Exam Room – CBD: A Game Changer
CBD, or cannabidiol, is the latest craze in the health industry and on the PGA Tour and is expected to grow by 49 percent annually compounded yearly in the next five years.
With that being said, it is important to understand a few things about CBD in order to reap the benefits. CBD is from the cannabis plant, however, it is just one of over 100 compounds found in cannabis. THC, another famous compound in cannabis, is known for its psychoactive effects. However, CBD and THC are completely different compounds, with completely different benefits.
Using CBD is not the same as getting “high” as CBD is known for its anti-inflammatory benefits. Hemp is sometimes used interchangeably with cannabis, however, hemp is the classification for cannabis or CBD products that have less than 0.3 percent of THC in them – which is the legal limit.
In all 50 states, hemp products are now legalized. Many hemp products contain either no THC or very little – the 0.3 percent I mentioned earlier. This is not enough to cause any psychoactive effects, but even this small percentage will increase the benefits versus just hemp alone that contains zero THC. The FDA has recently approved a prescription CBD called Epidiolex, which means the pharmaceutical company is seeing the benefits, and wants a piece of the industry.
CBD has become increasingly popular, especially on the tour, due to its pain and anti-inflammatory properties. Players and people are turning toward more natural alternatives for pain remedies with minimal to little side effects. Over the counter medications, such as Advil and Aleve, prescription anti-inflammatories like Melixocam or Celebrex, or even opioid derivative medications have way more severe side effects. CBD is an anti-inflammatory, as your body produces chemicals similar to CBD, called endocannabinoids, which regulate pain and inflammation. What this means is CBD is a natural pain remedy for your body, versus putting something artificial into your body, such as over the counter options like Advil or Aleve, prescription anti-inflammatories or opioid pain medications. Your body contains many receptors for CBD, meaning it can have an effect on many different parts of the body, along with different effects.
The Health Benefits for CBD Include
Pain reduction
Works for acute or chronic pain
Inflammation
Arthritis
Muscle spasms
Regulation of sleep including insomnia and promoting proper sleep cycles
Blood pressure and heart health
Increased immune system function
Skin conditions such as eczema
and psoriasis
Anxiety and depression
Seizures, Parkinson’s, Glaucoma
Addiction
You can get CBD in many different forms. The two most common forms are oil tinctures, which you take orally, and smoking, inhaled in the form of vape cartridges. We recommend the tinctures, which do not have the side effects of smoking, including vaping. When taking sublingual tinctures, it is best you let it sit under your tongue, as this allows for direct absorption into your bloodstream, along with swishing around in your mouth before swallowing. CBD also comes in creams, which work more locally, like for muscle pain, soreness, skin conditions and muscle spasms. You can also get CBD capsules, but I recommend against taking capsules versus taking sublingual. CBD is poorly absorbed into the digestive tract and will not be as effective as orally, vaping or cream. Other popular CBD products are gummy bears, chewing gum, CBD water and others.
Forms of CBD
Tinctures
Vape cartridges
Creams
Capsules
Chewing Gum, gummy bears, CBD
infused water
A recent article written about CBD on Golf.com (1) states:
“The World Anti-Doping Agency removed CBD from its list of banned substances in January, but the PGA Tour remains wary. In April, the tour cautioned players that some CBD products might contain THC, which could show up in drug testing. Hoffmann (Morgan, recently diagnosed with a muscle condition muscular dystrophy) says he alerted the tour of his plan to use CBD and was told ‘to be careful about the source of the product,’ and that if THC shows up in testing, ‘that’s on you’.”
This brings up a very important point. As CBD increases in popularity the most important part is knowing the source. With so many companies out there, it is important that you select a company that gets their products tested for correct dosage, and that their product is USDA certified organic. Many companies do not spend money on being tested or certified, however it is important to know that what you put in your body is what the company states it is. Many companies do not grow their own cannabis, as it is cheaper to purchase it from a distributor. It is important where the company you select gets its cannabis from, which is usually overseas – grown in soil that is not properly tested for toxins, poisons and metals. The other important piece of information is how the CBD is extracted. The extraction process of CBD using CO2, however other common and cheaper extraction processes utilize toxic solvents.
Working with athletes, you have to know the product contains the proper amount of CBD, especially to know if and how much THC it contains. There are many companies out there, but the company we use and trust is WAAYB (Wind Always at Your Back). They have been tested and certified organic.
After you have selected a company, the dosage of CBD can be confusing and daunting. It is actually very simple. Most bottles are labeled based on the total amount of CBD per bottle. This is typically somewhere from 500-1200 mg. This is the total amount of CBD per bottle, not per dose. Divide the number of doses per bottle, typically 30 or 60 doses (one mL) to get your total dose, which is typically one dropper or one ml. We recommend starting at a dose of 20 mg/mL, which is one dropper or one mL per day. This would be a 600 mg bottle with 30 doses. This is a middle of the road dosage, which should last about a month. You can adjust the dose after a week if you do not see a difference. If you do not notice a difference, take an extra dropper per day which would be two mL and 40 mg of CBD. If you do notice a difference, you can back off to 0.5 mL or half a dropper, to see if you get the same benefits as a 20 mg dosage. We recommend taking at night before bed, as CBD tends to have a calming effect and induce sleep.
Typical CBD Dosage
600 mg per bottle with 30 servings
One mL or one dropper contains 20 mg
of CBD
Take dropper, letting dissolve under the
tongue, then swishing around and finally
swallowing after a few minutes
Adjust dosage after taking for at least a
week consistently
It is important that you consult with your doctor, to make sure CBD does not interfere with any medications you are taking. Typically CBD can interfere with blood thinning medications such as Coumadin or Warfarin, and with seizure medications and anxiety medications. CBD can increase the concentrations of medications in your body, similar to the grapefruit effect. Please consult your doctor before starting, even with CBD being a natural remedy. The side effects from CBD are minimal but can include drowsiness, changes in appetite, nausea and diarrhea, however CBD is generally well-tolerated. Lastly, there have been no cases of overdose of CBD, similar to marijuana or THC.
In a nutshell, CBD has a wide range of potential health benefits with the most common for pain and inflammation. But with so many companies out there, it is important to know your source and proper dosage. Choose a company that grows their own cannabis and extracts the CBD themselves using CO2 without the use of solvents or chemicals. The dosage of CBD starting out is typically one mL per day of 20 mg. This is a standard 600 mg bottle of CBD, which will last you a month. Lastly, the side effects are minimal, but there are some drug interactions, so please talk with your doctor before starting.
Dr. Chris Miller treats all types of patients, ranging from average patients and professional athletes, including PGA Golfers and the Dallas Stars Hockey Team. For more info about ChiroSport Specialists of Dallas and Dr. Chris Miller please visit www.chirosportspecialists.com or call 972-239-0010.