York Mills Archives

13/Aug/2022

Cannabinoid therapy for sleep

I have noticed consistently good results using cannabinoids for sleep disorders. I am often asked what are the top indications for cannabis therapy in my practice and insomnia would always be in the top three.

I first started to gain an interest in cannabis and cannabinoids back in 2015. One of the most common reasons that my patients were using cannabis was for various types of insomnia. Most of these patients were having very good results. That really peaked my interest because I too suffered from insomnia for a large part of my life.

I had used various natural sleep aids but needed a change as my current medication was producing some inconvenient side effects. After receiving my medical cannabis prescription I started using a balanced THC:CBD oil which improved my sleep latency and nighttime wakeup’s within a few days. Cannabinoid therapy is now one of my most recommended treatments for various types of insomnia as it is safe, inexpensive, fast acting and effective.

Cannabis can have calming or stimulating effects depending on the preparation, dose and mode of administration. I really wanted to find out what made cannabis effective for sleep and what would be the optimal way to use it for sleep. My research pointed towards a few mechanisms through which cannabinoids likely have sleep promoting effects: GABA, Serotonin and Endocannabinoid modulation.

GABA

GABA is an inhibitory neurotransmitter that generally promotes a relaxation response in the central and peripheral nervous system. It is well established that activation of GABA receptors favours sleep and many pharmaceutical drug classes, including benzodiazepines, act on GABA receptors.

Both animal and human studies have demonstrated that cannabidiol (CBD) has a modulatory effect on GABA activity. CBD can both increase and decrease GABA activity depending on neurotransmitter activity levels (if there’s too little it increases, if there is too much it decreases). This makes CBD useful for sleep disorders resulting from too little GABA activity (think of the overactive brain) without the addictive potential of GABA stimulating pharmaceutical preparations.

Serotonin

Serotonin is a neurotransmitter that is involved in mood and sleep/wake responses. Many antidepressant medications specifically target serotonin activity. Research from the early 2000’s by Bambico et al demonstrated that cannabinoid receptor agonists (things that stimulate cannabinoid receptors) have the ability to modulate serotonin activity. Low doses seemingly to raise serotonin activity while high doses have little effect.

Both endogenous cannabinoids (cannabinoids we make ourselves) and phytocannabinoids (THC, CBD etc..) seem to have the ability to modulate serotonin activity via stimulation of our cannabinoid receptors. This may explain some of the physiology involved in the sleep promotion and anti-anxiety effects of cannabis preparations. CBD seems to be particularly useful through its interplay with our endocannabinoid system.

The Endocannabinoid System

All species, with the exception of insects, have an endocannabinoid system. The endocannabinoid system is our bodies harm reduction system, keeping chemical and electrical singling in balance. Overall, stimulation of the endocannabinoid system has a calming effect and a known modulator of our sleep/wake cycle.

Many chronic diseases that have been linked to disruption in the endocannabinoid system (Fibromyalgia, Migraine, Inflammatory Bowel Disorder) have a sleep disruption comorbidity. This sleep disruption can usually be helped with a prescription of cannabinoids such as CBD. It is certainly plausible and empirical evidence supports the theory that patients with sleep disorders have endocannabinoid disruption. Therefore, phystocannabinoids like CBD can be helpful to restore endocannabinoid tone and subsequently better sleep.

Dosing Considerations

Cannabis is a unique medicine as it cannot be prescribed based on age and weight. Everyone has an individual response to cannabinoids due to the fact that everyone has unique endocannabinoid tone and metabolism.

Cannabinoids like CBD and THC can interact with particular medications and preexisting conditions. Some preparations of cannabis are very different in their effect and duration. Smoked cannabis has a very fast acting effect but a short duration. Edible cannabis can have a slow onset of effect but last for a long time.

Therefore it is highly recommended to have a healthcare professional knowledgeable in cannabinoid therapy work with you for the initial stages of treatment. This will ensure a safe and effective dosing strategy with minimal chance for adverse effects. With that being said cannabis is a very safe medication and when prescribed correctly can make a significant difference in those suffering from sleep disorders. Check out the Cannabis Therapy page for more information.

References

Pretzsch CM, Freyberg J, Voinescu B, Lythgoe D, Horder J, Mendez MA, Wichers R, Ajram L, Ivin G, Heasman M, Edden RAE, Williams S, Murphy DGM, Daly E, McAlonan GM. Effects of cannabidiol on brain excitation and inhibition systems; a randomised placebo-controlled single dose trial during magnetic resonance spectroscopy in adults with and without autism spectrum disorder. Neuropsychopharmacology. 2019 Jul;44(8):1398-1405. doi: 10.1038/s41386-019-0333-8. Epub 2019 Feb 6. PMID: 30758329; PMCID: PMC6784992.

Gottesmann C. GABA mechanisms and sleep. Neuroscience. 2002;111(2):231-9. doi: 10.1016/s0306-4522(02)00034-9. PMID: 11983310.

Moreira FA. Serotonin, the prefrontal cortex, and the antidepressant-like effect of cannabinoids. J Neurosci. 2007 Dec 5;27(49):13369-70. doi: 10.1523/JNEUROSCI.4867-07.2007. PMID: 18057193; PMCID: PMC6673093.

drshawn

06/Jul/2022

What is NAD?

NAD IV therapy was described to me as a “game changer” while I was at a medical conference in Arizona. Up until then I had regularly treated my patients with vitamin and mineral infusions to help restore energy, sleep and manage the physical symptoms of stress amongst other things. I had come to terms with the fact that I could expect about a 60-70% response rate in my patients who were being treated for chronic fatigue. A colleague told me that NAD would be a game changer and that I could expect to see better and more consistent results. After my first NAD patient texted me the following day that they felt like a million dollars, I was sold to the idea.

NAD stands for nicotinamide adenine dinucleotide. It is a coenzyme that our body requires in order to convert food into energy and for facilitating many biochemical reactions. We need NAD to metabolize nutrients, proteins, carbohydrates and fats. NAD also impacts the functioning of cells, formation of muscle and regeneration of tissue. Studies have shown that low NAD levels are detrimental to muscle development, while elevated NAD levels could improve muscle health.

Like many fundamental nutrients and hormones, NAD levels decline as we age. This can prompt changes to our metabolism, energy levels, and our biochemistry over time. Low NAD levels can also make us more susceptible to age-related diseases and health concerns, such as Alzheimer’s, sarcopenia, and inflammation. NAD has even been touted as an anti-aging nutrient.

At my Toronto Naturopathic located in York MIlls, between the Bayview village area and Leaside, we have started to incorporate NAD into many of our IV infusions. Here are some of the outcomes of NAD therapy backed up by clinical research:

Cognitive dysfunction

Boosting NAD intake can impact brain health by improving neuronal function, protecting brain cells from harm, and driving mitochondrial functioning. Animal studies have shown that a group of signalling proteins called sirtuins may be linked to memory and learning. Sirtuins protect the body from amyloid proteins, which are related to Alzheimer’s and other degenerative diseases. Sirtuin production relies on NAD. Boosting NAD levels may likely help protect the body from amyloid proteins via sirtuin production.

Recovery from substance abuse

Excessive consumption drugs and alcohol can cause damage to organs and tissues including the brain. Studies have shown that substance abuse can specifically cause a drop in NAD levels. NAD is fundamental in the repair and detoxification pathways engaged after consumption of drugs and alcohol. Boosting NAD levels with IV therapy can help with cravings while mitigating brain fog, anxiety and fatigue.

Athletic Recovery

Proper energy metabolism and inflammatory pathways are fundamental in athletic recovery from training and injury. NAD supplementation helps to optimize energy metabolism through mitochondria activity, increases blood flow and reduces inflammation. These benefits in turn help to hasten the recovery phase and lessen muscle pain.

Chronic Fatigue

If you’re struggling with Chronic Fatigue or Myalgic Encephalomyelitis (ME), NAD could offer some alleviation. One of the ways NAD works via the mitochondria is by boosting the production of ATP. ATP is the primary energy source of all cells in the body. Boosting NAD levels via IV infusion helps to increase ATP production thereby reducing the severity of chronic fatigue syndromes.

Wondering how you may benefit from NAD supplementation? Give me a call or email and we can discuss how NAD may help you reach your health and wellness goals.

CBD for Sleep