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Dr. Madelyn Fernstrom: 4 things you must know before trying CBD

The NBC News health editor separates fact from fiction and offers guidelines if you are interested in trying products that contain CBD.
NBC News health editor, Dr. Madelyn Fernstrom, talks to Know Your Value founder Mika Brzezinski.
NBC News health editor, Dr. Madelyn Fernstrom, talks to Know Your Value founder Mika Brzezinski.Miller Hawkins

From oils, to foods, to drinks, to beauty products, it seems like everywhere you look, there are products containing cannabidiol (better known as CBD), a compound found in the family of cannabis plants.

And while you rub it on your skin or ingest it, most of us know very little about what CBD actually is, or whether there’s any truth to well-touted health benefits from pain relief to reductions in anxiety and depression.

Whether you’re already a CBD user, or just considering, it’s important to take a closer look at what is known today to help make the best decision for your personal health.

1-CBD is short for cannabidiol one of the naturally-occurring compounds found in cannabis plants.

CBD can be extracted from the marijuana plant (containing a lot of THC, the psychoactive compound in cannabis) or the hemp plant (containing only tiny amounts of THC). Studies indicate that CBD is not psychoactive, and not associated with “getting high.”

2-While research is ongoing for the health benefits of CBD, the only FDA-approved use for purified CBD is for certain seizure disorders.

While CBD is surely an active compound in the body, the science is only just starting to look at what other ailments it might help. Claims abound for treating pain, stress, anxiety, insomnia and a variety of inflammatory issues. But evidence, although encouraging, is sparse at this point. Many of the studies have very small numbers of participants or are based on animals. That doesn’t mean it might not help, but personal experiences fuel most of the claims for CBD, not evidence-based information. The placebo effect – you think it works, therefore it does – can be a big factor here. And another big factor is whether it’s ingested (capsules, oils, foods, vapor) or applied (creams, oils) to the skin. There is huge variability in product purity, dosage, and use – because of the lack of current regulations.

3-CBD products are not regulated for purity and safety by government agencies.

It might surprise you to know that CBD products have no official regulation by either the FDA or the USDA. This is a problem, because without any oversight, products can vary widely in purity, and might have more or less active amounts of CBD than claimed, or possible harmful contaminants – which makes the recommended “dosage” unreliable at best. And, because of potential interactions with other medications or supplements you might be taking, it’s best to talk to your doctor before trying. The use of pure CBD seems to be safe for short term use (although it’s hard to know just what a “pure” product is out there), and there are not yet any long-term studies to confirm long-term safety.

4-State and federal legal regulations for CBD can differ.

There’s a gray area for legal use of CBD products throughout the country. The U.S. government is slowly creating a regulatory process for CBD. In December 2018, the Agriculture Improvement Act passed, making CBD derived from hemp legal, nationwide. But CBD derived from the marijuana plant is not a national policy, because it might contain the psychoactive THC; but some states also consider this a legal source.

And the CBD-edibles market has already begun to change, because CBD has not been approved as a “food additive.” Both New York City and the state of Maine have programs in place to stop marketing and selling CBD-containing foods.

If you’re interested in trying CBD-containing products (especially by mouth), here are some smart guidelines to follow:

-Talk to your doctor first if you take prescription or over the counter medications. While CBD appears to be safe, it might interact with other medications you’re taking. Or it might have impurities or contaminants that might interfere with other medications you’re taking.

-When trying creams and lotions, or other topical products, try a tiny patch first, to make sure you don’t have a skin reaction.

-Company quality varies greatly, so check for the type of preparation used, the amount of CBD per dose or serving, its documented purity, and country of origin - as well as the ability to be absorbed by your body. Many products are poorly absorbed when ingested, so biological activity is limited.

-If you’ve done your background homework, and feel it’s worth a try, don’t stop your current medications without medical advice from your own doctor, because everyone is different! CBD compounds might support, but not replace your current treatments.

Madelyn Fernstrom, Ph.D. is the NBC News Health Editor. Follow her on Twitter @drfernstrom.