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What are the REAL benefits of CBD? With Mary Clifton, MD

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Content By: Ari Whitten & Dr. Mary Clifton

In this episode, I am speaking with Dr. Mary Clifton – a world-renowned expert on CBD and cannabinoids. We will talk about the real benefits of CBD and how it impacts your health. (Quick side note: Dr. Clifton also has an amazing CBD Summit that’s about to be released. You can get FREE access to it HERE.)

In this podcast, Dr. Clifton will cover:

  • The CBD Health Revolution
  • CBD vs THC. How to spot the difference in hemp plants
  • How safe is CBD? The truth might surprise you
  • Sleep soundly with CBD. Learn the most effective dosages to take
  • Intro to the endocannabinoid system and its critical role in your body
  • Seizures, Tourette’s syndrome, and ticks. How CBD helps

In her CBDHealthRevolution, Dr. Clifton, interviews 30 renowned experts on the revolutionary healing properties of CBD (from the hemp plant and legal in all 50 US states) for helping people with a wide variety of symptoms and medical issues, including pain relief, addiction, cancer, insomnia, PTSD, anxiety, skin issues, and more!

I am lucky enough to be included as one of the featured speakers, and you can listen to my interview on energy enhancement, mitochondria, and CBD by registering for the free summit, which airs between January 13th and 19th.

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What are the REAL benefits of CBD? With Mary Clifton, MD - Transcript

Ari Whitten: Hey there. Welcome to The Energy Blueprint podcast. I’m your host Ari Whitten. Today I have with me a very special guest, someone who I’ve been excited to interview for a very long time. It is Dr. Mary Clifton, who is a widely recognized CBD and cannabinoid THC expert, this whole topic. I’m going to read her official bio here. She is a board-certified MD practicing in Manhattan. She’s a recognized expert in CBD and cannabis and the host of the CBD Health Revolution, which there’s going to be a link to on this podcast page which is going to be at theenergyblueprint.com/CBD.

You can opt into this new CBD-focused health summit right there. It’s free access. I just wanted to quickly mention that. She’s the host of the CBD Health Revolution and the highly respected professional certification course, The Cannabinoid Protocol. She’s worked with several pharmaceutical CBD and– I’m getting it mixed up with cannabinoid.

Dr. Mary Clifton: It’s hard to get it.

Ari Whitten: Cannabis corporations on product development and has provided medical and scientific directorship in the US, Europe, Asia, and Africa. I almost said dictatorship there. That wouldn’t have been good. That wouldn’t have been a good slip up at all.

Dr. Mary Clifton: I think I’d be benevolent in a dictator role, though.

Ari Whitten: You would. I was going to tell you right before we started recording, you have a very soothing voice, so I can’t imagine you being a harsh dictator.

Dr. Mary Clifton: No.

Ari Whitten: She’s also the bestselling author of The Grass is Greener Medical Marijuana, THC & CBD OIL: Reversing Chronic Pain, Inflammation and Disease and Get Waisted. That’s W-A-I-S-T-E-D as well as five companion cookbooks. She speaks at major cannabinoid events around the world, including Africa, Europe, and Asia. Welcome, Dr. Clifton. Such a pleasure to finally have you. I know this has been a long time in the making, so I’m glad we’re finally making it happen.

Dr. Mary Clifton: I am so glad too. I’ve been looking forward to this for a long time. You have such a marvelous audience, and I always love when an audience is really engaged, very educated and elevated already and then I can dig really deep. I’m excited to talk to a group of people that want to know the details.

What CBD actually is

Ari Whitten: Yes, absolutely. I’m sure there’s a lot of avenues we can take within your range of specialties here. I’m sure that you could do five hours of discussion just on CBD or just on marijuana. I want to focus probably more on CBD though I’m totally fine if you want to inject anything on marijuana throughout this discussion. First of all, for people who haven’t heard of it, and I can’t imagine that all this applies to a lot of people at this point because CBD has exploded in popularity and so many people are talking about it. I think probably I think you’d agree with me, there’s probably a lot of people talking about it in an unrealistic panacea cure-all way and there’s a lot of pseudoscience out there.

I’m looking forward to actually interviewing a real expert on the subject who can maybe speak to the actual evidence and maybe we can debunk some of the myths along the way or areas where there isn’t good science to support some claims. First of all, to start, what is CBD for people who haven’t heard of it or maybe heard of it but they don’t really know what it is?

Dr. Mary Clifton: I agree with you on the research, we don’t have multimillion-dollar research that was done in multiple different places that we can draw on for really any of the conditions that cannabinoid formulations may work on. We have to rely on some very elegant but small studies that give us a better idea of how it’s working. I have all of my favorites outlined for our talk today. CBD is just a distillation product from a cannabis or hemp plant. Some hemp plants, cannabis plants are designed to grow up with a very high concentration of THC. You can recognize those if you look at the flowers of the plants, they’ll have a lot of crystals all over the flowers of the plants. They’ll have like a whitish if you will a little froth or frosting on the buds, and that’s a very high THC concentration on that plant.

Plants that grow more hemp will have flowers that are concentrated in hemp and they just look like a green flower, like the flowers you see in Christmas decorations or in fall, really beautiful fall bouquets. Then drug companies or different CBD companies can work to distill that as much as you like. They can just get the CBD product directly from the plant with all of the other plant chemicals and any others, CBG or CBN, any other cannabinoids that might be in the plant.

They could give you that product, which is considered full spectrum or broad-spectrum CBD products or they can take that CBD product and usually work with an alcohol distillation and distill off the CBD isolate so that it’s pure. There’s nothing else in the isolate but the CBD. Then some people prefer a very pure isolate when they want to see if something’s working and other people prefer more of a whole foods approach to their treatments. That really differentiates those two.

There’s also a small risk that if you use the CBD that is a broad spectrum, it could have a very small amount of THC in there up to 0.3%. If there’s any problem with you getting any exposure to THC, those broad-spectrum or full-spectrum, hemp-derived CBDs just need to be considered a little bit differently. The CBD, CBN, CBG, THC are all cannabinoids that live and grow within the hemp or cannabis plant. The CBD is just the workhorse out of that crowd as much as we know about CBD although we’re gaining more knowledge on all of the other cannabinoids but CBD appears to be the leader for the antiinflammatory work, for work in helping to control pain and help people relax from anxiety and insomnia.

The importance of the Endocannabinoid system

Ari Whitten: Definitely, I know you’re cutting off the list there very quickly. I want to get into that very long list of benefits and potential benefits of CBD. First, I would like to ground this whole discussion in maybe the broader context of the endocannabinoid system. Can you speak to what the endocannabinoid system is? I think there’s a lot of people out there who have heard of CBD at this point and certainly, everyone knows of what marijuana is but not a lot of people know what the endocannabinoid system is. Can you speak to what that system is and what physiological roles it has?

Dr. Mary Clifton: Sure. We really didn’t know as doctors or health providers or scientists what the endocannabinoid system was until the late ’80s or early ’90s when we finally started to study cannabis. When people who were suffering from cancer, who were dying from HIV/AIDS at the time, were saying that they were getting such great relief of their symptoms with those products. Scientists started to look at it, and we find this amazing endocannabinoid system that is located literally on every organ and tissue in your body.

The endocannabinoid system overlays the rest of your systems in a similar way to the adrenal and cortisol axis where if your cortisol is low or high, your entire body responds to that shift or your thyroid where if your thyroid is thrown off, every organ in your body has a response to that. The endocannabinoid system is very similar. It’s on all of our tissues and all of our organs, primarily CB1 and CB2 receptors, although now scientists are finding CB3, CB4 CB5 receptors in various isolated parts in the brain. The CB1 receptors are located primarily in the nervous system and in our spinal cord and our brains and in the nerves that exit out to our arms and legs.

The CB2 receptors are located primarily in muscles and other organs also very predominantly in the immune system. There’s this very far-reaching functionality that’s already in your body. Your body is actually already making endocannabinoids which are referred to as 2-AG and anandamide. Those are the endocannabinoids that your body makes naturally from the fats in your diet. Those endocannabinoids are there already to stimulate CB1 and CB2 receptors throughout your system.

For example, if you take a biopsy, if you take a sample of someone’s inflamed colon and study that inflamed colon compared to normal, there’s a higher concentration of CB receptors in the lining of the colon and also in the smooth muscle that surrounds that area of the colon in that area of inflammation. The same thing if you have a rheumatoid arthritis joint that’s swollen with rheumatoid fluid and you pull that joint fluid off, that fluid has a higher concentration of 2-AG and anandamide. Your body is already setting up an anti-inflammatory trying to reduce the pain, trying to restore homeostasis in these areas that are injured. Your body is already primping the system so that if you decide you want to try some plant cannabinoids, they might be valuable. The system is already there for them to be received.

Ari Whitten: How are they received? Well, actually, before we get there. Let’s go a little deeper into what specifically the 2-AG and anandamide are doing in the body. You mention anti-inflammatory, but what is the list of these physiological roles? I’m under the impression that it’s not just inflammation and pain, but also the body’s resilience response to stress. The ability to turn of the stress response, things of that nature.

Dr. Mary Clifton: I think it’s just another great example of systems in our bodies that are designed to restore homeostasis and help us stay calm in the setting of stress. They basically work at the point where nerves talk to other nerves, like other drugs that impact in neurotransmission. These formulations impact neurotransmission. For example, when you take an antidepressant. You’re trying to increase the amount of serotonin, or norepinephrine, or dopamine that lingers in that neurotransimitter point where two nerves are talking to each other, and that will elevate your mood.

The cannabinoids through the CB receptors function in a lot the same way, but they also have functions that are similar to gabapentin in the peripheral nervous system that help to reduce nerve-based pain. They behave like a lot of other pain medications. In fact, even the opioids that operate through the mu receptors. Their functionality is fairly similar to the way that cannabinoids function. They work in the central nervous system in the brain and then the spinal cord to help temper anxiety responses or pain responses.

Sometimes when pain goes up and down the spine, or when it hits the cortex of the brain, it’ll expand and generate and enlarge itself along those pathways. The endocannabinoid contribution is that it reduces that ability of the pain to amp itself up as you’re dealing with chronic pain. It’s also great to have these products available for when you’re dealing with a lot of anxiety. It works to help to stabilize all of the stress and anxiety responses so that you have a more limited anxiety response rather than more of a generalize response.

Ari Whitten: Got you. There’s a lot to unpack there. I guess you could maybe treat this separately or all as one. Specifically, between anandamide and 2-AG, what are the differences in terms of how they are affecting our physiology? I guess also part of that question is CB1 vs CB2. What roles the CB1 receptors versus CB2 receptors are playing? Then, this is the part that could either be treated all under this umbrella or as a separate question after, where does CBD fit into this system, these different mechanisms?

Dr. Mary Clifton: Right. Well, the CB1 receptors with their primary location in the central nervous system work on things that are managed within the central nervous system, the anti-inflammatory effects, the anti-anxiety affects and CB1 receptors. Both receptors are stimulated by any of the endocannabinoids. It’s not that CBD works here, and THC works here, and CBN works here. All of the different receptors are responsive and similarly having similar responses to 5-AG and anandamide, the endocannabinoids that your body is creating. This work in the central nervous system to help avoid that amping up, but also works similarly on the tissues in the body and the organs in the body that are under inflammation or under stress to help to temper that stress response.

I don’t think that there is a significant difference between 5-AG and anandamide in terms of one or the other functioning differently out in the body.

Ari Whitten: You say 5-AG or 2-AG?

Dr. Mary Clifton: I’m sorry. 2-AG and anandamide, yes.

Ari Whitten: I was like, “I don’t think I know of a 5-AG.”

Dr. Mary Clifton: No. I don’t know of a 5-AG either. [laughs]. Maybe we can make it up today. [laughs]

Ari Whitten: There are some people listening who might have heard what you just said there. We don’t necessarily know if there’s a big difference between the affects. Maybe they interpreted that as THC and CBD are acting the same way.

Dr. Mary Clifton: No, I’m sorry.

Ari Whitten: No, don’t apologize. I want you to clarify, because there’s a lot of people out there who hear CBD comes from cannabis plants and then they immediately go, “Oh, it’s marijuana. This is a drug to get people high. This is going to cause me to fail a drug test. This is a drug that’s harmful. I need to avoid drugs and marijuana.”

Dr. Mary Clifton: It’s so important to get that clear right way because CBD is definitely a distillation from the same basic plant but it doesn’t have the psychotropic affects of THC. The stuff that gets you high, that gives you that dizzy, light headed, disassociated feeling is all from the THC. When you’re using a CBD product, you’re not going to get any of that experience. It’s just the workhorse portion of all of those CBD molecules, so you get all the benefits of using a full spectrum in a lot of cases and then you don’t have to deal with all of the affects of the THC and those effects that many people just don’t like.

I was referring to the 2-AG, not the 5-AG. [laughs]. The 2-AG and anandamide is not having really significantly different affects. Person to person, there is a significant difference in the amount of those products in the body and also in CB1 and CB2 receptors and the receptor concentrations. Oftentimes when I talk to a patient who says this didn’t work for me, we have to go back and think about why that didn’t work. What was going wrong with the formulation? Maybe we chose the wrong formulation or maybe they didn’t take enough. Sometimes it’s just because there’s genetically a different ability to respond to cannabinoid formulations overall.

It’s important to just take time to learn about what you’re doing here, like you’re doing today, and then give yourself plenty of time to change your serving size, up or down, and see what works best for you.

Ari Whitten: Got you. Now, did I misunderstand something that you said a little bit ago as far as– I think you said something to the affect of it’s not as if these compounds only affect just CB1 receptors or just CB2 receptors. I think you were referring to CBD and THC when you were saying that, is that correct?

Dr. Mary Clifton: Yes, that’s correct. Whenever you’re using either the endocannabinoids that you’re body produces itself, the 2-AG and anandamide, or the products that you might be taking from a plant or the products that are synthetic– Some drug companies have some synthetic products that are 100% man-made. All of those products affect all of the receptors. There is some early discussion about some receptors being impacted differently, but we really don’t have any clear data on that yet.

Ari Whitten: They have to be impacted differently if THC gets you high in that way that you described, that euphoric light headed state where CBD doesn’t do that. Doesn’t that necessarily mean that they’re interacting with the receptors in different ways or what’s going on there?

Dr. Mary Clifton: That’s a very good point. It could be that they are reacting with the receptors in a different way and creating a different outcome. I guess I meant to say like I think that the THC and the CBD both impact receptors in the central nervous system and all over the body. The way that they interact with the receptor is definitely different, but both of those cannabinoids cross the blood brain barrier and get into the central nervous system, and both of them affect all of the receptors through the body. You can use a THC product. A lot of times, if you don’t like that feeling or if you don’t want to get that exposure. You can use the CBD product and get a pretty good benefit from just using the CBD exclusively and not having to ever add the THC.

The potential effect of large doses of CBD oil

Ari Whitten: Got you. Now, I have to ask. Both my wife and I have experimented with higher doses, quite high doses of CBD. At a very high dose of it, she and I have both felt some sort of- definitely some pychoactive effect. It’s definitely way different than just plain marijuana, but there was some– I don’t know. I don’t even know how to describe what the feeling is, but some kind of psychoactive effect.

Dr. Mary Clifton: No, it’s exactly as you say. That’s exactly true. I think that you’re not the only person who said that. To say that CBD is entirely not psychoactive doesn’t actually tell the whole story right because we know that CBD is having a central nervous system effect because it relieves anxiety and helps some people with their depression. It works in both of those cases in many cases. We know that it has an effect on mood, but the psychoactive effect, the experience of getting high is really reserved to the THC. At higher doses, people do experience– Excuse me, I should say serving sizes. The FDA doesn’t want us to say doses. At higher serving sizes on the CBD, you are going to have some of those experiences where you feel deeply calm, but I still don’t think that you’re getting the psychoactive dissociated dizzy effects that you see with using THC.

Definitely, you’re going to see some changes in the way that you are perceiving things and the way that you’re interacting.

The usefulness of CBD in managing pain, MS, and seizures and more

Ari Whitten: Got you. Now, you mentioned there’s some, I guess, debate or still much research to be done to identify the specific unique patterns of activation and THC versus CBD and why they’re affecting us in different ways. In terms of the relevant physiological benefits or health benefits of consuming these, and maybe I should just ask you what the list is, but I’m thinking like obviously combating chronic pain and chronic inflammatory conditions, neurodegenerative conditions or neuroprotection. There’s some research on clinical Endocannabinoid deficiency as it relates to chronic fatigue syndrome, fibromyalgia and migraines, and chronic pain and some other things. Cancer, also that’s the other one I wanted to mention.

What are the differences, if any, as far as the relevance or usefulness of CBD versus THC for those different kinds of symptoms and health conditions?

Dr. Mary Clifton: Well, Ari, I really thought when I first started to work more intensely in this, I’ve been writing cannabis cards for members of my practice for 15 years and just listening to their stories but not necessarily acting on it until just a few years ago when I experienced two deaths, two hospice cases right on top of each other one with and one without cannabinoids and saw such a stark contrast that I felt I had to learn more about this and see if there was something that people needed to know.

After starting to do research, I am amazed at the depth and breadth of the research for so many things. I’ve shot now 100 different videos, and I have to shoot shortly after this bipolar disease and also a bunch of videos surrounding heart disease and metabolic syndromes. There is a lot of data on helping to manage addiction on multiple sclerosis and other muscle spasms and nerve-based pain. There’s data on managing chronic low back pain and fibromyalgia. There’s the amazing, absolutely jaw-dropping data, I think on seizure disorder.

We’ve got six different good studies, five excellent studies of over 500 children who were still sick as they could be on maximum medical management with their seizures, and the addition of CBD cut those seizures in half in almost all cases. Kids that were so disabled that the majority of the surveys that were getting filled out, were getting filled out by a caretaker. A really remarkable improvement for some pretty significant conditions. All of that is exciting too. The cancer research, I would have to say out of this incredibly broad list and there’s a lot of research also I should say around skin, and just maintenance of really healthy youthful skin with high-functioning sebaceous glands, or people that have chronic inflammation on their skin getting such nice results in some cases.

I was circling back to the cancer data, almost all of the cancer data that we have on cancer-fighting with cannabinoids is all a petri dish test tube data, we really do need better research. The other side of the coin is that the petri dish and test-tube data is pretty good data and you’re certainly not going to hurt yourself in the studying up-

Ari Whitten: Meaning impressive data as far as the effect size of the CBD and the THC and their anti-cancer potential.

Dr. Mary Clifton: Yes, there’s a number of different ways they work. They work within the cell with the MPK pathway, the pathway that does energy control and management and helps the cell move into like a cell death plan rather than being immortal like most cancer cells are. Working through that pathway is a very important pathway to help guide cancer cells toward a more normal life and death rather than the weird immortality thing that cancer cells get into. In the same way, it appears to work with the ceramides within the cell that also help to program cell death in a more appropriate way.

Another really exciting way is through these PG pumps, these pumps that live on the surface of the cell and work to pump out toxins like chemotherapy. When people are sick with cancer and they get a second or third round of chemo and it quits working, a lot of that we think is because of these pumps on the surface of the cells that get all those toxins out as fast as they come in, which in most cases is really good. If you’re trying to kill cancer cells, we want to keep those toxins in the cell as long as we can. The great news about cannabinoid formulations is that they appear to help those pumps to work slower so that in the setting of cancer, they can appear to boost some forms of chemotherapy.

The cancer data is also amazing around the heart disease associated with certain chemotherapies you can get illness and damage to your heart. You can also get a lot of damage to your nervous system and deal with chronic pain and numbness in your fingers and in your feet after you’ve survived cancer. You can get ringing in your ears from damage to your auditory nerve, and all of those different problems appear to be at least partially alleviated by using cannabinoid formulations during the time of your chemotherapy. Again, these are small studies. They’re not big multicenter trials, but the people who are doing these studies are very excited about those outcomes. Very excited.

Ari Whitten: Yes, I appreciate you explaining the caveats to interpreting the literature there. Are there any other benefits to CBD that you haven’t mentioned thus far?

Dr. Mary Clifton: Oh, I think in that there’s also some research around Parkinson’s and tremor and movement disorders. That is sort of give or take, Ari. Some studies show results that are very impressive with Parkinson’s. I think the best studies really don’t show a significant improvement in the actual tremor. People who have Parkinson’s have a very significant sleep disorder where they have these frightening nightmares and they’ll kick or punch in their sleep because they think that they’re in a fight. Oftentimes at work or with an animal, very scary dreams. Then they’ve oftentimes hurt their bed partners. These episodes occur like once a week in the people who experienced them and taking the CBD almost completely eliminates them, for people who are dealing with that.

Ari Whitten: It’s got to be interpreted as a hugely positive sign.

Dr. Mary Clifton: For the patient and for their bed partner.

Ari Whitten: Even if it’s not altering the output of dopamine from the substantia nigra in the brain, it’s affecting something in the brain that’s changing something in the direction of less negative emotional states and dream states.

Dr. Mary Clifton: Yes, the dream states and the insomnia, the control of nightmares has been very well studied in one Canadian trial, with a group of PTSD sufferers that were sleeping only five hours a night, and were having nightmares five nights a week. Very difficult sleep patterns, even with all we could do with medical management. They were able to improve the sleep by two hours per night with a cannabinoid formulation and then also reduce the nightmares to one a week down from five a week.

Ari Whitten: Wow. That’s phenomenal.

Dr. Mary Clifton: You can imagine with everything that you know about sleep, Ari, oh, my word, what a major difference that made for those people. That was life-changing.

Ari Whitten: Yes, awesome. Yes, just to give them two hours more sleep and higher quality sleep. As far as building that out to their overall health trajectory and disease trajectory over the next several decades of their life, that’s massively life-changing for sure.

Dr. Mary Clifton: Yes, I’m so excited about this sleep and nightmare issues. I talk to people about those issues every single day, all day long. Everybody that is dealing with other issues, the sleep and the anxiety or depression, overly all of that. In some cases, I’m not able to find great data on how CBD or cannabis is working in a particular situation with a larger trial and sometimes not even a small trial, but you can get some data surrounding the anxiety and insomnia that plagues so many people that are dealing with chronic disease.

One situation that I was so surprised and so excited to read about was about tics and Tourette’s. There’s only four case reports that are published from a German psychiatrist, two separate case reports of two case reports each, so it’s actually not just one guy doing all the publication. They had patients with tics and Tourette’s that were very sick adolescents and young adults who were getting so sick with the tics, especially the vocal tics that they couldn’t really talk to people and one just couldn’t even go to school anymore.

They started them on, of course, every possible Western management and then eventually got to cannabinoid formulation and they went back to school, both of them. Then very interestingly got sick again, ended up having to leave school, everything fell apart and it turned out they had stopped using their cannabinoid formulation. When they got back on it, everything got back to normal again. I shot those videos and then I was meeting an old high school friend for dinner and she said, “Do you mind if I bring my daughter with us to dinner?” I said, “Absolutely not, that would be great.”

Then sure enough, unbelievably, she was loaded with tics and all of a sudden I had somebody who really needed this information. I shared it with them and some months have passed because that kid is really, really brilliant, they didn’t want to impact their scores by changing anything but did work over the summer, and what a remarkable outcome with their conditions, very exciting. I’m excited to share even those smaller case reports and give people at least an opportunity to know what’s out there for whatever they’re dealing with.

Ari Whitten: Very interesting. You said cannabinoid formulation, is that THC and CBD? Some kind of mix of the two in this case?

Dr. Mary Clifton: Most of the time when I’m talking about all of these things, I talk about cannabinoid formulations. I can refer to studies that are just purely CBD, we can stay there. A lot of studies are CBD with THC and unfortunately not necessarily the same formulation for everybody who’s in the study at the same serving size. People are titrating to where it’s working for them and so one person might be taking quite a bit more or quite a bit less but then, on top of that, they might be taking an entirely different formulation or an entirely different mode of administration.

Somebody might be taking a gummy bear and another person’s using a whole flower in a vape. To some degree here, we’re still in the infancy of learning, of getting everything standardized so that we can give you a recommendation.

 

The science on CBD for sleep

Ari Whitten: I want to go back to the sleep thing for a minute. I know there’s some studies that have shown that CBD can improve deep sleep. Do you have any comments on that? I know that also some, if I remember correctly, some of those studies use quite a high dosage, like in the neighborhood of- I want to say 70 or 100 mg, which is considerably higher than the serving size of most CBD products. Do you have any thoughts on optimal dosing for sleep, and can you speak to the studies that have examined the effects of CBD on sleep?

Dr. Mary Clifton: We have quite a bit of data around sleep. We have the amazing Canadian study but then we also have some companies that are tracking what people are taking and then giving them an opportunity to report on how well it worked so they can drive you to a particular strain or a particular formulation that is working for most people. Some of these companies are collecting hundreds of thousands of serving sizes of various different products, and they can give us quite a bit of clarity on what’s working and what’s not.

You’re absolutely right, some people are getting excellent results with higher concentrations of CBD for sleep, but I’ve had patients taking up a fairly small concentration and getting an excellent result on a problem that they really couldn’t get under control before that with anything that their doctor was giving them. It’s really exciting to see these start to take shape.

I can’t really tell you what serving size is going to be ideal, and I think in a lot of cases, you might be coming in at quite a bit lower than 70 to 100. In my experience working with patients, it’s quite a bit lower in most cases. The best thing to do is just start at a lower a serving size and then–

Ari Whitten: Something like 15 mg?

Dr. Mary Clifton: Whatever you have, get a decent concentration in a container no less than 1000 mg in a container and then start with a half a dropper full and then see how that works for you. If that’s not working, then go ahead and increase. That probably is going to give you your best opportunity to just see how it’s working in your system and not get too much at first or [crosstalk]–

Ari Whitten: What if somebody is taking it in pills? How much does half a dropper full equate to an in pills?

Dr. Mary Clifton: I would consider not taking it in pills until you know exactly how much tincture works because if you can hold the tincture in your mouth, you can get virtually instantaneous results. You can get results in eight or nine minutes. If it doesn’t work, you can take a little more at 20 or 30 minutes and then see if that works. You can monitor or modify your serving size much more readily. If you take a pill or a benign-looking little gummy bear, it’s going to give you an onset of action 60 to 90 minutes later. At that point, did it work or did it not?

More often than not, when people start with an edible, they’ll say that it didn’t work for them. If you’re just starting out, I wouldn’t start out with an edible. I would start out with a tincture or some sort of vape or flower that is available to you too.

 

How to take CBD most efficiently

Ari Whitten: Got you. You said some stuff there that I want to come back to as far as holding it in your mouth, instantaneous effects versus swallowing. Very important, and I’ve actually never heard someone talk specifically about that. Maybe that’s just my own ignorance or just haven’t stumbled across other people talking about that, but I want to come back to that. First, is there any literature around– We’ve talked about sleep. There’s, I think, a really nice potential there to help people with sleep problems, but is there any other areas related to common complaints that people listening to this podcast might have? People, very common for them to have fatigue, energy problems, and sleep problems, brain-related symptoms like brain fog, depression, anxiety, chronic pain. Do you have any thoughts on that kind of constellation of factors there?

Dr. Mary Clifton: I think it’s a good idea to give the formulations a try in those settings. In different ways that chronic pain presents itself, chronic pain to some degree has a life of its own. When you’re dealing with chronic pain, you’ve got all of the pathways that are ascending in the spinal cord, you’ve got the cortical acceleration of the pain on the surface of the brain and then the pain can ramp up again on the descending pathways and the spinal cord as it goes back out.

In that way, like interstitial cystitis, fibromyalgia, low back pain, headaches, irritable bowel syndrome would all seem to be different, but they’re all actually very similar in that they have this chronic pain generator that throws off all of your neurotransmitters. Using a product that works at those neurotransmitter junctions and its intent is to stabilize and improve your responses with serotonin and norepinephrine and Neurontin and Gaba in a similar way that Neurontin does these products all work in those areas to help to calm and restore balance.

The data on chronic pain is very interesting, very reassuring. There’s some Israeli work on– The work in Israel is very, very good and right at the frontline of all the new research but there’s an Israeli study that was published surrounding fibromyalgia women, about 80 of them and about half of them on opioids when they first presented to start the trial with cannabinoids. The women were all on one or two medications, they’d been maxed out, they were getting no relief and they started on THC, CBD for cannabinoid formulation and all of them stopped their opioids. Half of them– stopped all of their other medications and went exclusively with their new formulation. Some very fascinating–

Ari Whitten: There’s no sales pitch for CBD necessary. Just cite that one study and it’s like, “Damn, that’s impressive.”

Dr. Mary Clifton: They have other studies of patients who are not a fibromyalgia but different pain generators. One study that was done in patients with low back pain, again with a shocking amount of people who were using opioids. A lot of other problems around chronic pain management, opioids and all other conditions, we use antidepressants at high doses. We also use antipsychotics sometimes because that will help to further release and dopamine. A lot of these in this other trial were effectively weaned off the patients along with their opioids. Just we use cannabinoid formulation. What a lot of the really exciting research is now is trying to figure out what’s the big player? Are any of these littler, lesser known cannabinoids really the star of the show? If we can find out that CBN, for example, is remarkable for sleep or that CBG or CBC is amazing for gut inflammation, they can distill that off too or synthesize that molecule. Then we’ll have some other products that are going to be super, super good in very specific conditions. That’s where all of the really interesting work right now is being done. Not only in Israel, all over the world.

Ari Whitten: I’ve seen some studies, I think more recent studies that have discovered some cannabinoid receptors on mitochondria. Are you familiar with any effects of CBD and other cannabinoids on mitochondria and how that could maybe relate to people dealing with chronic fatigue?

Dr. Mary Clifton: Well, I’m very excited about this molecular level, how the CBD or other cannabinoids are impacting people at this mitochondrial level and affecting metabolism. It’s interesting that even though THC is affiliated with the munchies and everybody thinks that smoking cannabinoid formulations will lead to these massive outbursts of appetite and people eating Doritos and cookie dough and crazy food. It turns out that if people use cannabinoid formulations over their lifetime, they actually stay healthier. They have better HDL to LDL ratios. They have lower triglyceride levels, less insulin resistance, better waist to hip ratio. They keep a waist into their adulthood better. The only reason that at least what we’ve been able to identify so far is that people stay slim. All of these wonderful impacts on the metabolism are a result of being able to keep your body weight really low when you’re regularly using cannabinoids, and then these people stay at a high school weight or just slightly above a high school weight. That’s the healthiest weight to live your whole life.

There’s probably a million reasons why that’s happening. One of them is the change in the metabolism at the mitochondrial level, I believe. Some of it might be that people are getting dopamine and feel good hormones without having to drink a lot of high calorie alcohol or eat high calorie desserts and other things that also stimulate those receptors in a similar way. People just don’t have to eat in large part if you’re using a high CBD product or less THC. It’s not as much of an appetite stimulator as you would think. If you want to cut the nausea of end stage cancer patient or manage their appetite, you really have to go very high on the THC and then that helps to dissociate from all of those central nervous system responses, the nausea and appetite. A person who’s just using cannabinoid formulations on a regular basis over the course of their lifetime, can expect to have a healthier metabolism and healthier markers, have a good metabolism too. I think that’s just fascinating.

Ari Whitten: I almost interrupted you there because I want to interject that a lot of people, going back to what we talked about at the beginning of this, a lot of people have this very negative stigma of marijuana use. I’m not a marijuana user myself, but I do use CBD. I have used marijuana, probably, I don’t know, 25 times in my life. Something like that. It’s a nice experience, but I use CBD regularly.

Anyway, a lot of people have this very negative association with marijuana. It’s a drug. It causes brain damage and messes you up. It messes up your health. I just want to contrast that with what you were just saying that you’re basically pointing to research suggesting that long-term use of these compounds is actually associated with better health outcomes. First of all, is that accurate and are there any nuances there? Maybe also is smoking versus ingesting oral oils and things like that, is that a factor in terms of health outcomes in long-term health effects?

Dr. Mary Clifton: There probably is a quite a caveat there, and that I covered this in my one-hour long lecture, stopping the top killers like how cannabinoid formulations help to reduce your risks for accidents and heart disease and cancer and stroke and bacterial infections. The top five things that kill people. There’s the most controversial one. The number one thing is the reduction in heart disease. All still very theoretical at this point, but people will see all of these excellent biochemical markers toward a healthier metabolism.

There are case reports scattered throughout the literature of a person who smoked cannabinoid formulations and then developed an elevated heart rate, or an anxiety response that landed them in the ER, or worse, people who had a predisposition to heart disease and then smoked and had chest pain and went on to have heart attacks. There are also reports of young people who have used drugs of all kinds, cocaine and meth and cannabinoids, who have experienced negative cardiac consequences. The literature is a bit divided on that.

Ari Whitten: What about the smoking itself as far as the smoke by-products. Are there concern for lung health?

Dr. Mary Clifton: There is actually some research being done right now on adding CBD to tobacco to try to reduce the amount of inflammation that someone gets from smoking tobacco.

Ari Whitten: That’s interesting.

Dr. Mary Clifton: A lot of our data that we have on what happens to your lungs is based on smoking, and not really smoking tobacco versus smoking cannabinoid formulations. If you think about it you know a tobacco smoker is smoking 400 inhalations a day if you’re smoking a pack a day, and a person who is using cannabinoids might inhale eight times a day at a heavy use.

It really is a different exposure to your lungs. Different formulations as we’ve obviously seen from vaping different formulations are going to have different impacts on your insides. Probably between smoking and vaping you might be better off using one of the electronic baits that uses whole flower. Not the kind that has a liquid where the product is suspended and propylene glycol or vegetable glycerin, but where you can actually crush up a whole flower and put it inside your vape. That will help so that it doesn’t burn the flower and release all of the carcinogens. It’s more of a superheating which has considerably less concentration of carcinogens and other damaging things.

Ari Whitten: Got you. I want to get into the practical side of some CBD recommendations and I have some questions for you there. I want to just quickly recap some of the key benefits we’ve discussed so far. We’ve mentioned sleep, the nightmares as well as, I believe also increasing deep sleep as well, and overall sleep time, decreasing inflammation, combating chronic pain, potentially combating this endocannabinoid deficiency that is linked with chronic fatigue syndrome, fibromyalgia migraines, chronic pain and so on. Combating chronic inflammation, I assume maybe could have some positive effects in various chronic inflammatory and autoimmune conditions. What else? What am I missing?

Dr. Mary Clifton: Everything that you’re saying is right on track. In terms of managing inflammation, you’ve got its ability to help in the central nervous system and also in the periphery and so many conditions arise from inflammation. In terms of having your immune response have a different or maybe better immune response to an inflammatory episode is also in its infancy of being evaluated, but really promising results on helping to tamper the inflammatory response and change how much inflammation the body creates in some cases where it might be over-responding like when you get the flu, for example, and you get a terrible headache and horrible body aches. If there’s some early [unintelligible] data that pre-dosing people or giving CBD prior to getting exposure to the flu actually reduces the significance of all of that response. It tampers the response to the virus. You and your neighbor may get the flu, but your neighbor without the cannabinoids in place may get quite a bit sicker while you’re still able to go back and forth to work.

I do believe that there’s an overlay of the system for a reason. If we were before the prohibition of the 1920s, we’d be getting cannabinoids in our system whether we wanted to or not. It’s a weed and it grows in the ditch. It’s a very simple weed to grow. I have nothing to say about the growers. I say that, but I can’t keep a cactus alive [laughs]in my– Blessings to those amazing farmers that are feeding me because otherwise, I’d be starving.

Ari Whitten: It’s really easy to grow, but for other people, not you.

Dr. Mary Clifton: It would pollinate itself six times a year unless it was in my garden. All of that fantastic pollen that you breathe into your lungs, you would get that exposure and the animals presuming you’re eating any animals or drinking any milk or eating eggs, the chicken would peck away at the herbs, they’re herbivores. The cows would munch on the herbs and it would incorporate into their body just like it does in ours. You would always be getting this little exposure. This is one of those propositions or one of those limitations that our society and our current modern culture has just unfortunately really done us harm in doing in my opinion. We have something that is designed to regulate and restore and balance, and access to it is being thwarted by, unfortunately, some laws that are slower to change than I’d hope.

The good news is CBD is legal in all 50 states and you can get it anywhere and then give those products a try without any risk to anybody ever coming in and putting you in danger.

Ari Whitten: I know we’re at the end of our allotted window, but do you have like five more minutes? I just have a few more questions or do you have to run right now?

Dr. Mary Clifton: [unintelligible] more minutes.

Ari Whitten: Yes, you’re good?

Dr. Mary Clifton: Yes.

Can you build up tolerance to CBD?

Ari Whitten: Okay. One question I have, I want to get into like very practical recommendations on products and some of the aspects of that, but first, as far as chronic use of these products, is there any concern with disrupting the natural regulation of our endocannabinoid system, if you use, for example, steroid users. Obviously, if you inject testosterone then you interfere with your body’s own production of testosterone. There’s lots of other examples of hormonal negative feedback loops like that. Is there any effect like that where the more you use these external cannabinoids, the more that your internal endocannabinoid system is disrupted?

Dr. Mary Clifton: There’s not a lot of discussion in the literature about a buildup of tolerance when people are using the products over time. A lot of times you can get to a good dose and stay at that dose for a surprisingly long time without a lot of trouble. The build-up of tolerance is much of a problem as I think it could be. They certainly up-regulate your CB receptors, down-regulate your CB receptors based on availability. There is your body managing that and probably suppressing the development of 2AG and anandamide when you’re giving a lot of phytocannabinoids from cannabinoids from plants that you might be supplementing with your diet.

[crosstalk] – changes that can happen.

Ari Whitten: One example I talk about often in my work is with caffeine and how chronic use of caffeine can cause neurotransmitter adaptation. Caffeine works on the adenosine neurotransmitter system. Adenosine is an inhibitory neurotransmitter. It’s normally like calming to the brain and relaxing and basically caffeine goes in and locks into that same adenosine receptor, but doesn’t act like adenosine. It just blocks adenosine from getting in. By blocking this inhibitory neurotransmitter, you create a stimulant energizing effect.

We know from lots and lots of good research over many decades that that works in the short term and it does absolutely give you a stimulant energizing effect. With chronic use of caffeine, the body basically ramps up levels of adenosine and the amount of adenosine receptors so that your baseline levels of energy and your mood and wakefulness, alertness all drop. That’s why people then become dependent on caffeine and so they wake up groggy and then they need their coffee in order to get their brain going.

Dr. Mary Clifton: We said that all during medical school. You start out thinking I’m going to be able to do this and the whole situation is overwhelming. Then by Christmas time in your first year, you’re a caffeine addict, but it hasn’t really solved the problem. It solved the problem way back in November, but by December– There were a couple of people very smart, intuitive people in our medical school that wouldn’t touch caffeine because they said at some point, all you’re going to be doing is peeing more, it’s not going to provide you any extra benefit except now you have a caffeine problem.

Ari Whitten: Yes, now you’re dependent on the caffeine to function normally. The research is quite clear that that happens in the long term it works very effectively. If you only used it during finals week and nothing else, it would be great, but when you use it every day, it doesn’t actually do what people think it’s doing. It’s quite insidious because the subjective perception of it is that it is helping you. In fact, all it’s really done is lowered your baseline levels of energy and wakefulness and brain function such that you’re dependent on it to function normally. Anyway, I guess I’m asking, is there any indication that a similar type of effect could happen with THC or CBD use?

Dr. Mary Clifton: I am not seeing that signal in the literature, no. I’m not seeing that. It could be happening if you’ll significantly down-regulate the receptors or the body’s concentrations of 5AG and anandamide aren’t able to be supported because you’re using a lot of plants, but I am not seeing that signal in literature. There is some very aggressive work being done around the cytochrome systems in the liver and how these cannabinoids are metabolizing in the setting of the P450 systems in the liver. We all know about grapefruit that if you get into grapefruit, it changes your [unintelligible] and you’re a little bit lower in level medications because it plugs up that particular cytochrome system in the liver.

It’s interesting with Phytocannabinoids. With cannabinoids, they break down through the same pathway as opioids in the liver. Initially, people were arguing, well, it’s a liver effect. You don’t have to take as much opioids because it plugs up the system and the opioids don’t break down. That doesn’t turn out to be true, it appears that they use the same system for a breakdown, but there’s no evidence that one or another thing is being held back where the other thing is being metabolized. Everything appears to be metabolizing smoothly and at the same time.

There’s one small trial that suggests that cannabinoids metabolized first. Even so, if that were true, it’s not affect where it’s throwing other drugs off of their metabolism by hours or days. It’s just by moments really. At this point, we feel pretty confident that a lot of the changes that are made in other pain medicines when you add the cannabinoids are because they’re effective directly at that neurotransmitter junction and helping nerves talk to other nerves in a healthier way and not continue on that chronic pain pathway.

That’s a very good question, but I don’t see any tolerance building up. There’s no evidence that people have to go higher and higher and higher.

How to source the best CBD oil for you – what to look for

Ari Whitten: Got you. Very interesting. On a practical note, there are some companies now offering, there’s a variety of different products with some CBD isolates, mixed cannabinoids, like CBD plus some other stuff. There are some people offering, I don’t know the correct term, but I think it’s like decarboxylated versus non-decarboxylated, non-heat treated, sort of raw, unheat treated. I think it’s like CBG and CBN. Then when it’s heat-treated, it turns into CBD. Please correct me, I’m sure I’m getting some aspect of that wrong. What is your perception of the relevance of the non-heat treated versions of these versus the CBD and the THC?

Dr. Mary Clifton: Well, there’s some thought that the heat treatment will carboxylate and allow these products to be more effective. A lot of times passing through heat is not a bad idea for these products. Heat treatment is a good idea, but probably more important. The more important thing to think about with your formulations is just what kind of a person you are, what is important to you, what you’re trying to achieve and what your limitations are.

A pure CBD isolate should have zero THC. If you’re being drug tested at work, you need to talk to the people that are doing those drug tests because some of them want to limit your CBD exposure also, but if you’re using a full spectrum or broad-spectrum CBD oil, it’s going to have the CBD, but it’ll also have CBG and CBN and CBC and some small amount of THC potentially. That can pop a drug test if you’re taking higher concentrations, but also CBG is very interesting and that will break down into a little bit of THC.

In a full spectrum product, if you have to 100% avoid THC, you could run into some problems, but if you’re not getting tested, if a very tiny amount of THC is not a problem or if the CBG is not a problem, you do get this whole plant experience, more of like an essential oil experience when you’re using a full spectrum or broad-spectrum CBD supplement. If you’re using just the CBD isolate, if you’re a person who’s like, “I want to know if CBD works for me. I don’t want to know if CBN or CBG or whatever other vital nutrient, I just want to know about CBD.”

Then get a CBD tincture that’s made from a CBD isolate. I would expect from any company you work for in this industry and there’s a lot of good ones. The majority of them are excellent, but I would expect total transparency so that you can flip your jar over or your box and be able to scan a QR code or something like that and be able to see the third-party testing on that particular batch.

Ari Whitten: As far as purity and how much THC is in there?

Dr. Mary Clifton: I care about CBD and THC concentrations 100%, but I also want to know if there’s herbicides or pesticides, that matters to me. It doesn’t matter to everybody, but it matters to me. You can do third party testing that covers just THC and CBD if that’s all you want to know about, but a lot of good companies are also looking at third party testing for the pesticides and herbicides, and then also- we’re way over time – also the terpenes, which is another whole discussion.

The terpenes are sort of what drives the car here, where the CBD starts the engine, but the terpenes will help to promote calm or help to promote a higher level of energy and creativity. They are like the essential oils of the cannabis community. There’s a lot of different CBD products out there with different mechanisms just based on those formulation changes.

Ari Whitten: Yes. My personal experience is I’ve tried some CBD isolates and I’ve tried some mixed cannabinoids, CBD plus, sort of the others and I know there’s the entourage effect, which you’ve alluded to here. My experience is I can’t identify any noticeable effect from the CBD isolates where I can from the others, the mixed stuff.

Dr. Mary Clifton: That supports my view of everything as much as you can, you should derive everything you can from whole products, whole foods, whole bud and if you can get that, then taking some vitamin C in lieu of eating an apple is okay every now and then. You might need to supplement those things all the time based on how your food is being sourced or just your lifestyle. If you can get a whole plant, that is a much more valuable form of nutrition than being a distillation, in so many cases.

Ari Whitten: Yes. There was a liposomal formula that you gave me a sample of, when we met in person four or five months ago, whenever it was. That one definitely has noticeable effects as well as when I’ve tried with mixed cannabinoids from Bluebird Botanicals. My last question to you is, let’s go back to what you mentioned before about holding it in your mouth. Is it absorbed through the mouth? My personal experience is, and I’m totally uncertain as to whether this is a placebo effect or it’s a real effect, if I put it in my mouth and hold it there that I get sort of like an instant calming effect that occurs.

I don’t know if it’s a reaction from the taste or if it’s actually absorption of the compounds or if it’s just placebo, but you mentioned this idea of holding it in your mouth, so I’m curious what you’re referring to there.

Dr. Mary Clifton: The compound should absorb very readily through the membranes in the mouth, under the tongue or through the cheeks especially. Of course, the brain is very close to that, so it doesn’t take long for that blood to flow from one area to the other. It really helps you to get a good idea of how quickly you’re getting or what kind of a result you’re seeing. Just because the onset is so much more rapid when you hold a tincture in your mouth or if you inhale, you get so much blood moving through your lungs that that gives you very quick effects.

Oftentimes effects in as little as eight or nine minutes, but it can be shorter and maximum effects coming on in 20 or 30 minutes. Most dosing calculators are suggesting that you do that, that you take a serving size and then set an alarm for 30 minutes or 40 minutes out. You’re going to be at maximum effect if you use it inhaled or by holding it in your mouth and absorbing it across the buccal membranes. Then you can see if it’s going to work at 40 minutes and write that information down. If you do that 14 or 20 times, you’ll know exactly what works for you.

Ari Whitten: Excellent. Dr. Clifton, this has been a blast. Thank you so much for coming on the show. I want to mention to everybody listening again that Dr. Clifton has a whole CBD Summit coming up. I’m one of the speakers on it, talking mainly about energy. It’s more of a conversation, I want to say, where like there’s me talking about some things related to energy and circadian rhythm and things like that. Then Dr. Clifton’s bringing in a lot of the connections with the endocannabinoid system and the CBD and things of that nature.

I strongly recommend you listen in, there’s going to be a ton of amazing information just like you got in this podcast episode. Hope you guys enjoyed this. Again, you can opt-in for that CBD Summit at the energyblueprint.com/CBD. The energyblueprint.com/CBD. Dr. Clifton, thank you again so much. Thank you for going overtime. 15 minutes here. I really appreciate it. Sorry if you’re late for your next meeting with a patient and have a wonderful rest of your day. Thank you.

Dr. Mary Clifton: Thank you, Ari. Thank you for the honor of talking to your community. It’s just been a wonderful day.

Ari Whitten: Yes. Thank you so much. Take care.

What are the REAL benefits of CBD? With Mary Clifton, MD – Show Notes

What CBD actually is (2:31)
The importance of the Endocannabinoid system (6:42)
The potential effect of large doses of CBD oil (19:32)
The usefulness of CBD in managing pain, MS, and seizures and more (21:15)
The science on CBD for sleep (33:25)
How to take CBD most efficiently (37:00)
Can you build up tolerance to CBD? (52:57)
How to source the best CBD oil for you – what to look for (59:10)

Links

Listen to the podcast with Alex Viada and learn more about how CBD improves sleep!

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