Cannabidiol CBD and Mental Health

This episode was pre recorded as part of a live continuing education webinar on demand. CEUs are still available for this presentation through all CEUs. Register@allceus.com Counselortoolbox you I'd like to welcome everybody to today's presentation on cannabidiol, the mental health uses and cautions. I am Dr. Donnelly Snipes and I will be taking you through this next hour. In this presentation we're going to learn the difference between CBD and thc. Identify the research based uses for cbd. I really wanted to stick with good research based information, so you're going to see a lot of citations in here. I didn't want to just go to any old website and take any old claim. There are a lot more claims out there that we're not going to talk about because I didn't necessarily find the research on it. So that being said, we'll explore the impact of CBD on mood and we're really going to tie it in. If you've been with me over the past six weeks or so, we're really going to tie it into the neurotransmitters and the leaky gut and all that kind of stuff and identify ways to support the endocannabinoid system. That's just fun to say. Endocannabinoid. I digress. We'll identify ways to support the endocannabinoid system and increase activation of the CB1 and CB2 receptors without the use of marijuana or cannabis. A disclaimer because we are talking about a medicinal product or a supplement. This is for educational purposes only and not a replacement for medical advice. People, people really need to talk with their doctors. And we'll talk about it later in more detail about the fact that CBD actually interacts with just about every drug out there. So it's really, really important that people, if they're on any kind of medication, OTC or prescription, talk to their doctor before starting to ingest it. Let's start at the beginning. What is cbd? Cb. CBD is one component of cannabis. There are a lot of different cannabinoids in cannabis. What we're going to talk about today is cannabidiol. THC is the psychoactive component of cannabis. Now, that term's a little bit misleading because CPD has some effects on mental health. So you could argue that it's also psychoactive, but it doesn't produce the euphoric effects that THC does. Thc, now this is not cbd. This is THC has antispasmodic analgesic, anti tremor, anti inflammatory, appetite stimulating, antiemetic properties. So antiemetic is it keeps you from throwing up. It does have benefits, which is why we see it used a lot medicinally. High levels of THC is commonly used for sleep inducing effects. And THC mimics the effects of the 2Ag endogenous cannabinoid, which modulates sleeping and eating habits and the perception of pain. GABA neurons contain CBD receptors which are activated upon use of THC and maybe even cbd. So THC has a place in medicinal use. And a lot of your medical marijuana has very low levels of THC in order to conform to regulatory things. CBD is the major non psychoactive component of Cannabis sativa. Okay, so we're going to keep saying non psychoactive. What I want you to hear from that is it's not going, people are not going to get high from CBD oil. According to a 2013 study published in the British Journal of Clinical Pharmacology, CBD benefits include acting as an anti inflammatory. So benefit there. Remember our connection between inflammation and depression. There's a lot of research connecting those two. Anti inflammatory, anticonvulsant, antioxidant, antiemetic, anxiolytic, neuroprotective, immunomodulatory and antipsychotic. We're going to learn about all of these things in a little bit more depth. But CBD has a lot of benefits. The endocannabinoid system is involved in all of these things. So if your endocannabinoid system is offline for some reason, then you may have problems with inflammation, convulsions, muscle spasms, nausea, anxiety, neurological issues, which is why we can't just ignore CBD and or the endocannabinoid system. CBD is a biphasic drug and it has different effects on the body at different blood level concentrations, kind of like alcohol does. Until the blood alcohol of alcohol reaches 0.05%, it's a stimulant. And then after that point it causes sedation and depression. And then when it starts leaving the body, people are sedated for a while. And then if you've worked in a detox unit, you're well aware of the fact that when their blood blood alcohol level gets to a certain point, then they start having anxiety, hypertensive effects, stimulatory effects. The same thing is true with CBD at low concentrations. And the definition of low concentration in the research is anywhere from 60 to 160 to 600 milligrams so low concentration is very relative. It depends on the person, depends on the quality of what you're using. CBD is not standardized by the fda. So you're not going to get something like if you get Zoloft or Xanax or something from the pharmacy, you know you're getting exactly that number of milligrams per pill or per dropper, full or per whatever per dose with CBD and other supplements that you get over the counter. It's not that standardized. So it's really important to recognize that. And the quality and purity is not nearly as tightly regulated. Again, it's really important. So what you get from one supplier may be far stronger than what you get from another supplier. At higher levels, CBD has a sedating effect. THC can have a sedating effect, too. And at higher levels, CBD can. So you can get the sedation from cbd. And I want to point out I should have done a comparison slide, but a lot of the effects of CBD are similar effects as that THC has. So you can get a lot of the effects of what people normally attribute to THC from cbd oils or cbd. What's the word I'm looking for? Supplements. Okay. 36% of respondents in one study reported that CBD treated their medical conditions, whether it was pain, muscle spasms, sleep problems, depression, anxiety. 36% were really happy with CBD all by itself, while only 4.3% reported that CBD didn't work very well. Now, that's an interesting number because you know, or we've seen in the research, that anywhere from 25 to 60%, depending on the study that you look at, of people who take antidepressants report that it doesn't work for them very well at all. Okay, well, and as I've talked about over and over and over again, there are multiple different causes of depressive symptoms and anxiety symptoms. So we do want to look at what's going on with the person. What's the underlying pathology that is causing the symptoms that the person is presenting with. But if one third of the people taking it, a little over a third report that it treats their medical conditions very well by itself, then that's awesome. Yes. You've got 64% of them out there is not working for. That's okay. We need to look maybe at multiple causation. There could be multiple things going on that are causing the particular person's symptoms. And if you remember, I told you we were going to tie this stuff from previous lessons all up in a Bow gut health, when the gut is dysfunctional, when the microbiome is out of whack in the gut, it doesn't produce or get rid of byproducts from the production of neurotransmitters nearly as well. And there's a direct connection via the vagus nerve of the gut and the brain. So we know that if the gut is not functioning well and the serotonin is out of whack in the gut, or the dopamine or whatever, there's a lot of stuff produced in the gut that people may have mood symptoms. We know that when the HPA axis is elevated for too long, people can develop hypocortisolism. And HPA axis activation comes from trauma and physical stress, like poor nutrition, lack of sleep, as well as cognitive stress. Just what we think of when we talk about stress and counseling and cognitive distortions. So that could be contributing to people's current presenting conditions. We know that when people are depressed, they tend to have associated inflammation, so they may have more pain. It can go both ways. Inflammation can influence depression, and depression can influence inflammation. Sex hormones, when testosterone and estrogen are out of whack, and progesterone for that particular person, it can contribute to imbalances in the neurotransmitters, which can lead to depressive symptoms. When there's a dysfunction in the endocannabinoid system, as you're getting ready to learn, it can also affect the amount of glutamate and dopamine and serotonin that's available in the person's brain. And finally, thyroid hormones. When people are hypothyroid, they tend to present with symptoms of depression, and hyperthyroid tend to present with symptoms of anxiety. So the symptoms the person is presenting with could be caused by a myriad of different things. We can't just point to one thing, but if somebody's taking antidepressants and it ain't working for them, well, we might want to look and see what other system that contributes to the balance of our neurotransmitters, which. What other system or systems might be offline a little bit. And one of those is the endocannabinoid system. And that's what we're going to focus on today. Let's talk a little bit about those receptors. I know it gets kind of tedious going into the neuropsychology of it, but let's go ahead and talk about that. CBD and THC. So two of your constituents of cannabis both bind to the CB1 and CB2 receptors, but they interact with them in different ways. CB1 and CB2 are both responsible for regulating neurohormones, which are involved in memory, mood, sensations of pain and appetite regulation. CB1 is found in the central nervous system and responds to your endogenous, your natural cannabinoids as well as responding to thc, which activates those receptors, and cbd, which is a mild antagonist, it kind of turns off those receptors. So one turns them on, one turns them off. CB1 is abundant in the areas of the brain, conserved with movement, coordination, pain and sensory perception, emotion, memory, cognition, autonomic and endocrine or hormone functions. So it's involved in a lot of stuff. And if any of those things go offline, we could have a lot of problems. Yes, the high comes from the thc and it's really important for people who are organizations that are marketing CBD oil in most states. Thc, not legal. So it's really important to make sure that there's no THC in it. But CBD does interact with a lot of other medications, so it is important to recognize what you're taking and how it interacts. CB2 receptors are found only in the immune system. And I remember this, it's weird, but CB2, achoo. You know the sound you make when you sneeze? That helps me remember that CB2 is only in the immune system, not in the CNS. But it does seem to reduce inflammation and related pain. It responds to the endogenous cannabinoids as well as CBD and thc. Benefits of CBD According to the National Institute of Health, manipulating the endocannabinoid system by introducing external cannabinoids like CBD could be useful in treating a variety of medical ailments, including pain, anti inflammatory. It's also, you'll find out later, involved in making serotonin more available. Epilepsy, multiple sclerosis, als, Parkinson's, inflammation, depression, diabetes, rheumatoid arthritis, dyskinesia, anxiety, adhd, schizophrenia, substance abuse, withdrawal, heart disease and irritable bowel syndrome. Oh my gosh, it is so helpful for a lot of things. It is involved in a lot of things. So again, any of the medications that you're taking or herbs that you're taking that are addressing any of these issues are probably also going to interact with cbd. Just being aware of that. And I did not look in response to what I saw in the, in the chat room, I actually did not look to see if it was involved with or helpful for psoriasis or anything like that. CBD can help people recover from Colostrudum difficile. I think I'm pronouncing that right. It's called C Diff, if you get it. That's what the doctors refer to it as, because most other people can't pronounce it either. And restores the intestinal barrier when people are given antibiotics, especially young children and the elderly. But it can happen at any age. Sometimes the antibiotics kill off and disrupt the microbiome so much that this particular bacterium becomes very prolific in the intestine and can lead to. Actually can lead to death because it causes extreme diarrhea. It causes ulceration of the intestines. You know, lots of bleeding. It's really ugly. My best friend's niece was going through this not too long ago. She's six. And it was just. It was devastating. CBD reduces chronic pain. And they've shown in multiple studies, studies, that taking CBD oil or CBD products at certain levels, and depending on the study, you know, the levels really varied, it does reduce chronic pain, especially pain associated with inflammation, like rheumatoid arthritis and those things. CBD binds with estrogen receptors. When the CBD binds with the estrogen receptors, it acts sort of like a phytoestrogen. It's a mild estrogen receptor. So it binds to it, but instead of turning. Turning the lock completely like estrogen does, it only turns it a little bit, but it's blocking that receptor. So it's really helpful, in theory, with people who have estrogen dominance, it impacts insulin levels via the cannabinoid receptors in the pancreas. This is something else that people need to pay attention to, not only for if they've got diabetes or hypoglycemia, but also because when our blood sugar levels get really low, what happens? HPA axis kicks on and the body starts dumping blood glucose or glucose into our blood. So it's important to recognize the effect of blood glucose. As I said earlier, 160 milligrams to 600 milligrams of cannabidiol may play a therapeutic role in sleep regulation. Increase in sleep time and reduced awakenings. That is a really wide spectrum. Part of it depends on people's body weight and body composition, as well as other things. It is really. Important to recognize that the supplements aren't standardized. So what one study may have used may have been more potent than what another study used. But they're hoping that they were getting right around those milligram rankings. The endocannabinoid system plays a significant role in the regulation of the HPA axis and reduces cortisol production. How awesome is that? This is one of those things that is really important for people who have high levels of cortisol, high levels of stress, but it's also really important for us to recognize if we're working with somebody who has hypocortisolism, CBD may not be a good fit for them. If they already don't have enough or aren't producing enough cortisol, then that could be an issue. The activation of adenosine receptors by CBD produces anti anxiety and anti inflammatory effects. That's good. It also causes the release of dopamine and glutamate. Remember, dopamine is involved in cognition, motor control, motivation and reward mechanisms. It's one of those main neurochemicals that's involved in some schizophrenia. So dopamine is our feel good chemical. It's our reward chemical. Glutamate is the main excitatory neurotransmitter and is also involved in memory, learning and cognition. Glutamate is our get up and go neurotransmitter. Remember, THC generally turns on the receptors. CBD generally turns down the receptors. Higher concentrations of CBD have been shown to activate the 5HT1, a serotonin receptor which impacts pain perception, sleep and mood. CBD, the only one that wasn't mentioned here was norepinephrine. But your dopamine, your glutamate and your serotonin are all impacted. If you've got somebody who's on an antipsychotic and anti anxiety or an antidepressant, it's great going to interact with CBD using marijuana or CBD because marijuana has CBD in it while on antidepressants or antipsychotics can be potentially dangerous as it can intensify any or all of the effects making the person's condition even worse. There is a link here for an overview of CBD safety that was put out by the National Institute of Health. Not going to go through that right now, but it does provide some useful information for clients if they're interested in learning more about cbd. Talk a little bit about CBD and Parkinson's and I see the discussion in the chat room about the legalities and drug testing and I will get to that. But let's talk about Parkinson's for a few minutes first. Parkinson's disease is associated with impairment of motor control after the loss of 60 to 80% of the dope producing neurons. Well, remember that CBD oil does seem to impact the dopamine receptors. The endocannabinoid system plays a major role in Parkinson's disease. CBD boosts dopamine levels in short term pre clinical studies, but long term heavy marijuana use could reduce dopamine levels. Looking at differentiating, they didn't have any studies on long term heavy CBD use. So they were comparing it to marijuana and were not sure whether it was the long term use of CBD or long term use or exposure to the other cannabinoids that are in marijuana were able to reduce dopamine levels. But it is important to recognize if you're working with someone who has a long term history of use of marijuana, especially heavy use of marijuana, being aware how it impacts over the long course the dopamine receptors is important and it's important to educate clients about that digestive imbalance. Your sick gut may play a role in the advancement of Parkinson's disease and the severity of symptoms. Remember that a lot of our neurotransmitters are actually produced and a lot of our hormones are actually produced in our gut. So when the gut is sick, it is a problem and we're going to get to it at some point. But I'll bring it up here too. CBD has actually been shown to. Cannabidiol has actually been shown to help repair that leaky gut and close up that leaky intestinal barrier which is really good for people who are experiencing leaky gut. Cannabinoids have a neuroprotectant, antioxidant and anti inflammatory property which can be beneficial for managing Parkinson's disease. Parkinson's disease obviously involves the degeneration of neurons. So since it's a neuroprotectant, you know, bonus and the anti inflammatory properties when the nerves become inflamed, then it causes more problems. So it can be really effective for managing Parkinson's. Another side effect of Parkinson's disease. Some people experience hallucinations and delusions. And there is a little bit of evidence out there that indicates that CBD with its antipsychotic properties can be helpful for people to assist them in managing those symptoms as well. And Christine, that's a good question. If probiotics would help manage Parkinson's disease since a sick gut is implicated, then it would be logical to believe that probiotics could help at least. Prevent this Parkinson's disease from getting any worse. That's def. That would be something that would be interesting to look at. I'll Try to remember to do that when we get through class today. So any drug metabolized by the CYP450 enzymes could potentially interact with cannabidiol. CYP450, we've probably all heard that before. And you're just like, I have no idea what that is. Well, it's an enzyme and it is an enzyme that's involved in breaking down a lot of different medications. So drugs known to use the CYP450 system include steroids. And that's not just your bodybuilder steroids that can also be steroids that you're using like prednisone, calcium channel blockers, heart medications, antihistamines. How many of us are on antihistamines? And I know one of the anti histamines that I'll use occasionally is a nose spray, which is, guess what, a steroid. Antivirals and immune modulators. This is important for patients who have cancer as well as those who have hiv. If they're on one of those new immunomodulating drugs for cancer, then CBD may not be a good choice for them. Benzodiazepines. Since CBD tends to have anti anxiety properties, combining them with benzos could give you a too much of a reaction. Antiarrhythmics, again, heart medication, antibiotics. Interesting. I never knew that antibiotics were in the CYP450 system. If people are taking antibiotics, then they probably want to lay off the CBD or at least check with their. Definitely check with their doctor before they take it to make sure the antibiotics are going to have full effectiveness. Anesthetics. They generally recognize or recommend that people who are going to undergo a procedure in which they have anesthesia, lay off the CBD oil as well as a lot of other supplements for a certain period of time before undergoing the procedure because of the interaction. We already talked about how it interacts with antipsychotics and antidepressants, your antiepileptics. It can also like klonopin is an anticonvulsant that it may interact with your beta blockers which are used for high blood pressure. Can interact with CBD oil or CBD, sorry, your NSAIDs, that's your ibuprofen and your, what's the 12 hour one, your Aleve and those sorts of things. Oral hypoglycemic agents. Remember it messes with the or there are endocannabinoid receptors in the pancreas and any antidiabetic medications. So we've got heart problems, high blood pressure Allergies, anxiety, antivirals, bacterial infections, anesthetics. Like I said, it interacts with just about everything that's out there. Now, some may be a very mild interaction, which is between the patient and their doctor to decide whether it's worth continuing to take the CBD while they're taking something else. They also, in some cases, some people cut back on their dose of certain pharmacological medications or synthetic medications, whatever you want to call it, and balance it out by adding CBD oil. So they're taking sort of half and half. It depends on the person, it depends on the doctor, what the decision is going to be. Interestingly, with alcohol, CB1 receptor agonists, THC encourage alcohol consumption. So when people smoke marijuana, the cannabinoid THC encourages them to want to drink alcohol. But cannabidiol actually antagonizes that receptor and decreases people's desire to consume alcohol. CBD has some benefits here. Cannabinoids have an effect on nearly all enzymes responsible for metabolizing alcohol, which means you're going to metabolize it differently when you're smoking pot or using CBD oil or whatever you're doing than when you're not. Combining alcohol and CBD interestingly enough, results in a significantly lower blood alcohol level. Now that is not a hint to people to combine these two things so they can drink more because CBD reduces the reinforcement, the euphoric effect of alcohol. It reduces motivation and generally it reduces relapse because it's takes the all of the psychoactive benefits of alcohol or a lot of them out, or it blunts them enough that it's like, might as well drink a diet Coke just without the rum. CBD attenuates alcohol induced liver steatosis and inflammation because when we drink alcohol, it inflames the liver. Well, CBD can actually protect against that a little bit. So that's, that's a bonus. And cannabinoid agonists also mitigate alcohol withdrawal. Antagonists also mitigate withdrawal symptoms, which CBD is the cannabinoid antagonist. CBD can be really helpful in a detox situation. Alcohol detox can be life threatening. I am not encouraging people to manage their own detox with CBD products by any means whatsoever. But it is interesting that it could be an alternative treatment that is employed in detox units or even ambulatory detox settings. Increasing natural cannabinoids. In order to produce the proper amount of endogenous cannabinoids, the body requires sufficient amounts of omega 3 fatty acids. Which are the precursor to the endogenous cannabinoids. We keep hearing about omega 3s, how we need to have them. It helps with mood, it helps with serotonin, it helps with depression. Well, now we know it helps with the endocannabinoid system as well. Where can you get it? Hemp seeds and hemp oil. These are things that are useful. Chia seeds, walnuts, fatty fish like your salmon and your mackerel and eggs, typically the ones that are pasture fed or omega 3 enriched. Only because the chickens that just eat straight up grains don't have the same levels of nutrients. If you get an egg from the grocery store and you look at the yolk, it's generally a pale yellow. If you get an egg from one of my chickens and you look at it, it is bright orange because it has a lot more vitamins and fatty acids and things in it. Cacao powder, just your regular dark cocoa powder, contains three compounds that are structurally similar to the endocannabinoids and inhibit the breakdown of endocannabinoids. Bonus. One of the things that I do is I have the dark cocoa powder and I put it in my coffee. It's high in magnesium and a lot of other trace minerals. I happen to love chocolate, so it's a bonus. And come to find out it also helps support the endocannabinoid system for people who don't want to do just the powder doing. And yes, caico and cocoa are roughly the same. You want to look for something that's at least 70 to 90% dark chocolate. And I noticed when I was in the grocery store the other day that in the baking aisle they actually do sell things that are bitter chocolate and semi sweet dark chocolate that can that are registered or labeled as having 70, 80, 90% cocoa content, which is, you know, really good. You can also get the cocoa nibs. Those tend to be a little bit more expensive, but those are also very helpful. And yes, Misty points out, do not, do not, please do not let your dogs get access and probably cats to chocolate. Chocolate is one of those things like onions that is great for us, but extraordinarily toxic to dogs. Beta caryfulline is found in black pepper, lemon balm, hops, cloves, interestingly enough, cannabis, oregano, cinnamon and cinnamon and stimulates the CB2 receptor. Remember that's your, the one that's in your immune system. But beta carophylline is an anti inflammatory. Great thing to know. Most of us have at least black pepper in our house. If not cinnamon and cloves as well. Those are really easy to work in. I personally don't like lemon balm or hops, but you know, to each his own. But those are things people can start incorporating in their diet. You don't need a ton of it, you don't need a tablespoon of black pepper. But the fresher the spice, the more of the compounds, important compounds that we need are in it. So your fresh ground pepper is going to have a lot more of the beta Caroline in it than something that has been sitting on the store shelf for three years. Echinacea also contains CB2 agonists, which is really interesting to know because we know that there's a lot of research out there that shows that echinacea is great for immune support. Kava, Remember kava and valerian are two herbs that you can take that tend to have pretty strong anti anxiety effects. Kava may stimulate the CB1 receptor. Remember that's the one that is involved in a lot of the other stuff, not just anti inflammatory immune functioning. Black and green tea. And we hear about black and green tea and chocolate over and over and over again in our classes on supporting neurotransmitters and supporting gut health. So there's got to be something to it. Black and green tea prevents the breakdown of the endocannabinoids and actually stimulates the cannabinoid receptors, which is beneficial. Lactobacillus acidophilus is your basic Lactobacillus bacteria. It's the one that's prevalent in all of your yogurts. You don't even have to get a special yogurt or a special probiotic. It activates. I meant to put one there. It activates CB1 receptors. Bonus for the yogurt. Studies show that DIM, which is a compound that is extracted, it's the compound that's in broccoli that makes it such a good cancer fighter. DIM reduces inflammation by binding to CB2 receptors. So it reduces inflammation. But we also know that it is a potent antioxidant and works with the immune system in affecting cancer levels. Curcumin, also found in turmeric, raises the endocannabinoid levels. Excellent to know. Now I'm not a huge person for using turmeric in my cooking, but you can get it in capsules. It's really easy. Interestingly, the curcumin is actually the an alternate that you can use to make yellow rice. Who knew? Read that in an article the other day. It does have a strong yellow color and the curcumin as opposed to the turmeric, has a much milder flavor which is more akin to the yellow rice. Obviously in yellow rice it's saffron is what they typically use. So we've talked about dosing and I guess here is where we will address some of the legal concerns. Technically, anything with CBD in it should be 100% THC free. Again, it is not super duper ultra regulated. So do you want to take the chance when people are drug tested it? Depending on the drug test, you know it may show up if they're testing for any cannabinoid versus if they're just testing for thc. It's important to check with your regulatory agency if, especially if you're a dot driver or something or a doctor who has extra special regulations on you, check and make sure that it is okay to take CBD oil or cbd. I keep saying oil because that's how I'm used to it. But it comes in many different forms even if something is prescribed by a doctor. So for example, if you have nausea or chronic pain and your doctor prescribes you medical marijuana, you know, not CBD but medical marijuana. So you do have some THC in your system. Even if you have a medical reason for it and a prescription for a doctor from a doctor, that does not matter. When it comes to employment related drug testing and other situations, potentially legal oriented drug testing, it is really important for clients to understand that that just because they have a prescription doesn't mean that it's going to give them a pass to use it. The FDA has not created a recommended daily intake for CBD which means CBD does not have an official serving size nor is it formally regulated. I know I said that about 17 times. CBD impacts are affected by people's body weight. So obviously somebody who is 100 pounds soaking wet isn't going to need as much as somebody who's 250 pounds. It's affected by body fat percentage. Two people that are 100 pounds, one person has 30% body fat, the other person has 8% body fat. They're going to have a different reaction and other hormonal and physiological processes depending on what supplements they're taking. And you know, estrogen, testosterone, progesterone levels, all of those things impact the effect of CBD on people. With that being said, one article I found, and this is obviously not an NIH article, one article I found indicated that a good rule is 1 to 6 milligrams of CBD for every 10 pounds of body weight to start. So if you're 100 pounds, then you may start out with 10 milligrams of CBD. One article that I read indicated that people who took more than 60mg of CBD 60, not 160, but took more than 60mg of CBD felt a little bit hungover the next day and lethargic. Another study found that people that were taking 160 to 600 milligrams felt a lot better. We're not sure why and obviously those were two different studies. And it is going to have a lot of individual variation between the providers, the company that's providing you the CBD and between different people, and also just your level of hydration and other things may impact it. Maria points out a very good thing. There are a lot of scams out there, unfortunately. So it's important to get. If you're going to get CBD oil, it's important to get it from a reputable provider and make sure to do due diligence. Because even on things like sports supplements and over the counter supplements and herbs that people take, when there's been an investigation and people have gone in and really looked at the concentration of the supplements, a lot of times there are things in there that are not listed on the label and they're not as potent as they're supposed to be. It is important, once you find a supplier that you really like, then you can stick with them regardless of, you know, if they say there's 100 milligrams in it and it's actually 110 milligrams or whatever you'll find, or the person will find the level, the dose that works for them and they'll be able to stay at that. And generally the strength of the concoction stays the same within the same provider. Cannabidiol comes in oil, which is CBD oil, which is what we hear about most. It also comes in tincture, which is something that you can put drops under your tongue, you can vape it, it comes in capsules, it comes in topicals like creams, and it comes in suppositories. You can get cannabidiol any old way you want. And it is important, though, to recognize that there are probably different uses. Just like when you take other drugs, the method of administration also impacts the effect. So if you smoke it or vape it, you're probably going to get a quicker, more intense reaction that goes away faster. Whereas if you ingest it orally, it's going to be a slower, more gradiated effect. So, and Maria says there's already a pharmaceutical grade CBD out there specifically for people with seizures, which is really awesome. Cannabidiol is the non euphoric cannabinoid. THC is the cannabinoid which produces the euphoric effects, the endocannabinoid system. So all of the cannabinoids that are in there. But in our body, the endocannabinoid system is highly connected with sleep, inflammation levels, our mood via inflammation, but also the levels of serotonin, dopamine and glutamate, our sex hormones, especially estrogen and muscle coordination. Again, for women, when we're looking at the endocannabinoid system, the interaction of CBD with estrogen, especially estrogen dominance, the amount that or the dosage for a woman at certain times of the month may be different than at other times of the month. If you're taking, like we said earlier, if you're taking NSAIDs, you know, you wake up and oh, you overdid it at the gym and you take an anti inflammatory, then that's going to affect the dosing of the CBD oil. Now probably, you know, one NSAID or whatever is not going to have this huge life altering interaction with a small dose of CBD oil. That's probably going to be a decision. Obviously it's a decision between the patient and their doctor, but it's probably going to be relatively safer. We would see all these, you know, huge warning labels. Don't take this with any other supplement. However, it is important to recognize that it can impair the effectiveness of prescribed medications and over the counter things. Significant research has shown the benefits of cannabidiol for everything from anxiety to inflammation and even psychosis. Which bonus, it's important to note that CBD and THC can interact with most medications, so medical supervision is strongly advised. Natural methods to enhance the endocannabinoid system include ensuring that you're getting enough Omega 3s, taking curcumin, black and green tea, black pepper, cinnamon, kava, echinacea. There was a whole list of things that people can incorporate in a reasonably healthy diet. Remembering especially kava does interact with other medications and it does interact with your GABA receptors. That would be one that you wouldn't want to probably take CBD and kava at the same time without having medical supervision. Yeah, there is a lot of stuff out there that is confusing to deal with when, when you're talking about CBD oil, it sounds like a great option for people who are experiencing treatment resistant, whatever, treatment resistant depression, treatment resistant inflammation. Even some of the, what's the word I'm looking for, autoimmune diseases, since they involve inflammation, can be positively impacted. It won't correct it, but it can be positively impacted by CBD oil according to a lot of, lot of the studies out there. So this is an up and coming field and an up and coming area for people to learn more about. And let me show you really quick for those of you who haven't seen this before, If you go to PubMed, that's the easiest thing to remember and. Cannabidiol and you can look at using cannabidiol with epilepsy, cancer, pain, anxiety, depression, inflammation, it just keeps going on and on. But. Let's just look for psoriasis. So there's an article from 2007 that shows that cannabinoids actually do have a potential therapeutic value in the treatment of psoriasis. So bonus. Who knew? When you go here you can find these articles and these are all in peer reviewed journals so you can have some level of confidence that they're not overly biased. And you can read the information if you want to get the whole article. Not all of these have a whole article. If you don't have access to a university library then you can go here to pubmed and you go free full text and there's not any for psoriasis. Free full text. I usually say within the last five years on humans because I get tired of reading about rats. But there's 163 articles on the use of cadabidiol in the treatment of various disorders. You can obviously narrow it down some, some of these and I'll warn you, you have to be really careful because some of them are talking about cannabis and medical, medical marijuana, not just pure cbd. So you do need to read carefully. And here's one somebody asked about using it with adolescents. This is for treatment resistant epilepsy. Using cannabidiol in children and adults would be an interesting article to look at. I have heard CBD is good for pets. I have not looked at it. And impairment in driving it is not going to give you the euphoria. But CBD can be sedating. So just like any of those other things like your antihistamines that say use caution when driving, you'd want to use caution when driving with it. But PubMed is a virtual gold mine if you like reading through these. Okay, let's look at autism. I'm pretty sure there are see take out Free full text. Interesting. Nope, there haven't been any studies that have looked at it. Cannabidiol. I don't think dogs will show up in here, but. Okay, maybe, I mean, maybe I'd be wrong. It works for canine epilepsy. There are a lot of really interesting things that you can find here. You can also go to. Ocran database. And look for nabodiol. The Cochrane database gives you the quick and dirty summary of a lot of those articles in relation to other things. So you can search more specifically for cannabidiol and psoriasis or whatever, cannabis and schizophrenia, cannabinoids for the treatment of dementia ulcerative colitis. You can read about what the findings are and the Cochrane report will tell you pretty bluntly. Yeah, there's no research to support this. Or yeah, there's a fair amount. Here are the articles. So that's an interesting thing out there. I do encourage you if you are looking at articles on the Internet, just like with anything else, look at the research. If articles are cited in a blog post, great, go read the articles yourself just to make sure that you get the same interpretation from the article that the other person did. That being said, I really appreciate all of the discussion in here. I'm trying to see if I missed anything. If I missed something, please let me know and I will go back out to it. Okay, so Maria actually shared with us the link for the FDA approved drug for epilepsy, which is really awesome. Okay everybody, if there are no other questions, I will see you on Tuesday. Let's see. That would be such a blessing, Cheryl, if they did find something to help reduce the shaking in Parkinson's. I know that was the biggest thing that frustrated my grandfather so much because he used to make little dollhouse miniatures, the little furniture and at a certain point he just couldn't hold steady enough to work in that tiny environment anymore. And you know, he was, became very depressed. So if they can find a way to help people reduce the tremors from Parkinson's, that would be super duper awesome. And remember, it also helps with dyskinesia, which is can be a side effect from some of your older antipsychotics. Lots of, lots of interesting uses for it. Well, even if he had no shakes up until it wore off, at least there was a period where he wasn't shaking and he could do something which helps him, helped him have a richer, more meaningful life. We'll assume not just light a cigarette. All right everybody, have an amazing weekend and I will see you on Tuesday. If this podcast helps you help your clients or yourself, please support us by purchasing your ceus@allceus.com or getting your agency to sponsor an episode. A direct link to the on demand ceus for this podcast is@allce.com podcast ceus. That's allce.com podcastce. To sponsor an episode of Counselor Toolbox and reach over 50,000 clinicians per week, go to allce.com sponsor. Thank you.