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Age and certain diseases can adversely affect the health and density of bones. Research indicates that the endocannabinoid system regulates bone mass, suggesting that cannabis may help boost bone density, strengthening the tissue to reduce the risk of osteoporosis.
Overview of Bone Health
Bone tissue is continuously being broken down and replaced with new tissue. This remodeling process occurs through bone cells, which are called osteoblasts. Osteoblasts are responsible for the formation of bone and bone mineralization. While in a person’s younger years, the body produces new bone tissue faster than it breaks it down and thus causes bone mass to increase, after the age of 30, the body begins to break down bone slightly faster than it builds new bone, causing bones to weaken.
There are many kinds of bone diseases, and the most common is osteoporosis. Osteoporosis develops when bones weaken as a result of the tissue being broken down faster than it’s replaced. When bones are weaker, they’re more susceptible to breaking. Osteoporosis can make bones so brittle and weak that even mild-intensity activities like coughing and bending over can be stressful enough to cause a fracture. Women are particularly susceptible to osteoporosis due to hormonal changes that occur during menopause that cause bone tissue to break down at a faster rate.
Besides age, there are other risk factors than affect bone density. According to Mayo Clinic, the amount of calcium in the diet, physical activity, tobacco and alcohol use, gender, body size, race and family history, hormone levels, the presence of eating disorders, and the consumption of certain medications, can all increase the risk of bone disease.
Findings: Effects of Cannabis on Bone Health
Research suggests that cannabis can help boost bone density, thus strengthening bone tissue and lowering the risk of osteoporosis. Within osteoblasts of bones are CB2 receptors, which are responsible for handling the building and breakdown of bone tissue6. Studies indicate that the activation of CB2 receptors both stimulates the building new bone and inhibits old bone breakdown1,7. In one study, one of the major cannabinoids found in cannabis, tetrahydrocannabinol (THC), was shown to activate the CB2 receptor, in turn stimulating bone formation and inhibiting bone breakdown2. Even low concentrates of cannabinoids have been shown to be effective at activating human osteoclasts, thus boosting bone density and offering therapeutic benefits to bone disease9.
Other studies suggest that CB1 receptors are also involved in the regulation of bone mass8. One study found evidence that CB1 receptors are responsible for regulating trabecular and cortical bone5.
These findings suggests that those with higher risk factors of experiencing bone weakness or those already diagnosed with osteoporosis may benefit from regular cannabis treatment.
While research is currently limited in this area, this recent discovery demonstrates that cannabinoids could potentially offer additional bone health benefits4.
States That Have Approved Medical Marijuana for Bone Health
No states have specifically approved medical marijuana for bone health. Connecticut, however, allows medical marijuana for those diagnosed with osteogenesis imperfecta (“brittle bone disease”).
However, some states do consider other conditions and may approve medical cannabis for bone health treatments on a case-by-case basis. These states include: California (any debilitating disease where medical marijuana recommended by physician), Connecticut (other medical conditions may be approved by the Department of Consumer Protection), Massachusetts (other conditions as determined in writing by physician), and Nevada, Oregon and Rhode Island (other conditions subject to approval).
In addition, Washington D.C. allows medical marijuana to be used for any debilitating condition as recommended by DC licensed doctor.
Recent Studies on Cannabis’ effect on Bone Health
- Bab, I., and Zimmer, A. (2008). Cannabinoid receptors and the regulation of bone mass. British Journal of Pharmacology, 153, 182-188. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2219540/.
- Bab, I., Zimmer, A., and Melamed, E. (2009). Cannabinoids and the skeleton: from marijuana to reversal of bone loss. Annals of Medicine. 41(8), 560-7. Retrieved from http://www.tandfonline.com/doi/full/10.1080/07853890903121025?needAccess=true.
- Bone Health: Tips to Keep Your Bones Healthy. (February 9, 2013). Mayo Clinic. Retrieved from http://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/bone-health/art-20045060.
- Idris, A.I., and Ralston, S.H. (2012). Role of cannabinoids in the regulation of bone remodeling. Frontiers in Endocrinology, 3, 136. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3499879/.
- Khalid, A.B., Goodyear, S.R., Ross, R.A., and Aspden, R.M. (2016, October). Mechanical and material properties of cortical and trabecular bone from cannabinoid receptor-1-null (Cnr1(-/-)) mice. Medical Engineering & Physics, 38(10), 1044-54. Retrieved from http://www.medengphys.com/article/S1350-4533(16)30148-5/fulltext.
- Ofek, O., Karsak, M., Leclerc, N., Fogel, M., Frenkel, B., Wright, K., Tam, J., Attar-Namdar, M., Kram, V., Shohami, E., Mechoulam, R., Zimmer, A., and Bab, I. (2006). Peripheral cannabinoid receptor, CB2, regulates bone mass. Proceedings of the National Academy of Sciences of the United States of America, 103(3), 696–701. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1334629/.
- Sun, Y.X., Xu, A.H., Yang, Y., Zhang, J.X., and Yu, A.W. (2015). Activation of cannabinoid receptor 2 enhances osteogenic differentiation of bone marrow derived from mesenchymal stem cells. BioMed Research International, Article ID 874982, 8 pages. Retrieved from https://www.hindawi.com/journals/bmri/2015/874982/.
- Tam, J., Trembovler, V., Di Marzo, V., Petrosino, S., Leo, G., Alexandrovich, A., Regev, E., Casap, N., Shteyer, A., Ledent, C., Karsak, M., Zimmer, A., Mechoulam, R., Yirmiya, R., Shohami, E., and Bab, I. (2008, January). The cannabinoid CB1 receptor regulates bone formation by modulating adrenergic signaling. FASEB Journal, 22(1), 285-94. Retrieved from http://www.fasebj.org/content/22/1/285.long.
- Whyte, L.S., Ford, L., Ridge, S.A., Cameron, G.A., Rogers, M.J., and Ross, RA. (2012, April). Cannabinoids and bone: endocannabinoids modulate human osteoclast function in vitro. British Journal of Pharmacology. 165(8), 2584-97. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3423262/.