10 Natural Sleep Aids: What Works and Why

By now, the average person grasps just how important sleep is for our overall health. It seems like every month there’s a new popular science book extolling the virtues of sleep. Parents remember the zombified newborn days and can see (and hear), firsthand, what happens when a toddler doesn’t get enough sleep. And on a visceral level, we feel the need for slumber. Even if we’re unaware of or refuse to accept the health dangers of long-term sleep restriction, there’s no getting around the abject misery of a bad night’s sleep.

We all want better sleep. We all need better sleep. But how?

Sleeping pills are not the answer for most people.

(But please note: Don’t discontinue or alter a prescribed treatment or medication regimen without consulting your doctor…and, likewise, don’t begin a new regimen—like those below—without running it by your physician.)

In one recent “positive” study on the effects of sleeping pills, almost every single subject suffered one or more side effects, ranging from headaches to nausea to irritability to dizziness to dysgeusia (a condition where your sense of taste is altered).

In another, taking Ambien the night before decreased cognitive performance and increased subjective sleepiness the next morning.

Studies aside, there are thousands of horror stories about people ruining their lives (or behaving in a way that had the potential to do so) after taking sleeping pills. Twitter rants that get you fired, sleep driving, tooth grinding, furniture rearranging, sleep eating. And those are just the ones that people live to tell.

That’s not to say sleeping pills are useless. They’re legitimate drugs to be used for specific medical conditions, in specific patient circumstances. They aren’t to be trifled with. But if you’re just trying to “get better sleep,” you’ve got options. And I’m not even mentioning the lifestyle and behavioral modifications you can make to improve your sleep.

Here are my favorite natural sleep aids….

1. GABA

GABA is the inhibitory neurotransmitter. It calms the brain. It soothes the brain. It de-stresses the brain. And it’s a major factor in the creation of melatonin, the hormone our brain uses to trigger sleep onset. Insomniacs have reduced brain GABA levels compared to non-insomniacs; the same goes for people with sleep apnea. Restoring physiological levels of GABA, then, is a first line of defense against poor sleep.

Oral GABA has a blood-brain barrier problem—it doesn’t cross it particularly well. Children have more permissive BBBs, but most of my readers aren’t children. Nitric oxide tends to increase GABA diffusion across the blood brain barrier, and there are a couple of ways to increase nitric oxide in conjunction with taking GABA to make the latter more effective for sleep.

You could sunbathe. That increases nitric oxide release. The only problem is that most sunbathing occurs during the midday hours, not at night. It’s unclear how long the boost from sunlight lasts, though it certainly can’t hurt.

You could take apocynum venetum, an herb used in traditional Chinese medicine that increases nitric oxide release. In fact, one study showed that taking GABA with apcynum ventum improves sleep quality.

Before you start sedating yourself, see if GABA has an effect.

2. Melatonin

When it’s bedtime for your brain, your pineal gland starts pumping out a hormone called melatonin. This initiates the onset of sleep and triggers subjective feelings of sleepiness; it also sets your circadian rhythm.

Supplemental melatonin crosses the blood brain barrier and acts very similarly to endogenous melatonin.

Don’t use melatonin every night. Not because you’ll get “addicted” (you won’t) or “your natural production will stop” (it won’t), but because you should focus on producing your own. If I get a big dose of late night blue light, I might nibble on a little melatonin. If I have more than a single glass of wine at night, I’ll have some melatonin before bed as alcohol depresses its production. And when I travel, I always take a few milligrams an hour before my desired bedtime in the new time zone.

The main reason you shouldn’t rely on melatonin for everyday use is that supplemental melatonin pharmacology doesn’t quite emulate endogenous melatonin pharmacology. The way most people take it is in a single dose before bed. The way the brain produces it is consistently through the night. If you want to emulate physiological levels of melatonin, you’re better off taking a single dose of instant release melatonin followed by a dose of slow release melatonin, or a supplement that includes both forms. Even then, it’s not the same.

3. Collagen

I still remember the first time I drank a big mug of bone broth at night. It was one of the not-as-rare-as-you’d-think cold “winter” nights in Malibu. I was sitting on the couch, reading a book, and got about 3/4 of the way through a mug of chicken foot broth before, apparently, falling asleep right then and there. A bit of research the next day revealed that glycine, the primary amino acid in collagen/gelatin/broth, can have a powerful effect on sleep quality. Not only that, glycine also lowers body temperature (an important part of the sleep process) and improves wakefulness the next day. And if you’ve got REM sleep behavior disorder, glycine may be the solution.

In fact, the glycine-sleep effect was another consideration in creating Collagen Fuel and Peptides. Everyone talks about the benefits to joint health, performance, skin, nails, hair, and general inflammation, but I want folks to also discover the benefit of glycine-enhanced sleep, too.

If you take collagen, aim for at least 10 grams at night. If you’re taking straight glycine, 3 grams is the minimum dose. Those are threshold doses; more may help even more.

4. Magnesium

We talk a lot about “age-related” declines in health, vitality, performance, and basic physiological functions. We also talk about how much of what we call “age-related” isn’t inevitable. It’s not so much that the passage of time degrades our bodies and how they work, but that we become more susceptible to poor lifestyle, dietary, and exercise choices because of compounding negative interest. We’re born with robust health and if we fail to maintain it, our health worsens as time progresses. If we never stop moving, lifting weights, and eating right, aging doesn’t happen to the same degree.

One thing that changes with age is how we sleep. In older people, sleep architecture is different: More time is spent awake and there’s less slow wave sleep. Sleep spindles, those oscillating bursts of brain wave activity, begin disappearing. Sounds inevitable, right? Except that research shows that taking magnesium reverses these age-related changes to sleep architecture.

Taking some Natural Calm (a great magnesium supplement) after your CrossFit workout and falling asleep faster is one thing. But to actually restore youthful sleep architecture? Amazing.

5. CBD Oil

As I wrote a couple weeks ago, CBD is the non-psychoactive cannabinoid found in cannabis.

And to me, the most interesting aspect of CBD lies in its potential to improve sleep. A 2017 review provides a nice summary of the effects of CBD on sleep:

In insomnia patients, 160 mg/day of CBD increased sleep time and reduced the number of arousals (not that kind) during the night.

Lower doses are linked to increased arousals and greater wakefulness. Higher dose CBD improved sleep.

In preliminary research with Parkinson’s patients, CBD reduced REM-related behavioral disorder—which is when you basically act out your dreams as they’re happening.

More recently, a large case series (big bunch of case studies done at once) was performed giving CBD to anxiety patients who had trouble sleeping. Almost 80% had improvements in anxiety and 66% had improvements in sleep (although the sleep improvements fluctuated over time).

Here’s how to find a good CBD oil.

6. Theanine

Theanine is a chemical found in tea, especially tea grown in shady conditions. Because it is structurally similar to glutamate and easily passes the blood brain barrier, theanine binds to various glutamate receptors in the brain, inhibiting the action of some and promoting the action of others. It also increases serotonin, GABA, and glycine in the brain—all chemicals that can pave the way for better sleep.

Theanine is another of those sleep aids that isn’t expressly about sleep. It’s about relaxation, about letting you get out of your own way. If in the course of relaxation and stress reduction you end up taking care of the thing that’s messing up your sleep, theanine can be said to be a big sleep aid.

This is a good theanine. I also make a supplement (Adaptogenic Calm) that contains theanine and other stress-reducing compounds.

7. Lutein and Zeaxanthin

One of the most powerful sleep aids is wearing a pair of orange safety goggles that blocks blue light after dark. Viewed after dark, blue (and green) light suppresses melatonin secretion, pushes back sleep onset, and throws off your entire circadian rhythm. Blocking the light with goggles allows normal melatonin production to proceed and promotes earlier bedtimes and better, deeper sleeps.

What if you could take a supplement that simulated the blue-blocking effect of a pair of orange safety goggles? Lutein and zeaxanthin are carotenoids, plant-based pigments found in colorful produce and pasture-raised eggs that are actually incorporated into the eye where they offer protection from sunlight and inhibit the melatonin-reducing effect of nighttime light exposure. Human studies show that taking lutein and zeaxanthin on a regular basis improves sleep quality, reduces sleep disturbances, and lowers dependence on supplemental or pharmaceutical sleep aids.

Here’s a good one. Trader Joe’s also has a good supplement called Super Vision.

The best natural sleep aids restore the ancestral sleep baseline. At baseline, humans should be walking around with good GABA levels. They should be getting enough magnesium, collagen/glycine, and carotenoids from their diet. It’s normal to produce melatonin after dark. And even though humans haven’t been dosing themselves with CBD or theanine for very long, it also isn’t normal to be inundated with chronic, low level stress and persistent anxiety—the type of stress that ruins our sleep, the type of anxiety that CBD and theanine can regulate.

What else?

8. Lemon Balm

Lemon balm is an herb in the mint family. The fragrance is intoxicating (I’ve even used lemon balm in a roasted chicken), but not the effects. It doesn’t directly induce sleep—it’s not a sedative or a hypnotic—but if stress and anxiety are getting in the way of your sleep, lemon balm will help clear them out.

9. Valerian

Valerian root has a long history as an anti-insomnia herb. The ancient Greeks used it and traditional Chinese and Ayurvedic medical traditions continue to use to it to treat bad sleep. Valerian contains a compound that slows down the brain’s metabolism of GABA, thereby increasing GABA levels and letting what the brain already produces hang around even longer.

I’ll admit I’m more ambivalent about these last two options. While they’re certainly gentler than pharmaceutical sleep pills, and lemon balm in particular is a legit way to deal with stress and anxiety, their efficacy for sleep is questionable. The evidence just isn’t there, though I grant that many people report good results.

10. Combinations

Many of these individual compounds become more powerful and more effective combined with each other. Since these aren’t pharmaceutical drugs with very narrow safety profiles rife with contraindications, taking them together usually isn’t an issue, but check in with your doctor anyway (especially if you’re taking other medications or have known health conditions).

And today’s list isn’t exhaustive. There are other compounds, herbs, and supplements that can probably help people improve their sleep.

Most of the adaptogens, like ashwagandha or rhodiola rosea, have been shown in one study or another to improve sleep in humans. Anything that helps get you back to baseline, back to homeostasis, back to normal—will restore your sleep if it’s suffering. And if you’re suffering, your sleep is likely suffering because sleep is such a fundamental aspect of the human experience. Anything that improves your health will also probably improve your sleep.

This goes without saying, but don’t limit yourself to natural sleep supplements. Don’t forget about the importance of lifestyle, of exercise, of diet, of morning light exposure and nighttime light avoidance. Supplements can help, but they can’t be the foundation for good sleep hygiene. You’re just asking for trouble—or subpar results.

Thanks for reading, everyone. Now, let’s hear from you. What natural sleep aids have you found most useful? Is there anything I overlooked or forgot? Let me know down below.

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References:

Pinto LR, Bittencourt LR, Treptow EC, Braga LR, Tufik S. Eszopiclone versus zopiclone in the treatment of insomnia. Clinics (Sao Paulo). 2016;71(1):5-9.

Dinges DF, Basner M, Ecker AJ, Baskin P, Johnston S. Effects of Zolpidem and Zaleplon on Cognitive Performance After Emergent Tmax and Morning Awakenings: a Randomized Placebo-Controlled Trial. Sleep. 2018;

Yamatsu A, Yamashita Y, Maru I, Yang J, Tatsuzaki J, Kim M. The Improvement of Sleep by Oral Intake of GABA and Apocynum venetum Leaf Extract. J Nutr Sci Vitaminol. 2015;61(2):182-7.

Held K, Antonijevic IA, Künzel H, et al. Oral Mg(2+) supplementation reverses age-related neuroendocrine and sleep EEG changes in humans. Pharmacopsychiatry. 2002;35(4):135-43.

Kim S, Jo K, Hong KB, Han SH, Suh HJ. GABA and l-theanine mixture decreases sleep latency and improves NREM sleep. Pharm Biol. 2019;57(1):65-73.

Rondanelli M, Opizzi A, Monteferrario F, Antoniello N, Manni R, Klersy C. The effect of melatonin, magnesium, and zinc on primary insomnia in long-term care facility residents in Italy: a double-blind, placebo-controlled clinical trial. J Am Geriatr Soc. 2011;59(1):82-90.

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Dear Mark: Antibiotic Recovery, Sprinting on Keto, Preparing for Bad Sleep

For today’s edition of Dear Mark, I’m answering three questions. First up, what can a person do to help their gut recover its barrier function after too many antibiotics? Are there any foods, supplements, or dietary strategies? Second, what can explain rapid fatigue during sprint sessions on a keto diet? Is this simply part of the deal, or are there modifications you can make? And finally, what do I do when I know I’m going to get a bad night’s sleep?

Let’s go:

Mark – any idea how to cure leaky gut caused by overuse of antibiotics. Tried raw dairy for a month to no avail.

First of all, check out my post on leaky gut. Read through it and follow my suggestions for preventing and treating intestinal permeability. It’s a great place to start.

Then, let’s look at some other interventions that have been shown to improve recovery from antibiotic therapy. While most of the studies referenced don’t explicitly describe antibiotic-induced leaky gut, anything that improves gut function and restores healthy gut bacteria will also normalize leaky gut—since it’s the eradication of native gut bacteria that causes antibiotic-induced leaky gut.

Fermented dairy. You tried raw dairy. What about fermented dairy? While raw dairy has its merits, it’s fermented dairy that just works for recovery from antibiotics. Yogurt is a good option to try, although the evidence is a bit inconsistent. Kefir is probably better; it’s been shown to improve patients’ tolerance to triple antibiotic therapy during treatment for H. pylori infection. This is even worth consuming during antibiotic therapy, as many of the probiotic bacteria found in fermented dairy show resistance to common antibiotics.

Fermented vegetables like sauerkraut are also must-eats. The fermented cabbage contains ample amounts of L. plantarum, a bacteria strain that’s been shown to prevent antibiotic-related diarrhea in piglets (another omnivorous mammal). Good options exist in stores (check the refrigerated section; shelf-stable pickles and kraut aren’t lactofermented), and even more are available in farmer’s markets, but the best way to get the most bacteria-rich vegetable ferments is to make your own.

Supplemental probiotics are fantastic here, too: large doses of the desired microorganisms delivered directly to your gut. Some of the strains used in Primal Probiotics, like B. clausii and S. boulardii, have been shown to be effective against antibiotic-related diarrhea, so that could be a good choice.

Don’t forget the food for your gut bugs: prebiotics. You need to eat fermentable fibers and other prebiotics like resistant starch to support the growth and maintenance of the helpful bacteria that improve gut barrier function. Consider eating cooked and cooled potatoes, unheated potato starch, leeks, garlic, onions, green bananas, apples, pears, berries, and pretty much any fruit or vegetable you can get your hands on. Plenty of them are low-carb enough to work on a keto diet, if that’s your desire. Oh, and dark chocolate is a great source of fiber and polyphenols, which have prebiotic effects in the gut.

Incorporate intermittent fasting. Going without food for a spell gives your gut a break and induces autophagy, which can help with tissue healing.

Get dirty, too, to introduce potentially helpful bacteria. Go out and garden. Go barefoot at the park (do your due/doo diligence, of course) and practice tumbling, or roughhouse with your kids (or friends). Don’t immediately rush to wash your hands all the time (unless you’ve been handling raw meat and/or dog poop).

Whatever you do, don’t stress too much about the antibiotics you had to take. Stress is awful for gut health and you’ve already taken the antibiotics—which were probably necessary—so that ship has sailed.

If probiotics with prebiotics aren’t helping (or making things worse), you might want to try going the opposite direction—removing all plant foods and doing a carnivore diet for a few weeks. While I have doubts about the long term viability and safety of eschewing all plant foods, enough people have written to me about their great experiences resolving gut issues with a bout of carnivory that it’s worth trying.

When on a strict keto plan, why do I become so quickly fatigued while attempting a HIT sprint workout?

The first five seconds of a sprint are primarily powered by phosphocreatine (or creatine phosphate), a “quick burst” energy source that burns hot but disappears quickly. This is the stuff used to perform max effort Olympic lifts, short sprints, and other rapid expressions of maximum power. It doesn’t last very long and takes a couple minutes to replenish itself. A keto diet doesn’t affect our creatine phosphate levels. If anything, it should improve them if we’re eating meat.

After five seconds, anaerobic metabolism of muscle glycogen provides the lion’s share of your energy needs. The longer your sprint, the more glycogen you’ll burn. The less glycogen you carry in your muscles, the shorter your sprint. Because once you run out of creatine phosphate and glycogen, you’re left with aerobic metabolism—great for longer distances, not so great for max effort sprints.

Keto dieters tend to walk around with less glycogen in their muscles. If that’s the case, longer sprints will be harder.

If you want to keep sprinting:

Do shorter sprints. Try a 10-second hill sprint rather than a 20-second one. Really go hard. Heck, you can even do 5-second sprints and derive major benefits; just do more of them and make sure to recover in between. There’s no rule saying you have to sprint for 20-30 seconds.

Take longer rest periods. Give your muscles a chance to replenish more creatine phosphate (and take creatine or eat red meat and fish, which are the best sources of dietary creatine).

Eat 20-30 grams of carbs 30 minutes before a sprint session. See if it helps. Alternatively, you can eat the 20-30 grams of carbs after the sprint session to replenish lost glycogen stores (without really impacting your ketone adaptation, by the way).

Most people figure out their sprinting sweet spot while doing keto. They may have to play around with the dosages, durations, and rest periods, but you can usually make it work. Be open to trying new permutations.

If you knew you were going to have a poor nights sleep, what measures would you take to reduce some of the damage?

I would exercise hard that night. Normally, a bad night’s sleep tanks your insulin sensitivity the next day, giving you the insulin resistance and glucose tolerance of a diabetic. A good hard interval session the night before a bad night’s sleep, however, counters the next-day insulin resistance.

I would make the most of it. Don’t dawdle. Don’t beat yourself up because of the impending sleep deprivation. It’s going to happen. You have to accept it, not let it destroy you.

Enjoy it. A little-known acute treatment for depression is sleep deprivation. That’s right: a single night of sleep deprivation has been shown to ameliorate depression in patients with clinical depression. Sometimes the effect lasts up to several weeks. It’s not a long term or sustainable fix for clinical depression, obviously, and you can’t do it every single night—chronic sleep deprivation is a major risk factor for developing depression—but it can improve your mood if you give in to it.

I would set out a jar of cassia cinnamon. I always add cassia cinnamon to my coffee in the morning after bad sleep; cassia cinnamon the day after a bad night’s sleep attenuates the loss of insulin sensitivity and glucose tolerance.

That’s it for today, folks. Thanks for writing in and reading! If you have any input on today’s round of questions, let me know down below.

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References:

De vrese M, Kristen H, Rautenberg P, Laue C, Schrezenmeir J. Probiotic lactobacilli and bifidobacteria in a fermented milk product with added fruit preparation reduce antibiotic associated diarrhea and Helicobacter pylori activity. J Dairy Res. 2011;78(4):396-403.

Bekar O, Yilmaz Y, Gulten M. Kefir improves the efficacy and tolerability of triple therapy in eradicating Helicobacter pylori. J Med Food. 2011;14(4):344-7.

Erginkaya Z, Turhan EU, Tatl? D. Determination of antibiotic resistance of lactic acid bacteria isolated from traditional Turkish fermented dairy products. Iran J Vet Res. 2018;19(1):53-56.

Yang KM, Jiang ZY, Zheng CT, Wang L, Yang XF. Effect of Lactobacillus plantarum on diarrhea and intestinal barrier function of young piglets challenged with enterotoxigenic Escherichia coli K88. J Anim Sci. 2014;92(4):1496-503.

Jitomir J, Willoughby DS. Cassia cinnamon for the attenuation of glucose intolerance and insulin resistance resulting from sleep loss. J Med Food. 2009;12(3):467-72.

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5 Hemp Oil Benefits For Health and Wellness

Have you tried hemp oil?

After almost a century of being outlawed, hemp—a form of cannabis with extremely low levels of psychoactive THC—is now legal in the United States. This is big news for people interested in the therapeutic effects of cannabidiol (or CBD) because—while hemp doesn’t contain enough THC, the compound that provides the “high” of cannabis, or any other psychoactive compounds—it does contain cannabidiol (CBD).

For years, all anyone talked about when they talked about cannabis was the THC content. Breeders focused on driving THC levels as high as possible and ignored the other compounds. Even pharmaceutical companies interested in the medical applications of cannabis focused on the THC, producing synthetic THC-only drugs that performed poorly compared to the real thing. It turns out that all the other components of cannabis matter, too, and foremost among them is CBD.

CBD doesn’t get you high, but it does have big physiological impacts. These days, researchers are exploring CBD as a treatment for epilepsy, anxiety, and insomnia. They’ve uncovered potential anti-inflammatory, anxiolytic, and immunomodulatory properties. And now that it’s quasi legal, hundreds of CBD-rich hemp oil products are appearing on the market.

What are the purported benefits of using CBD-rich hemp oil, and what does the evidence say?

Although CBD research is growing, it’s still understudied and I expect I’ll have to update this post in the near future with more information. But for now, here’s a rundown of what the research says.

The Health Benefits of CBD In Hemp Oil

CBD For Anxiety Reduction

Anxiety can be crippling. I don’t have generalized social anxiety, but I, like anyone else, know what it feels like to be anxious about something. It happens to everyone. Now imagine feeling that all the time, particularly when it matters most—around other people. The average person doesn’t consider the import and impact of anxiety on a person’s well-being. If CBD can reduce anxiety, that might just be its most important feature. Does it?

Before a simulated public speaking event, people with generalized social anxiety disorder were either given 600 mg of CBD or a placebo. Those who received CBD reported less anxiety, reduced cognitive impairment, and more comfort while giving the speech. Seeing as how people without social anxiety disorder claim public speaking as their biggest fear, that CBD helped people with social anxiety disorder give a speech is a huge effect.

This appears to be legit. A placebo-controlled trial is nothing to sniff at.

CBD For Sleep

A 2017 review provides a nice summary of the effects of CBD on sleep:

In insomnia patients, 160 mg/day of CBD increased sleep time and reduced the number of arousals (not that kind) during the night.

Lower doses are linked to increased arousals and greater wakefulness.

High dose CBD improved sleep; adding THC reduced slow wave sleep.

In preliminary research with Parkinson’s patients, CBD reduced REM-related behavioral disorder—which is when you basically act out your dreams as they’re happening.

More recently, a large case series (big bunch of case studies done at once) was performed giving CBD to anxiety patients who had trouble sleeping. Almost 80% had improvements in anxiety and 66% had improvements in sleep (although the sleep improvements fluctuated over time).

Mental Health

While its psychoactive counterpart THC has been embroiled in controversial links with psychosis and schizophrenia for decades, CBD may be an effective counterbalancing force for mental health.

In patients with schizophrenia, six weeks of adjunct treatment with cannabidiol resulted in lower rates of psychotic symptoms and made clinicians more likely to rate them as “improved” and made researchers more likely to rate them as “improved” and not “severely unwell.” There were also improvements in cognitive performance and overall function. It seems the “adjunct” part of this study was key, as other studies using cannabidiol as the only treatment mostly failed to note improvements.

This was placebo controlled, so it makes a good case for CBD hemp oil as adjunct treatment (in addition to regular therapy) in people with schizophrenia.

Among 11 PTSD patients who took an average of 50 mg of CBD per day for 8 weeks, 10 (90%) experienced a 28% improvement in symptoms. No one dropped out or complained about side effects. CBD seemed to particularly benefit those patients who had issues with nightmares.

This is promising but preliminary. This was an 11-person case study, not a placebo-controlled trial.

Epilepsy

A recent review of four human trials lays out the evidence: More than a third of all epilepsy patients experienced 50% or greater seizure reductions with just 20 mg of CBD. The effect of CBD on seizure activity is so widely acknowledged and understood that the only FDA-approved CBD-based product is Epidiolex, a plant-based CBD extract used to treat seizures in patients with Dravet syndrome and Lennox-Gastaut syndrome.

CBD for epilepsy is legit. Side note: I wonder how CBD would combine with ketogenic dieting for epilepsy control.

Pain

By far the biggest draw for medical consumers of CBD is its supposed ability to nullify pain.

In one study, researchers induced arthritis in rats with intra-articular injections, then gave them CBD. Rats given CBD were able to put more weight on their joints and handle a heavier load before withdrawing. Local CBD reduced nerve damage.

That’s great for pet rats. What about people?

There actually isn’t a lot of strong data on pain management using CBD by itself. Far more robust is the evidence for using CBD with THC for pain. According to this group of researchers, the two compounds exert “constituent synergy” against neuropathic pain. One study found that low doses of each were more effective combined than high doses of either alone in neuropathic cancer-related pain. Another gave a THC/CBD oromucosal spray to otherwise treatment-resistant neuropathy patients, finding that the spray reduced pain, improved sleep, and lessened the severity of symptoms.

Anything Else?

Anecdotal evidence for pain relief and other benefits with CBD is vast. Chris Kresser, a practitioner and researcher I trust, swears by it. I have employees who use it quite frequently, reporting that it improves their sleep, hones their focus, reduces pain, speeds recovery, and reduces anxiety. These things are always hard to evaluate, but I can say that my people do great work, and I have zero reason to distrust them.

In later posts, I’ll probably revisit some of these other, more theoretical or anecdotal potential benefits to see if there’s any evidence in support.

Is It Safe?

A recent study gave up to 6000 mg of CBD to healthy subjects, finding it well tolerated and the side effects mild and limited to gastrointestinal distress, nausea, somnolence, headaches, and diarrhea. For comparison’s sake, keep in mind that a typical dose of CBD is 20 mg.

Mouse research indicate that extended high-dose CBD (15-30 mg/kg of bodyweight, or 1200-2400 mg per day for an 80 kg man) might impair fertility. Male mice who took high-dose CBD for 34 days straight experienced a 76% reduction in testosterone, reduced sperm production, and had dysfunctional weird-looking sperm. In the 30 mg/kg group, the number of Sertoli cells—testicular cells where sperm production takes place and sperm is incubated—actually dropped. Male mice taking CBD also were worse at mounting females and had fewer litters.

Those are really high doses. For epilepsy, a common dose is 600 mg/day, and that’s for a severe condition. Most other CBD therapies use much smaller doses in the range of 20-50 mg/day. Long term safety may still be an issue at these lower doses, but we don’t have any good evidence that this is the case.

There’s some evidence that the dosages of CBD required to achieve anti-inflammatory effects are also high enough to induce cytotoxicity in healthy cells, though that’s preliminary in vitro (petri dish) research and as of yet not applicable to real world applications. Time will tell, though, as the legal environment opens up and we accumulate more research.

Is Isolated CBD the Same As Whole Plant Extracts?

As we’ve learned over the past dozen years of reading about nutrition and human health, whole foods tend to be more effective than isolated components. Whole foods have several advantages:

  • They contain all the components related to the compound, especially the ones we haven’t discovered and isolated. Supplements only contain the isolated compounds we’ve been able to quantify.
  • They capture all the synergistic effects of the multiple components working together. Isolated supplements miss that synergy unless they specifically add it back in, and even then they’ll probably miss something.

It’s likely that whole plant hemp extracts high in CBD are superior to isolated synthetic CBD for the same reason. Is there any evidence of that?

A high-CBD cannabis whole plant extract reduces gut inflammation and damage in a mouse model of inflammatory bowel disease. Purified CBD does not.

Even at a 2:1 CBD:THC ratio, co-ingesting isolated CBD with isolated THC using a vaporizer fails to reduce the psychotic and memory-impairing effects of THC. In another study, however, smoking cannabis naturally rich in both CBD and THC completely prevented the memory impairment.

And as we saw in the pain section above, THC combined with CBD seems more effective against pain than either alone.

That’s not to say isolated (even synthetic in some cases—see note below) CBD isn’t helpful. We saw it improve joint pain and reduce nerve damage in arthritic rats. It’s just that full-spectrum hemp oil containing multiple naturally-occurring compounds is probably ideal for general health applications. Specific conditions requiring high doses may be another question entirely. Again, we’ll find out as more research comes out.

A word about synthetics: this is fodder for a follow-up, but it appears there may be additional concerns with synthetic CBD, and even supposedly “natural” CBD companies have in some cases allegedly added ingredients to their formulas without letting consumers know.

Is It Legal?

CBD-rich hemp oil lies in a legal grey area. The recently passed Farm Bill allows people to grow and make products from industrial hemp, as long as it contains less than 0.3% THC. That means CBD derived from industrial hemp is legal at a federal level. But because the Farm Bill has provisions that allow states to set their own rules, legality at a state level is more complicated.

States where hemp is still illegal—South Dakota, Idaho, and Nebraska—do not permit the sale or use of hemp-derived CBD oil.

In states that permit recreational cannabis—California, Vermont, Massachusetts, Maine, Oregon, Colorado, Washington, Nevada, Michigan, and Alaska—CBD derived from both hemp and psychoactive cannabis is legal.

In all other states, hemp-derived CBD is legal.

The FDA has yet to approve of CBD, so most of the big online retailers like Amazon and Walmart don’t allow CBD products to be advertised. However, Amazon sells a ton of “hemp extract” tinctures and oils with “hemp extract content” listed in milligram dosages—a workaround for listing the CBD content.

If you’re looking for CBD-rich hemp oil, watch out for culinary hemp oil, which comes in larger quantities and has no discernible CBD content. CBD-rich hemp oil will come in dropper bottles, not liters.

You can also buy directly from manufacturers online who proudly advertise their CBD content. I’ve heard good things about Ojai Energetics and Sabaidee, though I haven’t used either.

Many health food stores sell it. Surprisingly, I’ve seen it in every pet store I’ve entered in the last half year.

Word of Caution: Because it isn’t regulated by the FDA yet, there’s no telling exactly what you’re getting. Choose a product with verifiable lab tests. Many CBD hemp oil products have far less CBD than advertised. In addition to CBD content, the most reputable manufacturers also test for pesticides, heavy metals, mycotoxins, and bacteria and advertise their results.

CBD-rich hemp oil is a hot topic these days, and it’s only going to get hotter. I think the compound shows great promise in promoting health and wellness, and I’ll look forward to doing more research as it unfolds.

For now, what about you? Do you use CBD? Have you noticed any benefits? Any downsides? Share your questions and feedback down below.

Thanks for reading, everyone. Take care.

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References:

Bergamaschi MM, Queiroz RH, Chagas MH, et al. Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naïve social phobia patients. Neuropsychopharmacology. 2011;36(6):1219-26.

Lattanzi S, Brigo F, Trinka E, et al. Efficacy and Safety of Cannabidiol in Epilepsy: A Systematic Review and Meta-Analysis. Drugs. 2018;78(17):1791-1804.

Elms L, Shannon S, Hughes S, Lewis N. Cannabidiol in the Treatment of Post-Traumatic Stress Disorder: A Case Series. J Altern Complement Med. 2018;

Serpell M, Ratcliffe S, Hovorka J, et al. A double-blind, randomized, placebo-controlled, parallel group study of THC/CBD spray in peripheral neuropathic pain treatment. Eur J Pain. 2014;18(7):999-1012.

Silva RL, Silveira GT, Wanderlei CW, et al. DMH-CBD, a cannabidiol analog with reduced cytotoxicity, inhibits TNF production by targeting NF-kB activity dependent on A receptor. Toxicol Appl Pharmacol. 2019;368:63-71.

Carvalho RK, Souza MR, Santos ML, et al. Chronic cannabidiol exposure promotes functional impairment in sexual behavior and fertility of male mice. Reprod Toxicol. 2018;81:34-40.

Morgan CJA, Freeman TP, Hindocha C, Schafer G, Gardner C, Curran HV. Individual and combined effects of acute delta-9-tetrahydrocannabinol and cannabidiol on psychotomimetic symptoms and memory function. Transl Psychiatry. 2018;8(1):181.

Morgan CJ, Schafer G, Freeman TP, Curran HV. Impact of cannabidiol on the acute memory and psychotomimetic effects of smoked cannabis: naturalistic study: naturalistic study [corrected]. Br J Psychiatry. 2010;197(4):285-90.

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