, a loss of strength, and a lower quality of life as they’re forced to cope with their underlying condition as well as cachexia. This often causes added distress and anxiety both for the patient and their family.

In many cases, cachexia can be so severe that it ultimately causes death. In fact, Spanish researchers suggest that cachexia may be the cause of death in up to ⅓ of cancer patients rather than the tumour itself.

TREATING CACHEXIA

There are a variety of strategies for dealing with cachexia, but they vary depending on the individual patient and their underlying condition. Some possible cachexia treatments include:

  • Increased nutritional intake. While this may slow the rate of weight loss, it doesn’t reverse the effects of muscle wasting.
  • Progestagens, like Medroxyprogesterone Acetate (MPA) and Megestrol Acetate (MA). These are steroidal hormones, which have been shown to improve appetite and weight gain in some patients. How exactly they do so, however, isn’t clear.
  • Corticosteroids. These have also been shown to improve appetite as well as quality of life in some studies. They are about as effective as megestol acetate but have more side effects, making them less practical for long-term use
  • Thalidomide. Thalidomide is predominantly used to treat certain types of cancers, but it has also been used in the treatment of cachexia associated with AIDS and tuberculosis.
  • Selective COX-2 inhibitors. Some preliminary animal -based studies on specific non-steroidal antiinflammatory drugs suggest these drugs may help fight cachexia by suppressing systemic inflammation.

CACHEXIA AND CANNABIS

Over the last few years, a growing body of research has examined the medical potential of cannabis and its active compounds. Some of this research suggests that some of the cannabinoids in medical marijuana may help in the treatment of cachexia. In fact, cachexia is already considered a qualifying medical condition under many medical marijuana programs.

One of the most promising effects of medical marijuana for cachexia patients is the drug’s ability to stimulate appetite. Most people who have experimented with cannabis, even if only recreationally, will likely be familiar with the “munchies” it may cause.

The cannabinoid responsible for producing these munchies is Tetrahydrocannabinol (THC). Studies have observed that THC, once absorbed into the body, has the ability to increase the sense of smell in mice, ultimately leading them to find food and eat more of it. It does so by stimulating CB receptors in the brain’s olfactory bulb.

Previous research has also found that THC acts on specific receptors in a second region of the brain called the nucleus accumbens. This ultimately stimulates the production of dopamine, and results in feeling greater feelings of pleasure from eating.

Finally, studies have also found that THC interacts with cannabinoid receptors in a third region of the brain called the hypothalamus. In doing so, the molecule stimulates the release of a hormone known as ghrelin, which stimulates hunger.

All of these receptors form part of the endocannabinoid system which, although not fully understood, is known to play an active part in many physiological processes, including hunger and appetite.

By interacting with these 3 different parts of the brain, cannabinoids like THC have the ability to alter the senses and trick the brain into thinking it is starving, while simultaneously increasing the amount of pleasure a person feels from eating.

This is great news for cachexia patients who are known to deal with a severe lack of appetite, which ultimately leads to the drastic weight loss that characterizes the condition. In fact, many patients suffering from cancer and AIDS-related cachexia are known to already turn to cannabis for some relief.

MEDICAL MARIJUANA AND THE FUTURE OF CACHEXIA TREATMENT

Unfortunately, there is still a lack of research that directly explores how cannabis may help manage the weight loss and muscle wasting caused by cachexia. In fact, one of the few studies into the field found that cannabis extract and THC didn’t improve appetite or quality of life at all in the participants.

This strongly contradicts anecdotal evidence from patients who swear by cannabis as being one of the few substances providing them with relief from wasting or a loss of appetite. Afterall, up to 1 in 3 AIDS patients in the US is estimated to use cannabis to deal with symptoms like loss of appetite as a results of their treatment/condition.

It also contradicts the fact that medical cannabis is readily prescribed by Dutch doctors as a treatment for cachexia associated with cancer, as well as the fact that cachexia is a qualifying condition for medical marijuana programs in many US states, including Alaska, Arkansas, California, Colorado, and many more.

And these contradictions are exactly what makes it so hard to come to concrete conclusions about cannabis and the role it plays in treating cachexia. Hopefully further research into the field will provide clearer answers in the near future.

Note: We have taken the utmost care and precaution whilst writing this article. That being said, please take note of the fact that we are not medical professionals of any kind. Cannabis.info is strictly a news and information website. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment.

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