All about CBD Oil: How It Works and Its Potential Benefits | Chris Kresser
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All about CBD Oil: How It Works and Its Potential Benefits

by Chris Kresser

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CBD oil and other hemp-based products like these can carry a number of potential health benefits.
CBD oil has a number of potential health benefits. iStock/yavdat

Cannabidiol (CBD) has taken the health and wellness industry by storm.

In 2017 retail sales alone of hemp-derived CBD products reached an astonishing $350 million and, by 2022, they are projected to be a multi-billion-dollar industry. (1) Have you come across CBD oil online or in your local health food store and wondered what health benefits it may have to offer and how to use it safely and effectively? Read on to learn how CBD oil works, how it might help you manage or improve certain conditions, and how to select a high-quality oil from the many options currently available on the market.

Have you considered trying CBD oil? Check out this article to find out which health conditions may respond well to the product and get my recommendations on oils to try. #healthylifestyle #wellness #chriskresser

What Is CBD?

Cannabidiol is one of over 100 chemicals, known as cannabinoids, found in cannabis plants, including marijuana and hemp. Cannabidiol (CBD) and its infamous sister compound tetrahydrocannabinol (THC) are the two primary cannabinoids in cannabis.

Whereas THC is psychoactive and responsible for the characteristic “high” people experience from using marijuana, CBD is not.

CBD can be extracted from marijuana, which is cannabis with a high THC content (generally between 5 and 35 percent), or from hemp, a plant in the cannabis family that has a very low THC content of less than 0.3 percent. (2) When CBD is extracted from non-psychoactive hemp, it is legal to purchase in all 50 states in the United States. However, CBD made from marijuana is legal only in states with medical or recreational marijuana laws.

How CBD Works

The endocannabinoid system (ECS) is a network of signaling molecules, derived from arachidonic acid, that modulates many aspects of our biology, including central nervous system function, immunity, and inflammation. The two primary endocannabinoids in our bodies are anandamide (AEA) and 2-arachidonoylglycerol. Cannabinoids from external sources such as cannabis also interact with the ECS. THC exerts its psychoactive effects primarily by interacting with cannabinoid receptors in the ECS. CBD, on the other hand, doesn’t bind as easily with cannabinoid receptors. Instead, it works by interacting with non-cannabinoid receptors, inhibiting reuptake of the body’s own endocannabinoids. These various receptors impact functions ranging from serotonin neurotransmission to cell growth and survival.

CBD also enhances ECS activity by inhibiting the reuptake of endocannabinoids such as AEA and 2-arachidonoylglycerol. (3) This effect improves the overall function of the body’s ECS.

CBD is also an allosteric receptor modulator, meaning it can either enhance or inhibit the transmission of signals between cell receptors. For example, CBD enhances GABA receptor signaling, inhibiting excessive neurotransmission. This is likely one explanation for the calming, anti-anxiety effects of CBD. (4)

Clearly, CBD is a complex compound with many mechanisms at work, some of which can yield diverse health benefits, as new scientific research is demonstrating.

Eight Conditions That Benefit from CBD Oil

Though the research on humans is ongoing, with much more to be done, CBD has already demonstrated a broad range of potential health benefits for people with conditions ranging from autism to inflammatory bowel disease.

In many of these instances, CBD alters the course of disease, without the harmful side effects of pharmaceutical drugs. Here are eight instances where study results are very encouraging.

1. Autism

Recent research indicates that the ECS regulates neurobehavior and immunity, two aspects of physiology that are significantly impaired in autism. (5) This finding has led to a growing interest in the use of cannabinoids for modulating the ECS of autistic children and, hopefully, reducing the symptoms of this disorder.

Several small studies indicate that CBD reduces symptoms of autism as well as related conditions, such as anxiety. A trial conducted in Israel provided 53 autistic children with CBD oil at a dosage of 16 mg/kg per day; the CBD oil also contained THC, but in a very low amount. After a median treatment duration of 66 days, the children who received CBD demonstrated significant reductions in self-injury, rage, hyperactivity, and sleep problems, all common symptoms of autism. (6) Another study that used a similar CBD oil formulation found that CBD significantly improved anxiety, communication problems, and disruptive behaviors. (7) Currently, several more trials are underway to study the effects of CBD in autism. (8, 9)

2. Anxiety

Several small human trials suggest that CBD is beneficial for reducing anxiety. In a group of healthy young men, a single 400-mg dose of CBD significantly decreased self-reported anxiety compared to placebo. (10) A single 600-mg dose of CBD was found to reduce anxiety in subjects with social phobia. (11) Interestingly, the anti-anxiety effects of CBD are typically observed at moderate dosages of approximately 300 mg per day. Lower and higher doses either exert no impact or, paradoxically, increase anxiety. (12) An important note: some people with anxiety may experience a paradoxical reaction at any dose of CBD.

CBD quells anxiety by interacting with several central nervous system receptors known to regulate the fear response and anxiety-related behaviors, including CB1R (cannabinoid receptor 1) and 5-HT1A. Activation of CB1R by CBD promotes “fear extinction,” a decline in conditioned fear responses, while modulation of 5-HT1A receptors by CBD reduces anxiety. (13)

3. Cancer (And Side Effects of Treatment)

While medical marijuana has become popular for alleviating the side effects of cancer treatment such as pain and nausea, the psychoactive effects of THC are undesirable for many cancer patients. Fortunately, research indicates that CBD is a viable non-psychoactive alternative that not only alleviates side effects of conventional cancer treatment but also beneficially modulates the underlying cancer process.

In in vitro studies, CBD has been found to regulate signaling pathways involved in cell proliferation and survival, inhibiting cancer development and progression. (14) It also stimulates autophagy, the process by which the body cleans out damaged cells and regenerates new ones. CBD may be useful in the treatment of glioma, melanoma, breast cancer, and prostate cancer and appears to enhance the cytotoxic effects of chemotherapy. (15, 16, 17, 18, 19) While we await clinical trials examining the potential of CBD as a cancer treatment, the excellent safety profile and beneficial effects of CBD oil for nausea and pain indicate that it may be a useful adjunct treatment to incorporate into cancer treatment protocols today.

4. Infections

Each year in the United States, at least two million people succumb to antibiotic-resistant infections. The dwindling number of pharmaceutical drugs effective against antibiotic-resistant bacteria has led to a growing interest in the applications of natural compounds such as CBD for the treatment of such infections. CBD has potent antimicrobial activity against MRSA, a common antibiotic-resistant bacterium that infects humans. (20) This finding suggests that CBD may represent a valuable alternative to pharmaceuticals for the treatment of MRSA and, potentially, other antibiotic-resistant infections.

5. Inflammatory Bowel Disease (IBD)

In research, CBD has demonstrated beneficial effects on the symptoms and pathology of IBD, reducing tissue injury, reactive oxygen species production, inducible nitric oxide synthase activity, and levels of TNF-alpha in the colon. (21, 22) CBD also supports the maintenance of the intestinal barrier, which is frequently compromised in IBD. (23)

Compared to preclinical research, clinical trials on CBD for IBD are sparse. A recent study found that low-dose CBD (10 mg per day) was safe but not effective for Crohn’s disease; however, the dose used in the trial was extremely low, and higher doses may be needed to achieve therapeutic effects. (24) Fortunately, more clinical trials examining the effects of CBD in IBD are forthcoming. (25)

6. Post-Traumatic Stress Disorder (PTSD)

PTSD is notoriously resistant to pharmaceutical treatment and behavioral therapy. PTSD can occur after a traumatic experience, resulting in flashbacks, nightmares, and extreme anxiety. Interestingly, emerging research suggests that CBD may improve the symptoms of PTSD by reducing hyperactivity of the amygdala, a portion of the brain involved in the processing of fear, thus suppressing traumatic memories. (26)

7. Pain and Inflammation

CBD may be a viable option for treating different types of chronic pain. In animal studies, topical CBD reduces pain and nerve damage in rat models of osteoarthritis. (27, 28) While studies on CBD for pain in humans are limited, CBD does appear to alter the perception of pain, making it more tolerable. (29, 30) Several high-quality clinical trials are underway to further elucidate the effects of CBD on chronic neuropathic and post-surgical pain. (31, 32)

8. Seizures

Scientists have known for years that the ECS is involved in seizures; as a result, extensive research has been conducted on the therapeutic applications of cannabinoids for seizures disorders. (33) In 2018, the U.S. FDA made history when it approved the CBD-based drug Epidiolex for the treatment of two severe, rare pediatric seizure disorders—Lennox-Gastaut and Dravet syndromes.

Since CBD only binds weakly with CB1 and CB2 receptors, scientists believe that its anticonvulsant properties are probably due to interactions with the non-cannabinoid receptors TRPV1, 5-HT1A, and voltage-gated calcium channels. While many seizure disorders cannot be managed well with medication, CBD, in many cases, potently inhibits them without causing the side effects or drug resistance associated with traditional antiseizure medications.

CBD oil is useful for many other conditions as well. It has anti-inflammatory and analgesic properties, giving it the potential to offer therapeutic effects for a number of health issues aside from the ones listed here.

What to Look for When You Buy CBD

The CBD industry is a burgeoning market, with countless options available. You can choose from CBD oil-containing edibles, capsules, sprays, and topical salves and creams. However, because the federal government still considers cannabis an illegal drug, the CBD oil industry is under-regulated by the FDA, with very little third-party oversight. This means that the quality and suggested dosing of CBD products vary widely, requiring that consumers be savvy when selecting CBD products.

Read the Label Carefully

A 2017 study published in JAMA tested the cannabinoid content of 84 CBD products from 31 companies. The researchers found that a shocking 69 percent of CBD products didn’t contain the amount of CBD reported on the label, while 18 of the products contained THC. (34) In 2018, Consumer Lab published a product review on CBD extracts. In their survey of dozens of CBD products, they found that the dose of CBD per suggested serving ranged from 1.3 mg to 22.3 mg, a 15-fold difference! On top of that, the cost to obtain 10 mg of CBD from each product ranged from $0.80 to $4.73. (35)

When selecting a CBD oil product, read the label thoroughly and determine precisely how much CBD you’re getting, and at what cost. Look for products that list the amount of CBD per serving; products that list only “cannabinoids” provide no information about how much CBD is in a serving.

Consider Organic CBD Oil

In addition to taking a critical look at the labels of CBD products, you may also want to consider selecting CBD oil made from organically grown hemp. Pesticides used on cannabis and hemp during the growing process linger and may become concentrated during the manufacturing of CBD, ending up in the final product. (36) Once you find a CBD product in which you’re interested, get in touch with the company to learn whether they use organic growing methods.

My CBD Oil Recommendations

There are hundreds, if not thousands, of CBD products on the market today. Unfortunately, according to ConsumerLab.com’s recent review, many of these products don’t contain the dose of CBD advertised on the label.

The best option, according to ConsumerLab.com—both in terms of potency and price per milligram—is Bluebird Botanicals Hemp Classic 6x Concentrated formula and their Plus CBD Oil Hemp Softgels. Their products also use organic hemp seed oil, and they’re GMO-free.

Elixinol Natural Drops Hemp Oil + Coconut Extract is another option with a high concentration of CBD and a competitive price per milligram. However, it doesn’t contain some of the other cannabinoids found in hemp because it isn’t made from a hemp extract; it is made from hemp oil, with added CBD.

Sol CBD is another company that offers products with a concentration of CBD. They have a liposomal option, which may be better absorbed, and they have a “cinnamint-flavored” tincture that many of my patients find to be more palatable than standard CBD preparations. The downside is that Sol CBD products are about twice the cost per milligram of the Bluebird Botanicals product.

If you’re looking for a topical CBD product to apply directly to a painful area, Nature’s Love offers an organic salve with full-spectrum hemp extract. Mary’s Nutritionals Muscle Freeze is another topical option for aches and muscle pain.

For all CBD products, I recommend beginning with the recommended dose on the bottle and gradually increasing the dose until you notice an improvement.

You can also increase the bioavailability of CBD by eating it with a meal containing fat. Healthy fats enhance absorption of CBD by the intestinal lymphatic system. (37)

Who Should Avoid CBD?

CBD is generally well tolerated and has an excellent safety profile. However, certain people should avoid CBD—including pregnant and breastfeeding women and those taking pharmaceutical drugs.

CBD should not be used during pregnancy and breastfeeding because the effects of CBD on the growing fetus and infant are not well understood. However, THC is known to cross the placenta and enter breast milk, and it is likely that CBD does the same.

You may also need to avoid CBD or consult with your doctor before trying it if you are taking any pharmaceutical drugs that are metabolized by cytochrome P450 (CYP450) enzymes. CBD interacts with CYP450 enzymes and may enhance or inhibit the metabolism of drugs that pass through this system. Whether inhibition or enhancement occurs depends on the dosage of CBD, the dosage of the medication, and a person’s unique genetics and biochemistry.

Sixty percent of prescription drugs are metabolized by the CYP450 system; if you are taking any of the drugs in this list, please check with your doctor before trying CBD: (38)

  • Angiotensin II blockers
  • Anesthetics
  • Antiarrhythmics
  • Antibiotics
  • Antidepressants
  • Anti-epileptics
  • Antihistamines
  • Antipsychotics
  • Benzodiazepines
  • Beta-blockers
  • Calcium channel blockers
  • HIV antivirals
  • HMG CoA reductase inhibitors (aka statins)
  • Immune modulators
  • NSAIDs
  • Oral hypoglycemic agents
  • PPIs
  • Prokinetics
  • Steroids
  • Sulfonylureas

Now, I want to hear from you. Have you considered trying CBD oil? If you’ve already tried it, what has your experience been like? Let me know in the comments below.

  1. It’s a shame you didn’t recommend Charlotte’s Web, an excellent full-spectrum hemp extract oil. While the product does not currently state the CBD content on the product because until just recently CBD was classified as a class 1 narcotic, the company state’s the products are all 60-65% CBD. Lab results on each batch are readily available.

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