EFFICACY OF CBD AND THCV IN THE TREATMENT OF PATIENTS WITH METABOLIC SYNDROME: A SYSTEMATIC REVIEW

Abstract

Metabolic Syndrome is a complex and growing clinical condition, associated with factors such as obesity, dyslipidemia, hypertension, and insulin resistance, whose prevalence has increased due to lifestyle changes. Its combined manifestation significantly increases the risk of systemic and neurological diseases. Despite the various therapeutic approaches, there is still no single and effective treatment. In this context, Cannabis derivatives, such as Tetrahydrocannabivarin (THCV), stand out for their anti inflammatory, appetite-regulating, and metabolic-modulating effects. These effects are mediated by the endocannabinoid system, composed of CB1 and CB2 receptors. In particular, THCV presents a dose-dependent action: it antagonizes the CB1 receptor at low doses (reducing appetite and anxiety) and acts as a partial agonist of CB1 and CB2 at higher doses, promoting anti-inflammatory effects. OBJECTIVE: This systematic review aims to analyze the effects of THCV on weight loss and inflammation in patients with Metabolic Syndrome. METHODS: This study consists of a systematic literature review, following the PRISMA protocol guidelines. The search was conducted in the Cochrane, PubMed, American Diabetes Association, and International Journal of Neuropharmacology databases, using MeSH descriptors and free keywords combined with Boolean operators (“THCV” AND “Metabolic Syndrome”). Randomized clinical trials published between 2000 and 2025, without language restriction, that assess the efficacy of THCV in Metabolic Syndrome were included. Duplicated studies, narrative reviews, and opinions, as well as those not directly addressing the topic, were excluded. Results: The reviewed studies reveal that the oral administration of 10 mg of Tetrahydrocannabivarin (THCV) in healthy volunteers does not alter subjective experience but promotes a reduction in the functional connectivity of the default mode network and an increase in connectivity between brain regions involved in executive control, indicating a specific modulation of neural circuits related to cognitive processing and reward (Rzepa et al., 2015). In a clinical study with 44 participants who used mucoadhesive strips containing varying doses of THCV and Cannabidio (CBD) for 90 days, significant weight loss, reduction in abdominal circumference, systolic blood pressure, and total LDL cholesterol were observed, with the highest dose (16 mg THCV/20 mg CBD) showing superior metabolic effects compared to the lower dose and placebo (Smith, 2025). In patients with type 2 diabetes, the combined administration of THCV and CBD for 13 weeks resulted in significant improvement in fasting glucose, pancreatic beta-cell function, as well as a reduction in adiponectin and apolipoprotein A, while maintaining stable plasma HDL, and showing good tolerability without relevant adverse effects (Jadoon et al., 2016). Conclusion: The findings of case-control studies indicate that Tetrahydrocannabivarin (THCV), both isolated and combined with Cannabidiol (CBD), holds promising and effective therapeutic potential for the treatment of Metabolic Syndrome and associated syndromes, acting both on functional brain modulation and improvement of metabolic parameters. THCV’s ability to alter connectivity in neural circuits related to executive control and reward indicates a positive impact on eating behavior and energy regulation. Moreover, clinical interventions show significant support in weight loss, glycemic control, blood pressure reduction, and lipid profile improvement, especially when combined with CBD. Furthermore, the tolerance and safety of these substances are favorable and reinforce their potential as agents for the management of metabolic disorders, paving the way for new therapeutic strategies that integrate the benefits of phytocannabinoids in medicine.