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Medical Marijuana and Sjoren's Syndrome

marijuana and sjogren

It's only natural to worry when you've been afflicted with a disease that requires regular care. With Sjogren's syndrome, however, you're still able to maintain a healthy life and continue enjoying all the activities you've been doing without having to make any serious changes.

There is no cure for Sjogren’s syndrome, but treatments are available to help reduce the severity of symptoms and the risk of complications. Treatment options can include any combination of medication and good oral hygiene as well as surgery, if necessary. Medical cannabis for Sjogren’s syndrome can also ease some of the symptoms, like pain, swelling and inflammation, that could keep you from living your daily life.

What Is Sjogren’s Syndrome?

Sjogren's syndrome, which is pronounced as “SHOW-grins,” is an immune system disorder characterized by two common symptoms: dry mouth and dry eyes. It often occurs alongside other immune system disorders, such as lupus and rheumatoid arthritis. With this disorder, your moisture-secreting glands and mucous membranes of your mouth and eyes are typically affected first. As a result, you’ll likely see a decline in your saliva and tear production.

sjogren age

Although you can get Sjogren’s syndrome at any age, most individuals who receive a diagnosis are over 40 years old. It also is more common in women, though men and children can develop the disorder. Treatment is usually focused on relieving your symptoms.

It's not known what causes Sjogren's syndrome. However, individuals with the disorder have abnormal proteins in their blood, suggesting the immune system, that helps protect your body from infections and cancers, is attacking its own tissue. You have a decline in the amount of saliva and tears you can produce with this disorder because inflammation damages the glands that create these fluids. Viral infections and genetic factors may also play a role in why some people are predisposed to developing the condition.

History of Sjogren’s Syndrome

Henrik Sjögren first described the condition in 1933, which is where it got its name. However, there were several earlier descriptions of people exhibiting symptoms.

women and sjogren

Nine out of ten individuals who have Sjogren’s syndrome are women, and its onset is usually at middle age (between 40 and 60 years of age). For people who don't have another autoimmune disorder, their life expectancy isn't changed.

Symptoms of Sjogren’s Syndrome

Sjogren's syndrome has two primary symptoms:

  • Dry eyes: Your eyes may itch, burn or feel sandy.
  • Dry mouth: You may feel like you have cotton in your mouth, making it difficult to speak or swallow.

Some individuals also experience:

  • Joint pain, stiffness and swelling
  • Dry skin or skin rashes
  • Swollen salivary glands (especially the set in front of your ears and behind your jaw)
  • Persistent dry cough
  • Vaginal dryness
  • Prolonged fatigue

The condition may affect other areas of your body, too. You may experience dryness in your nose, throat, skin or lips, and the glands in your face and neck may swell up. Some people experience stiffness, pain and swelling in their joints — with or without rheumatoid arthritis where those symptoms are most prominent.

There is also the potential for heartburn, tingling and numbness in some areas of your body and fatigue. Your symptoms can vary in intensity and type, but most Sjogren's patients live normal lives.

Effects of Sjogren’s Syndrome

Sjogren's symptoms can involve the glands as above, but they also can affect other organs of your body.

When your lacrimal gland (tear gland) is inflamed from the condition, it results in eye dryness that can progressively lead to:

  • Eye infection
  • Eye irritation
  • Eyelid inflammation
  • Serious abrasion to the cornea
  • A sandy sensation in the eyes
  • Decreased tear production

The medical term for dry eyes is xerophthalmia. When the dryness causes your eyes to become inflamed, it's known as keratoconjunctivitis sicca.

Salivary gland inflammation can lead to:

  • Swallowing difficulties
  • Mouth dryness
  • Gum disease
  • Dental decay
  • Swelling
  • Mouth sores
  • Dry lips
  • Dry cough
  • Impaired voice or hoarseness
  • Cavities
  • Loss of or abnormality of taste
  • Infection and/or stones of your parotid gland that's inside your cheeks

Although many individuals experience dry mouth, dry eyes, joint pain and fatigue, the condition can also cause dysfunction in organs like your blood vessels, kidneys, lungs, gastrointestinal system, pancreas, liver and nervous system.

Additionally, you may also develop some extraglandular features like:

  • Arthritis
  • Arthralgia
  • Pulmonary disease
  • Raynaud phenomenon
  • Neuropathy
  • Anemia
  • Myalgia
  • Lymphoma
  • Lymphadenopathy
  • Leukopenia
  • Renal tubular acidosis
  • Vasculitis

Your diagnosis will depend on a physical exam, blood tests, the combination of symptoms you have and sometimes other studies. Dry mouth and eyes are usually the early signs of the disorder, but physicians conduct further evaluations since these same symptoms are often caused by medications and other conditions.

Your doctor may run some special tests to assess if you have a decrease in saliva or tear production. They may give you an eye exam to detect any eye changes that are typically seen with the disorder.

Blood tests will help determine if you have any presence of antibodies typical of the disease, which include anti-SSA and SSB antibodies, antinuclear antibodies or rheumatoid factor. However, these antibodies may not always be present. Your doctor may take a biopsy under the surface of your inner lip or your saliva glands to use for making a diagnosis.

Sjogren’s Syndrome Statistics

Statistics from the American College of Rheumatology reveal:

  • Sjogren's syndrome affects between 400,000 to 3.1 million adults
  • Among patients, women are ten times more likely to be affected
sjogren stats

Further, about half of individuals with Sjogren’s syndrome have cutaneous findings like palpable and nonpalpable purpura, dry skin or urticaria.

Current Treatments Available for Sjogren’s Syndrome and Its Side Effects 

Treatment may be different for each individual. It depends on which body parts the disease affects. Treatments may include drinking water, sucking on sugar-free candy for dry mouth and artificial tears for dry eyes. Medication can control severe symptoms.

Symptoms of Sjogren’s syndrome are manageable. In some cases, you can buy OTC medication, such as artificial tears, and get relief. You may also find gels you can apply on your eyes in the evenings. Gels stick to the surface of your eyes so you don't have to keep using them as much as you would the drops.

If artificial tears aren't helping, your doctor may prescribe you certain medication for your dry eyes such as:

1. Lacrisert

You use a unique, rod-shaped applicator to apply Lacrisert to your eyes, once or twice daily.

Common side effects of Lacrisert include:

  • Tearing
  • Eye irritation, discomfort or redness
  • Temporary blurred vision
  • Sticky eyelashes
  • Eyelid swelling
  • Eye sensitivity to light

2. Restasis

Restasis is a type of prescription eye drops you put in your eyes twice daily.

Common side effects of Restasis include:

  • Tearing
  • Eye burning
  • Pain
  • Discharge
  • Redness
  • Stinging
  • Itching
  • Visual blurring

3. Rituximab

Common side effects of Rituximab include:

  • Fever
  • Headache
  • Chills
  • Stomach pain
  • Diarrhea
  • Nausea
  • Flushing
  • Heartburn

Rituximab is used for severe extraglandular manifestations such as peripheral neuropathy, cryoglobulinemia or vasculitis.

4. Nonsteroidal anti-inflammatory drugs (NSAIDs)

These medications work well for inflammation and pain. Be sure to eat some food first as these drugs can be hard on the stomach and can cause ulcers.

5. Corticosteroids

These medications help reduce inflammation and can slow down damage to your joints. They can make you feel significantly better when used short-term.

Possible side effects may include:

  • Thinning of bones
  • Easy bruising
  • A round face
  • Cataracts
  • Weight gain
  • High blood pressure
  • Diabetes

6. Hydroxychloroquine (Plaquenil)

Plaquenil is an antimalarial medication used for inflamed joints.

Side effects may include:

  • Ringing in your ears
  • Headache
  • Spinning sensation
  • Mood changes
  • Weight loss
  • Change of appetite
  • Feeling irritable or nervous
  • Hair loss 
  • Itching or skin rash

7. Pilocarpine (Salagen)

Your physician may prescribe salagen medication, or Pilocarpine, for your dry mouth. 

Side effects of Pilocarpine may include:

  • Nausea
  • Sweating
  • Blurred vision
  • Chills
  • Runny nose
  • Flushing
  • Weakness
  • Dizziness
  • Diarrhea
  • Frequent urge to urinate

8. Cevimeline (Evoxac)

Cevimeline is a medication that can help dry mouth as it causes specific mouth glands to make more saliva.

Cevimeline has side effects that include:

  • Dry eyes
  • Blurred vision
  • Muscle pain
  • Salivating
  • Sweating
  • Drooling
  • Vaginal discharge or itching
  • Nausea
  • Constipation
  • Diarrhea
  • Loss of appetite

9. Immunosuppressants

These are medications such as Cytoxan and Rheumatrex that suppress your immune system, thus reducing the severity at which your body is attacking its own tissues.

Side effects of Cytoxan may include:

  • Loss of appetite
  • Diarrhea
  • Nausea or vomiting
  • Temporary hair loss
  • Stomach upset or pain
  • Darkening in skin color
  • Missed menstrual periods
  • A wound that doesn't heal

Side effects of Rheumatrex may include diarrhea, mouth sores, easy bleeding or bruising or black stools. It may also cause signs of anemia like pale skin or unusual tiredness and indications of liver problems like persistent nausea or vomiting, dark urine and yellowing of the skin and eyes.

Your doctor will carefully monitor you for any potential signs of developing lymphoma since the risk for this condition is much higher in Sjogren's patients.

Medical Marijuana for Sjogren’s Syndrome 

Patients who suffer from Sjogren’s syndrome often use CBD-enriched extracts to treat the potentially debilitating symptoms. These patients can use tinctures (typically administered under the tongue), topical ointments, such as a cannabis-infused cream, and CBD oil

cbd oil treatment

Most patients seeking medical marijuana to treat Sjogren's syndrome already know this alternative medication greatly reduces inflammation and may slow joint damage in the long-term.

Medical cannabis helps to reduce musculoskeletal pain that's caused by lupus, rheumatoid arthritis and Sjogren's, according to the Sjogren's Syndrome Foundation. This is significant since there is an association between Sjogren's syndrome, lupus and rheumatoid arthritis.

When using cannabis for Sjogren’s syndrome, you may want to consider vaporizing it or eating it in an edible form since smoking and inhaling marijuana can worsen dry mouth.

To date, Illinois has approved Sjogren’s syndrome as a qualifying condition for medical marijuana.

Side Effects of Medical Marijuana

If taken as prescribed, weed is reasonably safe. There are some side effects to it, however, that include:

  • Dry mouth
  • Nausea
  • Vomiting
  • Red or dry eyes

These side effects are mild.

How/Why Marijuana Is an Effective Treatment for Sjogren’s Syndrome 

Marijuana and Sjogren’s syndrome treatment stands to offer patients with lupus or rheumatoid arthritis therapeutic benefits. The cannabidiol (CBD) in marijuana has been shown to inhibit the progression of arthritis and reduce joint inflammation. Pot also helps reduce the pain that typically comes with inflammatory conditions like lupus. Your CB1 and CB2 receptors are involved in the interruption of inflammation-causing pain, and pain decreases as the cannabinoids act on these receptors.

Cannabinoids contribute to the regulation of your immune system and can fight against autoimmune diseases. 

Weed has hundreds of chemicals in it. However, the most popular chemical is delta-9-tetrahydrocannabinol (THC). This is the chemical that gives you that 'high' feeling when you smoke or eat products made with cannabis.

The THC binds to your brain's receptors and produces an analgesic effect. Some individuals suffering from chronic pain may even see a decline in their anxiety.

What Symptoms of Sjogren’s Syndrome Can Marijuana Treat?

Marijuana for Sjogren’s syndrome patients is ideal for symptoms such joint pain, swelling and stiffness or if the Sjogren's syndrome is secondary — meaning it’s accompanied by other immune system disorders, such as rheumatoid arthritis or lupus.

Relief from inflammation and pain are two common therapeutic properties of marijuana. Therefore, it isn't surprising that weed is used for treating lupus and Sjogren’s syndrome. The effective way to treat lupus and Sjogren’s syndrome with pot is ingesting CBD daily. 

Rampant inflammation can cause a lot of havoc in your body. Typically, when you suffer from a common cold or an injury, a healthy bodily response is inflammation. However, the excessive swelling that comes along with an autoimmune disease is much different. When your body remains in an inflamed state for an extended period, it can cause the body to age quicker and not function as well.

Since weed has gained much popularity as an arthritis treatment, cannabis for Sjogren’s syndrome treatment is becoming known, too. Weed helps reduce swelling and ease pain without the potentially life-threatening side effects that come with opiate or NSAID use.

You have pain-detecting nerves full of cannabinoid receptors, and these cannabinoids control the delivery of pain signals from your brain to your joints by attaching themselves to nerve receptors.

A controlled study found that cannabinoids helped to significantly improve pain during rest, pain with movement and quality of sleep. Physicians have treated rheumatoid arthritis successfully with CBD oil, which provides the patient with relief from pain and inflammation. During the 2005 study, patients used CBD oil for a five-week period. They experienced less inflammation and pain. The CBD oil also helped to significantly slow down the progression of rheumatoid arthritis. 

Older 2003 research used rats induced with an arthritis-mimicking condition to test non-psychoactive CBD. The study research showed that the cannabidiol helped to decrease the inflammation in a dose and time-dependent manner. After three consecutive days of treatment, the CBD continued to reduce the inflammation.

Best Strains of Marijuana to Use for Sjogren’s Syndrome

All these cannabis strains below can help relieve symptoms of pain, inflammation and swelling as well as combat the fatigue associated with Sjogren’s syndrome:

  • Bubba Kush (Indica)
  • Tangerine Dream (Hybrid)
  • Critical Mass (Indica)  
  • Sour Diesel (Sativa)
  • Obama Kush (Indica)
  • Cotton Candy Kush (Hybrid)

If you are a Sjogren's syndrome patient and are suffering from pain, inflammation and fatigue that comes along with the condition, search for a medical marijuana dispensary or doctor today. At MarijuanaDoctors.com, we aim to help improve the quality of your life.

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This information is not provided by medical professionals and is intended only to complement, and not to replace or contradict, any health or medical advice or information provided by healthcare professionals.  If you have any questions, please contact your doctor or other healthcare professional.

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