Touted for its health benefits, CBD, formally known as cannabidiol, has skyrocketed in popularity over the last few years with wide appeal to consumers seeking natural alternatives to traditional prescription or over-the-counter medications for conditions like chronic pain. Often associated with its psychoactive counterpart, tetrahydrocannabinol (THC), CBD is known for its calming effects without inducing a “high” state. While emerging research is promising, CBD remains to be a topic with many misconceptions surrounding it – a number of which healthcare professionals must better understand to help inform their patients. Read on to learn what CBD is, how it works, conditions it may be helpful for, and how to identify trustworthy, safe products.
The Science of CBD
Before diving into how CBD works in the body, it’s important to understand the system it interacts with, the endocannabinoid system (ECS). The ECS is our neuroregulatory system that regulates and controls many of our most critical bodily functions such as learning and memory, emotional processing, sleep, temperature control, pain control, inflammatory and immune responses, and eating.1 Cutting-edge science has shown that the ECS is dysregulated in nearly all pathological conditions so, it stands to reason that “modulating endocannabinoid system activity may have therapeutic potential in almost all diseases affecting humans.”2
While THC acts directly on the cannabinoid receptors in the ECS, CBD behaves differently. Currently, the clinical efficacy of CBD is not completely understood. However, it is suggested that the two main CBD targets include G protein coupled receptors (GPCRs) and ion channels, with the serotonin 5‐HT1A receptor and the transient receptor potential cation channel. Evidence supports the use of CBD as a drug treatment option for anxiety, neuropathy, and many other conditions.3
Key Differences Between CBD and THC
The cannabis plant produces hundreds of chemical compounds called cannabinoids, with the most abundant being cannabidiol (CBD) and tetrahydrocannabinol (THC). Both CBD and THC work with receptors that release neurotransmitters in your brain that can impact memory, mood, appetite, anxiety, pain, and sleep.
Though CBD and THC interact with the ECS, there are some key differences. THC is the main psychoactive ingredient in cannabis and upon consumption, triggers a high release of dopamine which creates the “high” traditionally associated with marijuana.”4 Conversely, CBD does not produce the same euphoric intoxication. While their molecular structure is the same, experts suggest that the differing effect of CBD and THC is due to its molecular arrangement which causes each to bind differently to receptors. For example, instead of creating the “high” associated with THC, CBD may increase the effects of other cannabinoids or binds to other receptors that researchers have not yet discovered.5 According to Holistic Cannabis Practitioner and Registered Dietitian Nutritionist, Janice Newell Bissex, MS, RDN, FAND, “You may read that CBD is non psychoactive, but this is incorrect since it does produce a neuro-calming effect on the brain. However, CBD is non-intoxicating and non-psychotropic (i.e., it will not make you high), unlike the cannabinoid tetrahydrocannabinol (THC), found in cannabis.”
The Rise of CBD
As people look for new tools to improve their overall health and wellness, they are seeking more natural alternatives to prescription and over-the-counter medications. However, despite the legalization and medical use of cannabis, many misconceptions remain amongst consumers. In addition, the desire for more information on how CBD works in the body is growing as various companies pursue it in drug development. Bissex says “CBD is anti-inflammatory and may offer relief for people suffering from pain, anxiety, insomnia, seizure disorders, neurological and neurodegenerative disorders, arthritis, autoimmune diseases, IBS/IBD, muscle spasms, and brain injuries.”
Currently, the only CBD products approved by the FDA is Epidiolex , which is for those who suffer from seizures associated with two rare and severe forms of epilepsy: Lennox-Gastaut syndrome, and Dravet syndrome.6,7 CBD is currently under investigation for potential use in various psychiatric, neurodegenerative, inflammatory, and cancerous diseases.8,9 Emerging data suggests that CBD, independent of THC, shows promise as part of an integrative approach to cancer management. According to one recent meta-analysis, literature based on animal cancer models has demonstrated CBD’s ability to inhibit the progression of different types of cancer including breast, lung, and prostate.10
While the future of CBD use for a vast range of medical conditions is promising, patients should consult with their medical team for guidance on its use. “While CBD can be helpful for a wide variety of medical conditions, it is not effective for everyone, nor for every condition,” says Bissex. She also explained that there are various modes by which CBD can be taken or administered, and the appropriate format depends on the condition and individual. This includes sublingual and ingestible to inhalation, topical, transdermal and suppository forms.
What to Consider When Buying a CBD Product
Under the Agriculture Improvement Act of 2018, (the Farm Bill), CBD products that contain less than 0.3% of THC are not considered illegal under federal law. With this new ruling, CBD products have flooded the market and as a result, along with quality products, questionable CBD products have entered the marketplace as well. In a July 2022 study, researchers at Johns Hopkins tested more than 100 topical CBD products available online and at retail stores and found significant evidence of inaccurate and misleading labeling of CBD content. The study further found that some of the CBD products made therapeutic claims not approved by the FDA.11
Given this, it’s important to know what to look for when shopping for and recommending CBD. According to Bissex, “Ensure your CBD is from a reputable company made from organically grown hemp (cannabis and hemp are bioaccumulator plants) that can provide a certificate of analysis (COA) to prove that what is on the label is accurate. Also, look for full spectrum (with all the synergistic cannabinoids, terpenes, and flavonoids in the plant) or broad spectrum (with all components except THC) products versus isolate products that are not nearly as effective”. Here are other tips to consider:
- Look for product labels that indicate the amount of CBD and THC per serving – not just the total cannabinoid content for the entire bottle.
- Beware of companies that make explicit health claims about CBD products as this is not allowed by the FDA.
- Don’t be afraid to contact CBD companies directly and ask questions; if you cannot reach them directly, try another brand.
While generally safe, CBD products is not risk free. Before considering CBD, the Centers for Disease Control and Prevention (CDC) recommends considering possible side effects and risks such as liver damage, interference with other prescription drugs you are taking, drowsiness or sleepiness, diarrhea or changes in appetite and mood.12
Janice Newell Bissex, MS, RDN, FAND is a Holistic Cannabis Practitioner who offers consultations and quality CBD at Jannabis Wellness. She is also the Program Director, Cannabinoid Medical Sciences, at John Patrick University School of Integrative and Functional Medicine. For more education and support on CBD and cannabis, visit www.jannabiswellness.com.
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For more science-based education on CBD, tune in to the below episode of The Good Clean Nutrition Podcast:
Episode 17: The Evolution and Evidence on Cannabidiol (CBD) and Cannabis with Janice Newell Bissex, MS, RDN, FAND
Listen Here >>
- Zou S, Kumar U. Cannabinoid Receptors and the Endocannabinoid System: Signaling and Function in the Central Nervous System. International Journal of Molecular Sciences. 2018; 19(3):833. https://doi.org/10.3390/ijms19030833
- Pacher, P., & Kunos, G. (2013). Modulating the endocannabinoid system in human health and disease–successes and failures. The FEBS journal, 280(9), 1918–1943. https://doi.org/10.1111/febs.12260
- De Almeida, D. L., & Devi, L. A. (2020). Diversity of molecular targets and signaling pathways for CBD. Pharmacology research & perspectives, 8(6), e00682. https://doi.org/10.1002/prp2.682
- DiLonardo, M. J. (2021). CBD vs. THC: Properties, benefits, risks, & legality. WebMD. Published December 15, 2021. Retrieved August 15, 2022, from https://www.webmd.com/pain-management/cbd-thc-difference
- Fontaine, D. (2022) CBD vs. THC: Differences, benefits, and effects. Medical News Today. Published July 19, 2022. Retrieved August 15, 2022, from https://www.medicalnewstoday.com/articles/325871#getting-high
- Silvestro, S., Mammana, S., Cavalli, E., Bramanti, P., & Mazzon, E. (2019). Use of Cannabidiol in the Treatment of Epilepsy: Efficacy and Security in Clinical Trials. Molecules (Basel, Switzerland), 24(8), 1459. https://doi.org/10.3390/molecules24081459
- Lattanzi, S., Brigo, F., Trinka, E., Zaccara, G., Striano, P., Del Giovane, C., & Silvestrini, M. (2020). Adjunctive Cannabidiol in Patients with Dravet Syndrome: A Systematic Review and Meta-Analysis of Efficacy and Safety. CNS drugs, 34(3), 229–241. https://doi.org/10.1007/s40263-020-00708-6
- Levinsohn, E. A., & Hill, K. P. (2020). Clinical uses of cannabis and cannabinoids in the United States. Journal of the neurological sciences, 411, 116717. https://doi.org/10.1016/j.jns.2020.116717
- Laczkovics, C., Kothgassner, O. D., Felnhofer, A., & Klier, C. M. (2021). Cannabidiol treatment in an adolescent with multiple substance abuse, social anxiety and depression. Cannabidiol-Therapie eines Jugendlichen mit multiplem Substanzabusus, Sozialphobie und Depression. Neuropsychiatrie : Klinik, Diagnostik, Therapie und Rehabilitation : Organ der Gesellschaft Osterreichischer Nervenarzte und Psychiater, 35(1), 31–34. https://doi.org/10.1007/s40211-020-00334-0
- O’Brien, K. (2022). Cannabidiol (CBD) in Cancer Management. Cancers, 14(4), 885. https://doi.org/10.3390/cancers14040885
- Spindle TR, Sholler DJ, Cone EJ, et al. Cannabinoid Content and Label Accuracy of Hemp-Derived Topical Products Available Online and at National Retail Stores. JAMA Netw Open. 2022;5(7):e2223019. doi:10.1001/jamanetworkopen.2022.23019
- Centers for Disease Control and Prevention. (2022, August 8). CBD: What you need to know. Retrieved August 17, 2022, from https://www.cdc.gov/marijuana/featured-topics/CBD.html
As a leader in high-quality, delicious-tasting, clean nutrition, Orgain is partnering with FoodCorps to launch Food for Thought, a back-to-school program that helps connect kids with healthy, nourishing school meals to fuel their growing minds.
As a valued healthcare professional, we invite you to participate and support FoodCorps’ hands-on approach to food education by adding any Orgain item to your Instacart orders* placed from Sept. 1 through Sept. 30. For each checkout, Orgain will make a donation to support FoodCorps’ mission, up to $250,000, directly impacting the lives and futures of thousands of students.
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New episodes of The Good Clean Nutrition Podcast are available!
Episode 17: The Evolution and Evidence on Cannabidiol (CBD) and Cannabis with Janice Newell Bissex, MS, RDN, FAND
Increased awareness and therapeutic use of cannabidiol (CBD) has sparked the need for consumer education from trusted sources. In this episode of The Good Clean Nutrition Podcast, host Mary Purdy, MS, RDN is joined by Holistic Cannabis Practitioner, Janice Newell Bissex, MS, RDN, FAND, to explore the growing body of evidence supporting the use of CBD to help treat many common health conditions including pain, anxiety, inflammation, insomnia, and more. Tune in as they debunk common misconceptions about cannabis, discuss the key differences between cannabinoids CBD and THC, and review dosage guidelines.
Don’t miss Orgain’s next live webinar on September 29 at 2pm EST, The Physiological Connections Between Diet & Sleep and Associated Risks for Developing Chronic Disease, presented by Marie-Pierre St-Onge, Ph.D, CCSH, FAHA
This webinar will explore the evidence related to the role of sleep in the development of chronic diseases. The influence of diet and physical activity in this relationship will be covered to illustrate the interconnectedness of lifestyle behaviors and their impact on chronic disease risk. You’ll also learn more about the cyclical nature of the sleep-diet/physical activity relationship.
Whether on-demand or live, all the webinars in Orgain’s Professional Education Webinar Series are available for 1.0 CPEU for RDNs and NDTRs.
Will you be attending FNCE this year? If so, we”d love to meet you in person. Please stop by Orgain’s FNCE booth (#1014) for samples, product information, swag giveaways, and the opportunity to ask questions directly to the Orgain Healthcare team!
And make sure not to miss our live culinary demo, Sunday October 9th from 11:30-12:15pm EST, featuring snack prep tips and easy, plant-protein-packed recipes featuring various Orgain products, presented by Orgain’s nutrition advisor and sports dietitian, Kelly Jones, MS, RD, CSSD.
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