Your Guide to CBD Capsules

Differences Between Hemp-Derived CBD and Marijuana

But first, to make sure there is no confusion, let’s take a look at the differences between hemp derived CBD and marijuana.

CBD is the abbreviation for cannabidiol. THC is the abbreviation for tetrahydrocannabinol, the substance that causes marijuana’s “high”.
Cannabidiol is one of hundreds of substances called cannabinoids (including THC) that are found in species of the cannabis plant. Industrial hemp is a member of the cannabis family, but the hemp strain from which CBD is purified was developed to have high fiber content first, and by coincidence, the plant breeders ended up developing plants with high CBD content and low THC content. Think of hemp as a cousin of the marijuana plant in the same way that tomatoes and eggplants are members of the nightshade family. They are in the same family but are pretty clearly different plants.

Importantly, by law in the US, hemp-derived CBD must contain less than 0.3% THC. It is also important to understand that there are some major and important differences between THC and CBD.

• CBD is not psychoactive and does not produce a high. THC is responsible for the “high” one can get from marijuana. CBD and THC act on certain receptors in the body much like a key in a lock except the CBD “key” won’t unlock the THC “lock”. It’s a bit like trying to use the car key to open your front door. The THC “key” works on different receptors that are found mainly in the brain and spinal cord while the CBD “key” works on a different set of receptors.
  • The human body has a natural system that binds cannabinoids like CBD. This is called the endocannabinoid system and it performs important functions, controlling the immune system, pain, mood and how the body responds to insulin, stress and inflammation.
  • The endocannabinoid system turns out to be a very important biological regulatory system and the system was discovered using plant-derived cannabinoids.
• In 2018, the US Congress passed the 2018 Farm Bill, removing industrial hemp from the DEA’s controlled substance list, making industrial hemp and its products such as CBD lawful in all 50 US states. The list of countries where hemp derived CBD is legal is growing and currently includes most of Europe, Canada, Argentina, Peru, South Africa and Turkey. You should check the legal status for your individual country or state.of Europe, Canada, Argentina, Peru, South Africa and Turkey. You should check the legal status for your individual country or state.
  • Even though hemp derived CBD was removed from the DEA controlled substance list, in some jurisdictions in the US, law enforcement has discretion and can decide that buying, selling or possessing CBD may be in violation of local law. Always check local laws before using CBD products.
• Research on CBD is ongoing but has shown a good deal of promise in helping to relieve depression, anxiety and other mood disorders and to help with insomnia and other sleep disorders. CBD is also effective in reducing nausea in cancer patients taking chemotherapy. One of the first medical uses for CBD was in treating certain forms of seizure disorders such as epilepsy in children.
  • CBD has shown effectiveness in reducing inflammation. Pain is commonly due to inflammation and CBD acts as an anti-inflammatory agent to reduce various types of inflammatory pain.

Capsules versus Topicals

When a person takes any substance by mouth, it passes through the digestive system. This, in terms of drug actions, is quite different than what happens when you put the same substance on your skin.

• When you apply a CBD product to a local area of skin, most of the CBD is directly absorbed but just into that small area of skin.
• Bioavailability is the amount of any substance that is able to be absorbed by the body. Some of a substance taken by mouth is degraded by the digestive system. Some of it goes through what is known as the “First Pass Effect” – where the substance first passes through and is metabolized by the liver. Essentially, the core point is that not all the CBD is bioavailable when it is taken orally. It is estimated that only about 5-15% of the original amount of CBD will pass into your body and reach the circulation.
• This does NOT mean that you necessarily have to take more capsules! It just means you should be aware that not all the CBD in a capsule will be absorbed.
• You should also be aware that taking oral forms of CBD can mean that it takes a bit longer to be effective when compared to using CBD oils on the skin. You need to be patient! It may take an hour or so for the full effects to be realized.
  • Topicals can work quite quickly when applied to a knee, for example but, the effect will be limited to that knee. On the other hand, a CBD capsule may be effective at relieving pain in both knees when it is taken orally. It may take a bit longer for the relief to be felt.
  • Another difference between topicals and oral use is that bodyweight can make a difference. Just as in most prescription medicines and OTC medications, the amount of CBD recommended to start out with depend on your overall weight.
• Always remember that more is NOT necessarily better! You may have to go through a bit of “trial and error” to find what dosage works best for you, but for your own health and safety, it is wise to use the motto of “Start Low and Go Slow”. Always talk to your own physician first.

Adverse Effects of CBD Capsules

There are very few known adverse effects of CBD taken by capsule, especially if you Start Low and Go Slow.

The most common side effect of CBD is some drowsiness or sleepiness. The first few times you take CBD should probably be at home and in the evening when this won’t be a problem.

Other less common side effects include a dry mouth, nausea, diarrhea, and lowered blood pressure.

Pregnant or breastfeeding women shouldn’t take CBD. Children under the age of 18 shouldn’t take CBD either. We simply don’t have the research available to be certain CBD is safe for such individuals.

Common Uses for CBD Capsules

So, what might someone take CBD capsules for?

The most common uses are for:

• Pain, especially pain due to inflammation.
  • Nociceptive pain: This can include pain from arthritis of all forms, joint pain from overuse or sprains, pain due to muscle strain or injury or recovery from exercising
  • Neuropathic pain: This is due to nerve damage. It is experienced by people with diabetes, multiple sclerosis and after cancer treatment.
  •  Anxiety and depression
  •  Sleep disorders such as insomnia
  • Chemotherapy related nausea

How to Take CBD Capsules

First, you should always consult your physician before taking any medication. Many people assume since CBD is natural, it is automatically safe. It is for the most part but you are taking it as a medication, and it can interact with other medications. This can occur when a medication you are taking is processed by a liver enzyme system known as the cytochrome P450 system. This can result in alteration to the blood levels of other medications. It all depends on the specific medication. This is another reason to Start Low and Go Slow. Taking CBD in this manner an allow you to notice any interactions before they become a problem.

CBD Can Interact with Other Medications

While there are few adverse effects with CBD, there are some significant interactions with prescription medications that you need to know about.

CBD can interfere with the actions of about 25% of all drugs. Talk to your physician and/or pharmacist before using CBD if you are on any other medication(s).

CBD may increase the blood levels of:

• MMacrolides (antibiotics such as erythromycin as azithromycin)
• Heart medications such as calcium channel blockers
• Anti-anxiety drugs such as benzodiazepines
• Immunosuppressive drugs such as cyclosporine
• Drugs used to treat erectile dysfunction such as sildenafil and other PDE5 inhibitors
• Antihistamines
• Antipsychotics such as haloperidol
• Antiretrovirals
• Some statins (atorvastatin and simvastatin)
• Antidepressants such as the SSRIs (Celexa, Lexapro, Luvox, Paxil, Prozac, and Zoloft) and the tricyclics (including Amitriptyline, Amoxapine, Desipramine (Norpramin) and Doxepin)
• Beta-blockers used to treat high blood pressure (eg. metoprolol, atenolol, propranolol. Betaxolol)
• Alcohol
• Barbiturates (secobarbital, butabarbital, phenobarbital, pentobarbital)
• Opioids (codeine, hydrocodone, oxycodone, oxycontin)

Second, remember to take CBD only as recommended. You should be able to feel relief or to detect any effects within 1-2 hours after taking the recommended number of capsules. Stay on the recommended dosage for at least 1-2 weeks and talk to your physician if you feel you need to increase the dosage. Always remember to increase dosage according to the recommendations and to increase the dosage slowly. The Arthritis Foundation recommends the following approach:

• “Use low doses, which seem to work best for pain relief.
• Start with a CBD only product, 5 – 10mg twice daily, and then slowly increase, going up to dose of 50 – 100mg per day. If that doesn’t help, try a CBD product which incorporates a low dose of THC
• Use only at night at first; slowly increase dose if needed.
• The effect of edibles’ effects last longer than vaping, so don’t try them until you know what CBD strain and dose work for you.
• Use caution if you are 25 years old or younger and using CBD products that contain THC. This age group is at highest risk of addiction, dependency or even psychosis.”

Advice your physician in order to set the preferred dosage. Most CBD capsules come in doses ranging from about 5-50 mg but this can vary. Read the label carefully to determine how much CBD, just CBD, is in the product. If you are not certain, call the company to find out! Labels can be difficult to read and understand so make certain you know how much CBD you are taking.

Choosing a CBD Brand

The most important thing to find the best cbd oil capsules you can do is to check the brand out. Call the company to ask for the quality control sheets. You are looking for purity and quality. Third party testing is a good way to determine both. If a company is willing to have its product tested by an independent lab (third-party testing), then you can be more certain that the quality is high. See what you can find out about the company’s reputation. Buyer reviews are not necessarily reliable, so see what independent information you can find. Check that the extraction methods employ either ethanol or CO2 extraction as extraction using these solvents produce the safest and purest CBD. Read the label carefully, looking to see if they provide information about how many mg of CBD are in an individual capsule or serving. Note that some products may say “x mg of CBD per serving” and a serving is given as 2 capsules. If your bottle says 10 mg per serving and the serving is 2 capsules, then each capsule contains 5 mg of CBD.

CBD products can be found in both many different brick and mortar stores and online. One way to compare prices is to determine the cost per mg of CBD. First, take the total cost of a bottle of capsules and divide it by the number of capsules to get the cost per capsule. For example, if a bottle of 30 capsules costs $39.00 then $39.00/30= $1.30 per capsule. The label indicates that each capsule contains 10 mg CBD so $1.30/10 mg= $0.13 per mg.

Full-Spectrum, Broad-Spectrum and Isolates

Many products contain “Full-Spectrum CBD” and these dosage forms often contain a substantial number of mg, often500-1000mg. “Full spectrum” refers to the fact that the extract contains not only cannabinoids, but other, potentially beneficial plant substances such as terpenes, flavonoids, fatty acids and other components. It may contain appreciable amounts of THC and this formulation may work better for some people. This represents a body of knowledge that has not been fully researched. It does NOT mean the product contains 500-1000 mg of CBD. The bottle should have a separate listing for how much CBD is in each capsule or softgel/gelcap.

Broad-spectrum formulations contain all the plant constituents but do not contain THC.

A CBD isolate contains pure CBD. These formulations are available in capsule form but tend to be significantly more expensive because of the purification process required to obtain CBD isolate. On the other hand, these products can be easier to use as you know exactly how much CBD is in each capsule, making it easier to determine exactly how much you need.

Advantages and Disadvantages of Capsules

Capsules and soft gels/gel caps have some distinct advantages over, for example, an orally delivered oil or tincture of CBD.

Capsules are:

• Odorless and tasteless
  • People who don’t have a lot of experience with herbs (and CBD IS an herbal medicine) are often surprised at the taste and not necessarily very pleasantly surprised! It can be a bit “earthy” for some and the taste can take some getting used to!
• Capsules are easy
  • With oils and tinctures there is some degree of measuring out drops and sometimes, lots of dripping! With capsules, once you have found your best dose, it can be much easier to consume what you need.
• While CBD has come a long way, not everyone feels comfortable with its use. CBD capsules look like any other supplement so no one has to know you are taking it.
• CBD can be taken with meals or between meals, though it is best to take any capsule with a large amount of water. See what works best for you. Be aware that taking CBD with meals may make it take longer to feel any effects because digestion of food slows down the absorption process.
• Most capsules are made with gelatin—so they are not vegetarian or vegan, though they may be kosher. You may have to call the company to determine if the capsules fit with your dietary choices. Some capsules may be cellulose based. These would be vegetarian and vegan though it is still best to call the company to make certain.

The Bottom Line

There are advantages to taking CBD in capsule form and this may be the best approach for many. Quality is important whether you take CBD as an oil, capsule or in the form of a topical application, so check for third party lab testing, how the CBD is purified and the cost per mg of the CBD. No matter which form of CBD you take, we will try to provide you with the most current information and give you guidelines about getting the highest quality product available.

References

1. Crippa JA, Guimarães FS, Campos AC, Zuardi AW. Translational Investigation of the Therapeutic Potential of Cannabidiol (CBD): Toward a New Age. Front Immunol. 2018;9:2009. doi:10.3389/fimmu.2018.02009
2. Crippa, José Alexandre S et al. Cannabis and anxiety: a critical review of the evidence. Human psychopharmacology 24 7 (2009): 515-23 .
3. Babson, KA., Sottile, J., Morabito. Cannabis, Cannabinoids, and Sleep: a Review of the Literature, Curr Psychiatry Rep 2017; 19: 23. doi: 10.1007/s11920-017-0775-9
4. Mechoulam, R., Hanus, L., The cannabinoids: An overview. Therapeutic implications in vomiting and nausea after cancer chemotherapy, in appetite promotion, in multiple sclerosis and in neuroprotection. Pain Res Manage 2001;6 (2): 67.
5. Blair, RE., Deshpande, LS., DeLorenzo,RJ. Cannabinoids: is there a potential treatment role in epilepsy?, 2015. Expert Opinion on Pharmacotherapy, 16:13, 1911-1914, DOI: 10.1517/14656566.2015.1074181
6. Nadulski, T., et al, Randomized, Double-Blind, Placebo-Controlled Study About the Effects of Cannabidiol (CBD) on the Pharmacokinetics of D9-Tetrahydrocannabinol (THC) After Oral Application of THC Verses Standardized Cannabis Extract.Ther Drug Monit, 2005; 27(6): 799.
7. Gallily, R. , Yekhtin, Z. and Hanuš, L. (2015) Overcoming the Bell-Shaped Dose-Response of Cannabidiol by Using Cannabis Extract Enriched in Cannabidiol. Pharmacology & Pharmacy, 6, 75-85. doi: 10.4236/pp.2015.62010.
8. Carter, GT., et al., Medicinal cannabis: Rational guidelines for dosing. IDrugs 2004; 7(5):464-470
9. Devinsky, O., et al Randomized, dose-ranging safety trial of cannabidiol in Dravet syndrome. Neurology. 2018;90:e1204-e1211. doi:10.1212/WNL.0000000000005254
10. D. R. Blake, P. Robson, M. Ho, R. W. Jubb, C. S. McCabe, Preliminary assessment of the efficacy, tolerability and safety of a cannabis-based medicine (Sativex) in the treatment of pain caused by rheumatoid arthritis, Rheumatology, Volume 45, Issue 1, January 2006, Pages 50–52, https://doi.org/10.1093/rheumatology/kei183
11. Miller, RJ., Miller, RE. Is Cannabis and effective treatment for joint pain?Clinical and Experimental Rheumatology. 2017:35 (Supple 107);S59.
12. Wallace MS, Marcotte TD, Umlauf A, Gouaux B, Atkinson JH. Efficacy of Inhaled Cannabis on Painful Diabetic Neuropathy. J Pain. 2015;16(7):616–627. doi:10.1016/j.jpain.2015.03.008
13. Langford, RM., et al, A double-blind, randomized, placebo-controlled, parallel-group study of THC/CBD oromucosal spray in combination with the existing treatment regimen, in the relief of central neuropathic pain in patients with multiple sclerosis. J Neurol. 2013; Apr;260(4):984-97. doi: 10.1007/s00415-012-6739-4.
14. Ward, SJ. et al, Cannabidiol inhibits paclitaxel-induced neuropathic pain through 5-HT1A receptors without diminishing nervous system function or chemotherapy efficacy. 2014:British Journal of Pharmacology. 171: 636–645
15. Crippa, José Alexandre S et al. “Cannabis and anxiety: a critical review of the evidence.” Human psychopharmacology 24 7 (2009): 515-23 .
16. Tringale, R., Jensen, C., Cannabis and Insomnia.O’Shaughnessy’s. 2011:31.—
17. Mechoulam, R., Hanus, L., The cannabinoids: An overview. Therapeutic implications in vomiting and nausea after cancer chemotherapy, in appetite promotion, in multiple sclerosis and in neuroprotection. Pain Res Manage 2001;6 (2): 67.
18. https://www.arthritis.org/living-with-arthritis/treatments/natural/supplements-herbs/cannabidiol-oil.php