Summary
Dr. Sydnee McElroy and her husband Justin take an entertaining but thorough look at CBD oil from both personal and scientific perspectives. Justin shares his experience buying CBD oil at a health food store to help with anxiety, noting a slight mellowing effect he can't definitively separate from placebo. Sydnee then dives into the medical evidence, explaining how CBD works by delaying the breakdown of anandamide at cannabinoid receptors, producing a longer calming effect similar to how SSRIs work on serotonin. The episode covers the FDA's 2018 approval of Epidiolex, a CBD-based drug for Lennox-Gastaut and Dravet syndrome (severe pediatric epilepsy), while noting the studies behind the approval had notable limitations including pharmaceutical company funding, high placebo response rates, and side effects that caused 23 patients to drop out. They discuss small but statistically significant results for anxiety in public speaking trials. A major theme is the regulatory gap: CBD products are inconsistently labeled, some contain no CBD at all, and a batch in Utah turned out to be a dangerous synthetic cannabinoid causing seizures. The hosts advocate for more research and proper regulation while warning against miracle cure claims, ultimately taking the position that CBD deserves serious scientific study rather than zealotry or dismissal.
Key Points
- CBD works by delaying the breakdown of anandamide, a calming substance at cannabinoid receptors, similar to how SSRIs work on serotonin
- The FDA approved Epidiolex (CBD-based drug) in 2018 for severe pediatric epilepsy syndromes Lennox-Gastaut and Dravet
- Small trials show some statistically significant results for CBD reducing anxiety in controlled settings like public speaking
- CBD products are poorly regulated: a Netherlands study found products often contain no CBD or mismatched amounts
- A batch marketed as CBD in Utah was actually a dangerous synthetic cannabinoid causing seizures and hospitalizations
- CBD bioavailability when taken orally is only 13-19% depending on preparation
- Marijuana's Schedule I classification has severely limited research into both THC and CBD
- The hosts emphasize CBD needs more research, not zealotry or dismissal, and proper regulation to ensure product safety
Key Moments
How CBD works through the anandamide pathway
CBD works by delaying the breakdown of anandamide, a calming substance in the brain, similar to how SSRIs keep serotonin around longer. This extends the natural calming effect.
"And as a result of it calming that, or as a result of delaying the breakdown of this substance that calms your brain, then you have a longer calming effect."
FDA-approved CBD drug for pediatric epilepsy
The FDA approved Epidiolex, a CBD-based drug for two severe pediatric epilepsy syndromes (Lennox-Gastaut and Dravet), marking the first official medical recognition of CBD's therapeutic value.
"Patients who, who have these syndromes may suffer from 50 or more seizures a day so these are what we kind of consider intractable epilepsy syndromes and so this isn't being used as like a drug of first choice among everyone who's ever had a seizure they're using it for patients who have probably tried and failed many, many other medications and maybe that ketogenic diet we talked about on our keto episode. So, but that is, that is a, an FDA approved usage now. So there are at least some studies that were compelling enough that the FDA said, okay, let's give it a go go for this okay um and as far as anxiety there was a meta-analysis in 2016 which is a big study of studies it's a big like compilation of a bunch of studies sounds like the best you could do really which showed that some animal studies suggest it might help with anxiety I'm an animal and in humans there I found case reports i found very small trials some of them were in indeed double blind trials like specifically there were some things for like give a give a speech something you could control very easily something that like you have to give a speech in public and you either do it with cbd or without cbd and there was like a placebo that had like corn oil in it or something. And anyway, I found studies that were small, but did show some of them, some statistically significant results. I know I shouldn't get yucked out by that, but like it really yucks me out this idea that like, I got a big speech coming up. Glad I just ate a whole syringe of corn oil. Anyway, time to blow them all away."
CBD excitement has far outstripped the scientific evidence
While in vitro studies show promising CBD interactions, clinical human data is still lacking. Much of the research is preliminary, and the hype has gotten ahead of what's been proven.
"But so far, clinical data that actually proves this stuff is still lacking. We just haven't done it yet."
