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Dosage is important, because CBD can have side effects—the most common are tiredness, diarrhea, and changes in appetite and weight—so it’s best not to take more than you need. As CBD becomes more prevalent, says J. Michael Bostwick, M.D., a psychiatrist at Mayo Clinic in Rochester, MN, “I’m reasonably certain new kinds of side effects will emerge.”
ISA HERRERA HEARD IT from her patients first. "I have less pain." "I'm having less anxiety." "My menstrual cramps are less intense," they told the New York City physical therapist about taking CBD oil, a product containing cannabidiol, one of many chemicals found in the cannabis plant. "I was like, 'I need to find out more about this,'" recalls Herrera, who specializes in integrative pelvic floor therapies.
Our bodies are thought to produce endocannabinoids by the billions every day. “We always thought the ‘runner’s high’ was due to the release of dopamine and endorphins. But now we know the euphoria is also from an endocannabinoid called anandamide,” its name derived from the Sanskrit word for bliss, says Joseph Maroon, M.D., clinical professor and vice chairman of neurosurgery at the University of Pittsburgh Medical Center. We produce these natural chemicals all day, but they fade quickly because enzymes pop up to destroy them. That’s where CBD comes in: By blocking these enzymes, CBD allows the beneficial compounds to linger. This is why Amanda Oliver, 31, a career consultant in Charleston, SC, pops a CBD gummy bear each night before bed. “I used to lie there tossing and turning as my mind raced from work projects to whether I had set the home alarm,” Oliver says. One piece of candy with 15 mg of CBD is enough to shut off her brain and facilitate sleep. She also swears by the CBD oil she takes at the height of her period, which she says quells her debilitating cramps.
After seasonal harvests of specific cultivars, these high-CBD hemp crops are put through a specialized solvent-free extraction process to yield a hemp oil that is naturally high in cannabidiol. This high CBD oil is different from hemp oil that is used in cooking. This pure hemp extract is then tested for safety, quality, and cannabinoid content before being exported to our processing facilities in the United States. Importing any cannabis or hemp product into the United States is a complicated and serious task, so we leave nothing to chance before our high-CBD hemp oil makes its journey across the Atlantic Ocean.
Full spectrum CBD includes hundreds of active compounds, each in varying amounts and potencies, each with their own subtle action. The Entourage Effect predicts that some of these compounds can work in concert with each other to produce larger effects than they could individually, and that some compounds support the actions of others or even help render active compounds that normally wouldn’t be.
Given CBD’s reputation as a popular, artisanal remedy, one would think that Epidiolex would command a lot of “off label” attention. After all, physicians often prescribe pharmaceuticals off label to treat conditions that were not the actual focus of clinical trials. But the costly price tag for Epidiolex (more than $30,000 annually) precludes off label prescribing as well as affordable access for tens of millions of Americans without health insurance.
That leaves those touting CBD’s effectiveness pointing primarily to research in mice and petri dishes. There, CBD (sometimes combined with small amounts of THC) has shown promise for helping pain, neurological conditions like anxiety and PTSD, and the immune system—and therefore potentially arthritis, diabetes, multiple sclerosis, cancer, and more.