CBD - An Emerging Tool In The Fight Against Inflammation

I wrote a piece a while back about my 30 day trial of a CBD oil supplement that I had a good experience with.  Since that time I have had some interest from some of my patients and other readers as a result.  And since that time as well I have done some more research about Cannabidiol (CBD) and have found some very compelling modern scientific research articles on the topic.  I want to describe just some of the things that I have found that I feel are not only interesting but potentially game changing for a lot of chronically ill people.  But not only chronically ill people can benefit.  The research that I have been reading shows great promise in the area of preventative medicine as well.
Before I get in to the details here I feel it is important to cover a few basic topics about medical cannabis that are common misconceptions or flat out judgmental bias about these compounds.  First and foremost CBD and THC are two different compounds. It is the THC that people know about and is the compound that produces the “high” from marijuana.  CBD is another compound found within the plant that does not lead to feeling high but instead has some pretty profound medical implications as research is showing us.  Interestingly, THC is found in much higher concentrations in the traditional marijuana plant.  Marijuana has much more THC and less CBD content.  The hemp plant however looks the same, grows the same and can even cross breed with marijuana but is a different strain.  The hemp plant contains very little THC and higher levels of CBD.  Basically smoking hemp would lead to a bummer of a high.  It just does not contain enough THC to produce any effect.  So why in the world it is not legal here in the States is beyond me.  CBD products however are legal in the States.  In fact they are legal for sale in every State in the US without the recommendation of a medical doctor.  The products that I am carrying now are all from hemp plants and contain virtually no THC whatsoever.  Nope….  Taking this stuff will not get you high but it will do a lot more for you.

One of the first concepts that I have heard people using CBD’s or Hemp oil for is in the treatment of cancers.  Now it is very important for me to point out that there is very little scientific literature out there at the moment that demonstrates a benefit of taking CBD products for the treatment of cancer. However, there is mounting anecdotal evidence coming in constantly about people who were at their end with chemotherapy and began using high quality and high dose CBD products (or other medical cannabis products) only to find their tumors were shrinking.  There are plenty of stories of people going into full remission as a result of adding in products like these and their MD’s having no explanation for the sudden turn of events.  So with any luck there will be some good studies in the near future on this topic. I for one will keep my eyes peeled.  Cancer however is not a specialty of mine.  The next bit of info however fits my patient population much better.

In pouring over some of the more current literature on the subject of CBD’s and physiology I have been surprised to learn just how extensive the benefits can reach.  I have written in the past about inflammation and how it can impact so many different parts of our health.  Indeed just about every chronic disease has its root in inflammatory activity.  I work a lot with autoimmunity and I see things like blood sugar disorders all the time.  Type II Diabetes is a growing epidemic in this country with the largest population of people developing the disease being teens and young adults!  In these cases there are soaring levels of blood sugar in the system with equally high levels of the hormone Insulin.  Insulin is essential for life but the idea is to keep these levels as low as possible.  Because even though it is essential, too much and you set off a cascade of inflammatory mechanisms that all lead to disease in the end.  The best plan is not to start things off in the first place.  But alas the reality is that we are already there folks! 

Before I describe some of the benefits of these compounds I feel that it is important to explain what I mean when I say “inflammation.”  In this case I am not talking about a swollen ankle that started during that beach volley ball match.  Sure, that joint is inflamed.  But rather, I am talking about molecules that the immune system releases into the blood as a result of some trigger.  These molecules called “cytokines” literally float around and wreak havoc on everything in their way.  If they land on a brain cell that brain cell suffers and even dies.  If they land on a hormone receptor that receptor fails to work optimally.  If they attach to the tissues lining the arteries that artery becomes sticky and attracts plaque leading to vascular disease and the leading cause of death – heart attack.  And something that I work with a lot in my practice, if that cytokine interacts with other immune cells they can lose their ability of self-control and begin attacking our own tissues!  That is autoimmunity.   Once the body loses the ability to determine the difference between self and non-self we are now forever under attack from our own forces.  This is not good…   Longevity rarely ever accompanies autoimmunity.  The focus on this article is a particularly nasty inflammatory cytokine called NF-kB.  The name isn’t all that important but trust me.  NF-kB is one of the really nasty bad guys you do not want to spin out of control.  If it does take hold you can end up with one or many of the things I just described above.  NF-kB plays a key role in vascular disease, autoimmunity, cancer, dementia, etc.  A lot of what I do with my patients is finding ways of lowering NF-kB activity so that their disease states do not spin out of control.  As of now there is no medication on the market that directly lowers this inflammatory cytokine.  Most drugs target the things that come as a result of this kind of activity.  Interestingly there are a few natural compounds that have shown to lower this cytokine activity. 

Enter CBD…  According to an article published in the Am J Physiol Heart Circ Physiol. Jul 2007, CBD has demonstrated a significant ability to squash the NF-kB elevations otherwise associated with the Insulin surges found in Type II Diabetics.  In essence this article describes a compound that can literally act as an “antidote” to Diabetes and recommends that further research on this subject be at a high priority! 

Another article from the British Journal of Pharmacology (2008) suggests that the potential for anti-inflammatory activity of CBD could lead to a new class of anti-inflammatory drug.  So this means that the pharmaceutical industry sees the benefit.  These are mainstream medical scientists who are publishing articles on the benefits of a compound found in medical Cannabis!  I personally find this to be somewhat of a huge step forward in an otherwise closed field of pharmaceutical control of symptom rather than source. 
My personal interest as I have mentioned, aside from the rampant blood sugar patterns I see all the time out there, is autoimmunity.  This particular patient population is literally awash in an intermingled web of inflammatory cytokine activity and NF-kB is at the core of a lot of it.  In an article published in the Am J Physiol Heart Circ Physiol. Jul 2007 it was stated that CBD has already been approved in the treatment of inflammation, pain, and spasticity associated with multiple sclerosis in humans. Multiple Sclerosis (MS) is an autoimmune disease.  And the CBD did not benefit the MS condition specific to the nervous system precisely.  Rather, it worked on the immune system which is at the root of the MS in the first place.  It is important to understand that an autoimmune disease is not just a disease of the particular organ or gland under attack.  First and foremost it is a disease of the immune system not knowing self from non-self!  So studies like these demonstrate potential benefits for all autoimmune diseases.  It just so happened that this particular study was focused on MS patients.
So in closing I just want to leave off with one more quote from my good friend and colleague         Dr. Chris Rasmussen, MD…  

Let me put this into perspective. If we had a drug that could effectively, and safely, attenuate or reverse the effects of our first-world, inflammatory lifestyle, while allowing patients to continue their destructive habits-the classic American way to approach healthcare-it would outsell statins [Cholesterol lowering medications and the go to treatment for heart disease currently] within the first year. That’s at least 30 billion in sales per year (some sources quote 200 billion in annual sales). Moreover, by operating at the root level and suppressing NF-kB, a real cure for atherosclerosis could be realized, and with it cures for a hundred more diseases of affluence. That could change the face of medicine folks. It would be as important, if not more so, than when penicillin was first introduced 70 years ago in the treatment of that generation’s biggest killer-infectious disease. 

I just want to point on one thing from this quote.  Disease of affluence as he states it is nothing more than people driving themselves into a disease state through inflammatory means.  This could be due to gallons of soda, cookies, etc.  Or due to food sensitivities to the ever increasing garbage and “frankenfood” we are being served and not to mention serving our children. It could be due to a lifestyle that is high in drugs, nicotine or alcohol.  And it could all be made worse by our high stress high intensity pace we have learned to accept.  Regardless, the lifestyle we have become accustomed to as Americans is literally killing us through mechanisms like NF-kB and its hydra head of consequences!  Will this lifestyle fade away any time soon?  Well, I think not.  But it is always nice to see new emerging tools we can draw from to turn down dangerous inflammatory activity like this.  It is time we put down the stigma of whatever “Cannabis” means to you and take a closer look at what is really waiting there for us to re-discover.  Remember, this is an herb that has been used for millennia up until the 1920’s when William Randolph Hurst stigmatized Cannabis and assigned it the rather derogatory name of Marijuana coined from Mexico which tied nicely into the rampant racism of that era.   But that’s another story altogether... 

…cannabis is a source not only of D9-THC, CBD and D9-THCV but also of at least 67 other phytocannabinoids and as such can be regarded as a natural library of unique compounds. The therapeutic potential of many of these ligands still remains largely unexplored prompting a need for further preclinical and clinical research directed at establishing whether phytocannabinoids are indeed ‘a neglected pharmacological treasure trove.’ - Journal of British Pharmacology (2008) 

A Product Test and Review: Cannabidiol (CBD) Oil

I was recently approached by a company by the name of Dose of Nature to test and review one of their medical cannabis products.  I get a lot of questions these days about "medical marijuana," so I was happy to try what I could without needing a prescription of my own.   And let me just say here and now that it is not within my medical scope of practice to prescribe or recommend medical marijuana for any patient.  You need an MD to make these recommendations.  It is silly but true.  We are the herbalists after all.  But that is beside the point.  It is extremely important to understand however that the term medical cannabis has many different meanings and forms.  We are all very aware of the concept of smoking or ingesting marijuana and getting “high.”  But the compounds in the cannabis plant primarily responsible for this high, TCH, are not contained in the formula that I was asked to review.  The cannabis plant is an extremely complicated medicinal herb and the research that is coming out on the different active compounds found in this plant are nothing short of extraordinary.   And Cannabidiol or CBD is one of those compounds and is the focus of this article.  CBD products are not the ones that lead to the typical mind altering experiences that many people know so well.  And because of this CBD products are legal in all fifty states without the prescription or recommendation of any medical professional.  

Let me first begin with my experience with the product itself and then get into some of the science behind it.  This is a liquid product that is taken with a dropper.  It is made of a CBD concentrate and blended with Extra Virgin Hemp Seed oil.  I squirted the oil under my tongue and swallowed the rest.  It had a nice taste with a little spicy bite in the back of my throat.  If you have ever sampled higher quality Olive Oils you may have noticed the same kind of bite.  This is a good thing actually. That’s the good stuff.  It lets you know that there are some active compounds within the oil.  I urge you to take a little swig of your current olive oil and see if it has that same bite.   If not, go buy some better oil!   So from an herbalist’s perspective, right off the bat I was pleased to notice the bite.   I have taken the recommended dose every day for the past three weeks or so and am almost through my bottle.  I generally take it in the evening before bed because I do notice that it has a very mild mellowing effect.  The best that I can describe this feeling is like someone placed a very thin calming veil over my head.  I feel totally aware and not impaired in any way, just a little more calm.  I feel no side effects of any kind otherwise. 

The big deal here with CBD’s are their anti-inflammatory effects.  This is an area of research that is really showing some serious promise.  In fact a whole new class of anti-inflammatory medications could likely arise from these compounds if the research continues. I have had the pleasure of consulting directly with a friend and colleague of mine Dr. Chris Rasmussen, MD, who publishes a fantastic blog entitled InflaNATION.  Stay tuned for his upcoming book as well.  It will be a must read!  He has recently published some fantastic research articles on this very subject.  And the medical literature is showing clear evidence that CBD and other medical cannabinoids are superb anti-inflammatory compounds specifically for the heart and vascular system.  Though the mainstream medical model is still holding steadfast onto the Cholesterol model of heart disease, the medical literature is showing more and more that things like heart attacks, strokes, deep venous thrombosis (clots in the legs) and pulmonary embolism (“heart attack” of the lungs) all owe their existence to rogue inflammatory conditions in the body.  If you want to have a heart attack or any other conditions listed above (and more) then you invite inflammation.  One key way to inflame your body is to engage in a diet and lifestyle that promotes blood sugar imbalance.  Diabetics and Pre-Diabetics (Insulin Resistance) for example are inflamed by the very nature of their condition.  And when I say “inflammation” I am not talking about that swollen knee you may have, but rather little molecules called cytokines that are made by the immune system that circulate throughout the body and literally work to destroy whatever they touch! 

To borrow a citation from a recent post of Dr. Rasmussen: 
Cannabidiol has been shown to be effective in protecting endothelial function and integrity in human coronary artery endothelial cells (HCAECs). The study demonstrated that CBD reversed the harmful effects of high glucose on HCAECs by inhibiting:
  • ·         Reactive oxygen species production by mitochondria
  • ·         NF-κB activation
  • ·         Transendothelial migration of monocytes
  • ·         Monocyte–endothelial adhesion in HCAECs[1]

This is all just a really fancy way of saying that a well-respected medical journal on Physiology and Heart health endorsed the benefits of CBD for Insulin Resistant people presenting with vascular disease.  Vascular Disease is of course the leading cause of death worldwide.  And anyone with Insulin Resistance / Diabetes will more than likely die of Vascular Disease in the end, not to mention suffer more disability while on the way.  This study suggests that compounds like CBD may act as an “antidote” of sorts to this condition. 

But what if you are not in the Diabetic spectrum of the population?  Well the research out there on the subject frequently studies a particular inflammatory cytokine called NF-kB (listed above).  NF-kB plays a major role in other conditions as well and particularly in autoimmune disease which is something that I work a lot with in my clinic here.  There are actually more people in this country right now suffering autoimmune disease than there are people having heart attacks!  In fact CBD therapies have shown true promise in autoimmune conditions such as Multiple Sclerosis and Rheumatoid Arthritis.  And furthermore, the NF-kB pathway is the final step for cellular death.  So the more this pathway is active the more cells will be dying at any given moment in time.  This pathway can also be particularly potent when talking about brain health as well.   Just look at the growing epidemic of dementia and Alzheimer’s. Brain health is a major concern for the aging population.  NF-kB is at the root of all of this.  So it would make a lot of sense to do everything that you can to squash these inflammatory pathways from running away with themselves. There iscurrently no known pharmaceutical drug that can do this!  So it is the opinion of this particular author that you put down whatever stigma you may assign to the notion of medical cannabis and look at the true benefits!

So getting back to what I felt when taking the CBD oil…  I personally have a known autoimmune situation myself going on that comes up from time to time.  This is not a disease but I do have antibodies which target and attack an enzyme in my brain that converts Glutamate, which is overly stimulating to brain tissue, into GABA which is calming.  It is quite possible that the CBD oil is dampening some inflammatory conditions that may be impacting this system.  In essence the oil may be allowing me to function more optimally by turning down the overactive, NF-kB driven immune response against that enzyme in my brain.  On the other hand, we are only scratching the surface here with how these things work.  But more and more research is pointing to positives.  Even the mind altering compound THC has considerable research demonstrating the protective and beneficial properties for many systems in the body.  There is still a tremendous amount of work needed to be done. It is all rather exciting. 

…cannabis is a source not only of D9-THC, CBD and D9-THCV but also of at least 67 other phytocannabinoids and as such can be regarded as a natural library of unique compounds. The therapeutic potential of many of these ligands still remains largely unexplored prompting a need for further preclinical and clinical research directed at establishing whether phytocannabinoids are indeed ‘a neglected pharmacological treasure trove’ (Mechoulam, 2005).[2]

In closing, I want to be clear here that I am still a little uneasy about suggesting that people go out and inhale hot smoke into their lungs on a frequent basis.  This could very well be inflammatory to the body.  The research on this is still not clear.  It could be that the anti-inflammatory attributes of the compounds found within the smoke negate some of the inflammatory impacts of the smoke itself on the lung tissue.  But that is admittedly speculation on my part.   There are however so many other ways of getting these beneficial compounds, like CBD, into your system without smoking the herb itself.  Liquid formulas like the Dose of Nature Red Strap CBD Oil is a great way to get the benefits described above while avoiding the potentially harmful impacts of smoking or the often times debilitating and illegal (in most States) “high” that Marijuana induces. 


[1] Mohanraj Rajesh et al., Cannabidiol attenuates high glucose-induced endothelial cell inflammatory response and barrier disruption. Am J Physiol Heart Circ Physiol. Jul 2007; 293(1)
[2] Journal of British Pharmacology (2008) 153, 199–215; 2008 Nature Publishing Group