As you are likely aware, in the race to differentiate their products from everyone else’s, companies are creating products with a veritable fruit-salad of cannabinoids and other ingredients. Further, they are marketing these new products for particular use, like sleep, relaxation, or energy.
Overall, these new products are confusing to patients – it’s hard to keep track of all these ingredients, and to know which ingredients are actually safe or helpful. It’s hard to know if you can trust these companies’ statements (or implications) that their products are good for a particular problem or diagnosis.
Let’s review these ingredients and talk about what we really know about their safety and effects.
A Review of Cannabinoids
In this section we’ll look at the cannabinoids that are commonly being sold. There are, of course, many others, but we’ll focus on those that are being pushed at the moment.
Let’s remember that the major medicinal chemicals in cannabis are called cannabinoids. There are other chemicals in cannabis including terpenoids and flavonoids that are not currently being specifically added to products and for which there are even fewer data.
THC (Tetrahydrocannabinol)
THC is the main medicine. It has been researched for over 70 years and we have good safety and efficacy data in humans. While the lay-press is often quick to point out that it’s “the part that gets you high” – which is true – it overlooks the proven medical value for pain, sleep, nausea, headache, anxiety, and other symptoms.
THC also can be misused and can cause dependence. Intoxication needs to be managed as a side effect as with all medications. THC is the primary ingredient to look for and must be used with caution under the guidance of a knowledgeable clinician.
CBD (Cannabidiol)
CBD is vastly popular at the moment. However, this is mostly as a result of legal policy, not medical efficacy. CBD has been demonstrated in the test-tube or in mice to have a range of exciting potential benefits, including being anti-inflammatory, anti-seizure, anti-pain, and perhaps pro-sleep. CBD has been approved by FDA as a drug called Epidiolex for treatment of seizures in children with rare genetic seizure disorders called Dravet’s, Lennox-Gastaut, and Tuberous Sclerosis syndromes.
However, other than for those children with these rare genetic disorders, there has been no successful translational research done to prove benefit from CBD to adult humans with other conditions. In other words, none of the benefits touted for adults from CBD have been proven in human beings. Very importantly, CBD, more than other cannabinoids, has been shown to interact with a wide range of conventional medications. This poses very real danger. If you are taking any number of heart medications, blood thinners, anti-rejection drugs, or even over-the-counter Claritin, CBD can mess with those medications, possibly even fatally.
Since none of the supposed benefits have been proven in humans but the risks are real and potentially severe, I advise avoiding CBD containing products unless/until new data comes to light.
CBN (Cannabinol)
CBN has long been touted as good for sleep. It’s not clear where this idea comes from, but until recently there were no human studies to confirm or deny. Recently there has been one such study. It showed no benefit for sleep for CBD, but that CBN was helpful for sleep. Unfortunately, this study (for legal reasons) did not include a THC arm, so we don’t know if CBN is better for sleep than plain old THC. It’s possible that 5mg THC plus 2mg CBN is better for sleep than 7mg of THC, or it might be the same. CBN is a relatively benign medicine, so for patients needing sleep it is not unreasonable to see if added CBN helps.
CBG (Cannabigerol)
CBG is another cannabinoid for which we have very little human data. CBG has been touted as anti-inflammatory and possibly neuro-protective (slows down neurodegenerative diseases like Parkinson’s and others) but we have no human data to support those ideas. There has been one study in humans that has shown CBG useful for patients with anxiety.
CBG is non-intoxicating and largely benign but we have so little data to support use that at this time I would not recommend seeking it as an ingredient.
CBC (Cannabichromene)
CBC is yet another cannabinoid that is being thrown into cannabis products. We have no human data on whether it is safe or useful – I would avoid.
THC-V (Tetrahydrocannabivarin)
THC-V is a distant cousin of THC. It, too, can be intoxicating though there is debate on how much and how long it lasts compared to THC. There is also a claim that it suppresses appetite and is often called “diet weed”. Sadly, this has actually been shown in humans not to be the case. However, THC-V has some early human evidence that it improves glycemic control and lipid profiles – so with more data there may, in fact, be use for THC-V. Stay tuned.
THC-A (Tetrahydrocannabinolic Acid)
THC-A is the precursor of THC. The cannabis plant actually makes THC-A, not THC, and we create the THC by burning or otherwise heating the cannabis material. THC-A is non-intoxicating, abundant, and has been shown in human tissue to be a strong anti-inflammatory. There are data showing benefit in humans for auto-immune diseases like Crohn’s, Ulcerative Colitis, and Rheumatoid Arthritis. I have used THC-A successfully to help patients with these diseases. Unfortunately, in the recreationally dominated market, it is rare to find THC-A products available.
Next Time
Now that we’ve covered some of the different cannabinoids found in the cannabis plant and their safety and effects, next time we’ll continue to talk about safety when it comes to additional additives, hemp, and more.
Consult with a Qualified Massachusetts Medical Marijuana Expert Today
Those considering using THC, CBD, or any type of medicine found in cannabis to help manage their condition should consider speaking to a trained medical expert who is knowledgeable about using cannabis therapeutically.
Massachusetts medical marijuana doctor Jordan Tishler, M.D. sits on the faculty of Harvard Medical School and has years of experience helping patients treat pain and other ailments using cannabis. He and the team at inhaleMD stand ready to assist patients in determining whether medical marijuana is right for them.
For more information, or to set up a virtual consultation with the team at inhaleMD, call us at (617) 477-8886 today.