CBD 101: The Ultimate Guide to Cannabidiol

Cannabidiol, (CBD) was tagged a few years back “as the most misunderstood compound on the planet,” so what Is CBD? Here’s everything you need to know about CBD and Cannabidiol
Written by 
Diana Rangaves, PharmD, Clinical Consultant, Google Scholar.
|Last Updated:
CBD 101

By many CBD apologists of marijuana. However, within the last 20 years, 33 States in the U.S. have approved the use of CBD from marijuana for medical purposes. Also, at the Federal level, CBD from hemp is legal under 2018 Farm Bill.

Cannabidiol, (CBD) consumers’ usage and popularity in the U.S. marketplace is on the rise. Industry experts project that the CBD revenue share will surpass $2 billion by 2020. Based on recent findings, about 7% of Americans use CBD products. According to Cowen & Co estimates demonstrate a rise to 10% by 2025 as consumers look for better alternative treatment for their ailments. CBD, according to Consumer Reports, is most popular among youths in their 20s; and less popular among seniors above 60 years. Gender demographics establish that women are likelier to use CBD for wellness purposes, compared to men for social and spiritual purposes.

Understanding CBD

 What is CBD?

Cannabidiol (CBD), according to the World Health Organization (WHO), is one of the natural cannabinoids compounds present in cannabis plants. CBD is a 21-carbon terpene phenolic compound formed because of a decarboxylation process from a cannabidiolic acid precursor.

CBD is the second most common active ingredients in cannabis plants (marijuana). For many years it has been an important part of medical marijuana. It is extracted directly from the hemp plant, a cousin of the cannabis plant. It is used in products such as edibles, gummies, and oils to provide a feeling of calm and relaxation.

Findings from preclinical and clinical research studies show that CBD has strong anti-convulsing, anti-inflammatory, anti-oxidant, anti-depressant, anti-tumor, anti-psychotic, and neuroprotective properties. According to a research published on Oct 2018, CBD does not have intoxicating properties, it does not make people feel high. There are a lot of claims by CBD proponents that it can effectively treat conditions such as anxiety, chronic pain, rheumatoid arthritis, cancer, PTSD, MS, and cardiovascular disease. Research is ongoing in the U.S., and other parts of the world to ascertain the effect of CBD on these and other ailments.

Substance identification

  • Physical appearance: A crystalline solid
  • Molecular weight: 314
  • Chemical Formula: C21-H30-O2
  • International Nonproprietary Name (INN) : Cannabidiol
  • Chemical Abstract Service (CAS) Registry Number : 13956-29-1
  • Other Chemical Names: CBD, 2-[1R-3-methyl-6R-(1-methylethenyl)-2-cyclohexen-1-yl]-5-pentyl-1,3- benzenediol;

Difference between CBD and THC?

CBD (cannabidiol) and THC (tetrahydrocannabinol) are the prominent natural cannabinoids present in the cannabis Sativa plants. They have the same chemical formula and interact with the body’s endocannabinoid system. However, there is a difference in the arrangement of their atoms. This accounts for their different effects on the body.

CBD and THC, due to their molecular structures, interact differently with CB1 and CB2 receptors in the endocannabinoid system. While the two bind with the CB2 receptor, their interaction with the CB1 receptor differs. According to the National Center for Biotechnology Information (NCBI), THC binds directly to CB1. This bonding, when completed results in reactions that transmit signals to the brain responsible for the euphoria feelings associated with marijuana. Brain imaging studies reveal that the prefrontal cortex region of the brain experiences increased blood flow during THC intoxication. This region is responsible for attention, decision-making, and other executive functions, such as self-monitoring, task initiation, and organization. THC overdose can affect any of these executive functions to varying degrees depending on the individual.

CBD, on the other hand, does not bind directly to the CB1 receptor. Its presence, according to research, can void the connection between THC and the CB1 receptors in a process, neutralizing the high effects induced by THC.

THC is the main psychoactive compound in marijuana responsible for the high effect. It is available in tinctures, oils, capsules, edibles, and more. It can also be consumed by smoking marijuana. In contrast to THC, “CBD does not cause psychoactive effects. This makes it attractive for people not interested in the high effects, but desires the other benefits CBD offers”, said Sara Ward, a pharmacologist at Temple University in Philadelphia.

According to the World Health Organization, CBD does not show any effect in either abuse or dependence potentials. In addition, there is no evidence to date of any public health-related problems linked to the use of pure CBD.

“CBD is an integral part of my training and post-fight regimen expediting my body’s natural healing process,” says Anthony. Sergio adds, “Rather than relying on potentially damaging anti-inflammatory like Tylenol and Advil, I have been turning to CBD and seeing incredible results with no side effects.”

Anthony and Sergio Pettis (Professional Mixed Martial Arts (MMA) and UFC Fighters)

Mechanism of Action: How does CBD work?

CBD and the Brain

Cannabinoid receptors present in the body are responsible for regulating many different processes that we undergo daily such as appetite, mood, pain sensation, and memory. The system is activated by naturally occurring endocannabinoids, CBD, or by the plant, cannabinoids present in hemp. Some ways CBD exerts its therapeutic influence on the body are:

CBD binds more to other non-cannabinoid receptors and ion channels compared to THC that binds strongly with CB1 receptors and CB2 receptors. CBD activates receptors that include 5-HT1A (hydroxytryptamine) serotonin receptor, vanilloid receptor, adenosine receptors, GPR55, and PPARs.

CBD also works by acting through multiple receptor-independent pathways (Receptor = Tiny proteins on the surface of most cells. Receptors act as the ‘go-buttons’ on cells, and when activated by compounds that fit into them, tell the cell what to do or not do.– for instance; it delays the reuptake of endogenous neurotransmitters, such as adenosine and anandamide.

CBD functions as an antagonist by blocking or deactivating GPR55 – another G protein-coupled receptor. CBD functions as an antagonist that blocks, or deactivates, another G protein-coupled receptor known as GPR55

CBD produces a different therapeutic effect depending on the receptor or ion channel activated.

Why CBD does not work for everyone

Perhaps you decided to try CBD because of the claims. After trying it for weeks or months, you did not notice any improvement or changes in your health. You are not alone. But, before turning your back on CBD, there are four legitimate reasons why CBD may not work for you,

Wrong Dosage

This is a significant issue with CBD users. CBD effects vary from individual to individual. Therefore, it makes is difficult to give one-size-fits all dosage advice when it comes to CBD. Failure to take the right dose at the right time limits your chances of getting the full benefit. Factors like age, health history, gender, medical condition, weight, and ethnic background may affect the dosing.

It is advisable to start low and go slow. By starting with a small dose and slowing increasing it after 4 or 5 days, you will find what is called your sweet spot. This is the dosing point, which activates your endocannabinoid system.

Low-Quality Product from Disputed Sources

There is so much hype about CBD, and many consumers are being taken advantage of by the fake news noise. CBD is available everywhere from online companies to over-the-counter shops. This raises a concern about the quality, especially in an industry is not yet regulated by the Food and Drug Administration (FDA). This provides the perfect opportunities for scammers to make quick money by selling low-quality CBD products that are not potent as claimed.

If you have been using a particular CBD product for weeks or months, and nothing has changed, you might need to try another CBD product. Many CBD consumers have tried different brands until they eventually find one that works for them. Element in selecting a quality CBD product include:

Pay close attention to online consumers’ reviews of the products

You can find this here on our website and also on other trustfull resources on the web.

Select CBD products from established brands

Some brands over the years have made a name for themselves in the CBD industry, due to the quality of their products. You can select a product from this list of favorite CBD products, and you will not have to worry about the quality of the product you are buying.

Ask for proof of third-party testing

Inquire about the evidence of a third party test. Lab testing can reveal the quantity of CBD present in the product.

Failure to Give it Enough Time

Our body chemistry is unique and each of us reacts differently to CBD. While some people might experience instant results, this, however, does not apply to everyone. CBD might not work for you as fast as you envisaged. It might take weeks or months before you start noticing the changes you anticipated. You must stay committed to your dosage for weeks before calling it quits on a particular CBD brand.

Failure to try a Different Delivery System

CBD exists in various forms such as vape oil, tinctures, gummies, topical creams, and capsules. If you have been trying a delivery system without positive results, you should consider trying another delivery system. However, in selecting a delivery system, bioavailability should be the primary determinant. This regulates the quantity of the CBD that eventually gets into your bloodstream. For instance, tinctures are absorbed faster into the blood compared to gummies that have to pass through the digestive tract before it is processed.

Misguided Expectations

There is so much fuss in the media about what CBD can do. Many consumers have tried CBD only to have themselves disappointed due to unrealistic expectations. It is essential to seek information regarding what CBD can or cannot do.

“CBD helps with pain, stress and anxiety. It has all the benefits of marijuana without the high.”

Jennifer Aniston (Actor, Film Producer and Business Woman)

Benefits of CBD

Research into CBD and the neural network that correlates anxiety indicates that CBD at high concentrations directly activates the 5-HT1A (hydroxytryptamine) serotonin receptor. This, subsequently gives it an anti-anxiety effect. The G-coupled protein receptor involved activates several biological and neurological mechanisms. Notably, but not limited to, appetite, anxiety, addiction, pain perception, nausea, sleep, and vomiting.

Sleep

There is a growing body of research that suggests CBD helps people with sleep disorders. For its sedation effects, CBD activates the GABA receptors and the serotonin receptors in the endocannabinoid system of the brain. These receptors play an important role in modulating mood and anxiety, which are vital for sleep. GABA inhibit excess activity in the brain, thereby promoting relaxation

Anxiety

Research implies that CBD produces a calming effect that eases anxiety in the central nervous system. CBD does this by activating the serotonin receptors. According to Dr. James Murrough, the Director of the Mood and Anxiety Disorders Program at the Icahn School of Medicine at Mount Sinai, activation increases serotonin in the brain, thereby boosting your mood.

Depression

There is limited scientific evidence that exists to support the assertion that CBD can treat depression. However, research since 2014 provides valuable information on why CBD is considered useful in treating depression. CBD’s positive interaction with serotonin receptors in the brain is considered by many to be a crucial element of therapy for managing depression.

Pain

CBD is judged effective in alleviating pain due to its anti-inflammatory properties. It reduces inflammation and promotes sleep by interacting with other receptors in the endocannabinoid system. Most of the scientific evidence that supports this claim is in animal-based research. Currently, very little evidence exists from human studies apart from testimonial claims.

Epilepsy seizure disorder

Epidiolex, a plant-based CBD product, was recently approved by the FDA to treat seizures in people two-years and older with Lennox-Gastaut syndrome (LGS) and Dravet syndrome.

Neuroprotection and neurodegenerative disease

CBD’s anti-inflammatory properties are regarded as a promising for neurodegenerative disorders.According to NCBI, inflammation is responsible for the loss of neurons in the nervous system. This, in turn, is responsible for the decline in motor and cognitive function, thereby causing the cascade of neurodegenerative symptoms.

Arthritis

CBD, according to a study in the European Journal of Pain reduces inflammation and signs of arthritis pain without any side effects when correlated to an animal-based study. The researchers noticed a significant drop in arthritis pain when topical gel containing CBD was administered to rats for four days. As always, additional human clinical evidence is needed to confirm this statement.

Diabetes

A 2015 study contends that CBD exhibits anti-inflammatory effects in rats. Excess inflammation is documented to affect the growth of insulin resistance and type II diabetes. This could have beneficial effects on humans.

In 2016, researchers from the University of Nottingham in the U.K. demonstrated that CBD, together with tetrahydrocannabivarin (THCV), reduces blood glucose levels and boosts insulin production in people with type II diabetes. .

What you need to know

Dosing

CBD proponents would tell you that you could not overdose CBD. That you can take as much as you feel until you get to your stop spot. Caution is warranted as, 2.5 mg/kg twice daily (5 mg/kg/day) is the recommended starting dose of the approved CBD product – Epidiolex for both children and adults. This can be doubled after a week to 10 mg/kg/day if the person does not experience any positive change. However, the maximum dose recommended is 20 mg/kg/day for both children and adults.

How long does CBD last, remain in your system?

How often should you take CBD and how long does it take to work?

The Medline Plus recommends that approved CBD products – Epidiolex should be taken twice a day, and this should not exceed 20 mg.

Our body systems differ, and the effect of CBD can manifest from 5 minutes upwards depending on the individual. According to NIH, CBD is detectable in your body fluid for up to 30 days or more after last use. The length of time that CBD stays in your system depends on the number of doses, the frequency, your age, gender, body mass index, and ethnicity.

However, currently, there is no definitive length of time that CBD remains in the body, as research is ongoing. The general rule of thumb is that it takes an average of a week for CBD to leave your system entirely.

CBD Side effects

Some research shows that the use of CBD may cause several effects such as:

  • Dry mouth
  • Diarrhea
  • Reduced Appetite
  • Change in mood
  • Fatigue
  • Nausea
  • Drowsiness
  • Nausea
  • Vomiting

Pneumonia and decrease oxygen in the blood or tissue are some infrequent side effects of CBD.

Liver damage, hypersensitivity drug reaction, and suicidal thoughts are some of the rare side effects of using CBD products.

Adverse reactions

A study reveals that CBD can cause adverse reactions such as digestive disturbances, irritability, sleepiness, and aggravation of seizures in children with refractory epilepsy.

Drug interactions

CBD interacts negatively with many drugs, though the degree fluctuates from one person to another. According to the Medline Plus, the use of CBD together with the partial drug list below may negatively affect the body system. It is recommended not to take CBD together with these drugs. The full list is available here.

  • Valproic acid
  • Clobazam
  • Eslicarbazepine
  • Topiramate
  • (Cytochrome P450 1A1 (CYP1A1) substrates)
  • (Cytochrome P450 1A2 (CYP1A2) substrates)
  • (Cytochrome P450 1B1 (CYP1B1) substrates)
  • (Cytochrome P450 2B6 (CYP2B6) substrates)
  • (Cytochrome P450 2C9 (CYP2C9) substrates)
  • (Cytochrome P450 3A4 (CYP3A4) substrates)

Promising Future

CBD is a non-psychoactive compound derived from the hemp plant and cannabis. It does not produce the high effect, unlike THC. With the soaring popularity and acceptance of CBD across the globe, one can say that CBD is here to stay. There is promising evidence from animal sources that shows that CBD is effective and safe. However, there is a need to exercise great caution until additional double blind, placebo controlled, human scientific research evidence is presented to verify the claims made.

With the current pace of continuing research encompassing the effectiveness of CBD, the future looks bright. You should seek the opinion of your medical professional before starting any CBD treatment.

Medical Disclaimer

The Federal Food, Drug, and Cosmetic Act require that we inform you that the efficacy of CBD or CBDV products has not been confirmed by FDA-approved research as a treatment for any medical condition. The information in this document is not intended to diagnose, treat, cure or prevent any disease.

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Diana Rangaves
Diana Rangaves
PharmD, Clinical Consultant, Google Scholar
Dr. Diana Rangaves is Doctor of Pharmacy (Pharm D). She graduated from the University of California, San Francisco and specializes in pharmacotherapy management. Diana has a broad range of acute clinical background and ambulatory care. She was an academic college professor; teaching critical thinking, ethics, pharmacology, addiction, behavior patterns, pharmacy, and nursing. As a Clinical Pharmacist, she is focused on chronic or disease state management.

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