Wow, a long title, but there is a connection between all these varied diseases, acetylcholine and cannabis therapy.

In my 35 years of practice as an internal medical doctor, I have dealt with many patients suffering from various neuromuscular disorders but prior to discovering medical cannabis was limited by traditional therapies. However, with several options for dosed medical cannabis therapies we are seeing some exciting and promising results.


It has become clear that many, but not all of, the mitochondrial diseases often have neuromuscular, cerebral and other issues. Each disease is different, but they share some common characteristics. They often have acetylcholine deficiency states, centrally, peripherally or both. Additionally, they frequently have circulating antibodies against acetylcholine receptors or acetylcholinesterase, the enzyme that breaks down acetylcholine.


We have found THC, THC-Acid and CBD all can lead to increasing acetylcholine activity and or function in the central and peripheral nervous system, it is well worth continued therapy using this multi-cannabinoid triad of therapy.


Distal weakness with respiratory insufficiency caused by the m.8344A > G “MERRF” mutation.

Blakely EL, Alston CL, Lecky B, Chakrabarti B, Falkous G, Turnbull DM, Taylor RW, Gorman GS.

Neuromuscul Disord. 2014 Jun;24(6):533-6. doi: 10.1016/j.nmd.2014.03.011. Epub 2014 Apr 1.


External ophthalmoplegia in human immunodeficiency virus-infected patients receiving antiretroviral therapy.

Pineles SL, Demer JL, Holland GN, Ransome SS, Bonelli L, Velez FG.

J AAPOS. 2012 Dec;16(6):529-33. doi: 10.1016/j.jaapos.2012.08.005. Epub 2012 Nov 14.


Mitochondrial myopathy associated with myasthenia gravis in a young man.

Chakraborty PP, Mandal SK, Chowdhury SR, Bandyopadhyay D, Bhattacharjee R.

J Clin Neurosci. 2007 Jul;14(7):705-8. Epub 2007 Apr 25.


Mitochondrial ophthalmoplegia with fatigable weakness and elevated acetylcholine receptor antibody.

Behbehani R, Sharfuddin K, Anim JT.

J Neuroophthalmol. 2007 Mar;27(1):41-4.


Chronic progressive external ophthalmoplegia: a report of 6 cases and a review of the literature.

Caballero PE, Candela MS, Alvarez CI, Tejerina AA.

Neurologist. 2007 Jan;13(1):33-6. Review.


[Chronic progressive external ophthalmoplegia: clinical and electromyographic manifestations in a series of cases].

Jiménez-Caballero PE, Serviá M, Cabeza CI, Marsal-Alonso C, Alvarez-Tejerina A.

Rev Neurol. 2006 Dec 16-31;43(12):724-8. Review. Spanish.


Changes in cortical acetyl-CoA metabolism after selective basal forebrain cholinergic degeneration by 192IgG-saporin.

Tomaszewicz M, Rossner S, Schliebs R, Cwikowska J, Szutowicz A.

J Neurochem. 2003 Oct;87(2):318-24.:



Eye muscle antibodies in patients with ocular myasthenia gravis: possible mechanism for eye muscle inflammation in acetylcholine-receptor antibody-negative patients.

Gunji K, Skolnick C, Bednarczuk T, Benes S, Ackrell BA, Cochran B, Kennerdell JS, Wall JR.

Clin Immunol Immunopathol. 1998 Jun;87(3):276-81.


Select item 8749048 9.

External ophthalmoplegia with ragged-red fibres and acetylcholine receptor antibodies.

Mitsikostas D, Manta P, Kalfakis N, Chioni A, Ilias A, Liakopoulos D, Papageorgiou C.

Funct Neurol. 1995 Jul-Oct;10(4-5):209-15.


Myasthenia gravis during interferon alfa therapy.

Batocchi AP, Evoli A, Servidei S, Palmisani MT, Apollo F, Tonali P.

Neurology. 1995 Feb;45(2):382-3.


Autoimmune myastenia gravis with thymoma following the spontaneous remission of stiff-man syndrome.

Piccolo G, Martino G, Moglia A, Arrigo A, Cosi V.

Ital J Neurol Sci. 1990 Apr;11(2):177-80.



[Two cases of mitochondrial myopathy (focal cytochrome c oxidase deficiency), long-term follow-up on a diagnosis of ocular type myasthenia gravis].

Matsuda Y, Sakata C, Sunohara N, Nonaka I, Satoyoshi E.

Rinsho Shinkeigaku. 1989 Sep;29(9):1180-2. Japanese.


Characterization of anti-acetylcholine receptor antibody activity in patients with anti-mitochondrial antibodies.

Sundewall AC, Lefvert AK, Norberg R.

Clin Immunol Immunopathol. 1987 Nov;45(2):184-95.

Allan Frankel, MD Dr Allan Frankel is one of the few physicians in the US who truly understands Cannabis as a medicine. All treatments suggested have been well studied. Every patient seen by Dr Frankel is given a personally created Treatment Plan created with the patient's specific issues defined. Plant medicine requires "tuning" of the dosing. Dr Frankel works with his patients thru a messaging portal. The use of this portal, allows quick and simple follow up contact with Dr Frankel. Patients are not charged for these messages, as this is how Dr Frankel has learned what he has learned. Follow up appointments in person or by phone/video are also available when needed

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