Updated: Jan 4
CBD, the non-euphoric cousin of THC has taken over as the wonder drug of choice for many conditions that have no real effective treatment or the treatment of choice involves multiple medications.
Whether CBD can carry its weight for pain relief, insomnia distress, anxiety worries, public speaking woes, neurological conditions and others remains to be seen from large clinical trials yet to be conducted. For now, anecdotal evidence of its effectiveness has driven it into a multi-billion-dollar industry.
How Does CBD Work?
All cannabinoids work by attaching to receptors in the body or by interacting with other molecules and creating chemical effects. Most cannabinoids act by interacting with the CB1 or CB2 receptors, but CBD appears to act by encouraging the body to use more of its own endogenous cannabinoid, anandamide, and by interacting with other molecules and enzymes within the body. CBD also interacts and modulates non-cannabinoid receptors- receptors that govern mood, pain and inflammation, for example. CBD interacts with the body’s own endocannabinoid system.
CBD and the Entourage Effect
The " entourage effect" refers to various chemicals from the marijuana/hemp plant that interact together to create a stronger synergistic effect than that achieved by a single chemical alone. CBD interacts with other cannabinoids, terpenes, and flavonoids in the marijuana plant extract that potentiates its therapeutic effects. Dosages from the whole extract of the plant are often effective at lower values than dosages from isolated CBD.
CBD Oil Forms
CBD oil comes in 3 forms and has differing therapeutic effects depending on the type of oil used.
Isolated CBD oil contains only CBD and no other chemical extracts from the plant. Dosages of the isolate are said to run higher due to the lack of synergistic actions of the other chemicals.
Broad form CBD has everything in the plant but THC. Oils can have up to .3% THC but both isolated and broad-based oils have none. So, you get the entourage effect from the other chemicals but not THC.
Full form CBD oil contains .3% allowable THC or less and the CBD, terpenes, flavonoids and all chemicals the plant contributes. Dosages are often lower to achieve desired effects when using full spectrum CBD.
Start low and go slow. There are no evidentiary guidelines from FDA yet for oral consumption but off label guidelines do exist. Proposed dosages are 1-6 mg for every 10 lbs. body weight based on severity of symptoms and type of product chosen to use.
Another set of guidelines based on severity of symptoms is:
General Health: 2.5-15 mg/day
Chronic discomfort: 2.5 – 20 mg/day
Sleep issues: 40-160 mg/day
Elderly patients are often started at a lower dose and increased slowly in coordination with other medications being taken. Since CBD can interact with many pharmaceuticals it is good to have professional guidance.
Can You Take Too Much of CBD?
CBD doses of up to 1200 mg have been taken with no adverse effects. The makers of the CBD drug Epidiolex cautions its patients that too much CBD may have adverse effects on the liver but better designed clinical trials need to be done to verify this.
CBD and Safety
The World Health Organization has given CBD a good safety profile when it comes to side-effects and potential for addiction.
CBD does utilize similar pathways as some pharmaceutical medications so the potential for interaction is present and needs to be considered.
CBD may cause lightheadedness, fatigue, nausea and, paradoxically, an ability to do public speaking.
While the federal government waffles over the legality of taking CBD orally, off label use continues and we just can’t stick our heads in the sand. We should be informed.
How much do you know about CBD?
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This article is not a substitute for medical evaluation, prescription or advice.