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[9 min read] Medicinal cannabis and anorexia
Cachexia is a condition, also known as ‘wasting syndrome’, characterised by loss of body mass associated with an underlying medical condition such as HIV, tuberculosis, autoimmune conditions, cancer and cancer treatments – to mention a few.
Learning how to get the most out of medical cannabis for your patient is important. If you are a doctor with a suitable patient, you can refer your patients to CA Clinics here or email email@example.com. You can also learn more about studies currently being conducted by Applied Cannabis Research, with patients recruited through CA Clinics, by emailing here.
For further information on this topic, you may be interested to learn more about the HealthCert Professional Diploma program in Medicinal Cannabis.
Medicinal cannabis and wasting syndrome: What can it do?
Patients suffering from cachexia, from any underlying condition, experience increased energy metabolism and severe lack of appetite. In this, they struggle to obtain necessary caloric intake with a flow-on effect being a lack of essential nutrients, leading to symptoms of fatigue, depression and decreased quality of life.
As cachexia progresses the loss in body fat, as well as skeletal and smooth muscle, can be devastating to the health of the patient. Increases in inflammatory responses, changes to protein synthesis and energy metabolism can fuel symptoms, further negatively impacting the underlying condition.
CACS: Cancer-related anorexia-cachexia syndrome
Cancer-related anorexia-cachexia syndrome (CACS) or cancer cachexia-anorexia (CCA) can be related to the side effects of the cancer treatment or as a result of the cancer itself, modifying metabolic and hormonal processes that impact hunger and appetite.
While there is evidence emerging for the use of medical cannabis for anorexia nervosa, the anorexia referred to here is relevant to the presentation of extreme lack of appetite, not the psychological illness. Cachexia refers to the changes in metabolic processes that contribute to a decrease in body mass.
In CACS these two conditions, cachexia and anorexia, collide creating a maelstrom of increased metabolic rate due to high inflammatory chemicals in circulation and extreme lack of appetite, resulting in patients “wasting” away. Additionally, malnutrition can impact the efficacy of drug treatments, making patients more susceptible to the toxicity of chemotherapy.
Treating cachexia with medical cannabis
The effects of cannabis on hunger may well be one of its most well-known consequences. Thus research into its effects on appetite has been widespread yet so far ambiguous.
Certain research has shown that when compared, cannabis formulations, THC-only preparations and placebo, have little variation in efficacy. Other research has shown that medical cannabis has been no more effective than its conventional counterparts.
To the contrary of the aforementioned studies, when assessing smoked medicinal cannabis, appetite and quality of life scores increased. When regarding cachexia in the context of HIV there have also been positive outcomes.
Discrepancies in efficacy abound in the medical cannabis landscape. Specifically, in the case of cachexia-anorexia, this may be due to dosage regimes not considering variables between individuals or the need for individual dose titration. Additionally, age and metabolic rate may have pertinent implications in the use of medical cannabis for cachexia.
The role of the endocannabinoid system
The endocannabinoid system (ECS) is a physiological system much like our immune or nervous systems. Endocannabinoids both interact with and regulate human immunity and impulses derived from the central nervous system, amongst a plethora of other actions.
The ECS is also known to have receptors in the gastrointestinal tract. Here cannabinoids and endocannabinoids (particularly anandamide) have the capacity to interact with cannabinoid receptors that send messages to the hypothalamus. The hypothalamus is the part of the brain that regulates hunger and instigates the cascades of hormones that tell us if we are full or hungry
By stimulating the ECS through cannabinoid medicines or antagonists for cannabinoid receptors there is great potential to manipulate mechanisms behind appetite that are impaired in CACS.
If you are interested in becoming an authorised prescriber of Medicinal Cannabis in Australia, the TGA SAS-B guidelines require you to prove that you have the knowledge necessary to do so. HealthCert’s Professional Diploma of Medicinal Cannabis pathway can serve as part of your documentation showing that you have undertaken education in this field when you decide to become an authorised prescriber.
This article has been provided by our partner, Southern Cannabis Holdings. Southern Cannabis Holdings builds, integrates and operates high-value brands across the cannabis value chain, including FreshLeaf Analytics, Cannabis Access Clinics and Applied Cannabis Research. HealthCert and Southern Cross Holdings have partnered up to bridge gaps in patient and clinician knowledge on medicinal cannabis.