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Hemp-derived CBD has exploded in popularity in recent years, popping up in recipes, at health food stores, and beyond, leading many to wonder what the hype is all about. To enlighten us on all things CBD and dispel any misconceptions surrounding it, we’ve tapped naturopathic doctor and medical advisor to CV Sciences, maker of PlusCBD Oil, Aimée Shunney. From its origins to its benefits and dosage recommendations, you’ll learn everything you need to know about adding CBD to your wellness routine.
What is Hemp-Derived CBD?
CBD can be found in hemp oil, marijuana oil, or on its own as isolated CBD. The legal difference between marijuana and hemp is based on how much delta-9-tetrahydrocannabinol (THC), the intoxicating compound that produces the “high” feeling, it contains. Only cannabis products with less than 0.3% THC, like hemp-derived CBD, can be classified as hemp. All those with a higher percentage of THC are considered marijuana. Because of hemp’s very low levels of THC (some CBD brands boast 0.0% THC), it does not give you the “high” effect. Hemp, unlike marijuana, is considered federally lawful.
A little history. Use of Cannabis as a medical treatment dates back at least 7,000 years. Cannabidiol (CBD) was only recently discovered in the 1940s as a unique cannabinoid from the Cannabis Sativa L. plant.
It took until the 1990s for scientists to uncover the true importance of cannabinoids when it was confirmed that humans have receptors in our bodies that respond to them. These cannabinoid receptors can be classified as CB1, which are found mostly in the brain, and CB2, which are found mostly within the immune system.
What is a cannabinoid?
A set of chemical compounds that interact with the body’s cannabinoid receptors, found in every organ of the body. Our body makes our own endocannabinoids, while the Cannabis plant makes phytocannabinoids (synthesized by plants), like CBD and THC.
Did you know? There are at least 100 cannabinoids in the Cannabis plant; CBD and THC are the two most well known.
Understanding the Endocannabinoid System
This cannabinoid–receptor relationship is the cornerstone of the endocannabinoid system (ECS). The main purpose of the ECS is to maintain homeostasis in the body. Dr. Shunney explains, “Our body is constantly responding to internal and external stimuli that’s telling us that we have to adapt.” Whether we are hungry (internal) or just handed a major project at work (external), the ECS helps us adapt by controlling our fight or flight response, impacting our endocrine function, the immune system, and inflammation. “The endocannabinoid system is an incredibly important system to help us function on a moment-to-moment, day-to-day basis,” says Dr. Shunney. “In fact, many scientists are calling the endocannabinoid system the ‘master control system’ because of those very reasons.”
The pitfalls of our modern, busy lifestyles, like poor eating habits, too much processed food, a lack of adequate sleep, and excessive stress, can push our ECS out of balance. So now, the system meant to balance us and help us adapt to change is also out of balance. This can lead to both emotional and physical health issues.
How does CBD Help?
CBD, by engaging with the cannabinoid receptors in our bodies, has the ability to restore balance to our ECS. “CBD helps to balance the system meant to keep us balanced and it does that directly in the endocannabinoid system by impacting CB1 and CB2 receptors. CBD is able to come in and help us be balanced and function optimally, create stress resilience, and respond well to the things that we are constantly being asked to adapt and respond to,” explains Dr. Shunney. “If CBD is going to help me balance my endocannabinoid system, then it’s going to help me with all things that make me respond better to stress. So sleep, anxiety, mood stability—these are all areas where CBD might help to balance the endocannabinoid system, which can make all of those things work better.”
“[CBD] impacts how we perceive and respond to stress via its effects on the ECS, potentially altering what we react to, how big our reaction is, and how quickly we recover,” Dr. Shunney also notes. Many of her patients who take CBD report feeling more calm and relaxed, “like better versions of themselves.”
The Many Uses of CBD
While scientists continue to learn more about CBD and its benefits, there’s much to be excited about. According to a 2013 National Institutes of Health study, “Modulating ECS activity may have therapeutic potential in almost all disease affecting humans, including obesity/metabolic syndrome, diabetes and diabetic complications, neurodegenerative, inflammatory, cardiovascular, liver, gastrointestinal, skin diseases, pain, psychiatric, disorders, cachexia, cancer, chemotherapy-induced nausea and vomiting, among many others.”
Dr. Shunney, whose practice mainly focuses on women’s health, hormone balance, functional endocrinology and general medicine, recommends CBD oil to her patients with sleep, stress, anxiety, pain, and inflammation issues. Other physicians, she says, use it for seizure disorders, neural inflammation with lyme disease, and more.
But is it safe? “Meta Analysis from 2011 found that CBD is safely tolerated in humans at doses that are 100 times more than I would give anyone in any product,” says Dr. Shunney. Therefore, she explains, there is a very large window of safety for people to go up and down to find their right dosage.
In a recent 2018 report, the World Health Organization (WHO) states that “CBD is generally well tolerated with a good safety profile.” It also notes that limited research on humans shows no dependency issue, meaning it is non-addictive.
Who Can Use CBD?
More data is needed in all of the below categories so Dr. Shunney often advises patients that usage is based on their comfort levels.
Kids. Having said that, Dr. Shunney explains that while not a lot of data on general use of CBD with kids is available, pediatric epilepsy is one of the most well-researched areas of CBD. She says that isolated CBD (the prescription drug Epidiolex) has been shown to be safe and effective for children with severe epilepsy.
She always leaves the decision up to parents, informing them that she has seen CBD used safely within her practice. But because it does have a small amount of THC, it comes down to their judgement.
Pregnant Women. Given the risks to the developing fetus, it is generally hard to do studies on pregnant women when it comes to chemical interactions. Because of this, there is no comprehensive clinical data on the effects of CBD on mom or baby.
Recently though in 2019, the FDA put out a warning strongly advising against use of CBD during pregnancy and breastfeeding. The agency warns, “high doses of CBD in pregnant test animals have caused problems with the reproductive system of developing male fetuses.” It also believes that some amount of CBD will be transferred into breast milk. Because much is unknown they discourage pregnant and breastfeeding women to put themselves and the baby at risk.
Pets. Dr. Shunney sees CBD as a fantastic option for pets because they, like us and all other mammals, have an endocannabinoid system. Her patients give CBD to their pets for issues like arthritis and anxiety.
Those Subjected to Drug Tests. Individuals who must regularly submit to drug testing should avoid all hemp products, not just CBD, says Dr. Shunney. This is mainly because the drug tests are not nuanced enough yet to decipher what’s CBD and what’s cannabis.
Those Who Take Other Medications. There is substantial data that shows interactions between isolated CBD and other medications, like anti-epileptic drugs and warfarin (a blood thinner). At this time, there is no evidence of drug interactions with full-spectrum hemp CBD products. That being said, there is theoretical risk and anyone on medications should ideally integrate CBD with their doctor’s support, says Dr. Shunney. “I’ve definitely seen CBD play well with other drugs, particularly antidepressants and anxiety medications as well as pain medication.” She does recommend that when adding any new medication or supplement to your routine, you do it slowly and watch carefully for any positive or negative changes.
Finding Your Ideal Dosage
Everyone’s ECS is different, therefore every person’s ideal dosage may be different. Dr. Shunney recommends you, “start low, go slow, and work your way up.” When you get to the right dose for your symptom, you may feel it work in minutes, putting it in stark contrast with other natural products that take weeks to see results. That’s what she loves about CBD. “To be able to offer people solutions that are natural and that act quickly, that’s where the real game changer is,” says Dr. Shunney.
Where does the FDA stand on CBD?
“Since hemp was federally legalized in late 2018, we have been waiting for the FDA to create a regulatory pathway for hemp CBD, but their toolbox is limited,” says Dr. Shunney. “The FDA is asserting that since CBD has already been approved as a drug, it can’t be a dietary supplement. But the CBD in prescription Epidiolex (approved for use with severe pediatric epilepsy) is 99% isolated CBD vs. hemp-derived CBD extracts that contain 1–2% CBD with the rest being other parts of the hemp plant. Do those sound like apples and apples to you? My sense is that over time, the FDA will come to the same conclusion. In the interim, however, their lack of action exacerbates an environment that is already the ‘wild west’ in regards to variabilities in hemp CBD products. We need regulation now to clean up the industry and promote safety and quality for consumers.”
Full Spectrum CBD contains terpenes and a full range of cannabinoids offering the “entourage effect” from the cannabinoids working together.
Broad Spectrum CBD contains terpenes and a range of cannabinoids, excluding THC.
CBD Isolate contains only CBD. All other plant matter, including THC, is removed.
There is hope though, says Dr. Shunney. “A bill was recently introduced to congress, HR 5587, which would fix this issue by simply amending the Federal Food, Drug, and Cosmetic Act to include hemp-derived CBD in the definition of dietary supplement. This bill is gaining momentum with 6 bipartisan sponsors, and may very well be the shortcut we’re looking for.”