CBD for aging: What are the risks and rewards?

Most of my patients are older, just like me! I live in the state of Washington where medical and “recreational” cannabis has been around for over a decade. I started learning more and more about CBD for several reasons. For one thing, I was getting lots of questions. For another, well, I have a rather unusual background for a naturopathic physician — I was originally trained as a drug design chemist and the “noise” around hemp-derived CBD was something that made me want to find out what it could do for my patients. Finally, as a naturopathic physician relying on natural methods for health and wellness, I felt that CBD could prove to be very useful for a wide range of health goals and it is really important that people get educated about CBD and its potentially wide-ranging benefits for pain management, sleep issues, as an antispasmodic and to elevate and balance moods.

More and more people over the age of 60 are using CBD. A recent study suggested that those over the age of 65 are the fastest growing group using medical cannabis. A recent Gallup poll indicated that almost 20% of adults over 50 use CBD while the rest said either they didn’t use it or weren’t familiar with CBD. My experience indicates that the rate of CBD use is probably quite a bit higher. Some people I find still have the old “reefer madness” image that historically was used to demonize cannabis and often feel free to tell me they are using it, but don’t want to tell any other healthcare provider for fear of being shamed.

The World Health Organization (WHO) has determined that CBD, derived from hemp, is safe to use and should not be listed as a controlled substance. WHO also determined that there was a very low chance of addiction to CBD. The 2018 Farm Bill removed CBD from the controlled substances list as long as the total THC content was less than 0.3% by weight.

Some ABCs for CBD

CBD is one of over 120 different cannabinoids made by the hemp plant. It is non-intoxicating meaning it will not get you high. The cannabinoid that does have intoxicating effects is THC — and remember that by law, CBD products must contain less than .3% THC.

Current research indicates that CBD has several properties that make it particularly interesting for those of us trying to age “gracefully, the so called ”the “baby boomers”. But first, is it safe for us?

The answer is yes. Research and clinical experience shows that CBD has a very wide “therapeutic window” both for safety and effects which means there is a wide range of doses that people can safely take and that some people benefit from a lower dose where others may need a bit more to see benefits.

Cannabinoids like CBD work on the natural “balancing” endocannabinoid system, the ECS which helps regulate sleep, appetite, pain and immune system response.

So, what are these potential benefits? Here is a list of the best-supported effects of CBD.

• Pain management
  • CBD can be used topically or orally in arthritic diseases to treat painful joints
  • Chronic pain can be managed by oral CBD
  • Sativex which contains a mixture of synthetic CBD and THC can be used to manage chronic pain and is FDA approved for several different conditions
• To manage mood disorders like anxiety and depression
• Sleep issue management
  • Both insomnia and poor sleep quality can benefit from CBD use
• Neurological disorders
  • To improve memory and cognition and to potentially protect against dementia, possibly because of CBD’s anti-inflammatory properties.
  • To reduce seizures in seizure disorders and muscle spasms in multiple sclerosis (MS)
  • Sativex is an FDA approved treatment for MS
  • CBD reduced the frequency of seizures in children and young adults with treatment-resistant epilepsy
  • Potential use in Parkinson’s disease to improve the quality of sleep and life
• To improve heart health
  • CBD has been shown to reduce blood pressure, reduce oxidative stress and preventing damage to the heart
• To reduce inflammation
  • Inflammation is at the core of chronic diseases like obesity, diabetes and heart disease. CBD has been shown to be an effective anti-inflammatory agent.

Where Can You Buy CBD?

The CBD market is virtually exploding both online and at brick and mortar stores. It can be hard to figure out which are the best CBD products. As a clinician, I always recommend that you only buy from companies with solid reputations and (this is really important) only from companies that provide access to lab reports confirming the purity and safety of their products. This can feel like an overwhelming task—so it may be best to check out review sites like Leafreport which compares products for you.

The form of CBD that is best depends on what your goals are. Topical products are best for localized pain, like arthritic joints or a sore knee. Oral products are available as oils or tinctures, capsules or edible gummies. The best oral product also depends on your goals and needs—and again, LeafReport has educational articles walking you through that decision-making process.

One of the most important things to remember when using CBD is to “Start Low and Go Slow” which means you should start at the lowest dose you can manage to get (eg. ¼ of a gummy or ½ of a dropperful), try that for a few days and record your results in a journal or notebook. Then, slowly increase the dose until you reach your desired goal, giving at least a few days at each dosing level and recording your results.

What About Adverse Effects?

Good question! Remember what I said about a “wide therapeutic window”? That means that a wide range of CBD is safe.

But adverse effects can happen. They are relatively rare and usually mild and include nausea, irritability, fatigue and a dry mouth. They sometimes include a loss of appetite and drowsiness. If this happens and is problematic, cut down the amount you are taking.

There can be some medication interactions with CBD so you should always talk to your doctor or pharmacist. I actually prefer talking to the pharmacist and I know many people find them a bit less – shall we say judgmental or just easier to talk to?

Potentially serious interactions may occur if you use CBD with:

• Alcohol
• Anti-depressant medication
• Anti-anxiety medication
• Pain medication
• Anti-seizure medication
• Coumadin or warfarin

I have patients that are on some of these medications when they begin using CBD. My general goal is to decrease the need for prescription medication slowly as the CBD dose is slowly increased, this process should always be done in consultation with your physician. That, unfortunately, can be a bit of a problem. I would suggest finding a local naturopath or other open-minded physician to walk you through the process.

CBD has a great deal of potential to improve your health. Treat it respectfully, but don’t be afraid to try it. CBD can be a safe, natural and effective approach to several issues we baby boomers face. Remember this? “Try it, you’ll like it!” I think you just might!

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