Treatment with CBD

Treatment with CBD – Your Gateway to the Science of Cannabidiol

CBD and sport performance

As cannabidiol (CBD) use becomes more common in everyday life, it will inevitably cross-over into use by female and male athletes, for its claimed therapeutic and enhancing properties. Indeed, some CBD products are already on the market specifically to target both elite and recreational athletes. Unlike the psychoactive tetrahydrocannabinol (THC) found in cannabis, since 2018, CBD is no longer on the banned substances list of the World Anti-doping Agency. However, there have been only limited clinical trials on the specific effect of CBD on sport performance and the potential impacts, good or bad, on an athlete’s body.

A review of the evidence on CBD and sport performance

In general terms, CBD has a range of positive physiological, psychological, and biochemical effects on the body that may also benefit sport performance. However, these findings are far from consistent and have not been extensively researched. Often the scientific data relate only to animal studies rather than real-world evidence. The only sure thing we currently know is that the body can tolerate high doses of CBD without harmful effects.

CBD and muscle recovery from damage

New or over-strenuous exercise or movement can damage muscle fibers and tissues. This damage induces an inflammatory repair response in the body, creating soreness and delayed recovery. In animal studies, cannabidiol, particularly at high doses, has known anti-inflammatory effects through a wide range of actions.

For example, CBD stimulates anti-inflammatory cytokine production and limits pro-inflammatory cytokines, and reduces the build-up of immune cells in the damaged area. However, studies in humans are very limited.

In muscle-inflammation studies in mice with a degenerative muscle disease, CBD improved muscle coordination and strength and decreased the muscle tissue’s degeneration after damage.

Even if CBD has the potential for muscle-recovery, other common anti-inflammatory drugs, such as ibuprofen, have similar, if not identical properties. Nevertheless, it seems worthwhile to pursue research on the potential broader benefits of CBD in muscle recovery – especially because anti-inflammatory drugs may have serious side effects.

CBD and protection against concussion

Concussion caused by impact force on the brain is a very common injury in full-contact sports, and is increasingly thought to lead to long-term neurodegenerative disease and even suicide. We have covered in depth the topic of CBD and protection from concussion in a previous article.

Briefly, CBD may have benefits in reducing the long-term effects of repeated concussions. It acts as a neuroprotector by reducing neuron excitotoxicity (where neurons are damaged or killed by the overaction of their receptors, reducing oxidative stress and inflammation).

Watch this 3:45 minute video segment about CBD for athletes

CBD and pain reduction

Athletes often experience consistent pain through tissue damage, repetitive strain injuries, or nerve damage. CBD has offered some positive results in reducing pain. Research suggests that CBD may only be effective in the development of neuropathic pain in diseases affecting the nervous system, for example, those that many para-athletes might experience.

Exercise-induced gastrointestinal damage

The body redirects oxygen and nutrients away from the gastrointestinal system during exercise. If sustained (e.g., over 40 mins), inflammation and oxidative stress can occur and may lead to post-exercise problems such as vomiting, nausea, pain, and diarrhea. The properties that CBD demonstrates for muscle recovery also aid the gut, by reducing inflammation, tissue damage, and increasing blood-flow. Specific research on gastrointestinal diseases, looking at whether CBD reduces the negative effects of Crohn’s disease and remission of ulcerative colitis, have so far not shown any benefit. However, CBD does help intestinal permeability to recover after exposure to bacterial infections.

CBD and bone health

A small number of studies have investigated CBD’s general effects on bone health, essential for sport performance. In rats, CBD improved the healing of femoral fractures, seemingly by reducing inflammation, and suppressing bone reabsorption and inducing bone matrix deposition. The findings are early indications that CBD may have positive effects on recovery from bone injury.

CBD and cardiovascular/metabolic functions

Preclinical research has shown that CBD influences vascular function in laboratory conditions. CBD produces a reduction in tension of the walls of the blood vessels (vasorelaxation) and restricted arteries (seen in conditions such as cancer and inflammatory bowel disease). Other findings suggest no effect on resting heart rate or blood pressure.

There is a lack of scientific studies assessing specific effects on cardiovascular performance in exercise. However, early findings suggest that CBD may increase mitochondrial activity (the energy-producing action of cells), and this could have implications for energy metabolism during exercise.

Dietary intake and feeding

In the pre- and post-exercise period, nutrient provision is critical to preparation and recovery. In rats, high doses of CBD suppresses appetite, and the same appears to be true in humans taking CBD for epilepsy. Unfortunately, we do not clearly understand the mechanism of CBD’s effects on appetite and eating, although this mechanism may be due to gastrointestinal side effects.

CBD and sport performance anxiety

Sport performance anxiety (SPA) is often damaging to athletic performance due to lack of sleep, poor appetite, and increased energy expenditure. Cognitive-behavioral therapy is the preferred treatment option.

Several clinical trials have tested CBD’s effects on anxiety, paranoia, and stress, with promising findings, particularly for “induced stress” situations like public speaking. Small scale studies suggest that a high CBD dose improves self-reported sleep duration in people with insomnia, although not necessarily the quality of the sleep experience. However, studies have generally provided conflicting evidence on CBD and sleep.

Overall findings are not always consistent with regard to the effect of CBD on sport performance, perhaps due to individual differences in response. However, using CBD for pre-competition anxiety (alongside behavioral therapies) shows some promise for further investigation.

CBD “nutraceutical” products

A discussed previously, commercially available (non-prescription) CBD-containing products are unregulated and may contain contaminants and unknown levels of CBD or THC. For this reason, professional or high-level athletes should very carefully use these products (e.g. under medical supervision) due to the risk of testing failure, over/underdosing, or unpredictable side effects. Be aware that full spectrum CBD products contain THC, and THC has been shown to accumulate in the body’s fat storage. The “wash-out” period could be as long as 77 days.

Conclusions

There are preliminary and very-early stage findings which suggest some largely theoretical benefits for athletes to take CBD. The effects seem to promise possible broad improvements in anti-inflammatory and neuroprotective effects, pain-reduction, anxiety reduction, and gastrointestinal protection. The results, however, remain contradictory and may not be replicable in human studies, and so athletes should use CBD with caution, and probably under medical supervision (especially professional athletes).

Reference

McCartney D, Benson MJ, Desbrow B, Irwin C, Suraev A, McGregor IS. Cannabidiol and Sports Performance: a Narrative Review of Relevant Evidence and Recommendations for Future Research. Sports Med Open. 2020 Jul 6;6(1):27. doi: 10.1186/s40798-020-00251-0. PMID: 32632671; PMCID: PMC7338332.

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