Cannabidiol (CBD) in Sport and Exercise

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• While CBD is not intoxicating, my understanding is that it does impact the brain so would be classified as psychoactive. Is this just splitting hairs or is there another explanation for the difference in definitions?
  • Yes, CBD is frequently referred to as non-psychoactive. I think that is reasonably tolerated among the literature. We're not in a place where anyone would ever say it is incorrect. In more recent work it is increasing exercise enjoyment so to say that it is not influencing those psychoactive characteristics or feelings at least a little bit might be on the verge of not 100% accurate. I tend to use the term "non-intoxicating" because we're not seeing any impairment of significant sedation or anything like that from CBD on its own.
• Is there any research at all on CBD for anxiety in adolescents/youth populations?
  • Yes. The Lambert Initiative recently completed an open-label trial and is close to being published, if not already. They took group of individuals with difficult-to-treat anxiety. This was a young group of people with anxiety that hadn't responded to conventional therapy and did see quite pronounced therapeutic effect of CBD in that population. I believe the dose was a high level (600 - 800 mg dose of CBD). There is some work out there but not too many studies in this population. 
• What about the increased hunger effects of CBD and body composition goals?
  • Increased hunger is only really associated with THC. THC's capacity to increase hunger seems to be driven by interactions with cannabinoid type I receptor so there's really no evidence that CBD increases appetite at this time but that said the research in this specific area is limited. Likely no need to be concerned about this at this time.
• How is it directly related to performance improvement? Or is it just indirectly?
  • It is hard to say. There is a shift in VO2 max which could potentially be beneficial but we've also seen an improvement in exercise enjoyment so it could be that they just ran longer because they were enjoying the exercise more. I don't think we can answer that yet, unfortunately. We're also dealing with a very small set of data as of now.
• What is considered low vs high dosage?
  • This is context dependent. If we're talking OTC, non-prescription CBD products, a high dose might be 300mg. If we're talking about therapeutic use in patient populations, 300mg might be low. Patients treated for epilepsy might be treated with 1000mg/day.
• I am curious what some possible proposed mechanisms of action of CBD that make us expect it would have effects on sports performance? For example, does it interact with any metabolic pathways or, perhaps, involved in epigenetic regulation of certain processes?
  • I'm not quite sure whether or not CBD can have epigenetic changes. In terms of its other mechanisms by which it might influence performance, there are documented mechanisms that I can't remember exactly for how it exerts anti-inflammatory effects, but those are documented. There is some research around the mechanism of analgesic effects. So it does seem to have capacity to interact with a wide variety of different systems and there are mechanisms that are being documented that match the therapeutic effects.
• For people who are getting closer to 50 that have to get up to use the restroom in the middle of the night, I want to sleep a little bit better and nothing seems to work. With CBD, is there any research on the impact it can have on improved sleeping habits?
  • There is more work to be done in this space. I am aware of some studies that are going on. Right now, the only published that RCT that I'm aware of is specifically the effects of CBD in sleep using objective sleep metrics. Showed no effect of I think 300mg on objective sleep quality. However, I think the key is that they had taken a group of healthy people who already sleep well so it is difficult to observe improvement in sleep in people who are already sleeping well. The thing that needs to happen now is we need to start looking at patients with insomnia, other sleep disorders, anxiety, or other things that can contribute to poor sleep. I think there is more scope for CBD to have an effect in these populations. In situations where anxiety is causing poor sleep is probably most likely the situation you will see a therapeutic effect.