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The strongest scientific evidence of CBD’s efficacy in humans is for reducing seizures in two rare types of epilepsy that occur in children: Dravet syndrome and Lennox-Gastaut syndrome. Based on that evidence, a liquid CBD anti-seizure drug, Epidiolex , obtained approval from the Food and Drug Administration (FDA) in June 2018. (7)

For Shannon Donnelly, her own experience with CBD is evidence enough. Since beginning a daily CBD regimen several years ago, she says her panic attacks are gone, as are other health problems, including depression. She currently takes 35 mg of CBD each morning and soaks in a tub of warm water laced with CBD bath salts each night.

In a nutshell, CBD interacts with the endocannabinoid system, a large messaging network in your body that plays a key role in regulating many physiological functions. In fact, cannabinoids are so essential to good health that your brain actually produces its own cannabinoids.

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Although the FDA has not approved using CBD to treat any of those conditions, there are signs CBD could be beneficial.

During the two-month study, 72 adults in a psychiatric clinic were given CBD oil capsules once daily. Most received 25 milligrams (mg) of CBD with a few receiving doses as high as 175 mg. Within the first month, more than 79 percent of the patients reported feeling calmer, and they continued to feel calmer for the duration of the study. “We saw no evidence of a safety issue that would limit future studies,” the researchers added.

In a survey published in the July 2018 issue of Cannabis and Cannabinoid Research, almost 62 percent of CBD users reported using it to treat a medical condition, the top three being pain, anxiety, and depression . ( 9 )

Otherwise, the only disorder for which there is “conclusive or substantial evidence” that CBD is helpful is multiple sclerosis, according to a report published in January 2017 by the National Academies of Sciences, Engineering, and Medicine. (8) The same report found “moderate” evidence that CBD improves sleep in people with chronic pain and certain other conditions, and only “weak” evidence for supporting or disproving all other claims of CBD’s health effects.

Remember, because CBD oils are largely unregulated, there is no guarantee that a product is either safe or effective.

Clinical research has shown that CBD oil can trigger side effects. Severity and type can vary from one person to the next.

Since some CBD oils contain trace amounts of THC, you should avoid driving or using heavy machinery when taking CBD oil, particularly when first starting treatment or using a new brand.

What to Look For

CBD’s exact mechanism of action is unclear. Unlike THC, CBD has a relatively low affinity for cannabinoid receptors in the brain. These are the molecules to which THC binds to elicit its psychoactive effects.

CBD oil is an extract of Cannabis indica or Cannabis sativa—the same plants that, when dried, make marijuana. CBD oil is believed by some to treat pain, reduce anxiety, and stimulate appetite in the same way that marijuana does, but without its psychoactive effects. CBD has also shown promise in treating certain types of seizures.

CBD oil can interact with certain medications, including some drugs used to treat epilepsy. CBD inhibits an enzyme called cytochrome P450 (CYP450), which metabolizes certain drugs. By interfering with CYP450, CBD may either increase the toxicity or decrease the effectiveness of these drugs.

There are no guidelines for the appropriate use of CBD oil. CBD oil is usually delivered sublingually (under the tongue). Most oils are sold in 30-milliliter (mL) bottles with a dropper cap.

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CBD may offer an option for treating different types of chronic pain. A study from the European Journal of Pain showed, using an animal model, CBD applied on the skin could help lower pain and inflammation due to arthritis. Another study demonstrated the mechanism by which CBD inhibits inflammatory and neuropathic pain, two of the most difficult types of chronic pain to treat. More study in humans is needed in this area to substantiate the claims of CBD proponents about pain control.

Side effects of CBD include nausea, fatigue and irritability. CBD can increase the level in your blood of the blood thinner coumadin, and it can raise levels of certain other medications in your blood by the exact same mechanism that grapefruit juice does. A significant safety concern with CBD is that it is primarily marketed and sold as a supplement, not a medication. Currently, the FDA does not regulate the safety and purity of dietary supplements. So, you cannot know for sure that the product you buy has active ingredients at the dose listed on the label. In addition, the product may contain other (unknown) elements. We also don’t know the most effective therapeutic dose of CBD for any particular medical condition.

The bottom line on cannabidiol

Cannabidiol (CBD) has been recently covered in the media, and you may have even seen it as an add-in booster to your post-workout smoothie or morning coffee. What exactly is CBD? Why is it suddenly so popular?

CBD stands for cannabidiol. It is the second most prevalent of the active ingredients of cannabis (marijuana). While CBD is an essential component of medical marijuana, it is derived directly from the hemp plant, which is a cousin of the marijuana plant. While CBD is a component of marijuana (one of hundreds), by itself it does not cause a "high." According to a report from the World Health Organization, "In humans, CBD exhibits no effects indicative of any abuse or dependence potential…. To date, there is no evidence of public health related problems associated with the use of pure CBD."

CBD is commonly used to address anxiety, and for patients who suffer through the misery of insomnia, studies suggest that CBD may help with both falling asleep and staying asleep.

Some CBD manufacturers have come under government scrutiny for wild, indefensible claims, such that CBD is a cure-all for cancer, which it is not. We need more research but CBD may be prove to be an option for managing anxiety, insomnia, and chronic pain. Without sufficient high-quality evidence in human studies we can’t pinpoint effective doses, and because CBD is currently is mostly available as an unregulated supplement, it’s difficult to know exactly what you are getting. If you decide to try CBD, talk with your doctor — if for no other reason than to make sure it won’t affect other medications you are taking.