For today’s edition of Dear Mark, I’ll be answering your CBD questions from the past few weeks. CBD, or cannabidiol, is exploding in popularity, but there are many unknowns. People have a lot of questions and there aren’t many definitive or comprehensive guides, so today I’ll do my best to make sense of it. We’re all piecing things together based on limited data—which, I suppose, is the fundamental human experience.

Let’s go:

What’s the difference between hemp and CBD?

Hemp is a (recently legalized) industrial form of cannabis used in the production of paper, textiles, clothing, biodegradable plastics, and overpriced Bob Marley shirts sold along Venice Beach. Hemp seed can be eaten (and is a fantastic source of magnesium, one of the best). Hemp is the plant.

CBD is cannabidiol, a non-psychoactive cannabinoid found in both hemp and cannabis. Unlike THC, CBD won’t get you high.

Due to legal issues, most big name online retailers won’t allow sellers to list “CBD oil” or “CBD” products, let alone CBD content. Descriptions like “full spectrum hemp extract” often mean CBD is present in the hemp oil, but it’s tough to know exactly how much. I recommend investigating the product, searching for the company that makes it, and seeing if they give more explicit details on their website. Even then, make sure the company is the actual seller on Amazon or else you may end up with a counterfeit product sold by wholesalers.

The best bet is to buy directly from the product website.

Is there oil for diabetics??

Although there aren’t any human trials that give CBD to diabetics to see what happens, there are some reasons to think it could be helpful:

Lowering stress. As stated in previous posts, CBD is an effective anti-stress agent. Stress is awful for anyone with diabetes. It increases blood sugar levels. It induces insulin resistance. And if you’re a stress eater, it can increase cravings for high-carb junk food that you really shouldn’t be eating in the first place. In other words, stress exacerbates all the physiological conditions a diabetic is already experiencing.

Improving sleep. Perhaps the most popular use of CBD is to improve poor sleep. Just about the best way to induce some serious glucose intolerance is to get a bad night’s sleep. A diabetic already has poor glucose tolerance; it’s pretty much the defining characteristic of diabetes. What’s worse, a bad night’s sleep has been shown to make a person more susceptible to the allure of junk food.

Inadequate sleep is a strong and independent predictor of type 2 diabetes risk. The less sleep you get, the higher your chance of developing diabetes.

Anything that reduces stress and improves sleep will improve a diabetic’s health. If CBD does that for you, it’ll probably help someone with diabetes. So in a roundabout, not direct way, CBD oil has the potential to help reduce the risk of diabetes and improve the symptoms.

Good MDA folks … does anyone have any experience using CBD oil in lieu of an SSRI to help with anxiety and panic? I’m using CBT techniques to deal with anxiety and panic episodes, and cutting back on my dosage of my SSRI with the intent to eliminate over the next couple of months. I was considering giving CBT oil a try (organic, full spectrum), starting out with just a drop or two and building up to a therapeutic dosage. Also, does CBT oil cause fatigue for anyone? It’s the last thing I want to happen as it’s a big reason I want to eliminate taking the SSRI?

Give it a try, making sure you keep your doctor in the loop.

There are several parallels between anti-depressants and CBD. Both antidepressants and CBD interact with the endocannabinoid receptor systems in the brain. Both antidepressants and CBD can stimulate neurogenesis and counter the depression-related reduction in brain-derived neurotrophic factor.

Any compound that’s used for sleep has the potential to increase fatigue. Sleep is fatigue at the right time. Fatigue is sleep at the wrong time. In an Israeli study of 74 pediatric epilepsy patients using CBD to quell their seizures, 22% reported unwanted levels of fatigue, so it’s a common complaint. Just consider that these were kids taking fairly high dose CBD to quell seizure activity, and that you may not have the same issue taking lower doses at a higher body weight.

Does CBD oil break my fast?

The dosages involved in most CBD oils include at most 1/8 teaspoon of carrier oils, so that’s not enough calories to impact your fast in any meaningful sense.

I haven’t seen any evidence that CBD itself inhibits or impedes ketosis, autophagy, or fat-burning. So, no, there is no indication that CBD oil breaks your fast.

How do I figure out how much cbd is in hemp oil?

As I indicated earlier, it’s impossible to know unless you buy a hemp oil that explicitly states the CBD content.

CBD oil is so expensive. Are there any other options for getting CBD?

You could make your own. It’s actually legal to buy “CBD flower,” which basically looks exactly like the cannabis or weed you’d buy on the street or at a legal dispensary, only it contains little to no THC and tons of CBD. One recipe I saw involved slow-cooking an ounce of the CBD flower in a cup of coconut oil for 8 hours, then straining out the solids. Whatever method you use to cook it, it requires fat, as cannabinoids are fat-soluble.

Here’s a place you can buy CBD flower online. (Note: I don’t have any experience with that company or any other that markets CBD flower or CBD products, so buyer beware.) There are many such places. Just search for them.

CBD is everywhere these days. Should I definitely use it?

Not necessarily. Like anything, it has its uses, there’s great potential, and as new research comes out I foresee the discovery of new modes of action and new applications. However, in all fairness, it’s being overhyped when promoted as a cure-all or panacea.

For what it’s worth, I’m not using it myself. I don’t feel the need, haven’t felt a “CBD deficit.” Don’t assume it’s yet another essential supplement that you simply must have. The basics are the important things—sleep, food, exercise, community, love, micronutrients.

CBD is best used for people who have an established need for it. Chronic pain patient who wants to stop using so many opioids? Great candidate. Kid with epilepsy for whom keto and meds aren’t working? Give it a try. Anxiety and insomnia? Better than just going with narcotics right off the bat. (But as always, work with a physician for any medical issue.)

That’s it for today, folks. If you have any more CBD questions, write them down below and I’ll be sure to answer them!

steak_sauce_640x80

References:

Rudnicka AR, Nightingale CM, Donin AS, et al. Sleep Duration and Risk of Type 2 Diabetes. Pediatrics. 2017;140(3)

Mcneil J, Forest G, Hintze LJ, et al. The effects of partial sleep restriction and altered sleep timing on appetite and food reward. Appetite. 2017;109:48-56.

Fogaça MV, Galve-roperh I, Guimarães FS, Campos AC. Cannabinoids, Neurogenesis and Antidepressant Drugs: Is there a Link?. Curr Neuropharmacol. 2013;11(3):263-75.

Tzadok M, Uliel-siboni S, Linder I, et al. CBD-enriched medical cannabis for intractable pediatric epilepsy: The current Israeli experience. Seizure. 2016;35:41-4.

The post Dear Mark: CBD Edition appeared first on Mark’s Daily Apple.

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Anxiety is normal. It’s something we all have experience with—to one degree or another. Most people are anxious about something that hangs over them and follows them around like a personal rain cloud. Then there’s the deeper but still familiar anxiety many of us carry. The anxiety about our self-worth. The anxiety of performance, of social situations. This type can grip us in an uncomfortable, but hopefully not chronic, way.

But not all anxiety is run-of-the-mill—or manageable. People with Generalized Anxiety Disorder, for instance, might have trouble leaving the house, ordering a coffee from Starbucks, going to work. Anxious thoughts cycling through their brains often keep them up at night. When untreated, people with this level of anxiety can end up living in a state of perpetual fear.

The conventional approach is to take anti-anxiety meds, which can be genuinely life-saving for some people. Nonetheless, these can come with downsides that vary depending on an individual’s dosage and reactions—and the nature of the particular medication itself. Some meds result in few side effects, but others’ effects can be heavy. For instance, there are the benzodiazepines, highly-addictive tranquilizers with the potential for abuse. They make driving unsafe. They lower productivity. They sedate you. When necessary for the severity of the condition, these side effects may be worth it.

In other cases, a person might have more space to experiment and want to explore a different route.

In some cases, people choose to try natural anxiety aids. These are supplements, nutrients, and herbs that have been designed across millennia by nature (and maybe some input from green-thumbed healers). They might not always be enough for something as serious as a clinical anxiety disorder (please talk to your doctor before making any adjustment or addition to your medication), but at least some may be important complements to a prescribed regimen.

For those who want or need an alternative strategy for anxiety beyond meditative practices and general good health, these natural remedies may be worth a try.

First, the NUTRIENTS….

These are basic vitamins, minerals, and amino acids that your body needs to work. They are non-negotiable. You don’t have to get them through supplements—in fact, that should be a last resort after food—and I wouldn’t expect “drug-level” effects, but you do need to get them.

1. Long Chained Omega-3 Fatty Acids

Some human evolution experts maintain that the human brain wouldn’t be the human brain without steady and early access to coastal food resources—fish and shellfish rich in long chain omega-3s. If the long-chained omega-3s found in fatty fish and other sea creatures made our brains what they are today, it’s safe to assume that our brains work better when we eat them today. And if we’re talking about anxiety, that appears to be the case:

Studies in substance abusers find that supplementing with enough fish oil (and, yes, here’s what I use regularly) to raise serum levels of the long chain omega-3 fatty acid EPA reduces anxiety, while increases in DHA (the other long chain omega-3) reduce anger. Rising EPA levels after supplementation predicted the reduction in anxiety.

In healthy young medical students, omega-3 supplementation (2 grams EPA, 350 mg DHA) lowered inflammation and anxiety. Follow-up analyses revealed that reducing the serum omega-6:omega-3 ratio also reduced anxiety scores.

And in early pregnancy, high DHA levels predict low anxiety scores.

2. Magnesium

Magnesium deficiency is a risk factor for anxiety. The evidence, considered by some to be low quality, nonetheless suggests that supplementing with magnesium can reduce subjective anxiety. The mechanistic evidence is stronger, as magnesium is one of those minerals that plays a role in hundreds of very basic and essential physiological processes—including the generation of ATP, the body’s energy currency. Without adequate energy production, nothing works well. One’s mental health is no exception.

Magnesium supplementation reduces subjective anxiety (the only kind that matters) in the “mildly anxious” and in women with premenstrual syndrome.

Magnesium L-threonate, a form particularly good at getting into the brain, is worth trying for more immediate, noticeable effects.

3. Zinc

Zinc deficiency is common in people with anxiety, including Chinese males and Americans. And although mainlining oyster smoothies probably won’t fix serious anxiety, a follow-up in the group of Americans with low zinc levels found that zinc supplementation did reduce anxiety levels.

4. Vitamin B6

Vitamin B6, or pyridoxine, helps regulate production of serotonin and GABA—two neurotransmitters that control depression and anxiety. In mice exposed to anxiety-producing situations, pyridoxine increases GABA, reduces glutamate, and reduces anxiety. In humans, correcting a magnesium deficiency with magnesium and vitamin B6 has a stronger effect on anxiety than magnesium alone. (Good to note: women on hormonal birth control may be depleted of vitamin B6 as well as other vitamins and minerals.)

The best sources of vitamin B6 are turkey, beef, liver, pistachios, and tuna.

Now, the NATURAL INTERVENTIONS….

These aren’t essential nutrients. Rather, they’re plant compounds with pharmacological effects and, in most cases, hundreds of years of traditional usage for dampening, inhibiting, or resolving anxiety.

5. Kanna

Kanna comes from a succulent plant native to South Africa. The story goes that an anthropologist noticed elderly San Bushmen nibbling on a particular type of succulent plant while displaying incredible cognitive ability and remaining calm, cool, and collected. The fact that they weren’t dealing with daily commutes, traffic jams, annoying bosses, and mounting bills probably had something to do with it, but it turns out that the succulent plant wasn’t hurting the cause.

Kanna has been shown to dampen the subcortical threat response, which is normally heightened in anxious states. It also increased well-being and resistance to stress in health adults who took it in a safety study.

6. Theanine

Theanine, an amino acid found in green tea and available as a supplement, isn’t going to obliterate your nerves before a big performance. One study showed that it (along with the benzodiazepine Xanax) reduced resting state anxiety but not experimentally-induced anxiety. Then again, neither did Xanax.

Theanine is instead a mild anxiolytic. If you get anxiety from caffeine, take 200 mg of theanine with your coffee. It will smooth out the experience, reduce/remove the anxiety, and leave the stimulation.

7. Kava

Kava is a plant native to the South Pacific. Traditionally, its roots were chewed fresh with the resultant liquid often spit into communal bowls for consumption, pounded to release the moisture, or sun-dried, ground, and steeped in water to make an intoxicating, relaxing mild sedative. Nowadays, the active kavalactones are also extracted and pressed into capsules.

I don’t use kava, but I have tried it a couple times in the past. For what it’s worth, I don’t have anxiety issues but it did seem to pair well with caffeine (similar to theanine).

8. Rhodiola Rosea

Rhodiola rosea is a longtime favorite adaptogen of mine. It hails from the barren wastes of Siberia, where for millennia people from all over the ancient world coveted it. There’s something about the harsh environment of the northern tundra that made rhodiola rosea incredibly resilient—and bestows upon those who consume it a similar type of mental resilience.

2015 study sought to determine the impact of rhodiola on self-reported anxiety, stress, cognition, and a host of other mental parameters. Eighty subjects were divided into either a twice-daily commercial formula (containing 200 mg rhodiola) group or a control group. Compared to the controls, the rhodiola group showed notable improvements in mood and significant reductions in anxiety, stress, anger, confusion and depression after 14 days.

Rhodiola rosea, along with theanine, features prominently in my anti-stress (and anti-anxiety) supplement Adaptogenic Calm. (If you’re interested, here’s a video of me talking about how I use it.)

9. Lavender

There’s a great lavender farm on the island of Maui. One of the favorite memories from that trip is strolling through the fields of lavender, brushing against the leaves and flowers, just basking in the relaxing scent that permeated the entire property. A very low-stress environment, to be sure.

One study gave lavender oil capsules to major depressive disorder patients suffering from anxiety who were already taking antidepressants. Not only did adding the lavender reduce anxiety, it also improved sleep.

Perhaps the most impressive study is this one, where generalized anxiety disorder patients either received lavender oil or a benzodiazepine anti-anxiety drug. Patients receiving the lavender had the same beneficial effects as the benzo patients without the sedation.

Lavender oil aromatherapy also seems to reduce anxiety, at least in cancer patients. One weakness of aromatherapy research is the difficulty of giving a “placebo smell.” Essential oil scents are quite distinct.

10. CBD Oil

As I wrote a couple weeks ago, CBD is the non-psychoactive cannabinoid found in cannabis.

Most recently, a large case series (big bunch of case studies done at once) was performed giving CBD to anxiety patients who had trouble sleeping. Almost 80% had improvements in anxiety and 66% had improvements in sleep (although the sleep improvements fluctuated over time).

In a five-year-old girl with PTSD (a category of patient that just shouldn’t exist) in whom pharmaceutical anxiety medications did not work, CBD oil provided lasting relief from anxiety.

Here’s how to find a good CBD oil.

What do you folks like for anxiety? What’s worked? What hasn’t? What did I miss?

Thanks for reading, everyone. Take care.

calm_640x80

References:

Cunnane SC, Crawford MA. Energetic and nutritional constraints on infant brain development: implications for brain expansion during human evolution. J Hum Evol. 2014;77:88-98.

Boyle NB, Lawton CL, Dye L. The effects of magnesium supplementation on subjective anxiety. Magnes Res. 2016;29(3):120-125.

Mccarty MF. High-dose pyridoxine as an ‘anti-stress’ strategy. Med Hypotheses. 2000;54(5):803-7.

Walia V, Garg C, Garg M. Anxiolytic-like effect of pyridoxine in mice by elevated plus maze and light and dark box: Evidence for the involvement of GABAergic and NO-sGC-cGMP pathway. Pharmacol Biochem Behav. 2018;173:96-106.

De souza MC, Walker AF, Robinson PA, Bolland K. A synergistic effect of a daily supplement for 1 month of 200 mg magnesium plus 50 mg vitamin B6 for the relief of anxiety-related premenstrual symptoms: a randomized, double-blind, crossover study. J Womens Health Gend Based Med. 2000;9(2):131-9.

Lu K, Gray MA, Oliver C, et al. The acute effects of L-theanine in comparison with alprazolam on anticipatory anxiety in humans. Hum Psychopharmacol. 2004;19(7):457-65.

Terburg D, Syal S, Rosenberger LA, et al. Acute effects of Sceletium tortuosum (Zembrin), a dual 5-HT reuptake and PDE4 inhibitor, in the human amygdala and its connection to the hypothalamus. Neuropsychopharmacology. 2013;38(13):2708-16.

Nell H, Siebert M, Chellan P, Gericke N. A randomized, double-blind, parallel-group, placebo-controlled trial of Extract Sceletium tortuosum (Zembrin) in healthy adults. J Altern Complement Med. 2013;19(11):898-904.

Fißler M, Quante A. A case series on the use of lavendula oil capsules in patients suffering from major depressive disorder and symptoms of psychomotor agitation, insomnia and anxiety. Complement Ther Med. 2014;22(1):63-9.

Woelk H, Schläfke S. A multi-center, double-blind, randomised study of the Lavender oil preparation Silexan in comparison to Lorazepam for generalized anxiety disorder. Phytomedicine. 2010;17(2):94-9.

Shannon S, Opila-lehman J. Effectiveness of Cannabidiol Oil for Pediatric Anxiety and Insomnia as Part of Posttraumatic Stress Disorder: A Case Report. Perm J. 2016;20(4):16-005.

The post 10 Natural Anxiety Remedies appeared first on Mark’s Daily Apple.

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The burgeoning CBD oil scene has made finding a product easier than ever, but it’s also made choosing a product harder. If you recall my post from years ago on decision fatigue, you’ll know what I’m talking about: the paralysis of too many choices…. I know my readership, and I know you’re the type of people who will wonder about optimizing their CBD ingestion. This stuff isn’t cheap, and it’s perfectly rational to want to get your money’s worth.

While the compound itself—cannabidiol, or CBD—doesn’t change from product to product, the way it’s administered does.

(Just a reminder that we’re talking here about CBD oil, a.k.a. “hemp extract,” a legal form of cannabis with extremely low levels of psychoactive THC: there’s no “high” with CBD oil, but CBD oil does contain cannabidiol, a component with big physiological impacts for health. Read more on those impacts here. Likewise, “hemp oil” is different from CBD oil; hemp oil isn’t made from the full plant and doesn’t contain substantive CBD content. For the purpose of this article, I’m covering CBD oil only.)

Let’s look at the forms of available CBD oil….

There are oral CBD oil supplements—gummies, capsules, infused teas, chocolates. Things you eat and drink and digest.

There are sublingual CBD oil supplements—sprays, tinctures, lozenges. Things you swish and swirl around your mouth.

There are topical CBD—creams, lotions, and balms.

There are patches—things you rub and attach to your skin.

There is high-CBD cannabis and CBD-only vape juice. Things you can vaporize and inhale.

But how do you choose? What are the differences between the various routes of administration?

What To Consider When Choosing A CBD Product

Speed of absorption. How quickly do you want the CBD to take effect?

Intensity. How powerful do you want your CBD “experience” to be?

Duration. How long do you want it to last?

Effects. Where do you want it to take effect?

CBD Product Choices: The Rundown

Oral

Oral CBD is the most common method of administration. It’s simple, easy, and intuitive. Everyone swallows pills, eats food, and drinks fluids. There’s almost no way to mess it up (choking aside).

Oral CBD is readily absorbed. Like most everything else that travels through the digestive system, it goes to the liver to be metabolized and converted into different metabolites. The liver is so central to oral CBD that people with poor liver function actually end up with higher serum CBD after taking it orally, since their livers aren’t as good at metabolizing it into different compounds. This liver route also means it takes longer for oral CBD to take effect, but it lasts longer.

Taking an acute oral dose every once in awhile is less effective than consistent dosing because of the liver’s tendency to regulate its bioavailability. When you take it on a regular basis, CBD—being fat soluble like other cannabinoids—gathers in your adipose tissue where your endocannabinoid system can theoretically utilize it on an ongoing basis.

  • Speed: Slow
  • Intensity: Low to moderate (depending on dosage)
  • Duration: Long
  • Effects: Systemic

Sublingual

Sublingual CBD goes under the tongue for absorption via the mucosal membranes in the mouth, which are highly permeable. From there, it bypasses the portal vein—the passage that leads from the digestive tract to the liver—and heads straight for the blood. And then whatever’s left over and not absorbed sublingually gets swallowed and makes it into the digestive tract, so nothing’s wasted.

You have several sublingual options….

Tinctures: Little dropper bottles.

Sprays: AKA oromucosal spray; think CBD-infused Binaca (anyone remember Binaca?).

Lozenges: CBD lozenges that slowly dissolve in your mouth and enter through the mucosa.

The longer you let the CBD sit in your mouth, the more you’ll absorb. 60-90 seconds appears to be the most commonly recommended period of time.

  • Speed: Fast
  • Intensity: Low to high (depending on dosage)
  • Duration: Moderate
  • Effects: Systemic

Inhaled

The original way to get CBD, inhaling CBD, is the fastest-acting and the most intense (with intensity meaning “effectiveness,” not “this will get you messed up, man,” since CBD is not psychoactive). The vapor or smoke enters the lungs, whose alveoli act as a direct conduit to the bloodstream. Inhalation is also the most legally precarious (depending on where you live) because many inhalation CBD products also contain THC, which remains illegal in most places.

You can smoke cannabis bred to be very high in CBD and low in THC, but there will always be some THC present. You couldn’t exactly call this non-psychoactive (or legal in most places) either due to the THC.

There’s also CBD-only vape juice/E-liquid that you can vaporize and inhale.

It’s certainly effective, though if you’re going for efficiency it’s not “optimal.” Your lungs can’t absorb all the CBD in the smoke or vapor; a significant portion is exhaled and lost to the atmosphere. Plus, there’s the whole fact that filling your lungs with smoke is a major stressor. Vapor might be safer, but I’m skeptical.

  • Speed: Fast
  • Intensity: Low to high (depending on dosage)
  • Duration: Shorter
  • Effects: Systemic

Topical

Like other cannabinoids, the CBD molecule is highly hydrophobic and thus cannot pass through the aqueous layer of the skin to reach general circulation. However, if you lather enough of it on to an isolated patch of injured rat skin, it can interact with peripheral cannabinoid receptors that reduce pain and inflammation at a local level. This hasn’t been confirmed in live humans, but anecdotal reports are positive.

  • Speed: Fast
  • Intensity: Unknown
  • Duration: Unknown
  • Effects: Local

Which One Should You Choose?

I don’t have a dog in this fight. I don’t use CBD myself (though I’m not opposed to it and am open to incorporating it in the future if it proves to be uniquely helpful). As a result, I don’t have any strong personally motivated opinion about specific products. What I can give is my objective take on the available evidence, which is fairly light and preliminary:

The best-studied CBD administration methods are oral and sublingual. The majority of human studies have utilized those two routes. There are quite a few positive studies on smoked or inhaled CBD, too, but those often include THC and fail to isolate CBD. If you’re only interested in CBD and not in THC (or it’s illegal where you live), those studies probably don’t apply to you.

In the large set of case studies that found CBD helped patients improve their sleep, the subjects took CBD capsules.

In a study on CBD and pain, the subjects used an oromucosal spray.

In epilepsy patients, oral CBD capsules were incredibly effective.

For general use, whether it’s for anxiety, inflammation, pain, or “general wellness,” oral and/or sublingual use seems to be the real ticket. You know how much you’re consuming. You get a long lasting, fairly fast-acting duration of action. You get the quick absorption into the bloodstream of inhaled CBD without losing any due to exhalation. And if you don’t absorb it all through your oral mucous membranes, you’ll simply swallow and digest the rest. Nothing is lost.

What about you, folks? I know there are some experienced CBD users out there reading this. What’s your favorite method of administration, and why?

Take care everyone.

whole30kit_640x80

References:

Taylor L, Crockett J, Tayo B, Morrison G. A Phase 1, Open-Label, Parallel-Group, Single-Dose Trial of the Pharmacokinetics and Safety of Cannabidiol (CBD) in Subjects With Mild to Severe Hepatic Impairment. J Clin Pharmacol. 2019;

Lattanzi S, Brigo F, Trinka E, et al. Efficacy and Safety of Cannabidiol in Epilepsy: A Systematic Review and Meta-Analysis. Drugs. 2018;78(17):1791-1804.

Richardson JD, Kilo S, Hargreaves KM. Cannabinoids reduce hyperalgesia and inflammation via interaction with peripheral CB1 receptors. Pain. 1998;75(1):111-9.

The post CBD Oil: How Should You Take It? appeared first on Mark’s Daily Apple.

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The burgeoning CBD hemp oil scene has made finding a product easier than ever, but it’s also made choosing a product harder. If you recall my post from years ago on decision fatigue, you’ll know what I’m talking about: the paralysis of too many choices…. I know my readership, and I know you’re the type of people who will wonder about optimizing their CBD ingestion. This stuff isn’t cheap, and it’s perfectly rational to want to get your money’s worth.

While the compound itself—cannabidiol, or CBD—doesn’t change from product to product, the way it’s administered does.

(Just a reminder that we’re talking here about CBD oil or “hemp extract,” a legal form of cannabis with extremely low levels of psychoactive THC: there’s no “high” with CBD hemp oil, but CBD hemp oil does contain cannabidiol, a component with big physiological impacts for health. Read more on those impacts here.)

Let’s look at the forms of available CBD oil….

There are oral CBD oil supplements—gummies, capsules, infused teas, chocolates. Things you eat and drink and digest.

There are sublingual CBD oil supplements—sprays, tinctures, lozenges. Things you swish and swirl around your mouth.

There are topical CBD—creams, lotions, and balms.

There are patches—things you rub and attach to your skin.

There is high-CBD cannabis and CBD-only vape juice. Things you can vaporize and inhale.

But how do you choose? What are the differences between the various routes of administration?

What To Consider When Choosing A CBD Product

Speed of absorption. How quickly do you want the CBD to take effect?

Intensity. How powerful do you want your CBD “experience” to be?

Duration. How long do you want it to last?

Effects. Where do you want it to take effect?

CBD Product Choices: The Rundown

Oral

Oral CBD is the most common method of administration. It’s simple, easy, and intuitive. Everyone swallows pills, eats food, and drinks fluids. There’s almost no way to mess it up (choking aside).

Oral CBD is readily absorbed. Like most everything else that travels through the digestive system, it goes to the liver to be metabolized and converted into different metabolites. The liver is so central to oral CBD that people with poor liver function actually end up with higher serum CBD after taking it orally, since their livers aren’t as good at metabolizing it into different compounds. This liver route also means it takes longer for oral CBD to take effect, but it lasts longer.

Taking an acute oral dose every once in awhile is less effective than consistent dosing because of the liver’s tendency to regulate its bioavailability. When you take it on a regular basis, CBD—being fat soluble like other cannabinoids—gathers in your adipose tissue where your endocannabinoid system can theoretically utilize it on an ongoing basis.

  • Speed: Slow
  • Intensity: Low to moderate (depending on dosage)
  • Duration: Long
  • Effects: Systemic

Sublingual

Sublingual CBD goes under the tongue for absorption via the mucosal membranes in the mouth, which are highly permeable. From there, it bypasses the portal vein—the passage that leads from the digestive tract to the liver—and heads straight for the blood. And then whatever’s left over and not absorbed sublingually gets swallowed and makes it into the digestive tract, so nothing’s wasted.

You have several sublingual options….

Tinctures: Little dropper bottles.

Sprays: AKA oromucosal spray; think CBD-infused Binaca (anyone remember Binaca?).

Lozenges: CBD lozenges that slowly dissolve in your mouth and enter through the mucosa.

The longer you let the CBD sit in your mouth, the more you’ll absorb. 60-90 seconds appears to be the most commonly recommended period of time.

  • Speed: Fast
  • Intensity: Low to high (depending on dosage)
  • Duration: Moderate
  • Effects: Systemic

Inhaled

The original way to get CBD, inhaling CBD, is the fastest-acting and the most intense (with intensity meaning “effectiveness,” not “this will get you messed up, man,” since CBD is not psychoactive). The vapor or smoke enters the lungs, whose alveoli act as a direct conduit to the bloodstream. Inhalation is also the most legally precarious (depending on where you live) because many inhalation CBD products also contain THC, which remains illegal in most places.

You can smoke cannabis bred to be very high in CBD and low in THC, but there will always be some THC present. You couldn’t exactly call this non-psychoactive (or legal in most places) either due to the THC.

There’s also CBD-only vape juice/E-liquid that you can vaporize and inhale.

It’s certainly effective, though if you’re going for efficiency it’s not “optimal.” Your lungs can’t absorb all the CBD in the smoke or vapor; a significant portion is exhaled and lost to the atmosphere. Plus, there’s the whole fact that filling your lungs with smoke is a major stressor. Vapor might be safer, but I’m skeptical.

  • Speed: Fast
  • Intensity: Low to high (depending on dosage)
  • Duration: Shorter
  • Effects: Systemic

Topical

Like other cannabinoids, the CBD molecule is highly hydrophobic and thus cannot pass through the aqueous layer of the skin to reach general circulation. However, if you lather enough of it on to an isolated patch of injured rat skin, it can interact with peripheral cannabinoid receptors that reduce pain and inflammation at a local level. This hasn’t been confirmed in live humans, but anecdotal reports are positive.

  • Speed: Fast
  • Intensity: Unknown
  • Duration: Unknown
  • Effects: Local

Which One Should You Choose?

I don’t have a dog in this fight. I don’t use CBD myself (though I’m not opposed to it and am open to incorporating it in the future if it proves to be uniquely helpful). As a result, I don’t have any strong personally motivated opinion about specific products. What I can give is my objective take on the available evidence, which is fairly light and preliminary:

The best-studied CBD administration methods are oral and sublingual. The majority of human studies have utilized those two routes. There are quite a few positive studies on smoked or inhaled CBD, too, but those often include THC and fail to isolate CBD. If you’re only interested in CBD and not in THC (or it’s illegal where you live), those studies probably don’t apply to you.

In the large set of case studies that found CBD helped patients improve their sleep, the subjects took CBD capsules.

In a study on CBD and pain, the subjects used an oromucosal spray.

In epilepsy patients, oral CBD capsules were incredibly effective.

For general use, whether it’s for anxiety, inflammation, pain, or “general wellness,” oral and/or sublingual use seems to be the real ticket. You know how much you’re consuming. You get a long lasting, fairly fast-acting duration of action. You get the quick absorption into the bloodstream of inhaled CBD without losing any due to exhalation. And if you don’t absorb it all through your oral mucous membranes, you’ll simply swallow and digest the rest. Nothing is lost.

What about you, folks? I know there are some experienced CBD users out there reading this. What’s your favorite method of administration, and why?

Take care everyone.

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References:

Taylor L, Crockett J, Tayo B, Morrison G. A Phase 1, Open-Label, Parallel-Group, Single-Dose Trial of the Pharmacokinetics and Safety of Cannabidiol (CBD) in Subjects With Mild to Severe Hepatic Impairment. J Clin Pharmacol. 2019;

Lattanzi S, Brigo F, Trinka E, et al. Efficacy and Safety of Cannabidiol in Epilepsy: A Systematic Review and Meta-Analysis. Drugs. 2018;78(17):1791-1804.

Richardson JD, Kilo S, Hargreaves KM. Cannabinoids reduce hyperalgesia and inflammation via interaction with peripheral CB1 receptors. Pain. 1998;75(1):111-9.

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