Written by Christopher Kelly
Nov. 1, 2019
[0:00:00]
Christopher: Well, Dr. Mike T. Nelson, thank you for joining me here at the Ancestral Health Symposium --
Mike: That's right.
Christopher: -- in San Diego. I was very excited to see your talk yesterday on cannabis. You're going to have to start with some definitions. First of all, before we get into that, I'm really interested to know how you chose this topic. I wondered if you were starting to be pigeonholed a little bit as that metabolic flexibility guy. Did you get bored about talking about metabolic flexibility?
Mike: No. What happened was about three and a half years ago, I started looking at research if I get dropped out of the sky kiteboarding on my head, have a TBI or some type of brain trauma. Is there something I should be doing ahead of time? My thoughts were fish oil, maybe some loading on creatine and there are some good studies on that. As I'm looking at it, these things called cannabinoids and CBD kept showing up in the research. At the time, I was like, I don't know. I didn't know anything about it. I grew up and thought that's just cannabis. That's going to make you one with your couch cushion or you get nothing done and your life's going to go to hell. I remember having a flashback that I talked to Peter Rouse who used to be out here in California -- I think he's in New Zealand now -- many years ago and he was telling me about CBD. I think he's the first guy who I heard about it and I'm like, "Oh! Isn't that from cannabis?" He's like, "Yeah, but it's non-psychoactive." This was maybe like ten years ago or something.
Christopher: Oh, wow.
Mike: I'm like, what? I just filed it away as something kind of odd. So I was looking at the research and it kept popping up again and again and I initially started writing -- I guess it was sort of a semi-technical paper on traumatic brain injury and the impact of nutrition, which morphed into the effect of cannabinoids and traumatic brain injury. As of last year, I was like, "What should I do for topics for presentation?" so I did sort of an informal poll and everyone was like, "CBD. You should go talk about CBD" and I'm like, okay.
Christopher: It's the sexy, new thing.
Mike: Yeah, and at that time -- this was a year and a half ago -- I just hooked my head up on the research and did Google search on CBD and I'm like, holy crap, this is everywhere. Two months ago, it's even more everywhere. About two years ago also, the guys who run Charlotte's Web, a buddy of mine does distribution for them through Driven Nutrition --
Christopher: What's Charlotte's Web? I have no idea what that is.
Mike: Charlotte's Web is probably one of the original people who did CBD into medical marijuana --
Christopher: I think of the story, the children's story.
Mike: Exactly. That's what it is.
Christopher: Oh, okay.
Mike: It's named after that. They're in Colorado and I had heard a little bit about them. It turns out I was there presenting at a neuro conference and it was the same weekend, so my buddy was like, "Yeah, another one of our employees are going to be out there. I can hook you up if you want to hang out with them for a weekend." I'm like, sure! So I signed an NDA, got a tour of the facility, got a tour of everything around there, and I was like, there actually is more to this. There are some companies appearing to do it in a correct and beneficial way and taking it very seriously and have been doing it for many years.
Christopher: Did they show you a certificate of analysis? That was one concern I had.
Mike: Yeah.
Christopher: I saw these FDA notices -- or maybe they were FTC, I can't remember which -- and they tested a bunch of products and they found no active anything in there. It's just a bunch of olive oil. It's just a bunch of carrier oil.
Mike: Yeah. Even going back three years now, there's three or four reported studies of inadequate amounts of CBD, high amounts of THC, so by definition, CBD oil that's sold as a supplement has to be under 0.3% THC.
Christopher: I was going to say this is probably a good time to do some introductions because there are all these words and I don't really understand what they all mean like cannabis versus marijuana versus CBD versus THC. What are all these things?
Mike: That's when I started looking at CBD. I tried to go all the way back to what are the first principles. I'm like, okay, CBD comes from the cannabis or also the hemp plant. Okay. Well, what's the difference between hemp? What's the difference between cannabis? What's the difference between marijuana? If you go all the way back, cannabis has been used for literally thousands of years. There was a study showing 2700 years ago -- I think it was in India or China -- they dug up some burial and found a stash of cannabis that appeared to had already been crossbred at that time, so if you go back in time, it's been around for a long, long period of time. The hard part with research in the US is that it's considered a Schedule 1 Drug. A Schedule 1 Drug means there's a super high potential for addiction and there's absolutely no medical use for it, which cannabis doesn't really fit in that category at all.
[0:05:00]
Even in 1994, Marinol, which is a form of THC, was approved as a pharmaceutical. So even during this time, the FDA says, "Hey, here's a pharmaceutical we approve that's basically from cannabis." Boom, the cannabis is a Schedule 1. Cocaine is a Schedule 2 meaning that there is a pretty high addiction potential, but there's a medical use for it, which is, as you may guess, numbing the nose during a surgical procedure, which is actually used.
Christopher: Why didn't they change it then once the drug was approved? Why was cannabis not changed to Schedule 2?
Mike: Oh, that gets into a lot of political stuff back in the '50s and '60s. Nixon threw it in with a lot of the other drugs. Psilocybin, LSD, those are all reclassified around that time too in the Reefer Madness Campaign, which was pretty much all fiction. There wasn't really any good research or medical reason for its rescheduling. Of course, if you make something a Schedule 1, it makes it highly illegal and the amount of paperwork to do research on a Schedule 1 drug is just astronomical.
Christopher: I see.
Mike: So there wasn't a lot of US research on it. Some of the research now is still from all US sources. If you look at what is the difference between cannabis and hemp, can we genetically disassociate them? There are studies that show that you can. The main definition that's used now according to US law, it's considered hemp if it's under 0.3% THC.
Christopher: Okay.
Mike: That was via the Farm Bill. When that happened, which it got changed relatively recently, that it is hemp, if you can say this is hemp, it is regulated under the Department of Agriculture.
Christopher: Interesting.
Mike: If you're a supplement company, you can now obtain hemp if it's low enough THC. It's regulated under the Department of Agriculture, so not the DEA, not the FDA. You're still subject to all the FDA for making it as a supplement, but that does mean that it is not a legal Schedule 1 compound. That opened up the floodgates to manufacturing a lot more CBD with less legal risk because of how it's differentiated at the government level, which also means that CBD is legal in all 50 states and can be sold as over-the-counter supplement. Obviously, cannabis, if you have a high amount of THC, even above that so it's not classified as hemp then it's classified as basically cannabis or marijuana which then is subject to state laws.
Christopher: Can you those two words interchangeably?
Mike: Marijuana is more of a slang term actually. It's actually the cannabis plant. Then within that, if you go to your local dispensary, you're like, "Oh, we have sativa this and we have indica this and we've got a hybrid now," what that was from was there's actually another compound called ruderalis, which is primarily a cannabis plant that's higher in fiber which is considered hemp. The street name, it turns out, that's probably all pretty much BS too because if you said, "Hey, I've got this new strain and I want to determine what it is," cool, I got all the fancy lab equipment or I'll do an HPLC or whatever method I'm going to look at, but I need a known 100% compound to compare it to. Otherwise, I don't know what percentage sativa this is.
It turns out those 100% known compounds just don't exist because the plants have been so crossbred that there's nothing to really compare that to. The folklore of where it came from was sativa, the plant itself, has a different leaf shape, tends to grow very high and a little bit more spread out. So the theory is that because of the structure of the plant, that is very uplifting and makes you feel better and gives you more energy and that the indica is more of this shorter, shrubby-looking plant and then it's closer to the ground. It chills you out. If you look in the research, the first time that sativa was used, as far as I can tell, was 1542.
Christopher: Wow.
Mike: The translation meant cultivated cannabis. Some people were trying to cultivate it. The big guy on that was actually -- his name was Fuchs.
Christopher: We would, of course, link to the spelling in the show notes.
Mike: Yeah. Indica was about 200 years later after that. Even now, like I said, if you go into the stores and they have the hybrid, which is a mixing of the two, genetic studies have been done on that. It's very hard to differentiate the difference. Now, what they're trying to get is there are different -- what they call fact sheets that'll say here's what we think this name of the strain is, here's where we think the sourcing is, but then they'll do a chemical analysis of all the compounds in it.
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Christopher: That's amazing.
Mike: So how much THC, how much CBD, how much of all these other possible cannabinoids that they can look for. They're usually not on the sheet right now, but then they also have all these other compounds like terpenes. Terpenes are in all sorts of different fruits, vegetables, and they account for the distinct smells. If you smell cannabis, some of it smells like diesel fuel. Some of it smells like lemons.
Christopher: From where I am, it always smells like skunk. Sometimes it's indistinguishable between a skunk. We have these stinky skunks where I live and a lot of people that smell weed --
Mike: You're in California, so --
Christopher: In fact, actually, there was a vacant lot right next to ours and there was a big fire in 2008 in Bonny Doon. They evacuated everyone and there was a lot of police and all kinds of other services in and around. The vacant lot, they were growing weed on it and they got busted. I'm not sure, but I think it was just like the number -- it's legal if you have a license. It's not like the plant itself is illegal. It's just that you didn't play by all the rules in order to grow it. I think that's why they got busted.
Mike: Yeah. They've changed the rules and I don't know what the exact rule in California is, but most states have a limit on the number of plants you can grow for personal use.
Christopher: Right.
Mike: Once obviously you get above that, they consider you're doing distribution and you need a license and all of that stuff.
Christopher: Obviously, it makes a lot of sense from a business perspective to have something that's unique like you can only get this from me. We see this with supplements as well. If you can come up with some crazy blend of amino acids or something else then you give it a special label and you can only get it from me then I'm not just going to find out about it on some podcast and then go buy the generic whatever from Amazon.com.
Mike: Yeah.
Christopher: I guess that's what drives people to create these special strains even though they're basically meaningless, right?
Mike: Yeah. The strain name doesn't mean a whole lot because you can take the same strain name from different locations and get different chemical analyses. Maybe at best, it gets you in the ballpark. Amsterdam has gone away from using those names almost altogether, or they're trying to.
Christopher: What do they use instead?
Mike: Well, that's the thing. No one is entirely sure because at one level from a consumer standpoint, having one name associated with one feeling is really, really good for marketing. So if you come in and you're like, "Hey, I want something that's going to really help me sleep at night," they're going to be like, "Oh, you need an indica" versus, "Well, let's break out the fact sheet on each one and look for this or that compound." It unfortunately adds a lot more complexity to the simple story and then we're not even 100% sure what all the terpene compounds do completely in isolation much less all mixed together.
Christopher: Right. Well, that was going to be one of my questions. Do you think it's even possible or useful to try and associate the different applications or effects or indications to specific isolated plant compounds or is it some heterogeneous effect of the cannabis plant? I don't know.
Mike: Yeah. There's the thing they call the entourage effect, which means that it's a synergistic combination of all these different compounds actually in the plant itself. There is good data to support that. If you look at even standardized for CBD and mixed cannabinoids or in different formats versus just 100% pure isolated CBD or even THC, when you have the other plant compounds in and controlled studies, you can get by with less of the active compound, which would support the notion that there is a synergistic effect going on. Those studies have started in the late '90s, but there is some data to support that entourage type effect which -- when anyone talks about synergy, I always get a little nervous because real synergy is --
Christopher: I know. It's real kind of woo, isn't it?
Mike: Very rare. The supplement world has done a horrible job with that of just take more of your creatine and then you take your beta-alanine --
Christopher: I knew you were going to say that.
Mike: -- and then you have a synergistic effect between them. At best, you may have an addictive effect, but --
Christopher: But it makes more sense when they're in the same plant, right? Humans do tend to try and reduce things down to their component parts and --
Mike: Always.
Christopher: -- and don't always understand what they're doing in doing so.
Mike: Yeah. I think the future would be more of a fact sheet. You have a little area on there now that says what are the expected effects from it.
Christopher: That fact sheet that you showed in your talk -- and I will, of course, link to your AHS talk in the show notes -- was quite extraordinary.
Mike: Yeah, super cool.
Christopher: The level of sophistication in that fact sheet was quite amazing.
Mike: Yeah, and the nice part of that is that that allows you to do more of a direct comparison, so in the future, we have more data to say okay, these one, two, three compounds are 80% of the effect or whatever it is.
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If your favorite weed guy doesn't make whatever anymore and you had the fact sheet on it, you could then maybe compare it to something else and have an idea of where to transition and where to start again.
Christopher: I'm just thinking about a recommended system. If you like that then you'll probably like this. You're giving me the attribute --
Mike: I'm sure somebody is working on that.
Christopher: I'm sure someone is. Tell me about the indications or the application. You've mentioned traumatic brain injury. Do you think there's anything there?
Mike: I think so. The data is still a little bit preliminary. One of the studies that was done was retrospective study, looking at THC content because at the time the study was done, THC was illegal, so you can't really do a prospective trial of we're going to dose these people with THC, and these people, we are not.
Christopher: We're going to do something illegal.
Mike: Right. You could, but the amount of paperwork and stuff to do it is very hard.
Christopher: Right.
Mike: So they did a retrospective analysis I think of 447 people and they looked at a tox screen, and people who were positive for THC and people who weren't, so they're just showing did you have THC present or did you not. The group that had THC present, they followed them up for -- I want to say 10 or 11 years. It's quite a while. Their mortality, so a hard end point, were you dead or were you not, which from a statistic standpoint is easy to determine --
Christopher: Right, and we couldn't really care -- Tommy has talked about this in the podcast before like I don't care if you reduce my instance of cancer if that gives me cardiovascular disease.
Mike: Exactly. It's what they call hard end point. They did show that having THC associated was beneficial for mortality. There's some mechanistic stuff done in mice and rats that do support possibly THC, possibly CBD, other cannabinoids, in TBI. One thing that happens in TBI is that all of a sudden, if you take this massive whack to the head, you have two main things that happen. There's a whole bunch of stuff that goes awry, but you have massive energy disruption. Your brain generally runs on glucose for the most part, but it can use ketones. If you get whacked in the skull, the glucose metabolism gets screwed up almost instantaneously. Now, you have a massive energy shortage. You can also have disruption to the blood brain barrier. It can get disrupted and now you've got all these compounds flowing into the brain that normally aren't present. You end up with a massive amount of neuroinflammation at the same time.
CBD and THC and other compounds may help with that neuroinflammation component of it. They seem to tone that down a little bit, but we do know that they do interact on what's called CB1 and CB2 receptors. How much they interact is debatable. Also, there's a very cool mouse study that show that if you had -- I believe it was CBD that was given, or it was a cannabinoid, mixed cannabinoids, I can't remember, that if you then whack the mice on the head, the blood brain barrier stays more intact. Prophylactically, potentially having that onboard before you get hit in the head may reduce your chance of having that blood brain barrier open up. Again, we won't have a prospective study in humans on that. No one is going to volunteer to be like, "Okay. You got cannabinoids. You don't. Okay. You get whacked in the skull really hard. You guys don't."
Christopher: Yeah, I can see that. Do cannabis do anything to rescue energy metabolism? You talked about the problems there with --
Mike: Maybe. I'm not as convinced on that, but there are some backdoor mechanisms where long-term it may be beneficial for that. What I do now, my bias is before I go on kiteboard trips -- I know you kiteboard a lot also.
Christopher: Yeah, I know it.
Mike: A fair amount of fish oil, which I'm normally taking -- so 2g to 3g per day -- increase my dose of creatine monohydrate to 20g per day.
Christopher: 20g of creatine?
Mike: Yeah.
Christopher: Holy shit!
Mike: And that's based on a mouse study. Mice studies, if you transfer them to humans, we're maybe 10g to 20g. In that study, they did take the mice and they did whack some of them on the head with creatine and whacked some on the head who didn't have creatine. I will use mixed cannabinoids standardized for CBD. Right now -- I'm purely guessing on the dosage -- I'm probably around 60mg per day.
Christopher: Okay. How do you define a TBI? I've been kiteboarding. I know what's involved and I don't feel like I've ever really -- I don't wear a helmet. Sometimes you do that whiplash thing where you catch your heel edge your head goes whack down on the water. It's not like I'm seeing stars or anything. Do you think that's enough of an impact to cause traumatic brain injury?
Mike: It's hard because TBI is probably occurring in different intensity. If you have a massive TBI, you'll definitely know. There's not really a lot of question about it.
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A whole bunch of stuff just goes offline from feeling horrible to light sensitivity, testosterone can directly drop, mental fog. It's not really did I have one or not, but you could have accumulation of small amounts of trauma especially with American football players, things of that nature. The mechanisms can also be different and the locations of what actually gets impacted can also be different. TBI is a very broad range term and there are different mechanisms from the brain is sitting inside the skull and it gets hit, so there's direct trauma that way, or if you have a high speed movement, you can shear some of the neurons apart from each other. There are even different mechanisms within TBI itself depending upon what was the mechanism of injury too.
Christopher: Okay. It sounds like it's highly applicable to me then as a kiteboarder and a mountain biker because that's the other thing. I wouldn't say -- unless you count the really -- I do think about this as well, the very violent jolting. I've got --
Mike: Jarring.
Christopher: Yeah. I have suspension in my mountain bike and it's very good, but still, there's probably more jarring than humans were designed to withstand on a regular basis. Then of course if I leave the trail and go into a tree then that could easily be a TBI. Maybe CBD would be indicative for people like me then.
Mike: I think so. I look at what is the potential upside versus what is the potential downside.
Christopher: Okay. Yeah, I very much appreciate that.
Mike: If we don't have a lot of data -- and the data right now is very preliminary -- the first thing I'm going to look at is what's the potential downside? Do we know that these compounds are generally regarded as safe? We've got a fair amount of data showing that they appear to be very safe. Are there issues that could happen? Absolutely. If you drink too much water, water can freaking kill you too, so everything can happen on the downside.
Christopher: It's very expensive there, right? We've been using it in our clinic somewhat. I wouldn't say a lot, but somewhat for gut inflammation.
Mike: Sure.
Christopher: It is like the most expensive supplement that we have.
Mike: Oh, it's very expensive. That's I would say a potential downside. On the upside with TBI, I think it can be beneficial. Again, we don't have a ton of hard data, but for me personally, I'm like, okay, not much of a negative downside other than cost. Potential upside, it's probably unbounded right now. We don't really know what appears to be beneficial, how beneficial, not really sure, but for me, I'll hedge my bets especially if I'm going to -- I was out in Hood River, Oregon for two weeks a couple of weeks ago, kiteboarding every day, and if I'm trying to save a little money, maybe I'll just start loading CBD for two-ish weeks before I go and then just throw out that whole trip. Again, highly theoretical, but I'm condensing that into a period of time where I know I'm probably going to be at a higher risk because I'm trying to mitigate some of the cost for other things like for sleep and stuff like that, which we'll probably get into. I've tested up to 300mg of CBD a day and you can definitely hear a sound of a Hoover Upright on your wallet. It just sucks all the money out of your pockets.
Christopher: Yes, so how much are you talking about? 300mg per day, how much is that going to cost?
Mike: Oh man. I'd have to look. I don't know. I'd have to double-check and run them.
Christopher: Maybe I'll do a [0:23:38] [Indiscernible] and put it in the show notes for this.
Mike: Yeah, because I was using 60mg concentration and I was using five of those, so I want to say it was probably $10 to $30 a day, somewhere in there. That's a guess.
Christopher: So it's kind of up there with the ketone ester. You just reminded me about the ketone ester as a potential neuroprotective agent. Have you thought about that for your kiteboarding too?
Mike: Yeah. I carry the HVMN ester in my --
Christopher: These bloody health coaches, they're dripping in money.
Mike: I know. The good part is because I'd only use it if I get whacked in the head really hard. I have the same vial. Maybe it's not good anymore.
Christopher: Oh, so you're thinking not as a prophylactic, but as a --
Mike: Yeah. I think prophylactically, it might be helpful, but man, that gets expensive fast at 25 to 35 bucks a pop, my thought being if something happens and I get to shore, I'm probably going to be fasting at that point and then I'll take that as soon as I possibly can to try to -- because we know some of that disruption occurs within minutes to hours. Four hours, a lot of it peaks. So my thought is if I can get super high levels of ketones within a short period of time -- so I have used the ester and I have tested my ketones. I can easily get over two to maybe sometimes three with just one of the vials depending upon other conditions, that kind of stuff. My thought is if I'd do that, maybe that'll be a bridge to try to mitigate some of that energy crisis --
[0:25:03]
Christopher: Right, because that can rescue -- Brianna Stubbs talked about the potential to rescue energy metabolism in the brain recently with the ketone ester.
Mike: Yeah. I probably should have another one because for someone my size -- and I talked to her like I probably need a dose of two of them actually --
Christopher: See, you've got me worried now. Cyclocross season is coming up and I could easily end up in a TBI as well. Maybe I should be thinking -- I didn't even wear a helmet when I was kiteboarding.
Mike: I usually wear a helmet now just because I've taken some pretty bad thrashes and stuff like that. It depends on what I'm doing or where I'm going, but I probably wear helmet 90% of the time.
Christopher: Do you use the strap that connects your board? I think that's a --
Mike: Oh, no.
Christopher: Yeah, I was going to say it. That thing is freaking lethal.
Mike: Yeah. I'll be honest. Probably four or five years ago, I did and I never had any issues with it. I use the one for surfing, so if it gets pulled too hard, it will snap, but I don't think having a hard implement potentially coming back at your head is a good idea.
Christopher: Yeah. I realized I should explain this now for the listeners. In kiteboarding, some people -- so you use the leash, right? The problem with kiteboarding is if you get separated from your board, you're kind of screwed because it's really difficult to go upwind to get it, which is inevitably what happens. It can be done, but it takes forever. Sometimes I've seen -- and you've seen this. People are like half an hour or even three quarters of an hour going backwards and forwards, trying to get back at wind just so they can get their board. The temptation is that you're going to attach yourself to the thing with a leash, but then what happens is if you get catapulted away from your board quickly, the tension in the leash builds and then it fires the thing at the back of you. I remember the first time I got hit by it. It hit me on my waist harness, so it's kind of padded, and it still nearly snapped me in half. I thought my God, if that hit me in the ribs or something --
Mike: Or in the head.
Christopher: Or in the head, it would've been lights out, right?
Mike: I would never use a leash without a helmet. Even then, I wouldn't recommend a leash. A good buddy of mine was in Dominican Republic and I told him, I'm like, "Dude, I should probably just pay you to take a lesson to figure out how to get my board back." He was super helpful. In Cabarete, it's kind of weirdly wavy and stuff, and so the hard one was you wouldn't see your board because of the waves. It would disappear behind the wave. What I found out, the trick to it -- and he taught me -- is as soon as you blow your board off, just automatically start heading upwind. Don't even look for your board. Don't worry about it. Count to 16, so I'm going upwind away from it, turn around, and then count backwards and come back through that area. At some point, because the board is going to drift a certain way, you'll actually come back to it.
Christopher: Okay.
Mike: The only exceptions are maybe if there's a really, really strong current, things like that. Amazingly enough, luckily there, I lost my board a bunch of times and I got back to it every time. Recently, a buddy of mine lost his board, wasn't able to get back to it, so I had to practice going to get his board, finding it, and then trying to carry it while you're kiteboarding. That was way harder than I thought it was going to be.
Christopher: Oh, yeah. I still think I can't do that. I really want to help someone that's lost their board, but I can't do it. Once I'm holding their board, I can't get back up on climbing again. I'm not really -- I'm worst than useless. The person thinks they're going to get their board back, but I'm just dicking around.
Mike: Yeah, that's happened too. Yeah, I think it can be helpful to that. Again, ketones, I think, can be helpful with that too. We know that there's not much of a negative downside and there's probably a fair amount of potential upside with that also. I think having that as a bridge is useful, which then makes you think even in the future NFL games, things of that nature, maybe they have their glucose drink on the side and they have the ketone drink on the side. You get whacked in the skull and no more glucose, maybe only ketones for you, or maybe we mix them prophylactically before you go out. Again, that's all highly theoretical. There's stuff about how the salt is going to be able to get you high enough as a ketone salt. You may need an ester, what type of ester or what type of byproducts, that type of thing.
Christopher: Talk about sleep. When Tommy first started looking at the data on this, he found this ancient paper that I know you know and it looks like cannabidiol, the CBD, it increased growth hormone and then altered the metabolism of cortisol, so it looks on paper like a stimulant. That led to our recommendation that you should probably split this into doses in the early part of the day because there's a chance it could interfere with your sleep. This was at the 60mg range split into four doses, but anecdotally, people say that CBD is good for their sleep. In fact, I think even Tommy is saying that now, maybe not at the 60mg range, but lower doses than that, micro doses. I'm not exactly sure. I'll have to ask him what he's using, but he's saying that it improves his sleep, which is paradoxical, right?
Mike: It can. There's one other recent study -- I know the paper you're talking about. I believe the scanned copy of it is super, super old.
[0:30:03]
Christopher: I'll link to it again in the show notes, but it's ancient.
Mike: Yeah. Well, it appears to be there's a different effect if you take it in the a.m. versus the p.m. In the a.m., it appears to help a little bit with reduction of anxiety, maybe a little bit of focus. It doesn't appear to make you sleepy unless you go up to a massively high dose. In the p.m., it appears to increase paradoxically sleep, so that may have to do with how it interacts with other compounds or hormones, which is really trippy to wrap your head around because you think caffeine, oh shit, I drink caffeine in the morning and I get the same response. I drink caffeine at night and I get the same response, but it appears that the response may actually be a little bit different and that does match a lot of the anecdotal stuff. I've tried that too where I take pretty high doses in the morning and I don't really get sleepy, but I take it in the evening and it does appear to help my sleep a little bit. I don't know. It's still hit or miss.
Christopher: Right.
Mike: I've noticed for myself personally, 60mg or more is probably the minimum threshold, but I have other clients show me their data at 20mg and they've seen an increase in it too. The research on sleep is all across the board. There is one brand new study that just came out in August that actually looked at randomized trials that have been done with it and they said that it appears to show a benefit. However, it's very limited data, low number events, some of the trails aren't properly controlled, all that kind of stuff scientists throw in when they're basically like, "Oh, we don't really know for sure."
Christopher: And then typically, how would they assess sleep in a study like that?
Mike: Well, that's the other question too. What are you looking at? Are you looking at a full PSG sleep study? Are you looking at self-report? Are you looking at any other markers? Then you get into the whole argument of, well, if I throw someone in a sleep lab and told them to sleep, are they really sleeping like they normally would? Now you give this other compound --
Christopher: And you've got this other group that doesn't go to the lab, and guess what?
Mike: Right, exactly. Yeah. There is good data to support that the endocannabinoid system is regulating sleep, pain, and a bunch of these other things. Initially, I looked at a lot of the claims that are made on CBD now and my first thought was, "That's all bullshit. There's no way. This is all just crap." Then you look at the endocannabinoid system and you're like, wow, that is all throughout the body. It does potentially help regulate sleep. It does help manage pain. It does do all these other things, so if CBD is interacting with that system, which it appears to, although not in a really super clean fashion, then there is the physiologic underpinning that it might be beneficial in a lot of other cases, anxiety, things like that. The actual hard data on that is debatable. The top three are potentially sleep, head trauma, there's some very interesting research on pain --
Christopher: Well, that was going to be my next question. What do you think about pain?
Mike: I think that there's pretty good data on that. Again, like I went into the talk, now you get into the messy area of okay, was it a CBD tincture? Was it an isolated CBD? Was it with mixed cannabinoids? What was the dose? When was it given? If you're looking at states where cannabis is legal, now you're looking at okay, did you just roll a joint of X amount percent THC to CBD? Did you put it in the vaporizer? If you vaporize the actual flower or the compound itself, what temperature did you vaporize it at? Because that will affect the compounds that come out. If you're doing a super low temperature, you'll get more of the other terpene compounds at a much higher percent. You actually won't get a lot of THC or CBD. The boiling point of CBD and THC are almost identical. They're very, very, very close, so you can't differentiate those two by just changing the temperature. You would have to change that by actually having the raw material be different. That's the part where it gets really messy when you're trying to look at all the different research studies, is you're going to go all the way back and have to look at what was the method.
Then with pain stuff, you look at animal studies. How do they induce pain? How do they report pain? With humans, they just use VAS, visual analog scale. What type of pain? There are different types of pain. Was it more of an in-hospital clinical study where they're giving a set dose to maybe people who have neural pain or something like that or bone pain or whatever and then just asking them, "How did you feel afterwards?" which again, for pain, it's probably a valid marker, but when you look at other studies for that, lots of stuff can modify pain too. I think for pain, it's probably pretty useful especially when you start getting into inhaled version especially with some THC, having some THC and CBD for pain.
[0:35:03]
There's some good data that shows that. There are a lot of anecdotal reports that yeah, that's probably pretty good. If you're using an edible version of a THC, that's actually a completely different compound in the liver, so it gets converted to 11-Hydroxy-THC, which for all rightful purposes, is a completely different drug.
Christopher: Wow.
Mike: There are some big anecdotal reports especially in people who come back for the military who have lost limbs. The phantom limb pain, I've talked to a lot of people in Colorado, ex-special forces, people come back, off the record, they report they use pretty high levels of edibles and they said that, for a lot of them that I talked to, that was the only thing that touched their phantom limb pain.
Christopher: Oh, really? So they've tried different methods of taking the drug --
Mike: A lot of them tried just about everything. If you've got a missing leg where you've got this blinding pain like you still have a leg, I get it. I would probably try just about anything. People are frankly scared away from opiates or things of that nature for a good reason, so different drugs appear to affect different maybe even types of pain.
Christopher: Right. Okay. What would you recommend? I guess it just depends on the application then. I worry about -- I don't want to be smoking stuff or vaping things like putting shit into my lungs that's not supposed to be there. That sounds like just a terrible idea in general. And then edibles, you totally end up with a completely different thing --
Mike: That's the hard part because if you're using an edible, a different pathway, so first phase, the liver will change the drug, but it's different than if you use vapor or inhalation. My bias if you find that you're in a state where it's legal and you're like, "I find that edibles didn't really do much of anything for it," I would look at a vape that is only the actual flower itself. There's a company out at Boulder called the Grasshopper. They have a vape where you can basically put in just the flower material itself and you can adjust the temperature. At least that way, you know there's no other compound that you're ingesting
Christopher: Wow. The level of sophistication is amazing.
Mike: Oh, it's crazy and it looks like a pen. I have one, but it actually looks like a pen. I could set it down on this table and most people would probably not even think anything about it. If you get into the oils, you have to be very careful and ask the manufacturer, "What else did you put in here? Can you guarantee what is the purity?" that kind of stuff. Price point is a good guide because if you're maybe just putting a bunch of THC and a bunch of oil, maybe throwing some other stuff there, you want to look to see what you have, or at least if it's just the vaping of the actual flower material itself, I know that there wasn't anything extraneous that's being entered into that equation.
Christopher: Okay. So you don't think the vaping is inherently harmful then? You don't --
Mike: Oh, it's highly debatable. There are only a couple of studies that have looked at that. It doesn't appear to be nearly as bad as cigarette smoking, things of that nature. If you look at long-term outcomes, even with just joints or rolled cannabis in terms of cancer, rates don't appear from what I've seen to be really high. I won't say that it's a guarantee that you're not. Anytime you're burning something and inhaling it into your lungs, there's probably going to be some type of reaction, but it doesn't appear to be nearly as bad as cigarettes and things of that nature.
Christopher: You say not as bad, but is it just not as well studied?
Mike: Well, that's the thing. The data we have now would say that it doesn't appear to be nearly as bad, but again, it's how much data do you want to see and need to see. Right now, there's just not a ton of data. The data we have shows that it doesn't appear to be super bad. It's like the same thing with sciences. They're like, "All right. We've got 12 studies that show that this is a good thing" like the early research in creatine. First five studies, oh, really positive. You could say, "Oh, that's just five studies. That doesn't mean anything." Okay, 12 studies, 11 of the 12 are positive. "I don't know. That's just not really quite enough data for me." What do you need to reach a consensus is now we have almost 500 peer reviewed studies on creatine, most of them all show it's positive. Yeah, now we can probably say there's a very good consensus that it's good. That's taken decades and millions of dollars and by far the most studied supplement ever, and then who's going to pay for the studies? Who's going to do the study? It's a long-term study. How long are you going to look at it?
Christopher: Yeah. That was something you mentioned in your talk, is that this is now big business, right?
Mike: Oh, yes.
Christopher: We're not talking about impoverished companies white labeling the same creatine that everybody uses.
Mike: Yeah. Cannabis, the CBD market, is estimated just to be around -- the last one I saw, it was $23 billion within a few years.
[0:40:04]
The fastest-growing area is beverages, so you'll see CBD in almost every beverage now. In the talk -- I said I was in Hood River -- you can get CBD added to your coffee for $2.
Christopher: Wow. Do you think there's actually any CBD in there? Do I need to see -- up until now, I was like, well, if I don't see the certificate of analysis, I'm not interested. If you can't show me how much of the compounds is in it --
Mike: Yeah, and that's the hard part. You want to know how much of the compound is actually in there. A lot of it is just really small doses, 2mg to 5mg, which probably not going to do much of anything. There is another company that has 25mg in theirs. Again, for how much it costs right now, I look a lot at price point. If you know anything about the beverage market in general, yeah, they want to give the highest price point they can, but at some point, you're not going to pay $10 for an energy drink, right? There's a point where lowering the price, you're going to make up for it in volume.
If you add something that's expensive -- so CBD right now is very expensive -- where's that happy medium where people are willing to pay for it, you can get your money back, it's a legit amount in there and make money on it, and you know that some people are just going to put it on the label and probably not put anything in there potentially until it's been tested and all that kind of stuff. Yes, it's still regulated by the FDA. Yes, you'd be in violation of the FDA because you're violating the ingredients you have on the container, so it is regulated. The hard part is it's not really enforced, so who's going to do that? Now, there are tons of CBD companies. As of this recording, the FDA hasn't really cracked on too many of them yet. I have a feeling that that's probably coming.
Christopher: Oh, really?
Mike: The rumors I've heard, which again is just completely a rumor at this point and hearsay, they may go after a couple of the top manufacturers that try to set a precedent for the industry probably because if you have a limited manpower, that kind of makes the most sense, not that I agree with it. Trying to chase down all these other small-fly-by-night companies, that's a lot of time, a lot of money, and the reality is the FDA just doesn't have much money put into enforcement for supplements. They just don't.
Christopher: What about people that get drug tested? Should they be worried about it either as a performance enhancing drugs in sport or maybe do a job where you get drug tested too? If I buy some isolated CBD oil online, should I be worried about the THC concentration that may get me busted at work or in a bike race?
Mike: I would say yeah because there is research to show that THC amount in some of the things that were tested was much higher than what was stated on the label.
Christopher: Okay. Could that vary from batch to batch as well? So the certificate of analysis that they published on the website, it costs a lot of money to do that stuff. They're not going to run every batch.
Mike: I would ask them that like, "How often do you run this? Are you taking certain samples? Do you do it per batch? What percentage do you test down to?" because by virtue of dealing with those compounds, there's going to be some THC in there. Now, that may be a one-billionth amount of whatever --
Christopher: But there must be a cutoff for the drug test. It's not like they're going to bust you if they find one molecule --
Mike: And that's the thing. There are all sorts of different drug tests. Are they just using a simple urine test? Are they using a blood test? What is their threshold? What are they cutting off too? If you go back in time to the Olympics -- I was just hanging out in the room where people were smoking. That potentially depended on what level you're looking down to.
Christopher: Do you buy that? I'm laughing. Do you buy that as the --
Mike: I would say it's possible depending on what level you're looking to. For people looking at it, I would say figure out what your testing is. Call and ask them and say, "Hey, are you testing now to a very low level?" because the reality is you're dealing with people who live in states where it's legal. If we're in California and we're hanging out with some people and they're doing something and I walk by, there's not a lot of good data to show what your risk is. From what I've heard, most companies aren't testing down to very, very, super low level because the testing is more expensive, but for CBD, because THC is legal in the product up to 0.3%, and if you have a drug test and it's at a very low level, that could be enough to have an issue.
There are companies who do make a CBD-only isolate. I know Charlotte's Web does make one. Again, I would probably only go with a very top manufacturer and I would call them to ask them what is their testing procedure and then what is the amount that they will test down to, but like I said, there's some very, very infinitesimal, small amount there. What is the analytical method and what is that testing limit? That CBD-isolated oil will be much more expensive.
[0:45:01]
Why? Because of additional processing, and also for the company, it's an additional risk because you are stating that, "Hey, we're putting our name on this. We are saying that this has a very low or zero percent THC." They don't want someone to come back after them and say, "Okay, we tested positive" and get into that whole thing, assuming you're a legit company trying to do it by legit reasons.
Christopher: Okay. We talked about traumatic brain injury. We talked about sleep. We talked about pain. Is there a potential ergogenic effect because it is a banned substance, right? I shouldn't be --
Mike: In most places, yeah.
Christopher: Okay.
Mike: You have to check what the ruling is because it does change. I can't say what organizations, but I know -- very high level organizations that make lots of money where humans run into each other are extremely interested in something that would be legal that may be a neuroprotective effect and there have been various lobbyists stating that maybe allowing a small amount of THC to lighten up the restrictions, that may actually be beneficial potentially for some of the players.
Christopher: Right.
Mike: I believe Robert Oberst was saying that World's Strongest Man, they do not test for marijuana anymore, I believe, partially because a lot of the people doing that were using it for pain relief and they said, "We'd much rather use this than take a bunch of opiates," but most sporting organizations right now, it's still considered a banned substance.
Christopher: Okay, so do you think this is going to help me win bike races?
Mike: Data on that is not super good. A lot of it is super old too. Data in performance, especially aerobic performance, usually the anecdotal thing you'll hear people say is, "It's so much easier. Everything felt better." Then I always ask them, "What was your hard performance data? It may have felt better because you're a little spacey and weren't paying attention, but did you actually perform better?" Most of the data that I pulled so far shows not a huge aerobic benefit that we've seen. Again, at a certain dose, work capacity went down. One of the studies had a thing that a certain percentage of people were not able to complete the work at all, which kind of makes sense, if you think about it. You do a little bit too much and you're [grunting] getting on that bike.
Christopher: Yeah. Anecdotally in Santa Cruz, I know lots of people that use it in the middle of bike rides and it seems unthinkable to me, but maybe I just don't understand the effects.
Mike: I've had people who do a lot of Brazilian jujitsu, things of that nature, report that it helps quite a bit. It's probably a personal thing. Again, there's just not a ton of data on that because again, most is probably funding, who's going to pay for it. And they get into the whole thing of what was the delivery method, what was the amount. You could even get into the genetic stuff. Some people have maybe faster metabolisms, all the different compounds. Some people will get a little paranoid. Also, how often do people use it? If you're more accustomed to using it, maybe you have a different motor learning effect because you've got learning going on with these compounds present. Maybe you need to do it under that condition.
Christopher: Pair conditioning.
Mike: Right. There's an old Russian research that showed giving people stimulants and then testing them. I don't remember what the stimulant was. Maybe it was Adderall or something similar. Basically, what the rumor was, what they found was if you didn't study under the stimulant, your testing didn't do better. So just giving someone a stimulant before a test, the testing got worse, but if you pair the condition right, if I study under a stimulant and I take the test under the stimulant then the scores are actually a little bit higher.
Christopher: Okay.
Mike: Now, it kind of makes sense with how you think about motor learning, what do you think about what's going on there, different things like that too. I've wondered about that in some of the caffeine studies also, do you train with caffeine and then does that transfer and that type of thing. Performance-wise, most of the data would say probably not a huge performance boost that we have seen so far.
Christopher: Okay. Well, let's tell people what we told them, see if I can summarize it for you. You talked about TBI and you think there's something there. In fact, you are using it. You talked about sleep and you think there's something there and people were getting benefit. You talked about pain and there's something there and people getting benefit, but as an ergogenic aid, probably not.
Mike: Probably not, and as I said, the ergogenic aid probably also really, really depends on what are you doing. Pool is even considered a sport, which would be very different than a mountain bike race or a kiteboard race or a power lifting event, so the amount of variables you're dealing with when you talk about just sport in general is massive.
Christopher: Yeah, it's not specific enough.
Mike: Even now, we're arguing still how many years later about the effect of freaking carbohydrates. How many studies have we looked at on carbohydrates for hundreds of years? The odds that we're going to have a simple answer on it in the next two, five, ten years are very unlikely.
Christopher: Well, this has been very helpful. Thank you very much, Mike. I will link to your Ancestral Health Symposium talk in the show notes for this episode that you can find over at nourishbalancethrive.com/podcast. Tell me, do you have space in your coaching practice? It's primarily strength athletes that you work with. Is that correct?
[0:50:10]
Mike: Yeah, primarily strength athletes, obstacle course racers, some crossfit people, people who are just looking to feel better, move better, better health, things of that nature. Yeah, I do have a few spots open. It may not --
Christopher: By the time I get this out -- yeah.
Mike: Yeah, so if you want info, just go to www.miketnelson.com. At the top, there's usually a way to get on the newsletter. Most information goes out over the newsletter. I also have a certification, which is just flexdiet.com. That's just talking about everything on the recovery side from nutrition, sleep, different impacts of that, mostly designed for more fitness trainers enthusiasts or people who run a gym that are trying to get more of the nutrition practice to go with their gym.
Christopher: Excellent! Well, thank you so much. I very much appreciate you.
Mike: Yeah, thank you very much for having me. I appreciate it, man!
Christopher: Thank you.
Mike: Yeah.
[0:51:08] End of Audio
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