CBD (cannabidiol) seems to be all the rage among athletes and regular exercisers. Among other things it purports to help relieve pain, reduce muscle soreness and inflammation, improve sleep quality and ease anxiety. Approximately 4 – 6 million UK adults have tried CBD. However, research to support its use is sparse and manufacturers are not allowed to make explicit health claims for it. Here’s what you need to know about cannabidiol.
What is CBD?
CBD is one of around 120 active compounds (cannabinoids) found in the Cannabis sativa plant. CBD is produced from the hemp (as opposed the marijuana) strain of the plant, which has a very low concentration of tetrahydrocannabinol (THC), the illegal psychotropic compound. Whereas THC enables you to get ‘high’, CBD does not. However, it is mistaken to describe it as having no ‘psychoactive’ effect, because it acts on the brain and appears to impact cognitive functions. CBD is widely available in the form of oils, tinctures, capsules, sprays, lotions and gummies.
What does CBD do?
There is not a great deal of research on CBD; and its mostly based on animal (not human) studies. Generally, it has only weak evidence to support its use, according to a review from the University of Nottingham, and there is no direct evidence that CBD improves athletic performance. Only a very small amount of pre-clinical evidence suggests that CBD may help relieve pain, reduce inflammation, reduce anxiety and improve sleep quality.
Despite this, one study of more than 500 rugby league and union players found that 26% currently or previously used CBD to provide pain relief or improve sleep quality.
How does CBD work?
It is thought that CBD works by interacting with the body’s endocannabinoid system (ECS). This is a network of receptors in your brain, peripheral tissues and immune system which is involved in regulating sleep, appetite, pain and immune responses. The body produces its own cannabinoids (endocannabinoids), that bind to CB1 and CB2 receptors and inhibit the release of certain neurotransmitters. It is plausible that CBD supplements augment the body’s own endocannabinoids.
In terms of improving sleep quality, it has been proposed that CBD inhibits adenosine re-uptake in the brain.
Is it legal?
Hemp-derived CBD is legal to buy and use in the UK provided it contains less than 0.3% THC. It is also legal for use in drug-tested sport since it was removed from the World Anti-Doping Association’s (WADA) prohibited list in 2018. However, UK Anti-Doping (UKAD) cautions against its use as it may be contaminated with THC or other prohibited cannabinoids.
A recent report by industry body, the Centre for Medicinal Cannabis, blind-tested 30 CBD products, bought on the High Street and online. It found almost half (45%) had measurable levels of THC, making them technically illegal in the UK. Only 38% of the products were within 10% of the advertised CBD content and 38% actually had less than half of the advertised CBD content. One product had 0% CBD. For this reason, athletes subject to anti-doping rules are advised to avoid it as it carries a risk of inadvertent doping.
Are there any side effects?
A 2018 report from the World Health Organisation says CBD is safe and doesn’t have the potential for addiction. Similarly, a review on the safety and side effects of CBD found it is well-tolerated although there are reports of tiredness, diarrhoea and changes in appetite. One study in mice indicated potential for liver damage and interactions with other medications.
Practical recommendations
The lack of published evidence for CBD and the risk of contamination with THC means it cannot be recommended to athletes and regular exercisers at present, particularly those who are subject to anti-doping rules. Even those products displaying a certificate of analysis cannot guarantee inadvertent doping. Another problem is the big variation in CBD concentration between products, as well as the lack of data on effective doses. Since CBD products are expensive, I recommend saving your money for now.
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