The Health Benefits of CBD Oil
This cannabis extract may help treat nerve pain, anxiety, and epilepsy
Cathy Wong is a nutritionist and wellness expert. Her work is regularly featured in media such as First For Women, Woman’s World, and Natural Health.
Lana Butner, ND, LAc, is a board-certified naturopathic doctor and licensed acupuncturist in New York City.
CBD oil is an extract of Cannabis indica or Cannabis sativa—the same plants that, when dried, make marijuana. CBD oil is believed by some to treat pain, reduce anxiety, and stimulate appetite in the same way that marijuana does, but without its psychoactive effects. CBD has also shown promise in treating certain types of seizures.
CBD is the short name for cannabidiol, one of the two chemicals—among the dozens in cannabis—that have the most health benefits. The other, tetrahydrocannabinol (THC), is what gets people “high.” CBD oil generally does not contain THC, although some trace amounts may be present in products sold in certain states.
CBD oil contains CBD mixed with an inert carrier oil, such as coconut oil or hemp seed oil. The bottled oil, called a tincture, is sold in various concentrations. There are also CBD capsules, CBD gummies, and under-the-tongue CBD sprays.
CBD’s exact mechanism of action is unclear. Unlike THC, CBD has a relatively low affinity for cannabinoid receptors in the brain. These are the molecules to which THC binds to elicit its psychoactive effects.
Instead, CBD is thought to influence other receptors, including opioid receptors that regulate pain and glycine receptors involved in the regulation of the “feel-good” hormone serotonin.
Proponents claim that CBD oil can treat a wide variety of health problems, including:
- Chronic pain
- Drug addiction and withdrawal
- High blood pressure
- Muscle spasms
- Parkinson’s disease
Despite the growing popularity of CBD use, CBD oil remains sorely under-researched. As such, some of these claims are better supported by studies than others.
Here is just some of what the current evidence says.
CBD shows promise in the treatment of anxiety disorders, suggests a 2015 review of studies in the journal Neurotherapeutics. According to the investigators, CBD demonstrated potent anxiolytic (anxiety-relieving) effects in animal research, albeit with counterintuitive results.
In all but a few studies, lower doses of CBD (10 milligrams per kilogram, mg/kg, or less) were better able to treat symptoms of anxiety. Higher doses (100 mg/kg or more) exhibited virtually no effect.
Part of this response could be explained by the way that CBD acts in the brain. In many cases, CBD works as an agonist, meaning that it triggers an opposite response when binding to a receptor. It is possible that low doses can elicit a positive agonist response, while high doses overwhelm the brain and trigger a compensatory effect to fight CBD’s effects.
Among the few human trials evaluating CBD’s anxiolytic effects was one published in the Brazilian Journal of Psychiatry in 2019. For this study, 57 men were given either CBD oil or a placebo before a public-speaking event. Anxiety was evaluated using physiological measures (such as blood pressure, heart rate, etc.) and a relatively reliable test for mood states known as the Visual Analog Mood Scale (VAMS).
According to the investigators, men provided 300 mg of CBD exhibited less anxiety than those given a placebo. Interestingly, those provided 100 mg or 600 mg of CBD oil did not.
CBD oil may benefit those with drug addiction, suggests a 2015 review of studies published in Substance Abuse.
In an analysis of 14 published studies (nine involving animals and five involving humans), scientists with the University of Montreal concluded that CBD “showed promise” in treating people with opioid, cocaine, or psychostimulant addiction.
However, the effect of CBD on each addiction type was often very different. With opioid addiction, for example, CBD showed little effect in minimizing withdrawal symptoms in the absence of THC. By contrast, CBD on its own appeared effective in minimizing drug-seeking behaviors in users of cocaine, methamphetamine, and other psychostimulant drugs.
There have also been suggestions that CBD may aid in the treatment of cannabis and nicotine addiction. Further research is needed.
Medical marijuana is frequently prescribed to people with intractable (treatment-resistant) pain, including those with terminal cancer. There is some evidence that CBD contributes to this benefit.
According to a 2012 study in the Journal of Experimental Medicine, rats injected with inflammatory chemicals in their hind feet experienced less inflammation and neuropathic pain when treated with an oral dose and spinal injection of CBD.
Scientists believe that CBD reduces nerve pain by binding to glycine receptors in the brain that regulate the speed at which nerve signals pass between nerve cells.
Human studies evaluating the use of CBD in treating chronic pain are lacking. Those that do exist almost invariably include THC, making it difficult to isolate CBD’s distinct effects.
CBD oil may reduce the risk of heart disease by alleviating hypertension (high blood pressure) in certain people, suggests a 2017 study in JCI Insight.
For this study, nine healthy men took either 600 mg of CBD or the same dose of a placebo. According to the researcher, those treated with CBD had lower blood pressure before and after exposure to stressful stimuli (including exercise or extreme cold).
In addition, the stroke volume (the amount of blood remaining in the heart after a heartbeat) was significantly reduced, meaning that the heart was pumping more efficiently.
The findings suggest that CBD oil may be a suitable complementary therapy for people whose hypertension is complicated by stress and anxiety. However, there is no evidence that CBD oil can treat hypertension on its own or prevent hypertension in people at risk. While stress is known to complicate high blood pressure, it cannot cause hypertension.
In June 2018, the U.S. Food and Drug Administration (FDA) approved Epidiolex, a CBD oral solution used for the treatment of certain rare forms of epilepsy in children under 2—Dravet syndrome and Lennox-Gastaut syndrome. Both are exceptionally rare genetic disorders causing lifelong catastrophic seizures that begin during the first year of life.
Outside of these two disorders, CBD’s effectiveness in treating seizures is uncertain. Even with Epidiolex, it is uncertain whether the anti-seizure effects can be attributed to CBD or some other factor.
There is some evidence that CBD interacts with seizure medications such as Onfi (clobazam) and “boosts” their concentration in the blood. This would not only make the drugs more effective but extend their half-lives as well. Further research is needed.
Possible Side Effects
Clinical research has shown that CBD oil can trigger side effects. Severity and type can vary from one person to the next. Common symptoms include:
- Changes in appetite
- Changes in mood
- Dry mouth
CBD oil may also increase liver enzymes (a marker of liver inflammation). People with liver disease should use CBD oil with caution, ideally under the care of a doctor who can regularly check blood liver enzyme levels.
CBD oil should be avoided during pregnancy and breastfeeding. A 2018 study from the American Academy of Pediatrics warned women to avoid marijuana during pregnancy due to the potential risks to a baby’s development. Although it is unclear how CBD contributes, CBD is known to pass through the placental barrier.
If you are thinking about using CBD oil to treat a health condition, be sure to speak with your healthcare provider to ensure that it is the right option for you.
Since some CBD oils contain trace amounts of THC, you should avoid driving or using heavy machinery when taking CBD oil, particularly when first starting treatment or using a new brand.
CBD oil can interact with certain medications, including some drugs used to treat epilepsy. CBD inhibits an enzyme called cytochrome P450 (CYP450), which certain drugs use for metabolization. By interfering with CYP450, CBD may either increase the toxicity or decrease the effectiveness of these drugs.
Potential drug-drug interactions with CBD include:
- Anti-arrhythmia drugs like quinidine
- Anticonvulsants like Tegretol (carbamazepine) and Trileptal (oxcarbazepine)
- Antifungal drugs like Nizoral (ketoconazole) and Vfend (voriconazole)
- Antipsychotic drugs like Orap (pimozide)
- Atypical antidepressants like Remeron (mirtazapine)
- Benzodiazepine sedatives like Klonopin (clonazepam) and Halcion (triazolam)
- Immune-suppressive drugs like Sandimmune (cyclosporine)
- Macrolide antibiotics like clarithromycin and telithromycin
- Migraine medications like Ergomar (ergotamine)
- Opioid painkillers like Duragesic (fentanyl) and alfentanil
- Rifampin-based drugs used to treat tuberculosis
Many of these interactions are mild and require no adjustment to treatment. Others may require a drug substitution or the separation of doses by several hours.
To avoid interactions, advise your doctor and pharmacist about any drugs you are taking, whether they are prescription, over-the-counter, herbal, or recreational.
Dosage and Preparation
There are no guidelines for the appropriate use of CBD oil. CBD oil is usually delivered sublingually (under the tongue). Most oils are sold in 30-milliliter (mL) bottles with a dropper cap.
There is currently no known “correct” dose of CBD oil. Depending on who you speak to, the daily dose can range anywhere from 5 mg to 25 mg.
The tricky part is calculating the exact amount of CBD per milliliter of oil. Some tinctures have concentrations of 1,500 mg per 30 mL, while others have 3,000 mg per mL (or more).
How to Calculate CBD Dose
To determine an exact dose of CBD, remember that each drop of oil equals 0.05 mL of fluid. This means that a 30-mL bottle of CBD oil will have roughly 600 drops. If the concentration of the tincture is 1,500 mg/mL, one drop would contain 2.5 mg of CBD (1,500 mg ÷ 600 drops = 2.5 mg).
To use CBD oil, place one or more drops under the tongue and hold the dose there for 30 to 60 seconds without swallowing. Capsules and gummies are easier to dose, although they tend to be more costly. CBD sublingual sprays are used mainly for convenience.
What to Look For
Aficionados of CBD oil will tell you to buy full-spectrum oils over CBD isolates. Unlike isolates, which contain CBD only, full-spectrum oils contain a variety of compounds found naturally in the cannabis plant, including proteins, flavonoids, terpenes, and chlorophyll. Alternative practitioners believe these compounds offer more substantial health benefits, although there is no clear evidence of this.
Remember, because CBD oils are largely unregulated, there is no guarantee that a product is either safe or effective.
According to a 2017 study in the Journal of the American Medical Association, only 30.95% of CBD products sold online were correctly labeled. Most contained less CBD than advertised, while 21.43% had significant amounts of THC.
Here are a few tips to help you find the best CBD oil:
- Buy American. Domestically produced CBD oil tends to be safer because of better growing and refining practices.
- Go organic. Brands certified organic by the U.S. Department of Agriculture (USDA) are less likely to expose you to pesticides and other harmful chemicals.
- Read the product label. Even if you choose a full-spectrum oil, don’t assume that every ingredient on the product label is natural. There may be preservatives, flavorings, or thinning agents that you don’t want or need. If you don’t recognize an ingredient, ask the dispenser what it is or check online.
Are CBD Oil and Hemp Oil the Same?
Not necessarily. Although some people use the terms synonymously, they may also be referring to hemp seed oil, which is primarily used for cooking, food production, and skincare products. CBD oil is made from the leaves, stems, buds, and flowers of the Cannabis indica or Cannabis sativa plant and should contain less than 0.3% THC. Hemp oil is made from the seeds of Cannabis sativa and contains no TCH.
CBD oil is made from cannabidiol, a non-intoxicating extract of marijuana, and is believed to treat pain, anxiety, and seizures.
How to Take Your CBD
Finding Your Optimal Serving Sizes and Formats
So you’ve decided to join the growing revolution of people using cannabidiol (CBD) for relief and support with anxiety, arthritis, pain, menopause symptoms, insomnia and other health issues. Now comes the truly hard decision: tinctures, topicals, vaporizers, edibles… Which is best for you? And how much should you take?
If you’re overwhelmed by the wide variety of CBD products, you are not alone. Each method delivers CBD to your body in a different way, which affects what it can be used for and how often you’ll want to take it. Adding to that confusion is the fact that each of our bodies responds differently to CBD, meaning there is no one-size-fits-all recommendation. That’s why we’ve put together a guide to help you design a cannabinoid treatment plan that fits your individual health goals — whether you’re choosing your first CBD product, or just optimizing your current routine.
Clarify Your Goals
With more than 65 different targets throughout your body, CBD has a staggering variety of therapeutic properties. Focusing on just one or two or those properties will help you find the best product and dosage quicker.
Ask yourself what you want CBD to improve. Do you want emotional support? Do you have a lot of arthritic pain? Are you just curious to see if life is somehow “better” with it?
Many people benefit from tracking their progress. You could use a score to rate your symptoms or try journaling about your current experience. Creating a baseline record will help you judge the effectiveness of your CBD treatment.
Where Does the CBD Need to Reach?
In order for this little molecule to be effective, it must get to where it’s needed. For most health goals, figuring out the location of CBD’s target will be straightforward.
If your target is located anywhere close to your skin or a mucous membrane (ie vagina), you could first try a localized product like a topical or suppository. This delivers the highest concentration of CBD exactly where you want it.
Otherwise, CBD needs to travel through your bloodstream to reach its target — whether that’s to your brain, immune system, or other locations. Vaporizers and oral products are best for this purpose.
What’s Your Time Frame?
How long CBD works in your body is a balance between how you ingest it and how quickly your body eliminates it. Some methods deliver a sharp, quick peak of CBD, while others offer a slow, steadier concentration.
If you’re looking for immediate, short-term relief, then inhaled products like a vaporizer might be ideal. On the other hand, if you want to maintain steady levels of CBD throughout the day, then an oral product would be more appropriate.
Many people benefit from a combination of delivery methods. Here are some examples of how people use CBD products:
1-3X daily oral supplement + vape pen as needed
1-3X daily oral supplement + topical as needed
Oral supplement a few hours before bedtime (lower doses can energize while higher doses encourage sleep)
Topical vulva spray as desired
Vaginal suppository as needed
Everybody’s Different: Finding Your Dose
How well each method works varies from person to person, and is influenced by many factors (covered in more detail below) so dosing is a highly individual process.
It’s always recommended to start with a very low dose to make sure you don’t react poorly to any of the product’s ingredients. Try one or two drops of an oral formulation, or a tiny puff off a vaporizer… this will be well below the recommended serving size listed on the product.
Then, wait until after the CBD has peaked and is leaving your system before trying a slightly higher dose. Wait at least an hour for vaporizers, and 6+ hours for an oral formula. You can take more sooner, but any effects you feel will be the cumulative result of both doses.
Even if you know how much CBD is in each serving, that value only represents the maximum amount that could be entering your body — most of that CBD will never reach your bloodstream or its targets.
But there are tricks that can help increase the amount of CBD your body absorbs.
- Before increasing how much you vape, experiment with different inhalation techniques.
- If you’re taking an oral formulation, try holding it under your tongue or swishing it around your mouth before swallowing.
For more tips and considerations, read about each ingestion method below.
CBD Sources & Quality
Once you find your optimal CBD method and dosage, be aware that it may change if you switch products. Some manufacturers are less trustworthy than others, so different CBD sources may have different effects.
What’s the best type of CBD to use? Scientists recently discovered that broad-spectrum CBD extracts (from cannabis or hemp plants) are much more effective than so-called “pure” CBD isolates. Researchers think broad-spectrum extracts work better because they contain a variety of molecules that are similar in size and shape to CBD — that all work synergistically together.
CBD: Can You Take Too Much?
If you’re worried about taking too much, just know that clinical trials have prescribed CBD doses up to 1,200 mg daily for months without observing any serious side effects . That’s more CBD than an entire bottle of Foria Basics , or 60+ suggested servings per day!
That said, we recommend speaking with a trusted medical professional before embarking on your CBD journey .
Although CBD is generally considered safe, it could lower your blood pressure. CBD can also interfere with your body’s ability to process certain pharmaceutical drugs. Both CBD and grapefruits inhibit cytochrome p450 , so take extra precautions if you are on a medication that comes with a warning not to consume with grapefruit . Topical or inhaled products could help minimize this interaction.
Ways to take CBD
Oral – Swallowed
Pathway to targets: When CBD is ingested, it passes through the digestive tract, where it’s absorbed into the bloodstream and travels throughout your body.
Time-frame: This is the slowest route for CBD to reach its targets, but also the longest period of time that it’s active. Peak bloodstream levels are reported anywhere between 1-6 hours. Best for long-term supplementation.
- Food. Food affects your body’s ability to absorb CBD, and more cannabinoids are absorbed on a full stomach . CBD is fat-soluble, and consuming with a healthy dose of fats can increase the amount of CBD that reaches your bloodstream 3-fold — which is why Foria Basics contains MCT coconut oil.
- Pay attention to THC. Swallowed products are first metabolized by your liver before circulating through your body (first-pass metabolism). If your CBD product contains THC (i.e it’s a “full-spectrum CBD”), it could be converted to 11-hydroxy-THC , which is a strong intoxicant. Many people find that CBD helps counterbalance the “high” associated with THC, but if you are sensitive to THC, look for CBD from a hemp source.
- Prescription drug interactions. As mentioned earlier, CBD could interfere with the processing of certain drugs by cytochrome p450. Because cytochrome p450 is most concentrated in the liver, ingested CBD is more likely than inhaled CBD to cause drug interactions.
- Time in your mouth. Everything above applies to CBD that is swallowed immediately. However, while it sits in your mouth, it can be absorbed directly into your bloodstream. See below.
Oral – Sublingual or “Buccal”
Pathway to targets: CBD can be absorbed directly into your bloodstream from capillary-rich areas underneath the tongue, along the gums and cheek. From here, it avoids first-pass metabolism and is sent throughout your body.
Time-frame: This route gets CBD into your bloodstream faster than swallowing. Under the tongue (sublingual) is generally quicker than against the cheek (buccal). However, because most of the CBD will eventually be swallowed, peak bloodstream levels range from 0.5 – 5 hours.
- Food. When evaluating an oral spray, researchers discovered that the total amount of absorbed CBD increases 5-fold if the person has recently eaten . Chewing helps increase blood flow to your mouth, which could help increase absorption.
- Increase surface contact. It’s often suggested to keep CBD oil in your mouth for 1.5 minutes or more before swallowing. During this time, increase absorption by vigorously swishing the oil around your mouth and even between your teeth — this increases the surface contact between the oil and your capillaries. (If you’ve tried oil-pulling as a tooth-and-gums cleanser, this will be familiar.)
Types: Vape pens, dabs, high-CBD cannabis
Pathway to targets: When CBD is inhaled, it passes to the lungs where it rapidly passes into the bloodstream. Inhalation avoids first-pass metabolism.
Time-frame: This is the quickest way to get CBD circulating through your system, but it also is effective for the shortest period of time. Peak bloodstream levels are within 10 minutes.
- Inhalation technique. Based on studies with THC, inhalation can get anywhere from 2-56% of this molecule into your bloodstream based on your inhalation technique. Try this: use the vaporizer for the first half of your inhalation, then finish your inhalation with a deep breath of fresh air — get those molecules deep in there! (This technique will also minimize irritation if the vapor is a bit too hot, by mixing in cooler air.) On exhale, any vapor that you can see is lost, so instead of exhaling fully, start a partial exhale until you see vapor — then inhale all the way back in and repeat a few times until you see less vapor on the exhale.
- Vapor Pen Hardware. Avoid cheap, disposable vape pens, and watch out for any that list “propylene glycol” in the ingredients. Look for higher-quality vape pens with ceramic heating elements, for a cleaner vapor.
Types: Creams, oils, lotions
Pathway to targets: Topical CBD diffuses across your skin and reaches local targets, like muscles, inflammatory cells, and pain-perceiving nerves. Very little, if any, enters the bloodstream — unless it is designed for transdermal activity.
Time-frame: Varies, depending on the target.
- Often paired. Topicals are great for on-the-spot treatment and arousal. But for long-term health goals, people often get the best results when they pair topicals with oral or inhaled CBD products.
Vaginal & Anal
Types: Suppositories, lubes, creams in applicators
Pathway to targets: CBD applied to the mucosal tissue of the vagina and anus have the strongest effect locally at muscles, inflammatory cells, and pain-perceiving nerves — similar to the way topicals work. However, because these areas are rich in capillaries, some CBD could be absorbed into the bloodstream.
Time-frame: For local targets like sexual pleasure or menstrual cramps, Foria’s Relief Suppositories with CBD and Awaken Arousal Oil with CBD are active within minutes (and possibly up to an hour) after application. Absorption into the bloodstream is highly variable and has only been studied rectally. Any molecules entering the bloodstream through the rectum should peak within 2-8 hours .
- Vaginal differences. Absorption across the vaginal wall will vary with your age, vaginal pH, and where you are on your menstrual cycle.
- Anal placement. Whether or not rectal suppositories deliver CBD into the bloodstream is highly variable between individuals. If the suppository also contains THC in a general cannabinoid formula, placement of the suppository into the lower rectum (closer to the sphincter) can help avoid first-pass metabolism and the risk of a more “stoned” feeling.
Everything we’ve been discussing — the pharmacokinetics of cannabidiol — is a complicated subject that scientists are still actively piecing together. There are no established guidelines for the best way to use CBD to achieve your health goals. Prepare for a truly unique experience that deserves patient and loving experimentation. We wish you success on your journey!
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If you’re overwhelmed by the wide variety of CBD products, you are not alone. Each method delivers CBD to your body in a different way, which affects what it can be used for and how often you’ll want to take it. That’s why we’ve put together a guide to help you design a CBD treatment plan that fits your health goals.