How The Entourage Effect Affects Migraines

You’ll have a decision to make when you first purchase a CBD product for migraine relief or any other condition. You’ll need to decide whether you want pure CBD or CBD with the entourage effect. Research describes the entourage effect as the synergy that develops between the multiple nutrients found within the hemp plant. This synergy, or entourage effect, increases a hemp extract’s medicinal benefits, counters side effects, and maintains benefits at high doses.

In a nutshell, a hemp extract that contains CBD, THC, other cannabinoids, terpenes, vitamins, healthy fats, and other nutrients is more likely to help you than isolated CBD alone. All of these hemp nutrients perform better when they are together.

Most companies refer to products with the entourage effect as “full-spectrum” as opposed to just CBD. But choosing a full-spectrum CBD requires a bit of knowledge about the entourage effect—which I’m about to hit you with.

7 Things You Should Know About the Entourage Effect for Migraine

7. The Synergy is Real

“Synergy” sounds like a marketing term used to sell a magical potion. However, synergy is the word that researchers use to explain the measurable increase in effect that cannabis extracts have over the results of single cannabinoids such as THC or CBD.

For example, a recent breast cancer study found that the entourage effect was far more effective at fighting tumor growth than pure THC.[1] The explanation that researchers gave is simple: “The cannabis plant produces hundreds of other compounds with their own therapeutic potential and the capability to induce synergic responses when combined, the so-called ‘entourage effect’.”

While researchers don’t know exactly which compounds are responsible for the amplified effect, multiple studies confirm increased medicinal benefits from extracts that contain multiple nutrients. These medicinal benefits apply to migraine prevention in multiple ways.

6. The Entourage Effect in Migraine

A study presented at the European Academy of Neurology in 2017 found that a mix of CBD and THC, and possibly other cannabis nutrients that were not specified, outperformed amitriptyline in migraine prevention. It was a breakthrough in migraine research. Also, the cannabis compound provided pain relief during migraine attacks—something that traditional migraine prevention medications lack.[2] [3]

There’s also a study from the University of Colorado that found cannabis cut the migraine frequency in half for 121 patients.[4] The problem with this migraine research, and cannabis research in general, is that cannabis strains vary widely in cannabinoids, terpenes, and other nutrients. The cannabis strains are often not tested for their nutrient levels and that makes it impossible to know what is responsible for the medicinal effects.

New migraine research published in the journal Headache suggests that the entourage effect is a documented medicinal benefit with real potential to treat migraines. However, we need more research on these individual compounds and their combinations.[5]

5. The Bell-Shaped Curve

There’s something called the bell-shaped curve that applies to nearly all migraine treatments. If you take too little migraine medicine, it doesn’t work. As you increase the dose, the migraine relief should increase until you hit a sweet spot. The sweet spot is the dose where your migraine medicine performs the best. If you take too much medicine, it will not add to the relief and overall relief will begin to diminish. If you take way too much medicine, you’re left with no relief at all. The rise and fall form the bell-shaped curve and it applies to cannabinoids and migraine relief.[6]

CBD isn’t much of a risk because ultra-high doses, we’re talking about 1500 mg, have been used in research and were well tolerated by humans.[7] THC can be a problem, even in low doses. We are using CBD and THC to boost the endocannabinoid system and to reduce inflammation and oxidative stress. That helps migraines. However, the bell-shaped curve shows us that too much THC can actually increase inflammation and oxidative stress—the two main migraine triggers.[8] [9]

Triptans are the best example of this problem. You’re only allowed to take a few triptans per month for migraine relief. If you take too many triptans in a month, it raises the levels of oxidative stress in the body. Elevated oxidative stress levels will trigger more migraines and you may end up with more migraine attacks per month. It’s called medication overuse headaches (MOH).[10] Even too many over-the-counter anti-inflammatories will do the same thing—raise inflammation, oxidative stress, and migraine frequency. Too much of a good thing is a bad thing. And going from good to bad will result in a bell-shaped curve.

Here is where the entourage effect is best documented. CBD reduces the side effects of THC. Studies in lab rats show that too much THC can increase anxiety and memory impairment.[11] You could also take a look at any stoned college kid, some of whom will describe their marijuana-induced anxiety as paranoia. But research shows that rats experience no undesirable effects when CBD is added to high doses of THC, according to a study published in 2017 by Indiana University researchers.[12] It is likely that marijuana with high levels of CBD would fix the side effect that some people experience with marijuana.

At the same time that CBD reduces the side effects of THC, it also drastically increases the medicinal benefits of THC. A breakthrough study published in the journal Pain Symptom Management found that THC mixed with CBD—and only when mixed with CBD—reduced the pain of terminal cancer patients by 30 percent.[13] This pain relief was achieved by the entourage effect, while isolated THC and even high doses of opioids had no effect. Imagine that. Natural compounds were able to help terminally ill people find relief when everything else prior had failed.

The combination of CBD and THC is just one part of the entourage effect. We know that treatments that come with too many side effects will not work for long-term migraine relief. Not only does the entourage effect limit side effects, but it also improves efficacy. Let’s look at a few ways the entourage effect can fight migraines.

4. Other Cannabinoids

Hemp or marijuana extracts may contain dozens of other cannabinoids in addition to CBD and THC. CBC, CBG, THCV, CBDV, and CBN are just a few of the other cannabinoids that may be part of the entourage effect. Any one of these cannabinoids could be responsible or partially responsible for the increased benefits of a full-spectrum cannabis extract when compared to isolated CBD or THC.

Cannabinoids from outside the body can increase your body’s natural endocannabinoids, which are part of the endocannabinoid system. Increasing your endocannabinoid levels are a good thing because migraine sufferers are severely deficient in endocannabinoids.[14] I won’t go into detail about how vital the endocannabinoid system is here, but you can read this free chapter from my new book for that info. The endocannabinoid system is complex and each cannabinoid may help fight migraines by promoting the endocannabinoid system in unique ways.

CBC is anti-inflammatory and provides pain relief. It also reduces THC intoxication.[15] CBG surpasses the pain relief of THC and may have anti-depressant effects, which would make it an excellent candidate for treating migraines.[16] THCV has anti-seizure, anti-inflammatory, and antioxidant properties. CBDV also has anti-seizure effects and is under human trials for treating epilepsy, which will likely make it a migraine treatment option in the near future.[17] CBC, CBG, THCV, and CBDV are only a few of the many cannabinoids found in hemp or marijuana.

The research on these lesser-known cannabinoids is in its infancy. However, they have a high potential to tame oxidative stress and migraines. I can’t wait to see the migraine research to come now that hemp is completely legal.

3. Terpenes

Do you smell a skunk? How about sweet citrus, pine, diesel, lemon, earth, lavender, lime, menthol, apricot, mint, mango, plum, coffee, apple, peach, or strawberry? According to new research published in the journal PLOS One, these are the aromas of different cannabis strains, which come from as many as 140 terpenes.[18] [19] Terpenes are found in cannabis and have some serious research behind their funk.

A few of the common terpenes found in hemp are myrcene, beta-caryophyllene, linalool, pinene, nerolidol, bergamotene, limonene, menthol, and alpha-humulene.

You may have heard of terpenes because they are also responsible for the medicinal benefits of essential oils. Before you scoff at the idea that essential oils hold medical benefits, look at the research behind them. Menthol, the base of peppermint, has outperformed migraine, anti-nausea, IBS, fibromyalgia, sinus, and muscle relaxer medications. You can learn more about menthol here. A little menthol goes a long way and it may boost the entourage effect that comes from the hemp plant.

Linalool has anesthetic effects equal to the strength of menthol, anti-seizure properties, and also decreased the need for morphine in patients that underwent surgery in a study published by the New York University Medical Center.[20] Migraine sufferers love linalool because it is behind the medicinal benefits of lavender. Lavender, if you didn’t know, is one of the most popular essential oils used by migraine sufferers. Linalool is found in high quantities in many cannabis strains, including both hemp and marijuana.

β-Caryophyllene is the most abundant terpene found in cannabis. It has anti-inflammatory effects that are on par with indomethacin, a powerful drug used for migraines.[21] There are many more terpenes with many other effects that may tackle migraines. A common theme is that many of the terpenes reduce oxidative stress, which is responsible for triggering migraines.

The entourage effect helps reduce the side effects of hemp and increase its medicinal benefits. When you think about it, it’s almost like a case of simple addition. Antioxidants reduce oxidative stress. These cannabinoids and terpenes have antioxidant properties and adding them together equal a greater reduction of oxidative stress. There are many other connections in my new book that reinforce this concept.

2. Healthy Fats

Nearly sixty percent of the brain is composed of fat. Recent research has determined that healthy fats are crucial for basic brain function.[22] Healthy fats help with neurological diseases such as epilepsy, Alzheimer’s disease, and Parkinson’s disease. What do all of these diseases have in common? They are all associated with high rates of migraine.

The brain needs healthy fats, and conditions that affect the brain benefit from healthy fats. Migraine is no different. Several studies have found that healthy fats may prevent migraines through various pathways, which are detailed in a study published in 2017.[23] The most powerful research on healthy fats and migraine, and one of the most successful migraine treatments ever documented, was accomplished with the help of the ketogenic diet. The ketogenic diet is rich in healthy fats. The ketogenic diet is an incredible migraine treatment, which you can read about here.

What’s fat got to do with hemp? Research from the University of Nottingham found that healthy fats may triple the absorption rate of CBD.[24] New research from the University of Illinois found that healthy fats are the building blocks of your body’s natural endocannabinoids.[25] When you eat healthy fats, they convert to endocannabinoids. People are taking CBD to increase endocannabinoids and fight migraines. Healthy fats are another way to do that.

Many hemp extracts naturally contain healthy fats or they are mixed in by adding MCT oil, olive oil, or hemp seed oil. You can also take healthy fat supplements or eat foods with healthy fats in addition to using hemp extracts. If healthy fats have the potential to triple the absorption of CBD, it’s totally possible that a full-spectrum hemp extract may have increased medicinal benefits over pure CBD because it contains healthy fats. Healthy fats compose a large portion of my new book Hemp for Migraine and you may want to consider their benefits for tackling your own headache or migraines.

1. Small Amounts of Other Vitamins and Nutrients

Hemp contains low levels of minerals such as calcium, magnesium, and potassium. I call these minerals migraine minerals and every little bit helps hydrate the body and detoxify migraine triggers.

Hemp contains low levels of B vitamins, which control a migraine trigger called homocysteine. You may want to add vitamin B9 (go for a premium version called methylfolate with methyl B12) to your hemp regimen because a study titled “Stoners eat your broccoli: Folic acid enhances the effects of cannabinoids at behavioral, cellular, and transcription levels” found that vitamin B9 increased the absorption of THC and endocannabinoids by 129 percent.[26] For stoners, this means that you more than double your high when you add B9 to your THC intake. For migraine sufferers with low endocannabinoid levels, this could mean a rise in endocannabinoid levels to fight migraines. Check out this article to get the right version of B vitamins.

Vitamin D is found in hemp and there’s some evidence to suggest that it helps with endocannabinoid function.[27] Vitamin D is needed to produce serotonin, a happy brain chemical that is necessary for migraine prevention. If you are taking a vitamin D supplement, make sure it is vitamin D3, which you can read more about here. Of course, sunshine still remains the best source of vitamin D3.

The low levels of vitamins and nutrients—listed in this section—may only increase the entourage effect a smidge or not at all. You may want to consider a healthy intake of minerals, B vitamins, and vitamin D.

Sum it Up

We know that the entourage effect increases the medicinal benefits of CBD and THC, while reducing the side effects of THC. What are the exact ingredients of the entourage effect? That remains to be researched. It may be from the other cannabinoids, terpenes, healthy fats, or low levels of other nutrients found in the hemp plant. Consider a full-spectrum hemp extract to get the most out of your CBD.