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This free article includes a basic explanation of the controversial entourage effect theory, an overview of CBD consumption avenues, and a description of CBD isolates versus broad-spectrum formulations versus full-spectrum preparations.
CBD & the ECS
A solid understanding of the medical efficacy of the hemp-derived cannabinoid cannabidiol (CBD) necessarily involves consideration of the network of specialized microscopic cellular receptors found throughout the body. CBD and other plant-based cannabinoids (called phytocannabinoids) interact with the body in sometimes nuanced ways with respect to bioavailability, dosing, and tolerance—among other efficacy characteristics.
The Endocannabinoid System
Understanding CBD & the ECS. An important discovery was made in 1992 when research scientist Dr. Raphael Mechoulam and his team uncovered something they dubbed the endocannabinoid system (ECS; sometimes denoted as eCS). The ECS is a series of microscopic cellular receptors located throughout the brain, central nervous system, and immune system that is intimately involved in the management of many critical bodily functions, including cognition, appetite, pain, sleep, and mood, among others.
"The ECS is intimately involved in the management of many critical bodily functions, including cognition, appetite, pain, sleep, and mood, among others."
Molecules such as CBD have been found to plug into this network of cellular receptors perfectly (meaning they exhibit what medical researchers call a strong binding affinity), producing positive health and wellness benefits.
The ECS is a feature of not only all humans, but also mammals and—in fact—all vertebrates. This has major ramifications for veterinary medicine, which is beginning to find value in administering CBD for household pets. Canines and felines suffering common ailments such as arthritis and digestion issues gain the same benefits from CBD as their human owners.
The Entourage Effect
Understanding CBD & the ECS. The superior health value of full spectrum extracts made from CBD oil is supported by a theory called the entourage effect. First suggested in 1998 by the same researchers who identified the ECS, this theory postulates that the consumption of several cannabinoids simultaneously produces synergistic benefits that exceed the value of the individual molecules alone.
The entourage effect was explored by Dr. Ethan Russo in his 2011 paper "Taming THC: Potential Cannabis Synergy and Phytocannabinoid-terpenoid Entourage Effects."
The entourage effect was further explored by medical researcher Dr. Ethan Russo. In 2011, Russo published a research report entitled "Taming THC: Potential Cannabis Synergy and Phytocannabinoid-terpenoid Entourage Effects." The study concluded, "More recently, the synergistic contributions of cannabidiol to cannabis pharmacology and analgesia have been scientifically demonstrated. Other phytocannabinoids, including tetrahydrocannabivarin [THCV], cannabigerol [CBG], and cannabichromene [CBC], exert additional effects of therapeutic interest."
Isolates vs. Broad Spectrum vs. Full Spectrum
Understanding CBD & the ECS. A tincture is often called an extract because it involves the separation of healthful molecules like CBD from the biomass of a plant like hemp. However, extracts are manufactured using a variety of approaches and methodologies. These include isolates, broad spectrum, and full spectrum.
Isolates involve extraction and delivery of a single molecule, such as CBD. Broad spectrum involves removal of some cannabinoids and is a filtering process intended to remove unwanted ingredients (typically tetrahydrocannabinol [THC], the psychoactive component of cannabis). Full spectrum (sometimes called "whole plant") formulations involve no removal or filtering of cannabinoids.
Many medical professionals prefer broad spectrum extracts because a notable percentage of their patients simply cannot tolerate even low doses of THC.
Many medical professionals prefer broad spectrum extracts because a notable percentage of their patients simply cannot tolerate even low doses of THC. Anxiety, disorientation, and panic attacks are sometimes experienced by those who consume even minor doses of THC.
CBD Consumption Avenues
Understanding CBD & the ECS. CBD products are available in many forms, allowing doctors and patients to optimize treatment protocols and match consumption avenue(s) to lifestyle, personal preference, subjective efficacy, and dosing requirements.
Tinctures, capsules, and other forms of CBD are available that can be discreetly consumed by patients, even during work or travel. Some of the highest quality tinctures and capsules are derived from CBD oil, a concentrate that intensities the potency and medical efficacy.
CBD Research
Understanding CBD & the ECS. Discovered in 1940 by Dr. Roger Adams and further clarified in the early 1960s by the pioneering research of Mechoulam, CBD has been on the radar of medical professionals for decades. It is only now, however, gaining widespread adoption due to the federal legalization of hemp and factors such as the emergence of the opioid epidemic, where adjunct therapies such as CBD are being used to help substance abusers.
CBD & the ECS: 2022 Study
A 2022 research study entitled "Cannabidiol as a Treatment for Arthritis and Joint Pain: An Exploratory Cross-sectional Study" that was published in the Journal of Cannabis Research explored the efficacy of the hemp-derived cannabinoid cannabidiol (CBD) for arthritis.
The study stated that its data reveal "associations between CBD use and improvements in patient's arthritis symptoms and reductions in other medications." Like thousands of other studies that have investigated the efficacy of hemp, cannabis, and its constituent cannabinoids such as CBD and THC, it recommended ongoing research that focuses on "the benefits of CBD use in this patient population with clinical trials."
CBD & the ECS: 2017 Study
A 2017 study entitled "An Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies" that was published in the journal Cannabis & Cannabinoid Research found CBD to be safe, reliable, and to offer few negative side effects.
Concluded the researchers, "In general, the often described favorable safety profile of CBD in humans was confirmed and extended by the reviewed research. The majority of studies were performed for treatment of epilepsy and psychotic disorders. Here, the most commonly reported side effects were tiredness, diarrhea, and changes of appetite/weight."
CBD & the ECS: 2012 Study
A 2012 study entitled "A critical review of the antipsychotic effects of cannabidiol: 30 years of a translational investigation" published in the journal Current Pharmaceutical Design found CBD to be effective in the treatment of psychosis and in buffering the tendency of THC to sometimes induce anxiety and panic attacks in users, especially in more potent doses.
Summarized the study, "Laboratory rodents and human studies have shown that this cannabinoid is able to prevent psychotic-like symptoms induced by high doses of Δ(9)- THC. Subsequent studies have demonstrated that CBD has antipsychotic effects as observed using animal models and in healthy volunteers."
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