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CBD – Everything You Need to Know

You may have noticed that over the last few years, on your social media or news feed, there has been increasing discussion of the properties of CBD. Maybe you’ve seen stores in your local shopping centre offering CBD products or even dedicating businesses selling them on the high streets. On the television it too is present, where some boast its health benefits. Perhaps some of you have even been recommended CBD by your doctor.

Cannabidiol (CBD) and other cannabis products have been the center of much media attention for some time now. In the US, cannabis is legal for medical use in 33 states and for recreational use in 10. In the UK cannabis for recreational use is illegal but CBD is perfectly legal for sale and consumption and is actually prescribed by doctors.

Medical and consumer interest in the treatment of illness with cannabis has been peaked by high-profile cases in children, such as epilepsy sufferers Alfie Dingley and Billy Caldwell in the UK and Ireland. This is because, there has much medical research performed that suggests the use of CBD has wide variety of medical benefits.

There is no doubt that CBD is becoming more and more present in our lives and with market intelligence firm Hemp Business Journal’s projection that the CBD market will grow 700% by 2020, it seems that this trend is set to continue. This projection is based on their recent research that found consumer product sales of CBD had recently risen 1,710% in one year alone.

The problem is, with such an overload of information flooding the web and the media, it is sometimes difficult to wade through the words, numbers and testimonies. Often facts lack consistency and myths get woven into claims. The experiments and studies focusing on CBD and its medical properties are endless, and frankly it must be said that this article could never be full and comprehensive. However, its goal will be to present a straightforward and unbiased guide to everything you need to know about CBD with links to recent and reputable medical sources.

What is CBD?

Cannabidiol, or CBD is one of the compounds present in the cannabis indica and cannabis sativa subspecies of the cannabis plant. While cannabis contains over 400 chemical compounds, CBD and tetrahydrocannabinol (THC) are the most common. However, the two are in many ways very different.

Firstly though, their similarities. CBD and THC molecules contain the exact same atoms: 2 oxygen, 21 carbon and 30 hydrogen. The molecular structures that these atoms create are very slightly different between the two chemicals though, resulting in totally different effects and interactions within the body.

The most important difference, and the factor that determines much of CBD’s medical versatility and legality, is that THC induces an intoxicating “high” in the user and CBD appears to be devoid of psychoactive effects. This is because, THC with locks on and binds to the CB1 and CB2 endocannabinoid receptors. On the other hand, CBD cannot make this same connection instead favoring other receptors out with the endocannabinoid system responsible for a myriad of possible benefits. In fact, there is evidence to show that CBD can counteract the psychoactive effects of THC. (2018)

So, what does CBD do?

To begin it must be said that, while the exact molecular mechanisms that give CBD its therapeutic benefits are still being worked out, cannabidiol has been used as medicine for centuries. A surprising example of this can be found in Queen Victoria who used varieties of cannabis with particularly high CBD to help calm pains from menstrual cramps. The study of the medical application of cannabis has been ongoing since the 16th Century. However, the isolated version of CBD that dominates today’s usage was not available until it was isolated by the chemist Roger Adams in the 1940’s, although it was not officially recognized as having medical value until the mid-1970’s when the British Pharmacopeia began referring to CBD for medical use.

Effects on Serotonin Receptors

You may have heard of serotonin already and for good reason. It is one of our most important neurotransmitters affecting a number of the bodies biological and neurological processes such as aggression, appetite, mood, sleep, nausea and countless more. As a result, many pharmaceuticals focus on its production and receptors (5-HT) to treat depression, psychosis, anorexia and anxiety. However, many of these drugs, such as Oxytocin, can be harmful and addictive leaving many users searching for a natural alternative.

A collaborative study between the University of San Paulo and King’s College London in 2014 found that CBD has promising interactions with 5-HT receptors. This was building upon the 2010 findings that CBD induced an antidepressant like effect in mice, presumably as a result of CBD affecting the serotonin receptors. However, it must be said that a very specific dose of CBD was required to produce an observable anti-depressant effect in the experiment, a result mirrored in similar studies of CBD (2006).

Consequently, many people have proposed that an effective medical use of CBD would be for treating depression and anxiety. A 2018 study also suggested that this discovery of CBD’s interactivity with serotonin receptors could be a reason to further explore its use in “novel therapeutic strategies for phobias, post-traumatic stress disorder, and drug abuse.” Because of these possibilities, the effect of CBD on serotonin is an extremely interesting field of study that is gaining more and more traction and is being applied to an increasing number of medical needs.

Effects on TRPV1

The most common use of CBD is for the mediation of pain and inflammation. This is primarily due to CBD’s relationship with the transient receptor potential cation channel subfamily V member 1 (which is a mouthful so let’s stick with TRPV1). The protein TRPV1 is a member of the ion channels family and, in humans, serves to detect and regulate body temperature. In addition to this and perhaps most importantly it can induce the sensation of pain, specifically burning. When your tissue is damaged and the area becomes inflamed a number of chemicals are released that increase the sensitivity of TRPV1. What this means more or less is that the affected area becomes more sensitive to painful and non-painful stimuli. This is a natural part of our bodies processes and is important as it can alert the sufferer to the damaged area. But for those who suffer chronic pain or are recovering from an injury, this function of TPRV1 can be distracting and, above all else, agonizing.

It has been suggested that CBD’s ability to mediate pain is in part because it can desensitize TRPV1. This along with its interactions with other receptors means CBD can also reduce inflammation itself (2004). This ability to sooth the pain and combat what’s causing the pain in some cases makes CBD a useful treatment for disease-associated chronic pain as it is non-toxic and, as mentioned above, non-psychoactive, making it a very unobtrusive form of medication.

Effect on PPARs

Positioned in the nucleus of cells, peroxisome proliferator activated receptors or PPARs are responsible for regulating your body’s expression of genes, a function that is one of the most complex and vital. PPARs are essential in a number of other bodily functions too such as cellular differentiation, development, metabolism and perhaps most importantly and unfortunately carcinogenesis: the formation of cancerous tumors. PPARs are as a result the target of many pharmaceuticals as activation of the receptors can stem cancerous proliferation and induce apoptosis (the killing of cells) in tumors.

There have been a number of studies (2016) to suggests that cannabinoids also have the ability to activate PPARs and as a result, slow cancer growth and even kill cancerous cells. CBD has been shown to have this effect specifically on lung cancers cells (2013), an infamously difficult form of the disease to treat. THC has also been proven to have a positive effect on breast and liver cancer cells however THC can not bind to all variants of PPARs and as result may not be as versatile in the treatment of cancer as CBD. (2014, 2007)

PPARs and their activation can also play a role in treating central nervous system related diseases such as Alzheimer’s and Parkinson’s. This is because direct activation of PPARs can lead to a reduction in the neuroinflammatory response that causes such diseases. (2011) CBD’s affinity with PPARs has led some to believe that its use in treating such diseases would be successful.

Anandamide reuptake inhibition

Much of CBD’s mobility in the human body, which allows it reach receptors such as PPARs which exist with cells themselves, is down to its ability to travel with fatty acid proteins (FABP). The same is true for THC, however it has been found that multiple FABPs have an especially close connection to CBD. Because of this, CBD is often in competition with other FABPs it does not travel with for access to cells. Ordinarily, once inside the cells, fatty acid amide hydrolases break down FABPs for the cells to reuptake (absorb), but if CBD has been ingested, FABPs take longer to reach the interior of said cells. What this essentially means is that CBD can delay the breakdown of FABPs by restricting access to cells.

Among FABPs are endocannabinoids, one of the most important of which is anandamide. Anandamide’s name is derived from the Sanskrit word Ananda, meaning “joy” or “bliss”. This to some degree explains part of anandamide’s function. It has been referred to as a “the body’s own antidepressant” as it is essential to mood and motivation.

When CBD delays the breakdown of FABPs it can lead to increased levels of anandamide in the brain, which accounts for some of CBD’s antidepressant and anti anxiety effects. On top of this, anandamide has been linked to the regulation of the cardiovascular system, meaning it can also be involved in the reduction of inflammation and could be, according to a 2018 study, involved in neuroprotection against seizures. (2008)

Side effects and adverse properties of CBD

As the use of medicines derived from cannabis become more widely used, the question of possible side-effects and patients’ safety rightfully come into frame. As a result, the research and claims surrounding such side-effects of the various chemicals present in cannabis can be a minefield of opinions and twisting of truths. However, there are many legitimate pieces of research that clear the fog and help those considering cannabis-based treatment.

THC is perhaps the most contentious compound in question. Despite the claims of many, it has long been known that there are negative side-effects related to cannabis consumption, primarily neuropsychiatric and cognitive deficits as well as synaptic and memory impairment, as a result of the THC present and its psychoactive properties. However, it has been shown that these effects can be eliminated. (2014) Besides the side-effects of THC, its addictiveness has also been discussed at length. While it is not often referred to as an addictive drug, cannabis seems to create dependency in regular users. In 2013 in fact it was estimated that roughly 13.1 million people worldwide were cannabis-dependant.

However, when CBD is extracted and used alone, research suggests that any serious side-effects are non-existent. That being said, a 2018 study that focused specifically on the experience of users of CBD for medical purposes found a number of side effects which were minor to say the least. The study found the top five most common “adverse” side effect were dry mouth, euphoria, hunger, redness in eyes and fatigue. These effects are very minimal and of course non-permanent, so they do not pose any threat to users. Furthermore, while in this study these side effects were considered a negative aspect of CBD use, for some who are plagued by insomnia or anorexia for example, they may specifically use CBD for one or more of these effects.

The fact that CBD seems to pose no dangerous long-term effects makes it an increasingly valuable form of medication. This is especially important in the treatment of epilepsy, chronic pain and anxiety because in comparison with other drugs commonly prescribed to treat these conditions, CBD has a much more desirable side effect profile. (2017) It is hoped that the implementation of CBD as a medicine could improve not only the experience of patients but their enthusiasm to comply with treatment schedules, which in theory would improve recovery time.

How is CBD used?

CBD can be consumed in a number of different ways and more options are readily available than ever before. Some methods have certain benefits and allow different doses, but how CBD is used is, in many ways, a matter of personal taste. However, before you consider how to use CBD, its important to understand its dosing.

CBD dosing

While CBD’s non-toxicity means it is impossible to overdose on, this is not to say that there’s no such thing as too much CBD. Those who consume too much cannabidiol could experience aggravated minor side-effects. However, the possibly of this occurring can be totally negated if CBD dosing is understood.

It is first important to realise how much CBD in each product. For instance, a 500mg tincture contains a 500 milligrams total in the bottle. The same can be said for vape oils, concentrates and topicals but capsules will be labelled per dose. Next you must learn to measure your doses, which can be done with some simple math.

Say we have a 30ml tincture that contains 1,500mg of CBD. For its application we have a dropper, which typically holds 1ml of liquid. The formula to determine how much CBD our dropper can hold goes like this:

CBD content of bottle in mg ÷ ml in bottle = mg of CBD per dropper

Or

1,500 ÷ 30 = 50 mg of CBD per dropper

A similar method can be used for CBD e-liquid for a vaporizer so long as you multiply your “mg of CBD per dropper” number by the capacity of your vaporizer’s oil chamber.

Deciding how much CBD you need in your dose greatly depends on a number of factors. Firstly, you must consider your body weight, and also the severity of the problem you’re trying to treat. While it is always best to discuss these factors with your doctor when considering any medical treatment, there are some handy methods for calculating your dose such as this chart from the Honest Marijuana Company shown below. It must be remembered though that these recommendations are general guidelines and will not necessarily apply to everyone in the same way, so again, it is always best to consult your doctor and when starting out with CBD, take it low and slow.

CBD Dosing Chart

Tinctures

The most popular form of CBD on the market are tinctures, as they provide one of the purest ways of consuming the cannabidiol. They are available in doses from 100mg to 1,500mg and are applied underneath the tongue in drops. They usually consist of only CBD and a form of oil, like coconut oil, although some manufactures will flavor the liquid to make the experience more enjoyable.

Concentrates

Like tinctures, concentrates provide a way of consuming CBD in its most unadulterated form. Concentrates are ingested in the same way as tinctures although are arguably easier to use as the most common form of concentrated oils come in syringes for oral use. Other forms of concentrates include, wax, shatter and crumble, however CBD in these forms must be burned and smoked, which may be an unattractive prospect for many CBD users.

Capsules

Capsules are perhaps the easiest way to use CBD as they do not have to be dosed by the user and can easily fit in to any vitamin routine. They tend to contain between 10mg to 25mg, so it is much easier to keep track of how much has been consumed. However, because of this they come in a limited range of doses meaning it could be difficult to tweak and perfect dosages to fit personal preferences.

Topicals

Lotions, salves and lip balms all fall under the category of topicals and boast a different range of benefit than more conventional forms of CBD consumption. As you may have already guessed, topicals are applied directly to the skin and can have a more direct and local effect than other forms of CBD medication. As a result, they are especially effective in combating chronic pain, inflammation and joint pain. Because of the difficulty in dosing with accuracy, the effective use of topicals will in many cases involve some experimentation to find the perfect treatment regime.

Vaping

Perhaps the most heavily marketed method of CBD consumption, vaping is considered to be less effective when compared to oral forms such as tinctures and concentrates. But because vapes make it easier to adjust dose by very small increments, some find it a more versatile and convenient way to medicate. That being said, vaping and e-cigarettes are relatively new phenomenon and the safety of the practice is still being debated.

To tie it all up…

It can be said without question that there is value in the use of CBD medically. There are countless pieces of evidence to suggest the value and safety in the use of cannabidiol to treat serious and minor illnesses of many different kinds. The building interest in these possibilities is spurring on constantly further research and study into the wide variety of effects CBD can have. It is important to remember though, that despite the extensive history and wide availability of CBD products, there is much to learn about the compound. While many of the effects of CBD are known, it is true that some of the mechanisms behind these effects are not totally understood. Because of this, users should keep up to date with the ongoing research and pay attention to new findings.

References

Khan, A. A., Shekh-Ahmad, T., Khalil, A., Walker, M. C., & Ali, A. B. (2018). Cannabidiol exerts antiepileptic effects by restoring hippocampal interneuron functions in a temporal lobe epilepsy model. British journal of pharmacology, 175(11), 2097-2115.

Gonzalez-Cuevas, G., Martin-Fardon, R., Kerr, T. M., Stouffer, D. G., Parsons, L. H., Hammell, D. C., Banks, S. L., Stinchcomb, A. L., … Weiss, F. (2018). Unique treatment potential of cannabidiol for the prevention of relapse to drug use: preclinical proof of principle. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 43(10), 2036-2045.

O’Sullivan S. E. (2016). An update on PPAR activation by cannabinoids. British journal of pharmacology, 173(12), 1899-910.

Costa, B., Giagnoni, G., Franke, C., Trovato, A. E., & Colleoni, M. (2001). Vanilloid TRPV1 receptor mediates the antihyperalgesic effect of the nonpsychoactive cannabinoid, cannabidiol, in a rat model of acute inflammation. British journal of pharmacology, 143(2), 247-50.

Vandrey, R., Stitzer, M. L., Mintzer, M. Z., Huestis, M. A., Murray, J. A., & Lee, D. (2012). The dose effects of short-term dronabinol (oral THC) maintenance in daily cannabis users. Drug and alcohol dependence, 128(1-2), 64-70.

Atakan Z. (2012). Cannabis, a complex plant: different compounds and different effects on individuals. Therapeutic advances in psychopharmacology, 2(6), 241-54.

Iffland, K., & Grotenhermen, F. (2017). An Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies. Cannabis and cannabinoid research, 2(1), 139-154. doi:10.1089/can.2016.0034.

Alexandre R. de Mello Schier, Natalia P. de Oliveira Ribeiro, Danielle S. Coutinho, Sergio Machado, Oscar Arias-Carrion, Jose A. Crippa, Antonio W. Zuardi, Antonio E. Nardi and Adriana C. Silva, (2014) “Antidepressant-Like and Anxiolytic-Like Effects of Cannabidiol: A Chemical Compound of Cannabis sativa”, CNS & Neurological Disorders – Drug Targets 13: 953. https://doi.org/10.2174/1871527313666140612114838.

Jamie Grierson, (2018), UK doctors will be able to prescribe cannabis medicine next month, https://www.bbc.com/news/health-46045487.

Steven Hoffman, (2018), CBD Consumer Products Sales up 1,710%, Primarily from Natural Retail Channel, Hemp Business Journal https://www.hempbizjournal.com/cbd-consumer-products-sales-1710-primarily-natural-retail-channel/.

James McClure, (2016) Henry VIII’s Reign Was a Golden Age for Hemp, Civilized, https://www.civilized.life/articles/henry-viii-england-hemp/.

World Health Organization, (2016) The Health and Social Effects of Nonmedical Cannabis Use, New WHO publication on cannabis, https://www.who.int/substance_abuse/publications/cannabis_report/en/.

Aaron Cadena, (2018), What’s the Best CBD Dosage?, Medium, https://medium.com/cbd-origin/whats-the-best-cbd-dosage-81ec4f95503b.

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