Cachexia Explained

Cachexia is a complex metabolic syndrome that is associated with an underlying illness, and can be characterized by loss of muscle with or without loss of fat1.

Cachexia causes you to experience extreme fatigue, weight loss that cannot be reversed by nutritional demands, and muscle and fat depletion. Cachexia can often be seen in older adults, but is also related to diseases such as AIDS, COPD and cancer. Cachexia is more prevalent in cancer patients, affecting around 80%, but is also prevalent in heart failure patients, those with COPD and end stage renal disease. The pathology of cachexia may be different depending on the patient’s chronic illness, however, the presentation between patients is very similar.

Cachexia is the result of imbalanced energy levels in your body leading to muscle breakdown and weight loss. Factors contributing to this imbalance include changes in metabolism and caloric intake, aging, disuse atrophy (muscle wasting), tissue hypoxia (inadequate oxygen levels), and certain medications2.

In order to diagnose cachexia, certain criteria need to be present. Three of the following five criteria must be met to make a diagnosis, which includes: decreased muscle strength, fatigue, anorexia (loss of appetite), low fat-free muscle index, and chronic inflammation in the body as seen by increased levels of cytokines and interleukins2.

In addition, a consensus definition incorporates a weight loss greater than 5% in the last 12 months2.

Patients with cachexia and their caregivers often suffer from psychosocial distress, especially in end of life care. In addition, it has been shown that caregivers feel inadequate in providing hydration and nutritional intake in end of life care2.

It is extremely difficult to treat patients’ illnesses when the body is already breaking down. This puts an extra toll on both the patient and loved ones because it is a visual representation of how sick the patient is.

Cachexia is a very concerning factor and one that needs to be addressed immediately if the patient is to improve. Since cachexia is multifaceted and essentially affects the entire body, it largely increases the risk of morbidity and mortality of the patient. Due to poor prognosis, every patient with an incurable disease should be screened for weight loss and nutritional status2.

In certain situations, cachexia is addressed by treating the underlying illness. However, there are certain medications and supplements that can be given in order to improve weight gain and functional status.

While there are some drugs available to treat side effects of cachexia, medical cannabis is a safe, reliable and effective way to treat the underlying side effects. There are many different strains of cannabis which contain a multitude of cannabinoids in each strain. These cannabinoids differ in what symptoms they treat. Appetite, vomiting, pain and general malaise are the major symptoms of cachexia that medical marijuana can treat. The strains of cannabis that are used to stimulate a person’s appetite are Sonoma coma, orange skunk, and caramel. The strains used to treat nausea and vomiting are Durban poisen, sour diesel, and mango kush. The strains that are shown to improve mood are blue dream, granddaddy purple, and chocolope. The strains of cannabis to increase overall energy are jack’s cleaner, super silver haze, and og kush. Also, the different ways to consume the cannabis should be taken into consideration as well. Those who are cachexic are already extremely sick, so it might be best if they do not combust any cannabis. However, tinctures, vaping, edibles and oils are all safe methods of using medical cannabis.

References:

Evans WJ, Morley JE, Argilés J, et al. Cachexia: a new definition. Clin Nutr 2008; 27:793. Uptodate.

Assessment and Management of anorexia and cachexia in palliative care. Last updated Jul 15, 2020. Evans WJ, Morley JE, Argilés J, et al. Cachexia: a new definition. Clin Nutr 2008; 27:793.

Cachexia and Marijuna. Updated on Apr 1, 2020. Marijuanadoctors.com