pain. Unfortunately, many of the studies on pain used products containing both THC and CBD, so delineating the benefit from CBD remains difficult. CBD may provide benefit for mild to moderate pain, but doses needed to affect severe pain may be both cost and logistically prohibitive.
Psychiatric: Both human and animal studies support the anti-anxiety benefit of CBD. CBD administration reduced symp- toms related to social anxiety disorders in two small human trials. In addition, CBD may buffer paranoia and anxiety associated with THC use.
Inflammatory bowel disease: CBD
administration reduced Crohn’s-related symptoms and trended toward symptom improvement in ulcerative colitis. Multiple studies demonstrate the benefit of CBD administration for reducing inflammatory pathways and pro-inflammatory cytokines.
Neurological conditions: Animal
studies show some benefit in the setting of Alzheimer’s disease, but human trials have not been conducted to confirm. In individu- als with Parkinson’s disease, CBD improved symptoms of agitation, nightmares, insom- nia, and aggressive behavior. CBD has been shown to improve symptoms related to Multiple Sclerosis, including pain.
Routes of Administration
The primary available options for tak- ing CBD include oral administration and topical application. Newer options for inhalation are becoming available including hemp cigarettes and vape liquids. Topical applications may effectively address super- ficial muscle/joint pain but lack systemic benefits. Most people using CBD take oral products, typically oils or capsules.
Although popular, oral administration suffers from delayed onset of effect (30-120 min) and limited absorption rates (6-20%). Newer formulations in water soluble preparations may offer increased absorption and quicker onset, but availability remains limited. Research to date has used oral administration of oils/capsules, so therapeu- tic dosing guidelines are applicable to these formulations only.
Safety
CBD is well-tolerated with a good safety profile even at very high doses. Ani- mal and human studies demonstrate mini- mal to no dependency or abuse potential with CBD use. However, due to concerns about drug-CBD interactions, consult your provider before starting CBD.
Regulations regarding the testing and safety of CBD products remains limited and unenforced. Independent testing of CBD products has revealed contaminants and irregular dosing. The growth of the industry is attractive to many, some of whom may not be interested in quality. When purchas- ing a CBD product, it would behoove the consumer to do some due diligence on the brands and products.
Cost Vs. Benefit Interest in the medical use of CBD
grows daily, as does the market. While CBD may offer a reasonable option for pain re- lief, anxiety management, or sleep support, calculating cost vs. benefit is important. Most of the studies cited used CBD doses ranging from 150mg to 600 mg per day. Depending on the product used, the cost per day of these doses would average $12 - $48. Some individuals may experience ad- equate benefit at a lower dose but moderate to severe symptoms will likely need more robust dosing. Generally, CBD therapy may be more appropriate for those with mild to moderate symptoms compared to those with severe symptoms.
Most CBD oils/tincture labels list the total amount of CBD or Hemp extract within the entire bottle, not a single dose. For accurate dosing, an individual must calculate milligrams (mg) per drop/dropper- ful and then how many dropperfuls equal their desired dose. Capsule dosing is more straightforward as the CBD content listed is per capsule.
Wholistic Approach and Conclusion
A wholistic approach will optimize the benefits from CBD use, rarely is a symptom or condition caused by one factor. Using CBD as one component of a wholistic ap-
proach including dietary changes, lifestyle changes, and mental/emotional support, will be more effective than using CBD alone. Finding a full-spectrum hemp extract with a specified CBD content will likely be more effective than an isolated CBD extract. When using botanical medicine, extracts of the whole plant typically provide superior benefit compared to isolated extracts of one component. However, if taking very high doses of CBD, consider an isolated extract product. Full-spectrum hemp extracts often contain a small percentage of THC, so very high doses of CBD may result in therapeutic doses of THC, causing unintended psycho- active effects.
Renée Lang, ND, FABNO, MPH is licensed as a naturo- pathic doctor in the state of Maine and is board certified in naturopathic oncology (FABNO). She received her
naturopathic doctorate from National College of Natural Medicine in 2003 and holds a B.S. in Conservation and Resource Studies from the University of California at Berkeley. In addition, she received her MPH in 2013 from Johns Hopkins Bloomberg School of Public Health, with additional certification in environmental and occupational health. As a Reiki Master and Shamanic practi- tioner, Dr. Lang has been incorporating these healing techniques in her since 2002. Dr. Lang currently sees patients at her office in the Parkview Office Building in Brunswick, ME. From 2009-2013 she worked as a naturopathic oncology con- sultant at the Cancer Treatment Centers of America (CTCA) in Philadelphia. While at CTCA, Dr. Lang provided integrative naturopathic care to thousands of indi- viduals with cancer. Visit
www.renee-
langnd.com or email info@reneelangnd. com for more information or to schedule an appointment. See ad on page 10.
www.elmmaine.com
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