Top questions from the TruPotency AMA on Reddit

TruPotency recently held an AMA on Reddit focused on CBD. For those who are unfamiliar with an AMA: "Reddit IAmA (as in I am a _____, Ask Me Anything) Community is a place on Reddit where a new kind of crowdsourced interview can happen, which we call an Ask Me Anything. The interviewee begins the process by starting a post, describing who they are and what they do. Then commenters from across the internet leave questions and can vote on other questions according to which they would like to see answered. "

If you want to see the questions, feel free to check out the Reddit thread here, or see some of the top questions and answers below.

Q:

There's a lot of claims of what CBD is good for. What's the greatest myth about it to you?

A:

I think some of the biggest myths are that CBD will cure X disease. At most, we think CBD might help with symptoms of various ailments, but a cure for Parkinson’s, Alzheimer’s, anxiety, and more is probably not the case. I would be more than happy to eat my words as more data and research comes in though.

Q:

What are some things CBD is actually good for? And what are things we think it might be good for but don't have enough data to prove it yet?

A:

CBD might possibly be beneficial on many therapeutic fronts. Although the only FDA approved medication of pure CBD is Epidiolex that is prescribed for seizures (Lennox-Gastaut Syndrome and Dravet Syndrome). Sativex is not available in the US but is a 1:1 THC:CBD available in other countries for spasticity and pain.

Here are a couple of reviews of what it might be good for:
* neuro/psychiactric: Psychiatric disorders like anxiety, depression, schizophrenia and more. Potentially mechanism related to serotonin, PPAR gamma, and a broad variety of other targets.
* anxiety: Anxiety is one big area that CBD might have benefits. Whether it is generalized, social, OCD, PTSD, and more, the data looks promising, but not many clinical trials yet.
* pain 1. This is cannabis-based medicine, but they talk about CBD as well. The lab I worked in focused on pain research and I believe CBD can be beneficial for multiple types of pain.
* pain 2 : CBD may be good for pain and inflammation related to osteoarthritis.
* inflammation: CBD is good for inflammation through potentially a broad variety of actions.
* epilepsy: This one is the most apparent since we have the FDA approved medication Epidiolex.
* many more issues like nausea: CBD might also be useful for nausea, blood pressure, insulin metabolism, reducing tumor growth (*added note from a comment below -- a suggestion of reducing tumor growth does not mean a cure for cancer, although there is ongoing research with CBD and other cannabinoids in oncology), and other diseases and disorders. Although I want to stress more research needs to be done.

Edit: spelling

EDIT 2: I wanted to add potential benefits for those with substance use disorder (e.g. alcohol or opioids) and there are many current and past clinical trials - https://clinicaltrials.gov/ct2/results?cond=&term=cannabidiol&cntry=&state=&city=&dist=

EDIT 3: Since this is the top comment I wanted to post an additional resource. Although not 100% CBD based, it is cannabis-focused and contains a lot of great information about CBD, including the opening talk "The Endocannabinoid System: The Biological Foundation of It All" and a wonderful Canadian neurologist whose talk is titled "Pediatric Epilepsy: Novel Cannabinoid-Based Treatment". https://be.arizona.edu/iics

Q:

This is all I want answered. Have we proven with repeatable double-blind tests that it is good for anything? Anything at all?

A: 

Here are clinical trials currently ongoing for CBD. Many actually related to substance use disorders, epilepsy, pain, anxiety, and other psychiatric conditions.

Q:

I'm a progressive candidate for the Texas State Legislature, and former harm reduction nonprofit executive and county health department associate director of POD / MRC response and logistics, among other things.

What role should state lawmakers and other officials take to work with the industries to ensure purity standards, promote awareness, and aside from the health and scientific aspects, what would you advocate for in terms of general policy, research, and legislative or other mechanisms regarding CBD?

It's been brought up by some constituents, but generally not negatively. It's very difficult to find comprehensive policy proposals, as of yet.

A:

Kudos for your former work in harm reduction. There is some promising research regarding CBD use for substance use disorders that I am sure you are aware of.

That is a complex question and I don’t think this answer will be fully satisfactory, but I think CBD should be federally regulated to ensure purity standards. With CBD showing up everywhere from online to CVS, gas stations, and corner stores outnumbering Starbucks, we need to make sure people have safe products.

I think the first thing to do is to talk to industry experts in analytical chemistry and manufacturing to find the best solution for a unified testing protocol. We should have confidence that if I test at lab A, then I should get the same results at lab B (within reason, of course, as there is always some variation). The exact variation that we should expect might be tough, but I think a +/-10% variation from the label amount might be a good target as well as a full panel for safety required (e.g. heavy metals, mycotoxins, and more). But the actual implementation would need more debate than we have room on Reddit.

There is also a huge amount of misinformation and I think public education is key. We do education events and even talked at a Plant Medicine conference recently. We need to let people know the good, but also the bad. CBD can interact with other medications (similar to grapefruit juice) and lead to issues.

Overall we do need more research into both positive and negative effects and that can start from a government funding aspect. NIH and NSF are the two biggest sources for research money for most PIs, but it can be very hard to actually get the funding for research into CBD.

Q:

When looking to buy CBD products as a consumer, is there a reliable way for me to know which products are legitimate versus not? If not, is there any inherent danger that comes with the > 70% of "false products" on the market?

A:

The best thing you can do is to make sure a product has a certificate of analysis (COA). This shows that the product was tested at an analytical laboratory and should have what the label states. Although there is a little gray area there. Labs are known to alter COAs for customers for “correct” results.

That is one reason we double check all the products on our site, because some companies have COAs, but they’re actually falsified or the COA is for the isolate used and not the final product. There is also a lot of variance from lab to lab in the quality of results. We really need better regulation, so we do not have to worry about the quality of product testing information.

The main inherent danger comes from having THC in a THC free product for those trying to avoid that, or there are other harmful chemicals like pesticides or synthetic cannabinoids.

Q:

Is it true you need a bit of THC to activate CBD? Why is this true?

I use medical marijuana and was told this.

A:

This is from the idea of the entourage effect and it seems that CBD and THC can work synergistically. There is some good data backing this as can be seen in this review. This meta-analysis suggests a CBD rich extract is much better than a pure CBD for treating epilepsy, using about 4 times less.

Q:

For real. There's a podcast I listen to, about sex, and one of the products that the female host is hustling is a CBD cream for a female's lady parts. Out of all the ridiculous applications for CBD, that one takes the cake (until CBD anus cream comes along)

A:

CBD may actually be able to increase blood flow to the clitoris. CBD will activate TRPA1 receptors leading to an increase NOS and then blood flow.

Q:

So what is in the "CBD" products that aren't labelled accurately?

A:

There can be heavy metals, pesticides, mycotoxins, and other harmful chemicals. Generally, the labeled amount of CBD is just way off (e.g. 500 mg on the label, but tested for less than 300 mg). We most often see missing cannabinoids or terpenes from the label (e.g. CBG claim yet no tested CBG) or cannabinoids that shouldn’t be there (e.g. d-9-THC in an isolate product).