By Janna Champagne, BSN, RN
As a holistic nurse who specializes in application of medical cannabis therapy, knowing which formulations are optimal for targeting patient’s health goals comes with the territory. After years of working with thousands of clients using a variety of cannabis products, I began noticing a trend: that the various cannabis products are not created equal in achieving optimal therapeutic results. This prompted intensive research into different types of cannabis formulations, so I could objectively advise my clients to optimal products, which led to creation of the following FLOW criteria. Please know I do not benefit from the sales of any products, so my perspective is completely objective and without profit-bias or personal gain.
In order to understand the FLOW criteria, it’s helpful to know a bit about the Endocannabinoid System (ECS). Many people, including fellow medical professionals, have never heard about this master control system in our bodies, much thanks to our recent cannabis prohibition in the US. Now that cannabis is becoming more readily accessible for research, we have learned that it contains vital nutrients needed to support optimal health balance. Cannabinoids found in the cannabis plant, such as THC and CBD, attach with ECS receptors in our bodies, which promotes internal homeostasis or balance. We know that the underlying cause of disease is imbalance, so this balancing “Entourage Effect” or synergy of cannabis may be profoundly therapeutic for improving the root cause of symptoms (4).
Following are the FLOW criteria, all of which my nurses and I deem important for safe and effective medical cannabis use. We educate these criteria to every client we serve, since our goal is ensuring that cannabis patients find the highest-quality products available.
Flower-Derived: The most potent spectrum of cannabinoids and synergistic components is found in formulations derived from cannabis flower. Since industrial hemp is sparse in flowers, often producers source oil from less optimal parts of the industrial hemp plant, such as the stalks and stems. While industrial hemp has many applicable uses, including textiles, bioaccumulation (cleans soil), building materials like Hempcrete, when it comes to medicinal potency, industrial hemp leaves a lot to be desired (9).
To clarify, many CBD producers have a USDA hemp license allowing them to legally produce and distribute hemp throughout the United States, because their cannabis flower products meet the federal hemp regulations (less than 0.3% THC). A new term, “Medical Hemp”, was recently coined by optimal CBD oil producers, to differentiate their products derived only from CBD hemp flower, the best choice for optimal quality. Medical hemp products have the added convenience of shipping legally anywhere in the United States.
Lab tested: Oregon is one of a few states that are fortunate in this regard, as they require every product on a dispensary shelf to be lab tested by a state-certified facility. Lab testing is important to know cannabinoid content, potency or strength, and to rule out contamination with toxins. Lab testing allows clients to consistently dose with improved accuracy, which is important when using cannabis for health purposes. Labs are the only conclusive method for knowing exactly what’s in a formulation, without reliance on strain name (which may not be accurate) to know which components are present.
Terpene lab results reflecting the cannabis strain’s profile are not as commonly available. When available, having this information is optimal to predict a cannabis product’s therapeutic benefits, and the terpene profile is also used to determine whether a retail product is categorized as sativa (energizing) or indica (sedating) (11).
Organic: This may seem like an obvious requirement, for those who understand the harm that toxins may cause. Unfortunately, USDA Organic certification is not yet available for all forms of cannabis farming/processing, so we rely on labs to rule out any toxic pesticide, fertilizer, mold, or heavy metal contamination. We know, especially with already sick patients, that adding toxic exposure may be harmful to their health, and could potentially negate the benefit received from cannabis. The recent theory linking Cannabis Hyperemesis Syndrome, or excessive nausea, vomiting and abdominal upset, with Neem pesticide toxicity (same symptoms) further supports the importance of using lab testing to ensure product is clear of toxins, and verified safe for medical use (10).
Whole Plant Spectrum: Products concentrating the cannabis flower as nature intended, with little to no loss, are the best option for therapeutic cannabis use. Cannabis formulations extracted using food grade ethanol or infusion methods are preferred to meet these criteria. Whole plant spectrum formulations conserve and contain hundreds of flower-derived cannabis ingredients, most of all of which remain intact in the final product. In comparison, CO2 processing nets around a dozen compounds (isolate cannabinoids + terpenes), and isolate contains only one compound (one cannabinoid). These lesser methods are popular despite research and patients outcomes clearly supporting that the Gestalt theory applies: the whole cannabis flower is truly greater than the sum of its parts (2).
Cannabis is a very complex plant, containing over 140 cannabinoids, 200 terpenes (similar to essential oils), bioflavonoids, chlorophyll, essential fatty acids, and antioxidants (1). Research supports that synergy between all of the 500+ compounds enhances the "Entourage Effect" experienced by the consumer, defined as the ability of cannabis to promote homeostasis. Many of the new and popular cannabis extraction methods in today’s cannabis industry, such as CO2 extraction, isolation, or fractionation, remove many of these ingredients contributing to the Entourage Effect (8).
It’s the balancing effect (homeostasis) that we specifically seek when the patient's goal is improved health outcomes that reach beyond superficial symptom management (4). Research comparing the efficacy of whole plant spectrum vs isolate cannabis clearly reflects that isolates, even with added terpenes comparable to CO2 and "Full Spectrum" products, aren’t as effective for exerting the balance we seek for optimal health outcomes. Research reflects that whole plant spectrum works as well or better than isolate CBD at 20-25% of the dose of isolate (or co2), thereby improving health outcomes for far less cost to the patient. Research also reflects that isolate and co2 extractions exert a bell curve response, narrowing the therapeutic dosing range, and risking little to no benefit with intensive dosing as indicated for serious conditions like cancer. In comparison, whole plant spectrum exerted a more predictable response, increasing anti-inflammatory response with higher dosing (2, 3, 6).
Another emerging issue is the increased risk of using human-altered cannabis products. This insight follows a tragic event in February 2020, when a patient using CBD for two years switched to a human-altered liposomal formulation, and immediately suffered onset of Stevens-Johnson Syndrome, a known adverse effect of her long-time medication, Meloxicam. It’s important to note that this patient did not experience any interactions between meloxicam and the first CBD formulation, despite a shared metabolic pathway (CYP450). Upon switching to a liposomal CBD, that same medication was potentiated to such an extent that she died only two days later.
Now that CBD is freely available for purchase, and most consumers don’t understand that it may interact with pharmaceuticals, this situation could repeat. This is another reason to ensure your product's effects are predictable, since we don't yet understand how our tampering with whole spectrum changes bioavailability and metabolism of cannabis with concurrent pharmaceuticals. When it comes to optimal therapeutic quality, based on my experience and the research, whole plant spectrum cannabis is the frontrunner.
For more information on FLOW criteria and a list of certified suppliers, please visit: www.cannabisnurseapproved.com
1. Echo (2017). Other compounds in cannabis. Retrieved from: https://echoconnection.org/other-compounds-in-cannabis-terpenes-chlorophyll-etc/
2. Blasco-Benito (2017). Appraising the entourage effect. Retrieved from: https://www.ncbi.nlm.nih.gov/labs/pubmed/29940172-appraising-the-entourage-effect-antitumor-action-of-a-pure-cannabinoid-versus-a-botanical-drug-preparation-in-preclinical-models-of-breast-cancer/
3. Pamplona (2018). Potential clinical benefits of CBD-rich Cannabis extracts over purified CBD in treatment-resistant epilepsy: observational data meta-analysis. Retrieved from: https://www.biorxiv.org/content/biorxiv/early/2017/11/01/212662.full.pdf
4. Russo, E. (2001). Cannabis and cannabis extracts: greater than the sum of their parts? British Journal of Pharmacology. Retrieved from: http://cannabis-med.org/data/pdf/2001-03-04-7.pdf
5. Echo (2017). Major and minor cannabinoids in cannabis. Retrieved from: https://echoconnection.org/a-look-at-the-major-and-minor-cannabinoids-found-in-cannabis/
6. Gallily (2015). Overcoming the Bell-Shaped Dose-Response of Cannabidiol by Using Cannabis Extract Enriched in Cannabidiol. Retrieved from: http://www.scirp.org/Journal/PaperInformation.aspx?PaperID=53912#.VP4EIildXvY
7. Fundacion Canna (2017) Cannabis bioflavonoids. Retrieved from: http://www.fundacion-canna.es/en/flavonoids
8. Echo (2017). CBD Alcohol or CO2 Extraction. Retrieved at: http://www.cbd-hemp-oil-drops.com/articles/57-cbd-alcohol-or-co2-extraction
9. Price, M (2015). The difference between hemp and cannabis. Medical Jane. Retrieved online at: https://www.medicaljane.com/2015/01/14/the-differences-between-hemp-and-cannabis/
10. Mishra, A., & Dave, N. (2013). Neem oil poisoning: Case report of an adult with toxic encephalopathy. Indian Journal of Critical Care Medicine : Peer-Reviewed, Official Publication of Indian Society of Critical Care Medicine, 17(5), 321–322. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3841499/
11. Cannabis Safety Institute (2014). Standards for cannabis testing laboratories. Retrieved online at: http://cannabissafetyinstitute.org/wp-content/uploads/2015/01/Standards-for-Cannabis-Testing-Laboratories.pdf
12. Han Y et al. Commercial cannabinoid oil-induced Stevens-Johnson Syndrome. Case Reports in Opthalamological Medicine. 2020.
by Janna Champagne, BSN, RN
In the winter, boosting your health can make the difference between chronic bouts of illness and staying well. The fall and winter months can be especially hard on our health, between the weather shifts, having less sunlight exposure, and the holiday stress. The following are 5 simple tips for supporting optimal wellness:
1. Support Your Lymph System: Our lymph system is like a drain that helps to remove waste and balance the immune system. Daily care of the lymphatic system helps the body work better and keeps the immune system operating the way it should. Consider the following supports:
a. Daily Detox Tea Recipe (and it tastes amazing!): https://draxe.com/recipe/secret-detox-drink/
b. Daily Rebounding Session: https://www.wellbeingjournal.com/rebounding-good-for-the-lymph-system/
2. Limit Incoming Toxins: Our immune system functions best when we limit our exposure to environmental toxins. Toxins can contribute to inflammation and suppress our immune system, making us more vulnerable to infection and illness. Consider the following strategies to limit environmental toxin exposure:
a. Consume Primarily Organic foods
b. Use personal products that are free of parabens, sulfates, or synthetic perfumes. For healthier scented products, look for those with essential oils in the ingredients, or purchase unscented and add your own favorite essential oil or blend.
c. Filtered Water: Depending on where you live, water may have high levels of contaminants. Using filtered water can make a big difference, both in drinking/cooking and in the bath/shower. Filter prices vary, and even the most affordable options are worth the investment.
3. Stress Management: The holidays often create extra levels of stress, for various reasons. Stress is a major factor in illness, so it’s important to seek strategies to alleviate stress during the more chaotic times. To better stress management, the first step is to be aware of its impact. We often can’t control the external sources of stress, but we can learn to control our own response. The next time you feel stressed, try to notice the tension in your body and make a conscious decision to decrease that response. Practice stress-relieving strategies that appeal to you, whether it’s deep breathing, meditation/prayer, or something like exercise or reading. Find what is meaningful, and what works best for you, and use it at every opportunity.
4. Consider Cannabis Supplementation: CBD is a non-intoxicating component of cannabis that has far-reaching immune benefits supported by research, including balancing the immune system, decreasing inflammation, and killing bacteria as strong as MRSA. Not all cannabis formulations are equal for medical use and knowing what to purchase can be confusing. Here’s our blog article on optimal cannabis formulations for guidance on choosing the best product options (we don’t benefit from ANY product sales): http://www.integratedholisticcare.com/blog
5. Emergency Response: If you start to feel sick despite your efforts to stay well, there are immediate interventions that may help to reduce the length and severity of illness. At the first sign of a cold/flu, taking supplements like Vitamin D3, Vitamin C, Zinc, and Virastop enzymes can offer a substantial immune boost. Other options include medicinal teas (Yogi is a reputable brand), and food-sourced support like Elderberry syrup or Echinacea lozenges. Most importantly, listen to your body. Winter is the season we are supposed to slow down. So try to honor the times you feel extra rest is needed, or shorten your to-do list if possible. You’ll feel better in the long run.
All of us at Integrated Holistic Care wish you all the best wellness possible this winter solstice, and hope the above suggestions are helpful for optimizing your health!
By Janna Champagne, BSN, RN
I was first introduced to the topic of epigenetics in 2008 at a conference in Florida, and as a medical professional I was immediately intrigued. Epigenetics is defined as the environmental impact on gene expression, which explains how genes can be influenced to alter our genetic health expression, sort of like an on/off switch. Depending on exposures, environmental interaction with genes may result in positive or negative impacts on our health. Pretty exciting, since this exemplifies that our overall health is not determined solely based on what our parents contributed. Instead, we as individuals have the ability to positively affect our inherited risk factors for familial diseases (1).
Correctly applied Nutrigenomics (genetically-individualized nutrition) is a positive environmental factor with the potential to improve genetic predisposition to illness, by slowing or halting many contributors to disease (1). This supports what we’ve known for a long time: that given what it needs, the body can balance and heal itself.
Over the years of helping clients optimize their health through nutrigenomics and other alternatives to pharma, I’ve seen some amazing results like successful weaning off harmful pharmaceuticals (with physician oversight), and reversals of difficult to treat conditions like cancer and autoimmune disease. knowledge of genetics has since crossed over another area of passion: medical cannabis therapy.
Contrary to it’s abhorrent social reputation in the last century, cannabis is proving to be a source of vital nutrients needed to maintain balance in the body, and is therefore a perfect compliment to almost any nutrigenomic regimen. Of course, unique varieties of cannabis exert varying effects on individuals, an issue that may be resolved through a new process allowing for genetic guidance of cannabis therapy.
As you may have already guessed, genetically guided cannabis is very cutting edge, and a bit complex. It’s the overlap of several emerging sciences: the endocannabinoid system, human genetics, cannabis genetics, and botany are all in the mix. If this intrigues you, then you’re definitely a kindred cannabis nerd.
Here’s a little background info: All humans have a master control Endocannabinoid System (ECS), which is so important that it’s widely argued that life would not be possible without its balancing influence (1). The ECS produces endocannabinoids that interact with our body’s receptors, and when activated they promote balance throughout the body systems. (4) Since the role of the ECS is homeostasis or balance, and the underlying cause of most chronic illness is some sort of imbalance, it makes sense that endocannabinoid deficiency (lacking what’s needed to maintain homeostasis) is linked to chronic illness (5). Since plant derived phytocannabinoids exactly mimic our internally-made endocannabinoids, cannabis supplementation can help fill the EC deficiency gap, and promote the balance necessary to recover health. (3)
This explains how medical cannabis therapy may benefit those suffering chronic illness, and many report cannabis is more effective than pharmaceuticals sans the dangerous side effects. Cannabis is very safe overall, and since it promotes underlying body balance it’s also a powerful tool for targeting the imbalances causing many diseases. (3) Very few pharmaceuticals exert a curative effect, making cannabis a far superior intervention for chronic illness.
Endocannabinoid deficiency is especially prevalent in today’s society, thanks to nearly a century of cannabis prohibition (lacking phytocannabinoid accessibility) combined with human ECS pathway mutations that may impair our ability to produce endocannabinoids. (5) Every individual has a unique genetic profile, and mutations may reflect predisposition to ECS deficiency, along with many other contributors to imbalance. The cannabis plant contains many medicinal components, including 140+ phytocannabinoids and 200+ terpenes, thereby providing a broad spectrum of the components needed to fill an individual’s ECS deficiency profile (4).
Assessing an individual’s genetics specific to the Endocannabinoid System (including other system pathways that overlap) can help to guide cannabis therapy, which is proving useful to decrease the “trial and error” phase upon starting cannabis, and provide more consistently positive health outcomes. There are several pathways assessed to determine which cannabis components might best fit an individual’s needs, and genes considered include those from the following pathways (6):
-Serotonin/Dopamine and GABA/Glutamate -Neurotransmitter pathways (cannabinoid profiling, terpene guidance) 9
-Vitamin d3/gcmaf (ECS receptors affected) 10
-Choline pathways (mutation predispose ECS deficiency) 11
-Immune system pathways (for targeted cannabinoid therapy) 12
-AKT1/Schizophrenia predisposition-only known contraindication to THC (13)
-Methylation pathways (addressing mutations mitigates risk factors) 7
and many more...
The process of genetic screening is especially important in pediatric applications of cannabis therapy, because methylation pathway mutations predispose neurodevelopmental risks with child/adolescent use of cannabis (7). Methylation mutations are linked to many chronic illnesses, and sickness is the main reason most seek cannabis therapy for a minor child, reflecting that neurodevelopmental risk factors may be inherent in treating with cannabis (8).
TO BE VERY CLEAR: This doesn’t mean that children and adolescents (even with methylation mutations) shouldn’t use medical cannabis when it’s indicated. Instead this supports that methylation should be optimized with targeted supplementation (nutrigenomics) to mitigate this risk factor, in addition to following medical standards of balancing possible benefit and risk of any intervention.
Genetics are important, but it’s equally imperative to work with a medical professional that understands the basis of an individual’s condition(s), plus other unique cannabis considerations such as medication interactions, etiology of symptoms, and lifespan risk factors. Mitigating as many contributing factors as possible, balancing risk vs benefit, and assessing client goals as a holistic process reinforces optimal medical outcomes. Luckily there are knowledgeable practitioners available to assess genetic cannabis risk factors, and optimize health further through nutrigenomics.
In addition to screening genetics to improve cannabis therapy, full genome assessment and applied nutrigenomics may help address other pathway mutations implicated in chronic illness. My favorite analogy to describe the potential of combining nutrigenomics and cannabis therapy is a sink that’s overflowing with imbalances, thereby causing chronic illness symptoms. Starting cannabis therapy helps the body start balancing, and can be likened to taking the plug out of the drain in this overflowing sink scenario. Applied nutrigenomics can slow or turn off the running faucet. This is a powerful duo for chronic illness indeed.
My hope is to spread knowledge about this very pertinent issue, so that patients and medical professionals alike are aware of the power of using human genetics to guide cannabis therapy. I truly believe this approach represents the future of medical cannabis, and offers a viable option for comprehensive healing of the widespread chronic illness found in our society today.
For more information about genetically guided therapy and nutrigenomics assessment, please visit our website at: www.integratedholisticcare.com
1. Watters, E.(2008) DNA is not destiny. Accessed online at: http://www.geneimprint.com/media/pdfs/1162334912_fulltext.pdf
2. Piomeli, Daniele (2002). The molecular logic of endocannabinoid signaling. Nature Reviews Neuroscience 4, 873-884 (November 2003). https://www.nature.com/nrn/journal/v4/n11/full/nrn1247.html
3. Department of Chemistry, Kennesaw State University, 1000 Chastain Road, Kennesaw, GA 30144, USA (2002). Endocannabinoid structure-activity relationships for interaction at the cannabinoid receptors. Prostaglandins Leukot Essent Fatty Acids. 2002 Feb-Mar;66(2-3):143-60. https://www.ncbi.nlm.nih.gov/pubmed/12052032
4. Grant, I., & Cahn, B. R. (2005). Cannabis and endocannabinoid modulators: Therapeutic promises and challenges. Clinical Neuroscience Research, 5(2-4), 185–199. http://doi.org/10.1016/j.cnr.2005.08.015
5. Smith, SC, Wagner, MS(2014). Clinical endocannabinoid deficiency (CECD) revisited: can this concept explain the therapeutic benefits of cannabis in migraine, fibromyalgia, irritable bowel syndrome and other treatment-resistant conditions? Neuro Endocrinol Lett. 2014;35(3):198-201. https://www.ncbi.nlm.nih.gov/pubmed/24977967
6. DiMarzo, V., Lutz. B.(2014). Genetic dissection of the endocannabinoid system and how it changed our knowledge of cannabinoid pharmacology and mammalian physiology. http://onlinelibrary.wiley.com/doi/10.1002/9781118451281.ch4/summary
7.Neuroscience & Biobehavioral Reviews. High times for cannabis: Epigenetic imprint and its legacy on brain and behavior. Neuroscience & Biobehavioral Reviews, May 12, 2017. http://www.sciencedirect.com/science/article/pii/S0149763417300659
8. Lertratanangkoon K, Wu CJ, Savaraj N, Thomas ML. Alterations of DNA methylation by glutathione depletion. Cancer Lett. 1997 Dec 9;120(2):149-56. https://www.ncbi.nlm.nih.gov/pubmed/9461031
9. Sammit, S., Owen, MJ, Evand, J., et al (1995). Cannabis, COMT and psychotic experiences. Br J Psychiatry. 2011 Nov;199(5):380-5. https://www.ncbi.nlm.nih.gov/pubmed/21947654
10. Siniscalco, D., Bradstreet, J., et al (2014). The in vitro GcMAF effects on endocannabinoid system transcriptionomics, receptor formation, and cell activity of autism-derived macrophages. Journal of Neuroinflammation 2014, 11:78. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3996516/
11. Basavarajappa, B. S. (2007). Neuropharmacology of the Endocannabinoid Signaling System-Molecular Mechanisms, Biological Actions and Synaptic Plasticity. Current Neuropharmacology, 5(2), 81–97.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2139910/
12. Cabral GA1, Staab A.(2005). Cannabis effects on the immune system. Handb Exp Pharmacol. 2005;(168):385-423. https://www.ncbi.nlm.nih.gov/pubmed/16596782
13. DiForti, M., et al (2012). Confirmation that the AKT1 (rs2494732) genotype influences the risk of psychosis in cannabis users. Biol Psychiatry. 2012 Nov 15;72(10):811-6. https://www.ncbi.nlm.nih.gov/pubmed/22831980
Cannabis and Depression
By Janna Champagne, BSN, RN
The role of the Endocannabinoid System in our body, which is activated by cannabis intake, is to maintain balance within the systems of our body. Depression and bipolar disorders signify that underlying imbalances exist, specifically in neurotransmitters (i.e. dopamine and serotonin), and this imbalance is what causes debilitating mental health symptoms. Upon appropriate intake of medical cannabis, the body is activated to intelligently balance what is askew. Of course, it’s always best to work with a medical professional experienced in mental health disorders to individualize cannabis recommendations, since some formulations may actually exacerbate mental health symptoms. Unfortunately, some clients seek my services after failing to find relief using generalized cannabis supplier protocols, or after blindly following the recommendations of a dispensary employee lacking both a medical understanding of individual disease mechanisms and the potential for cannabis-medication interactions. I urge anyone who is seriously considering medical cannabis therapy to pursue expert medical oversight, for which cannabis nurse consultants represent a viable option for obtaining optimal client outcomes.
By Janna Champagne, BSN, RN
As cannabis progresses toward government deregulation, and more domestic research is allowed and supported, we can better understand the potential of cannabis to replace pharmaceuticals in a manner that is condition-specific. Many patients rely on anecdotal testimonies or case studies when seeking support and knowledge about using cannabis effectively. Cannabis nurses are on the forefront of learning optimal formulations, and appropriate clinical application of cannabis’ numerous components, as we guide individual clients through the process of discovering their optimal medical cannabis regimen. Once cannabis research is openly allowed in our country, the patient outcomes we witness first-hand will be objectively supported, representing a positive stride toward mainstream acceptance of cannabis as an alternative to pharmaceuticals.
Intro to Cannabis for Autism
by Nurse Janna, RN, BSN, Holistic Nurse & Warrior ASD Mama
In the Autism Parent community, word spreads FAST. If you’ve been paying attention, you’ve surely heard the stories about seemingly miraculous results from a parent who discovered cannabis for their ASD child. I’m one of those parents, and can personally vouch for the extreme positive potential of this most controversial herb. *Disclaimer: Legally accessed and administered*
As a holistic nurse focused on natural alternatives to pharma, residing in a cannabis-legal state, learning how best to apply medical cannabis therapy was a logical decision for me. Cannabis quickly became a major life passion, as this amazing plant was integral in saving my own ASD teen daughter from out-of-home placement. I thought of doing what many consider unthinkable (foster placement), due to safety concerns when my daughter suffered a major puberty crisis, with high-level behaviors including self-injury, aggressive rages, and property destruction. I can attest: there’s nothing more helpless than watching your child suffer to the extent of injuring themselves and others in a blind rage.
The trauma of puberty crisis is experienced by an estimated 50% of Autism families, and is therefore an exceedingly common presentation during many a child’s coming-of-age (1). Having been there myself, I completely empathize and offer hope of resolution upon connecting with kindred ASD parents. After recovering my own daughter from her ASD puberty crisis, my resulting passion turned our trauma into purpose: to help other families.
I’ve since personally guided many ASD parents through optimal application of cannabis therapy. For most it has provided safe and effective relief, and eased their family crisis. As an added bonus, many using cannabis have successfully weaned off harmful mental health pharmaceutical medications, some of which have permanent side effects (google extra-pyramidal symptoms, not a good scenario). *Disclaimer: I highly recommend medical oversight for pharmaceutical weaning.*
The only shame of this process is how many parents don’t consider cannabis therapy until every other option to manage their ASD child is completely exhausted. No judgment by the way. It’s lack of education about cannabis that prevents consideration of this safe and effective option. Now that word is spreading, many parents are using cannabis as a crisis prevention strategy (sometimes well before puberty) and the ASD biomed treatment addage “the earlier the better” certainly seems to apply.
I want to be clear that the goal of medical cannabis use for ASD isn’t for parents to get their kids “high” to mellow them out. Instead, the goal is to improve internal balance and optimize function, through individualized microdosing and experimenting to find the “sweet spot” titration. The experimentation process is needed because individual cannabinoid needs vary greatly. With successful medicinal cannabis titration, even with use of psychotropic components such as THC, a “high” is rarely discernable.
Now for the science supporting cannabis therapy for Autism. First and Foremost: Endocannabinoid Deficiency Predisposes Autism (2). Read that a few times and let it sink in for a minute. For those who are brand new to the Endocannabinoid system (ECS), think of it as the motherboard that manages the interactions within and between our body’s organ systems. The role of the endocannabinoid system is homeostasis (maintaining balance) throughout the rest of the body. In response to an imbalance, the ECS will intelligently rebalance what’s out of skew. This includes some important areas for treating ASD such as neurotransmitter balance, immune modulation, and mitigating inflammation (3). In fact, one cause of ASD is genetic Endocannabinoid System receptor mutations which lead to ECS deficiency (4). The cannabis plant has the most prolific source of phytocannabinoids available to supplement what is lacking in the ECS of those with ASD. This explains why cannabis can have such a profoundly positive impact as an intervention for Autism.
So, how exactly does cannabis benefit one with Autism? Well, let’s start with symptom management. Cannabis is very effective at minimizing or completely stopping extreme Autism behaviors before, during, or after puberty. The anxiolytic (5), pain-relieving (6), and anti-inflammatory (7) effects of cannabis seem to come in particularly handy for managing Autism behaviors. In addition, cannabis is considered very safe with much milder side effects compared to its pharmaceutical alternatives (8). Hence the symptom management piece that is renowned for alleviating harsh situations in ASD families, even when at or near their breaking point.
In addition to its symptom management efficacy, cannabis also promotes balance of some underlying issues that cause Autism...hence my inclination to call it potentially “curative”. Biomedical ASD 101: Autism is caused by a combination of genetic and environmental impacts that result in pervasive imbalances, predominantly in the gut, brain, and immune systems (9). When cannabis activates the Endocannabinoid System, the effect includes balancing of all three of these major organ systems gone defunct in ASD. Cannabis is immune modulating (10), neurotransmitter balancing/neuroprotective (11), plus anti-inflammatory to the gut and brain (12), to name a few of the profound curative effects. Cannabis itself has definitely been one of the “big hitters” in recovering my own ASD daughter, who made more progress between the ages of 11-14 (post cannabis) than in the biomed-heavy decade prior.
If you have a child with Autism who you believe may benefit from cannabis, but are unsure where to begin, I highly recommend connecting with Mother’s Advocating Medical Marijuana for Autism (MAMMA). I urge you to seriously consider this safe and effective therapy if you have a child with Autism.
In the next blog I will review optimal starting formulations and cannabis components that are especially helpful for individualizing cannabis therapy. I hope this information is helpful for those new to cannabis for Autism, in understanding the powerful potential of this amazing plant to improve what is often considered untreatable by mainstream medicine.
For more information about my consultation services, please visit:
Ballaban-Gil, K. et al (1996). Longitudinal examination of the behavioral, language, and social changes in a population of adolescents and young adults with autistic disorder. Pediatric Neurology, 15(3):217–223
Chakrabarti, B., Persico, A., and Battista, N.(2015). Endocannabinoid signaling in autism. Neurotherapeutics, 12(4): 837–847.
De Petrocellis, L., Cascio, M. G. and Di Marzo, V. (2004) The endocannabinoid system: a general view and latest additions. British Journal of Pharmacology 141, 765–774.
Dilja, D., Krueger, N. (2013) Evidence for a common endocannabinoid-related pathomechanism in autism spectrum disorders. Neuron: 78(3):408–410.
Blessing, E., Steenkamp, M., Manzanares, J., Marmar, C., (2015). Cannabidiol as a potential treatment for anxiety disorders. Neurotherapeutics: 12(4):825-36.
Russo, E. B. (2008). Cannabinoids in the management of difficult to treat pain. Therapeutics and Clinical Risk Management, 4(1), 245–259.
Nagarkatti, P., Pandey, R., Rieder, S. A., Hegde, V. L., & Nagarkatti, M. (2009). Cannabinoids as novel anti-inflammatory drugs. Future Medicinal Chemistry, 1(7), 1333–1349.
Medical Marijuana vs. Traditional Pharmaceuticals (2016). Medicinal Marijuana Association, accessed online at: http://www.medicinalmarijuanaassociation.com/medical-marijuana-blog/infographic-medical-marijuana-vs.-traditional-pharmaceuticals
Caroline, G., Lopes, S., Silva, P., et al (2011). Pathways underlying the gut-to-brain connection in autism spectrum disorders as future targets for disease management. European Journal of Pharmacology, 668:S70–S80.
Thomas, W., Klein, L., Newton, C., Larsen, K., et al (2003). The cannabinoid system and immune modulation. Journal of Leukocyte Biology. 74(4): 486-496
Hampson, J., Grimald, M., Axelrod, J., Wink, D, (1998). Cannabidiol and tetrahydrocannabinol are neuroprotective antioxidants. National Academy of Medial Sciences, Vol. 95, pp. 8268–8273.
By Janna Champagne, BSN, RN
As a holistic nurse focused on natural alternatives to pharma, also residing in a cannabis-legal state, learning about medical cannabis was a logical decision for me. Cannabis quickly transformed into a major life passion, as this amazing plant spared my teen daughter from out-of-home placement from safety concerns during her Autism puberty crisis. This puberty crisis situation is exceedingly common, affecting an estimated 50% of children with Autism (ASD), when parents are suddenly confronted with intense behaviors which may include self-injury, aggressive rages, and property destruction. Cannabis is effective for calming ASD behaviors, and our suffering and transcendence provided a new life purpose: to teach others about the healing potential of cannabis. My current work is very rewarding, as I educate and support many clients through successfully adopting a medical cannabis regimen, which in most cases improves their situation and avoids potentially heart-breaking scenarios.
By Janna Champagne, BSN, RN
Being in the state of Oregon, and having recreational laws in place, we are pretty spoiled in our ability to access good quality cannabis. Anyone over 21 can grow 4 plants of their own, or access cannabis without any paperwork required. Medical cannabis laws are well-established here, and every cannabis product in an Oregon dispensary has been lab tested for optimal product safety and individual medical application. We are one of the more progressive states in that regard, and now that I’m working with clients in other states and internationally, I realize how much progress is still needed in regards to quality cannabis accessibility. Despite the progress in my local area, from a worldview cannabis patient’s rights are still in their infancy stage. As a cannabis nurse, I’m dedicated to advocating for medical cannabis progress, and through education and sharing reputable medical cannabis research, we continue to exemplify to the world that access to cannabis should be reinstated as a basic human right.
Ongoing legislative change is needed to improve medical cannabis access and affordability, with special focus on preserving medical cannabis patient autonomy — the right to choose their preferred medicine. Federal deregulation of cannabis would facilitate a broad reaching legislative paradigm shift, alleviating the need to pursue state by state changes to ensure medical cannabis access. Despite more than half of the states in our union having adopted medical cannabis laws, many patients are still required to either relocate or face potential legal ramifications in order to use their optimal formulation of cannabis as medicine. Our federal government’s current stance is not sustainable, and their double standard of holding the patent for cannabis as medicine while concurrently designating that cannabis has no medicinal value — criteria for current Schedule I placement — is doomed to fail under increasing popular demand. Every American successfully educated by a knowledgeable nurse about the medical safety and efficacy of medical cannabis is another vote for federal deregulation, and another nudge toward this inevitable outcome that will benefit many cannabis patients in the future.
by Janna Champagne, RN, BSN
Cannabidiol (CBD) is a non-psychoactive cannabinoid found in the cannabis plant, and it boasts the broadest therapeutic potential of any other component (1). CBD is widely known for its vast array of medicinal uses, including relief of anxiety, nausea/vomiting, mental health disorders, inflammation, cancer, AND...(drumroll please)...CBD kills infectious organisms (2). These facts, combined with CBD being readily available to purchase anywhere in the US (and many other countries), makes supplementation an excellent treatment option for many conditions.
But there's a catch! Caution is warranted when administering CBD for Autism or related immune or infectious diseases, and considerations are necessary or CBD may actually result in the opposite of the desired effect. Imagine taking CBD and expecting symptom relief, and instead having it worsen illness symptoms! Being a professional cannabis dosing nurse with Autism as one area of specialty, I have witnessed this very reaction on many occasions. Curiosity prompted me to further research this phenomenon, and now I'm sharing my theory and solutions below.
Fact #1: A major underlying factor for MOST kids with Autism and related immune disorders is chronic infections (3). Chronic infections result from a combination of factors commonly underlying in Autism, including endocannabinoid deficiency (4), which can contribute to the immune dysfunction that facilitates the presence of chronic infections.
Fact #2: CBD is the most powerful anti-microbial component in cannabis, making it a very therapeutic intervention for killing infections (5). CBD is especially helpful for remedying immune and infection-related disorders, because killing infections lowers the overall infectious load. This is a critically important step to recover a struggling immune system from it's chronic state of overwhelm, as seen in Autism and related immune disorders.
Fact #3: Another phenomenon supporting the potential for therapeutic benefit of CBD is research exemplifying an increase in production of CB2 (Cannabis-specific) receptors in the bodies of those with Autism. So the Endocannabinoid Systems of those with Autism are literally begging for cannabis supplementation (6). Pretty exciting stuff to this cannabis nerd!
So what's the problem with giving CBD to someone with Autism or chronic infections? It's not so much a problem per se. It's the conditions that exist, which if not taken into consideration, may result in worsening of symptoms. Basically, giving CBD as a first-step intervention without taking any of the appropriate precautions is the equivalent of feeding a starving person Thanksgiving for their very first meal. It's going to overwhelm their system and make them feel worse!
One possible issue that arises from giving CBD to a patient with Autism or chronic infections is the die-off effect, also known as a Herxheimer reaction. Die-off occurs when harmful infections are killed, upon which their cell wall ruptures and they release an influx of toxins into the body. Of course, the actual killing of harmful infections is a positive therapeutic action.
BUT with Autism and related immune disorders, die-off may increase illness symptoms when:
1. CBD is dosed too aggressively (detox can't keep up with die-off)
2: CBD is given without prior optimization of the detoxification pathways.
Without effective detoxification, die-off toxins add significantly to the already high levels of toxins found in those with ASD (7). A Herxheimer reaction is known to increase symptom severity, which in Autism often presents as a spike in behaviors (especially in those with impaired communication abilities).
Those who do not understand Herxheimer reactions may incorrectly blame CBD or cannabis for the symptom exacerbation, when the issue is actually caused by inefficient detoxification. The good news is that detox efficacy can be supported through a variety of interventions, including epson salt baths and activated charcoal administration (8) along with nutrigenomic interventions to optimize the body's own detoxification pathways. That brings me to another contributing aspect.
Fact #4: Most children with Autism (70-80%) have mthfr genetic mutations, which impair glutathione production, so they lack what is arguably the most important antioxidant in the human body (9). Glutathione deficiency alters many areas of health, with one major impact being decreased ability to detoxify and clear toxins effectively. So if nutrigenomic detox pathway optimization isn't completed, combined with a CBD-triggered increase in toxic load from die-off, then boom: Herxheimer misery. This is best described as feeling like a severe flu, and in some cases the severity may require seeking medical attention...no wonder we see a spike in Autism behaviors!
In summary, CBD has considerable therapeutic potential as an intervention for Autism and related immune disorders, but I recommend taking special consideration of the patient's detoxification status before starting CBD supplementation. This helps prevent a severe die-off reaction, and decreases the risk of an adverse event that may discourage use of cbd, however beneficial.
Of course, there are additional considerations, such as a CBD-rich strain's tendency to be more sativa dominant in terpene profile, which may also be problematic for some with Autism or anxiety. This exemplifies the need to work with a practitioner who views clients from a holistic perspective, and can individualize recommendations based on a broader view of the mechanisms involved. That's what holistic nurses do!
At Integrated Holistic Care, we offer help for those seeking support in managing therapeutic cannabis to treat Autism and related immune disorders and beyond. If you would like more information, or to schedule a consultation, please visit our website at: www.integratedholisticcare.com
1. J Nat Prod. 2008 Aug;71(8):1427-30. doi: 10.1021/np8002673. Epub 2008 Aug 6.
2. Zhornitsky S, Potvin S. Cannabidiol in Humans—The Quest for Therapeutic Targets. Pharmaceuticals. 2012;5(5):529-552. doi:10.3390/ph5050529.
3. Jepson, Bryan, and Jane Johnson. Changing the course of autism: A scientific approach for parents and physicians. Sentient Publications, 2007.
4. Siniscalco, D., Sapone, A., Giordano, C. et al. J Autism Dev Disord (2013) 43: 2686. doi:10.1007/s10803-013-1824-9
5. Lone, Tariq Ahmad, and Reyaz Ahmad Lone. "Extraction of cannabinoids from Cannabis sativa L. plant and its potential antimicrobial activity." Universal Journal of Medicine 1.4 (2012): 51-55.
6. Siniscalco, D., Sapone, A., Giordano, C. et al. J Autism Dev Disord (2013) 43: 2686. doi:10.1007/s10803-013-1824-9
7. Grandjean, Philippe et al. Neurobehavioural effects of developmental toxicity
The Lancet Neurology. 2014; 13(3): 330 - 338
8. Woeller, Curt MD. Autism Treatment: Herxheimer reactions and Autism. Website: http://autismrecoverytreatment.com/autism-treatment-%E2%80%93-herxheimer-reactions-and-autism/
9. Boris, Marvin, et al. "Association of MTHFR gene variants with autism." J Am Phys Surg 9.4 (2004): 106-8
By Janna Champagne, RN, BSN + ASD parent
I talk with clients about the importance of epigenetics and nutrigenomics every day and often get the "wha???" response. With a little explaining, the light bulb brightens until the realization hits. Yes it's true, epigenetics are a major cause of many chronic illnesses, including Autism Spectrum Disorders (plus many other conditions) .
I consider nutrigenomics so important for recovering kids with ASD, that it's often the first tool I grab from my bag of tricks. The following is my rationale for prioritizing nutrigenomics plus some bonus info on the subject. Because I'm sweet like that😊
First, a couple of helpful definitions:
1. Epigenetics- environmental impact on gene expression (switches genes on and off)
While our genes are inherited and static (DNA doesn't change), every gene has an on and off switch that can be triggered by environmental factors. This is a phenomenon known as epigenetics. University of Berkeley has been integral in researching and has published extensively on this subject.
2. Nutrigenomics is the term for genetically individualized supplementation used to offset the health-damaging results of epigenetic mutations.
Basically it's like the oil for your car. Helps keep all the moving parts flowing as they should. (It's really more of a chemical thing, but I'm a fan of car analogies)
3. Single Nucleotide Polymorphism (snp) is a fancy name for a gene. Pronounced "snip" in conversation.
In referring to mutations:
Homozygous means inherited from both parents, (double=more severe impairment)
Heterozygous means inherited from only one parent (single=less severe impairment).
The most recognizable snp in regards to health impact is mthfr (methelenetetrahydrofolate reductase). In this case mthfr isn't the abbreviation for a bad word, but if this mutation isn't offset, the "less PC" term is a fair description of the insult to ones health. See, mnemonics work!
Mutation of mthfr is found in 70-80% of those with Autism. This mutation manifests as lack of an enzyme which impairs the body's ability to metabolize (break down and utilize) folic acid appropriately. Ample folate is pretty important, so this is kind of a big deal.
Those with mthfr end up with folate deficiency, which results in lacking critical components for several foundational chemical cycles. Correct folate metabolism is required for production of neurotransmitters, detoxification (glutathione production), neuro development, immune balance, and the list goes on. Bonus question: which epidemic childhood illness features these very deficiencies and imbalances? You guessed it....Autism.
The severity of mthfr mutation impact varies. Homozygous (double) mutation causes an 80% impairment in folic acid metabolism, while heterozygous (single) is only 40% impairment (while less the impact is still significant). Offsetting mthfr mutation requires nutrigenomic supplementation, which entails matching individual gene mutations with the best nutrient formulations to fill the specific deficiency. This ensures the body gets critical nutrients despite the missing chemical reaction links.
Mthfr is just one of several dozen Autism-applicable snp's that are addressed through our nutrigenomics consulting process at Integrated Holistic Care. The gene test kit costs $99 and uses saliva, which is collected at home and submitted by mail. Easy peasy.
There's is a prioritization to therapeutic nutrigenomics, and mthfr is not the first snp on the list, so medical oversight by a knowledgeable practitioner is strongly advised. Our body is one system made of many moving parts, all of which work synergistically. The order snps are addressed is individual and based on which mutations are present, with consideration of all the moving parts and the body as a whole.
I chose to exemplify mthfr because it's the popular kid, the most readily recognized, and reputable information can be found here for those wishing to delve deeper: www.mthfrsupport.com *Disclaimer: the information contained herein may cause overwhelm and anxiety. No worries, a nurse specialized in nutrigenomics is standing by, and consult scheduling is just a click away! www.integratedholisticcare.com/services
The take home message is that nutrigenomic interventions help slow or stop a major contributor of the imbalances and toxic build up causing symptoms of Autism. Once the foundational/causal issues are addressed, faster recovery from the collateral damage is facilitated. Nutrigenomics helps halt the incoming toxins, and facilitates clearing what's already built up. For those with Autism, this is a necessary component to healing and the road to recovery.
Happy to answer questions😊. Please share if you found this helpful. Wishing you all a blessed New Year❤