DoctorShawn – Page 9

04/Sep/2020

By: Dr. Shawn Meirovici N.D.

Intro

As a cannabis educator and naturopathic doctor I naturally get asked several questions about cannabis. Specifically cannabidiol (CBD) and epilepsy. I believe CBD enriched cannabis oil can be an effective and safe first or second line therapy for various forms of epilepsy and this is why.

Back Story on CBD and Epilepsy

Allow me to first tell you a bit about the story behind CBD and epilepsy. The potential of CBD as a therapeutic option in treating epilepsy came to the forefront back in 2013. Renowned CNN medical journalist Dr. Sanjay Gupta did a special report series on cannabis called “Weed”. One of these episodes highlighted a 5 year old girl named Charlotte Figi.

Charlotte, who had been diagnosed with a severe form of epilepsy called Dravet Syndrome, was being treated with a concentrated CBD oil. Dravet syndrome is characterized by prolonged and frequent seizures that typically begin in the first year of life. Without successful treatment, Dravet can lead to severe health concerns including developmental disabilities. After several anti-epileptic drugs failed to control her seizures, Charlottes family had began to research alternative options to help their daughter.

A little known fact is that CBD was actually discovered and researched before the most famous of the cannabinoids, delta-9 tetrahydrocannabinol (THC). Not too long after the discovery of CBD, research into the calming effects of CBD on the neurological system and its potential as an anti-epileptic came to surface.

One such study came from the Journal of Clinical Pharmacology. Published in 1981, the study found that cannabidiol was effective in almost all epileptic patients (secondary generalized epilepsy) at a dose of 200-300mg daily for 4.5 months. There were no psychological or physical symptoms suggestive of psychotropic or toxic effects. (1)

The Figi’s soon came across some of this research and began searching for high CBD strains of cannabis (not easily attainable at the time). They came across the Stanley Brothers in Colorado who had bred a high CBD low THC strain of marijuana known as “Hippie’s Disappointment”. The name suggesting its low THC content and little to no psychotropic effects.

Charlottes parents and physician said that she experienced a reduction of her epileptic seizures after her first dose of CBD oil! The strain was then renamed “Charlotte’s Web” and thus began a flurry of interest into cannibidiol and changing of marijuana laws across America.

More recently there have been several high quality clinical trials, including three phase 3 clinical trials in 2017. These trials demonstrated the efficacy of cannabidiol in reducing convulsive seizure activity; specifically in children with treatment-resistant Dravet syndrome and Lennox-Gastaut syndrome. (2)

Dr. Sanjay Gupta M.D. CNN Special Report “Weed”

How CBD works

I will now explain how we think CBD works in convulsive syndromes. In order to do so I must first briefly explain an important biological system that all humans, in fact all creatures with the exception of insects, possess called the Endocannabinoid System (ECS). The ECS regulates many bodily systems to maintain balance. One such job of the ECS is to function as a self-regulating harm reduction system; essentially acting as a breaker system shutting down power when circuits get overloaded.

The ECS is able to do this via chemical messengers in our body called endocannabinoids (Cannabinoids found within our body). The two main endocannabinoids are Anandamide (AEA) and 2-Arachidonoylglycerol (2-AG). Endocannabinoids are released at the postsynaptic neuron (the receiving end of a chemical signal). Through retrograde inhibition (a feedback loop) can turn off or quiet a signal. As you can imagine, if there was no off switch things would go haywire very quickly.

Circling back to epilepsy, one of the ways the ECS functions is by maintaining homeostasis in the nervous system. The ECS is involved in the prevention of excess neuronal activity as is the case with a convulsive seizure. So you may now be wondering how CBD fits into this picture.

Our ECS is activated via receptors called cannabinoid receptors. We have many types of these receptors throughout our body. Our endocannabinoids (AEA and 2-AG) as well as phytocannabinoids (cannabinoids from plants such as THC) activate these receptors. Unlike THC, however, CBD does not fit well into our cannabinoid receptors. CBD instead boosts the activity of our endocannabinoids (AEA and 2-AG) by slowing their enzymatic breakdown.

In short, CBD can increase our endocannabinoid tone by inhibiting re-uptake. Much like how an antidepressant boosts serotonin activity by inhibiting re-uptake of serotonin.

There are many other physiological actions of CBD, such as being a potent anti inflammatory and having antidepressant effect. However, for the purposes of understanding how it can work in epilepsy, CBD is thought to act by increasing endocannabinoid tone in the nervous system.

CBD is regarded as a very safe medicinal substance as it doesn’t directly stimulate our receptors, as do many other drugs. Rather, it boosts our own innate endocannabinoid activity.

CBD Safety In Epilepsy

CBD is a generally well tolerated medication, and has no known toxicity (we’re not sure if its even possible to overdose from it). There are however some things that are important to point out to patients considering using CBD, especially when it comes to epileptic patients already taking other anti epileptic drugs (AED).

A randomized control trial (RCT) from 2018 in the journal of Neurology aimed to evaluate the safety of CBD in children with Dravet syndrome. The patients were aged 4-10 years and they received a CBD oil at relatively high doses (5, 10 or 20mg/kg/day). That equates to 65mg per day on the lower end and 260mg per day on the higher end for a 30lb child.

Considering the average adult using CBD consumes somewhere between 20-60mg per day, that’s a pretty hefty dose for a child. The results of the study indicated that for the most part CBD had no effect on other AEDs’ (Clobazam, Valproate, Levetiracetam, Topiramate and Stripentol). There was one exception with N-desmethylclobazam in which it increased levels of this drug. This effect is likely due to how CBD can slow down liver metabolism via a specific enzyme called CYP450. (3)

There was also an increase in liver enzymes in 6 patients taking both valproate and CBD. Something that may not be of much clinical significance but should be monitored. Most of my medicated patients with epilepsy are prescribed Keppra (Levetiracetam) as a first line therapy. It’s good to know that even at high doses (260mg/day) CBD is not likely to interact with this medication. Valproate is the second most common AED that I see clinically. In these patients it is recommended to test the liver enzymes every so often.

There were more adverse effects (AE) in those patients taking CBD as compared to placebo. The most common AEs’ being pyrexia, somnolence, decreased appetite, sedation, vomiting, ataxia and abnormal behaviour. In general CBD was well-tolerated. To compare, the most common AEs’ in patients taking Keppra (Levetiracetam) are: headache, increased blood pressure, somnolence, drowsiness, fatigue, anorexia, weakness, nasopharyngitis and cough. Keppra is also one of the more well tolerated AEDs’. In my opinion CBD, at the very least, is very similar to Keppra in safety profile and efficacy and should therefore be considered as a first or second line therapy.

CBD Efficacy in Epilepsy

One of the more recent studies looking into CBD and epilepsy was conducted just down the street from me at the Hospital for Sick Kids (a world renowned children’s hospital in Toronto Canada).

The study was published in the Annals of Clinical Translational Neurology in August of 2018. What was even more exciting is that the study used a CBD enriched cannabis oil from a licensed producer (Tilray) that many of my patients have access to. The CBD oil contained 100mg/ml CBD and 2mg/ml THC. Nineteen children with Dravet syndrome received the CBD oil for the complete 20-week intervention. The average dose was 13.3mg/kg/day (right in line with the dose of previously discussed safety study). The most common AEs’ were: somnolence, anorexia and diarrhea. Liver enzymes increased in patients also taking Valproate (so it looks like the interactions and adverse effects are pretty consistent).

There was a statistically significant improvement in quality of life, reduction in EEG spike activity (correlated with seizure activity), an average motor seizure reduction of 70.6% (motor seizure reduction rate in Keppra is around 37%) with a 50% responder rate of 63% (comparable to Keppra). (4)(5) Click Here for Sick Kids Study

CBD as first line therapy in Epilepsy

At this point you may be wondering why CBD is not generally considered as a first line therapy option for convulsive seizure disorders?

The reality is that the medical system in North America is generally very conservative in accepting new treatments. This is often a good thing (protecting the public from potentially dangerous or useless medications). However, on the flip side it can be a obstacle for getting naturally derived medicines, that we know to be safe and likely effective, to the patients that would benefit from them.

Currently we only have studies using CBD oil or CBD enriched cannabis oil (Containing other cannabinoids like THC) in patients with severe forms of epilepsy, or who have failed to see benefit with several other AEDs’. However, if we take into account all the information we do have on CBD, we can draw some pretty solid conclusions about its safety profile, the potential adverse effects, interactions with other drugs and its efficacy.

Until we see a robust amount of research using CBD as a first line therapy in a wider array of seizure disorders it is not likely to be accepted as a first or second or third choice by many neurologists. As a Naturopathic Doctor and cannabis educator I do see the potential of CBD for epilepsy. I will therefore continue to advocate for CBDs’ consideration as a first or second line therapeutic agent in many of my patients with epilepsy.

Check out my other articles on CBD and medical marijuana

Epilepsy Foundation stance on medical marijuana

References

Carlini EA, Cunha JM. Hypnotic and antiepileptic effects of cannabidiol. J Clin Pharmacol. 1981;21(S1):417S-427S. doi:10.1002/j.1552-4604.1981.tb02622.x
O’Connell, Brooke (May 1, 2017), “Cannabinoids in treatment-resistant epilepsy: A review.”, Epilepsy Behav, Epilepsy & Behavior, 70, 6, 341-348, 70: 341–348, doi:10.1016/j.yebeh.2016.11.012, PMID 28188044
Devinsky O, Patel AD, Thiele EA, et al. Randomized, dose-ranging safety trial of cannabidiol in Dravet syndrome. Neurology. 2018;90(14):e1204-e1211. doi:10.1212/WNL.0000000000005254
McCoy B, Wang L, Zak M, et al. A prospective open-label trial of a CBD/THC cannabis oil in dravet syndrome. Ann Clin Transl Neurol. 2018;5(9):1077-1088. Published 2018 Aug 1. doi:10.1002/acn3.621
Abou-Khalil B. Levetiracetam in the treatment of epilepsy. Neuropsychiatr Dis Treat. 2008;4(3):507-523. doi:10.2147/ndt.s2937

DoctorShawn

18/May/2020

By guest author: Sean Roberts

How to make cannabis butter? I am sure if you are just learning to cook with cannabis you might have several questions up your sleeves. And the good news is, you’ve come to the right place because we can help you cook cannabis butter safely from your home. You don’t require several decorated ingredients or a set of fancy cooking equipment.

All you need is simple cooking items that you can easily find in your kitchen pantry. Along with that, you will also need high-quality cannabis that you can obtain from a licenced dispensary, or directly from the producer with a medical marijuana prescription.

You don’t have to be a master chef to cook cannabis butter. However, the process requires attention, patience, and some techniques. So, jump on the bandwagon of cooking with cannabis and learn how to make cannabis butter at home.

Start With Decarboxylation Process

For beginners, the process of decarboxylation might be a little tricky. However, you will get the gist of it once you follow all the instructions given below carefully. Before we begin, here are a few things you need to learn. First and foremost, cannabis butter is a form of an edible and there are different ways of making it.

Some might avoid the decarboxylation process in order to make the butter less potent. While others look for potency in the butter. In fact, cannabis edibles are highly potent and to do so you need to first decarboxylate your cannabis. This will help you activate the psychoactive elements of the herb to its full potential.

Ideally, you have to heat cannabis at a certain temperature. The chemical reaction caused due to heating will help activate THC (psychoactive compound of the cannabis plant) and the compounds will bind together to generate the desired effect. In addition to this, you also have to take note of one more important thing. The cannabis flower contains THCA when in its raw form and this compound is non-psychoactive in nature.

Although heating causes the flower to convert THCA to THC, yet, most canna experts believe that drying cannabis before heating will help you achieve the best results. Also, keep in mind that soaking raw cannabis in heated butter will not produce the desired results. The less you soak, the better your butter will be. That said, let’s begin with the process of decarboxylation.

Things You Need To Do

You can use a microwave to decarboxylate cannabis at home. Other types of equipment that you will need include a baking tray, parchment or baking sheet, aluminum foil, and cannabis. Once you are sorted with the material, preheat your oven at 245 degrees Fahrenheit. While the oven is preheating, take a parchment paper or baking sheet and cut it to the size of your baking tray. Place the baking sheet inside the tray.

You can also keep a double layer of the aluminum foil or the baking sheet on the tray for even heat distribution. Which brings me to a very crucial scientific aspect of heating cannabis? You see, heat rises in the upward direction. Similarly, while your oven is being preheated the heat will rise in the upward direction making the oven warmer on the top and cooler at the bottom.

This means that you have to place the baking tray with dried flowers in the center of the oven in order to heat the buds at the correct temperature.

After the oven is preheated, take the tray and spread tiny pieces of cannabis on the baking sheet. Ensure that you do not break the flower into very small pieces. You can roughly break the buds into medium-sized ones to avoid the risk of over-heating or burning.

Next, place another foil paper on the top of the buds and put the tray inside the preheated oven. Bake for at least 45 minutes and once completely baked, remove it and let it cool down for another 30 minutes. Soon after cooling, you will get fresh, slightly roasted, golden-brown buds of decarboxylated cannabis ready to be infused in the butter.

How To Make Cannabis Butter?

To make cannabis butter you need to first gather a few ingredients and equipment. You will require a medium-sized saucepan, thermometer, wooden spoon, one cup of water, one cup of butter, 10 grams of decarboxylated cannabis. Next, take good quality cannabis butter in a bowl and make sure the quantity corresponds with the amount of cannabis you want to infuse in the butter.

For instance, with one cup of butter, you can use 6-8 grams of cannabis. So, make sure you infuse an optimum amount of cannabis in the butter.

For the next step, you need to take a saucepan. Put the butter using a spoon into the saucepan and add some water. Water addition is necessary because this way the butter will remain consistent. Not only this but water will prevent the bottom layer of the butter from burning or sticking to the pan. Now, turn on the gas and cook the butter in low heat.

While the butter is melting, take the decarboxylated cannabis and crush them with your hands. Add the coarsely crushed cannabis pieces into the pan containing butter and then stir it with the help of a wooden spoon. Stir until cannabis is completely soaked in the butter and cook on low heat for a maximum of two hours.

Experts believe that the ideal temperature for cooking the cannabis-infused butter is between 160-200 degrees Fahrenheit. So, check the temperature of the butter while you are cooking the mixture.

The Final Step

After two hours of stirring and cooking, turn the heat off and let the pan cool down. In the meantime, grab a cheese-cloth and a container you would want the butter to be stored in. Take the container, place a funnel on top it, and then keep the cheese-cloth over the funnel. Adjust the cloth properly and then pour the mixture over it.

Let the mixture strain into the container freely. Do not squeeze the cloth because it will allow the impurities to pass through the cloth. In case of that, you can use a spoon to create pressure on the cloth. This will allow the mixture to pass freely and the butter you get will be of high quality. After filtration, take the container and store it inside the freezer until the butter is completely ready for consumption.

About the author:

Sean Roberts is a writer by profession. He is a full time writer working with NY Marijuana Card, a leading clinic that provides medical marijuana recommendations. He aims at educating people about the medicinal use of cannabis.

DoctorShawn

21/Nov/2019

It was my hope to find an effective alternative to Cannabidiol (CBD) that wouldn’t land me in jail when I travel; so is PEA the new CBD?

PEA stands for Palmitoylethanolamide. It is a fatty acid that is found in Eggs, Cheese, Meats and Peanuts. We also make PEA during stress, infections, inflammation, trauma, allergies, pain, cardiac disease, kidney disease and obesity. Much like our endocannabinoids, PEA is responsible for maintaining cellular homeostasis.

Naturopathic Treatment for Multiple Sclerosis

How does it work?

While PEA does not have a direct effect on Cannabinoid receptor (CB1 and CB2) it does have similar mechanisms of action to our endocannabinoids and cannabidiol (CBD). PEA looks very similar to our body’s own endocannabinoids (AEA and 2-AG). These similarities allow PEA to exert effects similar to our AEA and 2-AG.

PEA down regulates mast cells, which are responsible for the release of histamine and other inflammatory mediators. PEA can therefore be a powerful molecule for immune heath, inflammation, pain, neuro-protection and allergies. PEA has direct action on receptors GPCR55 and GPR119, which produce effects similar to activation of CB1 and CB2 by endocannabinoids, THC and CBD. PEA also acts similarly to CBD by affecting the breakdown of endocannabinoids via inhibition of the enzymes FAAH and MAGL.

Pain Management — Micronutrient Infusion

The Research

Several studies have shown that when PEA is used with opioid type drugs for low back pain, the dose of the opioids could be reduced significantly. PEA was found to exert pain relief animal models of inflammation and neuropathic pain. These analgesic effects are thought to be due to increasing endocannabinoid levels similarly to how CBD works. All in all many studies have revealed that PEA exerts similar effects to CBD. So I thought I would give this supplement a whirl, as a alternative to CBD (especially for travel) would be an important option for patients using CBD.

My 5-day Trial with PEA

I took the supplement P.E.A. Activate from AOR , which contains 600mg PEA per lozenge. My daily dose was two lozenges per day and I did that for 5 days. I noticed a strange light-headed feeling about 5 minutes after chewing my first lozenge. The feeling lasted for a bout 30min. I was excited that I actually felt a bit different after that fist dose by unfortunately each dose produced a similar effect (a light relaxing feeling) that only lasted between 30-60min. There didn’t seem to be much carry over from one dose to another. The effects were always pretty fast acting but short-lived. Furthermore I had a return of some muscle soreness that was absent for most of the time that I was taking my CBD supplement. So, it seemed like, for me, the PEA was not having the same effect that I had experienced while on CBD.

In summary, the effects that I experienced during my PEA trial were fast acting but short-lived. PEA may therefore be a useful tool for acute episodes of anxiety, pain etc… but it did not have the same accumulative and long term effects that I experienced with CBD. The research on PEA is compelling and it is possible that this supplement warrants a more long-term trial. According to the research PEA seems to be a potential alternative to CBD but from my experience it falls a bit short. Check out my video review of PEA here.

https://youtu.be/Yfr-Ma19gGk

DoctorShawn

30/Oct/2019

“Let food be thy medicine, and let medicine be thy food”; a famous quote from the Classical Grecian physician Hippocrates. Lions Mane mushrooms are a perfect embodiment of this philosophy; as delicious as it is therapeutic.

Lions mane (Hericium Erinaceus) is a white clumpy mushroom with long dangling spines that tends to grow in late summer/early fall on hardwoods.

I was first introduced to Lion’s Mane a few years ago when I had a few patients tell me they were using an extract of the mushroom to help with memory. Supplements that enhance brain activity, AKA Nootropics, have always tweaked my interest as one of my areas of clinical focus is in neurology. At first I thought that maybe this is the newest “superfood fad” but once I began to investigate the research on this mushroom my opinion quickly changed.

It was clear that Lions Mane had some legitimate therapeutic value in inflammation, the immune system, psychiatric conditions, cognitive enhancement, diabetes, heart disease, bowel disease and cancer.

Inflammation and Depression

A 2012 study demonstrated that Lions Mane mushroom contains several compounds that have moderate to high levels of antioxidant capacity. This translates into an anti-inflammatory effect in the body. A 2015 study demonstrated that participants who consumed Lions Mane had less depressive symptoms and improvements in blo-markers of depression which was attributed to it’s anti-inflammatory effects. Another study demonstrated that Lions Mane can enhance immune function possibly by reducing inflammation and oxidative stress.

Immune

Not only does Lions Mane help boost immune function by reducing oxidative stress, it also seems to benefit intestinal immune function. A study on mice revealed that some of the proteins in the mushroom help encourage the growth of beneficial bacteria in the gut.

Memory

Cognitive enhancement is the main reason that I see people taking this mushroom. It is possible that it does have some cognitive enhancement properties but all the research so far has been done on animals. One such study found that mice given a lion’s mane supplement had better object recognition and recognition memory. Other research suggests that Lions Mane may have the potential to prevent or treat conditions of cognitive decline like Alzheimer’s and Parkinson’s disease.

Heart Health

Research on rats has demonstrated that Lions Mane may have cholesterol lowering effects and blood pressure lowering effects. Compounds in Lions Mane may help in the production of Nitric Oxide, which helps keep blood vessels relaxed.

Cancer

The antioxidant properties of Lions Mane may contribute to some anti-cancer effects seen in rat and in vitro studies. One in vitro study indicated that Lions Mane has activity against human leukemia cells. Another study showed that in mice, Lions Mane has activity against Liver, Colon and Gastric cancer cells.

Diabetes

After 4 weeks of Lions Mane supplementation, rats with diabetes had lower blood sugar levels than those who did not receive the mushroom. Diabetes can often result in life altering nerve damage. A 2015 study showed that diabetic rats given an extract of Lions Mane had reduced nerve pain and improved antioxidant activity after 6 weeks.

Digestive Health

I previously discussed how Lions mane can have anti-inflammatory effect of the digestive tract, as well as benefitting the growth of “good” intestinal bacteria. Another study demonstrated that Lions Mane has some interesting antimicrobial effects. Notably, Lions Mane seems to inhibit the growth of H-pylori, a bacteria responsible for close to 80% of stomach ulcers.

Nerve Repair

One of the most fascinating health benefits of Lions Mane came out of a rat study. Rats with nerve damage who were given daily extracts of Lions mane had quicker nerve cell regeneration than those who did not.

Culinary

Up until a few weeks ago I thought Lions Mane was an exotic mushroom that was only used therapeutically as a supplement. Recently, I found myself in a local Farmers Market and low and behold a mushroom farmer was selling fresh Lions Mane; I was amazed! I asked the farmer “how do I prepare this”? He told me to cut the mushroom in ½ inch slices and in a hot pan with butter, sear both sides. So, I bought some and followed his advice, and discovered that Lions Mane is absolutely delicious! It is now one of my favorite cooking mushrooms and I have since heard from many foodies and chefs that it is one of their favorites too. So let food be thy medicine everyone, and cook up some Lions Mane this fall!

Citations

Leonard, Jayne. “What are the benefits of lion’s mane mushrooms?.” Medical News Today. MediLexicon, Intl., 22 Oct. 2018. Web.
30 Oct. 2019. <https://www.medicalnewstoday.com/articles/323400.php>

Leonard, J. (2018, October 22). “What are the benefits of lion’s mane mushrooms?.” Medical News Today. Retrieved from
https://www.medicalnewstoday.com/articles/323400.php.

Lion’s Mane Mushroom, Hericium erinaceus (Bull.: Fr.) Pers. Suppresses H2O2-Induced Oxidative Damage and LPS-Induced Inflammation in HT22 Hippocampal Neurons and BV2 Microglia.

Kushairi N, Phan CW, Sabaratnam V, David P, Naidu M.

Antioxidants (Basel). 2019 Aug 1;8(8). pii: E261. doi: 10.3390/antiox8080261.

PMID: 31374912 [PubMed] Free Article

Thirteen-Week Oral Toxicity Evaluation of Erinacine AEnriched Lion’s Mane Medicinal Mushroom, Hericium erinaceus (Agaricomycetes), Mycelia in Sprague-Dawley Rats.

Lee LY, Li IC, Chen WP, Tsai YT, Chen CC, Tung KC.

Int J Med Mushrooms. 2019;21(4):401-411. doi: 10.1615/IntJMedMushrooms.2019030320.

PMID: 31002635 [PubMed – indexed for MEDLINE]

In Vitro and In Vivo Inhibition of Helicobacter pylori by Ethanolic Extracts of Lion’s Mane Medicinal Mushroom, Hericium erinaceus (Agaricomycetes).

Wang G, Zhang X, Maier SE, Zhang L, Maier RJ.

Int J Med Mushrooms. 2019;21(1):1-11. doi: 10.1615/IntJMedMushrooms.2018029487.

PMID: 30806251 [PubMed – indexed for MEDLINE]

Dietary Supplementation of Lion’s Mane Medicinal Mushroom, Hericium erinaceus (Agaricomycetes), and Spatial Memory in Wild-Type Mice.

Rossi P, Cesaroni V, Brandalise F, Occhinegro A, Ratto D, Perrucci F, Lanaia V, Girometta C, Orrù G, Savino E.

Int J Med Mushrooms. 2018;20(5):485-494. doi: 10.1615/IntJMedMushrooms.2018026241.

PMID: 29953363 [PubMed – indexed for MEDLINE]

A Polysaccharide Isolated from Mycelia of the Lion’s Mane Medicinal Mushroom Hericium erinaceus (Agaricomycetes) Induced Apoptosis in Precancerous Human Gastric Cells.

Wang M, Zhang Y, Xiao X, Xu D, Gao Y, Gao Q.

Int J Med Mushrooms. 2017;19(12):1053-1060. doi: 10.1615/IntJMedMushrooms.2017024975.

PMID: 29431066 [PubMed – indexed for MEDLINE]

Anti-Inflammatory Effects of Ethanol Extract of Lion’s Mane Medicinal Mushroom, Hericium erinaceus (Agaricomycetes), in Mice with Ulcerative Colitis.

Qin M, Geng Y, Lu Z, Xu H, Shi JS, Xu X, Xu ZH.

Int J Med Mushrooms. 2016;18(3):227-34. doi: 10.1615/IntJMedMushrooms.v18.i3.50.

PMID: 27481156 [PubMed – indexed for MEDLINE]

DoctorShawn

09/Oct/2019

Intro to Afghan Kush

I chose to review Pure Farms Afghan Kush because it is a best seller on the Ontario Cannabis Store and because it’s a genetically pure strain. Kush originated in Hindu Kush mountain region sandwiched between Afghanistan and Pakistan. Geographically, Afghan Kush is therefore pretty much as authentic as you can get. In fact, Pure Farms notes that this strain is the building block for many modern Kush varieties.

Pure Farms Afghan Kush is a medium to high potency Indica. The Farm is located in British Columbia. They have been cultivating for 25 years. The cannabis is grown in a modern green house facility with natural light and modern app-based quality assurance systems.

Appearance

The batch that I sampled was around 18% THC (mid-high potency) but it can land anywhere between 16-22%. When I took out my first bud I could see that it was heavily frosted with trichomes. I was also struck by the vibrant green color of the bud, which is an indication of its freshness and lack of oxidation. The texture was a bit drier than I prefer but the smoke was not harsh and very flavorful.

Smell Test

Immediately after opening the package I took a good whiff of the buds. The aroma was pleasant with definite floral and earthy notes. I knew right away that Myrcene and Linalool would be two prominent terpenes in this strain. I was able to confirm that Linalool and Myrcene were indeed part of this varieties profile, along with Nerolidol, Caryophyllene and Limonene (OCS.ca). Linalool and Myrcene are typically associated with relaxation, so I knew, even before smoking, that this would probably be a very relaxing strain.

The experience

I took 3 draws of the Afghan Kush from a joint. The effects started within 5-10 minutes and peaked around 45 minutes after smoking. The primary sensation was a nice enjoyable relaxation throughout the body and head. I would say that the body effect was not as potent as some other Indica’s that I have tried (see my review of MK Ultra). The high felt very clean and authentic, like I was transported back in time to when the first Indica strains were being cultivated. Despite the relatively high THC content there was no paranoia. I did develop a slight headache, and dizziness toward the end of the high (might have just taken a bit too much). Initially the experience wasn’t very sedating; however, towards the end I did feel quite sleepy. Therefore I would recommend this as an evening/night strain, not ideal for daytime use.

Final Thoughts

I recommend this strain to the cannabis connoisseur and those interested in trying something with a great deal of authenticity. I could also see this strain being helpful for tight sore muscles and issues with sleep and stress. Even if it was primarily a placebo effect, I enjoyed feeling connected to the roots of cannabis cultivation through this very authentic Indica.

https://youtu.be/zXiljCm2yoU

DoctorShawn

11/Sep/2019

My review of Ruxton by Broken Coast. Deeply relaxing, very potent 4 out of 5 stars.

DoctorShawn

14/Aug/2019

My review of Aurora Cannabis MK ULTRA 4.5 stars out of 5!

DoctorShawn

30/Apr/2019

Dr. Shawn Reviews...Cannabis: Tweed Argyle Spray

DoctorShawn

22/Sep/2018

Cold and Flu season is here! Now that kids are back to school and the season is changing we should start thinking about preventing colds and flu. As a Naturopathic Doctor part of my job is counseling parents on safe and effective ways to treat and prevent colds and flu for the whole family. Here are 5 things that will help prevent colds and flu and can even help to ameliorate symptoms and shorten duration of an active infection.

Probiotics

Probiotics help boost the immune system – Studies have shown that probiotics affect immune cells throughout the body. When certain strains of probiotics are introduced into our intestine they help to repair intestinal cells and they boost production of antimicrobial substances. In one study, 326 children aged 3-5 years were randomly assigned to receive, in double-blind fashion, probiotic supplementation. Treatments were given twice per day in divided doses for 6 months, including the winter season. Compared with placebo, the probiotic group had the following results; fever reduction 53-73%, cough reduction 41-62%, decreased runny nose 28-59%, decreased need for antibiotics 68-82%, reduced absence from school 28-32%.

Elderberry

Elderberry extracts inhibit bacteria and viruses – Not only does elderberry syrup taste great, studies have shown that it inhibits the bacteria and viruses associated with common colds and the flu. One study demonstrated that an elderberry liquid extract possesses antimicrobial activity against both streptococci bacteria and influenza viruses. Another study looked at 312 air travellers flying from Australia to an overseas destination. Those travellers who took an elderberry extract before, during and after travel had fewer colds, less sick days and less symptoms.

Vitamin C

Vitamin C supports immune cells – Vitamin C is very important for optimal immune system functioning. Vitamin C helps immune cells get to where they need to be, kill pathogens effectively, protect the body from damage and clean up after battling infections. Studies have shown that adequate vitamin C in the blood helps prevent infections, is necessary to fight infections and helps with recovery. The recommended daily intake of vitamin C is 100-200mg/day; however during active infection, the metabolic demand increases and therefore the requirement for vitamin C is likely to be higher. Even in this day and age, vitamin C is the fourth leading nutrient deficiency in North America. Poor diet and increases in free radical exposure due to an unhealthy lifestyle may be contributing factors. Excellent sources of vitamin C are Broccoli, Citrus Fruits and Berries.

Zinc

Zinc is essential for immune system communication – The importance of zinc for proper immune function has been well established. Zinc deficiency undoubtedly causes immune system malfunction. The cells of our body are in constant communication. During infection there is a need for effective communication between immune cells in order to get rid of the “bad guys”. Communication happens in the form of chemical messengers and enzymes. Zinc is an essential component of these chemicals and enzymes. As with vitamin C, during active infection our requirement for zinc is likely to increase. Studies have shown that Zinc supplementation during infection can shorten the duration of the illness. Excellent dietary sources of zinc include: Meat, Shellfish, Legumes, Nuts and Seeds. Supplementation may be important with a vegan or vegetarian diet.

Vitamin D

Vitamin D is the supervisor of the immune system –Vitamin D has many functions in the body, and receptors for vitamin D can be found on many different tissues. One important function for vitamin D is in the modulation of our immune system. Studies have suggested that vitamin D is able to both calm down and rev-up the immune system according to what our body needs it to do. This is why Vitamin D is thought to be as important in autoimmune disorders as it is in infections.

Vitamin D deficiency can cause the immune system to behave erratically. Unfortunately in Canada we have one of the highest incidences of vitamin D deficiency in the world. Our primary source of vitamin D is from sunlight and therefore supplementation becomes important especially during the winter months. Studies have shown that there is a higher incidence of upper respiratory tract infections in athletes who are deficient in the vitamin and who train in the wintertime. Supplementation had preventative and symptom reducing effects. Aside from sunlight, some dietary sources of vitamin D are: fortified foods, fatty fish, beef liver, egg yolks and cheese.

Even vitamins and minerals at high dosages can be dangerous, especially in children. It is always recommended to consult with a health care professional, such as a Naturopathic Doctor, before supplementing on your own.

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Leyer, GJ et al. Probiotic effects on cold and influenza-like symptom incidence and duration in children. Pediatrics 2009; 124-179. Walker, WA. Mechanisms of action of probiotics. Clin Infect Dis. 2008; 46 (Suppl2): S87-91.

Curr Opin Gastroenterol. 2011 October ; 27(6): 496–501. doi:10.1097/MOG.0b013e32834baa4d. Probiotics and immune health Fang Yana and D.B. Polkb,c,d

Elderberry Supplementation Reduces Cold Duration

and Symptoms in Air-Travellers: A Randomized,

Double-Blind Placebo-Controlled Clinical Trial Evelin Tiralongo 1,2, *, Shirley S. Wee 2,3 and Rodney A. Lea 4 Received: 8 February 2016; Accepted: 18 March 2016; Published: 24 March 2016

Krawitz et al. BMC Complementary and Alternative Medicine 2011, 11:16

http://www.biomedcentral.com/1472-6882/11/16

Inhibitory activity of a standardized elderberry

liquid extract against clinically-relevant human

respiratory bacterial pathogens and influenza A

and B viruses Christian Krawitz1†, Mobarak Abu Mraheil1†, Michael Stein2, Can Imirzalioglu1, Eugen Domann1, Stephan Pleschka2*,

Torsten Hain1*

Vitamin C and Immune Function Anitra C. Carr 1, * and Silvia Maggini 2

1 Department of Pathology, University of Otago, Christchurch, P.O. Box 4345, Christchurch 8140, New Zealand

2 Bayer Consumer Care Ltd., Peter-Merian-Strasse 84, 4002 Basel, Switzerland; silvia.maggini@bayer.com* Correspondence: anitra.carr@otago.ac.nz; Tel.: +643-364-0649 Received: 21 September 2017; Accepted: 31 October 2017; Published: 3 November 2017

Biofactors. 2014 Jan-Feb;40(1):27-40. doi: 10.1002/biof.1114. Epub 2013 Jun 27.Zinc signals and immune function. Haase H¹, Rink L.

Cochrane Database Syst Rev. 2013 Jun 18;(6):CD001364. doi: 10.1002/14651858.CD001364.pub4. Zinc for the common cold.

Singh M¹, Das RR.

Vitamin D3 Supplementation Reduces the Symptoms

of Upper Respiratory Tract Infection during Winter

Training in Vitamin D-Insufficient Taekwondo

Athletes: A Randomized Controlled Trial Hyun Chul Jung 1 , Myong-Won Seo 2 , Sukho Lee 3 , Sung Woo Kim 2 and Jong Kook Song 2, * 1 Department of Kinesiology, College of Health Sciences, University of Louisiana at Monroe, 700 University

Avenue, Monroe, LA 71209, USA; jung@ulm.edu

2 Department of Taekwondo, College of Physical Education, Kyung Hee University, 1732 Deokyoungdaero, Giheung-gu, Yongin-si, Gyeonggi-do 17014, Korea; smilly1004@khu.ac.kr (M.-W.S.); kswrha@khu.ac.kr (S.W.K.)

3 Department of Counseling, Health, and Kinesiology, College of Education and Human Development,Texas A&M University-San Antonio, One University Way, San Antonio, TX 78224, USA; slee@tamusa.edu* Correspondence: jksong@khu.ac.kr; Tel.: +82-31-201-2708 Received: 2 August 2018; Accepted: 10 September 2018; Published: 14 September 2018

Mechanisms Underlying the Regulation of Innate and

Adaptive Immunity by Vitamin D Ran Wei and Sylvia Christakos *

Received: 25 June 2015 ; Accepted: 15 September 2015 ; Published: 24 September 2015 Department of Microbiology, Biochemistry and Molecular Genetics, New Jersey Medical School, Rutgers, the State University of New Jersey, 185 South Orange Ave, Newark, NJ 07103, USA; weira@njms.rutgers.edu

* Correspondence: christak@njms.rutgers.edu; Tel.: +973-972-4033; Fax: +973-972-5594

DoctorShawn

31/Aug/2018

Multiple Sclerosis is a complex disease; those living with it need a simple approach. A treatment approach should appreciate the physiology of the disease process without neglecting the human body as a holistic system, and the patient as a person.

Naturopathy is an ideal philosophy of medicine for the treatment of M.S. as it aims to address disease processes and symptoms without loosing sight of the patient as an individual.

I chose to focus in neurological disease early into my professional career and as a result I have come across many complex chronic diseases of the nervous system including all subtypes of M.S. When patients come for their initial visit it is not uncommon to be privy to a long list of life events that have impacted the disease, symptoms that have evolved over years and medications that have been tried, stopped and tried again.

It’s easy to see why the practitioner on the other end of the patient with M.S. can become overwhelmed and confused, loosing sight of the big picture, dismissing the patients needs and goals. Unfortunately, this medical tunnel vision re-aimed at addressing each and every concern translates into complex and confusing treatment plans that most patients cannot comply with. I sympathize with these patients who have to remember to take dozens of pills while also dealing with a life altering condition.

To make matters worse, these confusing treatment plans hardly ever work because they tend to forget that the human body is not a series of islands, rather it’s a society striving to work in harmony and balance. The key to developing a simple, understandable and effective treatment plan is to figure out what is out of balance and how do we bring it back.

A typical treatment plan for M.S. has three parts: Foundations, The Immune System and Specific Symptoms. Since we are working toward bringing the body back into balance it is important to take the time to hear the full story and timeline of how the condition started and progressed. Often during the initial consultation it will become clear as to what type of events precluded the first attack and how these events triggered a physiological imbalance.

Foundations

It’s a futile effort to try and treat symptoms while the very basics of health and wellness are not fortified. The foundations of health can be summed up into three parts: Sleep, Diet and Exercise.

Sleep is the healing chamber for the body. Recently studies have shown that the brain undergoes a type of detoxification process while we sleep. Many neurodegenerative diseases have been correlated to poor sleeping habits. It is common to see sleeping issues in patients with M.S. In fact I have had a few cases where years of terrible sleep may have contributed to the patient experiencing their first symptoms related to M.S. This makes sense in the light of the new research demonstrating how important sleep is in clearing neurotoxic compounds from the brain.

One of the most important protocols I put together for my M.S. patients is aimed at improving sleep. This is achieved through sleep hygiene education and supplements that have been carefully vetted over my years in practices for their effectiveness in improving sleep initiation and maintenance.

Diet is important for a number of reasons, some are general and some are specific to M.S. The food we eat and its relation to our digestive tract determines our nutritional robustness.

M.S. is a chronic neuro-inflammatory state and therefore patients with M.S. will be using up vitamins and minerals involved in inflammatory processes at a greater rate than in a healthy control group. Therefor it’s important to determine what the nutritional status is of the M.S. patient (through consultation and specific lab tests), bring it back into balance and correct deficiencies. Otherwise the body will be unable to cope with the inflammatory process and the disease will progress.

It is also important to identify any food allergens, intolerances and sensitivities in the M.S. patient for these will perpetuate the inflammation. Chronic inflammation has a detrimental effect on the immune system, which I will discuss further in the next part of the treatment plan.

Another aspect related to diet is the health of the gastrointestinal tract and more specifically the micro-biome (the bacteria of the gut). A healthy micro-biome is important for detoxification, nutrient absorption and immune system regulation. A protocol addressing diet will focus on testing for nutritional deficiencies, food sensitivities, specific dietary guidelines for M.S. and supportive supplements where necessary.

A good dietary resource specific to M.S. is The Wahls Protocol.

Exercise is a powerful health modulator and is under-appreciated for its importance in chronic disease and specifically M.S. Often exercise comes in the form of physiotherapy in progressive M.S. and the first thing I will do with a patient is set them up with one of the physiotherapists in my clinic (if they don’t already have a physiotherapy program). Often patients newly diagnosed with M.S. are neglected by the medical system in terms of exercise. In-patient rehab programs are inadequate, scooters and wheelchairs are promoted over therapy. Exercise and physiotherapy are instrumental in promoting neuroplasticity, decreasing inflammation, improving energy metabolism, maintaining and improving upon range of motion.

My clinic specializes in neurological rehabilitation using the Bobath Physiotherapy approach. Physio-Logic

The Immune System

Multiple Sclerosis is an autoimmune condition and therefore one cannot overlook the role of the immune system. Autoimmunity basically translates to a confused immune system that has targeted healthy cells and tissues rather than disease. The philosophy behind this part of the treatment plan addresses two questions: how the immune system became confused and how to bring it back into harmony.

There are many theories as to the cause of M.S., to name a few: Genetics, Vitamin D deficiency, Environmental Toxin Exposure, Candida Overgrowth, Dairy Protein Antigen Confusion and Leaky Gut Syndrome. There are truths to be told within many of these theories but in reality we just don’t know exactly what causes M.S. Some things we do know are the triggers for symptom activation, and things that reduce the risk of developing M.S. We know that stress (physical and/or emotional) often precipitate symptom relapse and progression. We also know that having adequate vitamin D levels are protective toward the development of M.S.

Vitamin D is not longer thought of as merely a bone-building vitamin. In reality it is more of a hormone and has a very important role in maintaining the health of the immune system. Step one of addressing the immune system is making sure the patient has optimal levels of vitamin D and if not, to adjust those levels using specific supplemental doses of vitamin D along with calcium and regular follow-up blood work.

Stress, whether it physical or emotional, causes a burden on the body. Most of the time we are able to cope with short durations of stress; however, when the stressful event is severe enough or lasts long enough it can impact the immune system in a negative way. Chronic stress can affect the immune system in two ways: Creating chronic inflammation that harms tissues and suppressing immune cells needed to fight infection.

When the immune system is under prolonged stress it becomes tired and makes mistakes, much like how we feel when under stress. One of these possible mistakes is mounting an autoimmune attack, harming normal healthy tissue rather than disease. Prolonged stress also depletes natural anti-inflammatory compounds like cortisol, allowing inflammation to run amuck. Therefore the protocol built around the immune system is aimed at decreasing stress on the immune system and bringing the immune system back into balance.

Anything that can be causing unnecessary inflammation needs to be dealt with and therefore chronic infections and food sensitivities must be addressed. Specific lab testing is used to investigate infections and sensitivities. Common food sensitivities in M.S. patients include: Dairy, Gluten, Yeast and Egg.

Once the major obstacles to a healthy immune system are removed we can work toward assisting the immune system back into a balanced state. The most important cells involved in bringing the immune system back into balance are “regulatory T cells” also known as “T suppressor cells”. These cells maintain tolerance in the immune system preventing autoimmunity. Part of the protocol is therefore aimed at supporting these cells. Some compounds that influence regulatory T cells are: probiotics, vitamin D, vitamin A, Omega 3 fatty acids and food sensitivities.

Specific Symptoms

Treating foundations and immune system irregularities take time, therefore it is almost equally important to address the specific symptoms of the patient. Fatigue, weakness and pain are often obstacles to important foundational concerns like sleep and exercise.

Fortunately, there are many great strategies within Naturopathic medicine to help address the most common symptoms in M.S. namely: Weakness, Spasticity, Fatigue, Pain, Bowel and Bladder issues. There are dozens of supplements that have shown promise in treating the common symptoms of M.S. The art of the practitioner is in choosing the right compounds for the right patient. As an example, medical marijuana can be very effective for spasticity, pain, bladder dysfunction and sleep but can exacerbate weakness. A good practitioner with experience in treating M.S. will know how to choose the appropriate medications for the patients needs.

Multiple Sclerosis is a complex condition with many subtypes and many different ways it affects the individual patient. Naturopathic medicine aims to treat the root cause of disease while also addressing the individual concerns of the patient. The treatment plan can be summed up into three areas: Foundations, Immune System and Specific Symptoms. This helps direct the practitioner toward the right approach and simplifies the philosophy behind the treatment, improving upon compliance and therefore patient outcomes.

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By: Dr. Shawn Meirovici N.D.

Intro

Back Story on CBD and Epilepsy

How CBD works

CBD Safety In Epilepsy

CBD Efficacy in Epilepsy

CBD as first line therapy in Epilepsy

References

By guest author: Sean Roberts

How does it work?

The Research

My 5-day Trial with PEA

Inflammation and Depression

Immune

Memory

Heart Health

Cancer

Diabetes

Digestive Health

Nerve Repair

Culinary

Citations

Intro to Afghan Kush

Appearance

Smell Test

The experience

Final Thoughts

Probiotics

Elderberry

Vitamin C

Zinc

Vitamin D

Even vitamins and minerals at high dosages can be dangerous, especially in children. It is always recommended to consult with a health care professional, such as a Naturopathic Doctor, before supplementing on your own.

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