Therapeutic Benefits Of CBD

Overview of CBD

The therapeutic use of cannabidiol (CBD) has been gaining attention because of its promising potential benefits for various conditions. CBD is a substance naturally found in Cannabis sativa or hemp, which is non-psychoactive, unlike tetrahydrocannabinol (THC), which can be addictive.¹ CBD’s popularity is driven by its potential therapeutic benefits and relative safety exhibited in various animal and experimental studies. Ongoing research continues to uncover its mechanisms of action and its effects on humans.

Mechanisms of action

Endocannabinoid system (ECS)

The endocannabinoid system is a neuromodulatory system, meaning that it uses chemical substances from one or more neurons to modulate within the diverse neuronal population of the nervous system. The ECS controls emotion, cognition, sleep, appetite and motivation.² The benefits of regulating this system may emerge with therapeutic potential in various diseases.

CB1 and CB2 receptors

There are two main cell membrane receptors for cannabinoids like CBD- the CB1 and CB2 receptors:^3,4

• The CB1 receptors condense in the brain or central nervous system² and are less expressed in peripheral tissues such as the liver, fat or muscle tissue. CB1 receptors are related to a wide range of functions including:
  • Cognition 
  • Memory 
  • Mood 
  • Appetite 
  • Sensory responses
• The CB2 receptors are mainly found in the immune system and some organs 

Function

Endocannabinoids are chemical substances binding to CB1 receptors on neurons. They modulate neurons to release neurotransmitters, leading to signalling to promote activity across cognitive, emotive, and sensory functions.⁴

CBD is a substance found in cannabis and can act as an inhibitor against endocannabinoid signalling. If this signalling is activated too much, it leads to increased dopamine activity, causing drug abuse. Therefore, CBD has a promising effect in treating substance use disorder.⁴

Other biological pathways

TRPV1 receptors

The TRPV1 receptor is a key receptor associated with pain-signalling. After tissue damage or any stimulation such as heat, cold, chemical stimulation or mechanical force, the TRPV1 receptor will be activated and send pain signals.^5,6 CBD can inhibit the TRPV1 signal, promoting its role in pain relief.⁷

Serotonin receptor interaction

Serotonin (a neurotransmitter) is related to sleep, appetite, and overall mood control. Additionally, it shows a connection with pain, depression, and anxiety. Serotonin works by binding to serotonin receptors, located in the hippocampus and prefrontal cortex, controlling emotional and cognitive functions.⁸ 

A study showed that CBD can bind to serotonin receptors to reduce anxiety and pain.⁹ 

Therapeutic benefits

CBD has promising benefits in various diseases as it can affect many receptors in the human body.  

Pain relief

CBD has increased interest in pain relief. According to a survey on using CBD to treat chronic pain, the majority of patients said that it reduced their pain and decreased their use of pain medication such as opioids.¹⁰ 

However, current studies do not provide enough safety and efficacy evidence to support using CBD in pain relief. The majority of studies stated that using CBD alone and CBD with THC reduced pain between 42% and 66%. However, other studies showed no significant benefits in relieving pain.¹¹

In summary, CBD may have the potential for pain relief, but more scientific data is still needed to ensure its safety and efficacy.

Anti-inflammatory effects

CBD exerts its anti-inflammatory effects through several mechanisms. In interaction with CB2 cannabinoid receptors, CBD can modulate the immune system related to the endocannabinoid system and reduce inflammation. 

CBD also inhibits enzymes involved in the inflammatory process. Therefore, it reduces inflammatory mediators such as prostaglandin, or nitric oxide. CBD also has antioxidant effects by reducing oxidative stress, which is interconnected to inflammation.¹²

Conditions benefiting from anti-inflammatory properties

The anti-inflammatory properties of CBD enable it to be used in various conditions. It can help reduce joint inflammation and be immunosuppressive. CBD might be used to treat inflammatory bowel diseases (IBD) as it showed good results in animal models.¹³ In animal studies, CBD showed pain reduction and anti-inflammatory properties, but human studies are still inconclusive.^13,14

Anxiety and depression

Effects on anxiety disorders

CBD has presented efficacy for physical and mental health problems. According to its action on serotonin receptors, it may help protect neurons, leading to promising antidepressive and anxiety-reducing effects. 

In many studies, CBD showed helpful potential for reducing anxiety and greater anxiolytic effects were shown with lower doses compared to higher doses.  In clinical research, CBD improved anxiety scores and maintained the effect for 3 months with no harmful side effects. Nevertheless, this study showed some limitations. Thus, future work is needed to demonstrate CBD’s role in anxiety.¹⁴

Potential benefits for depression

As CBD can bind to serotonin receptors, involved with mood control, CBD should affect depression. CBD has shown a mood stabilisation effect in a laboratory study. In animal studies, CBD demonstrated an antidepressant effect by increasing the desire to do pleasurable activities. 

In human studies, CBD has improved depressive symptoms in patients who have used traditional medications to treat depression before. It should be noted that human studies are limited thus far.¹

Neurological disorders

Epilepsy and seizure reduction

CBD is particularly well-known for its efficacy in reducing seizures. Epidiolex is the only CBD medication approved by the U.S. Food and Drug Administration (FDA) to treat childhood seizures in Dravet and Lennox-Gastaut syndromes.¹ The exact mechanism of action remains unknown. The possible mechanism is that CBD may modulate the activity of neurotransmitters as it can bind various targets such as TRPV1, resulting in reduced epilepsy.^1,15

Other neuroprotective properties

CBD has neuroprotective effects, which can be applied to treating diseases like Parkinson's and Alzheimer's diseases. In animal models, CBD provides a good result for Alzheimer’s disease as it can reduce inflammatory substances and has antioxidant activities.¹⁶

Sleep disorders

As endocannabinoids play a role in the sleep cycle, CBD is supposed to enhance sleep quality. Animal studies stated that CBD improved both sleep quality and sleep cycle. High doses of CBD can increase the duration of sleep and increase rapid eye movement (REM) sleep, which may enhance sleep quality. 

In a human study, CBD in low doses can cause wakefulness, but in higher doses can promote sedating effects. Other studies in humans showed that CBD can increase the overall amount of sleep within sleep disorders.¹ In the previously mentioned study about anxiety, CBD helped improve validated sleep scores within the first month, but after that results fluctuated.¹⁴ 

In summary, CBD shows potential benefits for sleep. However, there is no study to ensure abstinence syndrome from CBD and long-term use for insomnia as the risk of developing CBD dependence.

Other potential benefits

Anti-cancer properties

CBD has shown the potential to treat cancer as it can act on receptors (CB1, CB2, or TRPV) or be associated with mechanisms such as inducing programmed cell death (apoptosis). 

The mechanisms of CBD in cancer are not fully understood. One proposed mechanism is its interaction with CB1 and CB2 receptors, causing inhibition of inflammation, cancer cell growth and apoptosis. 

CBD acting on CB1 can reduce pain. However, CBD acting on CB2 can promote the immune system to inhibit cancer cell growth and induce cancer cell death.

However, CBD cannot strongly bind to these receptors, meaning it has to interact with other receptors such as TRPV1. 

Furthermore, CBD can also affect the molecular pathways of cancer cells. This leads to inhibition of cancer growth, hence inducing cancer cell death, and suppressing blood vessels that support cancer cell growth.¹⁷

Cardiovascular health

CBD may benefit cardiovascular health in different ways. CBD can induce vessel expansion and has antioxidant effects, resulting in lower blood pressure. In experimental studies, CBD showed various positive effects on cardiovascular diseases such as heart disease, stroke, or cardiovascular diabetic disease.¹⁸

Skin conditions

CBD can cope with various skin conditions. Due to its anti-inflammatory and antioxidant properties, and ability to inhibit cell death, CBD could provide benefits for inflammatory skin conditions or keratin disorders such as eczema or atopic dermatitis.¹⁹

The main causes related to acne are the overproduction of sebum, sebum-producing cell proliferation and inflammation. According to many experimental studies, CBD can inhibit these pathways, which leads to potential benefits for acne.¹⁹

Safety and side effects

Common side effects

While CBD is considered safe, it can cause some side effects depending on the amount of doses and duration of exposure. The most common side effects include:²⁰

• Tiredness
• Diarrhoea
• Changes in appetite or weight

Long-term safety

Long-term studies of CBD are limited. Some studies on chronic use still showed tolerance of CBD. However, in long-term use (48-week duration), a common side effect is somnolence.

Interactions with other medications

CBD can interact with various medications because it can inhibit enzymes in the liver that are mostly used to metabolise medications. This can lead to changes in the amount of drugs in the body, which might not reach therapeutic effects or exceed the safe amount, causing adverse effects.²⁰

Summary

Cannabidiol (CBD), a non-psychoactive substance, is naturally found in hemp or Cannabis sativa. Its mechanisms of action are still being studied. It can bind various receptors such as CB receptors, TRPV1 receptors or serotonin receptors, which results in potential therapeutic effects. 

Currently, CBD medication is only approved for use in childhood seizures. According to its mechanisms, CBD has shown potential benefits in many diseases including pain relief, skin conditions, joint inflammation, anxiety and sleep disorders. 

However, it has to be noted that most of its proposed benefits have been shown in animal studies. Human studies are not conclusive and need more evidence to support the potential efficacy and safety. Always consult your healthcare professional before trying any CBD-containing supplements.