Did you know that 67% of potential CBD users are still not sure what CBD is and its potential benefits?* At CBII, we're committed to providing education so we’ve joined forces with Dr Dilara Bahceci, our CBD expert in science and innovation from our exclusive partner Bod Australia to answer some burning questions around our powerhouse ingredient.

Dilara’s has a BSc in Neuroscience and her PhD level education and profession makes her a trusted source with a wealth of knowledge on CBD to help you understand what CBD is within the wellness and skincare space, how it works and why it’s a fast-growing category for wellness. 

Pick a topic below:

1. What are your most interesting facts about CBD?
2. What are the benefits of using the hemp plant to create wellness products?
3. Can you explain the entourage effect?
4. Can you explain the endocannabinoid system: how CBD works to support sleep and anxiety
5. What are your most frequently asked questions about CBD?
6. What are your thoughts on the future of CBD?
7. What are your thoughts on CBD for sleep? 

Dilara is a pharmacologist and neuroscientist and CBII's CBD expert in science and innovation. She received a PhD in pharmacology from the University of Sydney for preclinical research into the aetiological role and pharmaceutical potential of the endocannabinoid system in the holistic treatment of childhood epilepsies.

She has extensive expertise in the endocannabinoid system and pharmacology of medicinal cannabis (spanning from individual cannabinoids to full-spectrum extracts). Dilara now works as a science communicator and clinical research associate for Bod, CBII's exclusive partner, a cannabis-centric healthcare company, and the University of Sydney’s Lambert Initiative for Cannabinoid Therapeutics. She is passionate about making science accessible to everybody to help empower all minds.

CBII have been working in partnership with Bod Australia and Swiss CBD producer Linnea to create our gold standard extract of CBD since our launch in December 2019. We're committed to providing the highest quality CBD through scientific research and exclusively selected partners. As leaders in the medicinal cannabis space, Bod are able to share their expertise with us to bring safe and innovative CBD products to the UK consumer market. Through Dilara, we aim to provide some much-needed education on CBD to our consumers. 

Dilara: One of the reasons why I think CBD is so interesting, and so popular, is how biologically versatile and diverse it is. It seems to have little effect in some people and be life-changing for others.

CBD COULD BE THE KEY TO WELLNESS
CBD is a multimodal drug, meaning it can interact with many biological targets to have an effect. Structurally, CBD is this big, flexible molecule that can bend itself into different ‘keys’. These different CBD ‘keys’ can then interact with different biological targets that act as ‘locks’ for these keys. When these CBD ‘keys’ interact with biological ‘locks’, they can cause different actions or effects. CBD has been reported to have anti-seizure, analgesic, anti-anxiety, anti-inflammatory and anti-oxidant effects [1].

CBD FOR SLEEP, ANXIETY AND MORE
CBD’s therapeutic diversity is also reflected in the research, which shows that CBD is being used for an array of reasons. A couple of recent studies have provided insight into how CBD is being used in real-world settings.

A survey of a predominantly UK population (majority female and mostly 25-54 years old) revealed that the top four reasons for using CBD were for:

- Managing anxiety (42.6%)

- Sleep problems (42.5%)

- Stress (37%)

- General health and wellbeing (37%) [2]

Interestingly, the majority of respondents reported taking CBD orally and using less than 50 mg CBD daily. They reported that CBD made them feel calmer and more relaxed, less depressed, better focused and that it decreased their pain.

While another survey, this one of a predominantly French population (mostly male and mostly 28-44 years old), revealed that the top reasons for using CBD was for wellness (27%) and for managing health symptoms (25%).

Those who reported using CBD for wellness, reported using CBD to:

- reduce stress (63% of that group)
- improve sleep (60%)
- reduce anxiety/depression (43%)
- reduce pain or inflammation (41%)
- increase concentration (16%)
- headache relief (16%) [3]

CBD COULD BECOME MORE EFFECTIVE OVER TIME
Another interesting fact about CBD that people might not know is that CBD is a highly fatty compound that accumulates in fatty tissue, which can then be released gradually [4]. This could partly explain why it might take some time to feel CBD’s effects (days to weeks), and why it might become more effective over time.

CBD HAS A REPORTEDLY ‘PLEASANT’ FEELING
Also, some people think that CBD has no subjective or perceivable effects. But there are a couple of placebo-controlled studies where at high doses, participants could feel CBD’s effects and confidently separate the feeling from a placebo [5, 6].

The perceptual effects of CBD were described as pleasant and the subjects reported liking the way it felt.

Dilara: Hemp seems to be the plant that gives more than it takes. Hemp is relatively easy to grow, needing modest amounts of soil nutrients and water. Simultaneously, hemp regenerating the soil – some farmers will plant hemp in between harvests to improve soil health and as a composting biomass, feed nutrients back into the soil. Additionally, most hemp varieties are naturally resistant to insect pests and predators, reducing the need for pesticides.

Speaking of versatility – hemp is a very versatile plant, being repurposed into a diverse range of goods. Hemp is the source of highly nutritious foods (such as high-protein hemp foods and meat alternatives, and hemp seed oil), gentle personal hygiene products, textiles, building materials and it is even being explored as a cleaner fuel source. Not to mention the medicinal and health benefits of hemp-based supplements.

On top of all of that, hemp is also good for the environment (when grown outdoors). It captures carbon dioxide from the atmosphere and is a great supporting plant for bee and pollinator populations – apparently bees love hemp too!

The entourage effect is the concept that the whole plant works better than individual compounds isolated from the plant. For example, eating an orange might be considered a better option than taking just vitamin C.

Dilara: With hemp, this concept has emerged due to people reporting better effects with whole-plant extracts compared to purified isolates, for example with treatment-resistant epilepsy [7]. The entourage effect is also supported by whole plant extracts performing better than individual cannabinoids at activating receptors (biological locks) [8], activating neurons [9] and reducing seizures in an animal model [10].

The hemp plant contains hundreds of compounds – including biologically-active cannabinoids, terpenes and flavonoids – and there is some argument that these compounds might support each other and work better together.

One explanation for why cannabinoids work better in combination than individually is that taking some cannabinoids in combination alters how they are absorbed and metabolised – allowing the cannabinoids to have stronger and longer-lasting effects [11, 12]. However, it should also be noted that some combinations can block each other’s absorption.

Another reason for whole plant extracts having superior effects to isolates could be due to the different hemp constituents, especially the cannabinoids, having different biological targets and potentially complimentary effects. That is, taking a whole plant extract, and cannabinoids in concert can cover a larger array of systems, which can be like creating a therapeutic symphony instead of playing just a melody.

Dilara: Did you know that your body makes its own cannabinoids? They are called endocannabinoids!

The endocannabinoid system (ECS) is present all throughout your body and functions to maintain biological balance or harmony, also known as homeostasis.

An example of homeostasis is the maintenance of internal body temperature between a narrow range. If your body temperature gets too hot, you sweat to cool down, or if you are too cold, you shiver to warm up.

Your ECS started supporting you when you were in the womb (as it essential for development) and keeps supporting you all throughout your life by regulating many different functions, including memory, mood, pain, sleep, stress, appetite, inflammation, immunity and metabolism [13].

When your physiological systems skews too far in one direction, your endocannabinoid system kicks into action to pull it back into sync – working like auto-tune – to reinstate harmony.

The ECS is made up of chemical messengers called endocannabinoids – the ‘keys’ – and cannabinoid receptors – the ‘locks’. CBD can support the endocannabinoid system by interacting with cannabinoid receptors and by increasing endocannabinoid levels [14].

Dilara: The question I get asked most often is “Which CBD product or brand should I get?”

Not all CBD products are created equal. CBD products can vary in quality, efficacy and even safety.

In a study of CBD products in the UK, only 38% of products tested contained CBD that matched what was on the label. To make sure you’re buying a quality CBD oil, make sure to look out for independent testing certificates that verify the amount of CBD in the product, such as CBII with its third party testing. 

People should look for a product that’s made with high-quality ingredients, produced well and consistent. If possible, select products that are backed by research. Additionally, look out for products that cater to what’s important for you. For example, you can find products that are:

Vegan: Would you prefer a vegan CBD product?
Allergen specific: CBD can be dissolved in different carrier oils, like medium-chain triglyceride (MCT) oil, hemp seed oil or sesame oil. Make sure the carrier oil is not something you’re allergic to.
Natural vs synthetic: Was the CBD naturally sourced (extracted from a plant), or synthetically made?
Organic: Is it important to you for your CBD oil to be extracted from non-GMO, organically grown hemp that is free from pesticides?
Ethical: Was the CBD product ethically produced?
Environmentally friendly: How environmentally friendly is the CBD product?

Dilara: Innovation is going to be the key driving force forward, which Bod and CBII are already at the forefront of. Interesting advances in new ways to take CBD and better formulations that will improve bioavailability are currently being developed. I’m personally excited to see more CBD skincare.

There are many people who want to try CBD but aren’t clear on how to select the best product for them. As the research and technologies advance, our understanding of how to best use CBD will grow with it. Wider acceptance of CBD has previously been limited by problems with product quality, inconsistency, and regulation. But the industry is evolving beyond these issues and it’s predicted that CBD will become much more accessible, better understood and more widely used.

As the evidence grows, we’ll have a better understanding of where CBD can be helpful and indications for its use will expand.

I’m interested in following the research on CBD for mental health, women’s health, and arthritis.

I think we’ll also see the emergence of other cannabinoids, which creates exciting new landscapes to explore. Bod has already started research into the next hot cannabinoid, CBG.

Dilara: Sleep disorders, like insomnia, are highly prevalent, with up to one-third of the world’s population reporting dissatisfaction with their sleep [15]. Interestingly, insomnia is more prevalent amongst the elderly and women, with 50% of older adults reporting sleep disturbances and women being twice as likely to have insomnia than men [16].

Treatments for insomnia aim to improve both quality of sleep, to reduce the impact of poor sleep and to improve daytime function (reduce drowsiness). While sleep-aid medications are available (like benzodiazepines, antihistamine drugs and some antidepressants) they can have unwanted adverse effects [17, 18]. There’s a need for novel insomnia treatment options that are safe, that work well, and have less side-effects.

Regarding the scientific evidence to support CBD for sleep, the studies needed to understand how CBD impacts insomnia have surprisingly not been conducted yet. But Bod has teamed up with some of Australia’s top sleep researchers from the Woolcock Research Institute to conduct the high-quality clinical research required to get answers to these important questions.

The preliminary and anecdotal evidence on CBD for sleep health is promising.

There are multiple reports of unexpected improvements in sleep when CBD was being investigated for other indications. Improvements in reports of sleep quality measures after using CBD were observed in patients with Parkinson's disease [19], epilepsy [20, 21] and autism spectrum disorder [22]. There are also case reports of improved insomnia symptoms in people with anxiety disorders or insomnia [23-25].

Anecdotally, a series of surveys on the use of CBD report a high prevalence of participants reporting CBD to help manage sleep issues amongst generally healthy people [2, 3, 26], athletes [27], people with fibromyalgia [28] and people with spine complaints [29].

For example, this figure shows the perceived effects of CBD from 522 participants who answered the question on CBD for sleep [2]. Participants were allowed to select multiple options.

There’s also emerging evidence to support CBD’s anti-anxiety and antidepressant properties in humans [30, 31]. Given that stress and mental health symptoms are common with insomnia disorders [32-34], it’s hypothesised that CBD may be able to improve both sleep and mental health symptoms, maybe in a bidirectional manner.

Furthermore, the endocannabinoid system is known to regulate the circadian sleep-wake cycle, including the maintenance and promotion of sleep [35, 36]. Interestingly, sleep deprivation causes dysregulation of endocannabinoid levels, while recovering from disturbed sleep involves upregulation of the ECS [36].

As CBD is a modulator of the endocannabinoid system, and other sleep-related targets, it has emerged as an interesting candidate to explore for improving sleep. If you’re taking other medications, it’s important to discuss CBD treatment with your doctor or pharmacist as CBD can interact with other medications [37]. But depending on your situation, CBD could be a safer alternative to other available sleep aids that has the potential for substantial benefits.

References

 *Prohibition Partners, CBD - The Consumer Report 2020

1. de Almeida, D.L. and L.A. Devi, Diversity of molecular targets and signaling pathways for CBD. Pharmacology Research & Perspectives, 2020. 8(6): p. e00682.
2. Moltke, J. and C. Hindocha, Reasons for cannabidiol use: a cross-sectional study of CBD users, focusing on self-perceived stress, anxiety, and sleep problems. J Cannabis Res, 2021. 3(1): p. 5.
3. Fortin, D., et al., Reasons for using cannabidiol: a cross-sectional study of French cannabidiol users. Journal of Cannabis Research, 2021. 3(1): p. 46.  (accessed 28/10/21)
4. Millar, S.A., et al., A Systematic Review on the Pharmacokinetics of Cannabidiol in Humans. Front Pharmacol, 2018. 9: p. 1365.
5. Spindle, T.R., et al., Pharmacodynamic effects of vaporized and oral cannabidiol (CBD) and vaporized CBD-dominant cannabis in infrequent cannabis users. Drug Alcohol Depend, 2020. 211: p. 107937.
6. Morgan, C.J., et al., Cannabidiol reduces cigarette consumption in tobacco smokers: preliminary findings. Addict Behav, 2013. 38(9): p. 2433-6.
7. Pamplona, F.A., L.R. da Silva, and A.C. Coan, Potential Clinical Benefits of CBD-Rich Cannabis Extracts Over Purified CBD in Treatment-Resistant Epilepsy: Observational Data Meta-analysis. Front Neurol, 2018. 9: p. 759.
8. De Petrocellis, L., et al., Effects of cannabinoids and cannabinoid-enriched Cannabis extracts on TRP channels and endocannabinoid metabolic enzymes. Br J Pharmacol, 2011. 163(7): p. 1479-94.
9. Ryan, D., et al., Differential effects of cannabis extracts and pure plant cannabinoids on hippocampal neurones and glia. Neurosci Lett, 2006. 408(3): p. 236-41.
10. Hill, T.D., et al., Cannabidivarin-rich cannabis extracts are anticonvulsant in mouse and rat via a CB1 receptor-independent mechanism. Br J Pharmacol, 2013. 170(3): p. 679-92.
11. Hložek, T., et al., Pharmacokinetic and behavioural profile of THC, CBD, and THC+CBD combination after pulmonary, oral, and subcutaneous administration in rats and confirmation of conversion in vivo of CBD to THC. Eur Neuropsychopharmacol, 2017. 27(12): p. 1223-1237.
12. Anderson, L.L., et al., Cannabis constituents interact at the drug efflux pump BCRP to markedly increase plasma cannabidiolic acid concentrations. Sci Rep, 2021. 11(1): p. 14948.
13. Lu, H.C. and K. Mackie, Review of the Endocannabinoid System. Biol Psychiatry Cogn Neurosci Neuroimaging, 2021. 6(6): p. 607-615.
14. Britch, S.C., S. Babalonis, and S.L. Walsh, Cannabidiol: pharmacology and therapeutic targets. Psychopharmacology (Berl), 2021. 238(1): p. 9-28.
15. Sake, F.T., et al.,, Insomnia Management in the Australian Primary Care Setting. . Behav Sleep Med, , 2019. 17(1): p. 19-30.
16. Momin, R.R. and K. Ketvertis, Short Term Insomnia, in StatPearls. 2021, StatPearls Publishing

Copyright © 2021, StatPearls Publishing LLC.: Treasure Island (FL).

17. Riemann, D., et al., European guideline for the diagnosis and treatment of insomnia. J Sleep Res, 2017. 26(6): p. 675-700.
18. Buysse, D.J., Insomnia. Jama, 2013. 309(7): p. 706-16.
de Almeida, C.M.O., et al., Cannabidiol for Rapid Eye Movement Sleep Behavior Disorder. Mov Disord, 2021. 36(7): p. 1711-1715.
20. Tzadok, M., et al., CBD-enriched medical cannabis for intractable pediatric epilepsy: The current Israeli experience. Seizure, 2016. 35: p. 41-4.
21. Anderson, C.L., et al., Seizure frequency, quality of life, behavior, cognition, and sleep in pediatric patients enrolled in a prospective, open-label clinical study with cannabidiol. Epilepsy Behav, 2021. 124: p. 108325.
22. Fleury-Teixeira, P., et al., Effects of CBD-Enriched Cannabis sativa Extract on Autism Spectrum Disorder Symptoms: An Observational Study of 18 Participants Undergoing Compassionate Use. Frontiers in Neurology, 2019. 10(1145).
23. Shannon, S., et al., Cannabidiol in Anxiety and Sleep: A Large Case Series. Perm J, 2019. 23: p. 18-041.
24. Shannon, S. and J. Opila-Lehman, Effectiveness of Cannabidiol Oil for Pediatric Anxiety and Insomnia as Part of Posttraumatic Stress Disorder: A Case Report. Perm J, 2016. 20(4): p. 16-005.
25. Berger, M., E. Li, and G.P. Amminger, Treatment of social anxiety disorder and attenuated psychotic symptoms with cannabidiol. BMJ Case Rep, 2020. 13(10).
26. Corroon, J. and J.A. Phillips, A Cross-Sectional Study of Cannabidiol Users. Cannabis and Cannabinoid Research, 2018. 3(1): p. 152-161.
27. Kasper, A.M., et al., High Prevalence of Cannabidiol Use Within Male Professional Rugby Union and League Players: A Quest for Pain Relief and Enhanced Recovery. Int J Sport Nutr Exerc Metab, 2020. 30(5): p. 315-322.
28. Boehnke, K.F., et al., Cannabidiol Use for Fibromyalgia: Prevalence of Use and Perceptions of Effectiveness in a Large Online Survey. J Pain, 2021. 22(5): p. 556-566.
29. Lovecchio, F., et al., Prevalence of Cannabidiol Use in Patients With Spine Complaints: Results of an Anonymous Survey. Int J Spine Surg, 2021. 15(4): p. 663-668.
30. Schiavon, A.P., Bonato, J. M., Milani, H., Guimarães, F. S. & de Oliveira, R. M. W. . Influence of single and repeated cannabidiol administration on emotional behavior and markers of cell proliferation and neurogenesis in non-stressed mice. Progress in Neuro-Phychopharmacology and Biological Psychiatry, 2016: p. 64, 27-34.
31. Larsen, C. and J. Shahinas, Dosage, Efficacy and Safety of Cannabidiol Administration in Adults: A Systematic Review of Human Trials. J Clin Med Res, 2020. 12(3): p. 129-141.
32. Hall, M.e.a., Symptoms of stress and depression as correlates of sleep in primary insomnia. . Psychosomatic medicine 2000: p. 62, 227-230
33. Neckelmann, D., Mykletun, A. & Dahl, A. A., Chronic insomnia as a risk factor for developing anxiety and depression. . Sleep 2007: p. 30, 873-880
34. Spira, A.P.e.a., Subclinical anxiety symptoms, sleep, and daytime dysfunction in older adults with primary insomnia. . Journal of geriatric psychiatry and neurology 2008: p. 21, 149-153
35. Sanford, A.E., Castillo, E. & Gannon, R. L., Cannabinoids and hamster circadian activity rhythms. Brain research 2008: p. 1222, 141-148
36. Vaughn, L.K.e.a., Endocannabinoid signalling: has it got rhythm? . British journal of pharmacology, 2010: p. 160, 530-543
37. Balachandran, P., M. Elsohly, and K.P. Hill, Cannabidiol Interactions with Medications, Illicit Substances, and Alcohol: a Comprehensive Review. J Gen Intern Med, 2021.