The CBD industry is booming, but how much of it actually works?
From CBD bath bombs to CBD lattes to CBD-infused workout gear, the questionable wellness trend is everywhere. Unlike THC, the molecule in cannabis that induces the "high" feeling weed is known for, CBD is being studied for its impact on sleep, anxiety, and inflammation without THC's psychoactive effects.
Because of interest in its to-be-determined powers, CBD is marketed as a cure-all. Consumer products, like CBD shots added to drinks, claim to guarantee relaxation, improve mood, and relieve pain. CBD has been clinically proven to treat anxiety at very high doses, reduce inflammation, and treat epilepsy, but it's not quite the miracle supplement it's marketed as.
In the first of a three-part series about CBD, here's what you need to know about CBD edibles.
Here's the thing: Orally administered CBD has so far been clinically proven to be effective at very high dosages. A 2015 study by New York University concluded that CBD could be used to treat patients with anxiety disorders, but the dosages ranged from 300 to 600 mg. In another study performed by the University of São Paulo in 2017, subjects were less anxious with public speaking after a 300 mg dose of orally administered CBD, but not after a dose of 100 mg.
Consumer products, on the other hand, typically range from 5 mg to 25 mg.
Basically, you may have to swallow a hand full of CBD capsules to feel less anxious beyond a placebo effect. As a study about insomnia and anxiety published in The Permanente Journal noted, "the current retail cost of CBD would make the use of 600 mg/dose cost prohibitive."
Why does the dosage need to be so high, while THC edibles can couch lock you at just 10 mg? It comes down to bioavailability, the amount of a drug that has an active effect when absorbed by your body. Like any drug, if you want CBD to work, it has to travel through your bloodstream to get to the rest of your body. When you pop a CBD capsule, it's absorbed by your digestive system, and then makes its way to your bloodstream and later impacts your brain. Orally-ingested CBD has a very low bioavailability compared to inhaling it, so you'd need to down a lot of capsules to get the same effect as vaping it.
There's no consensus on the exact oral bioavailability of CBD — a 2009 study published in Chemistry & Biodiversity concluded it's somewhere between 4 and 20 percent. That means that if you consume 100 mg of CBD, you may get less than 20 mg in your bloodstream. Since most consumer products have CBD doses of less than 25 mg, you'd get even less CBD into your bloodstream.
Known as the "first pass effect," the liver breaks down certain compounds so much, it may not have a noticeable effect on the body anymore. When THC goes through the liver, it metabolizes into another more potent psychoactive molecule. CBD, on the other hand, is susceptible to the liver's first pass, but it doesn't get broken down into something stronger like THC does. While 10 mg of THC can couch lock you into bingeing nature documentaries, orally ingested CBD tends to be less effective.
What edible versions of CBD do work, then? Here's a rundown of the products on the market right now.
CBD capsules and gummies
CBD capsules, pills, and gummies are often marketed as daily vitamins or sleep supplements. Dosages can range from as low as 5 mg per serving to 50 mg.
Daniele Piomelli, director of the Institute for the Study of Cannabis at the University of California, Irvine, is skeptical of low-dose CBD products.
"You will need approximately 20 of them to do anything that is of use," Piomelli vehemently explained when asked about low-dose CBD capsules. "And why would you do that? Besides, what else is in those pills?"
He's also concerned about the ingredients added to the edibles that may not be listed on product labels.
Alex Capano, chief science officer at hemp company Ananda Hemp and the first person to earn a Ph.D. in cannabinoid studies, says she recommends consuming more than 5 mg for oral dosages, but notes that not all gummies are produced effectively.
"Some companies spray CBD isolate over the gummy and it doesn't stick at all, so it has to be infused, uniformly," she said. "So they have to have a little more sophisticated manufacturing."
Additionally, some CBD edibles are cut with supplements like melatonin, which regulates sleep cycles, or L-theanine, which can induce relaxation without drowsiness. In those cases, is it the CBD working or the supplements?
It's worth noting that if you're looking for pain relief, CBD alone may not work for you. Even if you don't want to get high, researchers have said that CBD is more effective for pain when taken with a little THC. "Whole plant" or "full spectrum" products that include other cannabinoids and terpenes may also have the benefit of the entourage effect, which is believed to enhance both CBD and THC's therapeutic uses because they're working together.
Verdict:
Unless you're ready to throw down some serious cash to treat your anxiety, skip the CBD capsules, pills, and gummies. There haven't been any conclusive studies about using CBD capsules to treat other issues like pain and inflammation, and most "proof" of its success has been largely anecdotal. You don't have to rule it out entirely, but don't be disappointed if it doesn't work for you.
CBD-infused drinks
You've probably stumbled across CBD-infused water, CBD tea, and oh god, even CBD beer.
Remember that whole thing about bioavailability? It's that all over again. Chugging a bottle of juice infused with 25 mg of CBD may keep you hydrated, but it's unlikely you'll experience effects like reduced inflammation. A single bottle of water infused with 10 to 25 mg of CBD averages about $5.
Consumers should be especially cautious with CBD-infused beer. Piomelli likens mixing alcohol and CBD to "sledding on a very, very dangerous path" because mixing any substances together risks effects that are "nastier than alcohol itself."
"Look, I'm happy to have a glass of wine or maybe even a shot of whiskey every so often, but you know, it's once you start mixing the stuff we do not know what's happening," he said.
"That's not a whole lot of CBD to get any effects when you're consuming it orally," Capano said. Still, she points out that both alcohol and cannabinoids are processed through the liver, so it's like drinking and taking a Tylenol. The side effects may not be severe, but it's still risky.
And while some CBD drinks may leave you relaxed, it might not be from the CBD. As one company told Thrillist, they add adaptogens to enhance the purported effects of CBD. Adaptogens are fungi, roots, and herbs that wellness products claim can reduce stress. Drawing from Eastern medicine, extracts from plants like ginseng and reishi mushrooms are added to many infused drinks to improve mood. It's scientifically questionable, just like drinks with very low doses of CBD.
CBD is also fat soluble, which means that it won't dissolve in water. It's more likely to stick to the plastic bottle versus dissolve in the liquid. CBD is also persnickety when it comes to sun exposure, so clear packaging will hurt its shelf life.
Verdict:
Again, because of the low bioavailability of CBD, it's unlikely that infused drinks will be effective. As long as it's not mixed with alcohol, it probably won't hurt you, but it's probably also just an overly expensive drink.
CBD-infused food
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CBD-infused food is unlikely to cure your aches and pains. While edibles with THC have a reputation of being almost too potent for first timers, the digestive system doesn't break down CBD the same way.
Take, for example, the CBD-infused burger that Carl's Jr. sold for 420 in 2019. With only 5 mg of CBD, it's unlikely that it had any effect on customers.
"When you ingest it in a sandwich or a latte, you lose a lot of that active ingredient to your digestive system," Capano said. "It's not gonna hurt you, it's kind of a waste of money."
Like we noted before, CBD is fat soluble. A carrier oil, hemp seed oil or coconut oil, helps your body absorb cannabinoids. Capano added that most companies are misleading about CBD potency, since there's little regulation in the industry, 5 mg might mean 5 mg of carrier oil, not 5 mg of pure CBD.
Verdict:
You might get indigestion, but that's probably from the junk food (although too much CBD can give you diarrhea, according to the FDA). It's unlikely that infused foods will give you the therapeutic benefits CBD is proven to induce.
CBD shots added to a drink
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Is that additional $5 for a pump of CBD in your drink worth it? Probably not.
Remember how CBD doesn't play nicely with water?
"It's oil based naturally, so it may just stick to the mug and not even get in your mouth at all," Capano said.
She did note that CBD shots in beverages are at least better than most "infused" drinks, because it's difficult to make CBD stable in large volumes of liquid. In a smaller shot that's later added to a drink, at least, it has a chance of still being effective.
"It's probably not enough," Capano said.
If you do choose to add CBD to your latte, make sure you know how much you're getting and the purity of the shot. If it's only 5 mg, you're better off drinking plain coffee. If it's 25 mg, you may feel something.
Verdict:
Lattes can give you that boost you need to start your day. CBD may be able to give you the boost you need to get over your aches and pains. But they're probably better taken separately.
CBD sublingual products
Our digestive systems are hardy for a reason — they're supposed to break down what we eat. A CBD gummy, for example, will go through saliva, stomach acid, bile, the liver, and then to everywhere else in the body via the bloodstream. To bypass all of that, try using CBD under the tongue.
"Anything that's going to have that immediate bloodstream absorption," Capano said, has a higher chance of working. That's why tinctures, sprays, and lozenges are the "ideal way to consume CBD."
The sublingual gland, which sits right under the tongue, helps make saliva. Any medication applied to it will be absorbed into the bloodstream more quickly and more effectively because it's diffused through the thin mucous membrane that covers the underside of the tongue. It skips the whole digestion process and gets directly to the bloodstream.
Remember bioavailability? A 2002 study reported that the bioavailability of sublingually administered CBD is between 13 to 19 percent. A 2012 study reported bioavailability as high as 35 percent. As a reminder, edible delivery methods only have a bioavailability between 4 and 20 percent.
Different product concentrations affect how much CBD you're pulling in per drop, so it's better to start small and work your way up.
"Go slow, and start low," Piomelli said.
Verdict:
It's not perfect, but you have a better chance of feeling the effects of CBD through a spray or under the tongue strip than any other oral method. You can also try tinctures, which are concentrated and administered through droppers, if you don't mind the taste.
Final Verdict
Don't fall for the snake oil — CBD may be beneficial, but the industry is still new and largely unregulated.
Piomelli noted that while "many, many more" clinical research studies need to be done on CBD, it won't hurt to use it in moderation if you're trying to control minor issues like back pain or insomnia. But don't expect it to live up to the sweeping claims several companies are making. There has been some testing on CBD's effects on mental health and pain management. However, CBD won't, and shouldn't, replace medications that are proven to treat serious conditions.
If you have the cash and want to try something new for your anxiety or sore muscles, CBD is an option. Just don't be shocked if it doesn't work for you. And if it does, then money well spent.
The information contained in this article is not a substitute for, or alternative to information from a healthcare practitioner. Please consult a healthcare professional before using any product and check your local laws before making any purchasing decisions.
