CBD for Osteoporosis

By Dr. Frank Michalski


CBD has been shown to have endless benefits, from supporting a healthy mood, sleep cycle, easing feelings of depression and anxiety, all while acting as a potent anti-inflammatory. It would seem every day there is a new article in the media supporting the usage of CBD.


Did you know CBD has been shown to support healthy bone growth? There are two primary scenarios where bone growth is an issue. 


Scenario #1: Healing after a fracture. Fifteen million fractures occur each year in the US alone. 


Scenario#2: Supporting healthy bone density influencing osteopenia and osteoporosis, aka bone loss. Osteoporosis affects over 200 million people worldwide. 1 in 3 women and 1 in 5 men over the age of 50 will eventually suffer an osteoporotic fracture. 


Let’s begin by understanding how bone growth and weakening occurs. 


Bones are living organs mostly consisting of collagen, and secondly calcium phosphate. Collagen is a protein responsible for the structure of many body parts, including our hair, skin, nails, and joints. Calcium strengthens our bones.


Picture a bone in the human body. Chances are you are picturing a firm, hard, sturdy structure. Bone does not always remain this solid. Your bones are constantly changing. Bones are living organs, and everyday bone tissue is increased and or decreased. The density of your bones is ever-evolving.


Osteoporosis

When you are younger, more bone is deposited than withdrawn, hence why children have such strong bones. As we age, more bone is withdrawn than deposited, and our bone density begins to decrease.


Osteoporosis is quite literally a decrease in our bone density. More bone is being removed than being replaced, making bones fragile and more susceptible to fracture. For some, this process begins as early as the age of 20.


Our hormones determine much of our bone strength or density. For example, with female's, estrogen levels decline after menopause. Estrogen helps to protect the integrity of bones. A decline in estrogen is why many women in their 40’s and 50’s are susceptible to developing osteopenia and osteoporosis.


Men are also at risk of decreased bone density as they age. In men, the hormone testosterone begins to decline as they age, leading to an increased rate of bone loss.  


When osteopenia or osteoporosis is diagnosed, the individual is at an increased risk for bone fracture. Easy to imagine, if our bone density and strength decreased, there is a higher chance of breaking a hip, or vertebrae after a fall.


As I mentioned earlier, our bones are complex, consisting of multiple different cells and blood vessel innervations.


Two of the primary cells found in bones are osteoblast and osteoclasts. 

Osteoblasts are cells that build new bone. 

Osteoclasts are cells that break bones down. 


CBD and Osteoporosis

Going forward, I want you to keep one crucial fact in mind. Our bodies endocannabinoid system regulates bone loss. CB2 receptors are found on the osteoblast cells of our bones. Individuals with genetic mutations in the expression of their CB2 receptors have less CB2 receptors, which is associated with osteoporosis and bone loss.  It has been confirmed that our bodies endocannabinoids (our bodies naturally occurring cannabinoids) are responsible for bone loss and formation via activation of CB1 and CB2 receptors.


Recall how CBD oil works from our previous post and podcast. CBD blocks an enzyme called FAAH. FAAH breaks down your bodies naturally produced cannabinoids. If we block FAAH, we increase the activity of our endocannabinoid system. Increased ECS activity appears to have huge potential regarding new bone growth and healing. 


We know quite a bit about bone loss and CBD from females who suffer anorexia. It is hypothesized, that decreased endocannabinoid levels may lead to early onset menopause. Women who are underweight or entered menopause early have lower endocannabinoid levels and reduced bone density.


CBD and Bone Fractures

Now that we understand the physiology of bone loss let's explore the healing process.  


A recent study has come out of Israel (Hebrew University of Jerusalem and Tel Aviv University) supporting the theory that CBD may promote the healing of broken bones. 


Study conclusion: Osteoblasts rebuild broken bones with increased activity of the enzyme called Lysyl Hydroxylase which supports collagen crosslinking. CBD was shown to improve fracture healing and Lysyl Hydroxylase activity in osteoblasts. 


How reliable was the study that drew this conclusion? 


The study was carried out under a controlled environment with the supervision of eighteen scientists, the Institute for Biomechanics from Zurich, Lund University Department of Biomedical Engineering, and Department of Orthopedics. One of the scientist’s present was Dr. Mechoulam, who discovered THC fifty years ago.


The study was carried out on rats with fractured femurs. The rats were separated into three separate groups. 


Group A: The rats were given an injection of THC OR CBD while monitoring the structural and mechanical properties of healing. Healing was assessed with 3D x-ray images.


Group B: The rates were given an injection of equal parts THC & CBD while monitoring fracture callus formation, and bone strength. Strength was assessed by working the bone to failure (bending it until it breaks again).


Group C: Testing the effects of THC and CBD on osteoblast expression and collagen crosslinking. Osteoblast expression was assessed by studying the amount of Lysyl hydroxylase present in osteoblasts of newborn baby rat cultures. THC and CBD were added to the osteoblast cultures. 


Three parameters of bone healing were monitored. 

  1. Callus formation 
  2. Creation of collagen cross bridges 
  3. Osteoblast cell proliferation 

For a bone to heal, first bleeding occurs in the bones blood vessels. Secondly, the clotted blood will provide proteins that will fill in the break. Inflammation will happen (as an essential part of healing). Stem cells, bone marrow, and blood will rush the area of inflammation leading to bone formation and cartilage formation. 


Cartilage and soft callus formation will occur after about 8 days. It is not until 3 or 4 weeks after a break that new mature bone is first formed. The new bone formation is due to the osteoblast which creates new bone and adds minerals to make it strong. Full healing will take between 3 and 9 years.


What were the results of the experiment? 

 

Group A (CBD OR THC): After 6-8 weeks, the callus formation increased in the rats given CBD or THC compared to placebo. This means stimulation of the ECS receptors improved bone healing. It was also concluded that rats given CBD had significantly enhanced mechanical properties and bone strength.  


Group B (THC+CBD): After 8 weeks, THC was found to increase the maximal force and stiffness of bone slightly more than CBD.


Group C (Tested the effects of CBD and THC on the expression of osteoblast enzyme lysyl hydroxylase, which promotes collagen cross-linking): CBD was shown to increase mRNA levels of lysyl hydroxylase. This may be a landmark finding. Why? The study shows that CBD can impact genetics (your genes code for the production of proteins and enzymes).  


Conclusion

It is safe to conclude that CBD has a huge potential for helping those suffering from bone fractures and osteopenia/ osteoporosis. More research is necessary, but for now, it is safe to say we are looking forward to future studies and trials. Until more human clinical trials are carried out, it is impossible to make a dosage recommendation. For now, we encourage individuals to start slow and increase until the desired effect is achieved. Of course, you could always work with your physician to monitor bone growth and bone loss via x-ray and bone density testing. 


It is essential to understand that if you suffer a broken bone, you must see a physician for proper assessment. In many cases, surgery may be necessary.


If you suffer from osteopenia or osteoporosis, you may want to consider the following lifestyle changes:

  1. Eating a healthy diet, limiting grains, starches, and dairy products. Emphasize foods naturally high in absorbable calcium such as vegetables.
  2. Supplement with vitamin D3 or soak up some sun. 
  3. Carry out weight-bearing exercise. Weight training is a proven way to increase bone density.
  4. Have your hormone levels checked, always seek the root cause of bone loss. 
  5. Have urinary bone reabsorption markers measured (NTX, CTX, DPD). 
  6. Stop smoking and using nicotine. Nicotine and tobacco will cause mass destruction of the blood vessels in your bones. Tobacco usage results in poor and decreased healing ability.
  7. Limit or eliminate alcohol intake.  



*This content is strictly the opinion of Dr. Frank Michalski and is for informational and educational purposes only. It is not intended to provide medical advice or to take the place of medical advice or treatment from a personal physician. All viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions. Neither Dr. Frank Michalski nor the publisher of this content takes responsibility for possible health consequences of any person or persons reading or following the information in this educational content. All viewers of this content, especially those taking prescription or over-the-counter medications, should consult their physicians before beginning any nutrition, supplement, or lifestyle program.



References: