Drugs are an indispensable part of our modern-day lives. Whether they’re prescription drugs or over-the-counter medications, these usually help us recover from a bout of some disease or even help us survive!
Sometimes they’re merely taken as a single dose or a short course to overcome mild symptoms. At other times, they are a life-saver or even an unavoidable part of a long-standing treatment regimen. It’s the latter kind of medications that often become essential to manage symptoms of autoimmune diseases.
Autoimmune diseases are medical conditions that seem to pop up among the human population without any warning. Almost 7% of Americans suffered from autoimmune diseases last year, followed by the European Union (6%), and China (5%). Compared to 400 people, diagnosed with autoimmune diseases in America 30 years ago, the figure now stands at around 50 million, with 80% of them being women.
In such diseases, the immune system acts out against the body. Instead of attacking the microbial invaders, it treats the body’s organs as foreign. At least 80 types of autoimmune diseases have been identified so far, including asthma, chronic obstructive pulmonary disorders (COPD), rheumatic disease, Grave’s disease, & diabetes mellitus type I.
Prednisone, a glucocorticoid (a synthetic derivative of a steroid found in the human body) is one of the preferred drugs for autoimmune diseases. As an immunosuppressant, prednisone targets the body’s inflammatory responses.
Having said that, immunosuppressants, like most other pharmaceutical drugs, have many adverse effects that can wreak havoc on our health – both in the short and long run.
Common side-effects of prednisone include weight gain, muscle weakness, diarrhea, headaches, high blood sugar, and insomnia. Its prolonged use may lead to irreversible effects, such as depression, cataract, glaucoma, obesity, and abnormal facial hair growth. Besides, immunosuppressants like prednisone can leave your body vulnerable to infection.
Faced with such adversities, patients often for safer, more natural treatment methods to ebb over their inherent medical issues.
One such alternative that users these days turn to is Cannabidiol (CBD). But, what does CBD have that be comparable to prednisone?
CBD As An Alternative Therapy For Autoimmune Diseases
Let’s be very clear about this: Autoimmune Diseases are Non-Curable!
Their symptoms are, however, mostly manageable.
Cannabis plants contain a wide range of different kinds of chemical compounds, including a specific group of compounds that can uniquely interact with the human body. They are called cannabinoids.
Cannabidiol or CBD is one such cannabinoid.
Science has found many credible pieces of evidence to support its therapeutic activities in our body. CBD, along with its fellow cannabinoids, terpenes, phenolic agents, fatty acids, and minerals, have often been utilized for health benefits. Some have even been put to pharmacological use as well.
Nevertheless, research on this unique cannabinoid, with its complex pharmacokinetics, continues, as scientists keep finding new evidence of its therapeutic benefits.
Now, the question is: Can CBD help relieve or manage the symptoms of autoimmune diseases?
Plant-derived cannabinoids, like CBD, behave much like our endocannabinoids or endogenous cannabinoids (found in the human body; like anandamide). They interact with different kinds of receptors in the body, including those of the endocannabinoid system that regulates several bodily functions (working in tandem with the nervous system) and reinforces homeostasis, i.e. the chemical and physiological balance within the body.
Ever since research into cannabidiol began, scientists have found evidence of its anti-inflammatory and immunosuppressive properties. So, CAN it act like Pharmaceutical Immunosuppressants?
In this regard, CBD…
- Induces self-destruction of cells in the already activated immunity-inducing cells
- Inhibits the infected cells from growing or multiplying
- Suppresses signal-transducing proteins (cytokines that in this case intimate your brain to trigger immunity responses like inflammation)
- Activates several immunoregulatory (T-regulatory) cells (to protect and stabilize the body’s chemistry)
These ways may be broadly described in two basic ways:
- Reduces the body’s inflammatory responses by suppressing the immune system.
- Modulates the immune system to restore homeostasis.
Research into CBD’s Impact on Autoimmune Diseases
Several studies and clinical trials have indicated that CBD does possess some anti-inflammatory and immunoregulatory properties.
- According to a 1998 study, published in the Immunopharmacology, both CBD and THC are capable of influencing the production and activities of cytokines, responsible for signaling in the immune system. This exhibits CBD’s immunosuppressive properties. The paper points out that this could be of potential benefit to patients of inflammatory/autoimmune diseases.
- In another 2000 trial of the animal model, CBD was seen to suppress arthritis. This paper, published in the Proceedings of the National Academy of Sciences of the United States of America, suggested that oral CBD has anti-arthritic therapeutic benefits through its “combined immunosuppressive and anti-inflammatory actions”.
- Another comparative study, published in the Naunyn-Schmiedeberg’s Archives of Pharmacology in 2004, CBD was seen to be significantly effective in reducing swelling in affected rat paw tissues.
- A 2004 double-blind, placebo-controlled, human clinical trial, published in the journal Multiple Sclerosis, which investigated the effects of orally administered, standardized Cannabis sativa extracts (containing 2.5 mg THC and 0.9 mg CBD) on MS patients with poorly controlled spasticity, indicated that cannabis significantly lowers spasm frequency and increases mobility.
- In a 2011 study, published in Free Radical Biology and Medicine, the researchers indicated that the ECS, along with its own receptors and G-protein coupled receptors, should be exploited for their therapeutic benefits. Their findings suggested that CBD interacts with the ECS, but its actions are unlike most other cannabinoids, which allows it to act as a “prototype for anti-inflammatory drug development”. The paper particularly talks of CBD as a potent substance for the treatment of medical conditions, involving the immune system, such as rheumatoid arthritis, types 1 and 2 diabetes, atherosclerosis, Alzheimer’s disease, hypertension, the metabolic syndrome, depression, and neuropathic pain.
- A 2020 study, published in Cannabis and Cannabinoid Research, concluded that the ECS can effectively suppress the immune responses by activating different cell types, by inducing apoptosis (cell self-destruction) and promoting the actions of T-regulatory cells.
By 2005, scientists had found new cannabinoid and non-cannabinoid receptors in our body that seem to interact directly with the ECS (particularly when CBD is in the mix). While one of them involves interaction with transient receptor potential vanilloid 1 (TRPV1) receptors, another being possibly being G-protein-coupled receptor GPR55.
- According to a 2009 review, published in the Biochemical Pharmacology, CBD both suppresses and modulates certain functions of the immune system, without directly interacting with typical cannabinoid receptors (CB1 or CB2). To simplify this paper, we can say that this cannabinoid suppresses inflammation and inhibits inflammation-causing agents, even while promoting other agents of the immune system to reinforce their protective guards.
These studies seem to project CBD as a potent anti-inflammatory and immunomodulatory agent, capable of handling a variety of autoimmune diseases.
However, what about its safety profile when taken with prednisone. Can it enhance the latter’s effects or will it aggravate prednisone’s side-effects?
CBD & Prednisone: Possible Drug Interactions
Drug interaction is a real concern for those wanting to mix CBD with pharmaceutical drugs. A 2019 study, published in Medicines (Basel), found evidence of potential interaction between cannabinoids and other drugs when administered concomitantly. The paper recorded that this interaction involves the liver’s metabolizing enzymes Cytochrome P450.
For CBD to be metabolized in the body, the cytochrome enzyme CYP3A4, a metabolite of the Cytochrome P450 family, is required. This means it is a natural inhibitor of this isoenzyme.
- A 2019 study, published in the Journal of Clinical Psychopharmacology, established that cannabidiol inhibits both CYP3A4 and CYP3A5 isozymes.
- Earlier, a 1992 study, published in the Molecular Pharmacology, had already proven that prednisone acts as a CYP3A4 inducer, even though it requires the same enzyme to be metabolized.
This means that prednisone could effectively induce CBD’s quicker metabolism, while it stays in the body for a longer period. This action not only increases prednisone’s side-effects, but it also reduces CBD’s bioavailability.
Nevertheless, another study, primarily aimed at establishing the CBD’s safety profile, says CBD inactivates cytochrome P450 isoenzymes for a short period. Repetitive CBD administration could, however, induce the production of isoenzymes.
So, is it safe to use CBD with prednisone? Probably not.
- A 2019 study, published in the Journal of Clinical Medicine, showed CYP3A4 is induced by immunosuppressants, like prednisone. So, if CBD is taken with prednisone, CBD’s bioavailability would decrease in the body, while the same of prednisone will increase.
However, if taken in high doses over a prolonged period, CBD could have the opposite reaction.
- A 2011 comparative study, published in the journal Life Sciences, found CBD to a strong inhibitor of human CYP3A4/5 enzymes. This shows that with prolonged use, CBD’s bioavailability in the blood will increase, thereby decreasing prednisone’s bioavailability when used with high doses of CBD.
Since these studies do not give us a conclusive result on whether or not it is safe to mix immunosuppressants with CBD, it’s best not to try them together.
Taking combination drugs is usually not a good idea anyway – unless your doctor considers it useful. It will not only be a waste of money, but it could also put your health at risk by aggravating the adverse effects of both compounds.
Bringing the Discussion to a Close
While CBD is an effective compound for managing autoimmune diseases, so is prednisone. However, CBD may seem like a better option over the latter, owing to its safer profile.
So, if you must take CBD, it’s best to try it without taking prednisone. Of course, you should not abruptly stop your immunosuppressant medication if you are on it for managing your disease. That will be counter-effective. With your doctor’s advice, however, you may reduce prednisone’s doses as per your body’s ability to withstand the symptoms, and then stop it.
Owing to the not-very-encouraging results of past research, it’s not advisable to try them together. Until we have solid evidence to back the safety of taking CBD with immunosuppressants, like prednisone, it’s better to stick to either one of these compounds.
You must bear in mind, though, that neither prednisone nor CBD can cure you of an autoimmune disease. They can only alleviate the symptoms enough to let you live a normal life.