What Is CBD Oil?
This cannabis extract may help treat nerve pain, anxiety, and epilepsy
Cathy Wong is a nutritionist and wellness expert. Her work is regularly featured in media such as First For Women, Woman’s World, and Natural Health.
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Meredith Bull, ND, is a licensed naturopathic doctor with a private practice in Los Angeles, California.
Cannabidiol (CBD) oil is an extract from hemp plants called Cannabis indica and Cannabis sativa . You might be more familiar with cannabis plants because they are grown for marijuana. However, CBD is not the same thing as marijuana.
CBD oil contains CBD that’s mixed with a base (carrier) oil, like coconut oil or hemp seed oil. These are called tinctures. You can get tinctures in different concentrations. The oil can also be put into capsules, gummies, and sprays.
People who support using CBD oil say that it can treat pain and anxiety; can help stimulate appetite and may help manage some types of seizures.
This article goes over what CBD is used for, the possible side effects, and what you should look for if you choose to buy CBD.
CBD vs. Marijuana
CBD is one component (called a cannabinoid ) that’s found in a hemp plant. Marijuana is a separate plant but it’s from the same species that hemp belongs to. Marijuana has CBD and hundreds of other compounds in it.
The main difference between hemp plants and marijuana plants is how much of a compound called tetrahydrocannabinol (THC) is in them. Hemp is grown to have less than 0.3% THC, while marijuana has more.
THC is what’s responsible for the psychoactive effects of cannabis—in other words, it’s what makes you feel “high.”
CBD oil generally does not have THC in it; however, a very small (trace) amount might be in products sold in certain states.
What Is CBD Oil Used For?
We’re not sure exactly how CBD works. Unlike THC, CBD doesn’t have a strong connection with the molecules in the brain that THC binds to create psychoactive effects. These are called cannabinoid receptors.
Instead, CBD works on other receptors, like the opioid receptors that help control pain. It also affects glycine receptors that control a brain chemical called serotonin which helps control your mood.
People that support the use of CBD claim that CBD oil can treat a variety of health problems, including:
- Chronic pain
- Drug use and withdrawal
- High blood pressure
- Muscle spasms
- Poor appetite
As CBD has gained popularity, researchers have been trying to study it more. Still, there has not been a lot of clinical research to look for evidence in support of these health claims.
CBD is not a safe option for everyone. Talk to your healthcare provider if you want to try it for managing a health condition.
A 2015 review of research that was published in the journal Neurotherapeutics suggested that CBD might help treat anxiety disorders.
The study authors reported that CBD had previously shown powerful anxiety-relieving effects in animal research—and the results were kind of surprising.
In most of the studies, lower doses of CBD (10 milligrams per kilogram, mg/kg, or less) improved some symptoms of anxiety, while higher doses (100 mg/kg or more) had almost no effect.
The way that CBD acts in the brain could explain why this happens. In low doses, CBD might act the same as the surrounding molecules that normally bind to the receptor that “turns up” their signaling.
However, at higher doses, too much activity at this receptor site could produce the opposite effect.
There have not been many trials to look at CBD’s anxiety-relieving effects in humans. However, one was a 2019 study published in the Brazilian Journal of Psychiatry.
For the study, 57 men took either CBD oil or a sugar pill with no CBD in it (placebo) before a public-speaking event.
The researchers assessed the participants’ anxiety levels using measures like blood pressure and heart rate. The researchers also used a reliable test for mood states called the Visual Analog Mood Scale (VAMS).
The men who took 300 mg of CBD oil reported less anxiety than the men who were given a placebo; however, the men who took 100 mg or 600 mg of CBD oil did not experience the same effects.
CBD oil might help people with substance use disorder, according to a 2015 review published in the journal Substance Abuse.
The review looked at the findings from 14 published studies. Nine of the studies looked at the effects of CBD on animals, and five studies looked at the effects on humans.
The researchers reported that CBD showed promise for treating people with opioid, cocaine, or psychostimulant use disorders.
However, the effects of CBD were quite different depending on the substance. For example, CBD without THC did not decrease withdrawal symptoms related to opioid use.
On the other hand, it did reduce drug-seeking behaviors in people using cocaine, methamphetamine, and other similar drugs.
Some experts suggest that CBD could help treat cannabis and nicotine dependence, but more research is needed to provide this theory.
High Blood Pressure
A 2017 study found that CBD oil may reduce the risk of heart disease because it can lower high blood pressure in some people.
For the study, nine healthy men took either 600 mg of CBD or the same dose of a placebo. The men who took CBD had lower blood pressure before and after experiencing stressors like exercise or extreme cold.
The study also looked at the amount of blood remaining in the heart after a heartbeat (stroke volume).
The stroke volume in the men who took CBD was lower than in was in the placebo group, meaning their hearts were pumping more efficiently.
The study suggested that CBD oil could be a complementary therapy for people with high blood pressure that is affected by stress and anxiety.
However, there is no evidence that CBD oil can treat high blood pressure on its own or prevent it in people at risk. While stress can complicate high blood pressure, it does not cause it.
In June 2018, the U.S. Food and Drug Administration (FDA) approved a CBD oral solution called Epidiolex.
Epidiolex is used to treat two rare forms of epilepsy in children under the age of 2: Dravet syndrome and Lennox-Gastaut syndrome. These are very rare genetic disorders that cause lifelong seizures starting in the first year of life.
Other than for these two disorders, CBD’s effectiveness for treating seizures is not known. Even with Epidiolex, it’s not clear if the anti-seizure effects are from CBD or another factor.
However, there is some evidence that CBD interacts with seizure medicines like Onfi (clobazam) and raises their concentration in the blood. That said, more research is needed to understand the link.
Possible Side Effects
Clinical research has shown that CBD oil can cause side effects. The specific side effects a person has and how bad they are varies from one person to the next and from one type of CBD to another.
Some common side effects people report from using CBD include:
- Changes in appetite
- Changes in mood
- Dry mouth
CBD oil may also increase liver enzymes, which is a marker of liver inflammation.
People with liver disease should talk to their healthcare provider before taking CBD oil. They may need to have their liver enzymes checked regularly if they are using CBD.
Can You Use CBD If You’re Pregnant?
You should not use CBD oil if you’re pregnant or breastfeeding. Even though the effects of CBD are not fully understood, it does pass through the placenta.
The American Academy of Pediatrics (AAP) further states that pregnant people should not use marijuana because of the potential risks to a developing fetus.
Do not drive or use heavy machinery when taking CBD oil—especially when you first start using it or switch to a new brand. Remember that some products do contain THC, even in small amounts.
CBD oil can interact with medications, including many that are used to treat epilepsy. One of the reasons for this has to do with how your body breaks down (metabolizes) drugs.
Cytochrome P450 (CYP450) is an enzyme your body uses to break down some drugs. CBD oil can block CYP450. That means that taking CBD oil with these drugs could make them have a stronger effect than you need or make them not work at all.
Drugs that could potentially interact with CBD include:
- Anti-arrhythmia drugs like quinidine
- Anticonvulsants like Tegretol (carbamazepine) and Trileptal (oxcarbazepine)
- Antifungal drugs like Nizoral (ketoconazole) and Vfend (voriconazole)
- Antipsychotic drugs like Orap (pimozide)
- Atypical antidepressants like Remeron (mirtazapine)
- Benzodiazepine sedatives like Klonopin (clonazepam) and Halcion (triazolam)
- Immune-suppressive drugs like Sandimmune (cyclosporine)
- Macrolide antibiotics like clarithromycin and telithromycin
- Migraine medicine like Ergomar (ergotamine)
- Opioid painkillers like Duragesic (fentanyl) and alfentanil
- Rifampin-based drugs used to treat tuberculosis
Always tell your healthcare provider and pharmacist about all the medicines you take, including prescription, over-the-counter (OTC), herbal, or recreational drugs.
The interactions between these medications and CBD are often mild and you might not have to change your treatment.
However, in some cases, you might have to change medications or space out your doses to avoid a reaction. That said, never change or stop medication without talking to your provider.
Dosage and Preparation
There are no guidelines for using CBD oil. Each product works a bit differently, depending on the form.
For example, putting the oil under your tongue can produce effects more quickly than swallowing a capsule that needs to be digested.
Here are a few ways that you can take CBD oil:
- Placing one or more drops under your tongue and holding it there for 30 to 60 seconds without swallowing. You can also use a spray that is spritz in your mouth/under your tongue.
- Taking a capsule or chewing a gummy
There’s no “correct” dose of CBD oil. How much you take and the form you choose will depend on your needs and what you hope to get for effects. The average dose range is from 5 mg to 25 mg.
Most oils come in 30-milliliter (mL) bottles and include a dropper cap to help you measure.
That said, it’s hard to figure out the exact amount of CBD per milliliter of oil. Some tinctures have concentrations of 1,500 mg per 30 mL, while others have 3,000 mg per mL or more.
How to Calculate CBD Dose
To determine an exact dose of CBD, remember that each drop of oil equals 0.05 mL of fluid. This means that a 30-mL bottle of CBD oil will have about 600 drops in it.
If the concentration of the tincture is 1,500 mg per mL, one drop would have 2.5 mg of CBD in it. The math to figure that out looks like this: 1,500 mg ÷ 600 drops = 2.5 mg
What to Look For
CBD oil comes in different forms: isolates, broad-spectrum, and full-spectrum.
- Isolates contain only CBD
- Broad-spectrum oils nearly all of the components of the plan (e.g., proteins, flavonoids, terpenes, and chlorophyll), but does not have THC oils have all the compounds including THC (up to 0.3%)
Alternative medicine practitioners believe that the compounds provide more health benefits, but the is a lack of evidence to support these claims.
Remember that CBD oils are unregulated. There’s no guarantee that a product is what it claims to be on its packaging. You also can’t know for sure that it’s safe and effective.
A 2017 study reported that only 31% of CBD products sold online were correctly labeled. Most had less CBD in them than was advertised, and 21% had significant amounts of THC.
If you are interested in buying CBD products, here are a few tips to keep in mind:
- Buy American: Domestically produced CBD oil might be a safer option than those that have been imported.
- Go organic: Brands certified organic by the U.S. Department of Agriculture (USDA) are less likely to expose you to pesticides and other harmful chemicals.
- Read the product label: Even if you choose a full-spectrum oil, don’t assume that every ingredient on the product label is natural. CBD products can also have preservatives, flavorings, or thinning agents in them. If you don’t recognize an ingredient, ask the dispenser what it is or check online.
Hemp plants can be grown for different purposes. Some species are made for marijuana but others are used to make CBD products.
Unlike marijuana, CBD oil does not “get you high.” Instead, it may help relieve stress, anxiety, drug withdrawals, and nerve pain.
While there are many claims about the health benefits of using CBD oil, the evidence is lacking. A lot of studies were done with animals, not humans.
If you want to try CBD oil, you should learn about the different dosages and preparations first.
You should also know that the products are not regulated, which means you can’t know for sure that a product will work and be safe.
Before you use CBD oil, talk to your provider. If you take certain medications or have a health condition, you may not be able to use these products.
Frequently Asked Questions
It would be hard to overdose on CBD oil. Research has shown that human tolerance for CBD is very high. One study reported the toxic dose would be about 20,000 mg taken at one time.
It depends on where you live, the type of product, how it was sourced (e.g., is it from hemp or marijuana), and its intended purpose (medical or recreational). In many states, you must be 18 or 21 to buy CBD oil. Check your state’s laws.
Not necessarily. While the names are sometimes used interchangeably, hemp oil can also refer to hemp seed oil, which is used for cooking, food production, and skincare products.
CBD oil is made from the leaves, stems, buds, and flowers of the Cannabis indica or Cannabis sativa plant. It should contain less than 0.3% THC.
Hemp oil is made from the seeds of Cannabis sativa and does not have TCH in it.
CBD Oil: 9 Science-Backed Benefits
Dr. Bindiya Gandhi is an integrative medicine physician with expertise in functional and holistic medicine based in Atlanta, Georgia.
Commissions we earn from partner links on this page do not affect our opinions or evaluations. Our editorial content is based on thorough research and guidance from the Forbes Health Advisory Board.
Cannabidiol, or CBD, is a chemical compound found in the cannabis sativa plant. When applied topically or consumed through smoke inhalation or edible consumption, CBD interacts with neuroreceptors in your endocannabinoid system, which sends signals between your cells to help regulate your movement, mood, homeostasis and immune system.
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CBD is often extracted from the cannabis sativa plant in oil form and mixed with an inert carrier oil like hemp seed oil for consumption. In fact, of the 60% of U.S. adults who report having used CBD before, 55% of them use CBD oils and tinctures specifically, according to a recent Forbes Health survey of 2,000 U.S. adults conducted by OnePoll.
CBD research is growing, too. Here are nine ways studies suggest CBD oil could benefit your health.
1. Offset Anxiety and Depression
CBD’s ability to calm is perhaps its most popular effect and the reason its use is so widespread. A 2017 study in the Brazilian Journal of Psychiatry tested the anxiety levels of 57 men in a simulated public speaking test. Some received a placebo while others received either 150 milligrams, 300 milligrams or 600 milligrams of CBD before their speeches. Those who received 300 milligrams of CBD experienced significantly reduced anxiety during the test compared to those who received the placebo. Interestingly, participants who received either 150 or 600 milligrams of CBD experienced more anxiety during the test than the 300 milligrams group.
Meanwhile, at least one study in mice revealed CBD had effects similar to the antidepressant imipramine. Human trials are needed, though, to confirm whether CBD can induce this same antidepressant reaction in our bodies.
2. Treat Select Epilepsy Syndromes
In some instances, CBD can be used to treat epileptic seizures.
In 2018, the Food and Drug Administration (FDA) approved the use of CBD under the brand name Epidiolex to treat seizures resulting from Lennox-Gastaut syndrome and Dravet syndrome—two rare forms of epilepsy—in patients at least 2 years old.
Three well-vetted studies provide the basis of support for the FDA’s decision. In these trials, 516 patients with Lennox-Gastaut syndrome or Dravet syndrome received either Epidiolex or a placebo. Epidiolex, when taken along with other prescribed medications, decreased the frequency of participants’ seizures compared to the placebo.
3. Reduce PTSD Symptoms
In a small 2018 study in the Journal of Alternative and Complementary Medicine, 11 people with post-traumatic stress disorder (PTSD) received CBD along with routine psychiatric care for eight weeks in an outpatient psychiatric clinic. Ten of the 11 experienced a decrease in their PTSD symptoms. CBD was generally well tolerated, the researchers write.
Margaret Rajnic, a doctor of nursing practice experienced in medical cannabis and CBD, emphasizes the importance of using therapy in tandem with any type of cannabis or CBD for PTSD. “There is an amount of therapy that is needed for PTSD,” she says. “But CBD will give you that little bit of decreased anxiety.”
Four other human trials from 2012 to 2016 suggest CBD reduces PTSD symptoms, although some include THC, or tetrahydrocannabinol, the main mind-altering element in cannabis. When THC and CBD work together, they create what’s called an “entourage effect,” complementing each other’s benefits and potency. For example, taking the same dose of THC and CBD together tempers the “high” from THC, while just a little THC paired with more CBD enhances the effects of the CBD.
4. Treat Opioid Addiction
Some studies—both preclinical animal and human clinical trials—suggest CBD could be used to help treat people who are dependent on opioids.
In one such study, researchers administered CBD to people with heroin use disorder. Over the course of a week, CBD significantly reduced heroin users’ cue-induced cravings, withdrawal anxiety, resting heart rate and salivary cortisol levels. No serious adverse effects were found.
Other studies find CBD helpful in reducing various psychiatric and medical symptoms like anxiety, insomnia and pain in patients with substance use disorders, indicating that CBD may be an effective treatment for opioid addiction. However, further studies are necessary.
5. Alleviate ALS Symptoms
Amyotrophic lateral sclerosis (ALS) is a disease that causes nerve cells in the brain and spinal cord to deteriorate, resulting in loss of muscle control that worsens over time. It’s not yet understood exactly why ALS occurs, although it can be hereditary in some cases. There’s no known cure, and there are only two FDA-approved medications to help treat ALS symptoms.
Research suggests people with ALS can benefit from the entourage effect created by the combination of THC and CBD, similar to people with PTSD. In a 2019 study, patients received a combination of THC and CBD in varying doses depending on their needs and preferences. Those with mild, moderate or severe spasticity (muscle tightness and stiffness) due to ALS reported high levels of satisfaction with the treatment, and those with moderate to severe spasticity reported higher satisfaction rates than those with mild spasticity.
6. Relieve Unmanageable Pain
In 2005, Canada approved the use of Sativex, an oromucosal (absorbed in the lining of the mouth) spray with equal proportions of THC and CBD, for the treatment of multiple sclerosis-related central neuropathic pain. In 2007, Canada approved the medicine’s use again for cancer pain that proved unresponsive to other medications.
Meanwhile, continued studies in the U.S. indicate CBD is effective in treating chronic, non-cancer pain. In one 2020 study, researchers administered CBD topically to a group of patients with symptomatic peripheral neuropathy (a result of brain nerve and spinal cord nerve damage) while another group with the same condition received a placebo. Results showed a significant reduction in intense, sharp pains and cold, itchy sensations in those who used the topical CBD compared to those who used the placebo. No participants reported adverse side effects.
When introduced topically, CBD oil doesn’t affect the systemic issue as it might if it were introduced directly into the bloodstream. Instead, topical CBD is more localized and treats pain in a certain area. Since it’s more direct, it may have a more pronounced effect.
7. Ease Diabetic Complications
For starters, tests on human cells found that CBD helps reduce the effects of high glucose levels on other cells in the body, which typically precedes the development of diabetes and various complications. Researchers concluded that with further studies, CBD could have significant benefits when used in patients with diabetes, diabetic complications and plaque buildup in artery walls.
In another small study, 13 patients with type 2 diabetes who weren’t on insulin treatment were given both CBD and a placebo (in lieu of insulin). Researchers found CBD decreased their levels of resistin (which causes resistance to insulin, the protein that regulates sugar levels) and increased their levels of glucose-dependent insulinotropic peptide (a hormone that ensures a sufficient release of insulin from digested food) compared to their baselines before they started the test. These results suggest CBD could be a natural treatment for diabetes by helping the body regulate insulin-related hormone levels.
8. Protect Against Neurological Disease
Preclinical and clinical studies show that CBD has antioxidant and anti-inflammatory properties. Researchers deduce these characteristics can provide significant neuroprotection, or protection against numerous pathological disorders.
Several preclinical studies suggest CBD can produce beneficial effects against Parkinson’s disease, Alzheimer’s disease and multiple sclerosis. Huntington’s disease and cerebral ischemia were also tested, although significant positive results were not recorded. Further clinical studies are needed to confirm CBD’s benefits when used as a treatment for these disorders.
9. Inhibit Arthritis Symptoms
Arthritis involves the deterioration of the tissues in and around your joints. There are several types of arthritis, and symptoms include pain, stiffness and loss of motion. Arthritis treatment usually targets pain relief and improved joint function.
A 2006 study found that Sativex—a CBD-based botanical drug approved in the United Kingdom in 2010—promoted statistically significant improvements in quality of sleep, pain during movement and pain at rest in patients with rheumatoid arthritis when compared to a placebo. It was the first controlled trial of Sativex as a treatment for rheumatoid arthritis, involving 58 patients. CBD was found to have a pain-relieving effect, as well as an ability to suppress disease activity.
In 2018, in a study of more localized treatment, researchers administered a synthetic CBD gel in either 250-milligram or 500-milligram doses daily or a placebo to patients with knee pain due to osteoarthritis. Patients also stopped taking any other anti-inflammatory medications or painkillers, with the exception of acetaminophen, before and during the study period.
The results were interesting, although not entirely conclusive. On one hand, those treated with CBD did not experience much change in pain when compared with placebo patients. On the other hand, there were statistically significant differences between the group receiving the 250-milligram dose and the placebo group when measuring the average weekly improvement of their worst pain levels and their WOMAC (Western Ontario and McMaster Universities Arthritis Index) physical function rating. Additionally, men seemed to benefit from CBD more significantly than women in this test.
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Health Benefits of CBD
CBD is an abbreviation for cannabinoid. Cannabinoid is a natural substance found in cannabis, also known as marijuana, and also in hemp plants. Today, you can find CBD oil in capsules, oil bases for vaporizers, tinctures, food items, and beauty products such as bath bombs or lotions.
Unlike its cousin THC, CBD is not intoxicating or psychoactive. Proponents of CBD oil and other CBD products claim that it can be used to treat conditions such as chronic pain, inflammation, migraines, epilepsy, autoimmune diseases, depression, and anxiety.
Research into some of these claims is ongoing, and there is still a lot about CBD that we don’t know but researchers are trying to find out.
Researchers are looking for answers when it comes to the full potential of CBD. What have they discovered in the meantime? So far, we know that CBD is a proven treatment when it comes to certain types of epilepsy, and early research is showing promise in regards to various anxiety disorders.
Approved to Treat Epilepsy
In 2018, the first FDA-approved drug, cannabidiol (Epidiolex), containing CBD was released on the market to treat two different kinds of epilepsy — Dravet syndrome and Lennox-Gastaut syndrome.
The FDA approved the treatment for patients as young as two years old. Studies showed it was effective in comparison to a placebo in reducing the frequency of seizures.
Though we need more research, a 2015 medical journal review article looked at CBD and its effect on multiple anxiety disorders, including generalized anxiety disorder, seasonal affective disorder, panic disorder, and post-traumatic stress disorder.
The results showed that there was “strong preclinical evidence” to support the treatment of anxiety disorders with CBD, though more research is needed on long-term dosing.
Research surrounding CBD is ongoing, and there are many questions that researchers do not have the answers to yet, such as whether or not the means of taking CBD impacts the risks or efficacy. Some common means of taking CBD include inhaling through a vaporizer, ingesting through food, or taking orally as a pill.
Here is a list of a few potential risks and side effects that come with CBD. Some of these risks are controllable if taking CBD under the guidance of your doctor.
During drug trials for Epidiolex, the FDA determined liver injury to be a side effect of CBD. Signs of liver injury showed up on blood work used to detect early problems with the liver. You can manage this risk by only taking CBD under the supervision of your doctor.
Interaction with Other Medications
If you are taking other medications, CBD can impact their efficacy, and the dose you are taking may need to be re-evaluated by your doctor. CBD can potentially interact with other medications to cause side effects.
Because there is limited research on how CBD interacts with prescription drugs and with standard over-the-counter supplements, it is best to talk to your doctor before taking CBD if you are taking other medications.
Though not much research has looked specifically at CBD, it seems that there is a negative relationship between cannabis use and sperm count, as well as other measures of male fertility, including sperm viability and motility.
Most of these studies have focused on animal participants, and further research is needed. Experts recommend awareness around these potential side effects when prescribing cannabis to patients who are of reproductive age.
Amounts and Dosage
Because the FDA currently does not regulate CBD, there are no specific recommended doses. Doses in most clinical trials have ranged from 100 to 800 milligrams a day.
Before using any CBD product, you should speak to your doctor to come up with a safe dosage plan that works for you. This plan should also take into account your symptoms and any other medications or supplements that you may be taking.
Neurotherapeutics: “Cannabidiol as a Potential Treatment for Anxiety Disorders.”
The Journal of Urology: “Cannabis and Male Fertility: A Systematic Review.“
U.S. Food and Drug Administration: “FDA Approves First Drug Comprised of an Active Ingredient Derived from Marijuana to Treat Rare, Severe Forms of Epilepsy.”
U.S. Food and Drug Administration: “What You Need to Know (And What We’re Working to Find Out) About Products Containing Cannabis or Cannabis-derived Compounds, Including CBD.”