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Tuberculosis (TB) is a bacterial infection that mainly affects the lungs, but can affect the musculoskeletal system and other parts of the body as well. The cause of tuberculosis is a bacterium called Mycobacterium tuberculosis. Tuberculosis has been present in humans for thousands of years, and in the past was called consumption due to the weight loss associated with the disease.
Tuberculosis is usually spread through air droplets originating from an infected person’s coughing, sneezing, speaking or singing. Most infections show no symptoms and are known as latent tuberculosis. Ten percent of latent TB infections turn into active infections, in which typical symptoms include cough with blood-containing mucus, fever, night sweats and weight loss.
Approximately half of people with active tuberculosis will die from the infection if it is left untreated. In 2020, an estimated 10 million people developed active TB, resulting in 1.5 million deaths. This statistic makes TB the second-leading cause of death from an infectious disease in 2020, after COVID-19.
We do have an antibiotic for TB, the bacillus Calmette-Guérin (BCG) vaccine. However, antibiotic resistance is a growing concern. Overconsumption and misuse of antibiotics has meant that many diseases that we thought we “cured” or “wiped out” have developed a tolerance to current treatments. New treatments, improvements to current treatments and vaccines need to be developed.
Medical cannabis and the phytocannabinoids and terpenes it contains could help reduce our reliance on various antimicrobial agents, as some of them (e.g. CBG, CBD, THCA, pinene) have shown antibacterial and antiviral properties.
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Total Studies = 7
Types of Study = Meta-Analysis (3); Animal Study (2); Laboratory Study (2)
No. of Positive Results = 5
No. of Inconclusive Results = 2
No. of Negative Results = 0
Cannabis Compounds of Interest
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- Targeting CB2 receptors in the immune system, brain and gut could help reduce inflammation induced by bacteria.
- The terpene-cannabinoid beta-caryophyllene and the terpene camphene, could both have antitubercular properties.
- Neuroinflammation and a leaky blood-brain barrier (BBB) are part of TB. Cannabinoids like CBD may have neuroprotective and anti-inflammatory properties that could alleviate neurodegeneration (brain damage) to some extent.
- Cannabinoids like THC may help improve appetite and reduce weight loss.
- Terpenes like pinene and cannabinoids like THC may help ease breathing due to their vasodilatory effects.
- One study suggests that “The behavior of “hotboxing” (smoking marijuana inside a closed car with friends to repeatedly inhale exhaled smoke) fueled transmission” of TB. However, this is a rare incidence, and another study found no strong evidence that cannabis use was associated with the risk of being diagnosed with TB.
- Smoking cannabis may not be ideal for managing TB symptoms due to the potential to further irritate the throat and lungs.
- Cannabinoids like CBD may dampen immune response (immunosuppressive), which can potentially make fighting infections more difficult.
- Very little definitive evidence on the overall efficacy of cannabis for tuberculosis, as there are no human trials.
Strength of Evidence
How Might Medical Cannabis Help Treat or Manage TB or its Symptoms?
Although there is very little evidence on whether or not medical marijuana may help treat TB directly, there is some historical evidence of cannabis being utilized as a way to manage some of the symptoms associated with the condition. For example, in Meiji-era Japan (25 Jan 1868 – 30 Jul 1912), physicians utilized medical cannabis to help treat insomnia, chronic fatigue, chronic pain and improve appetite in those with TB.
Medical cannabis and the phytocannabinoids it contains represent one class of compounds with the potential to help reduce the development of antibiotic resistance due to immunomodulatory properties (i.e. medical cannabis may help regulate the immune system). Phytocannabinoids like tetrahydrocannabinol (THC), cannabidiol (CBD) and cannabigerol (CBG) also have anti-inflammatory and antimicrobial properties.
Although there is much promise in medical cannabis and its potential as an immunomodulator and antimicrobial, there is little research into this area, and few studies on medical cannabis and TB in particular. However, the recent COVID-19 pandemic has renewed interest in compounds that could help reduce reliance on antibiotics, antivirals, antifungals and antiparasitics. Ultimately, the cannabis plant could provide an intriguing – and rich – source of antimicrobials.
There is currently little evidence to support the notion that medical cannabis could help treat TB or manage any of its symptoms. There is significant interest in various cannabinoids’ and terpenes’ antimicrobial properties, though, and these could be of immense help in overcoming the problem of antibiotic resistance.
Note: the information in this article does not constitute medical advice.
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