January 25, 2018

Dr. Christopher Shade Discusses the Therapeutic Applications of CBD Oil in Clinical Practice

Sponsored by Quicksilver Scientific

In this video interview, Christopher Shade, PhD, describes the diverse clinical applications of cannabidiol (CBD) oil. Also included is information about safety, dosage, and other issues associated with this somewhat controversial natural substance.


About the Expert

Christopher W. Shade, PhD, founder and CEO of Quicksilver Scientific, specializes in the biological, environmental, and analytical chemistry of mercury in all its forms and their interactions with sulfur compounds, particularly glutathione and its enzyme system. He has patented analytical systems for mercury speciation (separation of different forms of mercury), founded the only clinical lab in the world offering mercury speciation in human samples, and has designed cutting edge systems of nutraceuticals for detoxification and antioxidant protection, including advanced phospholipid delivery systems for both water- and fat-soluble compounds. Quicksilver Scientific is recognized globally for innovating on behalf of the pharmaceutical and nutraceutical industries. Shade earned his PhD from the University of Illinois Urbana-Champaign and his undergraduate degree in Environmental Chemistry is from Lehigh University. Shade is regularly sought out to speak as an educator on the topics of mercury, environmental toxicities, neuroinflammation, immune dysregulation, and the human detoxification system for practitioners and patients in the United States and internationally.

About the Sponsor

Quicksilver Scientific

Quicksilver Scientific is a leading manufacturer of advanced nutritional systems with a focus on detoxification. We specialize in superior liposomal delivery systems and heavy metal testing to support optimal health. Our advanced liposomal supplements are highly absorbable, and support the body in the elimination of ubiquitous toxins, enabling you to achieve your genetic potential. At Quicksilver Scientific, we are passionate about health and well-being, and are committed to improving the lives of everyone we touch.

To purchase Quicksilver Colorado Hemp Oil as a Practitioner, please access www.THRTech.com. Consumers, please access www.VitaExpress.com.


Karolyn Gazella: Hello. I'm Karolyn Gazella, the publisher of the Natural Medicine Journal. Today we have a fascinating and somewhat controversial topic to talk about. We're going to be talking about the therapeutic effects of CBD oil from cannabis. Before we begin, I'd like to thank the sponsor of this podcast, who is Quicksilver Scientific. My guest today is Dr. Christopher Shade. Dr. Shade, it's always a pleasure.

Christopher Shade, PhD: Always a pleasure.

Gazella: And I have to ask you first of all, is there a reason that CBD oil would be controversial? Am I right in that?

Shade: Much ado about nothing.

Gazella: Maybe.

Shade: You know, is there a reason for controversy? Controversy's built out of us evolving as a society in which we had instituted cannabis prohibition, and we all had this reefer madness fear around the THC side of cannabis, the psychoactive high-inducing side. But CBD is coming from industrial hemp, which is the THC is bred out of it, and you're left with another component that is big in the resins of cannabis, and it's called cannabidiol. It's chemically different than THC, and its physiological effects are vastly different, and they seem almost magical when you look at so many ... At the variety of things that they do for you, but they don't get you high. They have an effect of balancing and calming the mind, but they have so many different therapeutic benefits, and it's really just getting people out of the fear of the evil weed, into this wonderful, medicinal plant and all the uses it has.

Gazella: I want to get into the mechanisms of action and all the science associated, but first, and I know that you're not a legal expert, but is it available freely? Is CBD oil available for purchase, or are there limitations because cannabis is not legal in many states?

Shade: Yeah. The entrance of CBD into use in the US was made possible by the 2014 Farm Bill, which was allowing the use of industrial hemp for various uses in trade in the US. In those uses came the use of the extracts. Now, by some interpretations, well, that's still cannabis, and that's still scheduled as a drug. Certain parts of the government are saying, "Hey." Like the DEA. "Hey, that should still be scheduled. We didn't say that's okay." Whereas other parts of the government are saying, "Hey, that's all right. That comes underneath the Farm Bill." Most of the states have rolled with this being under the Farm Bill, and being an allowed substance. It's gained so much widespread use, and a lot of that use is from very impaired people that rely on it heavily for their health.

Most places are reluctant to step in and go against the Farm Bill. Certain states, however, Indiana notably, recently the Attorney General said, "No. We're not doing this, except for under certain exemptions. If you have a certain type of a ..." It was probably a seizure disorder, "Then you can get a permit to use this." Missouri, I don't know the extent of their laws, but they're kind of difficult. Most people don't sell it in Missouri. Then other states are taking a tack of trying to adopt it into a state cannabis law. Making it like THC, where it's regulated by the state, just like Colorado regulates THC. It does not regulate CBD independently, but for instance, the State of Florida is trying to bring CBD into their medical marijuana world. We'll see how it rolls in Florida, but right now the places to stay out of are Indiana and Missouri. This is such a moving target that this might change in a month.

Gazella: Right. Now, just to clarify, though, CBD oil or hemp oil does not have THC in it.

Dr. Shade: No. In most of the extracts of industrial hemp ... Industrial hemp is defined in the Farm Bill as a plant that, on a whole plant basis, has less than 0.3% THC. When the Colorado Department of Agriculture goes and certifies a crop here for being harvested and processed, it will take representative plants and analyze them for this threshold of THC. Now, these plants usually have, oh, 7% to 9% to 10%, upwards to peak around 15% CBD as well. There's some residual THC along with the CBD. One of the concerns originally was, "Well, when we concentrate that up, will there be enough THC for people to get high?"

Now, processors who are trying to stay very clean with the law will use extraction technologies and post-extraction purification technologies that minimize the THC. For instance, in our CBD oil, there's virtually indetectable THC. Whereas some oils will have a 20-to-1 CBD to THC ratio, ours is around 500-to-1. It's super clean, and that's nice because a lot of people that want to use the oil have THC testing programs that they're in, if they're firefighters, or policemen, or airline pilots. A lot of the commercial extracts have enough THC that if you're using large amounts to be really therapeutic against something like pain, you will probably have enough THC to tip the scales on some of the analytical techniques looking for THC.

Gazella: Got it. Thanks for that clarification. Now, let's get into the science, which is your area of expertise. What's going on from a mechanism of action standpoint? How does CBD oil work inside the human body?

Dr. Shade: Well, it works on a number of different levels, and when we were describing this, we used to chase after one thing or another. We'd say, "Oh, it's antiinflammatory." Or, "Oh, it helps GABA-glutamate balance." As we go forward, we look at it more and more in this symphony, and this symphony, I call neuro-endo-immune poise, or balance. Neuro means neurotransmitters. Endo is endocrine or hormone, and immune is obvious. It's the immune system. Neurologically is how we used it the most, for damping neuro-inflammation. When I lecture to doctors, I say, "This is the most exciting supplement for us in the last 30 years in functional and integrative medicine."

Because we're treating a lot of people with [mole 00:07:45] toxicity, Lyme disease, mercury toxicity, and all these have as part of their symptomology neuro-inflammation, where you become ... Your autonomic nervous system becomes sympathetically dominant, you've got overactivity of glutamate receptors, there's activation of the immune system in the brain called the microglia, and they're sort of at war with the glutamate receptors. That's causing anxiety first, then brain fog, then a disruption with the autonomic nervous system. You're moving resources and blood in wrong ways throughout the body, and this acts to just stabilize all of that. It will block the excitation of the microglia. It will stabilize the glutamate receptor. That will result in a neuro-stabilization. Your neurotransmitter balance between glutamate and GABA gets balanced. Your autonomic nervous system balance between parasympathetic and sympathetic gets balanced.

But that starts cascading down even farther into the body, and we start to look at really what homeostasis or balance of the biology is, and it's a set of reactions that all have these yin-yang poles, which you want to sit in the middle of and take forays in the yin or yang as needed to handle different perturbations, but you always want to come back to the poise of the center, and CBD is always bringing that back to the middle. In hormones, in women, the organ with the greatest amount of cannabinoid receptors? The uterus. I always pair CBD with bitters, and guess what's in the ovaries, but bitter receptors. We find such a stabilization of the female cycle by taking those things together. Then the immune system. You want inflammation when you need to kill things, but then when it gets stuck on, and it won't turn off, you get things like development of chronic inflammatory states. These can be cardiovascular complications. These can lead to cancer. These are problems, so where's the switch to bring it back? The CB-2 receptor, the cannabinoid number two receptor, and where's that located through the body but on the peripheral immune cells of the body.

CBD lubricates your endo-cannabinoid system. Why would you have cannabinoid receptors if you didn't make cannabinoids. The two main cannabinoids you make are 2-Arachidonoylglycerol and anandamide, and the reason you make them is to zip together the neural system, the endocrine system, and the immune system have that neuro-endo-immune poise, and CBD helps you build more of those endo-cannabinoids and helps potentiate those CB-2 receptors. At the same time, it's up-regulating chemo-protective and antiinflammatory genes and down-regulating pro-inflammatory genes. There's really no one thing that helps you create that poise, that essential homeostasis. Nothing does it like CBD oil does, and that's why it seems like a panacea, because it helps so many things.

Gazella: That was actually my next question, because when I was researching for this interview, I found such a diverse amount of conditions that it was being effective for, so because it works on these multiple pathways, that's why you're saying it works for such a variety of conditions. Do you give practitioners who say, "Wait a minute. That's a little bit too good to be true. How can it be that good for that many things?"

Dr. Shade: Well, then I give them the neuro-endo-immune poise story.

Gazella: Exactly.

Dr. Shade: And as soon as you said neuro-endo-immune poise, they go, "Wow."

Gazella: That's right.

Shade: Because what are the disorders? There's some part of you in that yin-yang balance that's stuck over here, or stuck over there. Anything that helps you zip together so many fundamental processes, everything just starts to come back together again. I mean, it runs through all of our different protocols, because it's that X-factor for zipping it all up again.

Gazella: Right. Now, there's got to be some conditions that bubble to the top, and that was the other thing that I was so impressed with, with the research, is the amount of research associated with CBD oil has grown dramatically. But what conditions? As you're looking through the research and you're kind of identifying the strength of the research, what conditions are bubbling to the top, to say, "Yup, that's really what it's going to work for"?

Shade: Right. In our world, we deal with detoxification, and so we're dealing with people who have various problems that are associated with toxins. Autism is a really big one. That's always ... Unless they're just totally exhausted, autistics, always bringing CBD into that, because of that neurological stabilization. Then we're dealing with various mole toxicity, Lyme disease, and the neuro-inflammation that comes from that, the different metal toxins. All of our detoxification protocols, especially when they're neuro-detoxification protocols, involve the use of CBD. Then in distinct disease states, the big ones, MS, Parkinson's, any kind of tremor. Of course, everybody knows seizure disorders. Those are all crying out for some application of CBD.

But then since I understood the endocrine side of it, women who are having endocrine destabilization or hormone imbalance, we're always recommending CBD along with the bitter herbs to them, and we get great ... You might not think, "Premenstrual syndrome: CBD." But it's fantastic for that. Those are the main ones that we use. Oh, any chronic inflammatory pain. That's a really big one. Cardiovascular complications. That's really big, too. We've seen some great data emerging on the use of CBD, including some doctors who have used ours to get preliminary data, on the health of the inside of the vascular system, and you'll see those cells on the inside of the vascular system all getting less stress, increased poise, and so we recommend it in those cases as well.

Gazella: Now, what about mental health? You've now just listed some conditions that are related to our physical health, but what about some conditions associated with mental health?

Shade: Anxiety's just hands down the biggest one, because anxiety results from over-excitation of the glutamate receptors, and boom. CBD stabilizes that immediately. It's very, very fast around that. Now, it's interesting, for much more complicated problems, like schizophrenia, here you've got one plant, two chemicals, THC, CBD. THC is like putting the fast forward button on schizophrenia. It's really bad for a schizophrenic, where CBD has fantastic data around stabilizing schizophrenics, so there it's useful as well.

Even in depression. Depression, you think, "Okay, well anxiety, you're really stimulated, and that calms you down." But depression is also often cycling with anxiety, and so depressive disorders, there's been a lot of data around use of CBD too, and most of my favorite integrative psychiatrists like Kelly Brogan, they've showed very clearly that depression is a neuro-inflammatory disorder, and so you've got different reactions to antigens in your food, in your environment. You're having these constant allergic states and cytokines, these pro-inflammatory states that are contributing to depression, and CBD is working against all that, creating that balance again so it can be used in anxiety and depression.

Gazella: Yeah. It's fascinating.

Shade: Yeah.

Gazella: I'd like to talk about safety, because I have to tell you that I've read some conflicting statements associated with safety. Based on your interpretation of the scientific literature, is it safe? Are there any interactions, contraindications that we need to be worried about?

Shade: On its own, without you having to stick something else into your body like a heart pressure medication, CBD is inherently incredibly safe. We've found a couple of people here and there that seem to have an allergy to the plant, and they just feel unhappy on it, but the issue around CBD and safety is that it interacts with some of the cytochrome P450 system, which are metabolizing drugs. If you're taking a drug for blood pressure, CBD may either lower its breakdown, so increase its circulating levels, or increase its breakdown, and thereby decrease their circulating levels. If you're on a lot of pharmaceuticals, you usually have to do a little bit of research and see if there's some interaction between the CBD and the pharmaceutical that you're on. There's starting to be good lists online of the potential interactions. They've got to get a little bit better at where these are really relevant interactions, and where they're not relevant interactions. But this will be one of the things that we come up with in the future, is nice, clear guidelines on whether something's going to positively reinforce a drug, or work against the activity of the drug.

Gazella: I mean, the case that I read was specific to antidepressants, and that's where it was very conflicting. Some reports were, "Yes, it will react," as you describe, and some were, "It will not."

Shade: Because it's not antidepressants. It's, "This list of chemicals."

Gazella: Exactly. Yeah.

Shade: They just happen to be antidepressants to your body that get metabolized down different pathways according to their chemical nature. Your breakdown doesn't care whether it's an antidepressant or whether it's testosterone. It's got a chemical nature, and it's got to fit into the cytochrone that breaks it down. You get a list of antidepressants, they have different chemical natures, and they go into different cytochrome P450 enzymes to break down, and CBD interacts with two or three of those enzymes. If the antidepressant interacts with the same enzyme CBD does, then there could be an interaction, and if it doesn't, then there's no interaction. It's not about antidepressants.

Gazella: Yes, and nothing is ever clearly black and white when we're talking about this type of chemistry.

Shade: No.

Gazella: I'd like to talk a little bit about the product that you specifically formulated, Colorado Hemp Oil. What makes your product unique or special compared to other CBD oil products that are on the market?

Shade: Quicksilver Scientific specializes in delivery systems, ways to get the compounds into little, lipid-based carrier spheres that are so small that they passively diffuse through mucosal membranes, like your oral mucosa, the sublingual space, as you're swallowing, through the stomach, the upper GI. It's the rapid and complete absorption of these little nano-spheres which is what we do, and when we stick CBD in there, there's a very fast uptake, there's a high total uptake, and it's a very rapid uptake. One of the things that's a problem with CBD is there's only net about 10% uptake of all the CBD you swallow. That's a very expensive molecule, as you know, and so you're throwing away a lot of that and not getting a lot. The stuff you do absorb is absorbed over the whole transit time of the GI, so if we look at uptake versus time, you have a very gradual, slow movement into the blood. The blood levels, the peak blood levels never get very, very high.

Now, a lot of what CBD does, it does through interacting with receptors, and gene triggers, like nuclear transcription factors, like NRF-2, which turns up all your glutathione genes. Now, the receptors and those transcription factors react to peak doses. Level versus time, here's a regular CBD oil. Here's ours. You get a very high transient peak dose. You saturate the system. You're able to work very well on the brain. You're able to hit all of those transcription factors. You're able to interact with all of those membranes, and everything happens very quickly, and you get a very strong effect.

The total absorption is anywhere from four to sixfold higher than a regular pill, but even if you took four to six times as much, you don't get as much of an action, because you don't have that peak dose to really induce everything, ring the bell of those receptors. What happens when you hit receptors, you trigger a whole cascade of different proteins to be made, which is affecting the metabolism of the body. That transient peak dose really creates the effect that you're looking for.

Gazella: Now, your label says that the patient needs to hold it in their mouth for 30 seconds. How important is that, and is that all a part of the enhanced absorption of the product?

Shade: It is, because this is a nice space in the oral cavity. Interacting with the oral musoca is a space where your spheres that you've made have not had to interact with stomach acids or bile, so there's nothing modulating them or modifying them, changing their shape, their size. It's a nice, pure space where all the capillaries are very close to the surface, and you can get a whole bunch in. Now, that being said, for some of our products that are water-core, that are liposomes, those are a little bit more sensitive to the GI conditions, and a little bit more important that you do that oral holding. The nano-emulsion that we make, like the CBD, you have an oil core with a membrane around it. These are more resistant against change in the GI tract, and they will make it through, and you'll get the absorption anyways, but it'll be a little bit slower, and a little bit less efficient.

The more you can do the oral hold, the better, but it is not a game-breaker. That's important for a lot of the people that are very taste-sensitive, or if you're working with autistic children, and they won't do that, or you're giving it to your dog or something, goes right down.

Gazella: I don't know. My dog is pretty smart.

Shade: Yeah. You just say, "30 seconds."

Gazella: That's right.

Shade: "No. Five seconds more."

Gazella: It's interesting. I would like to stay on dosing. Is it complicated to dose from a practitioner's standpoint? Because you do have such a diverse offering of conditions that it can help. Is the dosing-

Shade: Yeah. It's really titration dosing. You start at a low amount. One of the doctors in town here, Joe Cohen, goes with two pumps three times a day as a sort of basis dosing for an adult, and then they'll add more as they need it. If you're not getting the effects, how about three pumps three times a day? Then four pumps three times a day? Titrate up until you get the required effect. You can even start down at one a day, like if you're dealing with kids and you want to start low and slow, but just keep titrating up until you get the effect you want, and often once you induce the effect and start training the body into the healthier state, you can bring the doses back down. Just start low and work up until you get what you need.

Gazella: Great. Now, before I talk about the future, because you know I like to talk about the future, I'd like to have you predict the future, is there anything else that practitioners need to know about CBD oil when it comes to using it in their clinical practice?

Shade: No. Don't be afraid to use it for a wide variety of conditions. Work your dosages up until you get the effects that you want. Let people know, especially if they've never had anything like this, the feeling that they have in the first couple of days may be more intense than it will be later, but it's not ... Most of the other supplements, there's more tricks around it and things to watch out for. Not so much with this.

One thing, though, you will, if you're using it alone, you will start to generate detoxification reactions through two mechanisms. One is NRF-2 up-regulation, that nuclear transcription factor that's turning up the glutathione system, and the other is the autonomic balance, bringing yourself over to a parasympathetic state, and detoxification doesn't happen in sympathetic states, because it's a luxury, and you're trying to survive when you're in sympathetic autonomic dominance. This will bring you over to parasympathetic. It'll help turn up these genes, so some people will start to have detoxification reactions. If they start getting headachey, or a little lower back stress, or rashes, give them good quality bitters, like the BitterX that we make, and maybe a little bit of GI binder, like our ultra-binder, or charcoal clay capsules, and that will help them detoxify.

Gazella: Oh, good. That's good to know. Now, the future.

Shade: The future.

Gazella: What excites you the most when it comes to CBD oil research?

Shade: Yeah. It's CBD not being just a standalone, but being an integrated ingredient in formulas, where it's doing this part of it, maybe the autonomic balancing, or the brain balancing, where the other things are doing other parts, and finding which things are synergistic together, which things are antithetical together. We'll find out how to blend it with other things, and really make it work better. Even if we're just working within the cannabis plant itself, there's the essential oils of the plant called the terpenes, very strongly affect the modulation of how CBD and THC work within the body. The science on the terpenes will be worked out, then the science on other nutriceuticals playing in with those will be worked out, and we'll start to see some really beautiful formulas come.

Gazella: What about when we began, we talked about the availability. Do you see things loosening up a little bit?

Shade: That part of the future. It's funny. There seems to be two forces at work within the United States around CBD. There's a liberalization movement that is not necessarily ... It's not coming out of Boulder County in California. It's coming from within the government, where they want to focus on real issues, like narcotics use, prescription pain med addiction, real drugs, heroin, cocaine, and they want to get away from talking about this. On the other side, there's other people who are just ... Some part of them are just working out what's already been started, where they're just really going to want to try to enforce this. We're starting to hear much more sophisticated language from the state departments of health about CBD, and that's towards a contractive thing. And who knows where that's really coming from? I mean, you have pharmaceutical companies getting into this now, and that may be the long, dark arm of the pharmaceutical companies.

There's two things now, contraction and expansion, happening at the same time. Hopefully the light wins and we expand out, and we're able to use this in a broad scale, and do all the research that's really necessary to put this to the best use.

Gazella: I would agree. I think that the therapeutic efficacy of CBD oil is really ... We're shining a light on it in the scientific literature. Even though it seems that it's preliminary, uncertain cases, it just seems like it's growing more [inaudible 00:28:22], it really should be something that we look harder at.

Shade: Oh, it absolutely is, and I can always gauge it by when I'm on a plane, when little old ladies start talking to me about it, or my aunt came over from Florida, and she had a bottle of it, and it's made its way out to the masses. They need it. They want it. We hope it's here to stay.

Gazella: I do too, and you know, we haven't even touched on the pain aspects, because right now we are in the midst of an opioid crisis in this country.

Shade: Oh, yeah.

Gazella: Is there an application for [crosstalk 00:28:57]?

Shade: Oh, absolutely. Maybe little smidges of opioids along with CBD. CBD, and what we'll find is what we can blend with it nutriceutically to increase its effect at stopping pain, but it's got all the right aspects for that, and for some pains, it's magic. For other ones, it doesn't work as well. Well, maybe we'll find certain blends, but it will always, if you're taking it with opioids, it will always lower how much you need of the opioids, and that's one of the most beautiful things to come out of the legalization of medical marijuana in various states. They've seen a lowering of opioid use.

Gazella: Right. It sure seems like CBD oil, hemp oil, is a valuable tool that clinicians can use in their clinical practice.

Shade: Absolutely.

Gazella: Great. Well, Dr. Shade, as per usual, this has been very interesting. Thank you so much for joining me today, and I would also like to thank the sponsor of this interview, who is Quicksilver Scientific. Thank you everybody for joining us. Have a great day.

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