Unexpected improvement of hyperhidrosis with cannabidiol

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Unexpected improvement of hyperhidrosis with cannabidiol

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Unexpected improvement of hyperhidrosis with cannabidiol
Rubens Pitliuk, 1 Christina Morotomi Funatsu Coelho, 2 and Tatyanny Paula Pinto da Costa Santos Fucci 3
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ABSTRACT
Hyperhidrosis is characterized by excessive sweating and it affects almost 5% of the population. The affected age group is wide, and it can affect from children to elderlies. There are two types of hyperhidrosis: generalized and focal. Treatment depends on the symptoms presented. In more severe cases, radiofrequency sympatholysis and bilateral thoracic sympathectomy are the options. However, recurrence is possible or the postoperative appearance of conditions called compensatory hyperhidrosis or reflex hyperhidrosis. We describe two cases of patients treated with Cannabidiol who had significant and unexpected improvement of hyperhidrosis. The first patient received Cannabidiol specific for public presentations at work, and the second patient had a diagnosis of autism spectrum disorder. The hyperhidrosis improved in both patients immediately after using Cannabidiol.

Keywords: Cannabidiol, Dronabinol, Hyperhidrosis, Sweating, Phobia, social, Sympathectomy
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INTRODUCTION
Hyperhidrosis is a condition characterized by excessive sweating in some individuals. Sweat glands overreact to stimuli and they are usually overactive by producing more perspiration than physiologically necessary and for causing social, emotional, and professional harm. According to the International Hyperhidrosis Society, almost 5% of the world population suffers from excessive sweating or hyperhidrosis.(1)Hyperhidrosis can also affect children and adolescents and these individuals experience a considerably reduction in their quality of life.(2)

Patients with focal or primary hyperhidrosis often present with sweating involving the face, palms, soles of the feet, or armpits. Generalized sweating suggests secondary etiology. The most common causes of generalized sweating are excessive heat and obesity. Other causes include systemic diseases such as infections, endocrine disorders, neuroendocrine tumors, malignancy, neurological disorders, toxins, and previous spinal cord injuries. Unlike primary hyperhidrosis, patients with secondary generalized hyperhidrosis often present in adulthood and they have excessive sweating, which occurs both while awake and asleep.(3)

The diagnosis is strictly clinical. Treatment suggestions are made based on the location and severity of the case, and, in general, therapy is done with 20% topical aluminum chloride, botulinum toxin type A (Botox) and type B (Myobloc), and anticholinergic agents (glycopyrrolate, propantheline, and oxybutynin).

In patients with hyperhidrosis triggered by specific emotional events, current treatment options include: beta-blockers or benzodiazepines, iontophoresis, radiofrequency sympathicolysis, and bilateral thoracic sympathectomy (the gold standard treatment), done by videothoracoscopy, which should be recommended only in severe cases.

No clear difference has been demonstrated between the various techniques for bilateral thoracic sympathectomy. By achieving the correct level division, the results tend to be good and reproducible. The sympathetic chain can be sectioned, resected, removed with caution or divided with a harmonic scalpel, or clips can be used.(3,4)

There are reports describing compensatory hyperhidrosis and reflex hyperhidrosis postoperatively.(5) In this article, we describe two cases of unexpected success using Cannabidiol (CBD) to control hyperhidrosis.

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CASE REPORT
First case
A 43-year-old man who were social phobic since adolescence and had undergone numerous treatments such as psychotherapy, duloxetine, desvenlafaxine, paroxetine, clonazepam, escitalopram, propranolol, oxybutynin, quetiapine, valproate, aripiprazole, among other. Any of these therapies was totally effective, but all brought side effects, including increased sweating.

Before and during professional presentations, the patient felt tachycardia, dyspnea, extreme anxiety, and increased sweating, which made it difficult for him to perform at work. Treatment suggested was a one-time dose of 300mg of CBD without tetrahydrocannabinol, about 1 hour before going to his work.

To avoid the surprise of unwanted side effects at the time of the presentation, we recommended to the patient to take a 50mg test dose on a normal day at home with no public engagement.

Without any mention of hyperhidrosis (so there was no suggestion or placebo effect), he noticed that when greeting people, he no longer needed to dry his hands on a handkerchief that he kept in his pocket.

Many months later, he still had no hyperhidrosis. On his own, he stopped the CBD, and within a few days the hyperhidrosis returned. The CBD therapy was restarted, and the patient had improvement on the same day. He then maintains the 25mg dose in two takes (in the morning and at lunchtime) since September 2019.

Second case
A 27-year-old woman diagnosed with autistic spectrum disorder, autonomic nervous system impairment, and epilepsy. Her additional complaints included multisegmental pain, anxiety, persistent thoughts, sweating on hands, difficulty in relating with people, and micturition discomfort characterized by frequent and urgent urge to urinate.

He had already used several medications, alone and in combination, without improvement of the complaints, and, many times, there was worsening of manifestations and/or new side effects. Among the medications already used were imipramine 75mg/day, oxybutynin 15mg/day, clonazepam 2.5mg/day, buspirone 5mg/day, atenolol 37.5mg/day, transcutaneous electrical stimulation (TENS) in pelvic floor (by recommendation of the urologist), oxcarbazepine 1,200mg/day, topiramate 200mg/day, lamotrigine 200mg/day, valproic acid 1,500mg/day, lacosamide 100mg/day, risperidone 2mg/day, and periciazine 20mg/day. The last combination therapy he had used was lamotrigine 200mg/day and risperidone 1mg/day, both with partial improvement of symptoms.

A combination of CBD (with up to 0.3% tetrahydrocannabinol) was suggested. The patient evolved with an important improvement in her complaints and, surprisingly, the sweating on her hands. The dose was titrated, starting at 10mg/day. The current dose used by patient is 50mg/day with maintenance of the basic medications. To date, the patient continues to use CBD.

This study was approved by the Research Ethics Committee of Hospital Israelita Albert Einstein under number # 4.571.353, CAAE: 43183221.6.0000.0071.

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DISCUSSION
Cannabinoids are used as alternative treatments in a wide range of diseases. The research on phytocannabinoids started in the last decades of the 20th century, in Israel.(6) The modernization of laboratory techniques, starting in the 1960s, the isolation and structural elucidation of 9-tetrahydrocannabinol, and many other phytocannabinoids were possible.(6,7)

Cannabidiol has complex pharmacology, and several mechanisms have been proposed to explain its action. Different studies have shown that the acute effects of CBD clearly depend on the facilitation of neurotransmission mediated by the serotonin 5HT1A receptor in defense-related areas. In addition, CBD possesses a wide range of antipsychotic, sleep regulatory, antidepressant, anxiolytic, mood stabilizing, antiemetic, antiepileptic, anti-inflammatory, and analgesic properties.(8-10)

These reported cases demonstrated unexpected success in the control of hyperhidrosis and suggest the use of CBD as a new treatment possibility. This alternative treatment approach needs further investigations given that this was not extensively reported in the scientific published literature.

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REFERENCES
1. International Hyperhidrosis Society (IHHS). Official Site International Hyperhidrosis Society. Pensilvânia (PA): IHHS; 2020 [cited 2020 July 10]. Available from: http://www.sweathelp.org [Google Scholar]
2. Mirkovic SE, Rystedt A, Balling M, Swartling C. Hyperhidrosis substantially reduces quality of life in children: a retrospective study describing symptoms, consequences and treatment with botulinum toxin. Acta Derm Venereol. 2018;98(1):103-7. [PubMed] [Google Scholar]
3. Cerfolio RJ, De Campos JR, Bryant AS, Connery CP, Miller DL, DeCamp MM, et al. The Society of Thoracic Surgeons expert consensus for the surgical treatment of hyperhidrosis. Ann Thorac Surg. 2011;91(5):1642-8. Review. [PubMed] [Google Scholar]
4. McConaghy JR, Fosselman D. Hyperhidrosis: management options. Am Fam Physician. 2018;97(11):729-34. Review. [PubMed] [Google Scholar]
5. Rezende RS, Caldeira IR, Gontijo RP, Brito MM, Cunha GM. Hiperidrose com-pensatória, uma revisão: fisiopatologia, diagnóstico e tratamento. Rev Med Minas Gerais. 2013;23(Supl 3):S18-22. Review. [Google Scholar]
6. Mechoulam R. Marihuana chemistry. Science. 1970;168(3936):1159-66. Review. [PubMed] [Google Scholar]
7. Paton WD, Pertwee RG. The actions of cannabis in man. In: Mechoulam R. Marijuana: Chemistry, Pharmacology, Metabolism and Clinical Effects. New York: Academic Press; 1973. p. 287-333. [Google Scholar]
8. Mechoulam R, Feigenbaum JJ, Lander N, Segal M, Järbe TU, Hiltunen AJ, et al. Enantiomeric cannabinoids: stereospecificity of psychotropic activity. Experientia. 1988;44(9):762-4. [PubMed] [Google Scholar]
9. Mechoulam R. Cannabis - the Israeli perspective. J Basic Clin Physiol Pharmacol. 2016;27(3):181-7. Review. [PubMed] [Google Scholar]
10. Crippa JA, Guimarães FS, Campos AC, Zuardi AW. Translational investigation of the therapeutic potential of cannabidiol (CBD): Toward a New Age. Front Immunol. 2018;9:2009. Review. [PMC free article] [PubMed] [Google Scholar]

Bron: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8827357/

Wietolie/CBD dus.... mmm interessant als nieuwe methode tegen hyperhidrosis. Ben benieuwd of er mensen zijn hier die daar al mee geexperimenteerd hebben......
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Re: Unexpected improvement of hyperhidrosis with cannabidiol

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JWBokx
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Re: Unexpected improvement of hyperhidrosis with cannabidiol

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En als het niet helpt, wordt je er vrolijker van?
Soort van wodka kuur, als het niet helpt interesseert het je niet meer...
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Re: Unexpected improvement of hyperhidrosis with cannabidiol

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Ik heb CBD olie nog nooit gebruikt maar ik lees in de comments van bovenstaande video dat het goed werkt tegen hyperhidrosis onder de oksels maar dus ook op andere plekken cq het hele lichaam. Dit kan nog wel eens een serieuze oplossing zijn/worden. Even in de gaten houden dus er is nog maar weinig van bekend en onderzoek naar gedaan.
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Re: Unexpected improvement of hyperhidrosis with cannabidiol

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A few weeks back I starting taking CBD 10mg x2 a day just to see what all the hype was about. I had never heard that CBD can help reduce sweating, I personally did not believe anything would happen from taking it. After a few days/week of taking it I stopped sweating. I have been battling sweating under my armpits for probably 10-15 years. Every day when I go to work I start sweating around 11am until I get home, I have to change my T-shirt 2-3x a day. This happens for no reason that I am aware of, but if I have a client deliverable or have to give a presentation its much worse. This has been terrible to say the least. So here I am two weeks of being able to wear the same shirt all day, so I started looking online to see if others have had a similar experience and it appears so. Just wanted to say that I had no pre-conceived notion that CBD could do this so I don't think its a placebo. Going to keep taking it to see if it continues to help, hope this helps others.
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Re: Unexpected improvement of hyperhidrosis with cannabidiol

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Ik heb dermatoloog Wim Venema om een reactie gevraagd:
Kan mij voorstellen dat het centraal de hypothalamus wat remt. Ook omdat cbd olie vaak een beetje thc (het relaxt makende) bestanddeel bezit.
HannieM
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Re: Unexpected improvement of hyperhidrosis with cannabidiol

Bericht door HannieM »

Heb er ooit ook veel over zitten lezen, bij mij leek het niet echt effect te hebben maar mss moet ik meer en langduriger gebruiken.
Ik slaap er wel merkelijk dieper van (gewoon ter info ;))
yandersen
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Re: Unexpected improvement of hyperhidrosis with cannabidiol

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Hé daar!

Weet je, het is echt interessant wat je zegt over het effect van wat je probeert. Soms is het inderdaad zo dat je iets langer moet uitproberen voordat je echt merkt of het werkt of niet. Het is een beetje zoals bij dar pak appelsap dat je koopt, je weet pas na een paar keer proberen of het echt je ding is, toch?

Wat goed dat je er dieper door slaapt! Dat is al een positief teken. Misschien moet je inderdaad gewoon doorgaan en kijken hoe het op de lange termijn uitpakt. Het menselijk lichaam reageert soms op subtiele manieren en het is interessant om te observeren hoe dat zich ontwikkelt.

Houd ons op de hoogte van je ervaringen, ik ben echt benieuwd of een langduriger gebruik een nog groter effect zal hebben. Succes en slaap lekker verder!
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