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While CBD has very few known adverse effects (can in- clude fatigue, diarrhea, and changes in appetite and weight), the right dose depends on multiple factors, including the condition being addressed and its stage or intensity, the individual’s biol- ogy, metabolism, and sensitivity to Cannabis, and how their ECS acclimates to the use of CBD over time. CBD should be used in low amounts initially and adjusted slowly until the desired effect is reached. In addition, there are certain contraindications and precautions that should be considered when ingesting CBD in any form. CBD temporarily alters the activity of cytochrome P450, a family of liver enzymes that metabolize both CBD and many widely-used pharmaceuticals, including steroids, proton pump inhibitors (PPIs), antibiotics, benzodiazepines, blood pressure medications, antidepressants, antihistamines, and anti-epileptics. CBD can either increase or decrease the breakdown of these and other drugs.


Other precautions include: (1) CBD should not be mixed


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with alcohol; (2) due to its “bidirectional effect,” with excess dos- ing or due to individual body chemistry, CBD can over-stimulate the ECS, causing or exacerbating the adverse effects it normally relieves; and (3) since Cannabis readily absorbs heavy metals, pesticides, and other potentially harmful chemicals that may be in soil or water, it is important to buy only reputable CBD brands that regularly test their products for THC and contaminants, and/ or use organic hemp.


CBD Effectiveness: Delivery Methods


The effectiveness of CBD varies widely among individuals, in part based on delivery method, dose, the time of day it is adminis- tered, the treated condition and degree of advancement, and how much food has been consumed relative to the time of administra- tion (because CBD is fat-soluble, its absorption increases greatly when taken with fatty food). Phytocannabinoids work better in whole plant extracts than in isolated, refi ned, or synthetic prod- ucts. CO2 extraction, the most widely used method for removing CBD from hemp, produces a safe, pure product.


As previously noted, CBD is available in multiple forms. Selection should take into account how quickly the CBD will take effect (onset), how long it will last in the system (duration), and bioavailability (how much will be absorbed). These guidelines gen- erally apply for the most readily available, and thus most widely used, delivery methods: (1) Topical (salves/creams): Onset – 15 minutes, Duration – 2-4 hours, Bioavailability – N/A (local relief only; does not enter the bloodstream); (2) Ingestion (capsules/ chewed and swallowed gummies): Onset – 30 to 90 minutes, Duration – 6-8 hours, Bioavailability – 8-15% (slow, erratic ab- sorption through the intestines; maximum plasma concentrations usually in 1-2 hours; can take 2-3 times/day); (3) Oral Mucous Membranes (oil based tinctures, gummies/lozenges dissolved in the mouth): Onset – 40-75 minutes (sublingual use – 30 seconds to 2 minutes), Duration – 6-8 hours, Bioavailability – 6-20% (can take up to 6 times/day).


Science-Based Uses of CBD Drawn from relatively limited, preliminary scientifi c evidence,


below is a short, alphabetized list of some of the more promising CBD applications when used responsibly according to the above guidelines. CBD also has widespread application in the treatment of veterinary health challenges.


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