Jump to content
We need you! See something you could improve? Make an edit and help improve WikSM for everyone.

Cannabidiol

From WikiSM

Alternative Names

  • CBD
  • Cannabidiol
  • Hemp-derived CBD
  • Cannabidiol extract
  • Hemp extract
  • Phytocannabinoid
  • Non-psychoactive cannabinoid

Background

  • This page covers the supplement Cannabidiol (CBD)

History

  • Early adoption among athletes was driven by anecdotal use for pain, inflammation, and recovery[1]
  • In 2018 WADA removed CBD from its prohibited substances list, allowing athletes to use it legally in competition while other cannabinoids remained banned.[2]

Introduction

Cannabidiol (CBD)

different types of CBD products[3]
Dietary and bioactive constituents of cannabis. CBD, cannabidiol; THC, tetrahydrocannabinol[4]

General

  • Cannabidiol (CBD) is a non-psychoactive phytocannabinoid derived from the hemp plant
  • Commonly used by athletes for recovery, pain relief, sleep support, and inflammation control without intoxicating effects[5]
  • Interest in CBD has increased in sports due to concerns over opioid use and NSAID-related adverse effects in managing musculoskeletal pain.

Mechanism

  • CBD modulates the endocannabinoid system indirectly, influencing CB1 and CB2 receptor activity involved in pain and inflammation pathways[6]
  • It interacts with serotonin (5-HT1A) receptors, contributing to anxiolytic and potential sleep-enhancing effects relevant to athletic recovery
  • CBD also affects TRPV1 receptors and inflammatory mediators, which may play a role in reducing nociception and exercise-induced inflammation

Formulations

  • Oral forms include oils/tinctures, capsules, and softgels, which provide systemic effects but have variable bioavailability
  • Edible formulations such as gummies and beverages offer convenience but have delayed onset due to first-pass metabolism
  • Topical and transdermal products (creams, balms, patches) are used for localized musculoskeletal symptoms
  • Inhaled forms (vaping) provide rapid onset but raise safety concerns related to pulmonary exposure

Terminology

  • Full-spectrum CBD contains multiple cannabinoids, including trace amounts of THC
  • Broad-spectrum CBD contains multiple cannabinoids but is processed to remove THC
  • CBD isolate refers to purified cannabidiol without other cannabinoids or plant compounds
  • Additional terms include hemp extract, phytocannabinoid, and nano-CBD (engineered for improved absorption)

Controversy

  • Product labeling is inconsistent, with studies showing variability in CBD concentration and presence of undisclosed THC[7]
  • Despite World Anti-Doping Agency permitting CBD, THC contamination may still result in positive drug tests for athletes[8]
  • High-quality clinical evidence in athletes remains limited, with most data extrapolated from non-athlete populations[5]
  • Regulatory oversight varies widely across countries and organizations, creating uncertainty in safety, legality, and standardization[9]

Athletic Performance Benefits

Cannabidiol (CBD) benefits

Pain Relief (Analgesia)

  • May reduce musculoskeletal and neuropathic pain via endocannabinoid and TRPV1 pathways[10]
  • May enhance anandamide signaling contributing to analgesia without opioid pathways[6]
  • May provide an alternative to NSAIDs and opioids for pain management in athletes

Anti-Inflammatory Effects May reduce pro-inflammatory cytokines such as TNF-α and IL-6[11] May modulate immune response and oxidative stress pathways after intense exercise May help reduce exercise-induced inflammation and tissue irritation

Muscle Recovery

  • May reduce delayed onset muscle soreness (DOMS) through anti-inflammatory and analgesic mechanisms[5]
  • Commonly used by athletes to support recovery between training sessions
  • May allow improved training consistency by reducing soreness-related downtime

Sleep Optimization

  • May improve sleep quality by reducing anxiety and promoting relaxation[12]
  • May help with sleep onset and maintenance in individuals with sleep disturbance[13]
  • Improved sleep may indirectly enhance recovery and performance[14]

Anxiety / Stress Reduction

  • May reduce performance anxiety via 5-HT1A receptor interaction[15]
  • May decrease stress response and improve mental focus under pressure[16]
  • May support recovery by reducing psychological stress load

Neuroprotection / Head Injury Support

  • May provide neuroprotective effects through antioxidant and anti-inflammatory mechanisms[17]
  • May reduce excitotoxicity and oxidative stress following brain injury
  • Potential role in concussion management remains investigational[5]

Other Health Benefits

Differences between hemp and marijuana as well as the effects of cannabidiol (CBD) versus tetrahydrocannabinol (THC). Hemp and marijuana are not scientifically differentiated but are legally classified according to the content of THC[18]
Cannabidiol (CBD) benefits

Cannabidiol (CBD) supplement


Mood Disorders (Depression / Stress)

  • May modulate serotonin signaling contributing to antidepressant-like effects in preclinical models[19]
  • May reduce stress-related behaviors and improve mood in early human studies[13]

Substance Use Disorders

  • May reduce cue-induced craving and anxiety in opioid and heroin use disorder[20]
  • May have potential role in nicotine and cannabis dependence through modulation of reward pathways[21]

Gastrointestinal Effects

  • May reduce intestinal inflammation via modulation of enteric cannabinoid receptors[22]
  • May help with symptoms such as abdominal pain and motility disorders in preclinical models

Dermatologic (Skin Health)

  • May reduce sebocyte activity and inflammation relevant to acne pathogenesis[23]
  • Exhibits anti-inflammatory effects that may benefit conditions such as eczema and psoriasis[11]

Immune Modulation

  • May suppress excessive immune activation through cytokine modulation[24]
  • May promote a shift toward anti-inflammatory immune profiles in preclinical studies

Bone Health

  • May enhance fracture healing and bone remodeling via cannabinoid receptor signaling[25]
  • May improve collagen cross-linking and bone strength in animal models

Metabolic Effects

  • May influence glucose metabolism and insulin sensitivity in early studies[26]
  • May affect lipid metabolism and body weight regulation via endocannabinoid pathways

Respiratory Effects

  • May have bronchodilatory and anti-inflammatory effects in airway models[27]
  • May reduce airway hyperresponsiveness in preclinical asthma models

Antimicrobial Effects

  • Demonstrates antibacterial activity against Gram-positive organisms including resistant strains (e.g., MRSA)[28]
  • May disrupt biofilm formation and bacterial virulence in early studies

Anticancer (Experimental)

  • May induce apoptosis and inhibit proliferation in certain cancer cell lines[29]
  • May reduce tumor growth and metastasis in preclinical models

Ophthalmologic Effects

  • May reduce intraocular pressure in some experimental settings[30]
  • Effects are variable and may differ based on dose and formulation

Anti-Nausea Effects

  • May reduce nausea via serotonin and central nervous system pathways[31]
  • Evidence strongest in chemotherapy-related nausea, extrapolated elsewhere

Seizure Reduction

  • Reduces seizure frequency in certain epilepsy syndromes[32]
  • Basis for FDA-approved CBD medications such as Epidiolex

Cardiovascular Effects

  • May lower resting and stress-induced blood pressure[26]
  • May have vasodilatory and anti-inflammatory vascular effects

Dosing

  • No standardized dosing for athletes; commonly reported ranges ~10–50 mg/day with higher doses used in clinical settings[33]
  • Dose-response appears variable with potential biphasic effects depending on dose and indication[15]
  • Oral bioavailability is low and inconsistent, often requiring individualized titration
  • Start low and titrate based on symptom response and tolerability[1]

Safety Profile

  • Generally well tolerated with favorable safety profile in most studies[1]
  • Does not produce euphoria or cognitive impairment typical of THC[6]
  • Low abuse and dependence potential compared to other substances used in sport[34]
  • Long-term safety data in healthy athletic populations remains limited

Adverse Effects

  • Common side effects include fatigue, diarrhea, and changes in appetite or weight[1]
  • May cause sedation or somnolence, particularly at higher doses[32]
  • Elevated liver enzymes reported in some clinical populations
  • Potential for contamination (e.g., THC) leading to unintended effects[7]

Pharmacokinetics

Metabolism of cannabidiol [59,60,61,62,63,64,65,67,68]. Abbreviations: 7-COOH-, 7-OH-CBD:7-Carboxy-, 7-hydroxycannabidiol; CBD: Cannabidiol; CYP: Cytochrome P450; p.o.: Per os, orally; s.c.: Subcutaneously; THC: Δ⁹-Tetrahydrocannabinol; UGT: UDP-Glucuronosyltransferase.[35]
  • Oral CBD has low and variable bioavailability due to first-pass metabolism[33]
  • Lipophilic compound with improved absorption when taken with high-fat meals
  • Metabolized primarily in the liver via cytochrome P450 enzymes (CYP3A4, CYP2C19)[36]
  • Half-life varies widely depending on route and chronicity of use

Interactions

  • Inhibits CYP450 enzymes, potentially increasing levels of co-administered medications[36]
  • May interact with anticoagulants, antiepileptics, and sedatives[1]
  • Potential additive sedation when combined with CNS depressants
  • Requires caution in athletes taking multiple supplements or medications[7]

WADA Considerations

  • CBD is permitted in sport by the World Anti-Doping Agency
  • All other cannabinoids (including THC) remain prohibited in competition[37]
  • Risk of THC contamination in supplements may lead to positive drug tests[7]
  • Athletes should use third-party tested products to reduce doping risk

See Also

References

  1. ↑ 1.0 1.1 1.2 1.3 1.4 Huestis, Marilyn A., et al. “Cannabidiol Adverse Effects and Toxicity.” Current Neuropharmacology, vol. 17, no. 10, 2019, pp. 974–989.
  2. ↑ World Anti-Doping Agency. “Summary of Major Modifications and Explanatory Notes: 2018 Prohibited List.” WADA, 2018.
  3. ↑ Kudrich, Christopher, and Christina Wiggin. "When your patient asks about cannabidiol." Clinical Phytoscience 11.1 (2025): 14.
  4. ↑ Fordjour, Eric, et al. "Cannabis‐infused foods: phytonutrients, health, and safe product innovations." Comprehensive Reviews in Food Science and Food Safety 23.5 (2024): e70021.
  5. ↑ 5.0 5.1 5.2 5.3 McCartney, Daniel, et al. “Cannabidiol and Sports Performance: A Narrative Review of Relevant Evidence and Recommendations for Future Research.” Sports Medicine, vol. 50, 2020, pp. 2079–2091.
  6. ↑ 6.0 6.1 6.2 Ibeas Bih, Carolina, et al. “Molecular Targets of Cannabidiol in Neurological Disorders.” Neurotherapeutics, vol. 12, no. 4, 2015, pp. 699–730.
  7. ↑ 7.0 7.1 7.2 7.3 Maughan, Ronald J., et al. “Dietary Supplements and the High-Performance Athlete.” British Journal of Sports Medicine, vol. 52, no. 7, 2018, pp. 439–455.
  8. ↑ World Anti-Doping Agency. “Summary of Major Modifications and Explanatory Notes: 2018 Prohibited List.” WADA, 2018.
  9. ↑ Corroon, Jamie, and Rod Kight. “Regulatory Status of Cannabidiol in the United States: A Perspective.” Cannabis and Cannabinoid Research, vol. 3, no. 1, 2018, pp. 190–194.
  10. ↑ Vučković, Snezana, et al. “Cannabinoids and Pain: New Insights from Old Molecules.” Frontiers in Pharmacology, vol. 9, 2018, article 1259.
  11. ↑ 11.0 11.1 Atalay, Selin, et al. “Antioxidative and Anti-Inflammatory Properties of Cannabidiol.” Antioxidants, vol. 9, no. 1, 2020, article 21.
  12. ↑ Babson, Kimberly A., et al. “Cannabis, Cannabinoids, and Sleep: A Review of the Literature.” Current Psychiatry Reports, vol. 19, no. 4, 2017, article 23.
  13. ↑ 13.0 13.1 Shannon, Scott, et al. “Cannabidiol in Anxiety and Sleep: A Large Case Series.” The Permanente Journal, vol. 23, 2019.
  14. ↑ Fullagar, Hugh H. K., et al. “Sleep and Athletic Performance: The Effects of Sleep Loss on Exercise Performance, and Physiological and Cognitive Responses to Exercise.” Sports Medicine, vol. 45, no. 2, 2015, pp. 161–186.
  15. ↑ 15.0 15.1 Zuardi, Antonio W., et al. “Cannabidiol, a Cannabis sativa Constituent, as an Anxiolytic Drug.” Brazilian Journal of Medical and Biological Research, vol. 36, no. 4, 2003, pp. 421–427.
  16. ↑ Bergamaschi, Mateus M., et al. “Cannabidiol Reduces the Anxiety Induced by Simulated Public Speaking in Treatment-Naïve Social Phobia Patients.” Neuropsychopharmacology, vol. 36, 2011, pp. 1219–1226.
  17. ↑ Hampson, A. J., et al. “Cannabidiol and (−)Δ9-Tetrahydrocannabinol Are Neuroprotective Antioxidants.” Proceedings of the National Academy of Sciences, vol. 95, no. 14, 1998, pp. 8268–8273.
  18. ↑ Liu, Zhenhua. "Cannabidiol (CBD) and colorectal tumorigenesis: potential dual modulatory roles via the serotonergic pathway." Current Oncology 32.7 (2025): 375.
  19. ↑ Zanelati, Thalita V., et al. “Antidepressant-Like Effects of Cannabidiol in Mice: Possible Involvement of 5-HT1A Receptors.” British Journal of Pharmacology, vol. 159, no. 1, 2010, pp. 122–128.
  20. ↑ Hurd, Yasmin L., et al. “Cannabidiol for the Reduction of Cue-Induced Craving and Anxiety in Drug-Abstinent Individuals with Heroin Use Disorder.” American Journal of Psychiatry, vol. 176, no. 11, 2019, pp. 911–922.
  21. ↑ Prud’homme, Mathieu, et al. “Cannabidiol as an Intervention for Addictive Behaviors: A Systematic Review of the Evidence.” Substance Abuse: Research and Treatment, vol. 9, 2015, pp. 33–38.
  22. ↑ Pellati, Federica, et al. “Cannabinoids and the Gastrointestinal Tract.” European Journal of Pharmacology, vol. 720, no. 1–3, 2013, pp. 57–66.
  23. ↑ Oláh, Attila, et al. “Cannabidiol Exerts Sebostatic and Anti-Inflammatory Effects on Human Sebocytes.” Journal of Clinical Investigation, vol. 124, no. 9, 2014, pp. 3713–3724.
  24. ↑ Nagarkatti, Prakash, et al. “Cannabinoids as Novel Anti-Inflammatory Drugs.” Future Medicinal Chemistry, vol. 1, no. 7, 2009, pp. 1333–1349.
  25. ↑ Kogan, Nir M., et al. “Cannabidiol, a Major Non-Psychotropic Cannabis Constituent Enhances Fracture Healing and Stimulates Lysyl Hydroxylase Activity in Osteoblasts.” Journal of Bone and Mineral Research, vol. 30, no. 10, 2015, pp. 1905–1913.
  26. ↑ 26.0 26.1 Jadoon, K. A., et al. “Efficacy and Safety of Cannabidiol and Tetrahydrocannabivarin on Glycemic and Lipid Parameters in Patients with Type 2 Diabetes.” Diabetes Care, vol. 39, no. 10, 2016, pp. 1777–1786.
  27. ↑ Karmaus, Peter W. F., et al. “Cannabidiol Inhibits Allergic Airway Inflammation in Mice.” European Journal of Pharmacology, vol. 671, no. 1–3, 2011, pp. 1–5.
  28. ↑ Appendino, Giovanni, et al. “Antibacterial Cannabinoids from Cannabis sativa: A Structure-Activity Study.” Journal of Natural Products, vol. 71, no. 8, 2008, pp. 1427–1430.
  29. ↑ Massi, Paola, et al. “Cannabidiol as Potential Anticancer Drug.” British Journal of Clinical Pharmacology, vol. 75, no. 2, 2013, pp. 303–312.
  30. ↑ Tomida, I., et al. “Effect of Sublingual Application of Cannabidiol on Intraocular Pressure: A Pilot Study.” Journal of Glaucoma, vol. 15, no. 5, 2006, pp. 349–353.
  31. ↑ Parker, Linda A., et al. “Regulation of Nausea and Vomiting by Cannabinoids.” British Journal of Pharmacology, vol. 163, no. 7, 2011, pp. 1411–1422.
  32. ↑ 32.0 32.1 Devinsky, Orrin, et al. “Trial of Cannabidiol for Drug-Resistant Seizures in the Dravet Syndrome.” New England Journal of Medicine, vol. 376, no. 21, 2017, pp. 2011–2020.
  33. ↑ 33.0 33.1 Millar, Samantha A., et al. “A Systematic Review on the Pharmacokinetics of Cannabidiol in Humans.” Frontiers in Pharmacology, vol. 9, 2018, article 1365.
  34. ↑ World Health Organization. “Cannabidiol (CBD) Critical Review Report.” WHO, 2018.
  35. ↑ Kicman, Aleksandra, and Marek Toczek. "The effects of cannabidiol, a non-intoxicating compound of cannabis, on the cardiovascular system in health and disease." International journal of molecular sciences 21.18 (2020): 6740.
  36. ↑ 36.0 36.1 Zendulka, Ondrej, et al. “Cannabinoids and Cytochrome P450 Interactions.” Current Drug Metabolism, vol. 17, no. 3, 2016, pp. 206–226.
  37. ↑ World Anti-Doping Agency. “Summary of Major Modifications and Explanatory Notes: 2018 Prohibited List.” WADA, 2018.
Created by:
John Kiel on 10 April 2026 13:27:51
Authors:
Last edited:
11 April 2026 11:51:17
Categories:
Retrieved from "https://wikism.org/w/index.php?title=Cannabidiol&oldid=42793"