CBD: What Can’t It Help?
Did you know all invertebrates have a biological system named after cannabis? Cannabinoids, active compounds found in cannabis plants, were discovered in the 1990's when scientists were studying how cannabis works, thus the name "endocannabinoid system" (ECS).
What Is the Endocannabinoid System (ECS)?
The ECS is a physiological system constantly working to maintain homeostasis at a cellular level. This system is made up of three parts:
Endocannabinoids (cannabinoids produced naturally inside the body)
Receptors throughout the body
Enzymes that break down endocannabinoids and cannabinoids (from external sources)
Scientists say CBD interacts with pain, gene activation and serotonin receptors, (among several other neurotransmitter receptors), as well as enzymes and other proteins.
Because of the numerous receptors and other sites where cannabinoids interact (both exogenous, from plants such as hemp, and endogenous, from the body), elevated or depressed levels of cannabinoids can have repercussions throughout your entire body.
Studies also indicate that CBD and other cannabinoids increase your body's own natural production of endocannabinoids. One reason is that CBD competes for binding proteins that are responsible for transporting neurotransmitters for breakdown. This means CBD is involved in reuptake inhibition of neurotransmitters, including serotonin, the same mechanism as pharmaceutical SSRIs (selective serotonin reuptake inhibiting anti-depressants). A balanced mood can actually increase your body's own production of cannabinoids!
Aside from its role in elevating mood, serotonin is also used throughout your body for many purposes, including bone sythesis, cardiovascular function and digestion (95% of serotonin receptor sites are located in the GI tract). And serotonin is just ONE neurotransmitter affected by CBD!
Pain Perception, Memory and Epilepsy
CBD also interacts with and desensitizes TRPV1 (transient receptor potential cation channel subfamily V, member 1), receptors found in the hippocampus and throughout the body, thereby helping patients with memory loss, pain and epilepsy.
CBD's Role in Genetic Expression
Another class of receptors CBD activates is peroxisome proliferator-activated receptor (PPARy), which is positioned on the surface of the nucleus inside immune and fat cells. When activated, PPARy changes which genes in your DNA are expressed, impacting metabolism, inflammation, antioxidant production and insulin sensitivity. among other functions.
Stimulation of PPARy by CBD provides neuroprotection when inflammation could be detrimental, such as following a stroke or other traumatic brain injury. Researchers believe this interaction at PPARy explains CBD's beneficial effects on inflammatory conditions such as ulcerative colitis, immune dysregulation (think autoimmunity, MS, asthma) and brain disorders such as Alzheimer’s disease and dementia.
CBD and Enzymes
CBD has been found to inhibit the enzyme that degrades the endocannabinoid anandamide, often referred to as the “bliss” molecule because it acts as a mood enhancer.
Other enzymes targeted by CBD are involved with cholesterol metabolism, mitochondrial function, melatonin synthesis, and much more!
Other Effects of CBD
Cannabidiol interacts with G-protein-coupled receptor 55 (GPR55), a receptor that influences appetite, bone density, insulin secretion and cancer proliferation. GPR55 helps cancer cells proliferate, and CBD appears to antagonize (block) the function.
In a recent study of mice being treated with chemotherapy for pancreatic cancer, those given CBD survived almost three times as long as mice who received only chemotherapy. Click here for the study.
CBD also increases your body’s production of antioxidants, and is a potent antioxidant itself — why many skincare products now include CBD.
How does CBD Interact with Prescription Drugs?
CBD is metabolized by a group of enzymes in the liver that is collectively called cytochrome p450 (CYP450), specifically CYP3A4 and CYP2D6. This accounts for many of the above-mentioned benefits, however, depending on how the drug is processed by these enzymes, CBD could elevate or decrease the concentration of medication in your bloodstream. This may necessitate decreasing or increasing your dose. If your medication comes with a warning about grapefruit consumption, you'll also need to also be cautious when adding CBD, since grapefruit targets the same CYP450 enzymes.
If you take blood thinners, anti-epileptics, HIV antivirals, or chemotherapy, it's best to consult with your physician before taking CBD as you may require extra monitoring to ensure the proper level of medication in your system.
Having said all that, in the 8+ years we've been recommending CBD for our patients, we haven't had any reports of drug interactions in doses up to 180mg daily (most patients don't require dosing above 30 mg daily).
While researching for this article, I found the following statement on the Project CBD website:
"Thus far, based on observations regarding the widespread use of raw cannabis flower and full-spectrum cannabis oil, it does not appear that there have been many problems because of cannabinoid-drug interactions....To the extent that there have been problematic drug interactions with cannabinoids, these have involved high doses of nearly pure CBD isolates..."
Whether or not you're taking any pharmaceutical medications, it's always best to start low and increase incrementally to achieve optimal dosing with CBD.