SweetSue's Class Notes

Dr. Axe
Time-Restricted Eating: Is It When, Not What, You Eat That Really Matters?

When you hear the word diet, you probably think of something that’s hard and confusing to follow, leaves you feeling deprived, and involves a list of foods to avoid, right?

Well, what if there’s another way to lose weight fast that’s dramatically different from most standard “diet” plans? And what if this alternative essentially eliminates the need for calorie-counting, sacrifice, deprivation and even willpower?

What Is Time-Restricted Eating?

Time-restricted eating (TRE) is a type of intermittent fasting, which in one way or another has been done by humans across the world for thousands of years. While most initial studies on TRE have been done using animals, humans are believed to likely react the same way. It makes sense to researchers, considering daily fasting was likely something that was practiced unintentionally by our ancestors who didn’t have 24/7 access to food like we do today.

And without even knowing about the scientifically proven health benefits of fasting, nearly every religious group throughout history has practiced some sort of variation of fasting rituals.

According to researchers at the Regulatory Biology Laboratory at the Salk Institute for Biological Studies, when we eat may be as important – or even more important – than what we eat. The Salk Institute in California has been at the forefront of the time-restricted eating phenomenon, working to understand the impacts of fasting for health and how the body reacts when its forced to fast for the majority of the day.

Researchers first stumbled upon this breakthrough in animal studies when mice were allowed to eat whatever they wanted, but only during a set time of day. The mice on the time-restricted eating plan ate what was considered a “poor diet” high in calories, sugar and fat, yet they still didn’t gain the weight that they were expected to.

However, once they had access to the same food any time they wanted, the mice’s weight gain doubled despite eating the same number of calories.

* 9-hour of access to food caused 26 percent weight gain in the mice
* 15-hour access to food caused 43 percent weight gain
* 24-hour access to food caused 65 percent weight gain

Their stunning conclusion was that periods of regularly fasting for 12–16 hours a day might dramatically impact body weight.

Time-restricted feeding caused less weight gain than all-hour access for mice eating a high-fat, high-sugar diet over 12 to 26 weeks, and it also led to weight loss of up to 12 percent when applied to mice that were already obese.

What does this mean for the dieting industry? You might be able to eat whatever you want and still lose weight, simply by limiting the period of time in which you consume food. And this might even be true if you increase calories — especially calories from fat, because your body seems to burn these best during the remainder of the day, your “fasting” period. However, imagine how much fat you can lose when following a smart, healing diet in this new style of eating?



Guide to time-restricted eating - Dr. Axe
How Time-Restricted Eating Works


As you can see, time-restricted eating is truly different from standard diet approaches, which usually fall into one of two categories: either calorie-restricted diets or food-restrictive diets. Time-restricted eating, on the other hand, simply allows you to choose the foods that work best for you and eat them in any eight- or nine-hour window that you choose.

Fasting for roughly 15 or 16 hours a day — possibly even as little as 12 hours — while keeping the times that you eat to a shorter period appears to have significant effects on hormone levels that determine your metabolism, blood sugar, and whether or not you burn fat.

The idea of eating as much as you want — and of any foods that you want — plus that calories don’t actually matter in the long run for weight maintenance goes against pretty much everything we’ve ever been told about losing and gaining weight. But yes, this is what results from several clinical trials using animals suggest.

These recent eye-opening studies show that by only eating during a shortened eight- to nine-hour window each day, your body is more likely to burn fat and keep your weight at a healthy level. And this even seems to be the case without the need to cut calories, avoid entire food groups, or count macronutrients like carbs and fat. How is this possible?

It appears that our bodily functions operate best when they act something like clockwork — preferring to schedule our repair, maintenance and “system backup” during planned downtimes. This means that when the body follows a predictable schedule of eating and fasting, our hormones might respond by producing fat burn and weight loss — potentially even rapidly.

Maybe you’re convinced that TRE can work for weight loss, but you wonder if fasting is healthy.

And aside from manageable weight loss, other benefits of fasting and practicing time-restricted eating might include:

*lower levels of inflammation
*better management over blood sugar levels and a lower risk for developing diabetes
*enhanced detoxification
*better control over appetite hormones, including leptin and ghrelin
*improved heart health
*better immunity
*lower risk of cancer
*improved brain function and lower risk for dementia
*better muscle recovery from workouts
and less harmful effects from aging or stress

A study conducted by the University of California San Diego involving 2,200 overweight women found that time-restricted eating also has positive effects on immunity and blood sugar control, which are closely tied to weight gain as well. Poor blood sugar control is a risk factor for diabetes, obesity and cancer, among other things. When someone is overly sensitive to insulin, the “fat-storage hormone” that signals cells to take in calories from food, more is produced by the pancreas, and this promotes the growth of cells, even mutated cancer cells.

After comparing women not eating or drinking anything for at least 12 hours with those who fasted less than 12 hours, researchers found that women who fasted for longer nightly intervals had better blood sugar control than those who didn’t fast as long. And this was independent of other eating behaviors such as how many calories women were eating.

How To Start Practicing Time-Restricted Eating

All of this might seem too good to be true, but the early research results are undeniable. So how can you implement time-restricted eating in a realistic way?

More research is still needed to determine the ideal meal schedule, period of fasting and period of restricted eating. For example, we still aren’t totally sure if it matters when someone starts her fast each day or how many days a week of time-restricted eating is best. As of now, the recommendation is to go between 12–16 hours without eating several times per week, but some people see even better results from further restricting their eating windows to only 5–6 hours daily.

Of course, when you are eating, what you choose to eat is still important for overall health. You don’t need to count calories, but aim to make the vast majority of your diet whole foods, including quality protein foods, healthy fats and plenty of different vegetables.

Luckily, it also appears that you don’t need to follow time-restricted eating every single day to see results. Eating within an eight- or nine-hour window most days of the week — about four to five — seems to still do the trick. In fact, Dave Zinczenko, author of the top-selling book “The 8-Hour Diet,” recommends following time-restricted eating only three or four days a week.

For many people, going against the norm and skipping breakfast seems to be the easiest way to practice time-restricted eating. Although for decades we’ve been told that breakfast is “the most important meal of the day” and that we’re doomed to gain weight without it, this doesn’t seem to necessarily be true for everybody. While time-restricted eating really relies on eating within a shortened window, and doesn’t mean you need to skip breakfast necessarily, it might be the most manageable way to follow a fasting program.

Are There Risks of Practicing Time-Restricted Eating?

TRE might not be for everyone, and some people appear to do better with practicing various types of fasting in general than others. Fasting has an impact on blood sugar, so anyone dealing with low blood sugar (hypoglycemia) should steer clear of fasting until glucose and insulin levels are well managed.

Fasting can also impact hormones, including cortisol and adrenaline. Women might be more impacted by these effects than men, although that isn’t necessarily a bad thing. Fasting isn’t meant to become a source of stress, but in some people with compromised or high cortisol and adrenaline levels, a further increase in these hormones from fasting can result in some unwanted side effects.

If you have existing adrenal or hormonal issues, or you’re healthy and try TRE but notice you’re experiencing fatigue, anxiety and irregular periods due to the hormone disruption, then TRE might not be for you — it might be better to eat more often throughout the course of the day.
 
Reviewing the class by Dr. Tishler over at Green Flower Media in preparation for sitting down with an adopted family member to discuss a regimen for treating bipolar. This is a course taught by a Harvard-trained physican with 20 years of clinical practice who's positioned himself as a cannabis medicine a specialist.

Info I lifted as reference material for our conversation:


I have serious problems with his suggestions, but then maybe it's because I see it from the perspective of the mother and cannabis caregiver to my daughter, who has arguably the worst case of anxiety any of her doctors had seen, but his methods don't hold up in her treatment at all.

1. Cannabis can help mild depression and anxiety.
- In our experience cannabis can help severe depression and anxiety.

2. Inhaled is the best route for most patients.
- Our experience suggests that micro-dosing over the day (4-5 doses) will level out the Endocannabinoid tone and be of great value for both depression and anxiety.

3. Strain doesn't matter much for most patients.
- Maybe for most patients this is true, but for my anxiety-driven patient chemovar choice makes all the difference in the world. Choose a sativa or a sativa-dominant hybrid and we're on suicide watch. I doubt that she's that unique a case that this wouldn't hold true for others.

4. Start with a very low dose, work upward slowly, final dose is likely to be low too.
- I'm good with the "start low and go slow" directive. That applies across the board, regardless of what you're treating. My patient takes 8 capsules over four doses. We've attempted to cut her back a tiny bit and her brain went straight to anxious.
- He recommends one singular dose, at bedtime, for most patients. This, in my opinion, is dosing that keeps things from becoming problamatic, but not necessarily enough to create the healing atmosphere that does more than cover symptoms. I'm interested in doing more than cover symptoms, and that applies to whomever I'm assisting.


5. Once you're sure cannabis will be helpful switch to a flower vaporizer.
- Dr. Tishler mentions more than once that edibles aren't as effective for treatment of anxiety and depression. I believe this stems from his policy of dosing once a day, for whatever reason that exists, and to be honest, if you're using edibles to counter an oncoming panic attack that won't be an effective administrative pathway.

The daughter and I have great success with edibles because we're micro-dosing across the entire day. Again, I feel this creates a more level endocannabnoid tone that supports healing over symptom control.

6. Panic attacks require immediate dosing, others should dose at bedtime.
- Agreed, panic attacks require immediate attention with a vaporizer. However, get the patient on a steady dose of incoming reserve troops and you can keep the panic attacks from coming on, for the most part. Creating an internal healing environment makes more sense than reaction dosing.

The daughter used to have panic attacks almost daily. Now they're down to occasionally, as in maybe a few a year. This was accomplished through a scheduled capsule regimen.

I'm really uncomfortable with the idea that you can treat anxiety and depression with a single dose at bedtime. Yes, you'll get better sleep, and sleep is a restorative modality, but there's more potential, IMO, to heal at least some of the damage done by these conditions with a more extensive dosing schedule.


Tips and tricks
1. Set and setting
- Choose a comfortable setting you can feel safe in to experiment with your dosing levels.
- Have a mindset filled with intention. Know what your goals are.
- Have a good support group around you.

2. Avoid high THC strains
- He means to stay with an upper limit of 15% THC value.
- His guideline is one puff of a 15% chemovar will offer approximately 3-5 mg of THC.

(X grams of cannabis * Y % of THC)/1000 = Z mg of THC in the dose

3. Avoid edibles, tinctures, and other oils
- Dr. Tishler believes that vaping is the best treatment modality for anxiety and depression.
- I respectfully suggest that he's not seeing the bigger picture of healing potential.

4. Figure out your dose
- Start sub-therapeutically.
- Increase after a week, but do so cautiously.

Other pertinent information to my consulting family member:
- With bipolar you must be alert for a hyper manic state. If you feel one coming on you'll need to make immediate adjustments.
- For this reason he suggests you attempt this treatment under the supervision of your attending physican.
- What if you have no attending physican?

Different types of anxiety or depression talked about in the course
- Unipolar depression: generalized mood disorder with sadness and lack of interest.
- Bipolar: manic depression characterized by drastic mood swings and a lack of social filter.
- Generalized anxiety : anxiousness over just about everything
- Panic attacks: overload of fear response with debilitating physical response when there’s no real threat


Headed to a graduation and the party following. I’ll get back to this later.
 
Frequently asked questions from Dr. Tishler's class on anxiety and depression

1. How do I take these "puffs" you keep talking about?
Gosh, can't we just call them inhallations, and be done with it?
- Take one reasonably deep breath in, and immediately exhale.

I breathe in, I breathe out.

2. How do I know when my vaporizer is empty?
- If you take an inhallation and at the exhale see no vapor it's time to empty and refill.

3. Do I want a high CBD strain? His answer took me by surprise.

"The general purpose of high CBD strains is to allow you to comfortably ingest a high amount of THC. But in this case, meaning in the case of anxiety and depression treatment, quite frankly we're aiming for fairly low amounts of THC, as we've talked about over and over again.

So in fact, a high CBD strain is probably irrelevant."

I don't buy it. I have a sneaking suspicion that the imbalance of neurotransmitters that result in the fear response of anxiety or the loneliness of depression have their beginnings in inflammation somewhere in the body, likely the gut. If my suspicions are correct this may explain why it was a high-CBD chemovar that worked for my daughter.

Am I the only one here that thinks he's missing the bigger picture?

4. What should I do if I get too high?
- Most of the fear can be contained by set and setting. Advance planning can be valuable.
- Have a supportive someone nearby to keep you grounded.
- Chew peppercorns(2-3). They contain b-caryophyllen even.

5. How do I control cannabis side effects?
- Getting too euphoric is controlled by proper dosing and ratios.
- Dry mouth can be controlled by drinking more water. Cannabinoids create a great need for water.
- Have water at your bedside when you take your bedtime inhallation.
- Somnolence, or sleepiness won't be a problem if you're taking a dose at the day's end, it'll be a benefit. Go to sleep. :battingeyelashes:
- Daytime meds (because I'll always be pushing. The idea of continuious low-dose regimens :battingeyelashes:) can trend to more uplifting and energizing terpenes.

6. How do I control the munchies?
- Despite the fact that most people report getting the munchies, most cannabis consumers that are at normal weight or above don't seem to gain any weight from the munchies.
- This possibly reflects the reality that the ECS is so focused on homeostasis.
- Underweight patients who get the munchies are the ones gaining weight, and that's usually something that is encouraged.
- Don't fight the munchies, stock the larder with better quality food that has a high nutritional value for the caloric intake.

Mmmmmm.....kale chips or some puffed black bean pods would be really tasty right about now. Think I'll go with some Greek yogurt, since we have that in the house. My pantry has better snacks. Lol!

Carrots are colorful, crunchy enough to satisfy the chewing urge, and are low in calories. Good for the eyes too.
 
Green Flower Beginners Series: Health Conditions and Cannabis

Insomnia and Cannabis with Alison Ettel, Cofounder of Treatwell

Is cannabis effective for insomnia?
- Definately. THC helps you fall asleep faster as well as increase slow-wave sleep, the deepest level.
- THC promotes healthy sleep without the fogginess that often accompanies many pharmaceuticals.

A 1:1 THC:CBD ratio is excellent for insomnia.
- It seems to relax the entire nervous system as well as help you go to sleep without psychoactivity.
OK, if you're sleeping you won't be affected by the euphoria, but a 1:1 ratio is psychoactive in a whole other way than high THC. But here we use it for somnolence, so that doesn't matter.

Specific guidance for treating insomnia with cannabis

Begin by determining the cause of the insomnia.
- Most patients with insomnia have issues with anxiety, pain, or both.

An anxiety patient needs to treat the anxiety during the day so it doesn't have such an impact on sleep.
-Many of these patients will likely respond to a high CBD chemovar.

Did we all catch that glaring discrepancy between her experience and Dr. Tishler's thoughts about CBD and anxiety?

Many pain patients, like those with fibromyalgia or nerve damage from chemo (neuropathy) report that their inflammation flares in the later hours of the day.
- Instead of treating that at night by knocking yourself out it's a better idea to treat it throughout the day, even if it's not all that pronounced during the day.

If you treat the inflammation and pain with a daily regimen you'll find it easier to fall asleep and stay asleep.

General insomnia isn't caused by any physical condition or pain.
- Try a 1:1 or high THC right before bed.
- Include myrcene and linalool in the terpene profile for their sedating effect.

Starting dose and frequency for treating insomnia
- Start low and slow. You never know how little will be effective if you don't take the time to listen.
- You're looking for the minimum effective dose.
- Much depends on the patient and what's being treated.

A good starting point is 2.5 mg total cannabinoids, or 1.25 mg THC and 1.25 mg CBD
- You can increase from there if needed, but sometimes more isn't needed.

Choosing the administrative pathway

If falling asleep is the concern you'll be looking for something fast-acting, like inhallation.
- You can feel the effects of a tincture in about 15 minutes.

If staying asleep is the issue you'll want something more long-term, like edibles or a capsule.
- Some patients take a capsule or edible at bedtime, take a tincture, and then have an inhallation.
- This approach hits the whole spectrum of challenges presented by insomnia.

What are realistic expectations using cannabis as a treatment for insomnia?
- If you hit your optimal dose you can see results pretty quickly.
- It may take experimentation to hit your minimal optimal dose, so don't be afraid to keep trying.
- Get it right and you'll fall asleep, stay asleep, and have more restful sleep states.

If you wake up with a green hangover it may be the quality of cannabis you're using.
- This is more of a concern with the use of pesticides, or the occurance of other contaminants like mold.
- If you feel any of these side effects check your source first.

Cannabis isn't a cure for insomnia, but it can help the underlying issue keeping you from finding restful sleep.
- If you're using cannabis to fall asleep it's not that it cures anything, but it helps you get sleep, which in turn helps to clear the mind of fear and confusion.
-It's safer than just about any other sleep medication.

Using topicals

Topicals went unmentioned in this discussion, but I've personally used a high-THC topical to stop a panic attack right at the beginning.
- Apply all around the neck, paying particular attention to the DMR (go all the way up to the hairline) and the sides of the neck.
- Apply to the temples as well as the sternum and surrounding area, the upper chest.
- Back up your efforts with a vaporizer.

This method hasn't been widely tested, as far as I know I'm the only one to try it, but it worked in such a dramatic fashion that it warranted mentioning.


This video is 4:47 seconds long.
 
Green Flower Beginner's Series: Health Conditions and Cannabis

Migraines and Headaches with Jessica Peters, Terpene and Cannabinoid Specialist

Can cannabis cure migraines?

Cure is a word no one wants to use, and that's understandable. Only the patient cures. We offer raw materials and reserve troops.

Jessica's seen many patients with migraines and menstrual headaches gain significant relief with cannabis.

In a recent study of patients regarding cluster headaches and migraines who consumed cannabis showed a 50% reduction in their pain, as well as a near 50% reduction in the frequency of the headaches or migraines occurring.

Specific guidance for those seeking to use cannabis to find the same relief.
- With patients reluctant to use cannabis internally, using a topical at the temple can be a good way to start.
- The most treatment value is found with ingesting.
- Jessica sees many patients find relief specifically from migraines using a CBD-rich medication.
- While some patients may find relief from migraines with a THC-rich medication, others may find THC exacerbates the situation.

For patients new to cannabis it's best to start with a CBD-rich medication and work your way through a range of ratios to determine your ECS response to them.

Starting doses
- Cannabis is biphasic, meaning it's dose-dependant. A small dose has a very different effect than a large dose.
- When starting to address your migraine it's best to start small.
- If you're comfortable with a little psychoactivity she recommends an even ratio ratio. It offers the best pain relief for most number of patients.

Advanced strategies for migraines

Some patients approach it as "acute pain only" and use cannabis only when it begins to hurt.

Those with chronic migraines and menstrual headaches find more relief with a consistent micro-dosing regimen.
- For these patients she's seen good results at least with 2-3 doses a day of a CBD-rich medication.
- A consistent regimen of CBD-rich medication will give the greatest relief from chronic migraines and hormonally-triggered headaches in the long run.

If you're looking to use only CBD, keep in mind that the data demonstrates that a 1:1 ratio offers the best pain relief for the greatest number of patients.
- A balanced ratio medication is considered a CBD-rich medication.

I did not know this until now. It makes perfect sense, considering the way THC got bred to the forefront as CBD was kicked to the back wall. Huh! Learn something valuable every day. :battingeyelashes:
- The ratios can move from 1:1 all the way to 30:1.
- A 30:1 ratio is considered a pediatric-appropriate medication.

Inhallation and tinctures applied sub-lingually offer the fastest relief.
- Patients may see better results with consistent micro-dosing.

I've seen tremendous results using a topical along with vaporizing, which could just as easily be smoking a joint, although the vaporizer is easier on the lungs.
- Apply the topical to the temples, up the sides of the neck and on the DMR. I've seen this stop a migraine just as the brain storms started to pound, and within 15 minutes it completely passed.
- Consider applying to the front of the neck too, which means I'm suggesting coating the entire neck at the sign of a nasty migraine approaching.
 
Green Flower Media Beginners Series: Health Conditions and Cannabis

Cannabis and Anxiety with Robbin Lynn (Co-founder & VIP of RX-C) and Dr. Michele Ross, PhD

It's all about the profiles and ratios you're choosing.
- For many people THC can cause anxiety. CBD is an anxiolytic, reducing anxiety levels.
- Some patients find THC relieves anxiety. It's really about doses. Higher doses of THC (over 10 mg)
can cause anxiety.
- Microdosing at 2.5 - 5 mg, spread over the day can provide the same type of anxiety relief as Xanax.

Some patients can't tolerate any amount of THC.
- For these patients you build a regimen with CBD-only medicines.

Panic attacks require immediate treatment.
- You can try CBD to slow a panic attack. It may work

Time for a break.

Continuing on.....

For those with generalized anxiety, a patch may be helpful to keep anxiety at a low level.
MICRO-DOSING!!!

If you find that CBD works the best approach is to treat it like a supplement and take it daily.
- Start with 10-25 mg, taken daily for 7 days, then assess the effects.
- Rate your coping levels while on CBD.

Cannabinoids are heavy, and they'll stay in your body a long time. My theory is you're establishing a baseline Endocannabinoid tone.
- When extra stress is known to be ahead you'll have that baseline to pull from that can be supplemented with vaping or extra drops of tincture.

Terpenes found in both hemp chemovars and cannabis chemovars that're helpful for anxiety.
- If using CBD isolates you can also add an essential oil like lavender, possibly applied to the hands so you can sniff them and get the calming effects.
- Cannabis products can be used in a complementary fashion with other plant essential oils and botanical products. Used together you can avoid using pharmaceuticals like Xanax.

Sometimes CBD will have the opposite effect and ramp up anxiety.
- Since there's no way to tell other than try it, the safest approach is to start low and increase doses slowly and thoughtfully.

If you notice your agitation is ramping up or you're losing control while on a CBD med discontinue and switch the ratios to a low-dose THC-dominant product and micro dose at levels between 2.5 and 5 mg.

When you switch you want to be very careful to assess your body's response. You don't want to exacerbate anxiety with too much THC. Before you take more you want to get a good feel for how your body responds to the THC.
- If inhaling, take a small toke, wait five minutes and assess your comfort level.
- If sublingually administered, wait 20-30 minutes to assess your response.
- Edibles need up to three hours before you assess response.

Keep a log to see the patterns of what works for you as you dial in your personal optimal dose.
-How are you feeling?
- Where are your levels before medicating?
- What was the dose (chemovar and dose size) , and how did you administer it?
- How did the cannabis dose effect you? Negative? Positive?
 
Green Flower Media Beginners Series: Health Conditions and Cannabis

Cannabis and Anxiety with Robbin Lynn (and Dr. Michele Ross, PhD

It's all about the profiles and ratios you're choosing.
- For many people THC can cause anxiety. CBD is an anxiolytic, reducing anxiety levels.
- Some patients find THC relieves anxiety. It's really about doses. Higher doses of THC (over 10 mg)
can cause anxiety.
- Microdosing at 2.5 - 5 mg, spread over the day can provide the same type of anxiety relief as Xanax.

Some patients can't tolerate any amount of THC.
- For these patients you build a regimen with CBD-only medicines.

Panic attacks require immediate treatment.
- You can try CBD to slow a panic attack. It may work

Time for a break.
I'm sure we've discussed this in the past, but that CBD oil is the shizznit for anxiety.:high-five:
I use it all the time... especially when I over-indulge on a good sativa & get paranoid. CBD is my go-to every time.

I still use it every morning to help with the social anxiety of daily life.

:passitleft:
 
I'm sure we've discussed this in the past, but that CBD oil is the shizznit for anxiety.:high-five:
I use it all the time... especially when I over-indulge on a good sativa & get paranoid. CBD is my go-to every time.

I still use it every morning to help with the social anxiety of daily life.

:passitleft:

At what dose and on what schedule Preston? What products are you using currently? Can you share any more about the regimen and how you came to its current stage? I'm trying to get a better understanding of the specifics of how members are successfully using CBD products.
 
At what dose and on what schedule Preston? What products are you using currently? Can you share any more about the regimen and how you came to its current stage? I'm trying to get a better understanding of the specifics of how members are successfully using CBD products.
Currently use CBD bio Care. 1000mg/40mg per dose... I think. I don't have the bottle in front of me right now.

I take a dose every morning to keep me "balanced", my anxiety can become crippling if not kept in check. But I'll also take multiple doses throughout the day if things get worse.
 
Currently use CBD bio Care. 1000mg/40mg per dose... I think. I don't have the bottle in front of me right now.

I take a dose every morning to keep me "balanced", my anxiety can become crippling if not kept in check. But I'll also take multiple doses throughout the day if things get worse.

My daughter has the most serious case of anxiety her psychiatrist had seen in 30 years. I have her on a capsule regimen of 2 capsules, 4x day, and for the most part those four doses a day are what she considers her baseline meds. It’s almost unbelievable how effective this has been for her. She’s 36 and has to learn to interact with society as a “normal” person.

Not that she’s cured. Not at all. But she can leave the house to shop for groceries without agonizing about the trip for a week in advance and paying for it with physical pain for the next three days. Panic attacks dropped from daily to none for almost a year before they returned, but even so they’re only occasionally, and take massive triggers. It’s been an amazing transformation so far.

I calculate her capsules to be approximately 16mg of CBD and 8mg of THC. She a large woman and takes 8 capsules a day. It sounds like you’re taking about the same dose of CBD, she just gets more of it on a regular schedule.

We feel that the regimen of 4 doses a day is what’s making the big difference. May I suggest you consider a micro-dosing regimen? Is there any reason your formulation lacks THC? Even a smidgen will potentiate the CBD dose without introducing euphoria into the experience. They work so well together seems a shame to use one all alone.

Also, a topical applied to the upper back, at the top of the spine and smoothing up to the hairline - we call this area the DMR - will do amazing things to lighten the mood. That simple trick we stumbled upon this year had proven to be one of the most valuable tools in the healing bag.
 
Gary Wenk, PhD, Ohio State U, in a presentation in April, 2012.

This is the genesis of the regimens for treating and prevention of Alzheimer’s.












What worked best was blocking uptake.


What didn't work was blocking catabolism. This causes things to build to dangerous levels. Tomorrow I'll define what I meant by "things". Lol!






One puff a day is all it takes. They now know that dose can be as low as 5mg a day, and I think that’s either THC or CBD.

Wonder what kind of luck Shed’s been having with his dad?
 
They knew in 2012 that 5 cups of coffee a day will have close to the same effect as that one puff a day.
 
On my way to bed. Got sidetracked by a couple Green Flower Media videos from their Cannabis 101 series.

Joe Dolce of Medical Cannabis Mentor had the most insightful class on pain relief without the high. Essentially, he's proposing start with CBD and micro dose THC to your level of relief. His contention is that you'll get better relief from very low doses of THC and high CBD than you ever will from high THC.

From what I've been witnessing with the members using CBD to counter opiate withdrawal I'd have to agree with his approach.

I find myself rethinking what I thought I knew about dosing cannabis. I used to think of a micro dose as between 5-10 mg of THC. I was wrong. We've all been trained by prohibition.

A micro dose of THC is between 1-5 mg. Start with CBD - seems like 25-50 mg doses will be effective, but see if you can get reasonable relief with CBD alone - and you can start with as low as 1 mg of THC and sometimes find relief. 1 mg.........

Some fun graphics from the class. :battingeyelashes:





He had a nice trick:
* Start with an oil with approximately 1-2 mg/ml.
* Set your capsules up and fill them with 1, 2, or 3 drops to get doses of about 1.5 mg, 3 mg, and 5 mg respectively.
* Keep them in marked jars and choose the potency as needed.

No one, in all of recorded history, has ever died from using cannabis. It's not possible to become physically addicted to cannabis. Play. Experiment. Find what works for you.

**************************************

Eloise Theisen did another talk on cannabis for seniors.


A little too technical and clinical for my taste, but loaded with information.

I find it interesting that they espouse the incredible safety of cannabis and yet go all control-oriented when they start talking about a personal regimen.

There was a moment when she looked fervently into the camera and stated that a therapy plan must include

You know, this kind of talk rankles the nonconformist side of me. Lol!

* how much of your medicines to take
* how frequently to take your cannabis medicines
* how long to take a specific dose

Discuss with your Health Care Professional when, and under what circumstances to either increase or decrease your dose, as well as the predicted length of the therapy.

Be prepared to experiment to find what works for you.
* try different Cannabinoid ratios
* play with terpene profiles
* try different dosages
* experiment with frequency of doses

Don't be afraid to try more than one canna med at a time. For example, a patient treating arthritis might use a topical for localized relief, take an edible for longer pain management, and use inhallation for breakthrough pain.

She ended with a pleasant

"Patience and persistence often pays off."
 
40 Strains For 40 Diseases (book in progress by Dr. Frank D'Ambrosio)

Gather samples of 40 chemovars and distributes,them to
* 20 patients with fibromyalgia
* 20 patients with anxiety
* 20 patients with cancer pain
* 20 patients with migraine

Let the patients try them and decide what works best for them. Evaluate the responses to see if patterns emerge.

If it works this could be very insightful about terpene profiles. I'd think that'd have more to do with effectiveness than other components. The individually expressive nature of cannabis and it's human hosts may muck up his search. Lol!


Data Points from the field
Dr. D'Ambrosio's office surveyed his patients and discovered the main reasons most of them were using cannabis aren't even listed as qualifying conditions on some of the states lists.

Of 4276 patients treating 39 different conditions
53% were men, 44% were women

Ages:
* 0.2% <18
* 24% 18-2
* 29% 25-34
* 12% 45-54
* 16% 54+
* 0.5% missing
* 18% 35-44


The patients chose either indica, sativa, hybrid, or pure CBD products to treat their concerns.

Indica
Alzheimer's
Anxiety
Arthritis
Headache
MS
Muscle pain
Autoimmune disease
Cancer
Chronic pain
Nausea mitigation
Liver disease
Neuropathy
CP
Disc, spine
Eating disorder
Parkinson's
PMS
PTSD
Epilepsy
Fibromyalgia
Insomnia

Sativa
Addiction
Asthma
Autism
Bipolar
Diabetes
Depression
Energy, focus
AIDS
IBS, Chron's
MECFS
Parkinson's
PTSDA

Hybrid
Sickle Cell
Glacoma
ACL reconstruction
Tourette's

CBD
Trigeminal


* 74% used cannabis to replace or reduce pharmaceuticals


When asked why they were using medical cannabis they responded
* 74% for anxiety
* 71% for sleep
* 70% for pain

The most common conditions being treated with cannabis were
* 63% anxiety
* 60% insomnia
* 43% depression
* 36% pain
* 35% well being
* 25% headache

Pharmaceutical drugs patients used cannabis to reduce
* 51% painkillers
* 27% antidepression
* 10% anxiolytic
* 3% barbiturates
* 2% anticonvulsants

61% of patients used cannabis daily
74% of these patients used less than 1 gram of cannabis on those days it was used.


Near the end of this piece, following an impassioned declaration that cannabis is a medicine the good doctor actually says

"Now, can people use it for the wrong reason? Can they use it for the elevated mood of THC? Of course. I mean people are still people.

But let's not minimize that it is medicine."

WTH? I'm thinking yet another doctor that never used cannabis for euphoric benefit and doesn't understand what it is. How does euphoria become "the wrong reason?"
 

Ah Warner has insight into terpenes for topicals. She's the woman who got it written into Washington State law that topicals could be sold in any store that wanted to sell them, and where I learned that b-caryophyllene and linalool will improve the skin absorption of cannabis topicals by creating a transdermal effect. In her opinion it's not worth dealing with DMSO when terpenes already available in canna is will do the job for targeted relief with topicals.

I'll pick up the comments later. This is a panel I've been meaning to dissect for quite some time. She also mentioned high mrycene and high limonene, but my notes were sketchy.
 
From Prof of Pot. I brought it here so I wouldn’t have to go looking for it again.

Thank you m’lord. This is a crash course on eCBs. :yahoo:


pexels-photo-101808.jpg

7 Things You Never Knew About Cannabinoid CB1 Receptors
The cannabinoid CB1 receptor is more complex than the “lock and key” model lets on. Here are 7 facts that everyone should learn.

The “lock and key” model is often used to explain interactions between receptors and their ligands. The CB1 receptor is like the “lock” which is activated by a single “key” such as THC.
receptors.gif

While this analogy may be useful for someone new to pharmacology, it is incredibly oversimplified. After reading the 7 facts below, you will be able to appreciate how complex CB1 receptors really are.
And just for fun, let’s see how long we can keep the lock and key analogy going…

1. The CB1 Receptor is Found in Unexpected Places
You expect to find locks on a car door, but not necessarily under the hood inside the engine.

19124186316_448690d361_z.jpg
Mitochondria in green [NICHD]The classical view of the CB1 receptor is that it is expressed on the cell surface and its function is to bind a ligand on the outside of the cell and generate a signal on the inside of the cell.

If this were true, then what the *#%! is the CB1receptor doing inside the cell on the mitochondria? This is still being worked out, but by regulating cellular energetics, mitochondrial CB1 receptors may influence memory, and a variety of other brain and bodily functions.


2. The CB1 Receptor Is Always Turned On
It is one of those chain locks that allow the door to be like 10% open, but still secure.
Another outdated model is that the CB1receptor is completely “off” until an endocannabinoid or THC turns it on. Wrong again! The CB1 receptor has what is called constitutive activity. It has a basal level of signaling even in the absence of any ligand that regulates release of neurotransmitters such as GABA.
Drugs called inverse agonists are capable of blocking constitutive activity. They tested a CB1inverse agonist called rimonabant and it produced serious psychiatric issues such as anxiety and depression in some people. It turns out that constitutive activity is important!

3. THC Is A Partial Agonist of the CB1Receptor…Until It’s Not
THC can open a locked door part way, but sometimes it just gets stuck so that better keys can’t open it.
keys-525732_640.jpg

You may have read that THC is a partial agonist at the CB1 receptor. This means that it activates the CB1 receptor, but not all the way. Although this is true in isolated cells, it does not always work that way in real life.
The effects of THC depend on the CB1 receptor density, coupling efficiency, and presence of endocannabinoids that are even stronger CB1receptor agonists. In the right context, THC can actually act like an antagonist and reduce activation of the CB1 receptor.

4. The CB1 Receptor Can Generate Multiple Signals
Sometimes the CB1 receptor opens a door to one hallway, but sometimes the same door leads to a different hallway. We are all in the Twilight Zone.
The old model of the CB1 receptors was that it could activate a single signaling pathway within a cell. Whether it was being activated by THC, an endocannabinoid, or a synthetic cannabinoid didn’t really matter.
Now we know better… not only can the CB1receptor activate different signaling pathways, but different ligands can selectively activate one pathway over the other. This phenomenon is called biased agonism, and opens the possibility of activating the pathways most beneficial for certain conditions while reducing side effects.

5. The CB1 Receptor Gets Around With Other Receptors
Two locks come together and you have to turn multiple keys at the same time as if you were launching nuclear missiles.
090108-F-1234P-011_opt.jpg

Another limitation of the lock and key model is that it shows each lock working independently. Nothing could be further from the truth! The CB1 receptor is floating in a lipid membrane where it can directly interact with many other receptors. In fact, the CB1 receptor can interact with at least 10 other receptor types.
The receptors in each heterodimer pair can modulate each others function in various ways. This is one mechanism of how the cannabinoid system interacts with the opioid system, the serotonin system, the dopamine system, and various others. Let’s not even get into the issue that CB1 may get down with multiple other receptor types at the same time (insert polyamorous joke here).

6. The CB1 Receptor Can Quickly Be Downregulated
If you unlock the door too many times, the keyhole disappears.
Consuming THC multiple times can cause tolerance to its effects. One of the way this happens is through receptor endocytosis – cells literally swallowing the receptor into itself so that there is less of it at the cell surface.
But here’s an interesting twist – CB1 receptor downregulation does not happen equally in all brain areas. This may explain why you can develop tolerance to some effects of THC more than others.

7. Not All CB1Receptors Are the Same
There are many different brands of locks.
Love-Locks-On-The-Bridge_opt.jpg

Finally, your CB1 “lock” is not mass produced. The CB1 receptor is highly polymorphic, meaning that there is a lot of genetic variation in its DNA sequence. The CB1 receptor that you have is not necessarily the same as that of your neighbors.
Although not all CB1 genetic polymorphisms have functional consequences, several CB1polymorphisms affect expression or signaling. Pharmacogenetic studies have linked these to psychiatric, cardiovascular, and inflammatory conditions and how you respond to THC.
 
Oh........ that deserves another hug. :hugs::hugs::hugs::hugs::hugs:
 
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