Why All The Hype About CBD?

A lot of media attention has exploded about CBD or cannabidiol in the last few years.  Touted as a cure-all for almost anything from seizures to anxiety to pain relief and even as a treatment for cancer, what is the real story behind CBD and why is it so popular? Read on to find out the scoop…

PS — Scroll down to “What’s My Take on CBD” if you want to skip the science and research mumbo jumbo.

What Is CBD Anyway and Is It Legal?

Hemp and marijuana have been used as medicinal herbs for thousands of years.  In the United States, until the late 1930s, many people, including physicians, grew their own herbs for medicinal purposes.   The story behind WHY Hemp and Marijuana fell out of the government’s favor is a bit murky.  I’ll go into it another time if (I should say “when”) I get around to writing Part 2.  I like to keep my options open and my throngs of readers excited. And for clarity, a throng can be made up of three or more people.  One of which is my Mom.   But back to CBD…

CBD is the second main active ingredient in marijuana.  While it is an essential component of medical marijuana, it also comes from hemp, a cousin of the marijuana plant. Although the government’s position on CBD is confusing, the bottom line is if it comes from hemp (which IS legal) and there is no discernible THC or Tetrahydrocannabinol in the formulation, then you are A-Okay.  Unlike the main psychoactive (“high” producing) compound THC, CBD doesn’t produce a high or euphoric feeling.

The Science Behind CBD and What It Can Do

CBD works on specific cell receptors in the body called CB1 (found on brain cells) and CB2 (found mainly in the body and the body’s immune cells).  Most of the research on CBD has been done in animal models or in cell culture.   Below I summarize some of the benefits reported by these research studies.

• anti-seizure activity
• anti-oxidant effects
• neuroprotection (think conditions like dementia, Alzheimer’s, Parkinson’s, MS)
• anti-inflammatory benefits
• pain relief
• anti-anxiety properties
• anti-tumor activity
• anti-psychotic properties

Although benefits in humans have been found in some small clinical trials, the work is very preliminary. There are multiple clinical trials currently underway to test the true benefit in humans.

What Do The Human Studies Say?

• Epilepsy — small trials have shown overall improvement in seizure frequency.
• Parkinson’s — a recent small trial in Parkinson’s patients found CBD improved quality of life scores
• Pain Reduction — harder to tease out the benefit on pain control from THC vs CBD.  Animal studies show improvements in both pain and inflammation.
• Anti-tumor effects — research does support improvements in pain, nausea and increasing appetite in patients with cancer but anti-tumor data is only in cell culture.  Clinical trials underway.
• Anti-psychotic effects — CBD has been reported to reduce symptoms in psychotic patients, according to a small clinical trial in patients treated with CBD.  There is some evidence that CBD can reduce psychosis in Parkinson’s patients and a small trial reported improvements in schizophrenic patients.
• Anti-anxiety — A lot of benefit has been noted in animal models in terms of reducing psychological and physical measures of stress and anxiety.  Some small human trials have also shown anxiety reduction.   Also it’s helpful in reducing social anxiety related to public speaking.  Feel free to give it to your pets who are going to be giving lectures or presentations — LOTS of data for those lucky bastards.

What’s The Safety Of CBD And Are There Any Precautions?

I have been using CBD in my practice over the last two years and have found it to be extremely safe with minimal to no side effects.

A review of 25 studies on safety and efficacy did not reveal significant side effects across a wide range of doses.  It is well tolerated in humans with doses up to 600mg daily.  By the way, I’m not suggesting anyone take 600mg, but in a controlled setting, it didn’t harm anyone.  Your mileage may vary.

Side effects — MAY include nausea, fatigue and irritability. May actually cause sleep issues.

Drug interactions — Oral forms of CBD MAY increase the level of a blood thinning drug called coumadin however it can be used if appropriately medically supervised.  It may effect the metabolism of certain anti-seizure drugs.  Generally use caution if on other medications, particularly blood thinners and anti-seizure meds.

Dosing — We don’t know the most effective therapeutic dose of CBD for any particular medical condition.  There is a lot of trial and error here and dosing varies between different preparations but the range of effective dosing could be as little as 5-10mg of actual CBD content up to 150 mg or more daily.  Work with a practitioner to find the right dose.

Will it trigger a drug test to be positive — the short answer is, it depends.  If you are doing a cheap urine toxicology screen, it MAY possibly trigger a positive reading, though even that is unlikely.  However on higher quality, more exact serum testing, your test should come out negative.  Have your doctor write a letter should a cheap urine test come back positive.  Now, this will NOT get you out of a THC issue.  So if you are using THAT, you are on your own.

What’s My Take on CBD And How I Use It In My Practice?

In clinical practice, you learn from your patients.  I started recommending CBD as a non-addictive sleep aide alternative.  Sleep problems are huge in my practice and there are a lot of downsides to using prescription drugs long term for sleep.

Prescription sleep aids are often addictive, can create withdrawal symptoms when not consistently used, have been associated with hallucinations, sleep walking (sleep driving) and when used long term, can increase your risk of dementia.  So….THAT isn’t sexy.  

I thought that CBD might be a good choice for sleep as it is not habit forming, it creates no withdrawal and it had significant anti-anxiety properties in animal studies. Well, for many patients CBD was very helpful for sleep, but they also noticed it improved their anxiety, their pain and other issues.  Here are some exchanges I had with my patients…..

Patient: “Hey Doc.  Is this CBD stuff supposed to help me with anxiety?”

Me: “Well yes it can…”

Patient: “Yeah, I’ve noticed my anxiety is a lot better.  Can I USE it for anxiety?”

Me: “Well, sure you can”

Patient: “Hey Doc, I noticed that my back pain is a lot better when I take CBD and I don’t need as much pain medication.”

Me: “You take pain medication?”

Patient: “Yeah, my back doctor gave me a script two weeks ago, but it makes me woozy.  Can I take the CBD instead?”

Me: “Well, yes, you can”

Patient: “Hey Doc.  Does CBD help with eczema?”

Me: (Here’s where I wised up..) ” It absolutely does, and you can continue to take it for that.”

Patient: “Thanks Doc. You’re the best!”  (Disclosure: I may have added that “you’re the best” sentence myself)

The point is, I kept getting feedback about how it was helpful for a lot of different issues in different patients.

Now, to be clear, it doesn’t help everyone.

I have plenty of patients who did not notice any benefit in sleep or anxiety or anything else.  Partly I think some weren’t willing to give it a chance and play around with the dosing to see what it COULD do. But for some it had no benefit.  Only a few patients had negative reactions like being kept awake at night or feeling funky on it.

Closing Thoughts and Summary

• In my practice I find CBD is useful for sleep, pain reduction, anxiety, libido, and various inflammatory conditions. And yes, I said libido.  More about that in Part 2.
• I use it in patients with autoimmune issues to see if it reduces pain and inflammation or whenever I suspect an imbalanced immune problem.  I think of CBD as immune-modulating.  This is the goldilocks phenomenon for immune system balance — not too much (as can occur with autoimmune disease, allergies and asthma) and not too little (as can be the case with constant infections and even risk for cancer).
• It has a broad safety profile but may interact with some prescription drugs.
• It may not work for everyone.
• CBD is the wild west right now.  Everyone and their mother is making it, selling it, using it, buying it and promoting it.  Not all CBD is created equal.   Here are my recommendations:
  • Beware of your source:
    • A survey conducted by the FDA in 2016 showed that 91% of products do not match packaging.
    • A study by JAMA showed that 71% of the time what was in CBD products analyzed did not match the label.
  • Ask for a certificate of analysis (COA) from the manufacturer and confirm that this process is done by a 3rd party.   More about this in Part 2.
• Working with a practitioner who has experience using it is best with regard to deciding if it’s worth trying for whatever your issue is and to help you figure out the right dosing.  Please don’t rely on a dispensary vendor for medical advise if you have access to that.  But in general, as long as you aren’t using a product that is crappy, there isn’t a ton of downside.
• Please don’t use CBD in place of standard medical therapy without direct supervision.  Clinical trials are underway for CBD’s role in more serious, chronic conditions.  Until that time, I would avoid just jumping in without using proper precautions.  Speak with your provider.

 

10 Things Happy People Have In Common

Ever wonder what makes Happy people Happy???  Ever open a newspaper? Or listen to the news? or your neighbors?  Who can be happy when there is just so much to be unhappy about?  As you have guessed, I’m not only the member of the happy club, I’m the President!!!

Some interesting facts about Happiness

Everyone wants to be happy. Except my mailman.  He wants to be irritated. I can’t help that Amazon delivers 40 packages to my house every day.  My family has needs.  And I try to ignore them by shopping on Amazon.  But, back to happiness…

Some could argue that everything we do, going to work, getting married, having kids, exercising, and buying stuff (and lots of it) we do in order to feel happier. But apparently we have been barking up the wrong happiness tree.

These things don’t change our level of happiness in a sustained way. Why is that? Because we have something called our Baseline happiness.  This is our personal level of “baseline” long term happiness.  There can be good days (like getting a raise) or bad days (failed your driver’s test) but apparently, our daily happiness levels pretty much hover around our baseline happiness.

Why is that?  Let’s look at the three components of happiness.

• Set point of happiness — our genetic predisposition for being happy. You may be all zen by nature or a Debbie Downer by nature.  But the good (or bad) news is this only makes up 50% of the happiness equation.  You can change your set point.
• External conditions — things like money, status, jobs, cars, beautiful homes and other external factors we seek out to get happy don’t really do much for happiness.  One study compared the happiness of people on the Forbes’ list of wealthiest Americans to the general population.  They found that most were slightly happier than average, but almost 40% of them were less happy than the average American.  These external forces impact your happiness by say 10%.
• Actions and thoughts — if you want to change your happiness baseline then you have to change you thoughts and your actions.  This impacts about 40% of your baseline happiness.  So this is what you DO have control over.

Before we get into the 10 things happy people seem to have in common, let’s cover the basics.  How do we change the 40% mark?  

Change Your Thoughts

• Be Grateful — Write down 3 things you are grateful for each night.  Gratitude reminders really help put things in perspective.
• Forgive yourself and others — Why dwell on your past failures and missteps.  Why put energy into being angry with other people.  It isn’t worth it and messes up your baseline happiness.  It’s like a C plus baseline happiness grade.  No Bueno.
• Meditate— There it is again. The old meditation recommendation.  Shown to increase happiness, mental acuity, improve health, reduce stress and is quite slimming.
• Pursue some goals — Most people feel energized and excited by working toward a desired goal.  Try it out.  My goal this week is to brush my teeth every night.  It’s been a rough month. This I believe will make other people VERY happy.

Change Your Actions

This is where we look at what happy people DO to be happy.

Here are 10 things happy people seem to have in common.

1. They have great relationships — not necessarily only romantic ones, but their social connections are solid and they feel supported.  Research continues to show that being socially connected reduces risks of depression, mortality from all causes and feelings of social isolation. Even interactions with casual friends, especially if they are happy, can have a powerful effect on your own happiness.

Action Step: Find a hobby and join a group doing that hobby.  Ballroom dancing? Jogging club? Mahjong?  Book club?  I draw the line at bird watching. Absolutely not. Find a group with people who share your interest and join up.

2. They have more time on their hands — Time beats money hands down.  Studies indicate that happier people prefer having more time and less money if they had to choose.  Why is this? Because money doesn’t buy happiness.  But spending time doing things that are meaningful to you does.

Action step: Find time in your schedule.  Like, right now.  Schedule an activity or perhaps a non-activity you wish to do this week.  Schedule a foot rub.  Or a tea with a friend.  Find a class you want to take.  Call an old friend and shoot the breeze.  Or just walk in the woods.  Do something that is not a chore or on a to-do list. But make it happen. Prioritize your time like you would any appointment.

3. They practice staying in the moment.  Studies show that people who practice mindfulness meditation have a greater sense of well-being.

Action Step: Remember all those meditation apps?  Get cracking. Yoga much? Get on it.  Like to pray? Go for it.

4. They choose fun over material things.   They spend money on experiences instead of another handbag or pair of shoes.  Researchers say that buying things that allow you to have the experiences you wish to have (like a new book to read or ski boots for your ski trip) can increase happiness.  Spending money on a trip or vacation creates memories and creates happiness both in anticipation of that trip and afterwards as well.

Action Step: Thinking about a weekend in the country? Book it now.  A trip to Europe? Start researching and asking friends about their trips.  Want to learn how to skate? Get some lessons.  Want to improve your tennis game? Well, you’re out of luck there.  Kidding! Take a lesson or clinic–you can always dream….

5. They exercise and sweat. Studies show that staying physically active is associated with increased feeling of happiness.  It also can reduce depression, anxiety, sleep issues and PMS symptoms.  Win win!

Action Step: Get your groove on.  Doing exercise doesn’t have to be a chore.  Play a sport? Join a team or take some lessons.  Like to dance?  Find a class or get some friends to go out dancing or find follow along videos on youtube.  Want to be more social? Join a gym with a lot of fitness classes.  Like the outdoors? Try biking, jogging, walking the dog or walking yourself.  Just pick something you like. I like to “exercise” my choice to not exercise.    And I think it still counts because I used the WORD “exercise” twice in one sentence.  So….yeah.

6. They are kind and generous with their time.  People who perform acts of kindness (like giving someone a ride, volunteering somewhere, or buying other people gifts) report being happier than those who don’t.

Action Step: Do something nice for someone else.  Even if they don’t know it.   Offer to babysit for a friend’s kid.  Give your time to a favorite charity or organization.  Have a skill that is unique? Give a local lecture about it.  Pay for the guy’s coffee in line behind you at Starbucks.  It feels great to make someone else’s day!

7. They stop to “smell the roses” — We all have friends that notice things that sometimes the rest of us are too busy to appreciate.  Like, seeing a beautiful yellow full moon.  Or noticing icicles hanging off of trees after a winter storm.  Or savoring every bite of dessert (personally, I hate when people do that—just ram it down your throat in one bite like a normal person).   But, the point is, they slow down to reflect on the good things in life.

Action Step:  Take the time to enjoy your morning cup of coffee. Instead of walking your dog while checking out facebook, notice what is going on around you on your walk.  Stop multi-tasking with whatever you are doing.  There is an exercise about eating a raisin that Jon Kabat-Zinn uses in his workshops to help teach mindfulness.  The point of the exercise is to really look, feel, smell and then taste the raisin noticing every aspect of it’s nature.   If you hate raisins, swap it out for a lamb chop.  It only works with those 2 foods.  Don’t shoot the messenger.

8. They have enough money.  So, tons of money is nice.  But studies show that beyond a certain point, it doesn’t make you significantly happier.  I would like to test that theory out by the way if anyone wants to fund that study for me.  The magic number seems to be an annual salary of about $75,000.  Obviously this number varies depending on your cost of living. But it seems to be pretty consistent in the US and Europe.

Action Step: Money can buy you happiness…..if you spend it on someone else.  The research shows that giving to others brings you more happiness in the long run.  On an unrelated note, I’m generally free for lunch on Tuesdays and I wear a size 7 Jimmy Choo.

(For the record, I don’t wear Jimmy Choo’s as they are not orthotic friendly nor do they accommodate bunions.)

9. They Get Plenty of Sleep.  The research shows that cutting down on sleep puts you in a bad mood, reduces your focus, worsens memory and decreases your physical and mental performance.

Action Step: Go to bed.  Not at midnight or 1 AM, Bedtime is 8 hours before you need to get out of bed.  Do the math.

10. They like to laugh a lot.  There’s a pretty significant connection between what happens in your body physically and what your mental state is like and vice versa.  Laughing, smiling, singing — this tells your brain that your are happy.  Likewise, having a calm, peaceful attitude can reduce the level of physical pain an individual experiences.

Action Step:

• Check out a comedy show (check netflix).  I’m a fan of Sebastian Maniscalco, Martin Short’s Jiminy Glick and Jerry Seinfeld.  In fact, Jiminy Glick interviewing Jerry Seinfeld is great.  Or maybe you are more of an Ellen Degeneres fan.   Or maybe you like one of the more humorous Late Night Talk Show Host Shows.  I’m in bed then so…..you are on your own there.
• Actually go see a comedian you enjoy.
• See a funny movie.  Not sure what floats your boat, but I for one find The Big Lebowski with Jeff Bridges and John Goodman hilarious.  Genius I tell you.  It’s WAY out there, but a classic.
• Hang out with people that can make you laugh.
• Check out some jokes online.  Google “funniest texts” — some are beyond HILARIOUS.  Not ALL of them, but the ones that work.  Crying…
• Also, youtube people falling on ice.  Always delivers.  Wait.  I might have a problem…..

Okay, Go Forth and Be 40% HAPPIER.  Check out the 10% happier meditation website for for some interesting happiness info and check out their app!

Please Share the Health if you liked what you read!!!

For more information about my wellness programs and my practice, check out my website drsadaty.com. Hey Look! You are already here…

Ready for the legal disclaimer? Information offered here is for educational purposes only and does not constitute medical advice. As with any health recommendations, please contact your doctor to be sure any changes you wish to consider are safe for you!