What is CBD?
Cannabidiol (CBD) is a compound derived from hemp for use as a dietary supplement. Though hemp is a type of cannabis, unlike marijuana, it contains only trace amounts of THC, so it has no psychoactive effects, nor will it show up in drug screening unless significantly high doses are used (high dosing would simply require specialized drug testing). Though CBD is legal in all 50 states, it cannot be grown or harvested in the US at this time, so it must be imported.
How CBD works
CBD activates receptors in the endocannabinoid system (ECS). All vertebrates make their own endogenous cannabinoids, and receptors are found throughout the brain/nervous system, organs, connective tissues, glands, and immune cells. The ECS performs different tasks in each area of the body, but the goal is always the same: maintaining homeostasis, a stable, steady state in the body’s internal environment despite fluctuations in the external environment. These compounds act as a bridge between body and mind. Understanding how this system operates helps to explain how states of consciousness can contribute to health or disease.
The three key components of the ECS are found within almost every major system of the body and include:
- Cannabinoid receptors are found on the surface of cells…they appear to “listen” to extracellular conditions and trigger the appropriate intracellular response
- Endocannabinoids are molecules made within the body that activate cannabinoid receptors
- Metabolic enzymes break down endocannabinoids after they are used by the body
How Could CBD Help You?
As a science-based practitioner, I’m always extremely skeptical of any type of medication or supplement that is marketed as a cure-all. However, given the unique nature of the body’s own endocannabinoid system, it’s no wonder that a compound that activates these receptors can help to normalize or improve such a wide diversity of conditions and symptoms. The following list of conditions that are known to respond well to CBD is provided by Project CBD. Click any condition in the list to see links to all the research compiled by Project CBD for that topic:
- General
- Acne
- ADD and ADHD
- Addiction
- AIDS
- ALS
- Alzheimer’s Disease
- Anorexia
- Antibiotic Resistance
- Anxiety
- Atherosclerosis
- Arthritis
- Asthma
- Autism
- Bipolar
- Cancer
- Colitis and Crohn’s
- Depression
- Diabetes
- Endocrine Disorders
- Epilepsy and Seizures
- Fibromyalgia
- Glaucoma
- Heart Disease
- Huntington’s Disease
- Inflammation
- Irritable Bowel Syndrome
- Kidney Disease
- Liver Disease
- Metabolic Syndrome
- Migraine
- Mood Disorders
- Motion Sickness
- Multiple Sclerosis (MS)
- Nausea
- Neurodegeneration
- Neuropathic Pain
- Obesity
- OCD
- Osteoporosis/Bone Health
- Parkinson’s Disease
- Prion/Mad Cow disease
- PTSD
- Rheumatism
- Schizophrenia
- Sickle Cell Anemia
- Skin Conditions
- Sleep Disorders
- Spinal Cord Injury
- Stress
- Stroke and TBI
Because CBD hasn’t been widely marketed until recently, we’re still learning about the many different ways it can be used, and even how to determine the correct dosing for each patient or condition. Because the ECS is spread throughout so many different systems and tissues in the body, and each person has their own unique imbalances, dosing and response times will vary.
Potential Drug Interaction
Also, since CBD is metabolized down the P450 pathway in the liver, the same metabolic pathway that processes over 60% of pharmaceuticals on the market, there is some potential for drug interaction. In one study, it was determined that CBD was a slightly more potent inhibitor of these liver enzymes than Bergapten, a P450 inhibiting compound found in grapefruit. However, in most research settings, CBD is used as an isolate, not as part of the whole plant with all the other plant constituents, which increases the likelihood of side effects, and the doses ranged from 25-40 mg daily, which is significantly higher than most patients require to regain homeostasis in the ECS.
Choosing the Right Product and Dosage
When CBD first caught my attention a few months ago, I spent weeks researching different companies and learning as much as I could about CBD. I finally settled on a vendor whose products are non-GMO, gluten-free, made from raw CO2-extracted hemp, free or artificial ingredients, and are EU certified organic. Though CBD can be freely purchased online, because I would feel most comfortable providing some guidance to first-time purchasers, I have chosen not to share the company name in an open forum at this time.
In our product line, “green” products contain 100% of plant constituents and are my preferred starting place. “Gold” products are high CBD, but not whole plant, so if I recommend a gold product (pain, hyper-stress states), I think it is best layered in with a green product to get the benefit of the whole plant and all the synergistic compounds, with lower risk of side effects.
My recommendation is to start with a “green” or whole plant product that delivers 1-3 mgs per dose, and use it 2-4 times daily, holding the oil in your mouth for 20 seconds or so to allow for the CBD to be absorbed sublingually. If you tend to be sensitive, you can start with an even smaller dose, and just slowly increase until you start to see the desired effects. If you’re seeking pain relief, or are extremely anxious, you may need to add in a “gold” product that delivers a more concentrated amount of CBD—always start with the lowest available dose and increase per your response. I would recommend continuing the “green” or whole plant product alongside it to provide the synergism of all the plant constituents. As you get started, simply pay attention to how you feel and increase or decrease your dose accordingly. For most patients, it takes around two weeks to establish your best dosing range, and the goal is always to find the smallest effective dose. Over time, as the ECS becomes balanced, you should be able to slowly lower your dose and discontinue. This may take several weeks to several months, or longer if symptoms are long-standing or severe, or if stress levels remain high.
Personally, I have found CBD oil to be the best sleep intervention I’ve found to date. I have landed on a dose of 3 mgs around 6 pm when I finish work for the day, then another 3 mgs at dinner, and my last dose of 3 mg at bedtime. I rarely wake through the night now with “monkey mind” and when I do, another 3 mg dose puts me back to sleep in about 10 minutes. After about 5 weeks of usage, I can say for sure I am also noticing a calmer, more focused brain. My preference is the peppermint flavored drops.
If any of you are already using CBD oil, please feel free to comment below. This is how we learn how to advise other users.
Edit from spring 2017: We’ve had major success with CBD oil! Check out our CBD Success post for more info on specific dosage guidelines and testimonials.
Patty Shipley, Naturopath, RN, Herbalist