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CBD products, hemp oil may be helpful but more research is needed, Mayo Clinic review says

Hemp CBD oil capsules spilled from a bottle and CBD tincture dripping from a glass dropper onto a white surface

ROCHESTER, Minn. — Cannabidiol (CBD) oils and products have become increasingly popular with consumers as ways to find relief from aches and pains, anxiety, sleep disturbances and other chronic issues. But are these products safe, and are they helpful?

A review of the latest research, to be published in September in Mayo Clinic Proceedings, finds there's a growing body of preclinical and clinical evidence to suggest that CBD oils may hold promise for treating conditions such as chronic pain and opioid addiction. But few clinical studies on the safety and efficacy of CBD have been reported, and more research involving humans is needed before health care providers can say definitely that they're helpful and safe, according to Mayo Clinic researchers.

"There are many intriguing findings in pre-clinical studies that suggest CBD and hemp oil have anti-inflammatory effects and may be helpful with improving sleep and anxiety," says Brent Bauer, M.D., an internist and director of research for the Mayo Clinic Integrative Medicine program. "But trials in humans are still limited, so it is too early to be definitive about efficacy and safety."

Dr. Bauer says there's reason for concern about a growing number of reports of liver injury in patients who have used CBD products. With greatly increasing patient interest in CBD and hemp oil products, it's important that clinical research moves ahead to better understand their potential value and safety, he says.

"Careful selection of a health care product is crucial, and though these products do not have Food and Drug Administration approval for therapeutic use, patients continue to ask for them and use them. Physicians need to become better informed about these products, and it's important that human trials examine issues of efficacy and safety."

Watch: Dr. Brent Bauer and Dr. Karen Mauck discuss CBD research.

Journalists: Broadcast-quality video sound bites with Drs. Bauer and Mauck are in the downloads at the end of the post. Please "Courtesy: Mayo Clinic News Network."

The legalization of marijuana for medicinal purposes has spurred intense interest by consumers in over-the-counter products containing CBD and hemp oil, especially for chronic pain relief. The review in Mayo Clinic Proceedings summarizes the latest research, as well as the current legal status of CBD and hemp oils, and concludes that the products are potentially useful for chronic pain and addiction management. The study's lead author is Harrison J. VanDolah, athird-year medical student at Creighton University School of Medicine.

With CBD a hot consumer trend, physicians may find it easy to dismiss them as unproven and untested. Dr. Bauer encourages health care professionals to learn as much as possible and develop an expertise about these products, and take their patients' interest seriously.

"We encourage physicians to not disregard their patients' interest in these products and keep both a clinical curiosity and a healthy skepticism about the claims made," he says. "Chronic pain management continues to challenge patients and physicians, and these therapies are a promising area that needs more research. For patients struggling with chronic pain, physicians taking time to listen to them and address their questions compassionately but with an evidence-based approach can help them make informed decisions.

The variety of CBD and hemp oil products, and the limited regulation of these products, is a concern for health care professionals, according to the study. No rigorous safety studies have been done on "full spectrum" CBD oils, which contain a variety of compounds found in the hemp plant, not just CBD. The variability of state laws regarding production and distribution of hemp and CBD products adds to the complexity of decision-making for consumers and physicians.

Co-author Karen Mauck, M.D., an internist at Mayo Clinic, says there are important distinctions between marijuana, hemp and the different components of CBD and hemp oil, and some clinicians may not be aware of them.

"Other than Epidiolex, a purified form of plant-derived CBD which was approved in 2018 for treatment of severe forms of epilepsy, all other forms of CBD are not approved by the Food and Drug Administration but are sold in a variety of formulations, including oral or topical oils, creams, sprays  and tablets," Dr. Mauck says. “They contain variable amounts of CBD, may contain other active compounds and may have labeling inaccuracies. Before using CBD or hemp oils, it's important to consult with your physician about potential side effects and interactions with other medications." 

Watch: Is CBD safe to use?

Journalists: Broadcast-quality video pkg (0:58) is in the downloads at the end of the post. Please "Courtesy: Mayo Clinic News Network." Read the script.

###

About Mayo Clinic Proceedings
Mayo Clinic Proceedings is a monthly peer-reviewed medical journal that publishes original articles and reviews on clinical and laboratory medicine, clinical research and basic science research. Mayo Clinic Proceedings is sponsored by the Mayo Foundation for Medical Education and Research as part of its commitment to physician education. Visit the Mayo Clinic Proceedings website to view articles.

About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news and An Inside Look at Mayo Clinic for more information about Mayo.

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Mayo Clinic Minute: Is CBD safe to use?

CBD has surpassed all other supplements in history in terms of rapid rise in sales and use in the U.S., says Dr. Brent Bauer, director of the Mayo Clinic Integrative Medicine and Health Research Program. It's being marketed to help with a myriad of aliments and diseases.

Before considering CBD, Dr. Bauer says it's important to speak with your health care provider. CBD may interact with other medications that you're taking, such as blood thinners.

Watch: The Mayo Clinic Minute

Journalists: Broadcast-quality video pkg (0:58) is in the downloads at the end of the post. Please "Courtesy: Mayo Clinic News Network." Read thescript.

"CBD comes from Cannabis sativa, which is the plant from which we get marijuana, which has THC, which is the effect that gets people high," says Dr. Bauer.

CBD is being touted to help treat nausea, anxiety, cancer, arthritis and even Alzheimer's. But does it work?

"We know in animal studies and some test-tube studies, it seems to be pretty good for anti-inflammatory, may have some anti-pain (properties), and it certainly has some effect on mood," says Dr. Bauer.

Patients, such as those being treated with cancer, should talk with their care team before using CBD. 

"It can interfere with the metabolism of some chemotherapy agents," says Dr. Bauer.

He says there needs to be more research on CBD. Early indicators show that it's safe, but many questions remain.

"If it's strong enough to help you, it's strong enough to hurt you," says Dr. Bauer.

So does this mean avoid it? Dr. Bauer says that he tells his patients to do their homework and be sure to talk with their health care provider. 

"I'm very optimistic that there will be something beneficial there. I don't think it's going to be magic," he says.

News Release: CBD products, hemp oil may be helpful but more research is needed, Mayo Clinic review says

Sours: https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-minute-is-cbd-safe-to-use/
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The Mayo Clinic Weighs in on CBD – Offers Dosage Suggestions.

The Mayo Clinic suggests CBD dosages based on scientific research, publications, traditional use, and expert opinion. Cannabinoid dosages and duration of treatment depend mainly on the illness (and countless other factors).

The following chart from Mayo Clinic provides specific dosage recommendations for various illnesses:

  • Loss of Appetite in Cancer Patients: 2.5mg of THC (orally), with or without 1mg of CBD for six weeks. [S] 
  • Chronic Pain: 2.5-20mg of CBD [with or without THC] (orally). [S]
  • Epilepsy: 200-300mg of CBD (orally) daily. [S]
  • Movement Problems Due to Huntington’s Disease: 10mg of CBD per kg of body weight daily for six weeks (orally). [S]
  • Sleep Disorders: 40mg-160mg of CBD (orally). [S]
  • Multiple Sclerosis (MS) symptoms: Cannabis plant extracts containing 2.5-120 milligrams of a THC/CBD combination daily for 2-15 weeks. Patients typically use eight sprays within any three hours, with a maximum of 48 sprays in any 24-hour period. [S]
  • Schizophrenia: 40-1,280mg oral CBD daily. [S]
  • Glaucoma: A single sublingual CBD dosage of 20-40mg (>40 mg may increase eye pressure). [S]

THE MAYO CLINIC WEIGHS IN ON CBD – OFFERS DOSAGE SUGGESTIONS.

Read more here: 

https://cbdoilreview.org/cbd-cannabidiol/cbd-dosage/

MEDICAL NEWS TODAY ALSO TALKS ABOUT THE MANY BENEFITS OF CBD

Sours: https://www.mahoneylimited.com/mayo-clinic-weighs-in-on-cbd-offers-dosage-suggestions/

CBD Hemp Oil

Cannabidiol (CBD) oils and products have become increasingly popular with consumers as ways to find relief from aches and pains, anxiety, sleep disturbances, and other chronic issues. But are these products safe, and are they helpful?

A review of the latest research, to be published in September in Mayo Clinic Proceedings, finds there’s a growing body of preclinical and clinical evidence to suggest that CBD oils may hold promise for treating conditions such as chronic pain and opioid addiction. But few clinical studies on the safety and efficacy of cannabidiol have been reported, and more research involving humans is needed before health care providers can say definitely that they’re helpful and safe, according to Mayo Clinic researchers.

“There are many intriguing findings in pre-clinical studies that suggest CBD and hemp oil have anti-inflammatory effects and may be helpful with improving sleep and anxiety,” says Brent Bauer, M.D., an internist and director of research for the Mayo Clinic Integrative Medicine program. “But trials in humans are still limited, so it is too early to be definitive about efficacy and safety.”

Dr. Bauer says there’s reason for concern about a growing number of reports of liver injury in patients who have used CBD products. With greatly increasing patient interest in CBD and hemp oil products, it’s important that clinical research moves ahead to better understand their potential value and safety, he says.

“Careful selection of a health care product is crucial, and though these products do not have Food and Drug Administration approval for therapeutic use, patients continue to ask for them and use them. Physicians need to become better informed about these products, and it’s important that human trials examine issues of efficacy and safety.”

Watch Dr. Brent Bauer and Dr. Karen Mauck discuss CBD research:

The legalization of marijuana for medicinal purposes has spurred intense interest by consumers in over-the-counter products containing CBD and hemp oil, especially for chronic pain relief. The review in Mayo Clinic Proceedings summarizes the latest research, as well as the current legal status of CBD and hemp oils, and concludes that the products are potentially useful for chronic pain and addiction management. The study’s lead author is Harrison J. VanDolah, a third-year medical student at Creighton University School of Medicine.

With CBD a hot consumer trend, physicians may find it easy to dismiss them as unproven and untested. Dr. Bauer encourages health care professionals to learn as much as possible and develop an expertise about these products, and take their patients’ interest seriously.

“We encourage physicians to not disregard their patients’ interest in these products and keep both a clinical curiosity and a healthy skepticism about the claims made,” he says. “Chronic pain management continues to challenge patients and physicians, and these therapies are a promising area that needs more research. For patients struggling with chronic pain, physicians taking time to listen to them and address their questions compassionately but with an evidence-based approach can help them make informed decisions.

The variety of CBD and hemp oil products, and the limited regulation of these products, is a concern for health care professionals, according to the study. No rigorous safety studies have been done on “full spectrum” CBD oils, which contain a variety of compounds found in the hemp plant, not just CBD. The variability of state laws regarding production and distribution of hemp and CBD products adds to the complexity of decision-making for consumers and physicians.

Co-author Karen Mauck, M.D., an internist at Mayo Clinic, says there are important distinctions between marijuana, hemp and the different components of CBD and hemp oil, and some clinicians may not be aware of them.

“Other than Epidiolex, a purified form of plant-derived CBD which was approved in 2018 for treatment of severe forms of epilepsy, all other forms of CBD are not approved by the Food and Drug Administration but are sold in a variety of formulations, including oral or topical oils, creams, sprays  and tablets,” Dr. Mauck says. “They contain variable amounts of CBD, may contain other active compounds and may have labeling inaccuracies. Before using CBD or hemp oils, it’s important to consult with your physician about potential side effects and interactions with other medications.” 

Sours: https://scitechdaily.com/mayo-clinic-cbd-products-hemp-oil-may-be-helpful-but-more-research-is-needed/

Clinic cbd mayo

Mayo Clinic Q and A: Consistent oversight to ensure purity, safety of nonprescription CBD products doesn’t exist

Cannabis of the formula CBD cannabidiol. Concept of using marijuana for medicinal purposes

DEAR MAYO CLINIC: I'm interested in trying CBD for knee pain. I see CBD for sale everywhere — even at gas stations. How do I figure out which kind to buy? Are CBD products that are available without a prescription safe and effective?

ANSWER: When it comes to trying products made with cannabidiol, or CBD, that you can buy without a prescription, be careful. There's some preliminary research that shows potential benefits of using CBD for certain medical problems, particularly pain, sleep disorders and anxiety. But at this time, there's no consistent oversight to ensure the purity and safety of nonprescription CBD products, or to verify claims manufacturers make about them. Before you try CBD, talk to your health care provider.

CBD is a chemical found in marijuana, but it doesn't contain tetrahydrocannabinol, or THC, the psychoactive ingredient in marijuana that produces a high. The typical formulation of CBD is a liquid that you take orally. But CBD is sold as an extract, a vaporized liquid and an oil-based capsule, too. There also are many CBD-infused products, including food, drinks and beauty products.

The only CBD product specifically approved by the Food and Drug Administration is Epidiolex, a prescription medication that's used to treat two types of epilepsy: Lennox-Gastaut syndrome and Dravet syndrome. Aside from Epidiolex, which is approved nationwide, laws vary from state to state regarding other forms of CBD.

CBD production is not tightly regulated. That means it's difficult to know exactly what's in the CBD products for sale in your community or if the dose listed on the container matches what actually is in the product. Some CBD products include chemicals and herbs, such as echinacea, that may or may not be listed on the label. One study of 84 CBD products bought online found that more than one-quarter of the products contained less CBD than labeled. In addition, THC was found in 18 of those products.

At this time, there is no definitive evidence to support the effectiveness of nonprescription CBD to treat specific medical problems. But research is ongoing into CBD as a treatment for a wide range of conditions, including pain, sleep disorders, anxiety, Parkinson's disease, schizophrenia, diabetes and multiple sclerosis. Some evidence suggests that CBD may be useful in treating pain, indicating that there could be a role for CBD as an alternative to opioid medication for challenging chronic pain or to treat opioid addiction.

Before you try nonprescription CBD for any medical concern, you need to talk with your health care provider. There are a few reasons for that. First, CBD can interfere with other medications, so it's important to review your current medications with your health care provider to confirm that CBD won't affect them.

Second, CBD can cause side effects, including dry mouth, diarrhea, reduced appetite, drowsiness and fatigue. It also can affect liver function. Before you begin taking CBD, your health care provider may recommend a liver function test, along with follow-up tests while you're taking CBD, to check that your liver is not being damaged.

Third, if you and your health care provider decide CBD may be worthwhile for you, he or she can help you determine which product to buy. Certain brands and preparations of nonprescription CBD have been tested to verify the amount of CBD they contain and identify other ingredients in them. Your health care provider can help you find one of those verified products. Do not take a nonprescription CBD product without consulting your health care provider first. Although CBD shows some promise, many CBD products on the market today are poorly regulated, and manufacturer's claims about their benefits are unsubstantiated, so it's important to proceed with caution. — Dr. Brent Bauer, Complementary and Integrative Medicine Program, Mayo Clinic, Rochester, Minnesota

Sours: https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-consistent-oversight-to-ensure-purity-safety-of-nonprescription-cbd-products-doesnt-exist/
Mayo Clinic Radio: CBD products - what's safe to use?

I keep hearing about CBD oil. Is it safe to try?

A: Cannabidiol (CBD) oil is popular for symptom relief in a number of ailments. While it's mostly considered safe, it's not without risks.

CBD is a chemical derived from Cannabis sativa (marijuana). CBD contains little or no delta-9-tetrahydrocannabinol (THC), the psychoactive ingredient in marijuana that produces a high. The usual CBD formulation is oil, but CBD is also sold as an extract, vaporized liquid or oil-based capsule.

Reported uses for CBD include relief from:

  • Physical discomfort or chronic pain
  • Involuntary movements related to conditions such as amyotrophic lateral sclerosis and multiple sclerosis.
  • Insomnia
  • Symptoms associated with mental health conditions such as anxiety, bipolar disorder, schizophrenia and social phobia

While it's generally well tolerated, CBD can cause side effects such as dry mouth, diarrhea, reduced appetite, drowsiness and fatigue. CBD can also interact with other medications you're taking, such as blood thinners. Another cause for concern is the unreliability of the purity and dose of CBD in products since they aren't regulated. CBD products can also be quite expensive.

The only CBD product approved by the Food and Drug Administration is a prescription oil called Epidiolex. It's approved to treat two types of epilepsy. Aside from Epidiolex, state laws on CBD vary. Some states place specific medical restrictions on who can purchase CBD products, while other states may allow people to obtain them openly at a dispensary or store.

If you plan to try products containing CBD, talk to your...

Sours: https://healthletter.mayoclinic.com/issues/june-2019/i-keep-hearing-about-cbd-oi-is-it-safe-to-try

You will also be interested:

Mayo Clinic Scientists Raise Concerns About CBD's Unexplored Risks

CBD is in everything — oils, lotions, drinks, gummies, sprays, dietary supplements, even puppy tinctures and mascara. It doesn’t get you high, but anecdotal evidence suggests it may make you feel better. CBD enthusiasts report pain relief, less anxiety, greater relaxation, better sleep, and reduced inflammation, and some evidence suggests it may even help curb opioid addiction and weight gain during HIV infection, improve nausea during cancer treatment, and help treat sleep disorders and Tourette syndrome.

But a new systematic research review from Mayo Clinic, one of the country’s leading medical centers, warns there’s still a lot to learn about CBD.

The big takeaway from the review is that no one knows exactly how effective or safe CBD really is. The researchers argue that more research on humans is needed to confirm many of the health claims made on the packaging of products containing CBD, short for the Cannabis-derived compound cannabidiol.

“I think it’s really too early to just try anything that you get at the gas station,” Karen Mauck, M.D., co-author on the Mayo Clinic Proceedings journal and internist at the Mayo Clinic, tells Inverse. “Unless you’re a much more educated consumer getting it from these medical dispensaries, I think it’s too early to really take them for any sort of therapeutic effect right now.”

CBD Confusion

Choosing a high-quality CBD product can be hard. The laws and regulations around the substance are confusing and conflicting, and it is regulated differently at the state and federal level, which complicates decision-making for consumers and physicians.

"Because CBD is not controlled, basically, it’s anybody’s guess what can be in these.

One of the concerns about CBD products is that there may be other substances at play. No rigorous safety studies have been done on “full spectrum” CBD oils, which contain a variety of compounds found in the hemp plant and not just CBD.

“Because CBD is not controlled, basically, it’s anybody’s guess what can be in these. And so they can claim that it’s 30% cannabidiol and otherwise pure. But if it’s not independently tested, it may have other pesticides, toxins, heavy metals,” Mauck says.

It’s hard to know exactly what you’re getting. A 2017 review of 84 CBD products published in JAMA found that only a third of the products accurately labeled CBD and THC levels: most over-labeled CBD and under-labeled THC.

Despite these challenges, Mauck stresses that it’s important for health professionals to be as current on the research and developments as possible. She and her co-authors designed the review to be a clinical tool to help physicians more effectively advise patients on CBD use.

“Oftentimes, the reflex is to say, ‘Well, I don’t know about that, but I’ve heard it isn’t safe.’ or say, ‘Oh, I’ll wait until I hear it’s safe,’” Mauck says.

But sometimes patients are desperate and curious about the miracle claims they see online regarding CBD. “They want to know, ‘Well, what do you mean by that?” she says. “Is it ‘Absolutely I shouldn’t try it,’ or ‘Try it at my own risk, and what are those risks’? They have those questions and they’re looking to us to answer those things.”

Knowns and Unknowns

The only thing we know for sure is that purified CBD can help children and young adults with two forms of particularly rare and brutal treatment-resistant epilepsy called Dravet syndrome and Lennox-Gastaut syndrome (LGS). In June 2018, the FDA approved Epidiolex, a purified CBD oral solution for patients with these conditions. Patients reported drastically lowered seizures, and in some patients, the seizures stopped completely.

But for conditions like depression, anxiety, migraines, and insomnia, only preclinical and pilot studies have been conducted, the Mayo Clinic review found. Most studies have been done on rodents, not humans, so there is not enough evidence to make concrete medical recommendations.

This preliminary research is promising, showing potential anti-inflammatory effects and suggesting CBD may improve sleep and reduce anxiety. The research also suggests the potential to block pain receptors and even change the reactivity of the amygdala, two developments that may have important implications for addicts and people with chronic pain. With a population grappling with the opioid crisis, alternative treatments to break the cycle of addiction are eagerly hoped for.

The review also looked at potential negative effects. The review found potential risks of CBD — liver damage, mislabeling, and drug interaction. Anecdotally, patients also report side effects of weight loss, diarrhea, and dizziness from CBD use, Mauck says. But potential side effects depend on how and how much you take in. Inhale CBD, eat it, or spread CBD lotion on your body, and the effects can vary.

Snake Oil or Miracle Cure?

The Mayo Clinic review emerged after Mauck and her Mayo Clinic colleagues were barraged with questions from patients about the safety and efficacy of CBD. Other patients weren’t consulting their doctor about CBD at all.

"Often, patients get the ‘poo poo’ for anything that’s natural.

“A lot of times patients won’t even bring this up because they think, ‘Oh, my doctor will just blow it off and they won’t take it seriously,” Mauck explains. The Mayo Clinic review is intended to provide health professionals with working knowledge to better advise their patients.

“Often, patients get the ‘poo poo’ for anything that’s natural,” Mauck says. “Or sometimes if it has not been proven or FDA approved, people say, ‘Oh, that’s just snake oil, that doesn’t work, forget about it.’ But I think patients want to know that their physicians at least are interested in some of these things and can advise them.”

The Mayo Clinic encourages physicians to keep “a clinical curiosity and a healthy skepticism” about CBD. Even though the FDA hasn’t approved any CBD or hemp oil products, besides the purified CBD oil for epilepsy, patients continue to ask for and use CBD products to self-medicate. As the CBD market explodes, more and more people are likely to try it. It’s crucial doctors remain informed and confident in guiding patients to use or not use CBD.

Wading through CBD

Even though CBD is legally and medically murky, consumers can take a few strategies to minimize risk. Scrutinize labels, buy organic, and purchase from a certified medical dispensary or company that has a certificate of analysis. This certificate means an independent lab has studied the product and certified what it does and does not contain. Find out how and where the hemp plant from which the CBD product is derived is grown, Mauck says. Make sure it is grown legally and not from a foreign source.

But again, the flimsy regulations and conflicting laws around CBD can make it hard to ensure that your CBD product is high quality. “It’s hard, because on the Internet, it’s difficult to try to get all this information and figure out all of these things. And the FDA and others can’t close these false claims down fast enough,” Mauck says.

Ultimately, everything we do comes with a risk, Mauck says. With time and more research, the potential risks and benefits will become clearer.

“I guess it depends on how desperate the patient is or how risk averse they are or not, you know?” she says. “If it were me or my family, I would say it’s a little too soon to tell; I wouldn’t try this right now. It’s exciting and I think there is something to it, but you just have to wait and see.”

Sours: https://www.inverse.com/article/58694-is-cbd-doing-us-any-good


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