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CBD – gospel or gimmick?

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I’ve seen a barrage of patients lately using CBD, or cannabidiol, for anxiety symptoms or as a sleep aid. Let me add here that these are NOT pregnant patients, and skip to the bottom if you want to see why you shouldn’t be using CBD while pregnant or breastfeeding. Simultaneously I started seeing CBD in clean beauty shops and in a ton of health care and skin care blogs. You may be thinking, isn’t it just marijuana?

Yes … sort of.

Cannabinoids are the major active constituents of the Cannabis plant. More than 100 are known to scientists, but the two most recognized are the psychoactive THC (tetrahydrocannabinol) and CBD (cannabidiol). THC is the regulated form of cannabis because of its psychoactive properties (don’t give me a hard time here … you know what those properties are).

So that leaves us with CBD. CBD is the ingredient you’ll see in over the counter health care / skin care. Its star is on the rise because of its well documented (scientifically studied / demonstrated) anti-inflammatory, analgesic (pain control), and anxiolytic (anti-anxiety) effects.

But these studies are for CBD taken orally, in pill or liquid form, where it can be absorbed into the bloodstream and levels measured. In these formulations, CBD has been shown to decrease both social and acute situational anxiety and promote longer sleep in insomniacs. In higher doses it has a sedative effect. In smaller doses, studied subjects described feeling more clear minded / quick-witted / alert.

The average dose studied to achieve these beneficial effects? Anywhere between 300-600mg of CBD. The low dose used to initiate the alerting properties was anywhere from 15mg to 1mg / kg (ie 60kg person would take 60mg).

What about topical CBD, which is what I’m seeing pop up all over the place? CBD applied to the skin does NOT cross into the bloodstream. In my deep dive into the medical literature here I did find a patent for a transdermal patch that will allow CBD to reach the blood stream. Clearly this is not what is sold over the counter in a high end clean beauty store.

Topical CBD is less studied, and let me tell you, I’ve spent a good few hours these last few nights scouring through the medical literature – both because I love a good scavenger hunt and because I wanted to find something sturdy to stand on. It seems to have well documented anti-acne and anti-bacterial properties, although the dose needed to elicit these effects isn’t clear. There seems to be some anti-inflammatory properties as well. In a rat study, skin application helped ease arthritis pain. Yes, you read that correctly. That was in a rat. The implication here being topical application may help with localized pain and inflammation. Topical application may be able to promote those anti-inflammatory, analgesic (pain control), and anxiolytic (anti-anxiety) effects to the area it’s applied without absorption into the bloodstream. I think we’ll be seeing an increasing number of studies on topical CBD, but at this point the effects seem more pseudo-science that scientific fact.

And how does this all apply to our lady parts and obstetrics and gynecology?

For pregnant and breastfeeding women, I’ve already written about the reasons to not use marijuana.  In short, THC crosses the placenta and breastmilk, which means CBD should as well. Even with these nice benefits of CBD in adults, babies don’t need messing with their neurotransmitters. So please, stay clear.

For gynecology patients, I personally haven’t seen any CBD products specific to pelvic health, but it’s just a matter of time before these products pop up (CBD balm for vulvar irritation? You heard if here first folks!).

If you’re looking for me, I’ll be in my kitchen formulating Vagaweed ™.

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March 1, 2018

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