A whole-plant extract of hemp likely contains some amount of THC, although some companies claim to be isolating the CBD (or removing the THC). Because of the lack of regulation, it is difficult to know exactly what you are purchasing. If you are planning to purchase a hemp-based product, look for one made from hemp grown in the United States from a manufacturer that conducts quality control testing.
Certificates of analysis may be available on their website, or you can request this. This analysis will confirm that there are no pesticides, microbial or fungal contamination of the product, and should provide you with the information on how many milligrams of CBD is in a dose. However, the FDA has warned that the labels are not always accurate. California has not mandated quality control testing for hemp-based products, while other adult-use cannabis must pass stringent quality control testing.
Health Benefits of CBD
CBD is being touted as a treatment for a wide variety of health issues. The strongest scientific evidence for CBD is for the most untreatable childhood epilepsies known as Dravet and Lennox-Gastaut syndromes. Recently the FDA approved the first-ever cannabis-derived medicine for these two conditions, Epidiolex, which is an isolated form of CBD and not a whole plant extract (contains no THC). This drug has not yet been approved by the FDA to treat any other conditions.
Some CBD manufacturers have come under FDA scrutiny for indefensible claims such as: “CBD is a cure-all for cancer” (which it is not) or will “stimulate hair growth” (no proof of this). We definitely need more research on what CBD may be useful for, other than seizure. For instance, managing anxiety, insomnia, or mild inflammatory pain (some research exists for these indications).
CBD is not a very potent compound, meaning that high doses are needed to produce pharmacologic effects (higher doses than required with THC, which is a very potent molecule). CBD is not typically sedating at the doses found in many hemp-based products, but research has shown that high dose (around 350 mg) may cause sedation. There is a dose-related risk of drug interactions with CBD and you should talk with your doctor about this potential. Despite some claims, CBD is not converted to THC in the body. However, if a hemp-based product contains any amount of THC this could show up in a urine or blood drug screening test.
Remember that CBD may not have much effect at a low dose (it has rarely been studied clinically at under 75 mg). Because of all of the hype around CBD, it is possible that the craze about it is just a “placebo effect” (due to the belief in the product, not because the product itself is effective). If you decide to try CBD, talk with your doctor — particularly if you are on other prescription medications, to ensure it won’t affect the metabolism of those drugs.
Until we know much more about what CBD is good for, the best that can be said is that it appears to be non-toxic or has a good safety profile, at least in healthy individuals. Alternatively, it could be the very low amounts of THC found in hemp-based products that boost the therapeutic benefit. The combination of all of the many compounds found in botanical medicines (whole plant extracts), used for thousands of years across cultures, resulting in a synergy that adds up to provide effects. More research, such as that occurring through the Center for Medical Cannabis Research at UCSD will help to clear up some of the haze around CBD!
Michelle Sexton, ND
Dr. Sexton is an Assistant Adjunct Professor for the University of California, San Diego Department of Anesthesia.
Dr. Sexton’s NIH-funded pre and post-doctoral research was on the topic of cannabinoids and their roles in neuro-inflammation and neuro-degeneration. She is a member of the International Cannabinoid Research Society, the International Association of Cannabinoid Medicine and the Society of Cannabis Clinicians. She maintains a medical practice in San Diego, CA and she sees patients for integrative neurology, chronic inflammation, chronic pain, autoimmune diseases and cancer support.