CBD, Doxy and Sensitization (long)

[Amelia]

I decided to try CBD oil about five weeks ago because it is supposed to be anti-inflammatory. I took Plus +CBD with 15mg cannabidiol. I had been taking doxy for over two years and was on 100mg once a day MWF.

First, I want to address the issue of whether CBD oil does or does not contain CBD. According to Consumerlab, which provides independent evaluations of supplements, hemp oil without any listing of CBD on the product would not be expected to contain CBD because it is usually made from the seeds which do not contain CBD. In contrast, the aerial portions of the plant contain CBD. The FDA says it is illegal to sell CBD products from the leaves and flowers to the general public. Plus + CBD claims that it is legal to sell CBD made from the stalk which is what they sell. Consumerlab tested 7 products for humans (there are some for pets) and found that all contained CBD, none had appreciable THC and none was contaminated by heavy metals. They tested the Plus+CBD 10mg version and found it contained 9.8mg CBD. On the basis of this, I assume the one I took had about 15mg CBD. (Plus +CBD also claims that they have an independent source evaluating all of their product regarding CBD content.)

I took the 15mg in the evening (makes you sleepy). The next morning, after walking around briefly, my ankles and feet became severely swollen. You could not see the ankle bone. My ankles and feet just looked like two tubes. The RA affected joints were noticeably more painful. I had tried low dose prednisone about two months earlier, and that caused a worsening of pain within 24 hours. I thought maybe the prednisone had decreased the inflammation thus making more mycoplasma exposed to the doxy and setting off a herxheimer reaction. I wondered if something similar was happening with the CBD and took it for about five more days and then stopped. The swelling gradually went down over the next 2 to 3 weeks but did not disappear. I also had indications of inflammation all over my body. I have very mild diffuse neurological damage which started about 25 years ago, apparently from celiac disease—at that time undiagnosed. These neurological issues get worse when there is an increase in inflammation. Well, they were dramatically worse after the CBD. I also had constant heart palpitations. Anyway, since swelling of the feet and ankles can be a side effect of doxy, I finally decided to have a washout period from the doxy. After about five days, the RA pain started to get worse so I started the doxy again but this time at 50mg. Well, the swelling increased again although not quite as bad as when I was taking 100mg doxy. I took the 50mg MWF of last week, thinking the swelling would again go down. However, I then developed a pain on the front left side just below the rib cage, which I think may be the spleen.

According to Consumerlab, CBD inhibits some liver enzymes including CYP 2D6. It now appears to me that the CBD caused the doxy levels to go sky high through inhibiting liver enzymes needed for doxy and that I am now sensitized to doxy. It seems clear to me that I can no longer take doxy, at least not in the near future.

I have several questions. Has anyone else developed a severe sensitivity to doxy and, if so, has it gone away over time? Would there be any reason to expect a cross-sensitization between doxy and minocycline? What is the lowest starting dose of minocycline? If I am also sensitized to minocycline, are their any other antibiotics that would work for RA?

Thanks in advance for any comments.

RA since 11/2015; recovering from severe vitamin A deficiency; celiac disease--gf since 2001, villi completely healed per endoscopy 2015
Meds: Doxycycline
Supps: Multiple including curcumin (BCM-95), probiotics, milk thistle, l-glutamine, l-cysteine, quercetin, salmon oil, evening primrose oil
Diet: gluten-free, grain-free, dairy-free, low oxalate, free of multiple other foods setting off osteoarthritis

[PhilC]

Hi Amelia,

Amelia wrote:

According to Consumerlab, CBD inhibits some liver enzymes including CYP 2D6. It now appears to me that the CBD caused the doxy levels to go sky high through inhibiting liver enzymes needed for doxy and that I am now sensitized to doxy. It seems clear to me that I can no longer take doxy, at least not in the near future.

I don’t believe that your assessment is correct. I did some checking, and it does not appear that CYP2D6 inhibitors affect doxycycline metabolism.

What I suspect may be happening is that the CBD oil is somehow enhancing the antibacterial effect of doxycycline, possibly because CBD oil is also an antibiotic. See:

Antibacterial cannabinoids from Cannabis sativa: a structure-activity study.
https://www.ncbi.nlm.nih.gov/pubmed/18681481

Since cannabinoids are fat soluble and tend to be slowly excreted by the body, it may take some time for the situation to normalize for you.

Phil

"Unthinking respect for authority is the greatest enemy of truth."
- Albert Einstein

[Amelia]

Hi Phil,

Your comments are very helpful. I did wonder if the CBD was staying in my body for awhile. If the CBD oil is enhancing the antibacterial effect, that suggests that continuing with the doxycycline makes sense rather than switching to minocycline since that has greater tissue penetration, something I don’t need right now. I am thinking to take doxycycline 50mg MF. I think that would be enough to stop the RA from getting worse. The swelling had started to go down when I was taking 100mg MWF.

I got scared when I resumed the doxycycline and the swelling in my feet and legs got worse. Years ago, when I did an elimination diet and then reintroduced foods one by one, the foods that set off my osteoarthritis caused much worse pain than what I had experienced before, demonstrating the increase in symptoms after a break. It may be that the same thing happened with the break from doxycycline and the increased swelling, which I assume is caused by the increased capillary permeability from the inflammation.

I looked but was not able to find which liver enzymes affect doxycycline. Do you have any information about that?

Regarding the heart palpitations, I saw my internist when the swelling had mostly gone down. The palpitations had also stopped. I told my internist who is also a cardiologist, and he was not concerned about the palpitations.

The other change that puzzles me is that since I took the CBD oil, I no longer have afternoon fatigue and no longer have to lie down for an hour later in the day.

Amelia

RA since 11/2015; recovering from severe vitamin A deficiency; celiac disease--gf since 2001, villi completely healed per endoscopy 2015
Meds: Doxycycline
Supps: Multiple including curcumin (BCM-95), probiotics, milk thistle, l-glutamine, l-cysteine, quercetin, salmon oil, evening primrose oil
Diet: gluten-free, grain-free, dairy-free, low oxalate, free of multiple other foods setting off osteoarthritis

[PhilC]

Hi Amelia,

Amelia wrote:

I am thinking to take doxycycline 50mg MF. I think that would be enough to stop the RA from getting worse. The swelling had started to go down when I was taking 100mg MWF.

That makes sense, and is consistent with the approach used by Dr. Brown.

Amelia wrote:

I looked but was not able to find which liver enzymes affect doxycycline. Do you have any information about that?

I also looked and did not find anything. This appears to explain why:

“Doxycycline is unique in the sense that it does not undergo metabolism and is excreted unchanged in the urine and bile.”

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5593444/

Phil

"Unthinking respect for authority is the greatest enemy of truth."
- Albert Einstein

[Lynne G.SD]

I have been researching cannabis for my brother who has cancer and came up on this,Interesting to say the least.Medical pot has been available here in Canada for the last 3 years and I am going to use myself as a Guinae pig again to see if it can help with SD.From all I have been reading it should help a lot.This Resunab that is in phase 2 clinical trial is just fake pot and Corbus expects to sell it at between 75 and 100thousand$$$$$$$ a year and that would be for life.Sheesh,I’ll use the real thing.

http://ushealthtimes.com/scientist-reveal-what-cannabis-does-to-your-bones/

[PhilC]

If I had cancer, or another serious illness that it might help, I would definitely consider using THC-free CBD oil, and/or similar products. Otherwise, I would not consider using it. The reason is because marijuana is not nearly as safe as many people seem to believe. Please believe me when I tell you that I wish it were true, I really do.

This is just a small “snippet” of the research that has been done:

Adverse cardiovascular, cerebrovascular, and peripheral vascular effects of marijuana inhalation: what cardiologists need to know.
https://www.ncbi.nlm.nih.gov/pubmed/24176069

Cannabis-associated myocardial infarction in a young man with normal coronary arteries.
https://www.ncbi.nlm.nih.gov/pubmed/24996293

Atrial fibrillation and marijuana smoking.
https://www.ncbi.nlm.nih.gov/pubmed/18031530

One Minute of Marijuana Secondhand Smoke Exposure Substantially Impairs Vascular Endothelial Function.
https://www.ncbi.nlm.nih.gov/pubmed/27464788

Toxic effects of marijuana on the cardiovascular system.
https://www.ncbi.nlm.nih.gov/pubmed/22194141

Phil

"Unthinking respect for authority is the greatest enemy of truth."
- Albert Einstein

[Author]

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