THC & Cannabidiol
THC and Cannabidiol are both cannabinoids found in Cannabis sativa as well as sub-strains of the plant including hemp. THC, tetrahydrocannabinol, is a psychoactive compound and is primarily responsible for the ‘high’ associated with cannabis. CBD, cannabidiol, while not producing a ‘high’, does affect the brain (and body) in a number of subtle, beneficial ways. THC is a regulated compound in the UK meaning it is illegal in products if found at amounts higher than 1mg. Aside from the legal aspect, THC is forbidden in most of the sporting world and is the major cannabinoid tested for all drug-tested sports and competitions. For this reason, athletes looking to benefit from CBD must make sure they are purchasing from a brand that produces 0% THC products and that they can prove this with lab reports and better yet, drug testing certification from specific sport supplement bodies like Informed Sport of BSCG.
While clinical data in humans is only just beginning to emerge, we do have a large body of pre-clinical and experimental data as well as a wealth of anecdotal evidence that suggests CBD may be useful in combating health disorders or supporting certain aspects of health which may be particularly beneficial to athletes.
Cannabinoids like CBD interact with something called the endocannabinoid system (ECS). The ECS is a highly conserved biological system meaning it is found in practically all animals, pointing to its critical importance to life processes. The ECS is a collection of specialised receptors and signalling molecules called endocannabinoids which collectively play a role in most known physiological processes including the sleep/wake cycle, energy regulation and appetite control, mood regulation as well as pain signalling and immune function. Cannabinoids like CBD interact with this system and thus, may influence many if not all of the biological processes mentioned above. Of particular interest to athletes and active individuals are the role of the ECS in mood regulation as well as immune processes such as inflammation.
Potential Benefits of CBD for Athletes
Athletes of all calibre are always looking for an edge whether that be in training to achieve a PR/PB or an edge over their competition. A mounting body of evidence suggests CBD could be that ‘edge’ for many athletes and as a safe, well-tolerated and legal compound, it is taking the sport supplement world by storm. So, what are the potential benefits that athletes could reap by using superior CBD products?
We know from numerous pre-clinical studies that CBD does appear to be an effective aid in cases of chronic pain and in some cases of acute pain which could translate to CBD being useful for athletes during recovering from injury. Multiple rodent studies have shown an analgesic effect of CBD and the limited human studies we have also point towards this. A wealth of anecdotal evidence, in sports people and beyond, also suggests a measurable analgesic effect.
‘Cannabinoids exhibit similar effectiveness to opioids in models of acute pain and even greater effectiveness in models of chronic pain’
-Fundamentals of Clinical Pharmacology, 2013 27(1), pp.64-80
While not directly related to sport a number of pre-clinical studies have shown the potential benefits of CBD within experimental contexts of pain;
• CBD was found to reduce inflammation and pain behaviours in a model of arthritis.
• Cannabidiol acts as a peripheral analgesic in a myofascial pain model – this suggests cannabidiol may provide analgesic relief for chronic muscle pain disorders such as fibromyalgia without central side effects.
• Cannabidiol can reduce nerve damage in models of osteoarthritis by reducing early stage inflammation.
• Cannabidiol can reduce pain associated with cisplatin induced neuropathy in pain models.
These studies highlighted above are here to show that cannabidiol does have a meaningful impact on pain in a variety of context and are is therefore a suitable suggestion for athletes looking for natural alternatives for pain management.
A Safer Alternative
Athletes, fitness enthusiasts (and millions of others) have been consuming over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen for decades. However, they may not be as safe as thought back when they were first approved. Endurance athletes, especially, are often advised to avoid NSAIDs where possible during training sessions and events mainly due to increased risk of kidney damage. Athlete or not, long-term or frequent use of NSAIDs may increase your risk for heart attack and stroke.
A growing number of athletes have found the pain-relieving effect of CBD can reduce or eliminate their use of NSAIDS for exercise-related pain, with minimal side effects. Additionally, toxicology studies suggest CBD is safe and well tolerated even in large quantities.
“There are no documented deaths from cannabis or cannabinoid-based products. In a systemic review of studies of oral and oral-mucosal cannabis for various medical conditions, the majority of adverse events reports were considered non-serious (96.6%).”
The Essentials of Pain Medicine, Fourth Ed
Although opioid-related deaths are much more of an issue in the USA, they do still occur in the UK and this is a persistent problem. Opioid pain medications (i.e. morphine and codeine) are highly effective for pain management but carry a significant risk of addiction and death by overdose; this is mainly because opioids effect a part of the brain that control basic functions like breathing – an overdose can therefore stop breathing. While cannabinoids may be less effective or of similar effectiveness as opioids for relieving acute pain they may be even more effective for long-term pain management either alone or in conjunction with other medications. This, coupled with a much less serious adverse effect profile makes CBD an exciting prospect for the management of pain.
Inflammation is a natural response to damage or infection and is a sign of greater blood flow and immune cell presence at the area. In small and controlled quantities, inflammation is helpful and a key step in repair but too much inflammation hinders recovery and hurts performance. CBD has fairly potent anti-inflammatory effects based on work conducting using animal models of inflammation (typically models of arthritis etc).
Cannabinoid Receptor 2 (one of the two key receptors of the endocannabinoid system) is expressed particularly heavily in immune tissues and this receptor may be one of the ways in which cannabinoids like CBD influence immune cell function and inflammation. We know, for example, that CBD modulates the production of TNF-, an inflammatory cytokine that plays a wide role in the immune/inflammatory response. By dampening production of this molecule, CBD may dampen the extent of inflammation after a particularly rigorous event or training session.
We also know from various rodent studies that CBD can be absorbed effectively through the skin when prepared in a certain way. CBD can therefore be used as a topical lotion to help reduce local inflammation but may also found utility when taken as an oral oil as systemic CBD can target inflammation throughout the body.
Sleep and Mood
Many trainers would argue that quality sleep is as important as good diet when it comes to achieving your best performance. Anecdotally, athletes who consume CBD report greater ease going to sleep and a more restful night’s sleep. One potential reason for this could be CBD inhibiting the reuptake of adenosine as well as its influence on the serotonin system. Rodent studies also show that acute dosing with cannabidiol increases time spent asleep. However, the effects of CBD may be location specific. Microinjections of CBD into the lateral hypothalamus of rodents, an area known to regulate arousal, actually increased alertness and reduced instances of sleep.
CBDs effects on sleep patterns and sleep in general may be due to adenosine as the endocannabinoid anandamide modulates adenosine levels in the brain to help regulate sleep. A large case study published only this year that involved subjects self-reporting on how CBD application affected their anxiety and sleep showed interesting results.
As endocannabinoids play a role in the regulation of sleep it is perhaps no surprise that cannabinoids from plants like CBD also interact with the sleep/circadian system.
Anxiety and anxiety-linked disorders appear to be increasing in prevalence in the Western world. This is partly due to better diagnosis but there are myriad other reasons including the rise of social media and the general busy-ness of our modern and often hectic lives. Anxiety disorders are insidious. Like with many mental health problems, sufferers of anxiety can appear fine on the outside and often carry on in silence. Untreated anxiety can seriously impact quality of life as individuals are likely to withdraw from situations that provoked anxiety in the past. Clinical anxiety is of course different to ‘nervousness’ or what athletes might call ‘pre-claim’ nerves but nonetheless are the result of similar mental processes and regulatory systems. Sport can be as much a mental game as a physical one and having a calm and focussed mind is as important as a pain-free and strong body if you are to achieve your best.
A growing body of pre-clinical evidence and self-assessment trials has shown that cannabidiol can produce marked improvements in anxiety symptoms for a range of anxiety and anxiety-linked disorders including Generalised Anxiety Disorder and Obsessive-Compulsive Disorder and may be useful for taking control back if you suffer from pre-game nerves.
‘‘Current evidence indicates CBD has considerable potential as a treatment for multiple anxiety disorders.’’
Neurotherapeutics 12(4) pp. 825-836
At the beginning of 2018, the World Anti-Doping Agency (WADA) removed CBD from the list of prohibited substances – in or out of competition. This means CBD is not a banned substance for any athlete. An important detail to remember is that only CBD was removed from the list. THC, the psychoactive component of cannabis is still very much a banned substance. This make it incredibly important for athletes to choose a 0% THC brand with independent, clear lab reports to back this claim up.
If you are interested, the specific wording used in the prohibited substance document is:
“The following cannabinoids are prohibited: Natural cannabinoids, e.g. cannabis, hashish and marijuana. Synthetic cannabinoids e.g. Δ9-tetrahydrocannabinol (THC) and other cannabimimetics.”
Legality outside of sports competition is entirely different and can vary from country to country but CBD is entirely legal in the USA, UK and most of Europe.
CBD is a well-tolerated and safe compound which has a range of purported health benefits, each supported to differing degrees by the literature. Some reported benefits are utter nonsense others do have a basis in science and fit with our understanding of the endocannabinoid system and human physiology. Of note, CBD does seem to have real effects on mood (anxiety) as well as aspects of pain and inflammation.
Athletes and active people in general may find utility in CBDs anti-inflammatory and analgesic properties as well as its potential mood stabilising qualities.
A note on safety and quality:
If you are thinking of using CBD and are a drug-tested athlete BE VERY CAREFUL about how you proceed. Many brands on the market contain illegal or at least detectable levels of THC in their products which may or may not be openly advertised. Always purchase your CBD from a reputable brand that knows their product inside and out and can provide you with evidence of their credentials and product ingredients. Dr. Ed Sport was created by scientists and athletes to address this specific problem,; creating a brand athletes and fitness enthusiasts can trust for advice and market leading, 0% THC CBD supplements and products.