On this episode of Healthy Happenings, Dr. Holly asks Dr. Lopez specifically about Hemp derived Phytocannabinoids. When looking at factors to consider when it comes to dosing, personalization and customization is key. The dosing regimen is so individualized and patients should be titrated from low doses to higher ones slowly. Dr. Lopez suggest to look at product type where you CBD that is an isolate (just the 99% cannabidiol compound) which is available in two different forms, synthetic and crystal isolate derived from the hemp plant. This is important because consumers should be aware of where the CBD isolate is coming from. If the CBD isolate is coming from total organic chemical synthesis, then it’s been shown that it’s actually a different stereoisomer than the one that is naturally biosynthesized in the plant. The synthetic CBD isolate is actually going to have some activity at the CB1 receptor and patients may say they get a little “buzz” from it. Whereas the hemp derived CBD isolate does not have activity at the CB1 receptor and patients will not report that buzz or high feeling. Holly makes a good summation, starting patients with CBD “go slow and low” when it comes to dosing. The other product to consider with dosing is the full-spectrum hemp derived CBD. This is made by taking the hemp plant and extracting the CBD, a whole host of other phytocannabinoids, terpenes, flavonoids and other bioactive compounds. With these products, the dosing usually ranges from 3mg-75mg a day and this often causes confusion for people compared to the dosing of the 99% CBD isolate.

Considering contraindications, it is important for patients to work with a practitioner! Any time you are dealing with a natural product that has bioactivity, particularly phytocannabinoids are metabolized by the cytochrome P450 system like drugs and medications, consulting your physician is the best choice, especially one who is comfortable working with botanicals. Physicians should be aware of the the main enzyme pathways like the cytochrome P450-2C9, 2C-19 and 3A4 and any drugs that use those pathways when prescribing CBD as well. The other obvious issue is with hypersensitivities and allergies. If you are not sure if you have an allergy to CBD, but you do have one with hops or other botanicals in the same family then you should test first.

When assessing the ECS, Holly asks how do you encourage practitioners to actually do that with patients and what tools you can use. Dr. Lopez states that we are still in the infant stages of assessing the ECS, but you can consider the endocannabinoid tone of the patients. The ECS affects many things, but the high level items to look at are the nervous system where you can look at neurologic stability (anxiety, mood, stress management, sleeping, quality of sleep, etc.). Holly suggests that practitioners “stay tuned” with the ECS because these are difficult clinical modern day issues that are very common. Considering the ECS, it brings a new level of assessment and treatment in the essence of “do no harm”.

Holly also asks what consumers and practitioners should be looking for in a brand that is manufacturing CBD products. He suggests that full traceability is very important so that a product can be followed from “seed to shelf”, where the brand has control of the entire supply chain. The seed should be characterized so that you know you’re starting with a hemp cultivar of cannabis sativa and not a marijuana or drug cultivar that allows you to start with a plant that will be manufacturing and synthesizing higher levels of CBD and much lower trace levels of THC and still allow you to bring some of the other phytocannabinoids and bioactives with it. Also, look to see if the brand is sponsoring their own research, do the have data on toxicology and safety, because there are few brands in the non-drug market currently doing this. Some brands are also sponsoring human clinical trials on CBD products as well.

Stay tuned with Healthy Happenings to hear more about CBD with industry leading experts.

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Dr. Hector Lopez integrates several safe and non-invasive approaches to optimize patient recovery and improve overall health. As a pain management doctor his innovative injection therapy, chronic pain management methods, minimally invasive spinal procedures, and nutritional consulting help patients return to daily life. For many patients dealing with chronic pain, medication and surgery are not always the best options. As an orthopedic specialist, Dr. Hector Lopez understands the needs of chronic pain sufferers seeking a less invasive and more natural alternative for pain management.

Advanced training and medical experience as a pain management specialist allow Dr. Lopez to provide safe and sensible alternatives to harsh procedures. His injection therapies restore function in joints damaged by injuries, tendonitis, or arthritis, and minimally invasive spine procedures relieve neck pain and back pain more comfortably. Also highly trained in nutritional medicine and physical therapy, Dr. Lopez supplements pain relief with a pain-friendly diet and exercise program. Consider getting treatment from a pain specialist who focuses on the most important issue: the patient’s well-being.

Dr. Holly Lucille, ND, RN serves as the President of California Association of Naturopathic Physicians. Dr. Lucille works at the Los Angeles Free Clinic providing health education, promotion and prevention. Dr. Lucille serves as a Naturopathic physician, an expert on women’s health issues. In her private practice, Healing from Within Healthcare in Los Angeles, California, she specializes in Women’s Wellness. She has extensive education in various modalities, including homeopathy, clinical nutrition, botanical medicine, body and energy work and mind body and lifestyle counseling. She serves as a Member of the Scientific Advisory Board of PhytoPharmica Inc. She serves as a Member of Scientific Advisory Board at EuroPharma, Inc. She serves as a Member of Medical Advisory Board at Integrative Therapeutics, Inc. She served as Member of the Scientific Advisory Board of Enzymatic Therapy, Inc. She serves as Member of Naturopathic Scientific Advisory Committee at Kamedis Bio Herbal Skincare. She is the recipient of the 2004 Southwest College of Naturopathic Medicine Legacy Award recognizing her incredible service and contributions to the naturopathic medical community. She is a Registered Nurse. Dr. Lucille has Doctorate from the Southwest College of Naturopathic Medicine where she received the ‘Daphne Blayden’ award for her ‘Commitment to Naturopathic Medicine.

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