Healthcare in the United States is based on the medical–pharma model of “one drug for one bug.” Pharmaceuticals typically work by blunting pathways in the body for effectiveness, which frequently comes with detrimental side effects. Cannabis with THC and whole plant CBD, on the other hand, work by enabling pathways, creating balance and homeostasis. Could the endocannabinoid system and cannabis be the answer to health and wellness? The more practitioners and researchers learn, the more the answer points to yes. The question of how much cannabis each person needs to produce the desired health effect is a bit trickier.
CBD is regarded among researchers as a generally safe product because of its lack of dangerous side effects. The most common side effects of CBD among otherwise healthy individuals are fatigue, diarrhea, and changes in appetite. That being said, if you have any health concerns whatsoever, it is important to speak with a healthcare professional competent in cannabinoid medicine before taking CBD. CBD can have harmful drug interactions (see The Grapefruit Rule below) and can even worsen some conditions, such as glaucoma.
Select CBD products based on individual needs, meaning that the dosage, the delivery method, and other factors are personalized for you specifically. There is no one-size- fits-all solution for any given condition. Two similar people with similar conditions can have completely different reactions to CBD delivery methods and dosages. Work under the guidance of a practitioner who is well versed in integrating cannabis into health and wellness.
FIND YOUR SWEET SPOT
CBD products indicate a wide range of dosages on their labels. That is partly because of the biphasic nature of CBD and partly because different cultivars and different doses work differently for different individuals—even for the same conditions. It is similar to diets—different food plans work for different people with the same conditions. That is partly because of biochemical individuality.
Finding your specific sweet spot for CBD—the product, delivery format, and dose—can take trial and error. A cannabis clinician can guide you on your journey with cannabis for health and wellness.
Here are some guidelines to help you get started:
- GIVE IT TIME. CBD can have subtle effects, so sometimes changes are not obvious. Other times, particularly for anxiety relief, CBD’s effects can happen very quickly when using sublingual products.
- SPREAD IT OUT. Depending on the format and recommended dose, dividing doses throughout the day may be helpful.
- LAYER PRODUCTS. Using various CBD formats can be helpful to gain maximum benefits.
- BE OBSERVANT. Watch for changes in your mood, sleep, and health condition. Keeping a journal can be helpful.
The grapefruit rule
Although CBD has a great safety profile, it can impact the clearance of other drugs because it is a P450 inhibitor—just like grapefruit. That means that it can affect how you metabolize medications such as painkillers, statins, blood thinners, and insulin. Cancer and epilepsy medications may also be affected by the presence of CBD. Always check with your prescribing doctor before adding CBD to your daily regimen if you take any medications. As a general rule, if grapefruit interferes with your meds, CBD probably will, too.
Less Is More: Start Low and Go Slow
CBD is biphasic, meaning it can have two different effects depending on the dose. Typically:
- A LITTLE CBD is stimulating.
- A LOT OF CBD is sedating.
That sweet spot is key. Think of it like a curve, but the size and slope of the curve depend on the individual. A dose that helps one person focus may make another person’s eyelids droop. Taking too much CBD can cause the opposite problem: while a low dose may mellow your mood, a high dose may amplify anxiety. That is why experts suggest to “start low and go slow.”
The grapefruit rule
- Choose your method. Pick the delivery method that works for you.
- Start low. Sometimes a little bit is all you need, so start with a low dose of CBD. And remember that because CBD is biphasic, taking too much can make it less effective.
- Talk to your primary care provider. If you have a primary care physician or other clinician, be sure to keep him or her informed about the supplements you are using, including CBD.
What to Watch For
Though CBD usually does not have serious effects, there are things to be mindful of:
- DRY MOUTH. Not everyone experiences dry mouth, but it is the most common side effect of ingesting hemp extracts. Some consider it a small price to pay for relief.
- DIZZINESS OR FAINTNESS. Dizziness and faintness may be good indications that CBD is working as a sedative rather than a stimulant.
- INCREASED ANXIETY. If you notice stress levels are rising, you may be overdoing it on the dosage or CBD may not be right for you.
- DRUG INTERACTIONS. CBD lowers the activity levels of certain enzymes in the P450 detoxification system in the liver. Because that system is responsible for clearing many drugs from the body and activating other drugs, it is important to talk to your pharmacist about potential interactions. See “The Grapefruit Rule” for more info.
Partnering with a Cannabis Clinician
Consulting with a healthcare professional who is well versed in integrating whole plant CBD with holistic modalities is preferable. Professionals who simply replace your medications with CBD are not necessarily working with you to optimize your health. Cannabis is not meant to be a bandage approach. An integrative cannabis clinician can truly guide you on your journey to wellness using CBD and other approaches to influence your overall health.
If your doctor does not know about the endocannabinoid system or does not appreciate holistic medicine, look for a practitioner who does. When it comes to your health, it is essential to explore all different avenues. Western medicine is based on treating symptoms that accompany disease, rather than healing the root cause of an issue. CBD can have powerful medicinal properties, so partnering with a clinician who understands and appreciates the benefits of cannabis is essential.
BE SMART ABOUT CBD
Deciding to integrate CBD into your lifestyle is an important step on your journey to health and wellness, a smart decision. Now what? How do you decide what type of product you need? What dose and timing are best for you and your specific needs? What are the differences among brands? These are just a few questions to ask as you set out to find your individualized path with CBD.
As with all supplements and personal products, caveat emptor—buyer beware. It is up to you as the consumer to know what you are buying. It is that simple and that challenging. Reading labels is a must, as is consulting with a healthcare practitioner knowledgeable about canna- bis. Doing a bit of research before you buy a product is key, but here is some guidance for getting started.
Whole Plant hemp oil
The term hemp oil is a bit confusing. What we are talking about in this book is whole plant CBD oil extract from the hemp flower. Whole plant means that the product contains various cannabinoids, terpenes, and other plant materials, creating the entourage effect. Many products are labeled “whole plant hemp oil” instead of “CBD oil” for that very reason. For products that you consume by mouth, whole plant hemp oil is generally preferred to CBD isolate. For skincare and beauty products, CBD isolate is acceptable.
Know Hemp Oil versus Hemp Oil
Confusing, right? The CBD oil, or extract, that is made from the flower is what this book covers. And then there is hemp seed oil that is used in cooking and on salads. These are two different products made from different parts of the hemp plant. These oils can be easy to differentiate, simply based on bottle size and price. The healing oil with CBD extract and other cannabinoids (known as whole plant) is typically in a smaller bottle with a dropper and costs more per ounce. Hemp oil that is in the food category has a lower price per ounce, similar in price to other cooking and salad oils.
Read the Label
A hemp-derived CBD label, which belongs in the dietary supplement category, can provide a lot of information. Look for:
- Name of the product and company
- Type of CBD—whole plant or isolate
- Milligrams of extract in the total product and per serving
- Source of the plant—organic, sustainable farm or not
- Ingredients listed in descending order of amount
- Supplement facts
- Directions for use and the recommended dosage
- Extraction method used
- GMP, or Good Manufacturing Practices
- Third-party testing verification
Consult with a cannabis practitioner to determine what is important for you specifically.
Cannabis is a bioaccumulator, meaning it draws toxins from the soil. Any contaminants that are in the soil can be absorbed by the whole cannabis plant. Toxins are absorbed more into the seed than the flower. When CBD is extracted and concentrated, it too will contain pollutants that were present in the soil. So it is important for CBD products to come from plants grown on farms that use organic growing practices, free of pesticides and other harmful chemicals. Unfortunately, some whole plant CBD brands tend to throw the term “organic” around lightly; again, buyer beware. There is currently no USDA certification for organic cannabis.
AVOID ARTIFICIAL OR UNNECESSARY INGREDIENTS
CBD does not require any chemical fillers, additives, preservatives, or flavors. Check the label for harmful ingredients such as:
- Artificial ingredients—colorings, flavorings, sweeteners
- High-fructose corn syrup
- Thinning agents, such as propylene glycol
Select products that have zero or little sugar. Sugar contributes to inflammation, which is the exact opposite of what you want from a CBD product. Many cannabis edibles contain sugar, so be sure to read labels.
regenerative agricultural practices
Some hemp farmers are using more organic and regenerative farming methods that increase soil health through crop rotation, cover crops, use of compost, and elimination of synthetic chemicals. Conventionally grown hemp, however, uses synthetic fertilizers and may be grown on land previously used for crops that used the herbicide RoundUp, which contains glyphosate. Glyphosate is a health hazard and has been associated with cancer, autism spectrum disorder, and ADHD. Research indicates that glyphosate is harmful to the gut microbiome, impacting the gut–brain axis. That means that certain hemp brands may do more harm than good because of trace levels of glyphosate in the whole plant CBD extract. Together with a cannabis clinician, you can make smart choices. Health begins in the soil, and consumers supporting organic and regenerative farming help create a better planet.
From The CBD Oil Miracle by Laura Lagano. Copyright © 2019 by the author and reprinted by permission of St. Martin’s Publishing Group.
Photography by Alyson Brown