With its recent legalization in many countries, the popularity of CBD is booming. There are many claims out there about what CBD can do but where does the truth lie? Today I thought we could dig a bit deeper into what CBD is, how it works and its potential for use in people with kidney disease.
What is CBD?
CBD, or cannabidiol, is a chemical compound from the cannabinoid family that naturally occurs in the cannabis plant and its use is nothing new. Cannabis and products derived from it have been widely used for recreational and medicinal purposes dating back to 4000 B.C in ancient Asia.
The two main cannabinoids found in the cannabis plant are CBD (Cannabidiol) and THC (delta-9-tetrahydrocannabinol).
To really understand how CBD works, you first need to have a basic understanding of the endocannabinoid system.
The endocannabinoid system
The endocannabinoid system (ECS) is a pretty unique communications system found in the brain and the body that affects many important functions. The main function of the ECS is to maintain homeostasis or balance within the body. The ECS exists and is active in your body, whether you take CBD or not.
How does it work?
The ECS is made up of three main parts: endocannabinoids, receptors and enzymes.
Also called endogenous cannabinoids, are molecules made by your body. They’re similar to cannabinoids but they’re produced on demand and as needed by your body.
The two main endocannabinoids are:
- Anandamide (AEA)
- 2-arachidonoylglycerol (2-AG)
These endocannabinoids have many effects in the body including a role in appetite regulation, cell regulation, memory, pain relief, mood and inflammation (this gives you some hints about the sort of things CBD is being used for!).
These receptors are found throughout your body. Endocannabinoids bind to them in order to get the ECS to take action.
There are two main endocannabinoid receptors:
- CB1 receptors- found in highest amounts in the brain and central nervous system and are essential for a healthy functioning brain.
- CB2 receptors- found in highest amounts on the cells of our immune system. They help moderate inflammation and our immune response.
Endocannabinoids can bind to either receptor. The effects that result depend on where the receptor is located and which endocannabinoid it binds to.
Enzymes are responsible for breaking down endocannabinoids once they’ve carried out their function. There are two main enzymes responsible for this:
- Fatty acid amide hydrolase (FAAH), which breaks down AEA
- Monoacylglycerol acid lipase, which typically breaks down 2-AG
So, what does CBD have to do with all of this?
Well, the way that CBD has an effect on the body is through the ECS.
I know what you might be thinking……… Don’t people just use cannabis to get high?
That may be one reason why people use cannabis but it’s not the only one. As I already mentioned, cannabis has been used therapeutically (yes and recreationally) for thousands of years for pain relief, to reduce nausea, to relieve anxiety and to help with sleep.
So, let’s start by answering the most common question: no, CBD will not get you high. The part of cannabis that gets you high is THC which is completely different to CBD. THC is psychoactive, which means it affects the way you think and feel, which can then affect the way you behave.
CBD (like THC) interacts with your ECS to produce its effects. Experts aren’t completely sure how CBD interacts with the ECS, but they do know that it doesn’t bind to CB1 and CB2 receptors the way THC does.
Instead, many believe it works by preventing endocannabinoids from being broken down. This allows them to have more of an effect on your body. Others believe CBD binds to a receptor that hasn’t been discovered yet.
What about THC?
THC also has beneficial actions within the body and is used therapeutically.
CBD and THC have some of the same medical benefits and can provide relief from several of the same conditions. However, CBD doesn’t cause the euphoric effects that occur with THC. Some people prefer to use CBD because of the lack of this side effect.
Some CBD preparations contain both CBD and THC, so you get the benefits of both. One of the advantages of this is that when CBD is given with THC, it blocks the psychoactive properties of THC and also prevents THC induced restlessness, dysphoria and anxiety that can occur when THC is taken alone.
Actions of CBD
- Protects the brain and nervous system
- Balances the immune system
- Reduces seizures
- Antiemetic (stops nausea and vomiting)
Actions of THC
- Protects the brain and nervous system
- Muscle relaxant
- Opens and relaxes the airways
- Antipruritic (anti-itch)
- Appetite stimulant
- Anti-emetic (stops nausea and vomiting)
What is CBD used for?
As you can see, CBD and THC have a wide variety of actions which means they are used for a wide variety of symptoms and conditions. More research is underway, but CBD is already a recommended treatment for several conditions including epilepsy and seizures, chronic pain, nausea and vomiting, multiple sclerosis, neurodegenerative conditions, sleep disorders, mood disorders and anxiety.
The potential role of CBD in Kidney Disease
CB1 and CB2 receptors have both been found within the kidneys and studies have shown that in certain kidney diseases, CB receptor function can be upregulated or downregulated which may contribute to the development and progression of kidney disease.
The use of CBD in people with kidney disease has not been extensively studied however there is no evidence to suggest that CBD has any adverse effect on kidney function.
In fact, CBD prevented kidney damage from cisplatin, a chemotherapy drug well known to cause kidney damage in a mouse model by reducing oxidative stress, inflammation and cell death in the kidney and improving kidney function.
In another study, CBD decreased oxidative kidney damage and inflammation in an animal model of ischaemia/reperfusion kidney injury and improved kidney function.
Further research is obviously needed on the use of CBD in kidney disease but considering inflammation and oxidative stress are two key contributors to kidney disease development and progression, CBD may well present a complementary treatment option for people with CKD.
CBD for symptom management in CKD
Many people with chronic kidney disease experience ongoing symptoms such as pain, nausea, sleep disturbance, anxiety and depression so CBD has been proposed to help manage these symptoms.
CBD for chronic pain
Cannabis has been used to treat pain for thousands of years so it makes sense that CBD would also be beneficial. There’s plenty of anecdotal evidence and some scientific evidence that CBD is effective in reducing pain.
CBD has been shown to be effective for treating different types of pain including inflammatory, visceral and neuropathic (nerve) pain. CBDs role in reducing pain is proposed to be due to its anti-inflammatory effects, its ability to reduce pain transmission along nerves, and through increasing levels of anandamide in the body.
Opioids and nonsteroidal anti-inflammatory medications are commonly prescribed to treat chronic pain. Both of these classes of medication come with their own adverse side effects and toxicity which are more common in people with kidney disease. CBD use has been shown to reduce the need for opioid and anti-inflammatory medication without the high level of adverse side effects.
CBD for nausea
Most of the research into the use of CBD in managing nausea has been done with cancer patients and chemotherapy induced nausea. CBD has been shown to be superior to many of the commonly used anti-nausea medications in reducing the frequency and severity of chemotherapy induced nausea and vomiting.
CBD for insomnia
Studies suggest that CBD may help with both falling asleep and staying asleep and may increase sleep amounts. CBD has also been shown to reduce insomnia in people who suffer from chronic pain. In smaller doses, CBD stimulates alertness and reduces daytime sleepiness, a common problem for those who suffer from insomnia.
CBD for anxiety and depression
Animal studies and anecdotal reports have demonstrated that CBD has anti-depressant and anti-anxiety like effects that are likely to be due to a number of mechanisms including effects on neurotransmitters such as serotonin and GABA. Research shows that CBD can reduce both mental and physical symptoms of anxiety.
Adverse effects of CBD
CBD is generally well tolerated with a good safety profile. A large review of herbal cannabis in Canada revealed no increase in serious adverse events with chronic administration, no harm on cognitive function, biochemistry (creatinine, liver function and complete blood count), blood pressure or heart rate.
CBD and THC induced side-effects are often dose dependent and frequently subside after continued use. Experts recommend using a ‘start low and go slow’ approach which just means start with a low dose and increase it slowly if needed- using this approach tends to reduce the risk of adverse side-effects.
Like any medications or herbal supplements, CBD and THC can interact with other medications and may not be suitable for everyone so before taking CBD it’s important you speak with your doctor to assess whether CBD is suitable for you. You should also enlist the help of a health professional with a good understanding of CBD use to guide you on taking the correct preparation, at the right dose and the right frequency.
Hopefully this blog has left you with a better understanding about what CBD is, how it acts on the body and the sort of symptoms and conditions it may be useful for. Like you, I’m looking forward to seeing more research on the use of CBD in kidney disease.
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See you next time!