Terpenes

Terpenes and Pain

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.

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

 

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.

 

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Terpenes and Pain

It is likely that the constituent in marijuana most responsible for pain benefits is THC. In fact, patients using marijuana for pain relief most commonly report that the most effective strains often have an equal balance of THC and CBD.  However, these two cannabinoids are not the whole story for cannabis and pain. The wide range of analgesic benefits derived from different marijuana strains cannot be explained by THC and CBD alone, other constituents also play a significant role, especially the terpenes.

Terpenes have a great deal of popular support for their pain benefits although most of this support appears to be anecdotal, meaning based on word of mouth opinions rather than actual meaningful research studies.  What research is available is largely limited to pre-clinical (animal or lab-based) studies. The following terpenes are most commonly referenced for their benefits for pain although β-Caryophyllen has by far the strongest evidence while the others have very weak evidence, mostly for neuropathic pain.

 

β-Caryophyllene (BCP) and Pain

Pre-clinical research indicates that β-Caryophyllene (VP: 266•F; 130°C)) has anti-inflammatory and analgesic properties and also facilitates wound healing. Unfortunately, clinical research with humans is still very limited.

 

Headaches

Anecdotal reports indicate Copaiba oil (55% BCP) can be used directly on the temples, back of the neck or other places involved in headaches. It also be used internally for headaches or migraines, using 3 drops about 3 times a day.

 

Muscle Pain and Soreness

Delayed onset muscle soreness (DOMS) and damage to muscles occurs as a result of intense exercise and activity. This muscle soreness is painful and also decreases power and performance capacity.

The oral consumption of BCP (Rephyll, see Nootropics Depot below) significantly reduced the pain scores in a study evaluating DOMS which demonstrated that Rephyll has potential for preventing DOMS. The improved recovery of pain intensity and muscle injury without any side effects showed that the product Rephyll may be an alternative supplement for pain management.

 

Osteoarthritis (OA)

Osteoarthritis (OA), otherwise known as degenerative arthritis, is the form of arthritis associated with aging. Until recently, OA had been considered solely a “wear and tear” disease, where cartilage degeneration caused by age and/or obesity cause the disease. However, recently the understanding of OA also emphasizes an inflammatory component that may develop early in the progression of the disease, not just in late stages.

Joint inflammation is associated with influx of immune cells that produce inflammatory compounds (cytokines) that drive the production of enzymes such as matrix metalloproteinases (MMPs) that play key roles in the breakdown cartilage. Elevated levels of several pro-inflammatory factors can be found in OA patients in comparison to those of healthy individuals, however the levels are lower than those in Rheumatoid Arthritis (RA) patients.

The wear and tear breakdown of joint tissues enhanced by inflammatory influences damage the  cartilage as well as the bone underlying the cartilage and leads to inflammation of the synovium (synovitis), the soft tissue that lines the spaces of joints, tendon sheaths and bursae. The synovium produces synovial fluid that functions as a lubricant as well as a vehicle through which nutrients and regulatory substances bathe the cartilage.

There is strong evidence for pain and inflammation reduction by CB2 receptor modulators in arthritis.  CB2 receptors are heavily distributed in the immune cells in joints that produce  inflammatory cytokines as well as having a large presence in joint cartilage and underlying bone. Activation of CB2 receptors by CB2 agonists have been shown to reduce pro-inflammatory cytokine and MMPs production in synovial fluid and reduce the breakdown of cartilage and bone. BCP, a CB2 agonist, has been shown in animals to protect against the breakdown of cartilage by reducing levels of MMPs and pro-inflammatory cytokines that contribute to OA as well as to increase anti-inflammatory cytokines to reduce inflammation and suppress pain.

If human studies substantiate these benefits,  BCP will be the first treatment for OA to actually slow the progression of the disease process (disease modification) as well as reduce pain. It stands to reason that BCP may be most beneficial when treatment is prolonged and begins in the early stages of OA. Of note also, BCP does not appear to develop tolerance related to the analgesic pain benefits with OA.

 

Rheumatoid Arthritis

Synovial tissues in joints with rheumatoid arthritis (RA) reportedly have more CB2 receptors than synovial tissues in joints with degenerative arthritis (osteoarthritis (OA), suggesting greater effectiveness and potency of CB2 activation with BCP in RA patients. Also, in RA, neutrophils are found in very high numbers in the joint synovium whereas neutrophils are absent in the synovial fluid in patients with OA. Elevated cytokine levels are thought to play a major role in the induction of neutrophil infiltration to the synovium in RA and BCP is known to inhibit migration of neutrophils.

Elevated cytokine levels are thought to play a major role in neutrophil infiltration to the synovium. Although neutrophils are absent in the synovial fluid in patients with OA, inflammatory cytokines, chemokines, and other inflammatory markers are found in pathogenic concentrations in the synovial fluids. While inflammation is a hallmark of OA, it is not its cause, unlike RA.

A 2020 placebo-controlled clinical study, patients with hand arthritis, both RA  and OA, applied BCP topically and BCP was found to be safe, well tolerated, and beneficial in reducing pain and inflammation.

 

Diabetic Neuropathy

BCP was administered as dietary supplement composed of a mixture of β- caryophyllene, myrrh, carnosic acid) and PEA to 25 diabetes patients with diabetes-related complications of painful distal symmetric polyneuropathy. It was found to relieve polyneuropathy  pain with good tolerance and no adverse effects (Semprini et al., 2018).

 

β-Caryophyllene: Paclitaxel-induced Peripheral Neuropathy (PINP)

Painful peripheral neuropathy is a common side effect of paclitaxel (PTX), a chemotherapy medication used to treat a number of types of cancer. However, currently employed analgesics have several side effects and are poorly effective. β-caryophyllene (BCP), a selective CB2 agonist, has shown analgesic effect in neuropathic pain models, but its role in chemotherapy-induced neuropathic pain is not yet known. A 2017 study in mice receiving PTX indicated that BCP reduced nerve pain sensitivity to mechanical stimulation (allodynia) induced by the PTX possibly through CB2-activation in the CNS and inhibition of inflammatory cytokines. These results suggest that BCP might be useful in treating the nerve pain associated with PINP.

Inflammation and Pain

β-Caryophyllene’s anti-inflammatory activity is comparable in potency to phenylbutazone, NSAIDs and indomethacin and is often used in topical anti-inflammatory ointments and salves. In contrast to NSAIDs, however, BCP protects the stomach lining  and has been purported to be effective in treating duodenal ulcers. Tissue inflammation enhances pain sensation through the sensitization of pain receptors which are peripheral nerves that respond to painful stimuli, and also through sensitization of spinal nerves which leads to enhanced transmission of pain signals to the brain resulting in hypersensitivity to pain (pain sensitization) .

The anti-inflammatory properties of BCP have been extensively shown in different mouse models of disease. A recent study shows that BCP synergizes with curcumin in exerting anti-inflammatory activity in an experimental in vitro model of osteoarthritis, strongly suggesting the potential benefit of a dual combination of these two compounds for the management of osteoarthritis. This curcumin synergy has also been found with the catechins found in green tea. Similar to curcumin, β-Caryophyllene suppresses inflammation by reducing levels of IL-1β, IL-6, through activity at  prostaglandin PGE-1 and at the NLRP3 inflammasome

 

Neuroinflammation and Pain Sensitization

Development of neuropathic pain is accompanied by the activation and proliferation of glia cells, immune cells in the spinal cord responsible for the development of neuroinflammation which leads to pain sensitization. β-Caryophyllene is thought to be effective against neuroinflammation by reducing activity of glial cells. Pain sensitization in the peripheral and central nervous system plays a pivotal role in the transition from acute to chronic pain. Hallmarks of pain sensitization include the manifestation of altered pain responses, such as painful hypersensitivity (mechanical allodynia and hyperalgesia). Neuroinflammation involving spinal neuronal facilitation and the activation of spinal microglia and astrocytes plays a fundamental roles in these processes.

Pre-clinical evidence shows that activation of CB2 receptors inhibits central sensitization and its contribution to the manifestation of chronic arthritis pain. These findings suggest that targeting CB2 receptors may have therapeutic potential for treating arthritis pain.   Early animal research in rats/mice have identified β-caryophyllene (BCP) as a selective full agonist and potent stimulator of the CB2 receptors.. In inflammatory hyperalgesia, indirect pain inhibition through CB2 receptors on mast and immune cells is possibly achieved by the reduction of prostanoids or cytokines release, which are responsible for peripheral nociceptor sensitization. Additionally, BCP activation of CB2 receptors on keratinocytes (superficial skin cells) stimulates the release of endogenous opioids, the β-endorphins. When combined with morphine, this provides an increased synergistic analgesic benefit.

CB2 is critically involved in the modulation of inflammatory and neuropathic pain. Based on animal studies, orally administered BCP reduces inflammatory pain and neuropathic pain. It has been shown to exhibit analgesic effects in neuropathic pain associated with chemotherapy, diabetes, and chronic nerve damage.  Chronic oral administration of BCP may reduce thermal hyperalgesia, mechanical allodynia and spinal neuroinflammation. No signs of tolerance to these effects after prolonged treatment have been identified.  This suggests BCP may be highly effective in the treatment of long lasting, debilitating pain states although additional studies are needed in humans.

 

Myrcene and Pain

Myrcene (VP: 334°F; 167°C) is sedating , aids insomnia and reduces anxiety but it has only very weak pre-clinical animal studies that suggest it may be helpful in the treatment of neuropathic pain. No human studies appear to be available to support targeting this terpene for use for pain other than topical use The research supporting myrcene for pain is mostly limited to animal and lab studies that do not include inhalation of myrcene and should not be extrapolated to smoking or vaping myrcene. Topical myrcene is purported to reduce pain produced by noxious thermal and mechanical stimuli as well as reducing acute inflammation. Rat studies have been performed with oral dosing of myrcene that support pain benefits crudely measured by  hot plate and acid-exposure testing.

 

Headache

In a 2018 study, “Patterns of medicinal cannabis use, strain analysis, and substitution effect among patients with migraine, headache, arthritis, and chronic pain in a medicinal cannabis cohort,” all subgroups of chronic pain patients, especially primary headache patients, responded best for pain with hybrid strains, particularly those with terpene profiles with dominant myrcene and Β-caryophyllene. In this study of the top 15 strains effective for migraine headaches all except two had myrcene contents ranging from 0.1% – 0.29%, with two outliers: 0.033% and  0.61%.

It is suggested that cannabis strains with myrcene in combination with THC, CBD and Β-caryophyllene may offer the best alternative combination for treating pain and headaches such as OG Shark.

 

Arthritis

It has been reported that arthritis patients prefer cannabis strains rich in myrcene to help manage their pain and inflammation. Myrcene has been evaluated for it benefit for arthritis in a 2022 animal study (rats) using an artificially induced model of arthritis. The data suggested that topical myrcene has the potential to reduce chronic arthritis pain and inflammation although repeated myrcene treatment had no effect on joint damage or production of inflammatory cytokines and therefor would not be expected to slow the progression of arthritis.

 

Linalool and Pain

Linalool (VP: 390°F; 198°C) is especially helpful for anxiety and insomnia. It also does have compelling evidence that it reduces pain with oral, topical and inhalation use.

 

Humulene and Pain

Only a few studies have reported humulene’s pain and anti-inflammatory properties and all of them rely on the use of essential oils of various plants (i.e. Peperomia serpens) in which humulene (VP: 225°F; 107°C) is in combination with other terpenes including β-Caryophyllene. This makes it difficult to evaluate the specific benefit of humulene or support targeting this terpene for use for pain.

 

Pinene and Pain

Pinene (VP: 311°F; 155°C) is purported to provide an uplifting effect, reduce stress and improve a person’s ability to focus their attention. Both α-pinene and β-pinene have pre-clinical, animal studies of essential oils rich in these terpenes that suggest potential benefit for pain.

 

Limonene and Pain

Limonene (VP: 349°F; 176°C) reduces anxiety, is sedating and is synergistic with CBD for these benefits. It is also an antioxidant and may help oxidative stress. No human studies appear to be available to support targeting this terpene for use for pain.

 

 

 

 

 

Resources:

National Academy of Sciences

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

 

References:

   

Terpenes for Pain – Overviews

  1. Analgesic Potential of Terpenes Derived from Cannabis sativa – 2021
  2. Efficacy of Essential Oils in Pain – A Systematic Review and Meta-Analysis of Preclinical Evidence – 2021

 

β-CaryophyllenPain

  1. Analgesic Potential of Terpenes Derived from Cannabis sativa – 2021

 

MyrcenePain

  1. Analgesic Potential of Terpenes Derived from Cannabis sativa – 2021
  2. Anti-Inflammatory and Analgesic Properties of the Cannabis Terpene Myrcene in Rat Adjuvant Monoarthritis – 2022

LinaloolPain

  1. Analgesic Potential of Terpenes Derived from Cannabis sativa – 2021

 

Humulene – Pain

  1. Analgesic Potential of Terpenes Derived from Cannabis sativa – 2021

 

PinenePain

  1. Analgesic Potential of Terpenes Derived from Cannabis sativa – 2021

 

 

 

 

 

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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