CBD: Truth or Hype?

Can CBD curb your appetite? Quash anxiety? Protect your heart and brain? Anecdotal evidence for these and other health benefits has created a surge, a potential tsunami of demand for CBD products. While the FDA recently declared CBD an illegal, Schedule 1 drug, it’s being sold in states where medical cannabis is legal, and some companies are shipping it across state lines.

Frankel smileI’d been hearing about the healing properties of CBD for years, but I had not heard that it cuts your appetite until I spent time with Dr. Allan Frankel, a renowned internist in Los Angeles who’s one of the country’s pioneers in “dosed cannabis medicine.”

Frankel, 66, who’s short and energetic with impressive dark eyebrows, has paid a price for cutting this path, but he’s paving the way for rigorous, professional medical treatment using cannabis.

Most of the four million medical marijuana patients in the U.S. get their license recommendations from a doctor they never see again.

They go to a dispensary, ask what’s good for migraines or whatever ails them, and the bud tender, a low-wage worker with no medical training, offers what often turns out to be bad advice. Misinformation is rampant, and most people have no clue how to use it.

Frankel runs GreenBridge Medical, which he founded in 2006, like an internist’s office. He begins with a one-hour consult, comes up with a treatment plan, and recommends products for which he designed the formulas: ten oils with different combinations of THC and CBD. (THC gets you high; CBD doesn’t, but is alleged to have strong healing properties) The #1 oil is almost all CBD, #10 is almost all THC, and #5 has equal amounts of both. So the doctor, patient, and dispensary know how many milligrams of what chemicals the patient is taking, and the doctor can adjust the dose as needed.

By contrast, products sold at dispensaries may be labeled, “13% THC,” but they don’t say how many milligrams you get per puff or drop or bite. Frankel says, “What the hell is medicine if you don’t know what’s in it?”

During a day at his office, I saw three patients who’d had success with CBD. The first was Sawyer Maddox, five, from Atlanta, who’d been diagnosed at three with a rare form of epilepsy, Doose Syndrome, which is resistant to medication. He was having more than 200 seizures a day, where he’d drop face first on the floor. His parents fitted him with a catcher’s mask for protection, and carpeted their home with foam to cushion his falls. The pediatric neurologist they saw in Atlanta gave him meds that made things worse. Desperate, the Maddoxes, a conservative Baptist family, flew to California to see Frankel. He started Sawyer on #1 oil, and three months later, the boy was seizure free.

Sawyer Maddox, left, at three, and right, after treatment,at five

Sawyer Maddox, left, at three, and right, after treatment,at five

The next two patients were women, Brigitte Bedi, a slim, blonde yoga teacher, who suffered severe brain damage in a car crash, and Tanya Lynn, from Canada, who had myasthenia gravis (MG), an autoimmune disease that weakens the face and throat muscles, so it’s hard to speak, swallow and breathe. Both had been given meds by their doctor that caused unpleasant side effects, and had been told they would not get any better. Frankel treated them with different cannabinoid oils, and within 12 to 18 months, both were better and leading normal lives.

 

Brigitte, after accident, and after a year of taking CBD

Brigitte, after accident

After a year of taking CBD

After a year of taking CBD

 

 

 

 

 

 

 

This strains credulity. How could one plant substance heal brain damage, seizures, MG, Parkinson’s, cancer, migraines, anxiety, panic attacks, uterine fibroids, tinnitus, and a long list of other conditions—attested to not only by Frankel but research scientists in many countries?         

Frankel also asserts that CBD reduces appetite—the opposite of THC, which triggers hedonic over-eating. I hadn’t read this anywhere, so I invited two friends, Tina and Cha Cha, to try it with me. We would soon be calling ourselves the Ladies Weed Detective Society. We squeezed a few drops of CBD-infused oil under our tongues and waited. An hour later, at the time we’d planned to have dinner, we noticed we weren’t especially hungry. All thoughts of food had been swept away. If this effect were widely known, Tina said, “Cannabis would be legal in twenty minutes.”

CBD is not always effective, though. Frankel estimates that he has a 60% success rate in treating patients using cannabinoids, which is notable, given that 90% of his patients are referred by doctors who haven’t been able to help them with conventional treatment and drugs. The patients often tell Frankel, “You’re my last resort.”

Frankel puts his hand on his heart. “Imagine the pressure!” he says. A complex soul, whose parents survived the Holocaust, Frankel says that when his patients don’t get better, he’s sad and disappointed, and starts to question if he’s wasting people’s time and money. “But then ten people will get better, and I feel… grateful. It makes me confident I’m on the right road, on the right side of history.”

He keeps careful records because, he says, it’s important to know when CBD doesn’t work and why. “Maybe a different dose or combination of cannabinoids will work the next time? But it’s scary, and risky, because I’m alone.”

Frankel had rarely tried cannabis until he was 49. He was a partner in one of the most successful practices in West Los Angeles and a clinical professor at UCLA Medical School. He’d been my family’s internist for 15 years, and I found him a skilled diagnostician, who listened carefully, and who cared. He had to quit practicing in 2000, after he’d suffered a disabling back injury, then developed a viral infection of the heart and was told he had six months to live. Some of his cancer and AIDS patients urged him to try cannabis. “They did a reverse intervention,” he said, and a year later, his heart was normal. He can’t be certain how or if cannabis healed his heart. “I’d been depressed and CBD stopped the depression,” he said. “It gave me something to look forward to. My brain was turned on.”

He did exhaustive research. He found there’d been decades of scientific studies on the effects of THC and CBD on cells and animals, but few trials with humans, because the FDA classifies cannabis and all its components as Schedule 1 drugs, which have “no accepted medical treatment use.” It took Sue Sisley, an Arizona physician, seven years of struggling with bureaucratic hurdles before she received the first FDA approval for a study, just beginning, of marijuana with vets who have PTSD.

Frankel grew plants, crossed strains, and tried them on friends as well as himself. Working with chemists and professional growers, he developed formulas for whole plant oils, which are manufactured independently and for which he receives no compensation. In 2006, Frankel felt he’d learned enough to open a new practice as a cannabis medical consultant.

In 2007, he was investigated by the California Medical Board and in 2008, his license to practice was suspended. He fought this in court, losing his house to pay legal bills, and in 2011, his license was reinstated. During those “hard years,” he said, he hired other doctors to write recommendations for medical marijuana licenses, then Frankel advised the patients how to treat their ailments. “I could have quit and taken a job that paid well, but I kept asking myself, what’s the best thing I can do for my patients?” He thought about what his parents had suffered in Auschwitz. “Why should I crumble because the medical board takes away a piece of paper? I was willing to fight for something I feel is absolutely good—because of its efficacy and lack of side effects.”

I asked if he knew why CBD is so broadly effective. Could it be a gigantic, all-purpose placebo? He shook his head. His theory is that it’s an essential nutrient, like vitamins and amino acids, and when there’s a deficiency of CBD, people get sick. Because CBD brings the body into homeostasis, or balance, it can work in two directions: cutting appetite in people who over-eat, and increasing appetite in those who need to eat more.

Are there cases, I asked, where CBD should not be used? He thought a moment. “No. It protects your brain and your heart, helps you control your weight, and at the same time calms you down.” He smiled. “CBD is awesome nutrition.” Then he sang, to the tune of the Saralee commercial, “Nobody doesn’t like CBD.”
 

Dr. Frankel may be coming to Colorado. If you live there and are interested in having a consultation, please respond to this email. The one-hour consult is $300, which is usually covered in part by insurance companies and Medicare.

 

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I look forward to hearing your thoughts and conversing. So please leave a comment below.

11 thoughts on “CBD: Truth or Hype?

  1. Peter Lake

    Cannabis may be legal in your state but I think you are having WAY too much fun and that is probably illegal now in every state.

    PS: When can I join you?

  2. Alberta

    Sara, this is fascinating! It reminds me of Ayelet Waldman’s new book “A Really Good Day” about microdosing LSD for treatment resistant depression.

  3. Judi Turner

    What if I’m only a tiny bit depressed but hate to leave my house?
    I think I will call him.
    JudiTurner

  4. Dr Peter Lim

    I live in Melbourne , am an economist with interest in sociology, ethics and welfare. Australia has taken steps to legalise the use of M for medical purposes, subject to rules and regulations, of course. Pain and suffering is hard to bear and whatever that brings relief and better well-being should be encouraged. Many thanks for your informative article. Please keep me posted. I am a composer and small-time writer, mainly of poetry and have started on prose–in a serious way. With my esteem and best wishes. Dr Peter Lim

  5. caroline muir

    I am very interested in the “TRUTH” concerning using Medical Marijuana for Rx needs. We have a Compassion Card for buyingin California, but I would love to know what we are ‘shopping’ for!
    I would make a trip to Colo for such clear knowledge. At the same time I would like to visit the Grossman Wellness Center in Denver, where I believe such work and research is being done, including Stem Cell.
    Perhaps your dear Dr. Frankel should get in touch with Terry Grossman, M.D. Alternative doctors do have an important role with us aging boomers, etc.
    Thanks, Sarah… Love to you!

  6. Paul Robertson

    First of all, my comments are those of a research scientist in the field of ecology and university professor with over 50 years of experience doing both research and trying to teach students and friends what science is and isn’t, and what it means to know something with reasonable certainty. Science is a process in the pursuit of truth whether you like what it tells you are not.

    First to your original question: truth or hype? My answer after reading your piece and going into the legitimate science literature on the subject: some real potential, particularly for certain forms of epilepsy and MS, and simply not enough hard data and properly performed research on any of the other possible medical uses of CBD. The human research situation for CBD is seriously compromised by the politics of marijuana. That is easing somewhat and there is likely to be a great deal more solid data on CBD within the next 10 years. As one scientist note, interest in CBD would be much, much lower if it was not tied to the popularity of recreational marijuana in some areas. Boulder would fall into that category. The suggestion that CBD is or has a high potential in the treatment of the broad range of illnesses mentioned in your piece is hype. It may turn out to be a valuable treatment in some of those but that is highly unlikely to be the case for many. Not only is the jury still out, it hasn’t even been paneled. Virtually impossible to assess the work that has been done by physicians like Dr. Frankel because it is not scientific research. That doesn’t mean its useless but it should be used to encourage research that will tell us what the potential is and what the possible dangers are. Just because something look great initially does not mean that there are not negative long term effects. Thalidomide is a good example of jumping the gun too soon. Let me point out that most doctors are not scientists. They are practitioners who use the results of scientific work to diagnose and to design appropriate treatments. The examples of cures illustrated above may or may not have been due to CBD. Frankel says he keeps detailed notes but detailed notes are not the same thing as carefully designed studies of sufficient size for statistical analysis, under controlled conditions so you know what is causing what, and with CBD of known strength and composition. With some of the supposed effects, the placebo effect may or may not be playing a significant role. The whole appetite idea is a perfect example. My other big concern is the lack of citations to high quality, peer reviewed, science journal articles on the subject. Apparently, he mentioned many other researchers in other countries coming up with support data. Well, let’s see it because I can’t find it in the literature. The term “researchers” is used so casually and inappropriately nowadays that I don’t take it very seriously without citations so I can check out who they are referring to.
    The bottom-line for me on the subject is there needs to be a great deal more genuine, high caliber research done before I would use or recommend it to anyone. He may be on to something really important and he may be dead wrong. But, ironically, he won’t be the person who can determine that with certainty.

    I am attaching the conclusions from what I considered to be the best review paper on the subject along with the citation for anyone who wants to pursue it. This paper cites lots of papers as well.
    Thanks for listening.

    CONCLUSIONS
    At this time, there does seem to be a growing body of basic pharmacologic data suggesting there may be a role for CBD, especially in the treatment of refractory epilepsy. However, given the lack of well-controlled trials, we must also ask if we are getting ahead of ourselves. Clearly, this is an emotionally and politically charged issue. If this were any other uninvestigated pharmaceutical compound, would we feel as compelled to make the agent widely available before statistically valid class 1 evidence was available for review? Until data from well-designed clinical trials are available and reliable, and standardized CBD products that are produced using GMP are available, caution must be exercised in any consideration of using CBD for the treatment of epilepsy. In the meantime, based upon promising preliminary data, further clinical research should be wholeheartedly pursued.

    Epilepsy Curr. 2014 Sep-Oct; 14(5): 250–252.

    Cannabidiol: Promise and Pitfalls

    Timothy E. Welty, PharmD*,1

    1Professor and Chair, Department of Clinical Sciences, College of Pharmacy and Health Sciences, Drake University, Des Moines, IA
    Adrienne Luebke, PharmD2
    2School of Pharmacy, University of Wisconsin, Madison, WI
    Barry E. Gidal, PharmD3
    3Professor and Chair, Division of Pharmacy Practice, School of Pharmacy, University of Wisconsin, Madison, WI

    1. Carrie Leon

      This is a nice, conclusive report. Dr. Frankel seems to just be doodling around. So I say HYPE-
      “I believe that Dr. Frankel suffers from a variety of psychiatric conditions which
      significantly interfere with his ability to process information, form judgments or
      relate a coherent history.”
      Diagnosis based upon DSM-V Criteria:
      • Axis I
      • 304.30 Cannabis Dependence
      • 305.20 Cannabis Abuse
      • 292.89 Cannabis Intoxication
      • Rule out underlying 296.89 Bipolar II Disorder or 301.13 Cyclothymic Disor

      der, Hypomanic.
      • Rule out 314.9 Attention-Deficit/Hyperactivity Disorder Not Otherwise Speci

      fied.
      Axis II
      • 301.9 Personality Disorder Not Otherwise Specified with Antisocial, Histrionic
      and Narcissistic features.

  7. Margaret Pevec

    Sara, now that marijuana is legal in Colorado, are formal studies being conducted to test out the properties of CBD in CO? Or is that still mired in red tape?

Comments are closed.