Researchers believe that Cannabidiol (CBD) shows promise as a potential treatment for osteoporosis, offering people a natural alternative to help manage their symptoms. In this article, we will explore what osteoporosis is, and how CBD might be able to offer relief, based on the latest scientific research.

What is Osteoporosis? 

Osteoporosis is a condition that causes bones to weaken, thin, and become more brittle. While the inside of a healthy bone has small spaces like a honeycomb, osteoporosis increases the size of these spaces, which causes them to lose density and strength. 

Image via MS Focus Magazine.

This condition puts people at risk of breaking bones from everyday activities, such as standing up, walking or giving someone a hug. In the UK, over 3 million people are estimated to have osteoporosis, with over 500,000 fragility fractures occurring each year.

The biggest risk factor of osteoporosis is age and the menopause. However, lots of other factors can also increase the risk of developing osteoporosis, such as:

• taking high-dose steroid tablets for more than 3 months.
• long-term use of certain medicines that can affect bone strength.
• other medical conditions – such as inflammatory or hormone-related conditions. 
• a family history of osteoporosis.

It’s often difficult to know if you have osteoporosis until after breaking a bone. However, some early symptoms of osteoporosis might include receding gums, weaker grip strength, and weak and brittle fingernails. Later stage symptoms include a fracture from a fall, loss of height, stooped posture or fracture, and back or neck pain. 

Existing Treatment for Osteoporosis 

Existing treatment for osteoporosis is based on treating and preventing broken bones, and strengthening your bones. These treatments typically include:

• Medications: Medications such as bisphosphonates, hormone replacement, and denosumab, help to slow bone loss.
• Lifestyle Changes: Maintaining a healthy diet that is rich in calcium and vitamin D, regular exercise, and avoiding smoking and alcohol can help to prevent bone loss.
• Fall Prevention: Reducing the risk of falls through physical therapy, home modifications, and the use of assistive devices.

While these conventional treatments are valuable, there is a growing interest in complementary and alternative therapies to manage osteoporosis symptoms. One example is Cannabidiol, better known as CBD, which is one of the many compounds found in the cannabis plant. Unlike delta-9-tetrahydrocannabinol (THC), CBD is a non-psychoactive compound and does not induce the “high” often associated with cannabis. 

Does CBD Help Osteoporosis? 

CBD interacts with our endocannabinoid system (ECS) which plays a crucial role in regulating several of our cognitive and physical functions, including bone mass regulation. The two primary ECS receptors are CB1 and CB2 receptors, which are both found in bone tissue. Understanding the ECS’s role in bone health and related functions can provide insights into how CBD may influence osteoporosis.

Bone Growth 

Pre-clinical studies demonstrate that the ECS has an important role in bone healing and bone homeostasis. Thus, there is promising evidence that CBD may increase bone healing through activating cannabinoid receptors. This is supported by a 2020 review on cannabinoids effect on bone formation and bone healing, which concluded that CBD treatment was shown to enhance bone healing in animals, but needs validation in further clinical trials. Indeed, a 2023 study on mice found that CBD exerts cell-specific effects which can be exploited to enhance bone metabolism and, when used in an osteoporotic population, may positively impact bone morphology, warranting further research.

A more recent 2022 literature review concluded that preclinical and clinical studies show that the effects of cannabis mediated through the endocannabinoid system may prove to be an effective treatment option for individuals with osteoporosis. 

Both a 2010 and 2012 review also found a steadily growing body of evidence suggesting that the skeletal endocannabinoid system plays a significant role in regulating bone mass and bone turnover in health and in disease.

Inflammation 

CBD has proven anti-inflammatory effects, which could help reduce inflammation within the bone — a contributing factor to bone loss and fractures in osteoporosis. Indeed, chronic inflammation of bone tissue often results in bone defects and hazards to tissue repair and regeneration.

One 2022 study found that CBD reduced inflammation and helped cells act like healthy bone cells, which could help the body build bone in situations where there’s inflammation.

General representation of the signalling pathways involved in CBD anti-inflammatory effects via Pellati, Brighenti, et al. “Cannabis sativa L. and Nonpsychoactive Cannabinoids: Their Chemistry and Role against Oxidative Stress, Inflammation, and Cancer.” Biomed Research International, 2018.

Osteoporosis Pain Management

CBD is known for its analgesic (pain-relieving) properties, and thus might be able to help manage the pain associated with osteoporosis, particularly after fractures or injuries. For example, in one 2022 study on cannabidiol as a treatment for arthritis and joint pain, CBD use was associated with improvements in pain (83%), physical function (66%), and sleep quality (66%).

In a 2022 review of studies, it was also concluded that CBD is an excellent alternative to an opioid in chronic pain because CBD is non-intoxicating in its pure form.

Sleep 

Osteoporosis can negatively affect sleep, in particular if the individual is in pain. CBD’s analgesic and anxiolytic (anti-anxiety) properties may help individuals relax and sleep better. 

Researchers evaluated the effects of CBD treatment in 72 adults with either anxiety or sleep problems and, after 2 months, 78.1–79.2% of participants reported improvements in anxiety symptoms and 56.1% reported improvements to sleep.

In another 2021 study, 48% of people taking CBD for sleep reported that it helped them to fall asleep quicker, with 40% saying it also helped them to sleep better. 

It is important to note that while these potential benefits are promising, more research is needed to confirm CBD’s effectiveness in managing osteoporosis. 

Best CBD for Osteoporosis

Selecting the best CBD product for managing osteoporosis is crucial for achieving potential benefits. There are no specific CBD products that have been approved for the treatment of osteoporosis, however there are some key factors to consider.

• Safety and Side Effects: Although CBD is generally considered safe and well-tolerated, it can cause mild side effects, such as dry mouth and fatigue. It might also interact with certain medications, so it is important for patients to consult with their doctor before taking CBD.

• Source and Quality: Choose CBD derived from organically grown hemp, as this ensures minimal exposure to harmful chemicals. You should also look for third-party laboratory reports to verify how pure and potent your product is, and to ensure there are no contaminants.

• Type of CBD: Broad-spectrum CBD is a great option for those who want to experience the effects of CBD without consuming THC, the psychoactive compound in the cannabis plant. Some clinical reports suggest that broad or full-spectrum CBD may have a better effect due to the number of cannabinoids and other plant compounds they contain that work together, otherwise known as the entourage effect. 

• Type of Product: CBD products come in various forms, such as oils, topicals, capsules, edibles, and vape pens, so you should choose a delivery method and dosage that suits your needs.

• Dosage: Finding the right dose and administration method can be a trial-and-error process as results can vary significantly from person to person. Start with a low dose and gradually increase it while monitoring its effects.

• Individual Variability: The effectiveness of CBD may vary from person to person; what works for one individual may not work for another.

Need additional help? Take our CBD Quiz for product recommendations in minutes, or read our full guides on How to Choose the Right CBD Product and The Different Types of CBD.

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Sources

• Clouse G, Penman S, Hadjiargyrou M, Komatsu DE, Thanos PK. 2022 19;17(1):146. Examining the role of cannabinoids on osteoporosis: a review. Arch Osteoporos.
• Federica Pellati, Vittoria Borgonetti, Virginia Brighenti, Marco Biagi, Stefania Benvenuti, Lorenzo Corsi. 2018 “Cannabis sativa L. and Nonpsychoactive Cannabinoids: Their Chemistry and Role against Oxidative Stress, Inflammation, and Cancer”. 
• Frane N, Stapleton E, Iturriaga C, Ganz M, Rasquinha V, Duarte R. 2022 24;4(1):47. Cannabidiol as a treatment for arthritis and joint pain: an exploratory cross-sectional study.
• Healthline. 2021. What Are the Symptoms of Osteoporosis?.
• Moltke J, Hindocha C. 2021 18;3(1):5. Reasons for cannabidiol use: a cross-sectional study of CBD users, focusing on self-perceived stress, anxiety, and sleep problems. 
• NHS. 2022. Osteoporosis.
• O’Connor CM, Anoushiravani AA, Adams C, Young JR, Richardson K, Rosenbaum AJ. 2020;13(4):379-384. Cannabinoid Use in Musculoskeletal Illness: a Review of the Current Evidence.
• Raphael-Mizrahi B, Gabet Y.  2020;18(5):433-438. The Cannabinoids Effect on Bone Formation and Bone Healing. 
• Shannon S, Lewis N, Lee H, Hughes S. 2019;23:18-041. Cannabidiol in Anxiety and Sleep: A Large Case Series.
• WHO. 2017. Drugs (psychoactive): Cannabidiol (compound of cannabis).