CBD (Cannabidiol). Is It Worth The Hype?

Dr Jess says: Cannabis has been used as a traditional Chinese herb for thousands of years. It is more commonly prized for its hemp seeds, which have numerous industrial uses, rather than its leaves (marijuana). Throughout history, the leaves of the cannabis plant have been known to have strong effects and were made illegal in the 20th century in many parts of the world. 

I believe there is a strong case for the use of medical marijuana for pain relief and symptom control in diseases like cancer, MS and chronic pain, yet conversely, I have also seen that marijuana used excessively as a recreational drug can trigger psychotic episodes and mental health problems. 

The extraction of CBD from cannabis gives us the opportunity to use a legal version of this powerful herb without the risk. It is thought that THC (Tetrahydrocannabinol) is the compound in cannabis that causes altered mental function (the ‘stoned’ effect associated with marijuana). CBD products contain less than 0.3% THC, avoiding the psychoactive effects of marijuana, yet they can still deliver considerable health benefits.

I have found CBD oil and products to be useful for anxiety, epilepsy support, sleep issues, stress, some types of pain and cancer support, but I do not believe it is a miracle cure-all, as many manufacturers claim. The only side effect I have observed is that its relaxing effect can mean that if you are fatigued or low in mood and apathetic, you can become even less motivated and less engaged with life. It seems particularly useful for people suffering from anxiety, nervous exhaustion and those who feel wired or highly charged. 

Personally, we have found CBD drinks a good alternative to alcohol for their relaxing effect.

CBD is very safe. It has been tested by human volunteers who were given oral, IV and inhaled CBD in both high and low doses. They were observed over short and long periods of time and experienced very few side effects (mainly tiredness and diarrhoea). 1,2 It has not however been tested extensively in pregnancy and we would encourage you to always consult with your medical practitioner or herbalist before taking any herb in pregnancy. CBD may also interact with other medications, as it uses similar pathways in the liver. 3

Small studies show that CBD may help anxiety, stress and psychosis. Multiple animal studies show that CBD has strong anxiolytic (anxiety-reducing) and stress-reducing effects and could help to treat PTSD. 4,5,6   Research suggests that CBD’s action is through its effect on serotonin and glutamate release. 6 Small randomised, double-blind controlled human trials have shown that CBD can improve simulated anxiety created with public speaking in both healthy 7 people and those with social phobias. 8 The ability of CBD to reduce anxiety has been backed up by brain scans showing that CBD reduces the activity of the area of the brain associated with anxiety.9 Animal studies show that CBD may be a promising support for psychosis and schizophrenia, but further human studies are needed. 6  

CBD is a promising treatment for epilepsy particularly in children and young adults. A small-scale randomised controlled pilot study of patients suffering from generalised epilepsy shows that those taking CBD had an improvement in seizures over a four-month period.10 Several larger studies of children and young adults with intractable (treatment-resistant) epilepsy have also shown a significant improvement with the use of CBD. 11,12,13  

CBD likely has use as a sleep support. The most common side effect of CBD is sedation (feeling drowsy), so it is logical to consider trying CBD if you are struggling to sleep. A pilot case study of a difficult sleep disorder (REM sleep behaviour disorder) which has muscle activity, vivid dreams and nightmares disturbing sleep showed that CBD is an effective treatment. 14   

CBD may improve pain, but there is not enough evidence yet. The endocannabinoid system responsible for the perception and modulation of pain is shown to be affected by CBD, giving us a likelihood that CBD can alter pain. Animal studies have shown that CBD can improve inflammatory, arthritis-related and nerve-related pain. 15  

There are presently only a few human studies – CBD used externally, applied as a gel had a benefit for nerve-related pain in a small study16 and other small studies seem to show that it may be the THC, rather than the CBD, which has the most value in pain relief, supporting the use of medical cannabis for chronic pain conditions rather than CBD alone. 15

Other possible benefits of CBD:

  • May have benefit in Parkinson’s disease from limited human case studies. Animal studies also show improvements in brain function, models of Alzheimer’s disease and neurological conditions. 17
  • Early research in cell and animal models of breast cancer (there are presently no human studies) showed that CBD may slow the progression of breast cancer (all types of tumour) and may stop metastases, but much more research needs to be done. 18
  • May improve hypertension (high blood pressure), but further research is needed. A small human clinical trial showed the benefit of a single dose of CBD on blood pressure after it had been raised by stress, 19 but a review of the evidence suggests this improvement in blood pressure may only occur when stress is the cause of the elevation. 20
  • CBD may protect your brain from damage after a stroke. Early pilot studies and animal research suggests that CBD appears to be able to protect nerve cells when they are damaged after a stroke21 and have shown it may help blood flow to the brain. However, much more research is needed to confirm this. 22

How to use CBD

CBD is best absorbed in fat or oil (or liposomal form), rather than in water-based formulas. Preparations vary widely and so we would encourage you to use CBD products that have been recommended to you by a practitioner and to test new products at low doses for up to two weeks before considering increasing the dosage, as their effectiveness also varies. 

CBD is currently not a well-regulated industry, but many of the adverse events that have been noted are experienced by patients taking synthetic forms of CBD and not the naturally-derived plant sources, which seem to be better tolerated. We would encourage you to choose an experienced and knowledgeable supplier like CBD brothers, who were pioneers in this industry and in our experience have excellent products.

In recreational CBD drinks: Companies like TRIP sell a range of soft drinks that use  CBD and other calming herbs like lemon balm to create a relaxing and enjoyable drink. These can be a useful aid to relaxation. Doses are low (around 15-20mg), so are unlikely to have any negative side effects. 

As CBD oil: CBD is better taken in a fat or oil-based preparation and is commonly sold as an oil. The strength of CBD varies widely and can be anything between 1-5mg of CBD per drop. We would encourage you to start at low dosages with CBD, not exceeding 20mg in one dose, no more than once or twice a day. The effects of CBD can take up to a week to build up, so only then should you consider increasing the dosage incrementally by no more than 5mg per week. 

CBD gummies or capsules: These are an option for people who prefer to take the oil in a solid form, or dislike the taste of the oil. 

As a balm. Anecdotally, many people swear by CBD balm used externally for pain. As CBD is well absorbed in fat, this means it can move through the skin and theoretically makes a balm a good way to use CBD for joint pain.

Not as CBD vapes. We don’t recommend any vaping products at The Natural Doctors as inhaling moisture and vaping products has been shown to cause an increased risk of dangerous lung conditions. 23

Q&A

Is it dangerous to take too much CBD? How much is too much?

Our weight and our individual genetic, physical and physiological makeup seem to change how CBD affects each person. This is why we would encourage you to start taking CBD at a low dose and to slowly increase that dose, while keeping a record of your symptoms. A 2017 review of a number of CBD studies showed that CBD is generally considered safe – even very high doses of up to 1,500mg have been used in trials for several weeks with no observed negative effects, but there are no long term safety studies at this dosage, so we would advise beginning to use CBD with caution. 24

 

References:

  1. Bergamaschi MM, Queiroz RH, Zuardi AW, Crippa JA. Safety and side effects of cannabidiol, a Cannabis sativa constituent. Curr Drug Saf. 2011 Sep 1;6(4):237-49. doi: 10.2174/157488611798280924. PMID: 22129319.
  2. Iffland K, Grotenhermen F. An Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies. Cannabis Cannabinoid Res. 2017 Jun 1;2(1):139-154. doi: 10.1089/can.2016.0034. PMID: 28861514; PMCID: PMC5569602.
  3. Iffland K, Grotenhermen F. An Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies. Cannabis Cannabinoid Res. 2017 Jun 1;2(1):139-154. doi: 10.1089/can.2016.0034. PMID: 28861514; PMCID: PMC5569602.
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