#07 Cannabidiol (CBD): Hype or Hero?
You're listening to the curious about cannabis podcast before we get started here. Let me just share a little disclaimer in this episode? We're going to be discussing. The medical uses of cannabis. Now all the information I present to you in this podcast in general is for education and entertainment purposes only and should definitely not be considered medical advice. Please never make decisions about your health based on anything. You hear me or any other podcast host talk about. I'm simply sharing information that I've collected from talking with professionals with relevant experience or from research studies that are available out there that have been published. But I'm not a doctor. You should always get your medical advice from a licensed healthcare professional now with that out of the way. Let's move on these days. Cd's all the hype ladies how everybody is talking about. Cb oil now comes to the cannabis plan and many believe that can help with everything from Zaidi and chronic pain diabetes even cancer. We're in the midst of a CBD oil boom the two thousand eighteen farm bill paved the way for legal hemp production in the United States seeming to open up a multi-billion dollar him market. That was now up for grabs of all the potential surrounding legal hemp. There was one section of the market the head. Everyone's attention and that's the CBD market. It's estimated that over a thousand. Cbd brands came onto the market in two thousand nineteen and it's estimated that approximately a quarter of the US population has tried CBD. Health claims have been boasted and promoted by CD Companies Doctors Entertainers and social media influencers. So what's the deal is C. D? Legit or is it just another snake oil? And what does she actually do to your body in this episode? We explore the history and the science of the canal annoyed. That's currently all the craze nabbed. I'll or as you probably know it. Cbd Hey everybody. This is Jason Wilson with the curious about cannabis podcast. Thanks much for tuning in once again in this episode. We're going to be taking a close look. At one of the most popular tabloid produced by the Cannabis Plant and that's NAPA. Dial or as it's better known. Cbd INTO GUIDE OUR CURIOUS QUEST. We're going to be exploring several primary questions one two how does CBD affects the body and the three what are CBD's potential therapeutic applications as well as some of its limitations risks so without further ado? Let's get started for the past. Few years has been big business. The price of a single one ounce bottle of CBD. Tincture can range anywhere from fifty dollars to two hundred dollars or more. Compare that to the average cost of a one. Ounce bottle of a different herbal extract. Tincture like ECHINACEA or elderberry though typically costs somewhere between ten dollars and twenty dollars but what is CB CB is an oily compound produced in the resins of cannabis plant now whether the canvas plants considered him or marijuana they both producing CD. Typically outside of some uncommon exceptions in the United States. Hemp is classified as canvas plants that contain less than zero point three percent. Thc In other countries limit can be even lower sometimes as low as zero point two percent THC instead of THC which is the primary intoxicating compound found campus varieties. They're often called marijuana. The primary Varieties of cannabis tend to produce is connect dial. Cbd THANKS TO INTENTIONAL. Breeding efforts CB can now be found in concentrations as high as twenty or twenty percent and hip plants intended for CBD rich resin production now CBD's markedly different than thc to start cd doesn't really cause any intoxicating or you work effects like THC. Does this features gotten the attention of a lot of people ranging for medical researchers that want to unlock the potential therapeutic effects of cannabis without the risk of abuse and all the way to consumers that. Just WANT TO CHECK OUT CANNABIS. But they're not looking to get high although CBD is not intoxicating it is psychoactive meaning that it does elicit effects from your neurons in your brain this is a common misunderstanding about CBD. It is psychoactive but it is not intoxicating the story of CBD goes back. Thousands of years as cultures across time have used non psychoactive McGregor. Myself Non intoxicating varieties of cannabis for different uses but the most relevant part of our story really starts in nineteen forty when researchers Roger Adams. Madison Hunt and J. H. Clarke published a report indicating the structure of a compound that they had extracted an isolated from wild hemp and Minnesota shout out to listeners and Minnesota your apart. Cbd History these researchers name this compound cabot dial or CBD as it would become commonly known CD was only the second cannabinoid found cannabis at the time with the first being canaveral or CBN a degradation product of THC in nineteen forty four. It was discovered that the effects of barbiturates could be extended if administered with CD but not with C. B. N. or. Thc researchers didn't understand why this effect was happening and they wouldn't get their answer to almost thirty years later for a moment in nineteen sixty three scientists in Israel would shine light on CBD once again until a year later in nineteen sixty four when they announced the discovery of THC as the intoxicating component of campus after that CD would become a bit more ignored once again until round the seventies and eighties when research into CBD really began to pick up steam in nineteen seventy to be discovered that CBD actually inhibits certain enzymes in the body which affects how the body metabolize certain foods and drugs. This helped begin to complete the puzzle that stemmed from the barbiturates study that was performed in nineteen forty four. Nearly three decades prior that we talked about previously in Nineteen eighty-one researchers were able to demonstrate anti-convulsant effects of CBD and humans indicating that it might be an effective treatment for certain forms of epilepsy and specificity in one thousand nine hundred eighty two year later. Cbd was found Exhibit Anti Anxiety Effects. Which would later be reconfirmed in Nineteen ninety-three in one thousand nine hundred five. It was discovered that CBD improves symptoms of psychosis ended. Nineteen Ninety Eight. The United States government actually filed a patent on the antioxidant neuro protective effects of CBD as well as Thc the two thousands would become the decade of elucidating the activity of CBD in two thousand and one researchers begin to finally understand more about how CBD actually works in the body by revealing that CBD targets non-cabinet receptors in the body that it stimulates the production of at least one. Indo cannabinoid an and denied and it inhibits and enzyme responsible for breaking down and might effectively allowing an to linger in the body longer in two thousand and two researchers would then confirm that CD exhibits anti nausea effects which had already been reported as far back as the eighteen hundreds when systematic cannabis research really began to take shape in two thousand and four. It was discovered that certain dosages. Cbd can increase wakefulness and counteract THC and do sedation. So if you're feeling a little sleepy after using THC cannabis a little bit of CBD Might Wake. You backup however be careful because CBD exhibits. What is known as by Faiza Activity? Meaning it acts differently in low doses versus high doses at high doses. Cbd CAN ACTUALLY BE SEDATING. In two thousand and five it was discovered that CD interacts with certain serotonin receptors in the body and in two thousand six researchers will go on to discover that CD also enhances a denizen receptor signaling which is associated with heart health blood pressure and body temperature regulation was also in two thousand six that researchers discovered that. Cbd Can kill breast cancer cells bringing significant attention to the compound as a potential anticancer drug into thousand seven researchers began to understand why CBD reduced the effects of THC in some of their prior research. It turns out that. Cbd CHANGES THE SHAPE and activity of CB one receptors even though it doesn't really exhibit much affinity for CB wonder sceptres directly in this way. It changes the way that teach actually binds to the CBO interceptor modulating. Its activity this. Kind of activity is called. Alistair modulation this why. Cd's able to reduce the high associated with THC It essentially deforms the CB wonder sceptre so that THC can't elicit same reaction from the receptor when it binds to it in two thousand and eight. It was discovered that. Cbd was a potent antibiotic against Mersa a powerful infection that's commonly picked up in hospitals and often resist treatment in two thousand twelve researchers discovered that. Cbd May be as effective as standard anti psychotics and in two thousand fourteen it was discovered the CD might be able to effectively treat acne in the skin by reducing inflammation fighting bacteria on the skin and changing the way that the skin produces oil in two thousand eighteen in the United States the Agricultural Improvement. Act of two thousand eighteen also known as the two thousand eighteen farm bill was passed which effectively legalised temp across the United States including all of the AIDS and other chemical constituents of all varieties of cannabis had thc concentrations the low zero point three percent and with that CBD was removed from the controlled substances list as long as the CD was him derived. Some may say that the CD market began at this time but really see beauty. Products had already been available in foods cosmetics and dietary supplements widely for years prior to the legalisation of him operating in somewhat of a regulatory gray area and then in twenty nineteen EPA dialects would officially become an FDA approved pharmaceutical for the treatment of certain forms of epilepsy in children the status of CBD as a pharmaceutical drug presents a real problem for the CD industry as a whole the FDA does not allow drugs to be added to foods or supplements unless they've been marketed as foods or supplements previously this is due to a set of laws in the food drugs and Cosmetics Act. Of course the irony is that the CBD industry's been around for quite some time not considering the exposure that humans have had to CD throughout history just from their interactions with cannabis cannabis in all its forms have been prohibited in the US for almost ninety years. So of course cannabis derived products have not been openly marketed and sold in the food drug and cosmetics act was enacted in nineteen. Thirty eight. Right around the exact same time that cannabis prohibition began considering that cannabis was included in the States Pharmacopoeia? For many years. All the way up until prohibition began. It's clear that cannabis derived products had been a part of society well into the Nineteen Thirties. And would have persisted. Had It not been for cannabis prohibition so in the nineteen thirties the opportunity for canvas to mature alongside the food supplement? Industries was effectively eliminated and the only pathway to get federally legal cannabis. Drive products to the public was through pharmaceuticals and now that him derive. Cbd AND OTHER AVENUES ARE FEDERALLY LEGAL. Ninety years later the government argues that it can't be put into food or supplements because it's a drug just seems like an awkward argument when you take the full history into account another argument that the FDA argues for resisting making any exceptions for CD in him derives cannabinoid in foods or supplements that there's not adequate data available to show that CBD is safe. They've argued that CBD could cause liver damage and interact with other drugs and thus it should be researched longer before it's allowed to be widely available to be consumed. The study they cite for this concern is a recent rodent study that looked at dosages that were orders of magnitude higher than the highest dosages used incomparable clinical trials for EPA dialects. I should point out that in this study dosages of fifteen milligrams per kilogram of body weight or less or not found exhibit these toxic effects and that's approximately nine hundred thirty milligrams or just round up to a gram of pure. Cbd for an average sized person. I spoke with Dr Ethan Russo about his thoughts on the idea of CBD causing liver damage. There's some concern lately too. And there's controversy of controversy over some of it but about the liver toxicity of high doses of CBD as well. Well I I think that's a blind alley it'd be truthful obviously Lower dose would be better but The liver issues mainly related to elevations of liver function tests and this is in Generally children Who are in Poly Pharmacy with a number drugs? Particularly of perk acid which is all known for being a bad actor in terms of Ltl avation arm so my strong suspicion is that's related to Poly Pharmacy Multiple Drugs rather than than a specific effect of Canal. Dial should also be noted that the World Health Organization issued a report on CD very recently attesting to CBD's remarkable safety profile at the time of this recording the future of the CBD industries very uncertain as him farmers CD product manufacturers and legislators plead their cases for changes to allow the CD industry to continue operating as it has with CBD foods dietary supplements and cosmetics readily available to consumers and now states are taking matters into their own hands just as they had to do with anything related to cannabis and they're setting their own laws for CD and now there's a patchwork of state legislation across the United States in regards to cbd any State Law protects a marijuana byproduct. That doesn't have mind altering properly inspected. Cbc products are now completely legal in the state and that's good news for farmers and companies who make those products as it essentially creates a new industry here in Ohio the crater question lingering around the FDA's involvement in the industry is whether the FDA will actually take action against these CBD companies today. They primarily seem concerned with going after companies making medical or health claims about CD but that could change in the future but the FDA is always going to go after companies making unapproved medical claims because that's in violation of the dietary supplement health and Education Act of Nineteen ninety-four which made it illegal to make such claims without FDA approval may also hear this rule referred to as DJ. Now this is why you see an FDA statement on every dietary supplement label which says something to the effect of these claims have not been evaluated by the FDA and are not intended to diagnose treat cure or prevent any disease and yet we see plenty of medical claims being made about CBD products. It really seems as though the only pathway forward to booming legal. Cbd industry across the country through changes to federal law to allow an exception for CD and other hemp derived natural products. Put any law. Changes that are proposed. Should be carefully worded. Even if CD is allowed in foods and supplements if a law change does not also determine. That CD is generally recognized as safe or grass than there could be another set of problems for the CD industry to tackle food additives like plant extracts and essential oils after have grasped status to be freely added to foods or formulated into supplements until the FDA takes on the role of doing this research and granting grass status to CPA and other cabinet itself. It's going to be up to private companies to do their own extensive research to achieve. What's called self affirmed grass status which only applies to their specific products and not their competitors even if their competitors using essentially the exact same ingredients as essentially makes a playing field. Where only the most well-funded CD companies can survive long term to put this into perspective gathering all the data needed to successfully achieve self affirmed grass status can cost as much is a million dollars or more at a time when the value. Cds A commodity is rapidly shrinking along with CD product margins. This is a difficult task for small or medium sized him companies to pull off without coming together and pooling their resources so okay these Cebu products there on the market. We know people are using them. Despite you know the feedback that the FDA's given so what are people actually experiencing with CBD? Since the two thousand eighteen farm bill was passed. Cbd shops have popped up across the country and even large retail chains. Like Kroger Fred Meyer. Cvs and walgreens starting to carry CBD products additionally specialized him in CD focused wellness. Stores have made their way into neighborhoods in cities across the United States. I spoke with Wendy win. An owner of a premiere CD shop in New York City about her experience operating. Cbd's store in a sense. I think the neighborhood felt like they were on the joining with US versus versus having huge the award redone so they knew they knew all that and they embraced with open arms. You know so. That's something that we are very lucky to have so. In the end I think for Artemis we get clients who are very curious about CBD. With I saw so they want the side. You WanNa know everything or we usually get there. Were there last thought. Would they meet with? Tried everything Detroit going on pain medications. Try going all that it wanted approaching much more of a natural plant based approach and we do get some kinds are in the middle with the China ended. Were coming back for another offer that most likely issue ships at the end that we get you know. And since we've been around now for few months would get off the middle which is try their CD other stores in other for second opinion. And they're coming to US without I opened. It wasn't like that op. Ed We have people who are so supportive and like we lost. Cbd WanNa try it you can see. My mother tried it or my dog right. Yeah anything that the other end of the spectrum where they came to challenge. Which was you know what what are you guys doing the sny. Fda approved at all so we saw the breath of clients that we were getting and you know and we really honestly appreciated the support off so the criticism because helped us grow as brand. That just meant that. We had to read a lot more books. That just meant that. We had to provide a lot more educational tools in the store and we designed the store actually twice to meet those demands right before I Open. Our Education Board was limited mainly because we didn't know what we needed to say as in what was helpful for clients But we did that. Education Board up probably a month after we quit because we realize this was a need that the thing will happen. And also we designed it to have a section where there's books available and as we were developing We started really working closely with Dr Chin. Slow the education side key much more up I think. Full breath a later on at war. Spawning for clients needs and with that being said to will. We redesigned the wall. Titrate was something that people don't understand. There's something I didn't understand when I first started down now and we realize that reading milligrams chew volumes to very very confusing and a Lotta time clients. Come in like I'm taking CD and it's not working and it will go. Kay how how much you taking a whole? What does that mean France? We don't know what was the bottle we don't know so. We realized that the map is fear that there there needed to be a little bit more guidelines on on intake and all that so we designed a section of the shop to be focused tight tradition. Which is that. You know exactly what you're taking with formulation Ran You're taking. And then we started designing a little Serving guides for clients so every time when a client walks away. They're walking away with a serving guy to to to couple with whatever off a so. All of that was really feedback. We've talked all the clients interaction that we had at the beginning of arts. One question that was on my mind when I was speaking with people about cbd was what dosages are needed to actually get an effect CBD products on the market. Have potencies of anywhere from one hundred thousands of milligram per one ounce bottle of oil when I reviewed the available scientific literature found that there wasn't a lot of information. Available EPA dialects clinical trials utilized. Essages a five milligrams per kilogram of body weight up to twenty milligrams per kilogram of body weight or around three hundred ten milligrams to nearly fifteen hundred milligrams for an average sized person in two thousand nineteen. There was a review of dosages that were utilized in published. Cbd Studies and it was found that dosages below around two and a half milligrams per kilogram of body weight were largely ineffective at treating most of the conditions that were being measured except for things like sleep disorders anxiety now that would be around one hundred fifty milligrams of CBD for an average person however the research on CD dosing complicated by the fact that CBD exhibits unique efficacy when it's administered isolation versus when it's administered in the presence of other cannabinoid peens and other fighter chemistry from the cannabis plant many clinicians that. I spoke with commented that they were seeing much better results at lower dosages with broad or full spectrum. Cbd versus isolate. It was interesting when we first started out. We thought half of our patients didn't want THC in their product. This is Dr James Taylor. A pain physician working in. North Carolina ever since hemp became federally legal in the United States. He's been working with his patients to understand how him extracts and CBD particularly might be a tool to help treat chronic pain so we gave him just CBD in the others did one a little. Thc In what we found is are once again in the waiting room the people who were trying the CBD products the ones that had a little bit of THC and had a full spectrum for having profound results. Those that were on the isolate weren't having such profound results so it was in the waiting room that the patients were talking so when they came back to the office visit they said. Hey I don't WanNa take the damn taken. I want to think it was the patients that were coming back telling us that the full spectrum was superior over an isolate so I'm assuming these large doses that folks need with the the deal oxen the CBD isolate is because a inferior product. And you can take much less. If you're taking a full spectrum product I asked Dr Taylor what dosages. He was noticing that his patients were finding relief with and this is what he had to say. My patients tend to be the poor and the elderly. They don't have a lot of money. Sure so we always recommend them to to start low. Go slow riots kind of in the industry. Everybody says that well our patients have to because they can't afford a thousand milligrams model and they've got they can. Were the two hundred fifty milligram bottle in so a lot of our patients tend to find relief in the eight to fifteen milligram A day range and I feel like a lot of that is is financial pressure. That can help. Keep them there Those that seem to be a little bit more successful Typically get up to thirty to forty milligrams a day and I am seeing in very general terms because we have patients with all kinds of different pain problems whether it's a inflammatory component or it's a it's a bone on bone type of pain or a neuropathic type of pain They're all different some generalizations but we have books that are taking two milligrams a day And some that are taking two hundred milligrams a day. So it's very hard for me to say what Milligram Works for folks So I do like to go start. Low go slow in. Just find a really where you're going to settle in but for me that's also we found that also doesn't make sense either because it's the cannabinoid profile That really makes a difference and we started seeing this in our practice. In the we were obtaining a product from a one extractor and then we started obtaining products from another extractor and our patients were having completely different effects. Right used to make me sleep now. It makes me awake and we were Lincoln cash. It's it's the same. No we looked under the hood and looked at the cannabinoid profile and it was a completely different ratio are there was hardly any. Thc In this product and there was nearly point three percent. Thc In this so we started realizing white. Cbd is kind of a In this industry while we've been talking about CBD other minutes easy for the consumer to think like that but it's really cannabinoid bright and it's these ratios cannabinoid. They're important and I think that's what really stimulated us to say. Gosh we have to start looking at this a little differently in but little more scientifically in. It's so much more complex than we realized. Reynosa we did a lot of retrospective data looking at these thousands of patients. We have taken this over the last two years in when we plotted out. It was not anything that we expected. And I wish I could show you an example where we put a positive responders in shades of green and a negative responders to a particular Whether we're talking about sleep or pain or anxiety In shades of red and it was just a mixture of green and red so. Cd's now this wonderful thing. That's going to turn everybody green and it works for everybody. Know it half the people working positively for in the other half. It's working negatively for all different things done. That's when we realized this is very complex Very individualized and I think that's what we started really paying attention To we need to start looking at people's genetics and epigenetics so we understand what they're bringing to the table And then I think eventually at the end of the day it's matching those up a genetics with certain cannabinoid profiles in order to modulate the system to a desired effect. I also asked Wendy would dosages. She was using to manage some of her pain and anxiety symptoms. So I remember I read all the books I said Micra Dunes and so I started with five milligrams. I didn't really feel much on five. Hogan's to newly I had an episode. A really really bad and I so can not working so I just took fifty. I said Yeah fifty which was not a good idea it. It worked wonders. Shifty was incredible. It really helped with my pain I also had a patch onto as well so I was kicking milligrams twice a day as documented and then I realized that after three or four days it stopped working like it perfect then it stopped working out back to Dr Juno Latte and I said what's happening like fifty was gray and the now's not working and she said potentially you might have kept on your tolerance you went. You went up to high now. Your body's just not passing it correctly in that sense and so we're to another formulation from me and that one had empty to L. which I didn't know So my own journey would see. Vdi recorded everything. And I've realized someone needs to. At least give me much more of a helping hand when I first started. And that's why we're so much more careful when it comes to our clients of artists that we really wanted to with the whole time but now. I know what my therapeutic doses whenever episode. I know what that is I would. Just go back to my. You know my microdosing periods after that was perfect and then would I don't need I just don't want to go that high. The frequency of dosing is very important because CBD liked THC lingers in the body and can accumulate over time with repeated dosing so it may be that low dosages of CBD might be effective when taken regularly but when acute relief is required in the moment higher. Dosages may be needed. Some people have a very profound effect after taking it initially and within the first couple days but the majority of my patients don't feel anything For weeks sometimes takes up two months for them to eventually things to start change so it's very subtle in so medicines typically have a very profound effect of It will lower your blood pressure. Your blood sugar do something you know very predictable at a predictable dose and CBD in Cannabinoid Medicine. Right now is kind of the opposite. There is no does we. Don't the the the effects that you're going to get taking? This are not predictable. So I think educating My patients in the community. That don't think of this as a medicine. You know really think it's closer to a nutritional supplement. Then I feel that it is a medicine at this point because we don't understand it we know it's modulating and changing your cabinet system but modulating and changing and in what ways rain-soaked bus yet. So a lot of this is just hit or miss in for me It being a position that's dealing with the OPIOID crisis. I don't have a lot to lose right. Sixty THOUSAND AMERICANS ARE DYING EVERY YEAR. And how we need a Hail. Mary In order for this to you know for our country to change in so for me. It felt good bringing something like this into the practice of medicine because we had nothing to lose It is positively affecting our patients. We are able to reduce their dependency on narcotics. And you know we are slowly getting there. But that's only because my organization is set up like that but for a patient who's on narcotic that just think they're gonNa buy this off the shelf and it's GonNa miraculously work very hard to make this work without having a healthcare professional or nurse that you could call or someone to help guide you through this process. You're going to be lost so clearly. People are having some sometimes profound experiences CD. But how does he did? He actually affect the body like all other cannabinoid. Cbd has not incredibly by available in the body most of the CBD that anyone ingest is simply excreted either unmet metabolize or as what's called a conjugated sugar meaning that a glucose molecule adhere to the CBD molecule as it passed through the body now some of the CD that's ingested sticks to other life affiliated or oil loving tissues in the body like fat which keeps from circulating in the body and reaching sites of action but for those molecules CBD that do make it into the bloodstream and get circulated throughout the body. An interesting series of events begins to take place first of all. It's important to know that. Cbd has a very very low affinity for either CB one or C two receptor. Which as you may remember from episode six of the podcast these are the two primary chemical receptors that make up into Connecticut System. Instead of directly affecting tabloid receptors CD tints to stimulate these receptors indirectly by affecting the production breakdown of Indo cabinets that the body produces on. Its own as mentioned before. Cbd's stimulates the production of Ananta Mine. Which is a partial agonists or stimulator of CB ONE NC two receptors much like thc additionally CD inhibits enzyme called fatty acid. A my hydro lease also known as far or F. A. H. Which would typically break down in the end mine as well as a lot of other things in the body. This allows the anatomy that the body produces to linger in the body longer the stimulating canaveral interceptors for a long time. At least theoretically you could think of this as CD nudging the Indo cabinet system to do its own thing rather than completely hijacking. The system altogether which is kind of what? Thc does that's not to say that the activity of THC is bad or undesirable. It's just very different now. Cbd also interacts with a putative cannabinoid receptor called GP are fifty five the GP are stands for g protein coupled receptor which is the type of chemical receptor. That canaveral interceptors are a little technical vocabulary now G. PR fifty five is thought to be responsible for some. Cd's anti epileptic activity among other things. In addition to these effects on into AIDS and cabinet receptors CD interacts with a lot of other chemical receptors including Vanna later sceptres like tr PV. One Trip v one which are also referred to as kept sason receptors because kept saying the chemical responsible for the spiciness and peppers. Also stimulates van alert receptors. Cbd also interacts with Serotonin receptors commonly associated with mood. Sleep and blood pressure. It also influences the activity of denizen receptors commonly associated with heart health and it also interact with p. p. a. r. Gamma receptors which are linked to insulin resistance and diabetes among other things. In addition to inhibiting enzymes that break down to mine. Cbd also has potent inhibitory effects on a group of liver enzymes called the site of Chrome P for fifty signs which are responsible for metabolising. Many common drugs this inhibitory effect is commonly referred to as the grapefruit effect because grapefruits are well known to cause the same enzyme inhibition. In fact you may have once been prescribed a medication that featured a label on the bottle that cautioned against taking with grapefruit one of the most well known drug interactions with CBD is with a blood thinning drug called warfare. Yes so as an anesthesiologist and pain position as a very heavy into interventional procedures. I'm always concerned about Kundun. To interject for just a second in case you don't know commit in. Is War friend Anna up in? We know that it's metabolism in delivered by the side of the people were the system in. That's with CBD consumers. You should be thinking about that as well And there were some studies out there to say that it could affect some bleeding times but we had not seen that clinically so our patients who were taking this were honor Kundun. Into we got laboratory tests we could not see their bleeding times change so I think theoretically it is possible but I'm not seeing clinically. What we do see clinically. Which could be worrisome. Is that when you are taking a CD product in your stimulating your system which I like to refer to as your inner physician. It's kind of nature's way of keeping balance in healing yourself is. Your Body is starting to heal end. Maybe it is competing with the site across four fifty system for certain drugs plasma levels of these anti hypertensive czar diabetic medications could theoretically be bolstered. A little in with your health becoming Improved we're finding patients needing to get off these medications So a patient Who sticking a blood pressure medicine? We don't recommend them taking her. Cbd At the same time they take their blood pressure. We make we ask them to take that two hours after that So we'RE NOT WORRIED ABOUT DIZZINESS. Or dropping one rusher in we really encourage them every patient That gets on. Cd Go to your primary care doctor. First and let them know you're taking this and have them start to monitor your blood pressure diabetics and so you can reduce these medications if you're able to Under their care for consumers to go out and try to do that on their own. I feel is is very risky. So you know that that. We haven't seen any problems in patients. But I feel like problems are just right around the corner if we as physicians aren't monitoring these patients as diligent as you need to. Cbd also has been demonstrated exacerbate the negative side effects of some epilepsy. Drugs like Valpo Acid because of these kinds of interactions. It's important that anyone taking CD with other medications do so under the supervision of a healthcare provider to stay safe one thing. That should be mentioned here. Is that so far? We've been talking about how. Cbd By itself and isolation interacts with the body when CBD is present in a complex mixture like cannabis extract with dozens or hundreds of other compounds or when it's formulated in. A food or topical product with other ingredients effects can be very different. A hint extract product should be judged by the total formulation not just the quality of the hemp extract used as a single ingredient in the product. It's also possible to manipulate the. Absorption and bioavailability of CBD using technologies like Nanno Mulsim was a process of breaking up a CD extract into the tiny tiny droplets the size of nanometer. Which is one billionth of a meter. And then these tiny droplets are surrounded by a little water friendly casing. What this does is it. Allows the oil droplets to remain suspended in an aqueous solution keeps the oil droplets from coming back together to one another. And this is how you make. What's often termed water soluble? Cbd But it's kind of a misnomer. There's really no such thing as water. Soluble CBD really. What's being made is kind of what would be referred to as a call away at something that remains suspended in solution that doesn't settle or rejoin It's not really soluble in water. But I digress. So far we've mostly been talking about how. Cd affects the body when it's ingested or inhaled. But what about the effects of CBD? On the skin there are all sorts of chemical receptors in the skin including cannabinoid receptors. Just like you have in other parts of your body in general when CD's applied to the skin or topically it only affects the area where it's applied exception is when CBD is Applied Trans Termoli usually with a patch these are similar like kept saying in patches or even nicotine patches in their specially formulated with ingredients. That will help carry things through the skin. That normally would have a hard time penetrating if can avenue. It's like CPA can soak through the outer layer of the skin the epidermis and reached the lower layer of the skin the durmus than it could end up reaching blood vessels and then getting into the blood and being distributed throughout the body. But we'll see B D actually help keep your skin healthy right now. Currently in the market. There's much there's a seavy. Beauty focused product star. Willoughby's does usually between oil or a beauty. Serra whatever it is right not necessarily like a clean base like like the treatment Roger that sense so I think a lot of times clients when they have asked me. They are association. Oil means more oil. Right right it's gonNA produce more oil right so right accusations so to break down that association to treat with oil is it takes some time for people to get used to you know if your if your skin issue. I think with fires much more intensive care we do suggest you to internally to take it as a tincture also a method to us. Well Abby. A- I find that to be romy percent the best approach as much as we advocate taking it for time and then stopped me. I did that myself. I took it for eight months straight and then I stopped taking two months to see what were wise and all that and the first thing. That was my skin by really. Oh yeah very like that was the first thing I noticed my skin wasn't as Halsey was as a internally glowing not like internally glowing As it was when I was on it that was my outside of the pain. Management course at that was my biggest motivator nowadays whenever meet people that was the first thing they say that your skin looks naturally low in honestly nothing's changed but my just the incorporation of CD my life to with you so you can see that. Cbs activity in the body is diverse and complex. We still don't understand the whole picture yet. And don't let anybody tell you otherwise yet despite our lack of knowledge about CBD evidence does seem to indicate that it's a pretty safe compound even if some regulatory agencies disagree. I've seen a lot of people. Conflate even an presentations at conferences can flay the side effect profile of pure. Cbd At high dosage to see bb in general. And that's not a fair comparison. I would save a Connecticut. Dial despite its many complex mechanisms of action is an extremely safe drug with very few adverse events the most common adverse effects associated with CBD or things like lethargy appetite disruptions and gastro intestinal distress. But everyone reacts to things differently and an uncommon cases. Some people may react unfavourably. Cbd just like they might anything else but like THC. It's incredibly difficult if not impossible to overdose or die from using CBD at extremely high dosages of fifteen milligrams per kilogram of body weight or higher. It is possible to cause liver damage with CBD but it's also very uncommon for anyone to ever take dosages that high to put this into perspective that equates to a dose of around one gram of pure cbd for someone that weighs around one hundred and forty pounds or sixty two kilograms for someone like myself that weighs closer to two hundred pounds that does have be closer to grandma and a half or fifteen hundred milligrams of CBD to put this issue into better perspective. Consider THAT MOST CD. Products readily available in the market have serving sizes feature doses of between five and fifty milligrams of CBD According to the Safety Data Sheet for EPA DIALECTS CBD is tolerated well in humans orally at dosages up to fifteen hundred milligrams per day based on the history of research that exists. It's clear that. Cbd has a lot of potential as a medicine. Research indicates it may be effective at treating things like anxiety. Depression sleep various forms of specificity pain. Bacterial Infections and inflammation. When it comes to skin treatment it might be effective in battling acne and regulating inflammation of the skin. It is true a lot more research is still needed to understand how to best unlocked therapeutic potential CD but it's clear that CD is certainly not another snake oil but like many things there's a lot of nuance around the topic. One of the big issues that needs to be understood as what dosages are needed to elicit therapeutic effects while we have a pretty good understanding of what dosages not to exceed to stay safe. We don't have a clear picture of what dosages to shoot forward to achieve targeted therapeutic effects under different conditions this is why many consumers of CBD are leaving it up to trial and error to find the dose that works best for them and then of course the other sneaky problem is at would dosages CBD actually active and which dosages are people mostly just experiencing placebo effects. This is a problem that plagues cannabis research. Broadly and we need to understand these issues. Better course another side to the puzzle is if people are experiencing placebo effects than is that necessarily a bad thing considering the safety profile of CBD. My personal opinion is Maybe it's not such a bad thing as long as you're not breaking the bank to get CD in the first place and this brings us back around to where we started in that CD products currently. You're heavily inflated in value although the CB market is rapidly devaluing and we should see the prices of a lot of CD products. Come much more in line with traditional herbal supplements in years to come. I think it's also critical to acknowledge that. Cd is not a wonder drug. It provides relief for some people facing certain conditions. But it doesn't help everyone in fact in some research. Trials CD actually exacerbated symptoms like seizures. Specificity in some people as we've discussed before on this podcast. There's no such thing as a magic bullet drug natural product or plant. That's going to provide nothing but positive benefits to all people all of the time. That's just not the way things work however clearly. Cbd HOLD SOME SERIOUS POTENTIAL. So let's briefly review. We've learned we've learned that. Cd is a common can have found hemp varieties of cannabis. But it's found in most varieties of cannabis in general varying concentrations. Cbd's not intoxicating THC is however it is psychoactive because it does affect neurons research into CBD really took off in the nineteen seventies and eighties but researchers didn't really begin to understand how CD affected the body until the early two thousands see but he doesn't interact with cannabinoid receptors very much directly but see but he does interact with cadaver interceptors indirectly by stimulating. The production. Of Mine in inhibiting the INS. I'm far or F. A. H. That would typically break into my down. Cbd Interacts with a host of other chemical receptors. In the body including miscellaneous g protein coupled receptors Fanta Lloyd receptors serotonin receptors denison receptors and gamma receptors and there are others interacts with as well. Cd inhibits enzymes in the liver that are responsible for breaking down many common drugs which can lead to elevated concentrations of those drugs in the body because of this. It's important to communicate with your healthcare provider if you're taking. Cd ALONG WITH OTHER MEDICATIONS. That may be affected. By the grapefruit effect is generally well tolerated by most people at dosages as high as one thousand five hundred milligrams per day common side effects include lethargy gastrointestinal distress and appetite changes at dosages above fifteen milligrams per kilogram of bodyweight liver. Damage could begin to take place the L. D. Fifty of CBD is thought to be somewhere about two hundred milligrams per kilogram of body weight or over twelve grams of pure cd for an average size person. Cbd's exhibited promises a medicine to treat things like epilepsy anxiety. Depression material infections pain inflammation and ACSI among other things but more research is needed to properly understand exactly what CDs effective at treating and at what doses currently the only CD pharmaceutical approved in the United States is drug called EPA dialects for the treatment of certain forms of epilepsy in children. In other countries you could also find. Tvd in the cannabis dried pharmaceuticals which features a standardized cannabis extract with equal parts CBD and THC CD's seems to be most effective at dosages above two and a half milligrams per kilogram of body weight or above around one hundred fifty milligrams for an average person. Though there is evidence that some people may find relief at much lower dosages the form of C B D can affect its efficacy and every clinician. I spoke to recommended broader full spectrum. Cbd Extracts over isolates and that it's best to start at a very very low sub clinical dose and slowly. Titrate your way up until you find your minimum effective dose so is CBD Hero. Her just hype. Well it certainly seems that for some CD is very much a welcome hero. There's no question that it's an effective treatment for some conditions for some people it can be quite safe and it could help treat a wide variety of conditions without getting people high however. I must point out that research has indicated that. Cbd tends to be much more effective in the presence of Thc so as TAC FREE CD products at the market. Keep in mind that those products might not be as effective as a product that contains at least a little bit of THC but for all of the promise of CBD. There's still a lot of unfounded hype for consumers to Wade through. It's critical that consumers pay attention to the quality of CBD products as well as the dosages many CBD products feature incredibly low concentrations a CD that are likely sub therapeutic in addition CB products can be quite expensive leaving consumers paying out fortunes for low potency sub therapeutic products and this trend is unlikely to go away anytime soon. Knew HIM HBEXTRACT products featuring other lesser known contaminates like CBGB'S CBC and CBN are already quickly gaining market buzz. And it won't be long before CD passes the hype torch onto these other tabloids. And with that. I'm your host Jason Wilson. Thanks so much for listening. Stay curious and take it easy. Thanks to our guests that were so gracious and spending time with me for interviews. That helped construct not just this episode but other episodes throughout the season to check out the citations for this episode. And there are plenty. 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