Article at a Glance
- Strict drug laws prevented cannabis and CBD research for years.
- Now that the laws are changing, we are seeing new studies evaluating potential health benefits of CBD.
- The medical benefits of CBD began with treating seizures, however, CBD is now emerging as a promising sleep aid and a natural treatment for anxiety.
- Some studies have even looked at CBD’s ability to relax and improve the performance of people who are nervous about public speaking.
- Vapes, salves and sublingual administration appear to be the most bioavailable ways of taking CBD.
Scientifically reviewed by Dr. Aaron Gardner
It seems like CBD is everywhere these days.
Case in point: fast food chain Carl’s Jr. just announced it plans to test a burger with CBD-infused sauce in Colorado. CBD has the lowest bioavailability when taken orally so it’s unlikely the burger will impact anything other than wallets and waistlines, but the marketing department at Carl’s is to be congratulated for thinking outside the box.
So, what is CBD, what health conditions is it rumored to benefit, and what’s all the noise about?
- CBD, Industrial Hemp and the Farm Bill
- How Does Cannabidiol (CBD) Work in the Body?
- What are the health benefits of CBD?
- Charlotte’s Web and Epidiolex: CBD-based pioneers
- Health Benefits of CBD Rated by Science Grade
- Pain Management
- Digestion and Gut Health
- If I want to try CBD, how should I use it and what dose should I take?
- Sublingual CBD
- CBD Vapes
- CBD Salves
- Which CBD products could benefit my health conditions?
CBD, Industrial Hemp and the Farm Bill
Cannabidiol (CBD) is one of more than 100 active compounds found in the cannabis plant. Cannabidiol is bioactive, but it’s not psychoactive. That means it doesn’t get you high like THC, the psychoactive compound in marijuana.
Cannabis plants high in THC, grown for recreational or medical use, include cannabis indica and cannabis sativa. Industrial hemp is a variety of cannabis sativa which has very low THC content and high CBD (cannabidiol) content. The 2018 Farm Bill signaled a huge change for industrial hemp in the U.S. It’s one of the main reasons there’s so much excitement around CBD because it means that industrial hemp used for CBD oil can be legally grown in the U.S. for the first time in decades.
Industrial hemp with no more than .03% (negligible) THC content is now legal in all 50 states, although most states are still setting up their licensing programs. In the past, hemp and CBD products had to be made from imported industrial hemp. A few states, including Montana, Colorado and Kentucky, had previously operating industrial hemp study programs which provide some raw materials for high-end hemp-based CBD companies to process into CBD oil. Charlotte’s Web is a strain of high-CBD, low-THC cannabis sativa grown in Colorado, and some other companies use industrial hemp grown in Kentucky for research and development purposes.
Industrial hemp isn’t just a good raw material for rope, fabric and smoothies in the form of hemp seeds. Its low THC/high CBD content makes it ideal for producing CBD oil, the basis of health-related CBD products.
How Does Cannabidiol (CBD) Work in the Body?
CBD binds to receptors in the endocannabinoid system (ECS). Most animals have an endocannabinoid system, which may have begun to develop as long as 600,000 years ago.
We make endogenous cannabinoids, including anandamide and 2-arachidonoylglycerol (2-AG). Anandamide attaches to CB1 receptors, found primarily in the brain and central nervous system. Its name was inspired by the Sanskrit word for “bliss.” 2-AG binds to both CB1 and CB2 receptors, which are found throughout the body, including the skin, muscles, joints, and organs. Two additional receptors have been proposed and are still under study: PPAR and TRP.
The ECS has more receptors than the endogenous opioid system. Still under study, the endocannabinoid system plays a role in regulating body functions and maintaining homeostasis. The ECS influences a wide range of bodily functions, from fertility to pain and from mood and stress to sleep. The ECS also plays a role in the immune system, including regulating inflammation and food tolerance.
Both CB1 and CB2 receptors influence gut health. To what extent and in which specific ways continue to be studied.
What are the health benefits of CBD?
If you listen to the marketing, CBD is a cure all.
As with many supplements, it’s likely the marketing has outpaced the science, but it’s also important to point out that the drug laws in our country have stifled CBD and cannabis research for years. Bottom line is we are just now learning all the benefits of CBD, and they do appear to be numerous, but more research is needed.
Charlotte’s Web and Epidiolex: CBD-based pioneers
The first hemp/CBD-based pharmaceutical approved by the U.S. Food and Drug Administration was Epidiolex. Epidiolex was approved in 2018 for use in children with severe epilepsy, including Lennox Gastaut Syndrome (LGS) and Dravet Syndrome. The drug was developed and approval was eventually granted primarily because of the experiences of Charlotte Figi, who was just 3 months old when she began suffering severe Dravet Syndrome seizures.
Charlotte’s seizures did not respond to traditional treatment. By age 5, she could no longer walk, talk, or eat unassisted and her parents were told to take her home and put her in hospice. At this point her parents tried a form of marijuana with very low THC and high CBD content. After months of regulatory battles to permit use of this type of marijuana with a child, Charlotte’s parents were given the go-ahead and purchased enough low-THC marijuana for a friend to extract CBD oil.
After just one dose, Charlotte stopped having seizures for a full 7 days. As the first batch of oil ran out, Charlotte’s mother Paige heard about the Stanley Brothers, the largest medical marijuana growers in Colorado. The brothers had been crossbreeding strains to produce a low-THC, high-CBD plant — but couldn’t sell it. The plant is now considered a variety of industrial hemp, Charlotte’s Web. Charlotte’s Web CBD-based products are available to the public not just for epilepsy but a variety of other potential health uses. Because they are hemp-based and contain no THC, they are legal for use in all 50 states.
Health Benefits of CBD Rated by Science Grade
The ECS is such a large body system that CBD may have potential benefits from head to toe.
CBD may help you sleep. Consumer Reports conducted a nationally-representative survey learning that 10 percent of people who tried CBD used it as a sleep aid. The majority of people surveyed who’d used CBD to help them sleep told Consumer Reports that it worked. A Colorado-based mental health clinic conducted a study of adult patients with anxiety and sleep disorders who took CBD as part of holistic mental health treatment. After one month of treatment, nearly 80% of patients reported improvement in sleep and anxiety symptoms. Research is beginning to indicate potential CBD benefits for post-traumatic stress disorder (PTSD), social anxiety disorder, and anxiety-related conditions including obsessive-compulsive disorder.
CBD may help with pain, especially joint pain resulting from rheumatoid and osteoarthritis. Daniel Clauw, MD, a chronic pain researcher at the University of Michigan, recommends CBD to patients and says that it “appears very safe.” He noted that a recent trial had found that CBD was effective in relieving OA knee pain. He recommends low doses of CBD-based products of 5 to 10 mg daily.
Digestion and Gut Health
CBD may help relieve or reduce symptoms of IBD, IBS, or Crohn’s disease and related inflammatory bowel diseases. Most prior studies have been done on rats and other animal subjects. An increasing number of clinicians are beginning to use CBD to potentially benefit patients with IBS or IBD. Preliminary studies of CBD’s use in Crohn’s Disease showed no clinical benefits, but the study also showed CBD resulted in no harm.
Studies have begun to show promise of CBD in treating addiction disorders. A pilot study in Addictive Behaviors showed that tobacco smokers who used CBD inhalers (vapes) smoked less tobacco and had virtually no nicotine cravings. Other studies are beginning to indicate there may be benefits of CBD in reducing withdrawal symptoms resulting from opioid use disorders.
Marinol, a synthetic form of THC, has been an approved pharmaceutical remedy for cancer-related nausea for years. Patient information offered by the American Cancer Society focuses on THC and medical marijuana, not hemp-based CBD containing no THC. Animal and cell studies have shown promising results in CBD slowing or halting the growth of cancer cells in the lab. The official word about cancer and CBD is that cannabinoids are safe and non-harmful, but there are no human-based clinical studies proving it benefits any specific cancer treatment.
If I want to try CBD, how should I use it and what dose should I take?
CBD is bioactive, not psychoactive, so if you ensure you’re buying a CBD product that’s 100% free of THC, you will not feel “high” after taking it. Look for products from companies that have reliable third-party testing programs that ensure that their products are free of toxins, contaminants, and THC. If you’re in California or Colorado, a lot of the CBD products out there have more THC:CBD than in states like New York that have yet to legalize marijuana. Test reports should also indicate the level of additional compounds found in hemp which may have synergistic benefits like flavenoids and terpenes.
CBD’s bioavailability varies depending upon how it’s administered, and different forms have different effects. CBD edibles like gummies or candies can be poorly absorbed, with only 6 to 20% of the compounds making their way past the wall of the gut and into the blood.
CBD oil can be taken sublingually. Sublingual CBD puts the compound into your bloodstream quickly and it will also increase the amount of CBD your body can absorb. CBD oil tinctures are one of the most common ways people with sleep or anxiety needs consume CBD. A standard beginning dose of sublingually-administered CBD oil is 5 to 10 mg. Sublingual CBD bioavailability rates range from 12% to 35%.
CBD vapes deliver 46% to 56% bioavailability. Vapes offer relief quickly, but the effects generally last 3 to 3 hours, not as long as orally-administered CBD, which may last from 4 to 6 hours.
CBD salves, lotions and creams can have a high rate of local absorbtion into skin, muscle and joints. Tests have been conducted on animals to determine how much CBD enters local endocannabinoid receptors when a cream or salve is rubbed into an aching joint. Topical CBD is usually absorbed locally without entering the bloodstream. Transdermal CBD patches do deliver CBD into the bloodstream and have high bioavailability, but they tend to be among the most expensive CBD-based products.
Which CBD products could benefit my health conditions?
CBD is still considered an herbal supplement, so aside from Epidiolex, no health claims of any type can be made by any manufacturer.
That said, if you’d like to try CBD for sleep and anxiety, a CBD tincture like the ones made by Curaleaf Hemp could be a good starting point. A bottle with 100 mg of CBD in a tincture could provide 20 doses of 5 mg to start. A CBD vape will work quickly with high bioavailability, and if used for sleep, its relatively short action of 2-3 hours won’t matter, because you will be asleep when it loses its effect.
If you’re suffering joint or muscle pain, CBD salves seem to be the most popular and most-effective according to anecdotal evidence of people with osteoarthritis or injuries. A jar of CBD lotion with 300 mg of CBD could provide up to 60 5-mg applications of CBD. CBD is safe to reapply so if initial pain relief goes away after 2-3 hours, a second or third application throughout the day can offer additional relief.
CBD edibles may smell “weedy” but are usually tasty. A 25 mg gummy will probably provide 5 mg of bioavailable CBD, so be aware of that factor when buying and using CBD edibles.
CBD’s effects may increase over continued use. Animal studies have indicated that CBD seems to encourage further growth of endocannabinoid receptors. Unlike other substances which may develop dependency, CBD may actually require smaller applications over time to achieve the same results experienced when first used.
CBD is not a miracle cure-all and it also doesn’t affect everyone in the same way. There are no reported harmful effects or health risks to date, including no indication of toxicity or overdoses. CBD is also not psychoactive. CBD moderates the effects of THC as a partial agonist on CB1 receptors in the central nervous system. This is the reason you may find CBD/THC mixtures recommended as “recovery” doses for people who have experienced undesired effects from too much THC. Although too much THC can result in unpleasant psychological symptoms, unlike some prescribed pharmaceutical medications, like CBD, there are no known deaths resulting directly from a THC overdose.