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Best Way to Take CBD?
We Asked a Prominent CBD Researcher—What’s the Best Way to Take CBD?
Only a few years back, your choices would have been limited to CBD capsules, tinctures, and topicals. Now, there are CBD-infused foods and drinks, eye drops, vape pens, suppositories, and more.
This leaves the savvy consumer to wonder, which type of CBD should I use?
We spoke with Dr. Debra Kimless, a cannabis researcher and passionate educator whose pioneering work is expanding what we know about cannabis as a medicine. Her expertise can help consumers decide what CBD products are right for them.
Calm by Wellness: Thanks for joining us Dr. Kimless. Would you be able to introduce yourself and tell us about your experience in the cannabis space?
Dr. Kimless: I am a board-certified anesthesiologist, pain medicine specialist, and most recently boarded in lifestyle medicine, which is a new medical specialty that actually looks at what we do in our lives holistically as the foundation for good health. In addition, I’ve spent since 2013 going around the world studying and then helping guide patients, as well as conducting clinical trials, on the use of medical cannabis for the treatment of different types of medical conditions.
Recommended CBD Products by Dr. Kimless
Calm by Wellness: What type of CBD products would you recommend for people to start with?
Debra Kimless: If they’re on other medications that could interfere with CBD’s efficacy, or that CBD can interfere with its efficacy, I try to tell patients to not swallow their medicines until we figure out where they are and how they respond. Which is why I love sublingual preparations the best.
One, it’s familiar. Vitamin D goes under your tongue, B12 goes under your tongue. So I mean people kind of get that. Some patients would never inhale, and so that can be off-putting to them. I don’t want to ever make that a no starter.
About 20% to 30% of what you put under your tongue, depending upon the formulation, will become bioavailable. And you kind of bypass the liver and so, therefore, you don’t have that issue. As soon as you swallow it, it goes through a whole digestive process and takes 60 to 90 minutes. The bioavailability is only about 8%. And then at the end of the day, you’re not even getting what you think you took, because it’s a whole new chemical.
So when I guide patients, I say “Let’s look for sublingual preparation, start at the lowest dose and slowly titrate upward.”
Calm by Wellness: When would it be appropriate to try an oral CBD, like a capsule or edible?
Dr. Kimless: There are some people that can’t sleep through the night regardless of what cannabis formulation they take. That’s when oral preparation could be of benefit because it lasts a longer period of time. But I don’t go there until I’ve figured out how their bodies are actually responding.
Pros and Cons of Vaping Cannabis products
Calm by Wellness: Vaping CBD is becoming increasingly popular. What can you share about the pros and cons of vaping cannabis products?
Dr. Kimless: I think the beauty of this plant is that it offers not only a huge number of bioactive constituents, but it offers a multitude of ways to consume it. That can be helpful. So if people are considering vaping, there are risks and benefits to that, right?
The benefit is you absorb it, it’s very efficient. You get, somewhere between 50% and 80% bioavailability. So if you are inhaling 100 mg, you’re getting 50 to 80 mg guaranteed in your bloodstream and bypassing the liver.
That’s incredible, right?
There’s a stigma attached to smoking thanks to our THC cousins. And people don’t like the look of it, or they feel that it is off-putting.
Medicinally speaking, when you’re applying heat to delicate tissue, like our oral cavity, our lungs, tracheobronchial tree, repeated heat is not a good thing. And so cancer has never been proven. But certainly, cough and bronchitis is something that is well known in inhalation methodologies of anything. And so I would be aware of that as a caveat. Not to vilify it.
I’ll give you an example of a patient with multiple sclerosis who has no pain and then suddenly an intense muscle spasm where inhalation or two, whether it’s CBD, or THC alone, or a combination, can break that spasm quickly without having to wait, is a godsend. It’s a beautiful thing. That’s why I think there’s an appropriate place, time, and dosage form.
How safe are Vape Products?
Calm by Wellness: With the different vape products on the market, how safe are these products? Are there any concerns with the products on the market?
Dr. Kimless: Lots of patients ask me this as well, and we always have to look at the risk-benefit ratio. The cleaner your vape cart product, the better it is.
So they used to thin out the extracted cannabinoids using PG or PEG, which sadly when upon heating to a vapor, turns into carcinogens, something we don’t want for sure…When patients feel they need to vape, I actually recommend vaping flowers. Because then you’re not worried about those diluents at this point. We just don’t have enough information to know yet with these products and vaporization what happens to them in our bodies, what happens to them in our lungs. And so that’s how I recommend it.
Thoughts on Topical CBD
Calm by Wellness: What are your thoughts on topical CBD?
Dr. Kimless: I believe the topical is the unsung hero of the cannabis industry. And I also believe that it is the gateway drug to having people understand, “Holy smokes, this really works” because it’s incredibly instantaneous if you’re using it for pain…I use topicals all the time for patients. I think they are truly amazing. There are cannabinoids and other non-cannabinoid receptors all over our skin. So our skin has all of the elements ready and available to be treated using cannabinoid topical preparations.
Calm by Wellness: When would a topical product be a good choice?
Dr. Kimless: My rule of thumb is if you can touch it if you could actually put your finger on where it hurts, that’s where it helps. So I’ve treated patients with neuropathic pain, post-mastectomy neuropathic pain, diabetic neuropathic pain. I transitioned a patient who was stuck in her house because she couldn’t put socks and shoes on to being able to go out and live her life after chemotherapy.
People who have chronic low back pain, especially if their pain generators are more muscular, it’s incredible. I have athletes using topically for post-workout recovery that’s been really positive for them. People with certain skin issues. So like psoriasis, eczema, dry, flaky skin. It’s amazing.
Tips for Consumers Shopping for a CBD Oil Product
Calm by Wellness: Any tips for consumers shopping for a CBD oil product?
Dr. Kimless: There are studies that show that what is on a label does not necessarily reflect what is inside the container. And so patients really should purchase CBD products through a reliable source that does stand by their products with a Certificate of Analysis. No, differently than we tell our kids at Halloween, don’t take candy from strangers until mommy and daddy check it out. Same thing. I don’t understand why patients suddenly believe that they can go to a gas station and buy CBD. And that’s okay.