Non-intoxicating cannabinoid from cannabis. FDA-approved (Epidiolex) for certain seizure disorders. In oncology, studied as part of nabiximols (THC:CBD) for cancer pain refractory to opioids, and explored for chemotherapy-related anxiety and sleep.
Cannabidiol (CBD) is a phytocannabinoid derived from the Cannabis sativa plant, recognized for its non-intoxicating properties. It has been studied for a variety of health applications, including supporting mood, managing discomfort, and promoting relaxation. Individuals typically consume CBD through tinctures, capsules, edibles, or topical applications.
Quick answer
What it is: Cannabidiol (CBD) is a phytocannabinoid derived from the Cannabis sativa plant, recognized for its non-intoxicating properties.
The 'A' evidence grade for CBD reflects a substantial body of human clinical trials, including randomized controlled trials and meta-analyses, particularly regarding its efficacy in certain severe seizure disorders. There is also a growing number of studies exploring its potential in areas like anxiety and chronic pain, contributing to a robust, albeit still developing, evidence base for various applications.
Last reviewed · Jun 2026
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A classical ketogenic diet typically provides ~70–80% of calories from fat, ~15–20% from protein, and only ~5–10% (often 20–50 g/day) from carbohydrates. The metabolic shift to ketosis lowers blood glucose and insulin, raises ketone bodies (beta-hydroxybutyrate, acetoacetate), and is being studied for neurological and metabolic conditions. Variants include the Modified Atkins Diet (MAD), Medium-Chain Triglyceride (MCT) ketogenic diet, and the Low Glycemic Index Treatment (LGIT).
Foods to emphasize
Fatty fish (salmon, sardines, mackerel)
Pasture-raised eggs
Avocado and olives
Extra-virgin olive oil, coconut oil, MCT oil
Grass-fed meat and poultry
Full-fat dairy (butter, ghee, hard cheeses)
Nuts and seeds (macadamia, pecan, walnut, chia, flax)
Low-carb leafy greens and cruciferous vegetables
Bone broth and electrolyte-rich foods
Foods to avoid
Sugar and sweetened beverages
Grains and starches (bread, pasta, rice, cereal)
Most fruit (except small portions of berries)
Legumes and beans
Starchy vegetables (potatoes, corn, peas)
Low-fat or sweetened dairy
Vegetable seed oils (soybean, corn, sunflower) in excess
Most processed and packaged foods
Key principles
Carbohydrate intake usually 20–50 g net carbs per day
Adequate protein (~1.2–1.7 g/kg) — not high-protein
Most calories from whole-food fats
Track electrolytes (sodium, potassium, magnesium) to prevent "keto flu"
Best initiated with clinician guidance if on medications for diabetes, blood pressure, or seizures
Typical duration: Often 3–6 months minimum to assess response; medically supervised protocols (e.g. for epilepsy) may be maintained for years.
Why it may help
Multiple Sclerosis (MS): Small trials and pilot studies suggest ketogenic and modified Atkins diets may reduce fatigue, improve quality of life, and lower inflammatory markers in relapsing MS. Used as an adjunct, not a replacement for disease-modifying therapy.
Cancer (Adjunctive Support): Investigated as an adjunctive metabolic therapy alongside standard oncology care — most evidence is preclinical or early-phase, with some glioma and glioblastoma trials. Should only be used under oncology and dietitian supervision.
Ketogenic therapy is a medical intervention when used for seizure disorders or oncology — work with a clinician or registered dietitian experienced in ketogenic therapy. Not recommended in pregnancy, type 1 diabetes without supervision, pancreatitis, certain fatty-acid oxidation disorders, or active eating disorders.
Anti-Inflammatory Diet
A whole-foods pattern designed to lower chronic, low-grade inflammation by emphasizing omega-3s, polyphenols, fiber, and minimizing ultra-processed foods, sugar, and seed oils.
The anti-inflammatory diet is not a single protocol but a synthesis of the patterns most consistently linked to lower inflammatory markers (CRP, IL-6, TNF-alpha) in human studies — Mediterranean-style eating, oily fish, abundant polyphenols, and low intake of ultra-processed foods, refined sugar, industrial seed oils, and excessive alcohol.
Foods to emphasize
Fatty fish 2–3x/week (salmon, sardines, mackerel, herring)
Extra-virgin olive oil
Berries, cherries, and other deeply colored fruit
Dark leafy greens and cruciferous vegetables
Turmeric, ginger, and culinary herbs
Green tea
Nuts (especially walnuts) and seeds (flax, chia)
Legumes and whole grains
Dark chocolate (≥70% cocoa) in moderation
Foods to avoid
Sugar-sweetened beverages and refined sugar
Ultra-processed snacks and ready meals
Industrial seed oils used at high heat (soybean, corn, sunflower, cottonseed)
Processed and cured meats
Refined flour products
Excess alcohol
Key principles
Cook with olive oil, finish with extra-virgin olive oil
Aim for 25–35 g of fiber per day from whole foods
Eat the rainbow — color diversity ~ polyphenol diversity
Limit added sugar to <25 g/day
Typical duration: A long-term eating pattern.
Why it may help
Joint Pain: Reductions in CRP and IL-6 on anti-inflammatory patterns translate to less pain and stiffness in arthritis trials.
Cancer (Adjunctive Support): Lower dietary inflammatory index scores are associated with reduced incidence of multiple cancers in large cohorts.
Multiple Sclerosis (MS): Lowering systemic inflammation is a plausible adjunct to disease-modifying therapy; aligns with Mediterranean-derived MS data.
Safe and flexible. Can be combined with Mediterranean, vegetarian, or plant-forward patterns.
Autoimmune Protocol (AIP)
A strict elimination version of paleo designed to calm autoimmune flares and identify food triggers through structured reintroduction.
The Autoimmune Protocol removes foods commonly implicated in immune activation and gut permeability — grains, legumes, dairy, eggs, nightshade vegetables, nuts, seeds, refined sugar, alcohol, and additives — for a 30–90 day elimination, followed by careful one-at-a-time reintroduction. It is most studied in Hashimoto's thyroiditis and inflammatory bowel disease.
Foods to emphasize
Quality meat, poultry, and seafood (especially wild-caught fatty fish)
Organ meats once or twice weekly
A wide variety of non-nightshade vegetables and leafy greens
Nuts and seeds (including seed-based spices like cumin, coriander)
Refined sugar and sweeteners
Alcohol
NSAIDs and food additives where possible
Key principles
Pair the elimination with sleep, stress management, and movement
Track symptoms in a journal during reintroductions
Reintroduce one food every 5–7 days and watch for symptom changes
Most people do NOT need to stay strict long-term — the goal is a personalized maintenance diet
Typical duration: 30–90 day strict elimination, then a structured staged reintroduction over weeks to months.
Why it may help
Multiple Sclerosis (MS): Used clinically as an aggressive anti-inflammatory elimination; evidence overlaps with Wahls-style and paleo trials showing reduced fatigue in MS.
Joint Pain: Eliminates nightshades, gluten, and dairy — common reported triggers — to identify dietary contributors to inflammatory joint pain.
AIP is restrictive and best done with a practitioner familiar with the protocol, especially when active autoimmune disease is involved or in pregnancy/lactation.
Vegan Diet
A fully plant-based eating pattern that excludes all animal products — meat, fish, dairy, eggs, and honey.
A whole-food vegan diet emphasizes vegetables, fruit, legumes, whole grains, nuts, and seeds. It has been associated with improvements in body weight, blood lipids, and glycemic control, and is being studied for autoimmune and inflammatory conditions. It requires deliberate planning for vitamin B12, vitamin D, omega-3 (EPA/DHA), iodine, iron, zinc, and (sometimes) calcium.
Nuts and seeds (especially walnuts, chia, flax, hemp)
Fortified plant milks and nutritional yeast
Algae-based EPA/DHA supplement
Vitamin B12 supplement (non-negotiable)
Foods to avoid
Refined grains and sugar as the bulk of meals
Heavily processed vegan junk foods
Coconut and palm oils in excess
Key principles
B12 supplementation is required, not optional
Include a reliable iodine source (iodized salt or seaweed in moderation)
Get vitamin D from sun and/or a supplement
Combine grains and legumes across the day for complete protein
Choose calcium-fortified plant milk if not eating leafy greens daily
Typical duration: A long-term eating pattern.
Why it may help
Multiple Sclerosis (MS): Small trials (e.g. Swank-style and McDougall plant-based diets) suggest reductions in fatigue and improved quality of life in MS.
Cancer (Adjunctive Support): Vegan cohorts show some of the lowest incidence rates of cancer in observational data, particularly for hormone-related and GI cancers.
Joint Pain: Several RCTs report meaningful improvements in pain, swelling, and CRP in rheumatoid arthritis patients on whole-food vegan diets.
Vegan diets can be excellent or deficient — quality depends on planning. Pregnant, breastfeeding, and growing children on vegan diets should be followed by a registered dietitian.
Vegetarian Diet
A plant-based eating pattern that excludes meat, poultry, and fish but typically allows eggs and/or dairy.
Vegetarian diets range from lacto-ovo (includes eggs and dairy) to lacto (dairy only) and ovo (eggs only). Done well, they are associated with lower rates of cardiovascular disease, type 2 diabetes, and some cancers. Done poorly, they can be high in refined grains and low in key nutrients (B12, iron, omega-3s, zinc).
Foods to emphasize
Legumes (lentils, chickpeas, beans, tofu, tempeh)
Whole grains (oats, quinoa, brown rice, whole wheat)
Vegetables and fruit, daily and varied
Nuts and seeds (almonds, walnuts, chia, flax, hemp)
Plan for protein at every meal (legumes, tofu, tempeh, eggs, dairy)
Pair iron-rich plants with vitamin C to boost absorption
Plan a reliable B12 source — fortified foods or a supplement
Include omega-3 ALA from flax, chia, walnuts; consider an algae-based EPA/DHA supplement
Typical duration: A long-term eating pattern.
Why it may help
Joint Pain: Vegetarian and largely plant-based diets have shown reductions in inflammatory markers and joint symptoms in rheumatoid arthritis trials.
Cancer (Adjunctive Support): Long-term cohorts (Adventist Health Study, EPIC-Oxford) associate vegetarian patterns with lower incidence of several cancers, especially colorectal.
Nutritional adequacy depends on planning, not just food choice. A registered dietitian can help avoid common gaps.
Carnivore Diet
An all-animal-foods elimination diet consisting of meat, fish, eggs, and (optionally) dairy, with zero plant foods.
The carnivore diet is the most aggressive elimination diet — it removes every plant food (and therefore every fiber, lectin, oxalate, gluten, and FODMAP source) to isolate animal-food tolerance. Proponents use it primarily as a short-term diagnostic elimination to surface food triggers in autoimmune, gut, and inflammatory conditions. Long-term safety data is limited and observational.
Foods to emphasize
Ruminant meat (beef, lamb, bison) — emphasized for nutrient density
Pasture-raised eggs
Fatty fish (salmon, sardines)
Organ meats (liver, kidney) once or twice weekly
Bone broth and bone marrow
Animal fats (tallow, butter, ghee)
Salt to taste
Optional: aged hard cheeses, heavy cream
Foods to avoid
All grains, legumes, and seeds
All vegetables and fruit
Nuts and plant oils
Sugar and sweeteners
Most processed foods
Alcohol
Key principles
Eat to satiety — no calorie counting
Salt food liberally to maintain electrolytes
Prioritize fattier cuts over lean meats
Reintroduce foods one at a time after the elimination window to identify triggers
Best tracked with a clinician given the radical nature of the change
Typical duration: Typically run as a 30–90 day elimination, then food reintroductions one at a time.
Why it may help
Joint Pain: Used as an elimination diet to surface plant-based food triggers (nightshades, lectins) reported by some people to drive joint pain. No clinical trials.
Long-term effects on cardiovascular markers, bone health, and the gut microbiome are not well established. Avoid in chronic kidney disease, gout flares, or active eating disorders without medical supervision.
Linked nutrient deficiencies
Vitamin and mineral deficiencies commonly associated with the conditions this remedy may support.
Magnesium
Mineral
Cofactor in over 300 enzymatic reactions; crucial for nervous system calm, sleep, and muscle function.
An estimated 50% of adults consume below the EAR. Low magnesium is linked to insomnia, anxiety, migraines, muscle tension, and poor blood sugar regulation.
Common symptoms
Muscle cramps or twitches
Poor sleep
Anxiety, irritability
Headaches/migraines
Constipation
Food sources
Pumpkin seeds
Dark leafy greens
Almonds and cashews
Dark chocolate (85%+)
Black beans
Avocado
Lab markers to discuss
RBC magnesium (more sensitive than serum)
Serum magnesium
Reference intake: 310–420 mg/day RDA depending on age and sex.
Supplementation notes: Glycinate for sleep/anxiety, citrate for constipation, threonate for cognitive/brain effects. Avoid magnesium oxide (poorly absorbed).
Why it matters here
Insomnia: Improves sleep latency and quality, particularly in older adults.
Joint Pain: Supports muscle relaxation and reduces secondary pain.
Omega-3 Fatty Acids (EPA/DHA)
Essential fatty acid
Anti-inflammatory lipids critical for brain, joint, and skin health.
Low vitamin D status is one of the most widespread deficiencies globally and has been linked to autoimmune disease activity (Hashimoto's, MS), mood disorders, recurrent infections, and poor skin barrier function.
Common symptoms
Fatigue
Low mood
Frequent infections
Bone or muscle aches
Hair thinning
Food sources
Fatty fish (salmon, sardines)
Egg yolks
Cod liver oil
UV-exposed mushrooms
Fortified dairy
Lab markers to discuss
25-hydroxyvitamin D (target 40–60 ng/mL per most functional ranges)
Reference intake: Adults 600–800 IU/day RDA; functional medicine often targets 2,000–5,000 IU/day with monitoring.
Supplementation notes: Take with a fat-containing meal. Pair with vitamin K2 (MK-7) when supplementing higher doses long-term.
Why it matters here
Multiple Sclerosis (MS): Strong epidemiologic and clinical evidence linking low vitamin D to MS risk and relapse rates.
Cancer (Adjunctive Support): Observational and some interventional data link adequate vitamin D to improved outcomes in several cancers.
Insomnia: Low vitamin D status is associated with poor sleep quality and shorter sleep duration.
Joint Pain: Deficiency is associated with chronic widespread pain and osteoarthritis progression.
Vitamin B12 (Cobalamin)
B-vitamin
Essential for nerve myelination, red blood cell formation, and methylation.
Deficiency is common in vegetarians/vegans, older adults, and those on PPIs or metformin. Strongly implicated in neurological symptoms (MS-like presentations), fatigue, anxiety, and cognitive decline.
Selenium reduces TPO antibodies in Hashimoto's and supports T4→T3 conversion. Deficiency is implicated in thyroid autoimmunity and viral susceptibility.
Complex polypharmacology: weak CB1/CB2 binding, allosteric modulation of CB1, agonism at 5-HT1A and TRPV1, and inhibition of FAAH (raising endogenous anandamide). No psychoactive effect.
How it works in more detail
CBD appears to interact with the human endocannabinoid system (ECS), although its primary binding mechanisms differ from those of THC. It is thought to influence cannabinoid receptors (CB1 and CB2) indirectly and may modulate other receptors such as serotonin 5-HT1A and vanilloid TRPV1 receptors. Preclinical studies suggest it may also impact enzymatic pathways involved in endocannabinoid metabolism and exert neuroprotective effects.
How to use
Always consult a qualified clinician.
Editorial guidance
Suggested dosage
Research studies have explored a wide range of dosages, from tens to hundreds of milligrams per day, often divided into multiple doses. Product labels typically suggest starting with lower doses, such as 10-25 mg, and gradually increasing as needed. Individual needs and responses to CBD can vary significantly, and consultation with a healthcare professional is advisable.
With or without food
With food
Improved absorption
Research dosage range
100–1000 mg/day as full-spectrum, broad-spectrum, or isolate
Typical onset
The onset of effects for CBD can vary based on the method of administration; sublingual tinctures may offer effects within 30 minutes to an hour, while ingestible forms like capsules or edibles may take 1-2 hours. Consistent daily use may be required to observe more sustained benefits, particularly for conditions like mood support or chronic discomfort.
Oil/tincture, Capsule, Oromucosal spray (with THC, as nabiximols), Isolate
Quality markers
A high-quality CBD product often features third-party lab testing results to confirm cannabinoid content and absence of contaminants like heavy metals, pesticides, and solvents. Look for products derived from organic hemp and those that clearly state the CBD concentration per serving. Full-spectrum products also contain other beneficial cannabinoids and terpenes, while isolates contain only CBD.
Medication interactions
Medications metabolized by cytochrome P450 enzymes (e.g., some chemotherapy drugs, blood thinners)
Avoid if
Concurrent use with strong CYP3A4/CYP2C19 substrates without medical supervision
Significant liver disease
Pregnancy / lactation
Limited human data in pregnancy and lactation — avoid unless directed by a clinician.
Community tips
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Suggested dosage
Research studies have explored a wide range of dosages, from tens to hundreds of milligrams per day, often divided into multiple doses. Product labels typically suggest starting with lower doses, such as 10-25 mg, and gradually increasing as needed. Individual needs and responses to CBD can vary significantly, and consultation with a healthcare professional is advisable.
While cannabis has a long history of traditional medicinal use in various cultures, the specific isolation and use of CBD as a distinct compound for health purposes is a much more recent development in modern natural health.
Safety
Safety warnings
Consult a healthcare professional before using CBD, especially if undergoing cancer treatment or taking other medications. The safety and efficacy of CBD can vary depending on the product's quality and composition. Potential interactions with other medications are possible.
Avoid if
Concurrent use with strong CYP3A4/CYP2C19 substrates without medical supervision
Significant liver disease
Medication interactions
Medications metabolized by cytochrome P450 enzymes (e.g., some chemotherapy drugs, blood thinners)
Reported side effects
Fatigue or drowsiness
Diarrhea
Changes in appetite
Liver enzyme elevation at high doses
Pregnancy & lactation
Limited human data in pregnancy and lactation — avoid unless directed by a clinician.
Scientific literature, clinical guidance, government sources, ongoing research, traditional use, and lived experience — grouped by source type and quality.
Overall grade (A)
The 'A' evidence grade for CBD reflects a substantial body of human clinical trials, including randomized controlled trials and meta-analyses, particularly regarding its efficacy in certain severe seizure disorders. There is also a growing number of studies exploring its potential in areas like anxiety and chronic pain, contributing to a robust, albeit still developing, evidence base for various applications.
Hsu M, Shah A, Jordan A, Gold MS, Hill KP · JAMA · 2026
Approximately 27% of adults in the US and Canada report having ever used cannabis for medical purposes. An estimated 10.5% of the US population reports using cannabidiol (CBD), a chemical compound extracted from cannabis that does not have psychoactive effects, for therapeutic purposes.
Conditions for which cannabinoids have approval from the US Food and Drug Administration include HIV/AIDS-related anorexia, chemotherapy-induced nausea and vomiting, and certain pediatric seizure disorders. A meta-analysis of randomized clinical trials reported a small but significant reduction in nausea and vomiting from various causes (eg, chemotherapy, cancer) when comparing prescribed cannabinoids (eg, dronabinol, nabilone) with placebo or active comparators (eg, alizapride, chlorpromazine; standardized mean difference [SMD], -0.29 [95% CI, -0.39 to -0.18]). A meta-analysis of randomized clinical trials among patients with HIV/AIDS reported that cannabinoids had a moderate effect on increasing body
Spiga F, Parkhouse T, Tang VM, Savović J, Le Foll B, Nielsen S · The Cochrane database of systematic reviews · 2025 · n=3201
Globally, cannabis use is prevalent and widespread. There are currently no pharmacotherapies approved for the treatment of cannabis use disorder (a problematic pattern of cannabis use that leads to clinically significant impairment or distress). This is the second update of a Cochrane Review first published in the Cochrane Library in Issue 12, 2014.
To assess the effectiveness and safety of pharmacotherapies as compared with each other, placebo or no pharmacotherapy (supportive care) for reducing symptoms of cannabis withdrawal and promoting cessation or reduction of cannabis use.
We updated our searches of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase and PsycINFO in May 2024.
Randomised controlled trials (RCTs) and quasi-RCTs of medications to treat cannabis withdrawal and/or to promote cessation or reduction of cannabis use, in comparison with other medications, placebo or no medication in people diagnosed as cannabis dependent or who are likely to
Häuser W, Welsch P, Radbruch L, Fisher E, Bell RF, Moore RA · The Cochrane database of systematic reviews · 2023 · n=10
Pain is a common symptom in people with cancer; 30% to 50% of people with cancer will experience moderate-to-severe pain. This can have a major negative impact on their quality of life. Opioid (morphine-like) medications are commonly used to treat moderate or severe cancer pain, and are recommended for this purpose in the World Health Organization (WHO) pain treatment ladder. Pain is not sufficiently relieved by opioid medications in 10% to 15% of people with cancer. In people with insufficient relief of cancer pain, new analgesics are needed to effectively and safely supplement or replace opioids.
To evaluate the benefits and harms of cannabis-based medicines, including medical cannabis, for treating pain and other symptoms in adults with cancer compared to placebo or any other established analgesic for cancer pain.
We used standard, extensive Cochrane search methods. The latest search date was 26 January 2023.
We selected double-blind randomised, controlled trials (RCT) of medical
Meta-AnalysisPubMedVery High Quality
Systematic Reviews(6)
Structured reviews of the full body of evidence (incl. Cochrane).
Part I of this systematic review summarized the state-of-the-art of pediatric psychopharmacology for Autism Spectrum Disorder (ASD), a severe and lifelong neurodevelopmental disorder. The purpose of this Part II follow-up article is to provide a systematic overview of the experimental psychopharmacology of ASD. To this aim, we have first identified in the Clinicaltrials.gov website all the 157 pharmacological and nutraceutical compounds which have been experimentally tested in children and adolescents with ASD using the randomized placebo-controlled trial (RCT) design. After excluding 24 drugs already presented in Part I, a systematic review spanning each of the remaining 133 compounds was registered on Prospero (ID: CRD42023476555), performed on PubMed (August 8, 2024), and completed with EBSCO, PsycINFO (psychology and psychiatry literature) and the Cochrane Database of Systematic reviews, yielding a total of 115 published RCTs, including 57 trials for 23 pharmacological compounds an
To provide an overview of recently published work on anxiety, focusing on generalized anxiety disorder (GAD) and its treatment.
Self-reported anxiety symptoms were highly prevalent during the COVID-19 global pandemic in both the general population and in selected groups. There remains divided opinion about whether internet-based cognitive behavioural therapy (CBT) is noninferior to face-to-face CBT for GAD. A systematic review of drug treatment for GAD showed efficacy for selective serotonin reuptake inhibitors (SNRIs), agomelatine, and quetiapine. There may be a place for repetitive transcranial magnetic stimulation in the treatment of GAD. There was some evidence of efficacy for complementary therapies, including physical exercise, yoga, acupuncture, and Withania somnifera (ashwagandha). However, a systematic review of cannabidiol and tetrahydrocannabinol found insufficient evidence of efficacy in anxiety disorders.
Antidepressants and quetiapine show efficacy in the treatment of G
Ayati Z, Sarris J, Chang D, Emami SA, Rahimi R · Phytotherapy research : PTR · 2020
Obsessive-compulsive disorder (OCD) is a relatively prevalent mental disorder that poses significant health burdens on the community. Although current conventional medications have good efficacy for many patients, they can elicit a range of associated adverse effects. Plant-based compounds have been evaluated for different mental disorders, with a range of anxiolytic properties revealed. To determine the current evidence in the area, we conducted a systematic review using the electronic databases including PubMed, Scopus, and the Cochrane Library up to June 12, 2019, for pharmacological and clinical evidence of herbal medicines and phytochemicals with antiobsessive-compulsive effects. Additional search criteria were employed for locating research on the underpinning mechanisms of action. Results revealed that tentative low-quality evidence exists for several plant medicines, including Crocus sativus, Silybum marianum, Echium amoenum, Hypericum perforatum, and Withania somnifera, along
Niño Cital S, Wakshlag J, Kennedy A, Tittle D, Petty M · Journal of feline medicine and surgery · 2025
The use of cannabinoids from hemp, which is classified as a cultivar of Cannabis sativa with up to 0.3% delta-9-tetrahydrocannabinol by USA federal definitions, is becoming increasingly popular in veterinary medicine. Owners frequently ask about their utility in a variety of conditions, including predominantly osteoarthritis, behavioral management, cancer, dermatitis and seizure disorders. Cannabinoid clinical utility, particularly cannabidiol (CBD) in dogs, is gradually emerging, while evidence for its use in cats remains limited. Several newer publications around the pharmacokinetics of CBD and cannabidiolic acid in cats show dramatic differences in bioavailability, elucidating that not all formulations are similar regarding serum or plasma concentrations. To date, although the pharmacokinetics look favorable, there are a handful of clinical studies on feline acute/chronic pain states and fear/anxiety/stress, alongside some pre-clinical studies where there is a potential for clinical
Nayak MM, Chai P, Catalano PJ, Pirl WF, Tulsky JA, Tung SC · JAMA network open · 2024 · n=50
Early evidence from studies outside of oncology has suggested that cannabidiol (CBD) may have anxiolytic effects without neuropsychiatric risks. An understanding of oral CBD in patients with cancer-related anxiety is urgently needed.
To determine whether a single 400-mg oral dose of a US Food and Drug Administration-approved CBD improves clinical anxiety in an oncologic population.
This phase II, double-masked, placebo-controlled, randomized clinical trial was performed at the Dana-Farber Cancer Institute's Breast Oncology Center from November 2, 2021, through March 1, 2023. Women aged 18 years or older with advanced breast cancer and baseline clinical anxiety were included.
Patients were randomized 1:1 to receive oral CBD, 400 mg, vs placebo within 48 hours before a scan assessing tumor burden.
The primary end point was a between-arm comparison of change scores on the afraid subscale of the Visual Analog Mood Scale (VAMS) before and 2 to 4 hours after study drug ingestion. The VAM
Grimison P, Mersiades A, Kirby A, Tognela A, Olver I, Morton RL · Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2024 · n=250
The aim of this randomized, placebo-controlled, two-stage, phase II/III trial was to determine the efficacy of an oral cannabis extract in adults with refractory nausea and/or vomiting during moderately or highly emetogenic, intravenous chemotherapy despite guideline-consistent antiemetic prophylaxis. Here, we report results of the prespecified combined analysis including the initial phase II and subsequent phase III components.
Study treatment consisted of oral capsules containing either tetrahydrocannabinol 2.5 mg plus cannabidiol 2.5 mg capsules (THC:CBD) or matching placebo, taken three times a day from days -1 to 5, in addition to guideline-consistent antiemetics. The primary measure of effect was the difference in the proportions of participants with no vomiting or retching and no use of rescue medications (a complete response) during hours 0-120 after the first cycle of chemotherapy on study (cycle A).
We recruited 147 evaluable of a planned 250 participants from 2016 to 2022.
Randomized TrialPubMedHigh Quality
Observational Studies(36)
Cohort, case-control, and cross-sectional human studies.
Schiele MA, Fagan HA, Baldwin DS, Domschke K · Psychotherapy and psychosomatics · 2026
Treatment resistance in anxiety disorders (TR-ADs) constitutes a major clinical challenge conferring a considerable burden regarding quality of life and societal health costs.
This systematic review provides an overview of pharmacological, psychotherapeutic, and neurostimulatory treatment options in adults with treatment-resistant generalized anxiety disorder (TR-GAD), panic disorder (TR-PD)/agoraphobia, and social anxiety disorder (TR-SAD).
A total of 26 randomized controlled trials (RCTs) and 36 open label studies were identified, with, however, mostly small sample sizes and several methodological limitations. According to RCTs, selective serotonin reuptake inhibitors (SSRIs) or clomipramine are effective in TR-PD after failure to respond to cognitive behavioral therapy (CBT). In pharmacological TR-SAD, switching from one SSRI to another or to venlafaxine was found helpful in open label trials. RCTs further suggest augmentation with quetiapine, risperidone, olanzapine, or pregabali
Mujahid K, Rasheed MS, Sabir A, Nam J, Ramzan T, Ashraf W · Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society · 2025
Cannabidiol (CBD), a non-psychoactive phytocannabinoid derived from Cannabis sativa, has emerged as a promising therapeutic agent due to its diverse pharmacological properties, including potent anti-inflammatory, neuroprotective, and immunomodulatory effects. CBD modulates immune responses, including the regulation of T cell activity, induction of macrophage apoptosis, suppression of pro-inflammatory cytokines, and modulation of signaling pathways involved in inflammation and immune homeostasis. A comprehensive literature search was conducted using PubMed, Scopus, and Web of Science databases to identify relevant preclinical and clinical studies on CBD's immunomodulatory effects. Preclinical and clinical studies demonstrate its efficacy in treating autoimmune diseases such as Type 1 diabetes, multiple sclerosis, rheumatoid arthritis, and inflammatory bowel disease, along with its potential in neuropathic pain and cancer therapy. Recent advancements in nanotechnology-based delivery syst
Vigano M, Kubal S, Habib S, Samarani S, Kasvis P, Koudieh N · Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025
This study explored the effectiveness of cannabidiol (CBD) alone and in combination with multi-modal exercise (MME) to improve signs and symptoms of chemotherapy-induced peripheral neuropathy (CIPN), quality of life (QoL), and functional capacity in cancer survivors.
Cancer survivors (n = 27) with CIPN were enrolled in a 4-month interventional open-label study. Participants underwent two consecutive 2-month interventions: CBD (up to 300 mg/day) and CBD combined with MME. They were assessed using the painDETECT questionnaire for CIPN-related neuropathic pain and the Functional Assessment of Cancer Treatment/Gynecological Oncology-Neurotoxicity-13 (FACT-GOG-Ntx-13) questionnaire for CIPN neurotoxic symptoms (Ntx), perceived physical function (PPF) and overall QoL. Their functional status was examined through gait speed and timed up and go for mobility, the 9-hole peg test for manual dexterity, a hand-held hydraulic dynamometer for hand grip strength, and five rep
Observational StudyPubMedLow Quality
Mechanistic Studies(1)
Lab and in-vitro work explaining how something might work.
Pongking T, Intuyod K, Thongpon P, Thanan R, Sitthirach C, Chaidee A · Journal of traditional and complementary medicine · 2024
Cholangiocarcinoma (CCA) is usually diagnosed at a late stage, leading to treatment failure. Cannabidiol (CBD), exhibits diverse anti-cancer effects in various cancers, offering avenues for improving CCA treatment. This study investigated the effects of CBD on human CCA cells and the underlying mechanisms in vitro and in vivo.
The effects of CBD on three CCA cell lines (KKU-213B, KKU-100, KKU-055) were assessed using the SRB assay, clonogenic assay, cell cycle arrest, and 3D holotomography. Morphological changes were examined using transmission electron microscopy, while mitochondrial ROS levels and mitochondrial membrane potential were studied using MitoSOX, JC-1, and DCFH-DA. Cellular senescence induction was evaluated via SA-β-gal staining. Protein associatedwith autophagy and cellular senescence were analyzed using Western blot and/or immunofluorescent assays. A xenograft model demonstrated the anti-tumor activity of CBD and the induction of cellular senescence through immun
Mechanistic StudyPubMedLow Quality
Animal Studies(3)
Preclinical animal research — not a substitute for human evidence.
Yang F, Duan S, Liu J, An Z, Liu W, Wang X · Phytomedicine : international journal of phytotherapy and phytopharmacology · 2025
Osteosarcoma remains a therapeutic challenge due to its aggressive behavior and high metastatic potential, necessitating exploration of novel treatment modalities. Cannabidiol (CBD), a non-psychoactive phytocannabinoid with emerging anticancer properties, has shown promise in preclinical cancer models. However, its mechanisms of action in osteosarcoma remain incompletely understood. This study systematically investigates the antitumor effects of CBD on osteosarcoma and elucidates its molecular targets within the TNF-α/NF-κB/CCL5 signaling axis.
The effective concentration of CBD was determined using the CCK-8 assay. Functional assays (EdU proliferation, Transwell migration/invasion, and scratch wound healing) evaluated its impact on osteosarcoma cell malignancy. A mouse xenograft model assessed in vivo efficacy. Network pharmacology and RNA-seq identified key pathways, which were validated via ELISA, qRT-PCR, and western blot. Molecular interactions were confirmed through
Sun Q, Bravo Iniguez A, Tian Q, Du M, Zhu MJ · Molecular nutrition & food research · 2024
Inflammatory bowel disease (IBD) is characterized by chronic inflammation in the gut, accompanied by impaired epithelial integrity, increased macrophage infiltration, and enhanced colon cancer risk.
Cannabidiol (CBD), a phytocannabinoid isolated from cannabis plants, is supplemented into mice diet, and its beneficial effects against dextran sulfate sodium (DSS)-induced experimental colitis is evaluated. Eight-week-old mice were fed a standard diet supplemented with or without CBD (200 mg kg-1 ) for 5 weeks. In the 4th week of dietary treatment, mice were subjected to 2.5% DSS induction for 7 days, followed by 7 days of recovery, to induce colitis. CBD supplementation reduced body weight loss, gross bleeding, fecal consistency, and disease activity index. In addition, CBD supplementation protected the colonic structure, promoted tissue recovery, and ameliorated macrophage infiltration in the colonic tissue, which was associated with the activation of cyclic AMP-protein kinase A, e
Huang T, Xu T, Wang Y, Zhou Y, Yu D, Wang Z · Autophagy · 2021
Glioma is the most common primary malignant brain tumor with poor survival and limited therapeutic options. The non-psychoactive phytocannabinoid cannabidiol (CBD) has been shown to be effective against glioma; however, the molecular target and mechanism of action of CBD in glioma are poorly understood. Here we investigated the molecular mechanisms underlying the antitumor effect of CBD in preclinical models of human glioma. Our results showed that CBD induced autophagic rather than apoptotic cell death in glioma cells. We also showed that CBD induced mitochondrial dysfunction and lethal mitophagy arrest, leading to autophagic cell death. Mechanistically, calcium flux induced by CBD through TRPV4 (transient receptor potential cation channel subfamily V member 4) activation played a key role in mitophagy initiation. We further confirmed TRPV4 levels correlated with both tumor grade and poor survival in glioma patients. Transcriptome analysis and other results demonstrated that ER stress
Animal StudyPubMedLow Quality
Clinical Trial Registries(20)
Registered ongoing or completed trials (ClinicalTrials.gov).
Investigating the potential role of a novel quadrate combination therapy Mifepristone(Antiprogestrone), Tamoxifen, Retinoic acid and Cannabidiol ( selective cyp 26 inhibitor) for treating early breast cancer.
Breast cancer is the main cause of mortality among women. The disease presents high recurrence mainly due to incomplete efficacy of primary treatment in killing all cancer cells. Therapy resistance remains a major problem in estrogen receptor-α (ERα)-positive breast cancer. Half of estrogen receptor-positive breast cancers contain a subpopulation of cytokeratin 5 (CK5)-expressing cells that are therapy resistant and exhibit increased cancer stem cell (CSC) properties. Here, we propose a testable hypothesis that treatment of breast cancer with tamoxifen or retinoic acid or a combination of the two, may result in induction or conversion of some ER-positive breast cancer cells to ER-negative cancer cells expressing the basal cytokeratin-5 (CK5) via stimulation of progesterone receptors effect, and production . Therefore, we raised an issue with the answer " Why Antiprogestrone such Mifepristone and cyp 26 inhibitors must be combined with Tamoxifen or its combination with retinoic acid in the era of oncology for treating early breast cancer" .In fact, limited evidence has indicated that induction of CK5+ cells in ERα+ breast cancer is a unique effect of progestin (Prg) but many studies have demonstrated that progesterone (P4) increases CK5+ breast cancer cells. In case-cohort study of 405 incident breast cancer cases, elevated circulating progesterone levels were associated with a 16% increase in the risk of breast cancer. A study demonstrated that tamoxifen induced progesterone receptors (PGR) in short term treatment. Another study showed that High progesterone receptor expression correlates to the effect of adjuvant tamoxifen in premenopausal breast cancer patients. These CK5-positive cells are therapy resistant and have increased tumor-initiating potential. Also, previous work has shown that retinoic acid, a chemical that results from the body's natural breakdown of vitamin A, should act against these CK5+ cells, but clinical trials of retinoids against breast cancer have been largely unsuccessful .Therefore we suggest that combination of retinoiac acid and tamoxifen was unsucssecful in treating breast cancer owing its ability to induce progesterone receptors and production leading to increasing numbers of CK5-positive cells which are therapy resistant . Although retinoid fenretinide reduced the accumulation of CK5+ cells during estrogen depletion. A study investigated the effects of all-trans-RA (atRA) on progesterone production in immature rat GCs cultured without gonadotropin. demonstrated that atRA enhanced progesterone production by upregulating the levels of steroidogenic acute regulatory protein (StAR) and cytochrome P450scc (Cyp11a1). Here, we suggest that tamoxifen or its combination with retinoic acid must be combined with anti-progesterone (Mifepristone) to achieve treatment with significant effect against early breast cancer. Moreover, Numerous studies have shown that CYP2D6 variant carriers (around 50% CYP2D6 variant carriers in Chinese population) will not benefit a lot from tamoxifen, and combined use of CYP2D6 inhibitors will further affect the efficacy of tamoxifen. In addition, All-trans-retinoic acid acts as an inducer of CYP26A1 expression. Which is the second expected cause of unsuccessful trial of Tamoxifen and retinoic acid in breast cancer treatment. Furthermore, The CYP26 inhibitor also induced expression of atRA-responsive genes. All-trans retinoic acid (ATRA) significantly inhibited aromatase activity in a concentration-dependent manner in microsomes isolated from JEG-3 human placental carcinoma cells. One study found that high retinol was significantly. associated with reduced breast cancer risk. Another found a significant trend of reduced retinol levels with more advanced disease stage. A study showed that intake of vitamin A and retinol could reduce breast cancer risk. Therefore we will take the benefit of cyp 26 inhibitor in this trial by combining Cannabidiol, a major phytocannabinoid, as a potent atypical inhibitor for CYP2D6.
Study of Cannabidol to examine the safety and efficacy of 15 weeks of CBD in postmenopausal women with aromatase inhibitor-associated musculoskeletal symptoms (AIMSS). Investigators are looking to see if patients with joint pain see improvement with the use of CBD.
An intervention study on the effect of cannabidiol on lean body mass in cancer patients receiving chemotherapy, at the department of Clinical Oncology at Zealand University Hospital, Roskilde, Denmark. Fat free mass will be measured by bioimpedance spectroscopy. As secondary outcomes protein and energy intake, nausea, taste alterations and life quality will be assessed by oral interviews and questionnaires.
Clinical TrialClinicalTrials.govModerate Quality
Evidence Summaries(1)
Curated cross-source summaries (TRIP Database and similar).
Provides an evidence-based summary of cannabidiol (CBD), including its uses, dosing, effectiveness, safety, and potential drug interactions. It offers detailed information for healthcare professionals on its application in various health conditions, potentially including pain management.
Limitations: Despite significant research, many studies examining CBD for common conditions like anxiety or pain employ small sample sizes or are short-term. There is also considerable heterogeneity in study designs, product formulations, and dosages, making direct comparisons challenging. Further, long-term safety data for chronic use in general populations remain somewhat limited.
Health Voice Perspectives
Independent of evidence grade
Approved mentions from health educators, physicians, and researchers across podcasts, videos, and articles. Educational context only — does not influence the scientific evidence rating above.
Dr. Michael Grandner discusses various interventions for improving sleep quality, focusing on cognitive behavioral therapy for insomnia (CBT-I) and lifestyle adjustments. He highlights the impact of chronic insomnia and untreated sleep apnea on cognitive function and resilience. The discussion also covers the strategic use of light, caffeine, and certain supplements, while cautioning against common pitfalls and misuses of sleep aids and trackers. The overall message emphasizes retraining the body for restorative sleep through scientifically validated methods.
"Chronic insomnia and untreated sleep apnea profoundly accelerate cognitive decline, impair performance, and diminish resilience. • CBT-I and stimulus control strategies can retrain your body for consistently restorative sleep. • Precise timing of morning light, caffeine, and supplements like melatonin can dramatically enhance sleep quality and daytime performance. • Sleep trackers have both accuracy and pitfalls, and their data should be used effectively. • Effort to sleep can keep you awake, and trying too hard to sleep can backfire."
This page is educational. Statements use phrases like "may support" and "has been studied for"because no remedy here is approved to cure, treat, or reverse any condition. Discussion happens on the ailment pages — community statistics here are derived from those reports. Always consult a qualified clinician.
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