Let’s start with a basic overview of Cannabidiol (CBD). CBD is a non-psychoactive cannabinoid produced by the cannabis plant. It makes up approximately 40% of the cannabinoids found in the plant and accounts for most of the health benefits associated with cannabis use.
There are several health benefit claims floating around the internet related to the use of CBD. Many are anecdotal (non-scientific) claims made by long time users of cannabis or self-proclaimed cannabis experts. That being stated, it’s not a stretch to believe that CBD from the cannabis plant offers significant health benefits considering that worldwide between 50,000 and 80,000 flowering plants are used medicinally (2).
Also, in the US, 74% of the top 150 prescribed drugs are plant-based, and according to the National Cancer Institute, 70% of the new drugs introduced in the United States over the last 25 years are plant based (1,3).
The main reason we have more anecdotal and less scientific evidence is because CBD research in the US is limited due to its classification as a Schedule I drug. However, it appears that is about to change following the FDA’s recent approval of the CBD based drug Epidiolex for the treatment of Epilepsy.
In the approval process the FDA advised the DEA to remove CBD from its current Schedule I classification. Once CBD is reclassified it will open the door for legitimate scientific research to be conducted in the US.
That being stated, keep in mind that high quality research is costly and takes time to conduct, so we can’t expect immediate results validating or debunking the health benefit claims of CBD.
The good news is research conducted outside the US is available and much of it provides valuable evidence supporting the medicinal benefits of CBD.
CBD is reported to exhibit a broad spectrum of potential therapeutic properties including anti-anxiety, neuroprotective antioxidant and improved brain health. The health benefits of CBD are dose dependent and studies suggest that it is well tolerated in doses of up to 1500 mg per day. There are very few reported side effects and unlike THC, CBD does not affect heart rate or blood pressure and does not alter psychological or psychomotor functions (4,5). If side effects are reported, they are usually mild and may include tiredness and diarrhea.
In the commercial market CBD is classified as a health supplement, resulting in products being produced without regulated guidelines, resulting in poorly advised dosing recommendations.
We have treated over 2,000 patients with CBD in our medical practice and found that our patients report the best results when taking 2-4 mg of CBD per kilogram of body weight divided into two daily doses, one in the morning and one in the early evening.
We are most excited about recent research focused on the use of CBD as an antianxiety, antioxidant and supplement to improve brain health
CBD for Anxiety
Anxiety is a general term associated with disorders that cause nervousness, fear, apprehension, unease and worrying. These disorders can negatively impact the way a person feels or acts and may affect a person’s ability to cope with the stressors of everyday life.
Acting in the capacity of an anti-anxiety, CBD has been reported to facilitate neurotransmission of the serotonin 5HT1 A receptor by indirectly binding at the receptor site and or causing interference with intracellular pathways at the receptor site (5,6).
Several anti-anxiety and anti-depressant drugs target the serotonin 5HT1 A receptor, whereby attempting to moderate serotonin and dopamine levels in the brain resulting in mood stabilization. CBD operates in a similar fashion within the body and has been reported to facilitate an elevated mood with significantly less harmful side effects.
CBD as an Antioxidant
Oxidative stress is an imbalance between free radicals and antioxidants in your body and is believed to play a role in the development of chronic diseases. Free radicals are formed when an oxygen molecule splits in two resulting in a free-floating reactive oxygen species (ROS) electron molecule.
Electrons prefer to be paired, so this newly formed ROS electron molecule will scavenge the body attempting to pair with another electron. This scavenging process results in cell injury or death, subsequent tissue damage, and chronic disease.
Acting in the capacity of an antioxidant, CBD helps reduce oxidative stress in the body by decreasing factors associated with the production of ROS (free radicals), scavenging free radicals floating in the blood stream and increasing the expression of the body’s internal antioxidant system (7,8).
Additional studies suggest that CBD can donate electrons to ROS free radicals seeking a pairing electron thus reducing the cellular damage caused by the scavenging process.
Also, CBD has been shown to be significantly more effective than vitamin C and vitamin E in protecting neurons from glutamate toxicity (8). Glutamate is a neurotransmitter responsible for passing nerve signals from one nerve cell to another.
Abnormally high concentrations in the body can lead to glutamate toxicity resulting in symptoms associated with ADHD, Anxiety, restlessness and pain amplification. Glutamate is found in many food sources, with monosodium glutamate (MSG) being one of the most commonly known.
CBD for Improved Brain Health
Healthy brain cells are imperative to physical, mental and psychosocial development. Lifestyle, disease and ageing causes changes to occur within the brain that may negatively impact neuronal activity and brain function.
Acting in the capacity of brain health, CBD has been shown to increase brain derived neurotrophic factor (BDNF) expression (12). BDNF plays an important role in brain cell survival and growth, serves as a neurotransmitter modulator, and participates in brain cell plasticity, which is essential for learning and memory.
It also binds to receptors at the synapses to improve signal strength between neurons and is widely expressed in the CNS, gut and other tissues (11). Studies suggest that lower levels of BDNF are associated with poor cognitive performance and have been linked to: developmental disorders, Alzheimer’s disease, accelerated aging, poor neural development, neurotransmitter dysfunction, obesity, and depression. Chronic CBD use has been shown to increase BDNF levels in the hippocampus (13, 14).
Even though we have limited scientific research involving human trials for the use of CBD, rat-based research and anecdotal evidence is pointing in a positive direction for the health benefits of CBD.
Soon high-level scientific research will begin with human trails. The results of these studies will provide more conclusive evidence related to the specific health benefits of CBD.
In the meantime, CBD users should look for quality standards prior to purchasing CBD products. Good quality standards include lot numbers linking the product to a specific batch of CBD isolate, good manufacturing practice certificates indicating the manufacturer follows quality assurance guidelines during the production process and the product should indicate it has been lab tested to ensure the ingredients match the contents of the bottle.
E.M. Rock, D. Bolognini, C.L. Limebeer, M.G. Cascio, S. Anavi-Goffer, P.J. Fletcher, R. Mechoulam, R.G. Pertwee, L.A. Parker, Cannabidiol, a non-psychotropic component of cannabis, attenuates vomiting and nausea-like behaviour via indirect agonism of 5-HT(1A) somatodendriti autoreceptors in the dorsal raphe nucleus, Br. J. Pharmacol. 165 (2012) 2620–2634.
M. Garcia-Arencibia, S. Gonzalez, E. de Lago, J.A. Ramos, R. Mechoulam, J. Fernandez-Ruiz, Evaluation of the neuroprotective effect of cannabinoids in a rat model of Parkinson’s disease: importance of antioxidant and cannabinoid receptor-independent properties, Brain Res. 1134 (2007) 162–170.
A.C. Campos, F.A. Moreira, F.V. Gomes, E.A. Del Bel, F.S. Guimaraes, Multiple mechanisms involved in the large-spectrum therapeutic potential of cannabidiol in psychiatric disorders, Philos. Trans. R. Soc. Lond. B Biol. Sci. 367 (2012) 3364–3378.
J. Fernandez-Ruiz, O. Sagredo, M.R. Pazos, C. Garcia, R. Pertwee, R. Mechoulam, J. Martinez-Orgado, Cannabidiol for neurodegenerative disorders: important new clinical applications for this phytocannabinoid? Br. J. Clin. Pharmacol. 75 (2013) 323–333
A.C. Campos, F. Brant, A.S. Miranda, F.S. Machado, A.L. Teixeira, Cannabidiol increases survival and promotes rescue of cognitive function in a murine model of cerebral malaria, Neuroscience 289 (2015) 166–180
T. Barichello, R.A. Ceretta, J.S. Generoso, A.P. Moreira, L.R. Simoes, C.M. Comim, J. Quevedo, M.C. Vilela, A.W. Zuardi, J.A. Crippa, A.L. Teixeira, Cannabidiol reduces host immune response and prevents cognitive impairments in Wistar rats submitted to pneumococcal meningitis, Eur. J. Pharmacol. 697 (2012) 158–164.
S.S. Valvassori, G. Elias, B. de Souza, F. Petronilho, F. Dal-Pizzol, F. Kapczinski, C. Trzesniak, V. Tumas, S. Dursun, M.H. Chagas, J.E. Hallak, A.W. Zuardi, J. Quevedo, J.A. Crippa, Effects of cannabidiol on amphetamine-induced oxidative stress generation in an animal model of mania, J. Psychopharmacol. 25 (2011) 274–280.