Not long ago, it seemed like few people in the States had ever heard of cannabidiol, or CBD, much less knew what to do with it. And those who were vaguely familiar often confused it with the stuff that gets you high. Fast forward five or so years and today, CBD is everywhere, tucked inside everything from oils, tinctures and pills to candies, smoothies, bath bombs and beauty creams. Safe to say, CBD is a ‘thing.’ 

Never mind that the product pile-on can sometimes seem like too much of a good thing. This surprisingly helpful and safe natural elixir makes a great alternative to over-the-counter drugs and prescription meds. In theory, it is possible to over-do CBD but even in large doses, the side-effects are mild, and the risk of dependency is virtually nil. Too much CBD is likely to result in extreme sleepiness, nausea and disorientation, rather than anything life-threatening. Even the World Health Organization has issued a declaration that CBD carries with it no major side-effects or risk of dependency. 

Still, there’s no reason to binge like a college kid on spring break. Think moderation, follow dosing instructions, and if you’re feeling unsure about how your body will react, start small with a quarter or half dose. From there, lean in to enjoy CBDs numerous health and well-being upsides. Still curious but don’t know where to start? Here are a few of my patients’ most frequently asked questions: 

1) What is CBD?

The ancient flowering herb marijuana houses over 500 phytochemicals and over 100 compounds known as cannabinoids. One of them is CBD and another is THC, or tetrahydrocannabinol. THC is the one that comes with intoxicating effects, CBD doesn’t. THC and CBD are also found in hemp (a botanical close cousin to cannabis), in varying amounts. But whether your CBD comes from a cannabis or a hemp plant, the non-psychoactive effects are the same.

2) How does CBD work?

CBD helps generate positive chemical changes in the body and confers a number of medical benefits. Though the exact mechanics aren’t fully understood, the current scientific thinking is that CBD appears to stimulate our endocannabinoid system, the internal feel-good factory that helps our bodies heal, elevates mood and take the edge off anxiety and fear. It also plays a role in helping to strengthen immunity, foster fertility and reproductive health, and endure stress. 

Our bodies do make some of their own endocannabinoids (responsible, for instance, for the “runner’s high”) but when we bring in outside sources like THC or CBD, we further stimulate and boost the endocannabinoid system. 

3) Which is better, CBD or THC?

I’d have to say, it’s a bit of a draw. It depends on your needs and lifestyle. While both compounds have their individual merits, together, CBD and THC work well as a team. CBD helps to enhance THC’s painkilling and anticancer abilities, while taming its mind-altering qualities. The result? Users feel better, more at ease, rather than ‘high,’ which allows for a longer-lasting, relaxing, yet non-intoxicating experience. 

4) Is it OK to use CBD during the daytime?

In a word, yes, CBD can be help with stress and anxiety during the day, or for that matter, any time. While THC also delivers plenty of therapeutic benefits, its psychoactive effects make it less than ideal for use in daily life especially when you need to be on your game at work, operating vehicles and so forth. There’s also some evidence that THC can reduce REM sleep, not good if getting restful sleep is an issue. 

For powering down at night, minus the intoxicating effects, consider switching to CBD to help you slip more easily into sleep. Another bonus? CBD, extracted from non-psychoactive hemp produced by a certified hemp farm, is legal in all 50 states. 

Still leaning more towards a THC-induced high? Then at night, consider going with a calming Indica strain, versus Sativa which tends to be more activating and energizing. Or, where legal, you can also purchase combo products, specifically designed for better sleep. Some of my patients swear by a product that contains both CBD and THC, plus melatonin, called Betty’s Nighttime Eddies – but you’ll need to get to Massachusetts (or other states where THC is OK) to purchase it legally as products containing THC cannot be shipped to other states. 

5) What conditions can CBD be used to help treat – and why is everyone taking it?

For both consumers and health care professionals, CBD is increasingly becoming a standard first stop on the treatment train, either on its own or in conjunction with more standard-issue therapies and/or pharmaceutical treatments. But perhaps what I love most about CBD is that it’s like an “anti-drug”— anti-inflammatory, antibacterial, antispasmodic, antioxidant, anticonvulsant, antidepressant, antipsychotic, antitumoral, and antianxiety. And all those ‘anti-s’ add up to good things for patients of virtually any age.

A lot of the recent interest in CBD though is coming from millennials, and their attraction to more natural, non-pharmaceuticals therapies. But the Boomer set is dealing with similar stress and anxiety issues, plus extra health baggage like chronic sleep problems, painful joints and backs, rheumatoid arthritis, multiple sclerosis (MS), even Crohn’s. And, according to one study, more than 50% of folks in their 50s and 60s have used it and report significant relief. 

6) Can CBD be helpful for other physical and mental conditions as well?

Not to oversell it but CBD is also being used as a complementary natural treatment for mental health conditions like PTSD and schizophrenia. If you’re looking to minimize your pharmaceutical load, or ‘cycle off’ periodically under doctor’s care, CBD can help here too. 

Interestingly, numerous studies suggest that CBD can also help ameliorate metabolic disorders like prediabetes and diabetes by taming inflammation, which could mean it has a role to play in treating cardiovascular disease and cancer. The most eye-catching reports suggest that CBD can help remove plaque from the brain that’s associated with Alzheimer’s disease — good news for all of us as we age. 

7) How does CBD interact with prescription meds?

No matter how minimal the side-effects, if you’re on a regular regimen of prescription or over-the-counter meds, it’s best to clear CBD use with your doctor first — CBD products can interfere with the body’s ability to metabolize some meds. 

8) What should I look for when buying CBD products?

The volume of products on the market these days can be overwhelming and, not surprisingly, potency and quality are variable. So: 

  • Do your research, figure out your specific needs, the condition(s) you wish to treat and what delivery system you prefer (i.e., pill form, tinctures, oils, drinkable seltzers, dermal patches, etc.). 
  • Clear it with your doctor and purchase from reputable sources. 
  • Among the brands we like are Charlotte’s Web, the Alchemist’s Kitchen, Southern Tier HempLord Jones  and Flora + Bast. 

Also, look for CBD product manufacturers who:

  • source their products preferably from organic plants or those that contain as few pesticides and chemicals as possible 
  • extract the oil using solvent-free processes
  • submit their products for third-party testing and publish the results

Another way to get started? Take a look at Health magazine’s just-published 10 Best List , which includes suggestions for the type of condition each CBD product is best suited for.

9) What about CBN? Is it the same as CBD? 

No. Though they sound alike and are both medicinal compounds found in cannabis plants, CBN (cannabinol), and CBD are two different molecules with different effects. Though like CDB, CBN is a non-intoxicating compound, CBN is created as THC ages, either naturally or when processed to age more rapidly. The resulting CBN, tends to have a more sedative effect — which is one of the reasons we’ve added it to our sleep toolbox for those patients who are having a particularly tough time with sleep. In animal studies, CBN has also shown promise when it comes to its antibacterial and anti-inflammatory properties, as well as its potential for pain relief – so we’ll be intrigued to see what the research shows. 

So is CBN right for you? Everybody is different but, it could give you an extra sedative boost, making it a good option if you’re struggling. However, how much of a boost you get will depend a good bit on what else is in the product – all of which should be reviewed with your doctor first to protect against possible interactions.

10) What’s the best way to take CBD?

CBD can be taken in a variety of ways, so it really comes down to personal preference. Here are a few popular ways to do it:

  • Oils and tinctures: Under-the-tongue drops gets CBD straight into the bloodstream, though you may not feel the effects for 30 to 90 minutes.
  • Sprays: Similar to tinctures and taken sublingually
  • Capsules and softgels: These are great for beginners because they offer consistent, straight-forward dosages, though they’re a slower method of delivery.
  • Gummies/edibles: Tasty but they’re the slowest means of delivery, and they often come with additives like sugar and other sweeteners
  • Patches: They tend to be more concentrated, delivering CBD directly into the bloodstream, great for extended release. 
  • Salves and ointments: Topical applications are most effective for localized discomfort, like joint paint and muscle aches. 
  • Smoke/vape: While this may be the quickest delivery method, I do not recommend smoking of any sort, in any form. Unfortunately, vape products – and the vapes themselves – often contain less-than-healthful additives. Steer clear to keep your lungs – and the rest of you — healthy.

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