CBD, or cannabidiol, is a non-psychoactive member of a plant family of compounds known as cannabinoids. We each have an endocannabinoid system which plays a role in regulating mood, pain, memory, and appetite (1, 2, 3). Our bodies actually produce two endocannabinoids; anandamide (known as the “bliss molecule”), and sn-2-arachidonoylglycerol. These endocannabinoids bind to cannabinoid receptors, which have been found in the brain, lungs, liver, kidneys, and immune system (2, 4). Then, an enzyme breaks down these endocannabinoids. We obtain phytocannabinoids from particular foods, like broccoli, cabbage, carrots, parsley, sunflower seeds, and cacao. When we consume higher amounts of phytocannabinoids, via CBD, for example, our body will break down the CBD thus preserving our endocannabinoids.
Some of the potential health benefits of CBD include decreasing inflammation, pain, stress, and anxiety (5-9). For the sake of time and attention to detail, this article will focus on peer-reviewed studies regarding inflammation.
CBD and Inflammation
Inflammation can range from acute (like a rash or the swelling we experience after injuring a knee) to chronic (presenting in conditions such as inflammatory bowel disease, Crohn’s disease, Alzheimer’s disease, heart disease, PCOS, and more)(10, 11). Pain often accompanies inflammation. CBD may decrease pain by binding to serotonin receptors and interacting with TRPV1 channels (12-15). An oral spray containing CBD was approved in Canada over ten years ago to treat pain in both multiple sclerosis and cancer (16).
Animal studies have demonstrated how the endocannabinoid system plays a role in inflammation occurring from allergies. For example, a study using a mouse model for allergic reactions of the skin found that when mice lacked cannabinoid receptors, their skin allergic reactions were heightened. Following in the same vein, when mice had increased levels of anandamide, their skin allergic reactions were decreased (17).
When it comes to conditions of chronic inflammation, CBD may also provide relief (18). A study published in PLoS One in 2011 found that CBD may decrease inflammation in patients with ulcerative colitis (UC). The researchers obtained bowel biopsies of 10 patients with UC and 8 control subjects. The biopsies were then cultured with CBD. The results indicated a protective action of CBD against further intestinal damage (19).
This isn’t the only evidence that CBD may have beneficial effects on gut conditions. A cell study in 2017 demonstrated that CBD may protect against inflammatory damage and restore the intestinal barrier (20). In Crohn’s disease, a randomized placebo-controlled trial on CBD was published in 2018 (21). The study included 50 patients with Crohn’s disease. After 8 weeks of administration of a CBD oil (containing 15% CBD and 4% THC), the Crohn’s Disease Activity Index decreased and quality of life increased compared to the control group that consumed an olive oil placebo (Naftali et al., 2018).
CBD and Headaches
Migraines may be related to inflammation. The prevalence of migraines is increased in women for reasons largely unknown (evidence published in 2018 suggests sex hormones may play a role)(22). There is evidence that women who suffer from migraines have greater FAAH enzymatic activity which results in greater breakdown of endocannabinoids (23). Other research indicates a decrease of anandamide in the cerebrospinal fluid of migraine sufferers (24). This further supports the theory that endocannabinoids may play a role in the regulation of migraines (25-27).
A review published in Current Opinion of Neurology in June of 2019 discussed the use of CBD oil for migraine relief (25). It is possible that the endocannabinoid system has several pathways of which it regulates migraine pain (25).
While human clinical trials on CBD, specifically, for migraine relief are sparse, a study was published in Pharmacotherapy in 2016 which included 121 patients who were migraine sufferers. The researchers found that daily medical marijuana use reduced the frequency of migraines from 10 to 4 migraines a month (28). While not specific to CBD, this study further suggests that the endocannabinoid system may play a roll in some types of headaches.
Can CBD Alleviate Acne?
One physical sign of inflammation can be acne. While we have all likely dealt with acne at some point in our life, it has the potential to greatly impact our self-esteem and quality of life (29). A pre-clinical study in 2014 determined that CBD may have a therapeutic effect on acne vulgaris partly due to its anti-inflammatory properties (30).
Are there any Side-effects?
CBD has been shown to be relatively safe for consumption with some reported side-effects being fatigue, diarrhea, and loss of appetite (31). It may put extra stress on the liver and interfere with other medications. Enzymes cytochrome p450, CYP3A4, and CYP2C19 metabolize CBD, so if other medications or supplements are also metabolized by these enzymes, there may be interactions (32). It is important to discuss with your healthcare provider before using CBD, especially if pregnant or breastfeeding.
The research on CBD and the cannabinoid system is evolving rapidly. I am curious to see what an increase in future clinical studies will confirm for us.
In health, Dr. Dylan Cutler, Ph.D.
Pin For Later:
1. Pacher P, Bátkai S, Kunos G. The Endocannabinoid System as an Emerging Target of Pharmacotherapy. Pharmacol Rev. 2006 September; 58(3): 389–462.
2. Aizpurua-Olaizola O, Elezgarai I, Rico-Barrio I, Zarandona I, Etxebarria N, Usobiaga A (January 2017). “Targeting the endocannabinoid system: future therapeutic strategies”. Drug Discovery Today.22 (1): 105–110.
3. Lu HC, Mackie K. An Introduction to the Endogenous Cannabinoid System. Biol Psychiatry. 2016;79(7):516–525. doi:10.1016/j.biopsych.2015.07.02.
4. Mackie K (May 2008). “Cannabinoid receptors: where they are and what they do”.J. Neuroendocrinol. 20 Suppl 1: 10–4.
5. Booz GW. Cannabidiol as an emergent therapeutic strategy for lessening the impact of inflammation on oxidative stress. Free Radical Biology and Medicine. 2011 Sep 1;51(5):1054-61.
6. National Academies of Sciences, Engineering, and Medicine. The health effects of cannabis and cannabinoids: The current state of evidence and recommendations for research. National Academies Press; 2017 Mar 31.
7. Blessing EM, Steenkamp MM, Manzanares J, Marmar CR. Cannabidiol as a potential treatment for anxiety disorders. Neurotherapeutics. 2015 Oct 1;12(4):825-36.
8. P Soares V, C Campos A. Evidences for the anti-panic actions of Cannabidiol. Current neuropharmacology. 2017 Feb 1;15(2):291-9.
9. Leweke FM, Piomelli D, Pahlisch F, Muhl D, Gerth CW, Hoyer C, Klosterkötter J, Hellmich M, Koethe D. Cannabidiol enhances anandamide signaling and alleviates psychotic symptoms of schizophrenia. Transl Psychiatry. 2012 Mar 20;2:e94.
10. Chen L, Deng H, Cui H, Fang J, Zuo Z, Deng J, Li Y, Wang X, Zhao L. Inflammatory responses and inflammation-associated diseases in organs. Oncotarget. 2018 Jan 23;9(6):7204.
11. Goyal H, Awad HH, Ghali JK. Role of cannabis in cardiovascular disorders. Journal of thoracic disease. 2017 Jul;9(7):2079.
12. Baron EP. Medicinal properties of cannabinoids, terpenes, and flavonoids in cannabis, and benefits in migraine, headache, and pain: an update on current evidence and cannabis science. Headache: The Journal of Head and Face Pain. 2018 Jul;58(7):1139-86.
13. De Gregorio D, McLaughlin RJ, Posa L, Ochoa-Sanchez R, Enns J, Lopez-Canul M, Aboud M, Maione S, Comai S, Gobbi G. Cannabidiol modulates serotonergic transmission and reverses both allodynia and anxiety-like behavior in a model of neuropathic pain. Pain. 2019 Jan;160(1):136.
14. Russo EB, Burnett A, Hall B, Parker KK. Agonistic properties of cannabidiol at 5-HT1a receptors. Neurochemical research. 2005 Aug 1;30(8):1037-43.
15. Reggio PH, Muller C, Morales P. Cannabinoid ligands targeting TRP channels. Frontiers in molecular neuroscience. 2018;11:487.
16. Russo EB. Cannabinoids in the management of difficult to treat pain. Therapeutics and clinical risk management. 2008 Feb;4(1):245.
17. Karsak M, Gaffal E, Date R, Wang-Eckhardt L, Rehnelt J, Petrosino S, Starowicz K, Steuder R, Schlicker E, Cravatt B, Mechoulam R. Attenuation of allergic contact dermatitis through the endocannabinoid system. science. 2007 Jun 8;316(5830):1494-7.
18. Liou GI. Diabetic retinopathy: role of inflammation and potential therapies for anti-inflammation. World journal of diabetes. 2010 Mar 15;1(1):12.
19. De Filippis D, Esposito G, Cirillo C, Cipriano M, De Winter BY, Scuderi C, Sarnelli G, Cuomo R, Steardo L, Joris G, Iuvone T. Cannabidiol reduces intestinal inflammation through the control of neuroimmune axis. PLoS One. 2011 Dec 6;6(12):e28159.
20. Gigli S, Seguella L, Pesce M, Bruzzese E, D’Alessandro A, Cuomo R, Steardo L, Sarnelli G, Esposito G. Cannabidiol restores intestinal barrier dysfunction and inhibits the apoptotic process induced by Clostridium difficile toxin A in Caco-2 cells. United European gastroenterology journal. 2017 Dec;5(8):1108-15.
21. Naftali T, Schlieder L, Lev B, Benjaminov FS, Lish I, Hirsch J, Konikoff FM. Cannabis induces clinical and endoscopic improvement in moderately active ulcerative colitis (UC). J Crohns & Colitis 2018 Feb 1 (Vol. 12, pp. S306-S306).
22. Galloway EA, Cottier KE, Kim J, Vallecillo T, Davis TP, Vanderah TW, Largent-Milnes TM. Role of Sex Hormones in Regulation of Sodium-Proton Exchanger NHE1: Implications for Migraine. The FASEB Journal. 2018 Apr;32 (1_supplement):533-60.
23. Fogan L. Treatment of cluster headache. A double-blind comparison of oxygen v air inhalation. Arch Neurol. 1985;42:362–363.
24. Greco R, Demartini C, Zanaboni AM, Piomelli D, Tassorelli C. Endocannabinoid system and migraine pain: an update. Frontiers in neuroscience. 2018 Mar 19;12:172.
25. Tassorelli C, Greco R, Silberstein SD. The endocannabinoid system in migraine: from bench to pharmacy and back. Current opinion in neurology. 2019 Jun 1;32(3):405-12.
26. Sarchielli P, Pini LA, Coppola F, Rossi C, Baldi A, Mancini ML, Calabresi P. Endocannabinoids in chronic migraine: CSF findings suggest a system failure. Neuropsychopharmacology. 2007 Jun;32(6):1384.
27. Lochte BC, Beletsky A, Samuel NK, Grant I. The use of cannabis for headache disorders. Cannabis and cannabinoid research. 2017 Apr 1;2(1):61-71.
28. Rhyne DN, Anderson SL, Gedde M, Borgelt LM. Effects of medical marijuana on migraine headache frequency in an adult population. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy. 2016 May;36(5):505-10.
29. Dunn LK, O’Neill JL, Feldman SR. Acne in adolescents: Quality of life, self-esteem, mood and psychological disorders. Dermatology online journal. 2011;17(1).
30. Oláh A, Tóth BI, Borbíró I, Sugawara K, Szöllõsi AG, Czifra G, Pál B, Ambrus L, Kloepper J, Camera E, Ludovici M. Cannabidiol exerts sebostatic and antiinflammatory effects on human sebocytes. The Journal of clinical investigation. 2014 Sep 2;124(9):3713-24.
31. Iffland K, Grotenhermen F. An update on safety and side effects of cannabidiol: a review of clinical data and relevant animal studies. Cannabis and cannabinoid research. 2017 Jun 1;2(1):139-54.
32. Zendulka O, Dovrtelová G, Nosková K, Turjap M, Sulcová A, Hanus L, Jurica J. Cannabinoids and cytochrome P450 interactions. Current drug metabolism. 2016 Mar 1;17(3):206-26.
Disclaimer: As the sole author of Phruitful Dish, I have based my posts on my own experiences and personal knowledge. However, I am not a medical doctor or a licensed nutritionist. The information in this blog is not intended as medical advice, and it is not endorsed by my employers or institutions I am affiliated with. Nutritional and supplemental choices should be made in consultation with your health care provider. This blog is intended to inspire and encourage readers to educate themselves on how nutrition and lifestyle are important and often overlooked aspects of health. Therefore, please use the information at your own risk. Occasional links may be provided leading to third party websites. The existence of these links does not infer a responsibility or an endorsement of the linked site, its operator, or its contents.