Eligibility

ADHD symptoms often include difficulty in maintaining focus for a longer period of time, inability to break focus as well as difficulty prioritizing focus to a point that it becomes an impairment which may result in impulsivity and hyperactivity. In childhood, three types of ADHD can be determined which is based on the kind of symptoms that are displayed. This can be primarily inattentive (also known as ADD), a combination of all three symptoms and primarily hyperactive which is extremely rare. Symptoms associated with primarily inattentive subtype of ADHD may be difficult to identify as they may be internalized.

Adult ADHD Treatments Need to be Multimodal.

1. ADHD Education: Advise family members on childhood versus adulthood symptoms
2. Explore how symptoms may impact another individual
3. Prepare individualized therapeutic strategies for coping
4. Maintain home and workplace accommodations to reduce impairments 
5. Review and assess whether coping strategies and accommodations benefitted your life. Review treatment options with a psychologist or therapist (mindfulness, CBT), ADHD coach, or physician.

Although some patients use cannabis as a complementary therapy for alleviating the ill effects of prescription drugs, many prefer it as the primary treatment to alleviate ADHD symptoms. Stimulant medication treatments aim to increase dopamine production, something that’s impaired for some ADHD patients. THC, a substance present in cannabis, helps increase dopamine production. Cannabis can help with anxiety, depression, behavioral problems as well as hyperactivity.

The world has only just begun researching the effects of cannabis on ADHD. Even though there is limited data available, a growing number of studies indicate that cannabis acts as an effective primary and complementary treatment to counter ADHD symptoms.

Information on medical cannabis and ADHD found here: https://honahlee.com.au/articles/cannabis-treatment-adhd/
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Over the last 30 years, extensive research on dementia has provided a lot of information on the effects of Alzheimer’s disease on the brain. Although there are no treatments to prevent Alzheimer’s at the moment, there are ways to improve brain health as well as some medications that help treat the symptoms of dementia. Research is ongoing to find effective cures and treatments as well as on how to prevent the disease in the first place.

Given the growing population of dementia patients around the world, there is a need for alternative therapeutic options. Most options that are currently available have an inconsistent evidence base and unreliable side-effect profiles. Although the full effect of medical cannabis on dementia remains unknown, it has emerged as a popular potential alternative treatment option. Cannabis engages the neurotransmitter systems that are affected by neuropsychiatric symptoms.

Alzheimer’s information on the disease and treatment comes from the Alzheimer’s Association at: https://www.alz.org/ca/dementia-alzheimers-canada.asp
Information for medical cannabis and Alzheimers can be found in the following paper:

Medical Cannabis for the Treatment of Dementia: A Review of Clinical Effectiveness and Guidelines [Internet]

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• Phobias
• Social Anxiety Disorder
• Panic Disorder
• Separation Anxiety
• Generalized Anxiety Disorder
• Obsessive-Compulsive Disorder
• Post-Traumatic Stress Disorder (PTSD)

Anxiety disorders can be treated successfully with a treatment plan. The traditional form for curing anxiety is using drug therapy and cognitive-behavior therapy (CBT). Many anxiety disorders have biological reasonings, therefore the drugs which are commonly prescribed are anti-depressants and anti-anxiety medications.

Cognitive-behaviour therapy (CBT): Its purpose is to assist individuals to reverse their overpowering anxious thoughts into rational ones. People learn more from being exposed to a concept, they fear in real life, in a controlled environment. Some disorders specifically use CBT techniques. People dealing with panic disorders can benefit from learning new therapeutic relief methods (meditations, breathing exercises, and yoga) to better control their anxiety.

Have your friends and family who are affected by the disorder, take part in support groups. It’s a great way to get them to learn more about the disorder while helping them recover or learn how to live with the condition.

For proper treatment and relief consider getting an evaluation diagnosis done from a specialist in anxiety disorders. Many people suffer for 10+ years before deciding to get the right treatment.

For many patients, medical cannabis has been proven to be an effective option to counter the symptoms of anxiety disorders. CBD – also called cannabidiol or cannabinoid – has anti-anxiety properties which makes it a very good treatment option. Federal laws in Canada restrict the use of CBD for recreational purposes, it has to be obtained through a Licensed Producer (LP) under Canada’s medical cannabis laws. BMCC can help you combat anxiety, follow the link below.

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Over 6 million Canadians suffer from arthritis and struggle with pain daily. Medication is a popular option as a treatment for arthritis. Certain medications can provide pain relief and in certain cases reduce inflammation, which can lead to reduced joint damage. Medications like Tramadol, opioids, and duloxetine are often used to contain osteoarthritis pain. While prescribed medications are frequently used, other options, such as a proper diet, lifestyle changes, exercise, and other physical therapies should also be considered as healthy alternatives.

Tramadol is usually used as an alternative treatment for osteoarthritis affecting the hips and the knee. It is mostly prescribed for patients who are unable to take or process acetaminophen or non-steroidal anti-inflammatory drugs. Tramadol can be used with non-steroidal anti-inflammatory drugs and acetaminophen as well.

For moderate to severe hip and knee pain that’s caused by osteoarthritis that does not respond to other treatments including non-steroidal anti-inflammatory drugs (NSAIDs), and acetaminophen, Opioids including Tramadol, is often used as a second-line medication and can be used over short periods for treating pain caused by inflammatory arthritis.

Duloxetine, a medication commonly used as an antidepressant, is also used as a second-line medication to treat osteoarthritis that affects the knees, as it has shown positive effects for patients with partial or no response to non-steroidal anti-inflammatory drugs or acetaminophen.

Source: Arthritis Society

Since 2001, in Canada, legal medical cannabis has been a treatment option for particular health conditions including arthritis. Cannabis is not a cure for arthritis, but people have stated it helps manage their pain.

There is a lot of research that suggests cannabis helps alleviate pain and aids pain management. It also promotes sleep and helps reduce inflammation. Several in-hospital studies indicate that when compared to placebo, patients using pain-relieving medicine of cannabinoid bases have experienced reductions in pain and reported an improvement in sleep quality.

Source: Arthritis Society
https://arthritis.ca/treatment/medication/medical-cannabis
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In the past, treatments for autoimmune diseases had a tendency to concentrate on lowering the effectiveness of the immune system through immunosuppression. New medications for diseases such as rheumatoid arthritis and lupus act as ‘guided missiles’ to target specific problems in the body. Although there have been improvements in the treatment, scientists are still struggling to understand what causes autoimmune diseases and how they can be cured.

Source: St Michael’s Hospital – Treating inflammation with inflammation: Keenan research examines a new approach to treating autoimmune disease

https://www.stmichaelshospital.com/media/detail.php?source=hospital_news/2019/0821

Several experimental models that have tested the use of cannabinoids indicate promising potential for its use as an anti-inflammatory agent to counter autoimmune diseases. The tests show that cannabinoids help shield the host from pathogenesis by initiating multiple anti-inflammatory pathways.

According to several studies, patients suffering from inflammatory bowel diseases like ulcerative colitis and Crohn’s disease can greatly benefit from the chemicals present in the cannabis plant. A 2010 study in the Journal of Pharmacology and Experimental Therapeutics indicates that chemicals like THC and CBD stimulate the specific cells that are responsible for healthy immune responses and gut functions. The study further states that the body produces THC-like compounds that increase the intestine’s permeability. This condition is also known as ‘leaky gut’ as it allows bacteria to slowly seep into the gut. Cannabinoids present in cannabis can effectively counter such compounds and lead to more tightly bonded cells in the intestine, reducing permeability.

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Historically, treatments have included speech therapy, occupational and behavioral therapies, as well as the use of pharmaceutical drugs, although there is no evidence of any medication affecting the three most distinguished characteristics of autism: communication difficulties, activities, and day to day behaviour that induces self-harm.

It is also important to note that treating medical conditions, associated with Autism Spectrum Disorder, such as gastrointestinal problems, sleep disorders, ADHD, depression, anxiety, obsessive-compulsive disorder, etc., can help in overall recovery.

A study published in 2015 has opened up the avenues for therapeutic uses of endocannabinoid drugs, including THC and CBD. The study suggests that the endocannabinoid system can play a key role in maintaining central nervous system as well as overall health. They can be used to counter neurodegenerative, neuroinflammatory as well as psychiatric disorders.

While there are several potential benefits of using cannabis oil to counter the symptoms, there is still a lack of scientific data that can conclusively declare it as a treatment for autism. However, significant research is being conducted on the use of cannabis oil as a potential treatment for autism, offering optimism that medical cannabis can be considered as a treatment option.

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The main reason for getting an opioid prescription is to be able to deal with lower back pain. Opioid has been known for misuse and increasing risks. Evidence suggests that medication should not be the main reason for the treatment of lower back pain. Recent guidelines list alternative treatment methods including self-management, therapy, physical activity, and psychological therapies. The rise of alternative remedies, pharmacological and surgical interventions has reduced the severity of lower back pain.

Chiropractors are also trained to assess and diagnose back pain, as well as offer comprehensive treatment plans.

CBD (cannabidiol) and THC (tetrahydrocannabinol) found in marijuana offer natural assistance, and exert benefits like the relief of inflammation, discomfort, and restlessness caused by back pain. Medical cannabis is a powerful tool in alleviating pain, removing the need for harmful opioids.

There are two traditional treatments for bipolar disorder, namely medication and, psychotherapy. Generally, both treatments are needed to bring symptoms to a moderate level. Medication is needed first. 

There are three types of medication used to treat bipolar disorder:

1. Mood stabilizers
2. Anti-psychotics
3. Antidepressants

Similar to any other chronic disorder such as hypertension or diabetes, bipolar disorder can be controlled with a healthy lifestyle and treatment. The bipolar disorder treatment is targeted to help the person feel like themselves again. 

• Relieve symptoms till no longer distressed
• Social functioning and work improvements
• Preventing the risk of relapse

Medical cannabis does not fully treat bipolar disorder. However, recent studies have indicated that it can have a significant effect on its symptoms. Medical cannabis can help enhance patients’ regular day–to–day routines by reducing stress, anxiety, depression, mood swings, and restlessness.

The serotonin compounds found in cannabis are also found inside the brain which plays a large role in our emotional state. When serotonin levels are kept in balance, this can greatly improve one’s feelings of depression or unworthiness.

Please Note: In extreme cases, patients might experience suicidal thoughts. Medical cannabis should not be considered as a cure for bipolar disorder and has not been scientifically proven to fully treat the condition. In such severe cases, it is best to seek the help of our medical practitioners.

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There are several types of cancer treatments: these include traditional surgery, chemotherapy, and radiation therapy. Treatments often include hormonal therapy, targeted therapy, immunotherapy, and stem cell transplants.

Cancer specialists are also known as oncologists, specializing in radiation therapy or chemotherapy and other drug therapies, are in charge of cancer treatments. Surgeons use their skills to remove tumors from growing.

Treatment depends on many factors which include: 

• Type of Cancer
• Stage of Cancer
• Any personal preferences
• Your age group

Chemotherapy: This popular treatment for several different cancers involves the use of strong enough drugs to destroy cancer cells. But, in the process, chemotherapy can also weaken the system. 

Radiation Therapy: This treatment method uses powerful radiation that can damage cancer cells, but in the process can also attack healthy ones.

Surgery: This involves carefully removing the cancerous region through an incision. 

Several recent studies on the effects of cannabis on cancer have shown promising results. THC present in cannabis has been effective in damaging and killing certain types of cancer cells and helped block the development of tumors. Another compound present in cannabis, CBD, has demonstrated promising results in treating breast cancer cells while limiting its effect on healthy ones. Alongside these positive effects, medical cannabis can also aid in pain relief, reduce inflammation and increase appetite. 

Using drugs that contain cannabinoids, cannabis, or a combination of both can help you relax and improve the quality of your overall day-to-day life. But according to recent studies, the exact effect of cannabis can vary. Many patients have found that using cannabis helps in coping with the various side effects and symptoms of cancer. 

Nausea & Vomiting: These are typical side effects of radiation therapy, chemotherapy, and a few other cancer treatments. Recent research indicates that some cannabinoids can effectively relieve both nausea and vomiting. Canada has approved the use of Nabilone (Cesamet), a pill that contains synthetic cannabinoids, to treat nausea and vomiting caused by chemotherapy. It is often prescribed to patients suffering from cancer to help relieve these symptoms when traditional anti-nausea drugs fail.

Loss of Appetite: Loss of appetite is typical for patients suffering from cancer and it is often accompanied by weight loss (called cachexia when severe) as well. Many people have reported that taking cannabis leads to an increase in appetite, although there haven’t been any conclusive studies that support these claims. As of now, research on the effects of cannabis and cannabinoids on the loss of appetite and weight loss has not shown clear results.   

Pain: Although there is not much research to support it, some individuals have claimed that using cannabis has helped them find relief from severe, long-term chronic pain. There have been some clinical trials where cannabis has helped decrease pain levels among certain patients. 

Source: Canadian Cancer Society

https://www.cancer.ca/en/?region=on 

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According to the Government of Canada, Health Canada resources there is currently no cure for ME/CFS. 

Treatment includes helping the patients manage the symptoms through medication, specially designed exercise programs, psychotherapy (for patients who experience anxiety, depression), lifestyle adjustments, and alternative therapies to help them deal with ME/CFS.

The outcome of the disease is unpredictable: patients may fully recover, or they may experience their symptoms getting better/ remaining unchanged/ getting worse over time.

It is not uncommon to see relapse after recovery.

Although many believe that chronic fatigue syndrome stems from dysregulation of multiple systems in the body, the truth is that the disease is multifaceted and can originate from several unknown causes. Dizziness, fatigue, memory loss, and irritability are some of the dozens of symptoms associated with chronic fatigue syndrome. This is why many people remain skeptical regarding its treatment.  

Fatigue that cannot be helped or reduced with rest or sleep is classified as chronic fatigue. Till now, there has been little scientific research regarding the effects of cannabis on chronic fatigue syndrome. However, developments in the research involving other diseases processes that share the same symptomatology offer more supporting evidence. 

The relaxing effects of cannabis often cause individuals to grow skeptical in regards to treating chronic fatigue syndrome with it. While most people use cannabis for relaxing, sleeping, etc. certain cannabis products can also help boost moods, harness focus, and increase energy levels.

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Chronic pain can be treated in traditional ways including the use of non-steroidal anti-inflammatories, over-the-counter pain medication (analgesics), and opioid therapy (in extreme cases). Chronic pain can manifest in many forms that are resistant to treatment and can induce increased pain as time goes on.

Chronic pain can get difficult to manage and various therapies including cognitive-behavioral therapy (CBT), focus on exercise and diet, regular stretching and, other positive lifestyle changes are included in treatment plans. Cognitive-behavioral therapy can help “rewire” the brain effectively and return altered pathways to their original state. CBT helps chronic pain patients “rethink” their suffering and pain and instead focus on other aspects of life.

Standard treatment medications tend to offer limited pain relief and are usually associated with adverse effects. This has shifted the medical community’s attention to the use of cannabis-based medicines. Based on one systematic review of guidelines and four overviews (with overlapping systematic reviews), there seems to be a suggestion of benefit with cannabis-based medicines for neuropathic pain. However, the benefits and harms need to be weighed against each other. If patients suffer from Fibromyalgia, Crohn’s Disease, multiple sclerosis, and musculoskeletal pain, research findings state that the effects of cannabis-based medicines are inconsistent This is after six evidence-based guidelines were identified. Recommendations for chronic neuropathic pain are addressed by the majority of the guidelines. The guidelines state that cannabis-based medicines could be considered for patients with chronic non-cancer pain, neuropathic pain, as a course of treatment but with some caution. Two guidelines do not recommend the use of cannabis-based medicines to treat pain associated with fibromyalgia as well as back pain. One guideline advised against the use of such medicines to treat pains associated with headache, osteoarthritis, and rheumatoid arthritis. One guideline states that when it comes to pain management in multiple sclerosis, cannabis medicines may or may not be used for treatment as it depends on the type of the medicine as well as the patients’ condition.

https://www.ncbi.nlm.nih.gov/books/NBK546424/

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To determine whether a person is suffering from depression or not, medical practitioners ask questions such as whether an individual is feeling hopeless or whether they have any interest left in their hobbies. 

Follow-up assessments may ask about:

• Personal feelings, thoughts, and behavior
• Mental health history and helpful treatments in the past
• Physical health issues
• Family history related to mental health
• Affairs of your day-to-day life like work, relationships, school, etc. 

Although health care professionals carry out various tests to rule out conditions that display similar symptoms to depression, there are no tests to determine the disease. 

The most common treatments used for depression are:

• Pharmacotherapy (prescription medicines), like antidepressants
• Psychoeducation
• Psychotherapy
• Brain stimulation therapies like electroconvulsive therapy (ECT), magnetic seizure therapy (MST), and repetitive transcranial magnetic stimulation (rTMS)

The above-mentioned treatments can be used individually or in combination, depending on the case. Families and friends along with self-help organizations can play an important part in the treatment. There is also recovery for people suffering from depression. 

Clinical depression can take time to cure and the person has to be dealt with patiently. This condition needs to be tackled throughout a person’s lifetime. Disorders similar to depression, like diabetes, can be effectively controlled and managed through a combination of treatments and maintaining a healthy lifestyle. Keeping an eye out for early warnings can also prevent a relapse.

Link here for source (**PLEASE REFERENCE): https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/depression

According to Canadian Cannabis Clinics research has indicated that medical cannabis might be useful for treating conditions such as depression. THC and CBD (two of the major compounds of medical cannabis) both act on the brain and could potentially increase serotonin and theoretically help treat depression.

Medical cannabis can also help with the issues leading to depression as well as potentially allay some of its symptoms. It can help treat chronic pain, insomnia, and anxiety: symptoms that usually go hand-in-hand with depression. This can potentially disrupt the onset of depression in the first place.

A study published in 2014 by the Hawaii Journal of Medicine and Public Health indicates that medical cannabis might be a very good option for people suffering from depression. The study suggests that pain management is just one of the potential benefits. Participants in the study also showed a decreased level of anxiety as well as improved sleep quality after using medical cannabis for their depression. 

Researchers at the University of Buffalo have focused on endocannabinoids, a particular set of chemicals in the brain that play a crucial role in regulating emotions and behavioral therapy. In their research, they found that endocannabinoids have a similar chemical makeup to that of medical cannabis. The study indicates that the use of medical cannabis to treat depression can aid with the restoration of normal levels of endocannabinoids in the brain, which would help manage the symptoms of depression. 

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Epilepsy seizures can be controlled but sadly there is no cure for epilepsy.

A common treatment for seizures normally includes the administration of anti-epileptic medication: it cannot cure epilepsy or stop the tendency to have seizures but it can help bring down the seizure activity. For patients on whom these drugs are administered, the seizures can be eliminated in almost half (50%) of the cases. Drugs on the other hand can reduce the occurrence as well as the intensity of the seizures in another 30% of the patients. The remaining 20% of patients tend to have seizures that cannot be controlled through conventional medication and drug therapy. They could be drug-resistant or they may require administration of a large dose of a drug or require more than one drug.

Futuristic approaches to epilepsy treatment could see new forms of stimulation to the brain through implanted devices that can help deliver the medication directly. These electronic stimulations can be administered to those areas of the brain where the seizures arise, for transplant of immature brain cells to replace missing or damaged neurons, and for conducting gene therapy.

There is now class 1 evidence to suggest that adjunctive use of CBD has shown improvement in controlling seizures in patients with specific epilepsy syndromes. Controlled studies have shown medical cannabis can lower seizures in patients of different ages. CBD is one of the most useful compounds that is being used to treat neurological symptoms that are associated with epilepsy. In some cases, THC has also worked well to treat epilepsy symptoms and a combination of CBD and THC worked best. The administration of both drugs together and its effect is commonly dubbed as the ‘entourage effect’.

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Currently, there is no cure for Fibromyalgia however by incorporating exercise, meditation, relaxation, and other lifestyle changes that reduce stress, has proved effective in lowering symptoms. Most people who suffer from FM find methods to reduce the pain and discomfort over time.

There is no ‘one treatment fits all’ that proves useful for everyone but people with FM will over time discover that with the help of a healthcare team they can figure out what course of action brings relief from symptoms. One of the most important things to be kept in mind when suffering from FM is to remain physically active. You might face difficulties initially to take up activities but begin regular exercise at a pace comfortable to you. This has been shown to reduce pain as well as the feeling of fatigue and helps overcome sleep difficulties and improves mood. For the majority of patients, medications show little effect to relieve symptoms and the benefits often fall short in front of the side effects. However, incorporating health-related practices which include regular activities, a healthy diet, weight management, and living a life and routine that keeps stress at bay can help reduce the overall symptoms associated with FM. Overcoming all the symptoms is usually not possible and therefore the aim of the treatment should be at reducing symptoms allowing patients suffering from FM to lead an active and enjoyable life.

Less than half the patients suffering from FM find little relief from the medication prescribed. This is why many are encouraged to turn to medical cannabis to help deal with symptoms. Every day, the medical community is discovering more and more about the correlation between fibromyalgia and medical cannabis as an effective treatment option. A National Pain Foundation Survey from 2014 discovered that the three prescription drugs prescribed by the FDA are not as effective as medical cannabis for treating FM. A double-blind (randomized) placebo study (using nabilone – synthetic cannabinoid), on those suffering from FM, showed positive and promising results as well: it was “well-tolerated” by the test subjects and was shown to reduce symptoms of FM. Another study was conducted on a different cannabinoid (synthetic) which too showed a good amount of reduction in pain with no adverse side effects reported (except for maybe a dry mouth).

This in no way suggests that cannabis can magically fix the symptoms of FM but it can be considered as a viable solution and can be added to your medical routine. A study from 2011 outlining the use of medical cannabis for FM patients can serve as a good example:

The study stated that patients who used cannabis found relief from almost all the symptoms that are associated with FM and not just pain management. There was no report of the symptoms worsening after using cannabis. The proportion of patients who affirmed relief fell between 81% for sleep disorders and about 14% for headaches.

The efficacy and efficiency of cannabis on a variety of symptoms varied but the positive aspect was that no single patient complained about the symptoms worsening after the use of cannabis. The symptoms which showed improvement were sleep disturbances, pain, stiffness, anxiety, and troubled mood. Even a slight relief in the symptoms can improve the quality of life for a patient who has been suffering from chronic pain and long-term suffering. The percentage of people who reported improved sleep patterns was as high as 81%. Sleepless nights can further aggravate the symptoms and affect the quality of life and patients greatly appreciate being able to get their sleep cycles on track.

Studies specific to the correlation between medicinal cannabis and fibromyalgia have only been taken seriously in the past decade or so. It would take years to conduct quality research based on which health care systems can start utilizing these breakthrough treatment options and emerging trends in cannabis treatment especially for treating FM. If you are suffering and are in pain – you need not suffer anymore!

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The good news is that in the past few years, thanks to medical advancement, highly effective treatments have come to the forefront to manage HIV infection. If you start treatment early, it is possible to live a long and healthy life.

HIV Positive patients can be treated with the help of antiretroviral medications. These medications are part of the antiretroviral therapy (ART) and they can help by:

• suppressing the viral load and reducing the amount of HIV in your body
• slowing down the spread of the virus in your body
• helping your immune system fight off other infections

HIV treatment can go a long way in improving the quality of life of people coping with HIV and can also prevent further HIV transmission.

The Canadian AIDS Society published a paper on Cannabis as Therapy for People Living with HIV/AIDS: “Our Right, Our Choice” (https://www.cdnaids.ca/wp-content/uploads/Cannabis-Executive-Summary-EN-Final-v2.4-Web-Quality.pdf) and found that, as many as 14% to 37% of patients who tested HIV Positive / have AIDS turn to cannabis to help manage their symptoms which include wasting, nausea, vomiting, pain, anxiety, depression, appetite loss, stress to name a few. It has also been estimated that approximately several thousand Canadians turn to the use of medicinal cannabis for other conditions which includes fighting side effects caused by chemotherapy for cancer, spinal cord injuries/ disease, acute pain due to arthritis, multiple sclerosis as well as seizures due to epilepsy.

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When the body suffers acute injury such as a sprained ankle, a scraped elbow, the body’s response to this is acute inflammation. The National Library of Medicine states that acute inflammation presents itself to localized injury spots and could also include swelling, pain, heat, redness and in some extreme situations, could also result in loss of function.

When tissues are damaged, they release Cytokines to respond to acute inflammation. Hormones, Immune cells, and other systems get triggered because of the Cytokines and begin to act on the damage to allow the body to heal. If there is an infection, the body then fights off outside invaders and bacteria by raising the core temperature to kill viruses and bacteria that may cause further harm.

Vasodilation is another physiological process that takes place along with increased blood flow to the area suffering from inflammation. This allows the tissues to heal faster and this is what could cause the redness and warmth that is usually associated with inflammation. Acute inflammation tends to subside fairly quickly once the body and damaged tissue has healed allowing the body to go back to normal. However, if acute inflammation does not subside it could lead to more serious issues like chronic inflammation.

While researchers know that chronic inflammation plays a role in advancing other diseases in the body, they are still discovering the mechanisms and underlying causes behind chronic inflammation and what they could imply for overall health.

Chronic inflammation differs from acute inflammation as it affects the entire body and not just the localized site of injury as seen in acute inflammation. It is usually low-grade inflammation that is present in the body at all times.

The immune system releases white blood cells to fight off a perceived threat and is the body’s response to chronic inflammation. However, if there is no threat, the white blood cells could begin attacking internal organs and healthy tissues.

Take, for example, the increased risk of heart attack and stroke caused due to chronic inflammation. There could be a build-up of plaque if inflammatory cells remain in the blood vessels for a long period. The immune system then tends to perceive this plaque build-up as a threat and could cause inflammation to block plaque build-up in the rest of the blood vessel. If the plaque goes on to become unstable or lose, it could further lead to a clot that would block blood flow which would ultimately cause a stroke or heart attack.

According to the Arthritis Society of Canada, Non-steroidal anti-inflammatory drugs (NSAIDs) are a class of medication used to treat the pain and inflammation of arthritis. They come under “non-steroidal” as they do not contain steroids. NSAIDs cover a large range of medications and some can even be obtained without a prescription. Examples of NSAIDs which can be bought without prescription include ibuprofen (e.g. Advil®, Motrin®), acetylsalicylic acid (ASA) – (e.g. Aspirin®, Novasen®, Entrophen®), and naproxen (Aleve®) with more than 20 available. A COXIB (Celebrex® ie celecoxib) has been designed specifically to treat and reduce the risk of stomach ulcers. COXIBs assure that they are safe for the stomach but they may come with other side effects associated with NSAIDs and could cause stomach cramps, heartburn, indigestion, and nausea.

The National Center for Complementary and Integrative Health states that a variety of naturopathic products can also be administered to reduce inflammation. These include the devil’s claw, turmeric, willow bark. In the naturopathic world, “Golden Milk” – a mix of milk, turmeric, and pepper has gained immense popularity as a natural anti-inflammatory drink.

A study conducted in 2010, titled “Cannabinoids As Novel Anti-Inflammatory Drugs”, went on to show the effect of cannabinoids on treating inflammation. The study went on to show that cannabinoids tend to act on both the CB1 and CB2 receptors present in the immune system which decreases the production of cytokine as well as chemokine which plays a part in triggering chronic inflammation. The study then went on to conclude that cannabinoids can suppress inflammatory responses and can be used to lower disease symptoms. This property present in cannabinoids can be mediated through various pathways for eg. suppression of cytokines, chemokines at the inflammatory sites, induction of apoptosis in activated immune cells, and upregulating FoxP3 regulatory T Cells.

More research in this field is needed to study the role cannabinoids play in treating inflammation. With the recent legalization of cannabis, these studies should not be too far along. Various subjective reports have found that people who use cannabis to manage inflammation and pain have found a reduction in their symptoms.

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Suffering from IBS is extremely common and in most cases, dietary and simple lifestyle changes can provide relief from alarming symptoms. However, there is no single course of treatment that can help everyone and the treatment depends on a variety of factors including the type of symptoms, the severity of it, and how much it affects your day-to-day life.

You could be prescribed OTC medication (over-the-counter) by your doctor if IBS symptoms are severe and lifestyle/dietary changes have not helped till now. Medications are typically prescribed to tackle and target dominant symptoms – constipation, pain, or diarrhea.
To reduce abdominal pain, muscle spasms, and cramping, antispasmodic medications can provide relief. When administered in low doses, antidepressant medications can also act on the chemical messengers present in the digestive tract to provide comfort from pain, cramping, and diarrhea. When administered in higher doses, these medicines can also help alleviate feelings of depression and anxiety that accompany IBS.
Loperamide, an antidiarrheal medication, helps reduce the stool frequency and slows the movement of the stool through the intestines.

For people suffering from constipation due to IBS, they can be prescribed laxatives to speed up the movement of the stool through the intestines. Laxatives are available in prescription or over-the-counter formulations. You should consult your doctor to figure out the best course of treatment for you. Analgesic agents and prosecretory can help reduce the sensitivity of pain nerves in the intestines and also provide relief by increasing the number of fluids in the digestive tract. They have been shown to soften bowel movements and make them occur more often, reduce the amount of bloating, and decrease abdominal pain in patients with IBS.

Patients suffering from IBS report concurrent anxiety and struggle with abdominal pain. So, it’s no surprise that some patients anecdotally report using cannabis, especially CBD, to help reduce pain and anxiety

There is scarce research on how cannabis helps treat IBD but the result findings are promising. A study in the European Journal of Gastroenterology and Hepatology in 2011 tried to evaluate the use of cannabis on patients suffering from IBD. Patients suffering from Crohn’s Disease and ulcerative colitis had to answer a questionnaire. They were asked about any past or current use of cannabis, socioeconomic factors, lifestyle factors, medical history, reaction to medicines they were taking. The study found that patients suffering from IBD use cannabis to control symptoms such as abdominal pain, depression because they found it improved their quality of life. However, the study concluded that cannabis use is common amongst people suffering from IBS. However more data is required to fully evaluate the effects cannabis has on IBS.

Recent legalization should allow researchers to conduct ongoing trials on how cannabis may be used to benefit patients with IBS.

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It’s important to factor in the impact of a healthy lifestyle during menstruation. It can make a huge difference in how your mind and body react. During menstruation, actively choose to improve your diet, participate in fitness activities, and reduce the amount of caffeine, alcohol, and salt you consume. A healthy diet means following a diet that ranges from vegetables, fruit, whole grains, dairy, seafood, legumes, less processed meats, drinks that contain sugar, and fewer refined grain products. During pre-menstruation, many women have increased cravings for sugar. Prevent sweet-tooth cravings from taking place by eating balanced meals with small snacks. Indulge in meals that offer a low glycemic index.

Each month, be sure to log your symptoms during menstruation. Be particularly accurate about each time of the day. Many women find late afternoons difficult, feeling extremely exhausted. Plan with a snack or meal to remain balanced during the time of day you feel symptomatic. Take part in a restorative activity such as a light walk or rest. Placing your personal needs ahead of time makes a huge difference on how you feel.

During half of the menstrual cycle, the hormones increase women’s constipation leading to diarrhea. To help with these symptoms, make sure to have lots of fiber and add fluids to your diet. Get proper sleep, learn more about what you can do to reduce stress, and change your behavior-related symptoms. Pain symptoms can be treated with over-the-counter medications. If physical or mood-related symptoms appear to be extremely critical, women can opt to get prescription medications.

CBD and cannabinoids have the power to treat painful menstrual cramps by helping in the following manner:

Anti-inflammatory: Cannabinoids have many anti-inflammatory components that work on cutting off inflammatory prostaglandins production. THC activates endocannabinoid receptors (CB2) found within the macrophages (killer cells) of the immune system. When the receptors startup, they intercept macrophages from releasing inflammatory proteins (cytokines).

Pain-relieving: Cannabinoids help defend the body’s nerves from inflammatory molecules including prostaglandins, which make pain-perceiving nerves more sensitive. Both CBD and THC (cannabinoids) target nerve receptors in the body to decrease the sensation of pain. The soothing effects can desensitize TRPV1 and spread to other neighbouring receptors as well.

Muscle-relaxing: Menstrual cramps are exacerbated by the contractions of the smooth muscle lining in the uterus. Cannabinoids are used to calm muscle tension. Both THC and CBD aim to relax contractions by targeting receptors in the muscle tissue.  

Vascular-relaxing: Blood vessels are parallel to the smooth muscle lining. When cannabinoids activate this muscle to relax, blood flow increases. The improved blood flow can help alleviate pain from starved tissues to reduce body cramps. 

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There are several preventive measures one can take to manage headaches and migraines. Certain prescription medications such as Antihistamines, Anti-inflammatories, Anticonvulsants, and Antidepressants can also treat and prevent migraines and some of their symptoms. Triptan, a migraine-specific drug is also used.

A study published in the Journal of Pain, suggests that cannabinoids play a key role in reducing pain associated with migraines and headaches by almost half. A study conducted by Washington State University also indicates the same.

A study by The Skaggs School of Pharmacy and Pharmaceutical Sciences at the University of Colorado reported that medical cannabis reduced the number of migraine attacks per month.

Almost 40% of 121 adult participants reported positive effects. Almost 20% claimed that medical cannabis helped prevent migraines and almost 85% reported reduced numbers of migraine attacks per month.

Medical cannabis assists with reducing inflammation in the protective dura matter which covers the brain, one of the biggest factors for pain associated with migraines. It works via the endocannabinoid system and decreases the release of pro-inflammatory substances.

Because migraines have such a complex set of underlying causes, triggers, and symptoms, cannabis might be an ideal migraine medication since it contains diverse compounds and has widespread roles in issues associated with migraines. Medical cannabis has anti-emetic as well as analgesic properties. It acts as an anti-inflammatory agent as well. CBD, a compound known for its anti-anxiety properties, can be perfect for preventing and treating stress-induced migraines.

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Although there is no cure for MS, ongoing research is zeroing in on its causes and exploring ways to repair the damage it causes along with ways to prevent it from occurring again. The MS Society of Canada and the MS Scientific Research Foundation, fund research for various aspects of the disease which includes:

• Progression/therapies – Examines current or potential therapies and aims to improve imaging technology by better visualizations of brain activities.
• Cause/risk factors – Explores potential MS triggers and factors which may increase susceptibility.
• Nerve damage/repair – Focuses on cellular mechanisms. This results in either damage or repair of underlying nerve cells and myelin.
• Symptom management/quality of life – Explores how MS affects day-to-day life and develops treatments that can manage symptoms more effectively.

Some prescription medication can ease the impact of the symptoms of multiple sclerosis. Pharmaceuticals can be used to control and reduce inflammation and accumulated nerve damage. This can prevent further deterioration of conditions and can decrease the severity and frequency of relapses.

Patients who have been diagnosed with relapsing multiple sclerosis are advised to begin their treatment process as early as they can. Treatments that are currently available for such forms of multiple sclerosis involve controlling inflammation by targeting the inflammatory process and preventing tissue damage. But for most patients diagnosed with progressive forms of the disease, inflammation is less relevant and thus, treatments prove to be ineffective. It is important to continue having open discussions with medical practitioners while exploring treatment options.

Pharmaceutical drugs are used for multiple sclerosis for:

• Relapse management treatment
• Symptom management treatment
• Disease-modifying therapies (DMT)

According to the MS Society of Canada, disease-modifying therapies for multiple sclerosis (MS) aim to either slow disease progression or manage symptoms of MS. A new survey conducted among multiple sclerosis patients indicates that over 90% of respondents have used or considered using medical cannabis as part of their symptom management care plan. More and more patients are speaking to their healthcare providers about the use of medical cannabis and its efficacy.

Spasticity is a very common symptom of multiple sclerosis affecting over 80% of the patients. It can cause stiffness (tonic) as well as spasms (intermittent). It is caused when lesions in the central nervous system alter the regular inhibitory/excitatory balance of the nerves that are responsible for movement. It can be extremely challenging and can disrupt daily activities like sitting and walking. Recent research on the use of medical cannabis to treat spasticity associated with multiple sclerosis has shown positive results. However, there is a lot more that remains unknown and would require years of research.

Most people suffering from multiple sclerosis experience musculoskeletal and neuropathic pain. The latest research on the use of pharmaceutical-grade cannabis treatments suggests that it can effectively reduce pain and provide at least some level of relief.

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It is advisable to try different approaches to help with a muscle cramp to determine which method works the best for you. A few traditional treatments involve:

• Massaging and stretching the muscle
• Consuming adequate fluids
• Heating pads, warm showers, and baths to help relax the muscle
• Ice packs and cold packs
• Prescription medications like ibuprofen, acetaminophen, and naproxen.  It is better to be cautious with medicines and to carefully read and follow appropriate instructions on the label.

Most muscle spasms are usually treated with pain relievers, muscle relaxers, anti-inflammatory, and anti-anxiety medication. These, however, can cause certain intolerable side effects and also prove ineffective for many patients. Thus, many have turned to use medical cannabis for treating spasms and cramps.

A report published in 2018 by the National Academy of Sciences titled “The Health Effects of Cannabis and Cannabinoids”, indicates that marijuana is effective in treating chronic pain and calms muscle spasms associated with multiple sclerosis. It further states that both inhaled, as well as oral cannabis, can help ease chronic pain.

“Conclusive or substantial scientific evidence has shown that marijuana products are effective at treating chronic pain, calming muscle spasms caused by multiple sclerosis, and easing nausea from chemotherapy.” – National Academy of Sciences

However, researchers also stress the fact that CBD and THC levels can vary between different strains of cannabis, and unless a standard is achieved through research, it could be difficult to ascertain the impact of different strains containing variable amounts of CBD and THC levels.

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According to the Cleveland Clinic, there are several ways to relieve or control nausea. However, if these methods and techniques do not work and fail to provide respite, you should consult a medical professional.

While trying to control nausea, its best to:

• Drink cold liquids slowly
• Consume bland, light food like bread
• Avoid anything fried, sweet, or greasy
• Frequently have smaller meals
• Avoid mixing hot and cold foods or beverages
• Avoid physical activity after meals
• Avoid brushing teeth after your meals
• Plan a proper diet that involves all food groups and provides an adequate nutrition

Treatments for vomiting include:

• Gradually drinking large quantities of liquids
• Avoiding solid food till the feeling or episode passes
• Getting adequate rest
• Avoiding oral medications temporarily

The benefits of cannabis as a treatment for nausea have been known for a long time. A 1975 study conducted by Zinberg, Sallan, and Frei concluded that THC actively helps control nausea. It mentions that all of the 20 subjects that participated in the study felt relief from nausea after using medical cannabis. A study conducted by Rock, Sticht, Duncan, Stott, and Parker also indicates that a type of CBD has antiemetic value.

Medical cannabis when used in combination with other antiemetics has increased the effectiveness of both and has shown that it can be used either as a stand-alone antiemetic or can be used with other antiemetics in case the symptoms are more severe and require stronger results.

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Although it is very difficult to completely cure nerve damage, several treatments can help reduce the effects of the symptoms. As nerve damage is a progressive disease, it gets worse over time. Thus it is important to consult a healthcare professional as early as you notice the symptoms.

Addressing the underlying conditions that are causing nerve damage and pain is the first step towards treatment. This can involve:

• Correcting nutritional deficiencies
• Changing medications
• Physical therapy for compression or trauma
• Treating autoimmune conditions
• Regulating blood sugar levels for patients with diabetes

Traditional medication used to minimize nerve pain may involve-

• Pain-relievers
• Antidepressants such as  duloxetine and venlafaxine
• Tricyclic antidepressants such as amitriptyline and desipramine (Norpramin)
• Anti-seizure drugs such as pregabalin and Neurontin
• Capsaicin cream

 Certain alternative treatment approaches that can alleviate pain include:

• Antioxidant Vitamins
• Electrical nerve stimulation
• Acupuncture
• Biofeedback
• Meditation

Medical cannabis works on the areas of the brain that are responsible for processing sensory signals like pain and can help reduce chronic nerve pain (neuropathy). The human body’s sensory receptors called endocannabinoids are similar to cannabinoids found in cannabis. Cannabinoids stop nerves from transmitting pain signals by binding to the receptors. Although medical cannabis does not act as a cure, it can help patients manage and reduce pain.

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Till date, no cure for Parkinson’s has been found. Patients can experience unique and specific symptoms and thus, treatment has to be designed to manage individual conditions. Much of Parkinson’s treatment involves reducing the effects of its symptoms. Common symptoms such as stiffness, shaking, difficulties in swallowing, etc. can cause much discomfort and impair one’s daily routines.

The use of prescribed medications can aid in functioning but carries the risk of harmful side effects. Thus, it is important to be careful and stick to prescribed doses. Certain pharmaceuticals work on the brain at extremely complex levels and need to be taken accurately to produce desired results. It is advised to consult your doctor before consuming any pharmaceutical medication.

Although drugs can help with some of the symptoms, currently available treatments are unable to cure or check Parkinson’s progress. Patients can live with the disease for years. Many can benefit from certain surgeries. Routine Physical therapy can help increase balance, flexibility, and mobility. Regular exercise can strengthen joints and muscles. Patients can opt for certain Occupational Therapies for helping them perform day-to-day activities as well as Speech Therapy for control and modulating one’s voice.

The Therapeutic Potential of Cannabinoids for Movement Disorders – After conducting clinical trials and having studied the observations, cannabinoid-based therapies suggest that there could be a benefit of using cannabinoids for tics but perhaps there is no benefit for tremor as found in multiple sclerosis or dyskinesias or the motor symptoms in Parkinson’s Disease. Despite multiple publications about the medical benefits of using cannabinoids, there is a requirement for further preclinical and clinical research to be able to better understand the physiological, pharmacological, and therapeutic effects of this class of drugs in movement disorders like Parkinson’s.

Neurokinin B, neurotensin, and cannabinoid receptor antagonists and Parkinson disease – This study went on to explore the effects of three receptor antagonists (neurotensin, cannabinoid, NK3) on the severity of and dysfunction of motor symptoms and levodopa-induced dyskinesias after having administered a single dose of levodopa in 24 patients who suffer from Parkinson’s Disease.

Cannabinoids reduce levodopa-induced dyskinesia in Parkinson’s disease: – This study indicates that in Parkinson’s disease, the cannabinoid receptor agonist nabilone significantly lowers levodopa-induced dyskinesia.
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Preventive Approaches: There are certain guidelines for preventing PTSD among people who have been exposed to events of traumatic nature, recommended by the WHO, BAP, and VA/DoD. As an early intervention in preventing PTSD after traumatic events, treatments such as trauma-focused cognitive behavioral therapy are recommended along with sertraline and propranolol. For patients suffering from acute insomnia, certain sleep hygiene and relaxation techniques are also recommended.  

Treatment Approaches: As a first-line pharmacological treatment, controlled use of serotonin reuptake inhibitors such as paroxetine, sertraline, and fluoxetine and serotonin-norepinephrine reuptake inhibitors such as venlafaxine is recommended. Eye movement reprocessing and desensitization, stress management therapies, and cognitive-behavioral therapies are recommended as initial physiological treatments. The recommendations do not mention combinations of medication and physiological therapies. 

The use of medical cannabis as a treatment for PTSD has been around for many years, predominantly among veterans. Much of the information regarding the benefits of medical cannabis for treating PTSD is derived from positive patient reports. According to a study published in the Journal of Psychopharmacology, patients who do not use cannabis have a higher chance of experiencing PTSD-induced depressive episodes.

Although our body does not produce CBD or THC, they are similar in structure to the human endogenous cannabinoids. THC and CBD interact with the endocannabinoid system and influence a plethora of biological processes. Brain imaging research indicates that patients with PTSD do not have enough endogenous cannabinoids that lock on to cannabinoid receptors although the latter is present in abundance. Supplementing the brain with plant-based cannabinoids, THC and CBD can help restore normal brain functions. Research suggests that cannabis can aid in erasing and extinguishing traumatic memories that are responsible for triggering PTSD. With gradual use, patients have known to experience improvements in their conditions and symptoms

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Some treatments for sleep disorders involve:

• Positive Airway Pressure (PAP) Therapies: This is used to treat sleep apnea. Treatment involves using a machine such as BiLevel, CPAP, and Servo Ventilators, to keep the patient’s airways open when he/she is asleep.
• Behavioral measures for sleep disorders: This includes non-surgical treatments for sleep and breathing related disorders.
• Oral appliances: Another treatment for sleep apnea, involves using a device to maintain position of the soft tissue in the airway to prevent it from collapsing. The device needs to be worn in the mouth while sleeping.
• Positional therapy: This involves training patients to sleep on their sides or at certain angles to effectively counter and resolve sleep-disordered breathing.

Some treatments for Insomnia involve:

• Cognitive Behavioural Therapy for Insomnia (CBTI): This therapy focuses on addressing the real factors that contribute towards persistent insomnia and guiding patients through the various changes in behaviors related to sleep.
  
• Medications: Certain forms of medications have been approved by Health Canada to help treat insomnia. These are called hypnotic medications.

Treatments for narcolepsy/hypersomnia involve:

• Treating narcolepsy: This also involves a combination of prescription drugs and certain behavioral changes to schedule nocturnal sleep and naps as well.
• Treating Kleine-Levin syndrome (KLS): Also known as hypersomnia, KLS currently has no particular treatment to control or cure it. Some measures can be taken to manage the disease.
• Treating idiopathic hypersomnia: This involves initiating treatment after a careful and thorough analysis of the symptoms and assessing their most probable causes

Treatments for circadian rhythm disorders involve:

Bright light therapy: This involves using light therapy to gradually enable a shift towards regular sleeping patterns. It can help manage circadian rhythm disorders like delayed sleep phase syndrome.

Treating Restless legs syndrome (RLS) usually involves using a combination of behavioral changes and pharmaceutical drugs

Depending on the balance of terpene profiles and different cannabinoids present in the strain, cannabis can produce calming or energizing effects. Tetrahydrocannabinol or THC is a psychoactive cannabinoid that binds to CB1 receptors and is responsible for producing sedating and calming effects and inducing sleep.

Terpenes also bind to receptors present within the brain and provide various therapeutic effects. Terpenes are secreted through the resin and are the chemicals that are responsible for the aroma of the cannabis plant.
The state of ‘deep sleep is the most beneficial part of the sleep cycle. Being more restful and restorative, it is the target for most sleep disorder treatments. Recent studies indicate that consuming high levels of sedative terpenes and THC can reduce the duration of REM sleep, the period during which one is dreaming. Thus, for patients suffering from PTSD, it can mean reduced traumas and terrors. Reduction of REM sleep increases the duration of deep sleep which helps the body recover faster.

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Fighting and dealing with stress is a constant effort and some good methods include maintaining a healthy eating habit, regular exercise, working on reducing negativity, limiting the intake of caffeine and alcohol, properly utilizing leisure time, avoiding drugs and cigarettes, and adopting proper sleep hygiene.

• prioritizing, arranging, and delegating tasks
• turning to friends and family for support
• being part of a support group, consulting a healthcare professional, accessing and using self-help materials, or enrolling in a stress management program

Once a person has reached a state of emotional well-being, they are capable of bouncing back from stress and come back feeling stronger to face the world. This can aid people to better face life events and better cope with difficult situations.

Anxiety disorder can be a sign of severe stress. If the signs and symptoms have appeared for too long, you should seek professional help especially if your home, work, school, or social life is affected or if you experience increased stress and emotional difficulties. Recovery from chronic stress is possible.

A recent study in the British Journal of Anaesthesia showed that significant therapeutic effects were produced by cannabis (similar to opioid analgesics). The research further shows that THC (Delta-9 Tetrahydrocannabinol) can bind to CB2 receptors present in the spinal cord which in turn reduces the pain signals being sent to the brain.

Another recent study conducted by the University of Illinois at Chicago (UIC) found that THC administered in low doses is capable of combating stress. The study also found that administration of high doses of THC shows opposite results. The author of the study, Professor Emma Childs, said that they found that THC at low doses reduced stress and at higher doses had the opposite effect, emphasising on the importance of dose especially when it comes to THC and its effects.

One of our medical practitioners will be able to help determine the medical management strategy that suits your needs when treating stress.

The need for medical management is reinforced when seeking stress treatment. Treatment is highly dose-dependent and it is always advisable to work with a team of practitioners and medical professionals who can determine your individual needs when it comes to cannabis.

The mentality of “start slow and less is more” applies perfectly to this situation. It is advisable to start with small doses, observe the effects of THC and then determine further administration of THC to achieve the desired effect. A lower dose of THC can be increased easily rather than risking a larger amount.

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[1] https://www.canadianepilepsyalliance.org/about-epilepsy/
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5767492/
[3] https://www.canada.ca/en/public-health/services/publications/diseases-conditions/summary-estimates-hiv-incidence-prevalence-canadas-progress-90-90-90.html
[4] https://www.canada.ca/en/news/archive/2014/12/fact-sheet-health-challenges-chronic-inflammation-initiative.html
[5] https://arthritis.ca/treatment/medication/anti-inflammatory-medications
[6] https://cdhf.ca/digestive-disorders/irritable-bowel-syndrome-ibs/
[7] https://cdhf.ca/digestive-disorders/irritable-bowel-syndrome-ibs/
[8] https://ichd-3.org
[9] https://www.atlasofms.org/map/global/epidemiology/number-of-people-with-ms
[10] https://mssociety.ca/about-ms
[11] https://mssociety.ca/hot-topics/cannabis
[12] https://us.humankinetics.com/blogs/excerpt/understanding-and-treating-spasms-and-cramps
[13] https://www.parkinson.ca/about-parkinsons/
[14] https://www.parkinson.ca/about-parkinsons/

[TE1]This is from HealthLine, but I’m guessing we don’t need to highlight this?

[TE2]This is from Rexall…I’m guessing we don’t want this? All other research relates nausea to diseases
[TE3]Nerve Damage can be so many different things – I suggest we take it out