TECHNIQUE TO FIND THE SWEET SPOT DOSE OF CBD AND THC
CBD being declared a Schedule 1 drug arbitrarily, rhetoric has no basis in reality.
CONTINUED FROM PART 2 OF THE SERIES - The therapeutic qualities of CBD and the many healing properties of cannabis.
Dr. Mercola: Sure I’d like to ask discuss the CBD at this point, since prior to this. rescheduling of CBD was legal in every state in the country. So we had widespread implications for everyone. and it may actually shift back. because, as I understand from watching the NBC news report. that President Trump’s appointee for the DEA is actually Walter White, who from Breaking Bad, I think he was… (joke).
Dr. Margaret Gedde: Oh! Yeah, yeah, yeah! The actor
Dr. Mercola: No, I'm just kidding, it was actually the Saturday night live skit, but the point is that Trump may appoint someone who may override this ridiculous decision. If they do, and hopefully they do, because it just makes no sense, for it just makes no rational sense. So it is illegal, it was legal in every state, who knows what it will be by the time this interview airs. But, while you review the indications and what you use it for personally, what the literature shows it’s beneficial for many things.
Dr. Margaret Gedde: Ok, and it’s it is quite a long list, because of the involvement of so many body systems. In a muscle spasm with pain, cannabis is a really good muscle relaxer. Both THC and CBD goes into the muscles really well in a topical pain rub. The cannabis can penetrate skin, because of its oily nature, it goes right through the skin, into the tissues. So it treats muscles spasm, either through the topical root or by the oral route, swallow down by mouth edibles where the cannabinoids is processed through the liver. It actually become hydroxylated and turned into a somewhat different form. It’s that edible root that will give the best deep relaxation, and pain relief, and it lasts the longest. This is because we get these hydroxyl forms. So in muscle spasm. the pain signals are sent effectively to settle down a nerve generating the pain.
Cannabis can be used in those various forms, it does seem to work in general for pain relief, and for long-term maintenance and management. The swallow down dose is going to be the most effective. It gives the longest lasting effect, but we find the very best effects are when people can layer their dosing, and use the topical, and yeah, something quick, either inhaled or under the tongue, and also use swallow down. OK, so we said its for pain and spasm, nausea, but also THC is famous for giving the people the munchies, and also helps people who are nauseous, from chemotherapy. So THC really, in my experience, has no peer in this way. There’s nothing we can prescribe that’s as effective as THC for nausea.
People can puff very quickly on a vaporizer, or swallow something and quickly settled nausea, and also improve digestive function, It’s an interesting thing, again when someone has irritable bowel syndrome, and it just makes the nerve and muscles are working together very well, and for constipation and diarrhea. Now what the cannabis does and is it doesn’t do, It’s not something, say that you would take if you’re constipated to make you go, and it doesn’t doesn’t push a person one way or the other. Again it always brings things into balance, so I mean, I don’t know all the details of how it works, but what my patients report to me is that when they can swallow down their dose, and get the dose to the proper place, their gut function just improves.
The dysfunction of gastroparesis, where the stomach is not moving correctly, it seems like the muscles and nerves the function improves, and how is it doing this? What is the actual mechanism to get things working together? Again, it’s fascinating and much research needs to be done, but for gut, for nausea, and a digestive function, for colitis and bowel function, for the inflammatory bowel diseases, that’s a huge area for THC and for CBD. That’s where the THC really is it’s important. We know from the literature and reports, that cannabis can help glaucoma, can help bring down intraocular pressure, and we do see it as well clinically. Cannabis helps to normalize blood pressure. Now that’s not one of the medical indications in Colorado, and if I could write a recommendation for everyone that had high blood pressure, you know then everybody could get it right there.
There is the psychological, the emotional and physical components, when you combine it in the body, its relaxation and the mental effects, people's talk about just being able to relax and it brings the stress down. So this probably part of how cannabis helps lower blood pressure, just bringing stress down, the tension goes down. It definitely does help normalize blood pressure, so people are able to reduce their pills, and that’s actually one of the real cautions I do tell people about. If they’re on blood pressure medication, and they add the cannabis blood pressure, it actually can go too low, so I learnt them to dial down the blood pressure medications, because the cannabis can normalize, not for everybody, but this something we do here frequently. That was pressures seizures, so that’s a famous indication, we have to be real careful with the dosing.
With seizures, I do find that that needs the most precise dosing, and we have found that CBD cannabidiol that’s not psychoactive, it actually is a bit harder to use for seizures than THC, and that is because the CBD definitely can be given in too high a dose, where it’s actually causing more seizures. So with the seizures, we learned this is where we have to be really careful, to be precise with the dose and find that sweet spot. Because if you can use too much, or go up too quickly, knowing that it takes three weeks to fully build-up in the body of a person. if a patient increases every week their dose, they can too easily just blow by their sweet spot, so with seizures, we're really careful to find that sweet spot, and then we can get steady maintenance that way.
Let’s see what other things on our list. In Colorado, AIDS- HIV is a one indication, someone has HIV, they can get medical cannabis, and it helps in numerous ways, with sleep, nausea and pain and also immune support. Let’s see the ones that are on the qualifying conditions listing in Colorado. It would include the more psychological diagnosis, so THC can induce anxiety, if the doses are wrong, or the strain is not compatible with the person, but many many people use THC to relieve their anxiety. I can mention at this point that, because we have just these hundreds of different strains of marijuana and cannabis, each of which is slightly different.
There is a huge potential to customize for each person, so in addition to the cannabinoids in the cannabis plant, where they’re probably about 60, we focus a lot on the THC and CBD. I would like to talk a little bit about the raw form for THCA, because Dr. Mercola, you we're talking about maybe putting cannabis in shakes and that sort of a thing. When you use it in the raw form unheated, you actually get a whole other set of cannabinoids, which is, which are also therapeutic, but those cannabinoids are in a range of variations in the different types of strains available.
But, there’s a whole other set of compounds in the cannabis plant called the terpenes. These are ones that are in essential oils, so these are oily substances as well, and these are the ones that give each marijuana strain different unique colors and smells. So some strains smell like lemon and other strains are purple, and they smell like lavender. In fact, the same terpene that is in lavender linalool, and that’s the calming relaxing linalool, that’s the same thing that’s in many other marijuana strains, and those tend to be the kind that are more calming and relaxing.
So we have this a whole range of range of strains, where the more common sleep inducing relaxing kinds which are called Indicas. We all remember this now, it’s a latin name, you know historically applied, but we say now that the Indicas put you on the couch. So patients can remember which one they should be looking for for sleep. The Indicas are not going to induce anxiety, they’re going to be relaxing and bring down the stress level. The Sativas are more stimulating and energizing. They can keep a person up at night like a cup of coffee might, and for some people they make them paranoid. They make them too edgy, especially people with post- traumatic stress.
So on the psychological spectrum the strain selection is very important. So the cannabis can definitely help anxiety, it helps depression or kind of a low mood, when you use those energizing strains, the one’s that are kind of the pick-me-up one's.
Post-traumatic stress is so difficult to treat, the veterans are a huge population. We are in Colorado Springs and the military bases are here, and so we see a lot of veterans who have been overseas, and not only do they have all the physical injuries, but they have the psychological injuries, so we see how much help benefit from choosing the correct strains, and being able to actually get the benefit of that well-known property of THC. THC causes forgetting, THC is known to kind of slow the mind down, and you can’t quite think about the things maybe you were going to. When you have a person with post- traumatic stress and they have intrusive thoughts, we need to have the mind slow down, and those thoughts just don’t break through, and the nightmares don’t break through. That’s a huge boost, in post-traumatic stress, we see a lot of good results, but I can’t write the recommendation for that, so that’s just what we do in our consultation.
Dr. Mercola: Sure, there may be another - off the list recommendation. I think it’s been shown in some research, cannabis is useful for Cancer, and Rick Simpson of course is that Canadian farmer, I believe is has a popular way of extracting cannabis oil and said he sells, but actually he tells you and explains how to produce it, so what is your experience in using cannabis to treat cancer
Dr. Margaret Gedde: Yes, for cancer…
Dr. Mercola: not just that nausea from the chemotherapy, which doesn’t treat the cancer but I mean…
Dr. Margaret Gedde: Yeah, the actual interaction, properties…
Dr. Mercola: Yes, the actual, yes tumour benefits, right. What is your stand in it…
Dr. Margaret Gedde: Cancer is one of the qualifying conditions in Colorado, that’s the one I hadn’t mentioned, certainly people with cancer are going to find great relief on multiple levels with a relatively low level of THC, for their nausea, for sleep, for pain, for spasm or an end to depression, for the stress and anxiety of their illness.
But as you mentioned, then reaching beyond is sort of controversial, but it actually can’t be denied, because of the research base that just keeps expanding both THC and CBD, have very well documented antitumor properties, that have been shown in laboratory and animal studies. So far it's preliminary, but there are some human studies which are blocked almost, you know completely in the United States, but there are studies in patients controlled trials coming out of Spain, and Israel and in the laboratory studies.
What we see is that CBD and THC both have multiple ways of inhibiting tumour cells. One way would be that there is an angiogenesis inhibition property, so that the tumours can’t make their blood supply, so they restrict their blood supply. Another mechanism seems to be is, that it triggers programed cell death, that is apoptosis, were it works through the immune system signals. So the antitumor property of cannabis isn’t a poison like the chemotherapy. It goes and target, the cells, then they die. It’s working with the immune system, it's working through our natural mechanisms to go after cancer cells. They worked out in the details of what molecules are being worked through, and when the cancer cells do die
This is something that even the National Cancer Institute acknowledges in their article on cannabinoids and cancer. They do have a nice article up on the National Cancer Institute website. They talk about all those palliative effects and they just have a small paragraph saying, there is some evidence that cannabis could get direct tumour effects, but much more needs to be known.
As you mentioned, there’s a Rick Simpson up in Canada, and he has this very nice website and he talks about his experiences making the concentrated cannabis and giving it to cancer patients. The reason it did need to be concentrated out of the plant material, is that the doses to shrink the tumour, to get after a tumour, are high, so this is the highest level dosing, this is where patients really need to have a strategy to become tolerant to the psychoactivity of the THC. In order to build a dose of enough, without really being you know completely besides themselves, and and it has been a huge boon to have the CBD available along with the THC, not only because the CBD has its own anti-cancer properties itself, it is not psychoactive, so it’s easy, easier to take in, in many circumstances, but also because of this very fortunate interaction.
That's a key thing I tell a patient about the CBD, it will literally block some of the high, the psychoactivity of the THC, and it sits on that CB1 receptor, a cannabinoid 1 receptor in the brain. When you combine CBD and THC together in a dose, and have them in a person’s body at the same time, the THC is much easier to take in high doses, because it’s that psycho activity that really makes it so difficult to dose-up. So with the availability of CBD, what we’re recommending now steps beyond what the Rick Simpson protocol was. People look to get about half and half - CBD and THC, and build-up to the gram of concentrate that Rick Simpson had recommended, has suggested that would be a daily dose.
So a gram of cannabis concentrate has about 800 milligrams of cannabinoid, so a person would take about four hundred milligrams of each of CBD and THC and build up to that level, and then that that’s just sort of a suggested target, knowing that those high doses are needed to push back a tumour, but that level might not be the best level for each cancer, so then what I advise people to do, is to get their dose up, but then of course you have to track the tumour markers, or whatever the scans are where you’re following the tumour, and then if that one gram is not holding it, then you know if they can move it even higher. Then they may be able to stop it. There is one patient I remember very clearly who talked about using two or three grams of cannabis concentrate a day to pushback and shrink an inoperable tumour, but at one gram a day, it wasn’t doing that. Another person might find that 500 milligrams a day would be sufficient to keep their blood markers steady and conclude there was no progression.
Dr. Mercola: That’s good information to know and I just finished writing a book called "Fat for Fuel" that focuses on the use of nutritional ketosis or teaching the body how to burn fat as a primary fuel. One of the primary benefits interestingly in clinical conditions, is cannabis use targeted for cancer. Clearly it's highly beneficial, and also, for the last 80 years, it's unequivocally the treatment of choice for drug-resistant seizure disorders, in neurodegenerative disorders and diabetes and obesity, the list goes on and on, but the reason I’m mentioning this is, it would seem its targeting a very similar diseases as cannabis.
I’m wondering, if you looked at the molecular biology, because the reason why nutritional ketosis works is that up regulates mitochondrial function. it improves of autophagy and mitophagy and cellular regeneration about mitochondrial regeneration. That’s the reason why it works. It would seem that would be a probable mechanism of action to explain some of the benefits and actions we're seeing in the use of cannabis clinically, and then wondered if you’ve looked and studied the molecular biology from that perspective.
Dr. Margaret Gedde: Wow! Actually Dr. Mercola, I have to say that I have not made that connection, it is something that I’m going to think about! I see in my pediatric seizure patients, that very often they are on the ketogenic diet, and so this is one element where ketosis just as you described can control seizures, and I have never known this mechanism. I haven’t dug into it and I think that what you’re describing, probably is related. We do see that it can be a very helpful diet, but then of course, depending on how extreme it needs to be, there can be problems with bone wasting and you know other medical problems.
Dr. Mercola: Let me send you a copy of the book and hopefully that will give you a really good grounding. A little while after I read hundreds and hundreds of articles and dozens of books, and spoke to some of the leading experts in the world on this one. It’s a speed course, to get you up to date and then when you have that, with your knowledge about cannabis, I’d really be interested in your feedback on that, because I think there really is a connection there, it seems you’re describing these benefits in the target clinical targets, it’s so similar to what ketosis is doing.
Dr. Margaret Gedde: There you go. I would not be surprised at all, it was a wonderful way to sort out and understand how this all working together, so thank you very much. I look forward to seeing that appreciate it.
Dr. Mercola: Ok, I will definitely send you a copy, we're really coming close to that amount of time we’ve allotted for the interview, so maybe if you can conclude or maybe mention in target, some specific items that you want to highlight, or reinforce, maybe mention something you hadn’t in the past, I mean really the point that you’re making.
I really appreciate you’re giving us this information, and sharing because you’re in the trenches. I mean, there’s not many people who are in the trenches. Out there in Colorado, it is that State that the business you’ve been in the trenches is the longest legally. So you know, we really appreciate your take on this and obviously the scientific bent and orientation you have been working with. The pharmaceutical industry I mean, you are really are grounded pretty well in the science , so why don’t you go to it and sort of conclude it for us..
Dr. Margaret Gedde: Thank you, I do have that scientific bent, so in collecting the information from patients over time, that’s really how we’re learning, where I know every patient. I say, what are you using? how’s it working? have you tried this? .... and then I ask them, what did that do? And then its all documented. Oh, that’s how we’re learning, so what we’re seeing, I think the thing I’d like to lead people with is that the CBD and THC work so well together.
This availability that we’ve had of the CBD just in the past couple of years, it really is historic because medical cannabis has been primarily THC, almost all THC so far, and although it’s been illegal most of the time. But CBD really wasn’t available, so with hemp being grown now, and hemp CBD returning to patients, you can really use the THC in doses that are effective, without the psycho activity, because the CBD combined so well, so this action now, I mean we’ve been telling patients, this is a huge boon for everyone to get your CBD and combine it with THC . It’s everywhere, it’s not restricted like the THC, so having this DEA action come out, really puts that kind of back on its heels for people who are not in a legal state. But here in Colorado, certainly we will continue to have the CBD and the THC, and continue working with them.
Dr. Mercola: OK, that’s important, because I know at some point I’m hoping that it will be legal, because I literally just acquired another, almost acre of land adjacent to my existing property, and converting it all to regenerative agriculture, so you know I could definitely grow some high quality CBD. I’m not interested in psychoactive component, and I think there’s a benefit of it but I’m not particularly interested in that at all. I mean you’re gonna get some THC and its not impossible to grow without it, but I’m really interested in the CBD and the related cannabinoids.
Dr. Margaret Gedde: And when the plant has not been heated, it actually doesn’t have THC in it …
Dr. Mercola: Alright!I did not know that.
Dr. Margaret Gedde: It has remarkable properties too, it’s the plant that makes the THC acid, tetrahydrocannabinol acid CBDA as well. So if you eat it raw, if you put some marijuana flower and shake in the morning, grind it up and drink it down, you get the THCA and not the THC, which relieves pain and spasm, it’s sort of synergizing but it doesn’t have the psycho activity.
Dr. Mercola: Did not know that…
Dr. Margaret Gedde: There so much in it. That’s just a little tip, that’s right, you can eat the marijuana raw and get health benefits, and there are doctors who are proponents of doing that as a dietary supplement, the raw cannabis, don’t heat it up.
Dr. Mercola: Yes, I’m a strong proponent of that, I would vote yes.
Dr. Margaret Gedde: Yes! There we go.
Dr. Mercola: I think there’s so many hidden and not yet discovered benefits of doing that therapeutically, and probably related to this nutritional ketosis, the molecular biology of that perspective, and we’ll figure it out a few decade, but you know, why wait a few decade? ... when we can do it now, and there’s no downside, there’s no side effects, and even the psychoactive side effects that you mentioned earlier, really are really related to the heating of it, if you’re not heating the fields aren’t there
Dr. Margaret Gedde: That’s right, and so here in Colorado, we’re going to keep experimenting, you know when I learned something new, then I make a new handout, I tell all my patients, and then when they come back. I asked them what they did, so we’re going to keep on working, with each new wrinkle roads, there’s so much customizability, so much to the plant, the plant just keeps on giving.
Dr. Mercola: I really appreciate your commitment to this work, and all that you’re learning and discovering, and bringing it to our attention, so that we can use this incredibly valuable resource to alleviate needless pain and suffering. I mean it just doesn’t have to be this way, and it’s the knowledge that you’re creating, this is really going to help change the world, so thank you for all your work.
Dr. Margaret Gedde: Yes, Thank you…
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