Terpenes

Terpenes, Cannabis Strains and Headaches

Terpenes are believed to offer a wide range of medical benefits although research remains inadequate to identify definitive clinical benefits at this time. Terpenes are especially thought to contribute to the analgesic benefits attributed to marijuana including headaches. Research is beginning to investigate which cannabis strains offer the best benefits for specific conditions, which in turn leads to the question of which terpenes (and cannabinoids & flavonoids) offer the best benefits for specific conditions.

Various terpenes appear to impact pain in general, but also the pain associated with headaches. This section explores what is understood at this time regarding the various marijuana strains relative to their terpene content and benefits for headaches.

 

Links to other Pertinent Educational Pages:

Links to ALL Marijuana Educational Pages

Terpenes – An Overview

 

Terpenes Therapeutic Benefits

 

Individual Terpenes:

The medical information on this site is provided as a resource for information only, and is not to be used or relied upon for any diagnostic or treatment purposes and is not intended to create any patient-physician relationship.  Readers are advised to seek professional guidance regarding the diagnosis and treatment of their medical concerns.

 

Key to Links:

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Headache Types

Migraine is usually a 4–72 hour headache that is typically unilateral, pulsating, of moderate-to-severe intensity, and associated with sensitivity to activity and bright lights or loud sounds. Tension-type headche is classified as frequent, infrequent, or chronic, typically with bilateral band-like pain of mild-to-moderate intensity and lasting minutes to days. Cluster headache is defined as severe unilateral pain in orbital, temporal, and/or supraorbital locations, lasting 15–180 min and typically occurring frequently and at regular intervals. Medication overuse headache( MOH) is a chronic condition (occuring more than 15 days per month) that develops from frequent use of anti-headache medications including butlbital (Fioricet) and others. Cannabis is used by many to manage headaches of all types.

 

Cannabis Use for Headaches

Limited studies support the benefit of cannabis use for headaches including migraines. A 2020 study that focused on patients who smoked or vaped cannabis flower reported better migraine symptom reduction, less negative headache impact, better sleep quality, and a decrease in the use of other medications. A 2019 survey study of inhaled cannabis usage demonstrated that headaches were reduced by 47.3% and migraines by 49.6%. A higher percentage of males (90.9%) compared to females (89.1%) reported a greater reduction of headaches, whereas females (88.6%) compared to males (87.3%) reported a greater reduction of migraines. Research also shows a significant benefit of marijuana in improving the nausea and vomiting associated with migraines.

Another study evaluated frequency of cannabis use where 60.8% of the participants reported one to five hits usage per session. Concerning the dosage of cannabis, 12.3% of respondents used less than 1 g/week, 20.3% reported using 1-2 g/week, 31.8% reported using 3-5 g/week, 26.1% reported using 7 g/week, 6% using 28 g/week, and 3.4% using more than 28 g/week

 

 

Patient Preference for Forms of Cannabis Use in Headache Management

Several studies have evaluated preferred forms of cannabis for treating migraines and headaches, noting that all forms (oral, inhaled, sublingual, edible, topical) have been demonstrated to be useful. One survey reported the primary method of use was smoking, followed by vaporization (5.6%) and “dabs” (2.8%). Another study found that 84.1% of the participants reported inhalation as the most common form of use. Males appear to prefer smoke and vaporized forms more, whereas females appear to prefer edibles, tinctures (oil-based), and topical cannabis forms.

 

Beneficial long-term and short-term effects of medicinal cannabis are reported. Chronic pain and mental health (anxiety & depression) are the two most common reasons reported for medical cannabis use. Cannabis use has been found to be effective in decreasing daily analgesics intake, dependence on other analgesics, and on the level of pain intensity. Some patients experienced a prolonged and persistent improvement in their health and well-being (both physically and mentally) after long-term use of medicinal cannabis. Overall, patients reported more positive effects rather than adverse effects with medical cannabis use.  In conclusion, cannabis (oral, inhaled, sublingual, edible, topical) may be indicated for managing headache and migraine symptoms.

 

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Cannabis Strains and Headaches

It has been reported that patients with headaches were 2.7 times more likely to prefer a hybrid (Cannabis sativa + Cannabis indica) strain than chronic pain patients. Males appear to prefer higher THC content and high THC:low CBD ratios vs. females who appear to prefer low THC: high CBD ratios.

There is very little information as to which cannabis strains are most effective. At this time, research is largely limited to self-reporting which in turn is largely limited to use of standardized questionnaires and apps such as ID Migraine.

A 2018 study using the ID Migraine questionnaire evaluated the cannabis strains most commonly preferred for relief of headaches in chronic migraine patients and other types of chronic pain.  “OG Shark,” a sativa/indica hybrid strain, was identified as the most popular for both migraine patients as well as those with other chronic pain syndromes including arthritis. Among the most preferred 15 cannabis strains, there were no statistically significant differences in specific strain preferences found between patients with headache as their primary pain compared to those with other diagnoses of chronic pain or arthritis.

While OG Shark was identified as the most preferred strain for headaches and pain, the following were the next preferred strains:

  1. OG Shark (29 patients; 8.9% of responders)
  2. Afghani (25; 7.7%)
  3. Skywalker OG (25; 7.7%)
  4. Lemon Sour Diesel (25; 7.7%)
  5. Jack Herer (24; 7.3%)
  6. Jean Guy (24; 7.3%)
  7. White Widow (24; 7.3%)
  8. Pink Kush (21; 6.4%)
  9. Master Kush (20; 6.1%)
  10. Sweet Skunk CBD (18; 5.5%)
  11. Headband (17; 5.2%)
  12. Island Sweet Skunk (17; 5.2%)
  13. Black Tuna (16; 4.9%)
  14. Warlock CBD (14; 4.3%)
  15. Cannatonic (14; 4.3%),
  16. Blueberry (14; 4.3%)

Click here for an analysis of the constituents of these 15 preferred cannabis strains for pain

 

Headaches – Cannabis strains and their terpenes, noted for their benefits for headaches

In order to assess which cannabis strain offer which specific therapeutic benefits it is most informative to determine which constituents found in a specific strain appear to be responsible for those benefits, including the cannabinoids, terpenes and other constituents such as flavonoids.

For example, the OG Shark cannabis strain, a cross between Great White Shark and OG Kush, is reported to be the most popular strain for headaches. OG Shark is a high THC/THCA (20+%), low CBD/CBDA (<1%) strain with β-caryophyllene followed by β-myrcene, limonene and linalool as the dominant terpenes. This is consistent with the potent analgesic, anti-inflammatory, and anti-nausea properties of THC, coupled with the documented anti-inflammatory and analgesic properties of β-caryophyllene and linalool along with the sedative and anxiolytic properties of myrcene and limonene.

A 2022 publication reviewed the current studies exploring the clinical effects of cannabis-related compounds on migraine as well as clinical evidence regarding involvement of the endocannabinoid system (ECS) in migraine. For a summary of the studies reviewed, click here.

 

Cannabinoids and Headaches

Of note, as evident with OG Shark, preliminary evidence based on self-reporting surveys, suggests that THC plays a more effective role in combating headaches (and other forms of chronic pain) than CBD. There is no evidence regarding other cannabinoids including CBG.

Terpenes and Headaches

Of note, as evident with OG Shark, preliminary evidence based on self-reporting surveys, suggests that β-caryophyllene, β-myrcene, limonene and linalool may be the best choices for treating headaches.

 

Medication Overuse Headaches (MOH)

Long-term use of cannabis can cause a physical reliance on cannabinoids (eg, THC) and drug tolerance, which may result in reduction or loss of pain relief benefits. Moreover, headache itself can be associated with cannabinoid medications and is common with cannabis withdrawal. Cannabinoid overuse in animal models induced latent sensitization, which increased sensitivity to stress, suggesting that vulnerable individuals using cannabinoids may have increased risk of developing medication overuse headache.

A 2021 publication surveyed patients to examine whether cannabis use predicts medication overuse headache (MOH) in patients with chronic migraine. It was noted that both current cannabis use and opioid use were significantly associated with MOH.  It was advised that for patients with chronic migraine and MOH reducing cannabis use may help treat MOH effectively.

According to the author,

“This study shows that there is some kind of association between cannabis use and medication overuse headache in people with chronic migraine, but it is unclear at this time whether patients are using cannabis to treat medication overuse headache or if cannabis is contributing to the development of medication overuse headache, or both.”

 

Strategies for Cannabis Use for Migraine Headaches

It is believed that migraine and cluster headaches are initiated in the brain in areas such as the hypothalamus, brainstem, or cortex. Tension-type headaches can originate in the brain but may also be triggered by muscles, often as a reult of stress. All headaches usually involve overactivation of the trigeminovascular pathway, resulting in the release of vasoactive peptides, such as calcitonin gene-related peptide (CGRP) and substance P, as well as vasoactive mediators such as nitrous oxide (NO), which can lead to further sensitization of pain receptors in the head and neck. Serotoninergic signaling, parasympathetic efferents, inflammation, and increased intracranial pressure also play important roles in headache disorders.

Alternative strategies for using cannabinoids in migraine management include using low-doses along with alternative compounds concurrently to target alternative pain-implicated pathways. Low-dose cannabinoids combined with nonsteroidal anti-inflammatory drugs (NSAIDs) can result in analgesia without the the side effects associated with larger doses of either cannabinoids or NSAIDs alone.

A proposed endocannabinoid deficiency in migraine, possibly due to reduced CB1 and CB2 receptor expression, supports the potential benefits for therapy with exogenous cannabinoids (cannabis). or compounds that may increase endogenous cannabionoids to enhance benefits and to reduce THC’s psychotropic side effects.  As such, preclinical and clinical findings suggest a possible role for supplemental use of palmitoylethanolamide (PEA) in migraine treatment by increasing levels of endogenous cannabionoids.

Aside from modulating CB1 receptors with THC, targeting CB2 receptors in immune cells can also reduce inflammation to reduce migraine pain, potentially both as abortive and preventative management. β-caryophyllene (BCP), the most dominant terpene found in cannabis strains found to be most effective in treating migraines, is a potent CB2 agonist. Research supports the use of BCP in various chronic pain conditions. Moreover, BCP is considered as food safe, a GRAS (generally regarded as safe) compound by the FDA with virtually no side effects and supplemental BCP products are available.

 

The endocannabinoid system (ECS) and how cannabis may impact headaches

The endocannabinoid system (ECS) consists of nerve receptors including CB1 receptors (found mostly in the central & peripheral nervous system) and CB2 receptors (found mostly in the peripheral nervous system) & immune system). There are currently two naturally occurring human endocannabinoids, anandamide (AEA) and 2-AG that activate these receptors under certain circumstances. AEA activates CB1 receptors leading to decreased neurotransmission of dopamine, γ-aminobutyric acid (GABA), and glutamate, while 2-AG activates CB2 receptors which leads to analgesia and decreased immune system function. THC activates both CB1 and CB2 receptors while CBD may indirectly impact activity of both CB1 and CB2 receptors.

The neurochemistry of migraine is among the most complex of any human malady. Current theory regarding migraine headaches suggests that the ECS system reduces migraine through several pathways (serotonin, inflammatory, opiate, and glutamine) both centrally and peripherally.

Serotonergic pathways are considered integral to migraine pathogenesis and treatment. Numerous points of intersection with cannabinoid mechanisms are evident: THC inhibits serotonin release from the platelets of human migraineurs; THC stimulates 5-HT synthesis, inhibits synaptosomal uptake, and promotes its release.

By its action on the serotonin pathways (AEA potentiates 5-HT1A and inhibits 5-HT2A receptors), CB1 activation is effective in reducing acute headache pain. Cannabinoids may also help prevent migraines due to their ability to inhibit platelet serotonin release and due to their peripheral vasoconstrictor effect. 

There is an abundance of CB1 receptors in the periaqueductal gray matter, an area important in pain and migraine perception. Cannabinoids have also been shown to have dopamine-blocking and anti-inflammatory effects which may also contribute to their therapeutic benefit for headaches.

The trigeminovascular system is integral to the pain, inflammation and secondary vascular effects of migraine, via the NMDA/glutamate system. Cannabinoid agonists inhibit voltage-gated calcium channels, and activate potassium channels to produce presynaptic inhibition of glutamate release.. NMDA antagonism is believed to be effective in eliminating hyperalgesia associated with migraine and NMDA blockade is recommended to treat chronic daily headache.

The unique attributes of cannabis to affect serotonergic, dopaminergic, opioid, anti-inflammatory, and NMDA mechanisms of migraine suggest cannabis may offer benefits for both abortive and preventative migraine management.

Resources:

National Academy of Sciences

The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research

 

 

References:

Terpenes – Headaches

  1. Patterns of medicinal cannabis use, strain analysis, and substitution effect among patients with migraine, headache, arthritis, and chronic pain in a medicinal cannabis cohort – 2018
  2. Medical Cannabis, Headaches, and Migraines: A Review of the Current Literature – 2021.pdf
  3. Medicinal Properties of Cannabinoids, Terpenes, and Flavonoids in Cannabis, and Benefits in Migraine, Headache, and Pain An Update on Current Evidence and Cannabis Science – PubMed – 2018.pdf
  4. Clinical Evidence of Cannabinoids in Migraine – A Narrative Review – 2022 
  5. Medication overuse headache in patients with chronic migraine using cannabis A case-referent study – PubMed – 2021
  6. Potential Therapeutic Role of the Endocannabinoid System for Migraine – 2022
  7. The Use of Cannabis for Headache Disorders – 2017
  8. Clinical Endocannabinoid Deficiency (CECD) – Can this Concept Explain Therapeutic Bene ts of Cannabis in Migraine, Fibromyalgia, Irritable Bowel Syndrome and other Treatment-Resistant Conditions? 2004
  9. The endocannabinoid system and related lipids as potential targets for the treatment of migraine-related pain – PubMed – 2022

 

Terpenes – Overviews

  1. Therapeutic and Medicinal Uses of Terpenes – 2019
  2. Terpenes:Terpenoids in Cannabis – Are They Important? – 2020
  3. Advances in Pharmacological Activities of Terpenoids – 2020
  4. Terpenoids, Cannabimimetic Ligands, beyond the Cannabis Plant – 2020
  5. The Cannabis Terpenes – 2020
  6. The “Entourage Effect” – Terpenes Coupled with Cannabinoids for the Treatment of Mood Disorders and Anxiety Disorders – 2020
  7. Cannabis Essential Oil – A Preliminary Study for the Evaluation of the Brain Effects – 2018
  8. A Systematic Review of Essential Oils and the Endocannabinoid System – A Connection Worthy of Further Exploration – 2020
  9. Efficacy of Essential Oils in Pain – A Systematic Review and Meta-Analysis of Preclinical Evidence – 2021

 

Terpenes – Aromatherapy

  1. Aromatherapy and Aromatic Plants for the Treatment of Behavioural and Psychological Symptoms of Dementia in Patients with Alzheimer’s Disease Clinical Evidence and Possible Mechanisms – 2017
  2. Corrigendum – A question of scent – lavender aroma promotes interpersonal trust -2015
  3. Odors enhance slow-wave activity in non-rapid eye movement sleepOdors enhance slow-wave activity in non-rapid eye movement sleep
  4. Essential Oils and Animals – Which Essential Oils Are Toxic to Pets?
  5. Essential Oils and Pets
  6. Herbs and Their Uses for Animals – Patchouli and Pets
  7. Reactivating memories during sleep by odors – odor specificity and associated changes in sleep oscillations – 2014
  8. Increasing Explicit Sequence Knowledge by Odor Cueing during Sleep in Men but not Women – 2016
  9. Effects of odorant administration on objective and subjective measures of sleep quality, post-sleep mood and alertness, and cognitive performance – 2003
  10. An Olfactory Stimulus Modifies Nighttime Sleep in Young Men and Women – 2005
  11. Massage with or without aromatherapy for symptom relief in people with cancer. – PubMed – NCBI
  12. Aromatherapy hand massage for older adults with chronic pain living in long-term care. – PubMed – NCBI
  13. A Systematic Review of Essential Oils and the Endocannabinoid System – A Connection Worthy of Further Exploration – 2020
  14. Human olfactory receptors – novel cellular functions outside of the nose,” – 2017
  15. The diversified function and potential therapy of ectopic olfactory receptors in non-olfactory tissues – PubMed – 2017
  16. How does your kidney smell? Emerging roles for olfactory receptors in renal function,” – 2017
  17. The Effects of Essential Oils and Terpenes in Relation to Their Routes of Intake and Application – 2020
  18. Pharmacology of Natural Volatiles and Essential Oils in Food, Therapy, and Disease Prophylaxis – 2021

 

Terpenes – CB2 Receptor

  1. Cannabinoid-based therapy as a future for joint degeneration. Focus on the role of CB2 receptor in the arthritis progression and pain – an updated review – 2021
  2. β-Caryophyllene, a CB2 receptor agonist produces multiple behavioral changes relevant to anxiety and depression in mice – 2014
  3. The CB2 receptor and its role as a regulator of inflammation – 2016

 

Terpenes – Synergy with Cannabinoids:

  1. Taming THC – potential cannabis synergy and phytocannabinoid-terpenoid entourage effects – 2011
  2. A tale of two cannabinoids: the therapeutic rationale for combining tetrahydrocannabinol and cannabidiol. – PubMed – NCBI
  3. Entourage Effect 2.0
  4. Cannabis and the Anxiety of Fragmentation—A Systems Approach for Finding an Anxiolytic Cannabis Chemotype – 2018
  5. Terpenoids and Phytocannabinoids Co-Produced in Cannabis Sativa Strains Show Specific Interaction for Cell Cytotoxic Activity – 2019
  6. Absence of Entourage – Terpenoids Commonly Found in Cannabis sativa Do Not Modulate the Functional Activity of Δ9-THC at Human CB1 and CB2 Receptors – 2019
  7. Terpenoids From Cannabis Do Not Mediate an Entourage Effect by Acting at Cannabinoid Receptors – 2020
  8. The “Entourage Effect” – Terpenes Coupled with Cannabinoids for the Treatment of Mood Disorders and Anxiety Disorders – 2020

 

Terpenes – Marijuana Strains

  1. Patterns of medicinal cannabis use, strain analysis, and substitution effect among patients with migraine, headache, arthritis, and chronic pain in a medicinal cannabis cohort – 2018
  2. Terpenoid Chemoprofiles Distinguish Drug-type Cannabis sativa L. Cultivars in Nevada – 2018
  3. Terpenoids and Phytocannabinoids Co-Produced in Cannabis Sativa Strains Show Specific Interaction for Cell Cytotoxic Activity – 2019
  4. Identification of Terpenoid Chemotypes Among High (−)-trans-Δ9- Tetrahydrocannabinol-Producing Cannabis sativa L. Cultivars 0 2017
  5. The Cannabinoid Content of Legal Cannabis in Washington State Varies Systematically Across Testing Facilities and Popular Consumer Products – 2018

 

Terpenes – Routes of Use:

  1. The Effects of Essential Oils and Terpenes in Relation to Their Routes of Intake and Application – 2020
  2. Antiviral effect of phytochemicals from medicinal plants – Applications and drug delivery strategies – 2020
  3. Cannabinoid Delivery Systems for Pain and Inflammation Treatment – 2018

 

Terpenes – Bioavailability

  1. Bioavailability and Pharmacokinetics of Natural Volatile Terpenes in Animals and Humans – 2000
  2. Bioavailability of Bioactive Compounds
  3. SPC Liposomes as Possible Delivery Systems for Improving Bioavailability of the Natural Sesquiterpene β-Caryophyllene – 2018

 

Terpenes – Arthritis

  1. Evaluation of the anti-inflammatory, anti-catabolic and pro-anabolic effects of E-caryophyllene, myrcene and limonene in a cell model of osteoarthritis. – 2015

 

Terpenes – Anxiety

  1. Cannabis and the Anxiety of Fragmentation—A Systems Approach for Finding an Anxiolytic Cannabis Chemotype – 2018
  2. The “Entourage Effect”: Terpenes Coupled With Cannabinoids for the Treatment of Mood Disorders and Anxiety Disorders – PubMed – 2019
  3. Medicinal cannabis for psychiatric disorders – a clinically-focused systematic review – 2020
  4. A Systematic Review of the Anxiolytic-Like Effects of Essential Oils in Animal Models – 2015
  5. A Systematic Review on the Anxiolytic Effect of Aromatherapy during the First Stage of Labor – 2019
  6. A Systematic Review on the Anxiolytic Effectsof Aromatherapy in People with Anxiety Symptoms – 2011
  7. Anxiolytic Terpenoids and Aromatherapy for Anxiety and Depression – PubMed – 2020
  8. Effect of Aromatherapy on Dental Anxiety Among Orthodontic Patients – A Randomized Controlled Trial – 2019
  9. Essential Oils and Their Constituents – An Alternative Source for Novel Antidepressants – 2017
  10. Essential Oils and Their Constituents Targeting the GABAergic System and Sodium Channels as Treatment of Neurological Diseases – 2018
  11. Possible Use of Phytochemicals for Recovery from COVID-19-Induced Anosmia and Ageusia – 2021
  12. The calming effect of roasted coffee aroma in patients undergoing dental procedures – 2021
  13. The Effect of Lavender Aroma on Anxiety of Patients Having Bone Marrow Biopsy- 2020
  14. The-Effects-of-Essential-Oils-and-Terpenes-in-Relation-to-Their-Routes-of-Intake-and-Application-2020
  15. Therapeutic Effect and Mechanisms of Essential Oils in Mood Disorders – Interaction between the Nervous and Respiratory Systems – 2021
  16. Anxiolytic-Like Effects of Bergamot Essential Oil Are Insensitive to Flumazenil in Rats – 2019

 

Terpenes – Infectious Diseases

  1. Phytochemical Analysis and in vitro Antiviral Activities of the Essential Oils of Seven Lebanon Species – 2008
  2. Antiviral effect of phytochemicals from medicinal plants – Applications and drug delivery strategies – 2020
  3. Essential Oils and Coronaviruses – 2020

 

Terpenes – Pain:

  1. Analgesic-like Activity of Essential Oils Constituents – 2011
  2. Analgesic-Like Activity of Essential Oil Constituents – An Update – 2017
  3. Medicinal Plants of the Family Lamiaceae in Pain Therapy – A Review – 2018
  4. Analgesic Potential of Essential Oils – 2016
  5. Medicinal Plants of the Family Lamiaceae in Pain Therapy – A Review – 2018
  6. Patterns of medicinal cannabis use, strain analysis, and substitution effect among patients with migraine, headache, arthritis, and chronic pain in a medicinal cannabis cohort – 2018
  7. Terpenoids, Cannabimimetic Ligands, beyond the Cannabis Plant – 2020
  8.  The Molecular Mechanisms That Underpin the Biological Benefits of Full-Spectrum Cannabis Extract in the Treatment of Neuropathic Pain and Inflammation – PubMed – 2020
  9. Cannabis-based medicines and the perioperative physician – 2019
  10. Cannabis‐based medicines for chronic neuropathic pain in adults – 2018
  11. Medicinal Properties of Cannabinoids, Terpenes, and Flavonoids in Cannabis, and Benefits in Migraine, Headache, and Pain – An Update on Current Evidence and Cannabis Science – 2018
  12. Role of Cannabinoids and Terpenes in Cannabis-Mediated Analgesia in Rats – PubMed – 2019
  13. Antinociceptive effect of inhalation of the essential oil of bergamot in mice – 2018
  14. Analgesic Potential of Essential Oils – 2016
  15. Analgesic-Like Activity of Essential Oil Constituents – An Update – 2017

 

 

Terpenes – Headaches:

  1.  Medicinal Properties of Cannabinoids, Terpenes, and Flavonoids in Cannabis, and Benefits in Migraine, Headache, and Pain – An Update on Current Evidence and Cannabis Science – 2018
  2. Patterns of medicinal cannabis use, strain analysis, and substitution effect among patients with migraine, headache, arthritis, and chronic pain in a medicinal cannabis cohort – 2018

 

Terpenes – Inflammation:

  1. Evaluation of the anti-inflammatory, anti-catabolic and pro-anabolic effects of E-caryophyllene, myrcene and limonene in a cell model of osteoarthritis. – 2015 
  2. Cannabis sativa L. and Nonpsychoactive Cannabinoids – Their Chemistry and Role against Oxidative Stress, Inflammation, and Cancer – 2018
  3. Patterns of medicinal cannabis use, strain analysis, and substitution effect among patients with migraine, headache, arthritis, and chronic pain in a medicinal cannabis cohort – 2018
  4. Therapeutic Potential of Volatile Terpenes and Terpenoids from Forests for Inflammatory Diseases – 2020
  5.  The Molecular Mechanisms That Underpin the Biological Benefits of Full-Spectrum Cannabis Extract in the Treatment of Neuropathic Pain and Inflammation – PubMed – 2020
  6. Evaluation of the anti-inflammatory, anti-catabolic and pro-anabolic effects of E-caryophyllene, myrcene and limonene in a cell model of osteoarthritis. – 2015
  7. Cannabis, Cannabinoids, and the Endocannabinoid System—Is there Therapeutic Potential for Inflammatory Bowel Disease? – 2019
  8. Therapeutic Applications of Terpenes on Inflammatory Diseases – 2021

 

Esssential Oils

 

Essential Oils – Overviews

  1. Essential Oils, Part I Introduction – PubMed – 2016
  2. Essential Oils, Part II General Aspects – PubMed – 2016
  3. Essential Oils, Part III Chemical Composition – PubMed – 2016
  4. Essential Oils, Part IV Contact Allergy – PubMed- 2016
  5. Essential Oils, Part V Peppermint Oil, Lavender Oil, and Lemongrass Oil – PubMed 2016

 

 

Essential Oils – Bearded Irises

  1. Identification of Floral Scent Profiles in Bearded Irises – 2019

 

 

Essential Oils – Bergamot

  1. The Anxiolytic Effect of Aromatherapy on Patients Awaiting Ambulatory Surgery – A Randomized Controlled Trial – 2013
  2. Antinociceptive effect of inhalation of the essential oil of bergamot in mice – 2018
  3. Anxiolytic-Like Effects of Bergamot Essential Oil Are Insensitive to Flumazenil in Rats – 2019
  4. Bergamot – Natural Medicines – Professional.pdf
  5. Citrus bergamia essential oil – from basic research to clinical application – 2015
  6. Role of 5-HT1A Receptor in the Anxiolytic-Relaxant Effects of Bergamot Essential Oil in Rodent – 2020 Neuropharmacological Properties of the Essential Oil of Bergamot for the Clinical Management of Pain-Related BPSDs – PubMed – 2019
  7. Possible involvement of the peripheral Mu-opioid system in antinociception induced by bergamot essential oil to allodynia after peripheral nerve injury – PubMed – 2018
  8. Peripherally injected linalool and bergamot essential oil attenuate mechanical allodynia via inhibiting spinal ERK phosphorylation – PubMed – 2013
  9. Neuropharmacology of the essential oil of bergamot – PubMed – 2010
  10. Effect of Harvesting Time on Volatile Compounds Composition of Bergamot (Citrus × Bergamia) Essential Oil – 2019
  11. Chemical Composition and Biological Activities of Essential Oils from Peels of Three Citrus Species – 2020
  12. Chemical_Composition_of_Bergamot_Citrus_Bergamia_Risso_Essential_Oil_Obtained_by_Hydrodistillation – 2010
  13. Cannabinoid Signaling in the Skin – Therapeutic Potential of the “C(ut)annabinoid” System – 2019
  14. Rational Basis for the Use of Bergamot Essential Oil in Complementary Medicine to Treat Chronic Pain – PubMed – 2016

 

Essential Oils – Plumeria

  1. Constituents of essential oils from the leaf and flower of Plumeria alba grown in Nigeria – PubMed – 2014

 

Individual Terpenes

Terpenes: β-Caryophyllene:

  1. (−)-β-Caryophyllene, a CB2 Receptor-Selective Phytocannabinoid, Suppresses Motor Paralysis and Neuroinflammation in a Murine Model of Multiple Sclerosis – 2017
  2. Antiallodynic effect of β-caryophyllene on paclitaxel-induced peripheral neuropathy in mice. – PubMed – NCBI
  3. Acute administration of beta-caryophyllene prevents endocannabinoid system activation during transient common carotid artery occlusion and reperfusion – 2018
  4. Antiallodynic effect of β-caryophyllene on paclitaxel-induced peripheral neuropathy in mice. – PubMed – NCBI
  5. Cannabimimetic phytochemicals in the diet – an evolutionary link to food selection and metabolic stress adaptation? – 2016
  6. The anxiolytic-like effect of an essential oil derived from Spiranthera odoratissima A. St. Hil. leaves and its major component, β-caryophyllene, in male mice – 2012
  7. β‐caryophyllene and β‐caryophyllene oxide—natural compounds of anticancer and analgesic properties – 2016
  8. β-Caryophyllene, a CB2 receptor agonist produces multiple behavioral changes relevant to anxiety and depression in mice – 2014
  9. Toxicological Evaluation of β-Caryophyllene Oil: Subchronic Toxicity in Rats. – PubMed – NCBI 2016
  10. The cannabinoid CB₂ receptor-selective phytocannabinoid beta-caryophyllene exerts analgesic effects in mouse models of inflammatory and neuropathic… – PubMed – NCBI – 2014
  11. The cannabinoid CB2 receptor-selective phytocannabinoid beta-caryophyllene exerts analgesic effects in mouse models of inflammatory and neuropathic pain – 2013
  12. SPC Liposomes as Possible Delivery Systems for Improving Bioavailability of the Natural Sesquiterpene β-Caryophyllene – 2018
  13. β-Caryophyllene Inhibits Dextran Sulfate Sodium-Induced Colitis in Mice through CB2 Receptor Activation and PPARγ Pathway – 2011
  14. Why wild giant pandas frequently roll in horse manure – 2020
  15. Beta-caryophyllene is a dietary cannabinoid – 2008
  16. Analgesia mediated by the TRPM8 cold receptor in chronic neuropathic pain. – 2006
  17. The menthol receptor TRPM8 is the principal detector of environmental cold – PubMed – 2007
  18. Molecular basis of peripheral innocuous cold sensitivity – 2018
  19. Involvement of peripheral cannabinoid and opioid receptors in β-caryophyllene-induced antinociception – PubMed – 2013
  20. NON-CANNABIS THERAPY – Cannabinoid Therapy Without Using Cannabis: Direct Effects™ Topical β-Caryophyllene
  21. Beta-caryophyllene enhances wound healing through multiple routes – 2019
  22. Preparation and Characterization of Liposomal β‐Caryophyllene (Rephyll) – 2020

 

Terpenes: Linalool:

  1. GS12-linalool
  2. Linalool – 1997
  3. The “Entourage Effect”: Terpenes Coupled With Cannabinoids for the Treatment of Mood Disorders and Anxiety Disorders – PubMed – 2020
  4. An olfactory stimulus modifies nighttime sleep in young men and women. – PubMed – NCBI
  5. Lavender and sleep – A systematic review of the evidence – 2012
  6. Lavender and the Nervous System – 2013
  7. Effects of odorant administration on objective and subjective measures of sleep quality, post-sleep mood and alertness, and cognitive performance – 2003
  8. In-vitro inhibition of human erythrocyte acetylcholinesterase by salvia lavandulaefolia essential oil and constituent terpenes. – PubMed – NCBI – 2000
  9. Odors enhance slow-wave activity in non-rapid eye movement sleep – 2016
  10. A question of scent – lavender aroma promotes interpersonal trust – 2015
  11. Is Lavender an Anxiolytic Drug? A Systematic Review of Randomised Clinical Trials – 2012
  12. Efficacy of Silexan in subthreshold anxiety – meta-analysis of randomised, placebo-controlled trials – 2019
  13. Essential oil of lavender in anxiety disorders – Ready for prime time? – 2017
  14. Linalool is a PPAR ligand that reduces plasma TG levels and rewires the hepatic transcriptome and plasma metabolome – 2014
  15. A Review of the Potential Use of Pinene and Linalool as Terpene-Based Medicines for Brain Health – Discovering Novel Therapeutics in the Flavours and Fragrances of Cannabis – 2021
  16. The Efficacy of Lavender Aromatherapy in Reducing Preoperative Anxiety in Ambulatory Surgery Patients Undergoing Procedures in General Otolaryngology – 2017
  17. Efficacy, Safety and Tolerability of Aroma Massage with Lavender Essential Oil – an Overview – 2020
  18. Antinociceptive and anticonvulsant effects of the monoterpene linalool oxide – 2017
  19. Exploring Pharmacological Mechanisms of Lavender (Lavandula angustifolia) Essential Oil on Central Nervous System Targets – 2017
  20. Linalool Ameliorates Memory Loss and Behavioral Impairment Induced by REM-Sleep Deprivation through the Serotonergic Pathway – 2018
  21. Effects of lavender on anxiety, depression and physiologic parameters – Systematic Review and Meta-Analysis – 2021
  22. Lavender and sleep – A systematic review of the evidence – 2012
  23. Lavender and the Nervous System – 2013
  24. A question of scent – lavender aroma promotes interpersonal trust – 2015

 

 

Terpenes, Linalool: – Silexan

  1. A Multi-Center, Double-Blind, Randomised Study of the Lavender Oil Preparation Silexan in Comparison to Lorazepam for Generalized Anxiety Disorder – 2010
  2. Is Lavender an Anxiolytic Drug? A Systematic Review of Randomised Clinical Trials – 2012
  3.  An Orally Administered Lavandula Oil Preparation (Silexan) for Anxiety Disorder and Related Conditions- An Evidence Based Review – 2013
  4. Lavender oil preparation Silexan is effective in generalized anxiety disorder – a randomized, double-blind comparison to placebo and paroxetine – 2014
  5. Silexan in anxiety disorders – Clinical data and pharmacological background – 2017
  6. Effectiveness of Silexan Oral Lavender Essential Oil Compared to Inhaled Lavender Essential Oil Aromatherapy for Sleep in Adults- A Systematic Review – 2018
  7. Silexan in anxiety disorders Clinical data and pharmacological background – PubMed – 2018
  8. Efficacy and safety of lavender essential oil (Silexan) capsules among patients suffering from anxiety disorders – A network meta-analysis – 2019
  9. Efficacy of Silexan in subthreshold anxiety – meta-analysis of randomised, placebo-controlled trials – 2019
  10. Therapeutic effects of Silexan on somatic symptoms and physical health in patients with anxiety disorders – A meta- analysis – 2020
  11. Silexan, an orally administered Lavandula oil preparation, is effective in the treatment of ‘subsyndromal’ anxiety disorder a randomized, double-blind, placebo controlled trial – PubMed – 2010
  12. A multi-center, double-blind, randomised study of the Lavender oil preparation Silexan in comparison to Lorazepam for generalized anxiety disorder – PubMed – 2009
  13. No Abuse Potential of Silexan in Healthy Recreational Drug Users – A Randomized Controlled Trial – 2021

 

Terpenes – Limonene

  1. Evaluation of the anti-inflammatory, anti-catabolic and pro-anabolic effects of E-caryophyllene, myrcene and limonene in a cell model of osteoarthritis. – 2015
  2. Neuroprotective Potential of Limonene and Limonene Containing Natural Products – 2021

 

Terpenes: Myrcene

  1. β-MYRCENE – IARC MONOGRAPHS
  2. Evaluation of the anti-inflammatory, anti-catabolic and pro-anabolic effects of E-caryophyllene, myrcene and limonene in a cell model of osteoarthritis. – 2015
  3. Myrcene—What Are the Potential Health Benefits of This Flavouring and Aroma Agent? – 2021

 

Terpenes: Pinene

  1. A Review of the Potential Use of Pinene and Linalool as Terpene-Based Medicines for Brain Health – Discovering Novel Therapeutics in the Flavours and Fragrances of Cannabis – 2021

 

 

Medical Marijuana – Product Evaluation

  1. The Cannabinoid Content of Legal Cannabis in Washington State Varies Systematically Across Testing Facilities and Popular Consumer Products – 2018
  2. Quality Control of Traditional Cannabis Tinctures – Pattern, Markers, and Stability – 2016
  3. Cannabinoid, Terpene, and Heavy Metal Analysis of 29 Over-the-Counter Commercial Veterinary Hemp Supplements – 2020

 

Emphasis on Education

 

Accurate Clinic promotes patient education as the foundation of it’s medical care. In Dr. Ehlenberger’s integrative approach to patient care, including conventional and complementary and alternative medical (CAM) treatments, he may encourage or provide advice about the use of supplements. However, the specifics of choice of supplement, dosing and duration of treatment should be individualized through discussion with Dr. Ehlenberger. The following information and reference articles are presented to provide the reader with some of the latest research to facilitate evidence-based, informed decisions regarding the use of conventional as well as CAM treatments.

 

For medical-legal reasons, access to these links is limited to patients enrolled in an Accurate Clinic medical program.

 

Should you wish more information regarding any of the subjects listed – or not listed –  here, please contact Dr. Ehlenberger. He has literally thousands of published articles to share on hundreds of topics associated with pain management, weight loss, nutrition, addiction recovery and emergency medicine. It would take years for you to read them, as it did him.

 

For more information, please contact Accurate Clinic.

 

Supplements recommended by Dr. Ehlenberger may be purchased commercially online or at Accurate Clinic.

Please read about our statement regarding the sale of products recommended by Dr. Ehlenberger.

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