Cannabidiol, more commonly known as CBD, is well known for its vast array of potential therapeutic applications and its proven efficacy as an anti-inflammatory and anti-convulsant agent, and positive results in influencing mood regulation and neurodegenerative disorders. Often preferred over its cannabinoid counterpart, THC, because of its lack of intoxicating effects, CBD is commonly utilised in the health and wellness worlds for its relieving and calming properties.
The extensive effects and vast potential of CBD can be seen in a first-of-its-kind, quantitative observational study that was conducted in New Zealand. Patients with neurological symptoms, mental health symptoms, cancer symptoms, and chronic pain symptoms all reported improvements in sleep, pain, appetite, anxiety, and depression scores when using CBD oil. This was reflected in an average increase of 13.6 points in EQ-VAS scores that are used to determine the quality of life, and the report records an absence of any major side effects.
Now, before we dive into the real guts of the discussion, we have to make one thing crystal clear. CBD, and medical cannabis in general, should never be viewed as some sort of magic cure-all for any condition, disease, or health issue. CBD does have proven health benefits, but it should always be seen as an addition to current, conventional treatment options as part of a holistic health care plan.
So, how can CBD help? Let’s find out…
The anti-anxiety properties of CBD
There is a mass of both clinical data and anecdotal evidence that demonstrates the positive influences CBD can have on symptoms relating to mental health. One of the most commonly cited anxiety studies tested the effects of CBD on healthy adults during a public speaking test. Most people feel at least a modicum of anxiety when faced with the idea of speaking in a public setting, especially in front of a crowd of people unknown to the speaker.
There was a correlation noted between 300mg of CBD and an improvement in anxiety, which was recorded through respondents' mood scores and also displayed in their physiological markers, such as heart rate and diastolic blood pressure.
Another study published the same year discovered a multitude of mental health symptoms experienced by patients with Post-Traumatic Stress Disorder (PTSD) were seen to improve during an 8-week trial of CBD-based treatment, reporting a 28% overall reduction in PCL-5 scores. PCL-5 scores are calculated by scoring the severity of PTSD symptoms including disturbed sleeping, unwanted memories, trouble experiencing positive emotions and reactions to stress.
These findings are extremely important because around 1 in 3 patients with depressive disorders are reported to build up a resistance to conventionally prescribed antidepressants over repeated use and time, and so, CBD has a lot of potential in providing an additional benefits for these patients. To understand this more, researchers have been analysing the pharmacokinetics of CBD, or to put it simply: how CBD moves around the body.
Scientists have so far discovered CBD has 65 targets, or opportunities for activity, once within the body. Using MRI technology, researchers found that a single dose of CBD improved encoding in the parahippocampal gyrus, and recall in the midbrain of patients with Schizophrenia. CBD is also known to inhibit the reuptake of dopamine, delaying its absorption within the body so dopamine levels within the body stay at a higher level, and is also known to boost the binding affinity of GABA A and serotonin receptors in a similar fashion to benzodiazepines, but with no risk of dependence or withdrawals.
Anti-inflammatory effects of CBD
Inflammation is an aspect of many complicated health conditions including immunological disorders, dermatological diseases, cancers, and conditions that involve neurodegeneration. Acute inflammation can cause pain of varying types and severity, with some research papers theorising that is the origin of all pain.
In 2017, a systematic review of clinical trials investigating CBD’s effects on inflammation found that patients with general pain, Multiple Sclerosis, Alzheimer’s Disease, Cardiovascular Disease, Inflammatory Bowel Diseases and other inflammatory conditions have found this cannabinoid to be therapeutically beneficial.
Due to its efficacy as a natural anti-inflammatory, CBD has also boomed in the beauty, wellness and cosmetic industries and is now a commonly sought ingredient by patients battling skin conditions. In 2022, a research team at The University School of Medicine in Miami discovered CBD has therapeutic potential in the treatment of acne, because it reduces the expression of cytokines like TNF-α and IL-1β which are pro-inflammatory agents.
CBD has also been shown to influence inflammation by regulating how many cells are in one specific area, which scientists call cell viability, and by influencing the rate at which these cells are produced, also known as cell proliferation. Pro-inflammatory Rheumatoid Arthritis Synovial Fibroblasts (RASF), which invade and destroy cartilage, have also been shown to reduce when CBD is administered, making cannabidiol a potential treatment option for patients with Rheumatoid Arthritis.
The pain-relieving potential of CBD
Although the pain-relieving qualities of cannabis are typically attributed to cannabidiols psychoactive counterpart THC, there is increasing evidence that suggests CBD may also have pain-relieving properties. It is thought that CBD is able to influence chronic pain by altering endocannabinoid receptor activity, interacting with neurotransmitters, and decreasing inflammation. When it binds to TRPV1 in the brain, also known as vanilloid receptors, CBD has the ability to interact with the regulation of pain perception and can reduce inflammation levels within the body.
For this reason, CBD is often incorporated into pain management routines. One successful example of this can be seen in a small-scale study that analysed the influence of CBD on kidney transplant patients suffering from chronic pain. Conducted in Uruguay, the participants in this study began CBD treatment a week prior to their transplant operation and they continued to do so for three weeks. Over one quarter, or 28%, experienced a total improvement in their pain, whilst another 57% reported a partial improvement in chronic pain.
In 2021, The Journal of Pain published data that compared CBD to conventional painkillers that are often prescribed to patients with fibromyalgia. This study found that when treated with CBD, patients were able to either stop or reduce their usage of benzodiazepines, opioids, NSAIDs, and gabapentinoids in over 70% of cases. Participants reported an improvement in symptom management and a reduction in negative side effects when using CBD, which allowed patients with fibromyalgia to either reduce or completely substitute their conventional painkiller usage.
Does CBD offer any neuroprotective properties?
It certainly shows potential. The neuroprotective properties of CBD have also been displayed in clinical trials and medical investigations, increasing its potential in the treatment of neurodegenerative disorders like Parkinson’s Disease. In 2013, it was discovered that by enhancing the ability of naturally produced cannabinoids, or endocannabinoids, CBD is able to regulate both inflammation and oxidative stresses in the brain.
This strengthened existing research from 2010 that demonstrated the neuroprotective qualities of cannabidiol. In this animal study a reduction in brain damage and cell death rates was displayed in test subjects after CBD administration. In humans, similar results have also been noted.
These clinical discoveries have prompted researchers to theorise that CBD may have the potential to slow the development of Alzheimer’s Disease (AD). In 2019 a comprehensive review of cannabis-based treatments in the treatment of Alzheimer’s Disease was published, noting the success and efficacy of several cannabinoids. In this paper, CBD was shown to suppress some of the causal factors associated with AD; however, this effect was shown to be more powerful when a combination of CBD and THC was administered.
The influence of CBD on epilepsy
One of the most well-researched effects of CBD is its positive influence on seizures, especially in patients who have shown resistance to conventional medicines and treatments.
Investigations into the relationship between this cannabis compound and severe or drug-resistant forms of epilepsy have been taking place since the 1970s, only around a decade after the successful isolation of CBD and THC was medically recorded. The clinical evidence for its potential as an anticonvulsant propelled cannabidiol to become the first licensed and approved cannabis-based medicine in the UK, under the product name Epidyolex, in 2018.
Researchers have demonstrated that CBD is able to have these therapeutic effects because of its interaction with a molecule in the brain called lysophosphatidylinositol, also known as LPI. In 2023, a research team from the UK and the US discovered that CBD uses the same signalling pathway as LPI, and so, it is able to block the seizure signals it carries.
Across the world, extensive clinical trials have tested the efficacy and safety of cannabidiol in patients with different forms of epilepsy and have found beneficial results when CBD is taken in conjunction with other anti-epileptic medications. A small-scale American study in 2016 noted a complete resolution of spasm in almost 15% of infants with epilepsy when being treated with CBD, whilst a larger clinical trial involving 100 children with intractable epilepsy showed an average seizure reduction of 63.6% after 12 weeks of treatment.
Last year in the UK, a case series of children with treatment-resistant epilepsy was analysed using the data available from the UK Medical Cannabis Registry in 2022. These findings showed that 31.6% of patients treated with CBD isolate found their seizures were half as frequent, which was also seen in 17.6% of participants being treated with broad-spectrum CBD. The patients that received a combination of THC and CBD noted the most impressive results, with 94.1% noting a reduction in seizures of over 50%.
Conclusion
Although there have been an incredible wealth of therapeutic and health benefits attributed to this cannabis chemical, it is important to emphasise that this cannabinoid is only at the start of its journey in modern medical investigation. As these clinical investigations have all taken place in the last 50 years or so, the limitations or potential long-term effects of CBD treatments have not been assessed thoroughly due to a lack of data in these fields.
For this reason, there is a call for further research into the study of cannabis compounds including cannabidiol, and precautions are advised when starting a journey with CBD. It is recommended that prospective patients seek the advice of a doctor that is registered to prescribe medicinal cannabis, and one that has a wealth of experience doing so.
Check out the rest of our CBD series for more information and guidance on how you can safely incorporate CBD into your daily routine.
Releaf understands the importance of medical cannabis in treating various medical conditions. With our tailored monthly packages, specialist consultations for medical cannabis, and a unique medical cannabis card for protection, you can access the treatment you need without worrying about the stigma.
