CBD: neuroprotectant, cardio-protectant and antioxidant

My blog posts on CBD are some of my most popular.  They helped me organize my thoughts on CBD, but I also want to hear what physicians have to say.  Thus, my guest post today.  It answers some of my remaining questions and will hopefully help those of you still doing your research. 

I want to reinforce that I come from the world of quality, safety and risk as a hospital administrator.  I'm very thoughtful and methodic and carefully look at new issues from a variety of perspectives.   This is my reason I write and invite guest posts on the subject of CBD.  I'm not there yet, but one day may also expand my horizon to include the benefits of THC for those with chronic conditions.

Guest Post:  Patricia Frye, MD, is an independent physician consultant with a focus on cannabis and the role it plays in the management of pain and chronic disease. Committed to furthering physician education in the field of cannabinoid medicine, Frye lectures at medical schools, physician and hospital seminars, and the National Institute on Drug Abuse. 

Cannabidiol, also known as CBD, is a non-intoxicating compound found in the cannabis plant. It has gained much popularity of the last few years as it is known to have an impressive number of health benefits.

Animal studies have shown that CBD to be a neuroprotectant, cardio-protectant, and antioxidant, effective in treating neuropathic pain and seizures, reducing inflammation, the incidence of diabetes, regulating fat and sugar metabolism, reducing anxiety and stress, as well as reducing appetite.  A few human clinical trials have supported what many of us see in clinical practice, that CBD alleviates pain, anxiety, migraines, and seizures.

Many physicians are not familiar with the benefits or adverse effects of CBD and may need to do some reading before they are comfortable recommending it to their patients. Whether your doctor is for or against the use of cannabis-based medications or products, it is important that he or she be aware if you decide you want to use it. CBD has the potential to interfere with other medications. This is of concern when those medications have a narrow therapeutic window. That means that slight increases in plasma levels could have toxic effects.

Cannabis and hemp are environmental cleaners, meaning they absorb contaminants like pesticides and heavy metals and the plant can be contaminated with mold or bacteria. Care has to be taken when choosing a CBD oil that is made from hemp that has been grown in controlled conditions and has been tested to ensure that it does not contain any of these commonly found substances. The industry is not regulated and there are many processors who use hemp that is contaminated and use processing methods that leave rubbing alcohol or light hydrocarbons like butane and propane in the product. If sanitary methods are not employed, oils can be tainted with E.coli, shigella, salmonella, and other harmful bacteria.

The best sources for CBD oil is from your doctor, pharmacy, or large retailer. They have likely investigated the products and sell only those that pass laboratory testing. While there are many fine products on the market, buying online can be especially harrowing. Anyone can say anything about their product and lab results are commonly falsified.  I warn my patients not to purchase CBD in vape or smoke shops and to either stay with the brands we recommend or do their homework and get their product tested, especially before giving to children.

As far as dosing, everyone responds to cannabis differently. Some patients respond to very small doses – around one milligram, while others require much higher doses. The best thing is to always start with a small amount and gradually increase the dose until the symptoms are relieved. How rapidly a dose is increased depends on the condition being treated. I advise patients to increase their dose every 30-40 minutes if they are treating pain; every 5-7 days if treating anxiety. I feel guidance is important for patients with serious illnesses; and in states with medical cannabis programs, getting an official recommendation for a child may avoid potential legal issues.

There are a number of resources for more information on CBD and dosing.

• • HelloMD.com thoroughly investigates the CBD oils available in their online market so buyers can be confident that they are purchasing a healthy product. Their site has a number of posts with useful information, much of it written by cannabis physicians.
  • Project CBD, a non-profit website, is another reliable source.
  • The Society of Cannabis Clinicians and United Patients Group are non-profits that can help patients locate healthcare providers experienced in cannabis medicine in their area.
  • My book, The Medical Marijuana Guide: Cannabis and Your Health is another resource for more information on hemp-derived CBD.