CBD Knowledge for Medical Providers

Updated: Jun 7

Wondering what all of the fuss is about with the patients regarding CBD?



CB1 & CB2 RECEPTORS

After 35 years of research, scientists have only just begun to understand the importance of the Human Endocannabinoid System (HEcS). The discovery of the HEcS is arguably the most important discovery in human physiology in the late Twentieth Century. Research has revealed that the HEcS is responsible for maintaining and controlling the body’s homeostasis, or balanced regulation of every system in the body. It does that through two known receptors called CB1 & CB2. While the body produces its own endogenous cannabinoids, many scientists suggest that most people are now suffering from “Cannabinoid Deficiency”. Without sufficient cannabinoids in our diet, the HEcS operates at less than peak efficiency, resulting in a general decline in overall health. Supplementing our diets with full-spectrum phytocannabinoids may be an essential component to achieving optimal health.


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The primary cannabinoid receptors are identified as Cannabinoid Type 1 receptors (CB1-R) and Cannabinoid Type 2 receptors (CB2-R). The receptors can be “unlocked” by three kinds of cannabinoids:


Endocannabinoids Endogenous-fatty-acid cannabinoids produced naturally in the body (e.g., anandamide and 2-AG).Phytocannabinoids Concentrated in the oily resin of the buds and leaves of plants such as cannabis (e.g., THC and CBD). Synthetic Cannabinoids Manufactured by artificial means such as in a laboratory.


Two Key Endocannabinoids




In the endocannabinoid system, there are two key endocannabinoids that our body produces on its own, anandamide and 2-AG. Anandamide borrows its name from the Sanskrit word ananda, which means joy, bliss, and delight. Nicknamed the “bliss molecule,” anandamide could be a cannabinoid ally against depression and anxiety and has been shown to modulate mood, memory, appetite, fertility, and is even believed to halt the proliferation of cancer cells. Arachidonoyl glycerol (2-AG ) is the most abundant endocannabinoid in our bodies. It binds very strongly to the CB1 and CB2 receptors embedded throughout the central and peripheral nervous system, and it behaves similarly to tetrahydrocannabinol (THC). 2-AG is believed to regulate sleep, immunity, pain, and appetite.


Science Behind CBD


CBD is a phytocannabinoid derived from the cannabis plant. Unlike other cannabinoids, CBD does not bind to receptors in the endocannabinoid system. Instead, it stops the breakdown of our own endocannabinoids. The main action it performs within the ECS is the inhibition of fatty acid amide hydrolase or FAAH. FAAH breaks down the anandamide molecules naturally occurring in our body, and cannabinoids work to prevent FAAH from destroying this bliss molecule. In this way, cannabinoids can work indirectly all throughout the body, ensuring that we have enough anandamide to manage our pain, mood, appetite, stress, and sleep. Since cannabinoids do not bind directly to endocannabinoid receptors, like the other well-known phytocannabinoid THC, it does not produce the intoxicating, “high” effect often associated with cannabis.


The Entourage Effect: Compounds Working Together

Some researchers believe that cannabis is more therapeutically beneficial when all the compounds found in the plant — including its a wide range of cannabinoids, terpenes, and flavonoids — are administered together. The theory known as the entourage effect suggests that all of the various chemical compounds in cannabis interact and work together synergistically to produce therapeutic benefits and regulatory effects.






Safety Profile of Cannabidiol (CBD)





Cannabidiol (CBD) and other cannabinoids are known to be non-toxic, with no known fatal overdose levels reported. The previously mentioned study from 2011 indicated that chronic use and high doses up to 1,500 mg/day of CBD are reportedly well tolerated in humans. The Department of Health and Human Services states, ‘no signs of toxicity or serious side effects have been observed following chronic administration of cannabidiol to healthy volunteers (Cunha et al., Pharmacology 21:127-185, 1980), even in large acute doses of 700 mg/day (Consroe et al., Pharmacol, Biochem, Behav. 40:701-708, 1991).

Side effects of CBD include nausea, fatigue, and irritability. CBD can increase the level in your blood of certain medications such as coumadin, and it can raise levels of certain other medications in your blood by the exact same mechanism that grapefruit juice does. A significant safety concern with CBD is that it is primarily marketed and sold as a supplement, not a medication. Currently, the FDA does not regulate the safety and purity of dietary supplements. So you cannot know for sure that the product they buy has active ingredients at the dose listed on the label. In addition, the product may contain other (unknown) elements. We also don’t know the most effective therapeutic dose of CBD for any particular condition. This is the reason why it is so important that your patients receive CBD products from a trusted source that provides them with third-party testing. When determining the product source, please do not hesitate to request Certificates of Analysis which should examine potency and quality of the oil. To learn more about phytocannabinoids (CBD) visit our click here.

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