I want to thank the wonderful people taking my successful AIP Course for the inspiration and motivation to dive into this topic in detail: I started fielding questions about CBD use for autoimmune diseases, and I ended up going on a deep dive into the scientific literature. This blog post is a result of that search!
What is CBD? CBD is an abbreviation for the phytochemical cannabidol, a non-psychoactive component of Cannabis sativa (AKA marijuana, the recreational drug that receives a lot of attention in the media and is legalized for recreational or medical use in some states in the United States). This is a different constituent from THC (tetrahydrocannabinol), the phytochemical responsible for the mental changes associated with marijuana use. So, when we talk about CBD, we’re talking about an isolated chemical compound from Cannabis that will not have any effects on personality apart from potentially being calming/relaxing.
I’m sure that some of you are wondering, “but isn’t this stuff illegal, at least in some states…?” And the answer to your question would be: well, kind of. In the US, the federal Controlled Substances Act controls substances with a psychoactive nature or that have abuse potential. Classification of a substance depends upon its medical effectiveness and abuse potential. Marijuana and its cannabinoid components are currently Schedule I substances, the criteria for which is that there’s no currently-accepted medical use, high potential for abuse, and lack of accepted safety for use of the drug under medical supervision. Whether Cannabis and its components are appropriately designated has been under debate for quite some time. However, CBD can also be isolated from hemp – another strain of Cannabis that is rich in CBD and does not have psychoactive properties. The use of hemp is one way that companies are able to legally manufacture CBD products.
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Since 1996, there has been a large push to legalize marijuana in multiple forms, including CBD, across the United States. Currently, CBD is not listed separately from high-THC marijuana, which makes sourcing CBD a challenge. As of 2018, 25 states and the District of Columbia have made medical marijuana legal, and another 17 states have legalized products that are high in CBD and low in THC.
So, long story short, the legality of CBD products is entirely dependent upon where you live! Please keep that in mind as you read. There is considerable evidence of medical benefit of CBD use, so that is what I will discuss here.
CBD for Nerds: The Pharmacology and Physiology of Cannabinoids
Cannabis sativa, despite its controversial legal status, has been studied extensively, and it is known to have hundreds of bioavailable chemical compounds that are psychoactive and not. These compounds can activate that naturally-occurring endocannabinoid receptors of the human nervous system and elsewhere.
The major bioactive phytocannabinoids include:
- Cannabidol (CBD)
- Cannabichromene (CBC)
- Cannbigerol (CBG)
- Cannabidivarin (CBDV)
- Tetrahydrocannabivarin (THCV)
- Tetrahydrocannabinol (THC)
That last compound, THC, is the most common phytochemical component of cannabis and is responsible for its psychoactive properties, and CBD is the second most common constituent of the plant. THC is similar in structure to CBD, with the ring structure and long hydrocarbon chain forming a tail. Despite this similarity, these compounds elicit different responses in the body; their pharmacological properties depend on how they interact with the endocannabinoid receptors and enzymes of endocannabinoid synthesis and degradation.
THC creates changes in mental status, motor function, memory, and body temperature by interacting with the CB1 and CB2 receptors in the endocannabinoid system. This effect can manifest as increased heart rate, anxiety, hunger, and eventually sleepiness. But, the presence of CBD lowers THC’s affinity for these receptors and thus reduces these collateral effects, making consumption of THC with CBD much safer than THC alone.
Some aspects of CBD pharmacology are still being researched, especially the pharmacodynamics (i.e., the mechanism of action) across many systems. But, there is a lot that we do know now.
CBD interacts with several important receptors throughout the body that are responsible for its physiological effects and potential medical benefits.
One example is that it acts in the body much like the compound capsaicin, an anti-inflammatory compound found in red peppers. CBD and capsaicin both bind to the receptor called TRPV1, which is known to mediate pain, inflammation, and body temperature. Fun fact: this receptor is referred to as a “vanilloid receptor,” because it mediates the effects of a wide range of medicinal herbs, including vanilla – a known antiseptic and analgesic. Cool, right?
At high concentrations, CBD activates the serotonin receptor 5-HT1A. Activation of this receptor triggers a cascade of intracellular signals that result in an increase in the production of serotonin. Serotonin is an important neurotransmitter for mood regulation, and deficiency in serotonin is associated with both depression and anxiety. This receptor has been implicated in a range of physiological processes, including anxiety, addiction, appetite, sleep, pain perception, nausea, and vomiting. Interestingly, the form of CBD found in unheated plant matter, cannabidiolic acid (CBDA), has an even stronger affinity for this receptor, which could be important when considering which forms of the compound could have the most impact.
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On the other end, CBD blocks another receptor called the GPR55 receptor, which is also called the “orphan receptor” because it hasn’t been identified as belonging to any other class of receptor. Overactive GPR55 is associated with risk for osteoporosis and cancer cell proliferation, so, as an antagonist, CBD is believed to decrease bone reabsorption and cancer cell proliferation. There is another mechanism for CBD as an anti-cancer agent: it activates PPARs, which are associated with anti-cancer proliferation, tumor regression, and degradation of plaques associated with Alzheimer’s disease. PPAR receptors are also associated with energy homeostasis, liquid regulation, insulin sensitivity, and other aspects of metabolism.
Finally, CBD acts on certain receptors by changing their structure and influencing how they respond to their substrates. One important example is that CBD acts as a positive allosteric modulatory of the GABA-A receptor, amplifying the calming effects of the amino acid/neurotransmitter, GABA.
The broad-ranging actions of CBD are responsible for its diverse health benefits, indicating potential medical use for a wide range of conditions.
Medical Uses of CBD by System
There are a few biological systems and disease conditions in which CBD has been extensively studied as an pharmaceutical intervention. Together, these studies demonstrate the compelling therapeutic potential for CBD. Let’s review this exciting research!
Immune system and inflammatory diseases.
The immune system is one area of health where CBD has been very well-studied. While there is some difference in the effect based on the amount of CBD used as well as the studied immune stimulus, the overall effect of CBD is immunosuppression. Interestingly, we see this effect through activation of the CB1 and CB2 receptors that we mentioned in the previous section. It’s been established that CBD has a strong capability to inhibit the production of the inflammatory cytokines interleukin 1-beta (IL-1β), interleukin 6 (IL-6), and interferon gamma (IFN-γ).
One well-studied example is inflammatory lung disease. There is a lot of evidence that use of CBD reduces the immune response, allowing the lungs to function appropriately. Specifically, CBD inhibited the migration and action of several immune cells, including neutrophils, macrophages, and lymphocytes and their associated pro-inflammatory signaling molecules called the cytokines.
CBD has also been studied in the context of degenerative diseases with an inflammatory etiology. Notably, there are some implications in the progression of the neurodegenerative diseases Parkinson’s, Alzheimer’s, multiple sclerosis, and HIV-associated dementia as well as cancer. The understanding here is that CBD inhibits cells called microglia, which are kind of like the clean-up cells of the nervous system and act like a lot of immune cells: when they function properly, they are critical to health, but overstimulation of them can cause diseases of the nervous system. That kind of sounds like an autoimmune disease, doesn’t it?
Outside of the action on the CB receptors, CBD has even more anti-inflammatory effects! Specifically, CBD decreases the movement of blood leukocytes by down-regulating some chemokines and vascular adhesion molecules. This increases motor functioning and has resulted in improvement of some autoimmune conditions. So, in combination with its effects on microglia, it looks like CBD has some potent neuropotential effects.
There’s more – seriously! CBD also acts as an anti-inflammatory molecule at the level of the retina of the eye, so it’s been implicated as a potential therapeutic for inflammatory eye diseases like uveitis (inflammation of the uvea), age-related macular degeneration, and diabetes-related glaucoma.
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You may be thinking about whether inflammatory bowel diseases like Crohn’s disease are also going to show up on this list. The answer is yes! In fact, CBD is an incredibly promising therapeutic for Crohn’s, because it modulates the secretion of interleukins 10 and 12 by macrophages in the gut. It has also been shown to inhibit the recruitment of mast cells and macrophages in the intestines, leading to a significant reduction of the inflammatory molecule TNF-α. Some preliminary studies have confirmed a reduction of symptoms in patients with Crohn’s – a huge relief for people in a lot of pain.
As you may suspect, CBD is being studied as an immunomodulating compound in the management of autoimmune diseases. This acts by reprogramming pathological memory T cells (the ones that tell the immune system to attack our bodies). One recent study confirmed that the immunomodulatory effects of CBD are mediated through the induction of regulatory T cells — this is an extremely exciting result because the insufficienty and/or inactivity of Treg cells is a main driver of all autoimmune diseases (and perhaps immune diseases as well). See also The Autoimmune Protocol and check out the AIP Lecture Series
If that kinda-sorta sounds like a miracle, it might be. Researchers are still trying to investigate the details. Despite all we do know, there is a lot that we don’t know about how CBD is related to immune activation in times when we want an immune response. Namely, the ability to fight infection, especially in healthy people. We also don’t have clear guidance from the literature on optimal dose, timing, or form of CBD to maximize benefits and minimize any potential risks. Still, I am super excited to watch the literature and see what scientists come up with in this field!
Nervous system.
As I already mentioned, we also have some evidence when it comes to nervous system function. CBD has been shown to have the following properties in the nervous system:
- Neuroprotective – CBD seems to be able to preserve neuronal structure and function, at least in cell cultures and in animal models of neurodegenerative disease.
- Antioxidant – cells cultured with CBD have been shown to help cells cope with oxidative stress, mitochondrial dysfunction, inflammatory changes, excitotoxicity, iron accumulation, and protein aggregation (all features of neurodegenerative disease).
- Analgesic – there is a lot of evidence that CBD exhibits an analgesic effect (reducing or eliminating pain), but scientists are still trying to understand the mechanism here.
- Anti-psychotic – some new evidence is suggesting that CBD may be used for the prevention and treatment of psychosis, which has been linked to neuroinflammation, but large-scale randomized trials are still needed.
- Anti-anxiety & antidepressant – CBD has long been known as a therapeutic for animal models of anxiety and stress, with administration leading to reduced muscle tension, restlessness, fatigue, problems in concentration, and behavioral and physiological measures of stress. This has been corroborated in some small human trials.
There are also some specific examples of CBD in neurological diseases. One important example is that CBD has been shown to reduce infarct size in models of stroke, and there is some evidence that it protects against epithelial cell damage in the brain. How? Activation of the PPAR receptors we discussed above!
Even still, there are some limitations to CBD use. While there is good-quality evidence that CBD improves pain compared to placebo in humans, it seems to have some tolerance issues and might interact with important drugs such as anti-convulsants and HIV protease inhibitors. As with a lot of what we discuss in this post, more studies are needed and high-quality evidence is essential. Scientists are hoping to also explore research of CBD for other psychiatric disorders, including:
- Obsessive-compulsive disorder
- Panic disorder
- Post-traumatic stress disorder
- Social anxiety disorder
See also Paleo for Mental Health
Cardiovascular system.
My guess is that you may have heard about the effects of CBD on the inflammation and the nervous system, but did you know that there are other known and proposed medical benefits? In fact, several studies in the past few years have demonstrated that the cardiovascular system may be an important target for cannabinoids.
CBD has an effect on the cardiovascular system by interacting with CB receptors that are at the central level, inhibiting the release of neurotransmitters and acting on the sympathetic nervous system. This in turn controls cardiovascular function, specifically by relaxing blood vessels and impacting health by temporarily reducing high blood pressure. It looks like CBD may also help with hypertension by promoting the release of the chemical nitric oxide, a potent vasodilator. The specifics of the mechanism(s) behind CBD’s anti-hypertensive effects are still being investigated. Some evidence also suggests that CBD may fight arterial plaque. The underlying mechanism for this is likely due to its anti-inflammatory, anti-oxidant properties. Other diseases being investigated in this realm are heart failure and ischemic injuries. See also The Paleo Diet for Cardiovascular Disease
Cancer.
You may have already heard of CBD in the context of cancer treatment and prevention. But, what does the evidence actually say? It looks like CBD may be anti-proliferative for several types of cancer cells, which is (potentially) a huge deal! One of the best-studied relationships between CBD and cancer cells is with breast cancer. It looks like CBD inhibits the proliferation of estrogen-positive and –negative breast cancer cell lines in laboratory studies. Studies have established a few different mechanisms, which seem to demonstrate that CBD targets the metabolically overactive cancer cells over normal mammary tissue. CBD also seems to reduce the chance of invasiveness in human lung cancer cells, making it very protective when it comes to lung cancer. Additionally, CBD shows antiproliferative effects with colorectal cancer, one of the major causes of morbidity and mortality in the Western world. Similarly, it looks like CBD may have anti-cancer and therapeutic value when it comes to brain and lung cancer as well.
More generally, the anti-inflammatory effects of CBD seem to be preventative when it comes to cancer. This makes sense considering some recent evidence that inflammation is very strongly related to cancer. See The Link Between Cancer and Autoimmune Disease.
CBD Products
Just doing a quick Google search for CBD products, SO many options come up: creams, salves, sprays, lozenges, oils… it goes on and on! So, what does the research say about these products? Well, the bottom line is that the above studies have mostly been conducted in animal models and/or used internal supplementation (pills/oils) that are in SUPER high doses. When we look at the possibility of taking CBD ourselves, we have to think about the form of the product and the amount of CBD we are actually going to get from each product. This comes down to bioavailability, which varies from product to product as well (and isn’t that well-studied).
The bioavailability of CBD depends on the different forms of it that are used. Research has shown that oral intake of CBD results in bioavailability between 13% and 19%. If that doesn’t seem like great bioavailability to you, that would be correct – it isn’t. Plus, metabolism of CBD is mostly regulated by the liver, where it is subjected to several modifications that influence its uses in the body (this is important to note for anyone who may have liver disease or is worried about the burden of other medications or supplements on their liver function). The established half life of CBD is 9 hours, meaning that it takes about 9 hours for the volume of CBD to be decreased in the blood by 50%, so the effectiveness of CBD can last about half a day.
Something interesting that I saw in the literature is that there is some evidence that injectable CBD might be the most ideal form for serious medical intervention, especially in cases of neurological disease, because it easily crosses the blood brain barrier without being modified by the liver. Given the barriers to CBD use presently in the current system, it seems like we’re a ways away from being able to implement this in medical intervention style. I can totally see IV CBD being available in medical clinics in the future if the legal barrier is eventually removed. Even still, injection is a relatively unpleasant way of getting a medicine!
As of 2018, 25 states and the District of Columbia have made medical marijuana legal, and another 17 states have legalized products that are high in CBD and low in THC. In states where recreational and medical use of cannabis is legal, the amount of THC is tracked and recorded for consumers. Likewise, the amount of CBD can be determined and reported to consumers, depending on the product and that person’s goals (medical or otherwise). Otherwise, quality and concentration of CBD can be less regulated.
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Notably, studies so far have found that CBD has very low if any potential for toxicity, largely due to the fact that it has no psychoactive effects. It also doesn’t seem increase genetic mutations or cause issues with growing fetuses in the womb (although more data is needed to definitively prove that CBD is not teratogenic). But, that doesn’t mean we have really clear-cut evidence regarding what the best dosage of CBD is.
Since there isn’t a lot of good research here, it’s hard for me to make any specific recommendations – especially not based on the evidence that we have available at this point. The most common dosage in practitioner-brand CBD products is about 10mg in oral form, which translates to about 1.3-1.9mg of actual CBD action. Salves and other topical forms have a variety of dosages, and it looks like they are less bioavailable than oral options. So, always take that information into consideration if you’re considering investing in CBD.
Quick Words of Caution
There is a lot of information out there that suggests CBD could be a potent medicinal chemical that could be helpful in the treatment and prevention of many diseases. That being said, I want to take a moment to pause and encourage some critical thinking regarding the level of evidence that is currently available to us.
The vast majority of studies to date are in animal models and with cell studies – in fact, I’m not aware of a single published paper that delineates a gold-standard, randomized controlled trial with appropriate placebo and/or comparative effectiveness studies examining the effects of CBD in humans. It looks like there is a current Phase I trial investigating the effects of CBD, but results may be years away. So, I don’t want my readers to leave this post assuming I think CBD is the answer to all medical problems even though I do think it’s very promising (of course, not a substitute for a healthy diet and lifestyle).
Take-Home Message
From what we know so far, there is evidence that CBD could be very helpful for a variety of medical conditions. While CBD research is certainly promising, we are in need of well-controlled human studies to delineate effects versus potential risks and to identify optimal dosing protocols. I absolutely can’t wait to see where this exciting field goes!
Have you tried CBD? Share your success stories (or otherwise) below!
Selected Citations
Pisanti S, Malfitano AM, Ciaglia E, et al. Cannabidiol: State of the art and new challenges for therapeutic applications. Pharmacol Ther. 2017;175:133-150.
Nagarkatti P, Pandey R, Rieder SA, Hegde VL, Nagarkatti M. Cannabinoids as novel anti-inflammatory drugs. Future Med Chem. 2009;1(7):1333-49.
Russo EB & Marcu J. Cannabis pharmacology: the usual suspects and a few promising leads. Cannabis Pharm. 2017; 67-134.
Bíró T, Tóth BI, Haskó G, Paus R, Pacher P. The endocannabinoid system of the skin in health and disease: novel perspectives and therapeutic opportunities. Trends Pharmacol Sci. 2009;30(8):411-20.
Oláh A, Szekanecz Z, Bíró T. Targeting Cannabinoid Signaling in the Immune System: “High”-ly Exciting Questions, Possibilities, and Challenges. Front Immunol. 2017;8:1487.
Basavarajappa BS, Nixon RA, Arancio O. Endocannabinoid system: emerging role from neurodevelopment to neurodegeneration. Mini Rev Med Chem. 2009;9(4):448-62.
Walther S, Halpern M. Cannabinoids and Dementia: A Review of Clinical and Preclinical Data. Pharmaceuticals (Basel). 2010;3(8):2689-2708.
Bogdanović V, Mrdjanović J, Borišev I. A Review of the Therapeutic Antitumor Potential of Cannabinoids. J Altern Complement Med. 2017;23(11):831-836.
Kaplan BL. The role of CB1 in immune modulation by cannabinoids. Pharmacol Ther. 2013;137(3):365-74.
Eisenstein TK, Meissler JJ. Effects of Cannabinoids on T-cell Function and Resistance to Infection. J Neuroimmune Pharmacol. 2015;10(2):204-16.
Breivogel CS, Sim-selley LJ. Basic neuroanatomy and neuropharmacology of cannabinoids. Int Rev Psychiatry. 2009;21(2):113-21.
Dhital S, Stokes JV, Park N, Seo K-S, Kaplan BLF. Cannabidiol (CBD) Induces Functional Tregs in Response to Low-Level T Cell Activation. Cell Immunol. 2017 Feb; 312: 25–34.
TPV Podcast, Episode 311: Sarah’s Back From Canada!
I started using hemp oil and also cbd oil for my pet ferret who got an intestinal infection from a baby ferret – she was avoiding eating, losing weight, had poor food absorption, and her coat was like an ally-cat. She was also very faitgued and slept a lot. After using the 2 above,once a day, for approx 1 month, it all turned around and her coat became soft and full even though it was would normally lighten going into summer.
Myself, I use a topical CBD THC blend for psoriasis and it works well at a higher potency although a lower diluation helps to keep under control a bit.
That’s so great that it helped your ferret! I’ve heard a lot of good things about CBD use for animals. Also, it’s great it works well for you too 😉 -Kiersten
Hi Shani,
Can you tell me what you used that helped your psoriasis? How long did it take to see improvement?
Thanks,
Janice
The vet believes my cat has autoimmune disease of the intestines. I have him now changed to an allergy free diet cat food. That seems to have cut back a lot of the issues but it’s still there. I’d ♥️ To help comfort him in other ways. How did you know what was “good” CBD oil? How much do you give them orally? (Or do vets usually have this info?)
Thank you!!
I have tried to research but info is difficult to find. Do you know if CBD oil can be made without THC or are they just passing hemp oil off as CBD?
CBD oil can totally be made without THC. There is some confusion that THC must be present in order for CBD to be functional, which is inaccurate. CBD can be extracted from both marijuana and hemp – they are part of the same plant family and have similar constituents. -Katie, Sarah’s Research Assistant
Thanks for writing about this, Dr. Ballantine! Very interesting and I’ve been curious about this myself. I have Hashimoto’s and I plan to ask my doc (functional medicine with an MD) about this.
I also rub by salve over my thyroid – I haven’t measured if it works but I like to think it may since Dr Kharrazian speaks about putting a different anti inflammatory compound over it, so thought this might be good alternative.
I started using CBD oil a couple months ago to help with my anxiety as well as pain associated with RA and fibro (hoping it could replace NSAIDs for me). I got topical and oral options, and both with and without THC (I live CO where both are legal). I’ve not noticed it making much dent in my pain (though I may just need to try another formulation or dose) but it has helped a noticeable amount with my anxiety. I tend to take it before orally bed and it helps me sleep better. If I’m having pain I’ll also rub some CBD/Hemp topical cream on my sore spots and then wrap them up for a while, this combination does help some, but it may be just the act of rubbing (increasing blood flow) followed by compression and warmth from the wrap. My experiences so far have definitely been enough for me to consider trying other CBD options beyond the oral oil. What seems to be the best route for administration? I’ve heard breathing it in, but I really don’t want to smoke weed (yuck!), but do vaporizers work? Diffusers?
Hm, this is a good question. Good-quality oral oils are really the best-studied (there isn’t any evidence about vaporizers or diffusers at the time of this post), and Sarah can’t make recommendations about marijuana since it’s not legal in all states. Let us know if you find something that works for you! -Katie, Sarah’s Research Assistant
how is your anxiety when you are not using it? is it only better on it? or is it also better off of it? i ask because in smoking, those who use it to control mood often have more anxiety and agitation when they are “sober”. but i am hoping cbd does not have that same affect for those that are using it. this would imply a negative long term affect. and there is not a lot of information on this question. thank you for your feedback
I am finding that the anxiety lowers while using it. To be honest, I wasn’t sure at first. I asked my husband for his input and he said he was seeing a difference. I have increased my dosage recently and I am feeling that it certainly helps.
I know you live in CO where it’s eady to purchase, but how did you know what was a “good” quality CBD oil? And how much do you take for anxiety please? That would be awesome to have something to help w/ that! 🙂 Thank You!
I am very impressed with the amount of research that you have done to write this article on CBD. You managed to navigate the complexities of this plant as well as the multi-tiered legalities.
I started researching cbd when I was diagnosed with colon cancer in March of 2017. My husband and I both found cbd (independent of one another) as one a part of my protocol for fighting cancer.
At that time, we only knew 1 source, and that was a local retailer. Those guys have so much knowledge because of their experience with medical marijuana. I was using the cbd/thc as a topical treatment. And…..I DID get some tumor shrinkage. The oncologist was flabbergasted! And he didn’t know what to say!!
I did choose Western medicine as my treatment, because I was diagnosed as Stage 3 and I didn’t want to delay treatment, or make a choice that would lead me to Stage 4. So…..chemo, radiation and surgery was the protocol.
During the 1 year of treatment, I used cbd with as little thc as I could find to alleviate the nausea. This also helped somewhat with pain control.
It wasn’t until AFTER the treatments ended that a friend itroduced me to hemp-derived cbd oil. This particular oil has only MINIMAL amounts of THC. I was so happy to find this oil, because it is made using nano technology and the absorption rate is above 95%. What a HUGE difference that made in my recovery!
My pain went away. I had energy that continued to increase over time and relatively quickly. My stomach pain went away, so did my headaches. I am sleeping better and I can handle stress with ease. There will be more studies and people will begin to realize how healing cbd really is. The CBD oil has been a huge help in recovering my brain too! Chemo brain is a real thing…..and it is no joke! My body tells me the story, I don’t need to read the scientific evidence. Of course, I have been studying cbd and I understand how and why it is so effective.
Thank you for bringing this wonderful plant into the light of day. The more we know about it, the more people it will help heal. It is nothing to be afraid of……there is no THC, and the CBD oil is legal in all 50 states.
Could you please tell me where you bought yours?? Online possibly? How much did you take?
I’m trying to discover how to know what’s a “good quality “ oil so I don’t get a cheap knock off. If you could share the Brand I would truly appreciate it! Thank you so very much! 🙂
I have been searching for more scientific evidence that CBD oil works. I have read your blog for years and when I saw this article I knew I would get some good information. I had MS for the past 25 years. I was on injections (avonex) for more than half of that time. I finally decided in the interest of protecting my healthy organs, I was going to fight this disease naturally and with food. I learn as much as I can and keep trying. Somewhere, I heard of CBD oil. It definitely sounded like a miracle drug that fixed everything but that is illogical, right. My husband and I, on a long drive, listened to a podcast by Dr. Hyman. He talked about CB receptors, like you do in the article, and also said our bodies need CBD oil like a supplement. We can naturally do all of the things that CBD oil gives us but sometimes we need a boost.
I was hoping your article would give me guidance about dosage, but I understand we need to let science catch up! Frustrating because I see evidence in my life and in the stories of others who use it that it really works and could be the future of our health care. Wish the profession really stood by, “do no harm”
Thank you for this article. I have read many articles on CBD as of late, but this one is the most comprehensible.
I follow many groups that treat auto-immune diseases, cancer, and urinary tract diseases in pets, and CBD has been incredibly useful tool for managing symptoms. In the groups combined, I am sure hundreds of owners are using it already quite successfully.
I have seen people using it to treat their pets cancer, asthma, ibd, inflammation, cystitis, pancreatitis, just to name a few. It is a really incredible substance.
What is the current consensus on whether using cbd will cause a false positive on a thc drug test? I have IBD and want to try it but am afraid I may lose my job if I show a positive drug screen.
I don’t believe there is a consensus at this point. What it looks like is that high-quality CBD extracts from hemp *shouldn’t* result in a positive screen, but it would be tough to risk that. Theoretically, there should be zero THC in a CBD supplement. -Katie, Sarah’s Research Assistant
I have been using CBD oil with zero THC for a few months now for anxiety. While I’m finding it’s helping somewhat, the dosing can be a little tricky. I’m still working on a correct dosage for myself.
With that being said, I was in a motorcycle accident in July. My left leg and particularly my left knee was injured. I think it has helped significantly with inflammation & possibly pain.
CBD was recently FDA approved in the form of Epidiolex to treat epilepsy, and CBD derived from hemp is legal in all 50 states and DC. Thousands of parents are using tiny doses of over the counter CBD to control epilepsy in their children, many with the support of their neurologists. I point this out simply because it is not clearly stated in your article that this is a legal substance, which it is.
i still have concerns about 1. suppressing the immune system. if it is overactive i would believe there may be a reason. it would be like yelling at a dog for warning you about a fire. my other concern is 2. the stimulation on the adrenals. i am not sure which part of marijuana that is such a stimulant on the adrenals. but am concerned about the long term affects for some. those with strong adrenals may be fine, but those with chronic illness do not have strong adrenals. there are many who have used this to stimulate their adrenals (ie feel good) and as a result are having symptoms of things like being unable to eat unless they are high and other symptoms of adrenal fatigue or even crises. of course, this is from smoking it, not cbd oil. i am hoping there is something i am missing, but if it is cbd that stimulates the adrenals then this could be the next wave of something we do very wrong. while there are obvious benefits such as stopping seizures in children or cancer, we must look at whether the good outweighs the unknown for most. it seems to me we are again treating a symptom instead of a root cause.. and we have got to stop doing that.
There isn’t any evidence at this point that CBD stresses or activates the adrenal gland. In fact, considering its hormonal- and immunological-modulating benefits plus its psychological benefits, it’s very likely that CBD would reduce the burden on the adrenal glands. -Katie, Sarah’s Research Assistant
“One well-studied example is inflammatory lung disease. There is a lot of evidence that use of CBD reduces the immune response, allowing the lungs to function appropriately.”
Would this include Idiopathic Pulmonary Fibrosis? My understanding is that concentrated inflammatory cytokines have been found in lung biopsies of IPF patients, so I’m wondering if CBD could be a good adjunct to their treatment…
We didn’t find anything specific about IPF, but the mechanism would totally make sense! -Katie, Sarah’s Research Assistant
I have used CBD topically in a salve for a trapezoid, very painful, shoulder injury. I only used it for a few days each time I tried it, which was twice, because it made me feel very lethargic and nauseous. When I was wracking my brain to figure out what I did to feel like I was, it occurred to me the only thing I had changed was the addition of the CBD Salve. I took it out, and felt better in 24 hours both times. I was hoping for a great natural way to help with pain while healing, but it wasn’t the answer for me.
I have asked a couple others with results, but how do I know if I am purchasing a “good quality “ CBD oil? Is there any certain numbers/amounts/words to look for? Do you know a specific brand that is reliable perhaps??
Thank you for any help!!
Sarah isn’t recommending any particular brands at this time. For now, CBD available through a practitioner is the absolute best bet. Otherwise, there are some factors you can check out as you vet companies. First, see if the company publishes how they extract the oil (they should); ideally, the CBD will be extracted using ethanol and/or supercritical Co2 extraction. It’s also better when the hemp is grown within the United States, and it’s best when grown organic if possible. I hope this helps! -Katie, Sarah’s Research Assistant
Thank you very much!!
Curious if you came across anything in the literature about potential for liver damage. I think my brother could really benefit from CBD (loads of health issues I won’t go into here), but he already has some liver damage from lifelong pharmaceuticals for his health problems and the doc’s think it could further the liver damage. I noticed you said CBD is “altered” by the liver to some extent; can it also damage the liver? Thanks!
What a great question! Sarah of course can’t make medical recommendations. However, there is some evidence that CBD can actually help with liver health in cases of damage! I didn’t see anything about CBD being harmful for the liver. Hopefully this answers your question! -Katie, Sarah’s Research Assistant