#prions are a whole different topic

[scorndotexe]

honestly the biggest thing i have against it in an irl setting is my irrational fear of prions

i understand but that's still not an argument based on morality

[pathologising]

Listen I don't know anything about that but I want to hear you talk about it please. Polymorphism of codon 129? What is that. Are those just words for jokes or is that a thing and if it is and it's something you're interested in please tell me about it

Ok i finally have time to answer this, thank u so much for asking also do remember I am not a doctor simply a premed and prion enthusiast !

Anyway, polymorphism is just the different alleles that exist of a gene (think poly = many, morphism = forms, to simplify)

Codons are just a sequence of three nucleotides along DNA or RNA and, in regards to this discussion, they correspond to different amino acids and act as the instructions for the creation of an encoded protein. (Remember the AUUAGGACCAGUAGCAU stuff? Yea those bad boys)

So, prions are mutations in the PRNP coding for the protein PrP^c. Basically the protein misfolds in a process not entirely understood and aggregates within the brain. Within the configuration of PRNP, the Met/Val variation at codon 129 can affect prion susceptibility. So, when there is high homozygosity at codon 129 (Met/Met and Val/Val), you are more susceptible to developing prion disease. And, therefore, a higher heterozygosity (Met/Val) at that codon (also read somewhere that codon 127 can be implicated too), then you're more likely to be resistant to developing a prion disease.

Its actually very cool once you get into reading about Kuru (a prion disease resulting from the now discontinued ritual of endocanninalism, wherein they would consume those who passed out of respect) , where you see that those of the Fore women (women and children would practice the ritual) who survived past ~50 were passing down that heterozygosity, making future generations more likely to be resistant (not 100% immune, but definitely resistant) to developing Kuru.

Its incredibly fascinating to look at and prions as a whole are a beloved topic of mine! Am in the process of writing a 30+ page paper on them and if you'd like to read it when I finish it (should be like...late January or so) I'll send it to you. :)

[neuroscienxe]

pls talk to me about prions I'm endlessly fascinated and slightly confused by them. CJD as a result of cannibalism? nutso! TSEs as a whole? bonkers!

Maybe I can help clear up some things! Buckle up my dude.

Prions are misfolded proteins that originate from the gene PrP (which stands for PRion Protein). Normal and healthy cellular protein is called PrPC (usually denoted with a superscript C but tumblr doesn’t let me lol). PrPSc is the misfolded isoform, named after Scrapie, the sheep form of prion disease. Having a prion disease makes your brain look like this: 

Those holes/white spaces are where neurons have died and been cleaned up by microglia, the immune cells of the brain. Image: http://www.cjd.ed.ac.uk/neuropathology-1

The primary structure is the same between PrPC and PrPSc . These diseased forms have a lot of hydrophobic residues (aka amino acids) that are exposed to the environment of the brain. Hydrophobic residues (hating water) tend to congregate together to get away from the watery area of your brain environment. Below is a kind of diagram showing how PrPSc accumulates. 

[Pls note I made this diagram so if anyone uses it please just credit me I guess].

Amyloids are aggregates of proteins that become folded into a shape that allows many copies of that protein to stick together, forming fibrils. People aren’t really sure how the accumulation of these causes damage. There’s a couple different lines of thought though, mostly that there is some gain-of-function where the prion protein when misfolded becomes neurotoxic. 

CDJ as a result of cannibalism

This probably resulted from one member of the tribe having spontaneous Creutzfield-Jacob Disease [pronunciation] (CDJ) and then it being passed on by consumption of diseased nervous tissue. 

If you’re at all interested in prions or kuru, there’s a really great paper from 2013 called Kuru: A Journey Back in Time from Papua New Guinea to the Neanderthals’ Extinction from the open source journal pathogens that goes over the history of Kuru. History of science stuff is just the best honestly. Would Recommend. 

Another great article I just found that’s aimed at a general scientific audience is called Prions Are Forever in Scientific American. A very good overview of the topic.

TSEs are bonkers

(Note: TSE = Transmissible Spongiform Encephalopathy, the name for prion diseases as a group)

Just the idea of cross species transmission is terrifying. My state has had an uptick in instances of chronic wasting disease, prion disease in deer. There have been no recorded cases yet of a human getting vCDJ (the transmitted type, v = variant). Yet.

However, it looks like the closer the amino acid sequence is, the easier it is to transmit. So the deer thing may end up being okay. Here’s an article from 2017 about cross-species transmission if you are interested.

All that to say: prions are wild and I love them from a very far distance. Because yikes. Let me know if you have questions!!

[nerajaana]

Lol ok then, I’m not gonna apologise for the lengthy med jargon.

Regarding the effects of extreme weather on chronic conditions- it does have an impact, but not as severe as google would make you think. Unless they’re out getting exposed to the worst of the weather it shouldn’t be having a significant impact on their preexisting conditions. For example, extreme heat is linked with asthmatic attacks because of higher incidence of wildfires, which in turn increases the air pollution and that affects the asthmatics. Low humidity, whether hot or cold, means drier nasal cavities so increased incidence of respiratory infections.

As for the effects of heat itself, how acclimatised one is to the weather is an important factor. Sudden weather changes make a significant difference: if i were to move to a different climatic zone that I’m not adapted to, my immune system will be weakened for a short while, until it’s adjusted to the new environment. Which is why the heat surges and uncharacteristic drops in temperatures create so much havoc. Exposing yourself to the worst of it by not taking adequate measures will obviously have an impact irrespective of how adapted you are - I was referring to the whole uv rays damaging your dna and skin changes and skin cancers thing in my earlier response when I mentioned that people must’ve adapted over generations to the environment. Do a quick google search and see which countries have the highest incidence of skin cancers, you’d get my point.

Common folk would deal with health issues in every kingdom, and I doubt they’d have perfect skin whether in Dorne or the North. Or hell, even Reach for that matter. Farmers have to deal with nasty fungi and parasites, especially in the medieval periods where sewage system and overall hygiene practices weren’t at their best. Weather extremities wouldn’t be that high in the list of hurdles they have to overcome in order to maintain a healthy enough life.

Coming to Elia, given that she’s a month premature, it’s likely that she must’ve dealt with mild asthma and hampered physical growth due to inability to gain/maintain ideal weight. And given Doran’s gout, the chances of Elia suffering from chronic hemolytic anemia are pretty high. Frailness, delicate health, long periods of bed rest post partum hint towards it.

Yeah google’s free but med school wasn’t, inspite of the full ride scholarship. Eh, well. And since we’re sharing personal experiences because otherwise the opinions would remain invalid- I’ve lived in semi arid region all my life. Where the average temperatures soar above 45 degrees for at least a third of the year and you can’t wear anything less than a whole ass fOrmAL indian outfit to the teaching hospital where there’s no air conditioning while being expected to run around the entire campus out in the sun. And bruh, it’s not bacteria that eat your brain, they’re amoebae. Of course, there are prions too but they’re not bacteria either. And tuberculosis is worse in those who’s immune system’s taken a hit- because of corticosteroid therapy or long standing viral infection like HIV that specifically target one’s immune system or inherited immune disorders or they’re diabetic or because they’re elderly. Cold weather, low af humidity aggravates tuberculosis which is already active, latent tuberculosis is a whole another topic- pls don’t blame the rainy weather.

Was thinking about an awful heat wave my city had in 2017 and started to wonder about how sheltered Elia's life must have been due to the harsh reality of living in a desert.

Long-term exposure to heat can exacerbate pre-existing chronic conditions. It can cause heat exhaustion, which can lead someone to feel faint or dizzy, feel nauseous and have muscle cramps.

If exposed to the sun for too long, there's always sun poisoning and the fact that UV radiation AFFECTS YOUR DNA????? BRO WHAT THE FUC--

The poor small folk of Dorne tho. I imagine skin cancer and just looking older (due to the sun damaging and aging the skin) is as common for them as frostbite is in the North :/

Also the Dornish nights are cold, considering it's a desert. I can see the winter nights in Dorne being particularly harsh (I wonder if they have fireplaces in the bedrooms for such occasions? Might brainstorm about it later), which wouldn't help Elia at all, considering the cold weakens your immune system.

If you think about it, the best region for her to live in was probably the Reach. It's warm, but not overly so, and the nights probably aren't cold.

Perhaps maybe even one of the castles on the Dornish mountains? Tho I'm not sure because it could be too cold, considering how altitudes work, realistically speaking. It is ASoIaF tho so you can never know how much they'll follow reality 🤣

[2whatcom-blog]

Mind Restoration System Explores Hazy Territory between Being Lifeless or Alive

One of many two authorized definitions of loss of life is irreversible cessation of all mind perform, generally referred to as "brain death." (The opposite is the halting of circulatory and respiratory perform.) It was extensively believed that mind cells endure rapid--and irreversible--degeneration instantly after loss of life. However a placing new research, revealed Wednesday in Nature, means that a lot performance will be preserved or restored--even hours after loss of life. A analysis staff, primarily based primarily on the Yale Faculty of Medication, managed to revive some features in the entire brains of pigs slaughtered 4 hours beforehand and to maintain them for an additional six hours. The work was motivated by the commentary that cells will be harvested from postmortem brains and sustained in cell cultures for research, neuroscientist and staff chief Nenad Sestan mentioned in a press briefing: "In short, if we can do this in a petri dish, can we do it in an intact brain?" The system Sestan and his colleague developed, known as BrainEx, includes three components: a computerized system of pumps, filters and reservoirs; a blood substitute containing no cells however able to carrying oxygen, together with quite a few compounds designed to guard cells; and a surgical process to hook every part up. The researchers in contrast brains they sustained utilizing BrainEx with brains that have been perfused with an inert fluid or that weren't hooked as much as something to evaluate their relative states at totally different occasions. The system lowered cell loss of life, preserved anatomical integrity, and restored circulatory, metabolic and a few mobile features. The staff was even capable of observe inflammatory responses from immune cells, known as glia, by introducing a molecule that mimics bacterial an infection. The findings recommend that cells are way more resilient to the injury attributable to stopping blood stream, which deprives the mind of oxygen (referred to as ischemia), than beforehand appreciated. "We didn't have any a priori hypothesis that we'd be able to restore cells to this level," Sestan advised journalists. "We were really surprised." This work may symbolize a significant contribution to strategies obtainable for finding out the mind. The analysis was funded beneath the Nationwide Institutes of Well being's BRAIN (Mind Analysis via Advancing Revolutionary Neurotechnologies) Initiative, and NIH consultants additionally briefed the press. "This is a real breakthrough for brain research; it's a new tool that bridges the gap between basic neuroscience and clinical research," mentioned Andrea Beckel-Mitchener, a BRAIN Initiative staff chief on the Nationwide Institute of Psychological Well being. "It provides experimental access like we've never had before; we anticipate interesting studies on brain circulation, cell metabolism, other cell biology and mapping long-range connections." The fast findings have implications for the way we perceive mind loss of life. "It's drilled into us as scientists and doctors that after even just a couple of minutes, there's no going back; this clearly turns that on its head," says Madeline Lancaster, an skilled in analysis on mind organoids (so-called "mini brains" grown from stem cells--at the College of Cambridge, who was not concerned within the work. "Where I see the most potential in the short term is just changing thinking about that and hopefully spurring people to do more research into humans who are potentially brain dead--and understanding how we might be able to bring them back." Extending the time earlier than declaration of mind loss of life has different implications--it may delay when organs may change into obtainable for donations, as mentioned in a commentary article in Nature. One near-term profit is the chance to be taught extra about ischemic harm. "We hope to better understand how brain cells react to circulatory arrest and if we can intervene and salvage these cells," Sestan mentioned. "By doing this, we can possibly come up with better therapies for stroke and other disorders that cause brain cells to die." In the long run, the system may present a strong technique for finding out mind connectivity, circuit perform and illness processes. A specific amount can already be realized utilizing mind slices, mind organoids (so-called "mini-brains" grown from stem cells) and postmortem brains, however this method presents no less than two benefits: First, an intact mind presents an unparalleled alternative to review mind circuitry. "If the question is one where you really need the context of the whole organ, this definitely gives you an advantage," Lancaster says. "If we knew were functional to some degree, being able to look at a fully intact circuit would be very powerful." Second, postmortem research restrict observations to discrete cut-off dates, which curbs understanding of how illnesses progress. As an illustration, neurodegenerative illnesses comparable to Alzheimer's are thought, by some, to contain poisonous proteins spreading within the mind. "You could do a lot more here in terms of perturbing the brain in various ways: introducing a prion protein, or amyloid-beta, for example, and looking at spreading," Lancaster says. "Being able to see it in real time is really key. This would be a way to do that." The staff engaged with present ethics frameworks from the time it started to plan the experiments. Chief among the many ethics considerations is whether or not resuscitated brains would possibly exhibit indicators of consciousness. The research particularly wished to keep away from the distant chance that consciousness would return, and the researchers have been ready to decrease temperatures and deploy anesthetics to extinguish such indicators in the event that they emerged. They regularly monitored electrical recordings from the brains' floor and noticed no proof of the worldwide electrical exercise that might be anticipated if there was something approaching cognition. "I'm very confident no consciousness was present in these restored brains," says Christof Koch of the Allen Institute for Mind Science in Seattle, a number one researcher within the neuroscience of consciousness. There have been not one of the indicators we affiliate with consciousness, and even sleep, Koch says: "Only a flat line, implying a complete absence of any sort of consciousness." However a part of the rationale for the dearth of electrical exercise might relate to the truth that the perfusion resolution contained neural exercise blockers. The researchers included these blockers as a result of they wished to maintain the brains quiescent to maximise mobile restoration. An energetic mind would require a massively better power provide, and the very act of firing can injury neurons (a phenomenon referred to as excitotoxicity). The staff took tissue samples to indicate that particular person neurons have been nonetheless electrically purposeful, which essentially concerned washing out the answer to organize the samples for electrophysiological recordings. However what would have occurred if these blockers weren't used? "We cannot speak with any scientific certainty to that point, since we didn't run those experiments," Stefano Daniele, co-lead writer of the research, advised journalists. If such future experiments have been to maneuver resuscitated brains nearer to aware exercise, that might spur discussions about what will be thought of actually lifeless. These concerns are mentioned in one other accompanying commentary article co-authored by authorized scholar Nita Farahany, a bioethicist who's a member of the Neuroethics Working Group on the BRAIN Initiative and who the researchers consulted from an early stage. The staff additionally consulted the Institutional Animal Care and Use Committee (IACUC) at Yale, and the members have been advised the research was not topic to animal welfare-protection pointers. Most clearly, the pigs have been already lifeless: the researchers procured the brains from a pork processing plant, so no animal was sacrificed for this analysis. In any case, such pointers don't apply to animals raised for meals. Shifting ahead, the work have to be replicated by different labs that should be taught the intricacies of the operated by hand system. The staff itself needs to ascertain how lengthy brains will be sustained this manner. The perfusion stage of the experiment solely lasted six hours as a result of at that time, the management brains that weren't within the BrainEx system had undergone an excessive amount of disintegration for significant comparisons to be made. If brains will be stored going for lengthy intervals, and researchers flip from prioritizing mobile restoration to reviving electrical perform in situ, that might enter uncharted moral territory. "There are some questions that need to be answered first," Farahany says. "Can we ever get EEG recovery? What are the limits to it if we ever get to that? And what are the implications, then, for animal research and for human research one day?" In Farahany's view, these unknowns put what was initially thought of lifeless tissue into a brand new moral class. "It's the potential that creates a moral status that's different and requires that we treat it differently," Farahany says. "One could go with the safest possible approach there, which is to give it some or similar protections that would be accorded to animal research subjects." Such an experiment would probably be first tried in rodents, initially by simply eradicating the chemical compounds that block electrical exercise. If something that appeared remotely like aware exercise have been to be detected, we might be in territory for which new moral pointers could be wanted. "At that point, if you start thinking about it more like a living animal, then minimizing any risk of pain or distress would be appropriate," Farahany says. "The problem is: right now, we think of this as tissue research and it's no longer just clearly dead. It's just not exactly alive either." Read the full article

[medicalmarijuana-news]

CBD: The Cinderella Molecule

“This changes everything!”

That was the immediate reaction of Bay Area journalist Fred Gardner as he stood in the office of Steep Hill Laboratory in Oakland and eyed a chromatogram showing the unusual cannabinoid content of a hitherto unknown marijuana strain. The year was 2009, and the strain of interest, an oddity called Soma A-Plus, didn’t top the charts for THC (tetrahydrocannabinol), a.k.a. the high-causer, unlike the several thousand other bud samples that Steep Hill had previously tested for California’s medical marijuana dispensaries and growers.

Soma A-Plus was the first of a handful of soon-to-be-discovered strains imbued with a significant amount of cannabidiol (CBD), a compound with intriguing medical properties. One of these strains, Women’s Collective Stinky Purple, tipped the scales at over 10 percent CBD by dry weight, with little THC. This genetic anomaly wasn’t hemp—it was a drug plant, a high-resin, CBD-rich marijuana strain brimming with medicated goo. But anyone who smoked it or consumed it as an edible wouldn’t get high, because CBD isn’t psychoactive. In fact, CBD can actually lessen or neutralize the THC high, depending on how much of each compound is in a given strain or product.

Traditionally, cannabis grown for hashish contained roughly equal amounts of THC and CBD. Starting in the late 1970s, however, cannabis genetics changed as renegade breeders in Northern California catered to the consumer demand for stonier THC-dominant varietals. Consequently, CBD nearly vanished from the grassroots gene pool in the Emerald Triangle, America’s cannabis breadbasket.

When Californians passed Proposition 215, the 1996 ballot measure that legalized cannabis for medical use statewide, few people knew about CBD. It wasn’t on anyone’s radar, except for a small group of scientific pioneers who were probing marijuana’s molecular mechanisms and healing potential. Early studies indicated that CBD had noteworthy anti-inflammatory, anti-tumoral, antipsychotic and anticonvulsant properties, with no known adverse side effects.

Fred Gardner had been covering the CBD science story in O’Shaughnessy’s, the journal of cannabis in clinical practice. In 2010, he and I launched Project CBD, an educational nonprofit that reported on the entire CBD phenomenon: the research, the patients, the doctors, the new strains and products, and the business angles. From the start, we sensed that CBD could be a game-changer for the medical marijuana movement, that it might be the key to liberating marijuana from the confines of the drug-abuse paradigm. How could the pretzel logicians in the Drug Czar’s office justify the ongoing prohibition of CBD-rich cannabis, a safe medicinal substance with no adverse side effects and that doesn’t even get you high?

The advent of CBD-infused products meant that a lot more people—including those who aren’t into getting stoned—would be open to using marijuana for health reasons. Not everyone enjoys the THC high; some folks get edgy and anxious on weed. CBD-rich cannabis could be the answer for those who want to experience marijuana’s health benefits without the buzz. We referred to it as “CBD-rich” (rather than “high-CBD”) cannabis to get away from the stoner connotation. That designation has since been adopted by medical scientists in peer-reviewed publications.

A Tipping Point

The serendipitous rediscovery of CBD in Northern California would eventually upset everyone’s applecart—cops and stoners alike—and usher in a new era of cannabis therapeutics. The crucial tipping point came in the summer of 2013, when CNN broadcast Dr. Sanjay Gupta’s special on medical marijuana, which featured the now-famous case of Charlotte Figi, a young girl from Colorado who suffered from Dravet’s syndrome.

Little Charlotte was having hundreds of epileptic seizures a week, and pharmaceutical medications weren’t helping. Her parents thought they had run out of options, but then they heard about a boy with Dravet’s syndrome in California who responded well to CBD-rich cannabis oil. They found a high-CBD/low-THC strain at a Colorado cannabis dispensary, and it worked like a charm for their daughter, reducing her seizures to a couple a month. That strain is now called Charlotte’s Web in her honor.

Suddenly, the CBD genie was out of the bottle. A national television audience was stunned by what they saw and heard: Marijuana, once slandered as the “assassin of youth,” could save the lives of desperately ill children. And what’s more, kids and grownups didn’t have to get stoned to get better. The idea that it might be possible to access the therapeutic upside of marijuana sans the euphoria or dysphoria produced by THC would prove irresistible to a lot of people after the CNN special.

But along with a growing awareness of cannabidiol as a potential medicine, there has also been a proliferation of misconceptions about CBD-rich cannabis, a remarkable botanical that has befriended humankind since before the written word. Cannabis has a rich history as a source of fiber, food and medicine in many countries going back thousands of years. But our ancient connection with this plant, and our knowledge of its utility as a versatile folk medicine, was broken by marijuana prohibition. Thus, we’ve had to recreate a rapport with cannabis and relearn how to use it for maximum therapeutic benefit.

Some might wonder: Why not just spark a phatty and inhale? That seems to do the trick for a lot of people. Actually, it’s gotten a lot more complicated now that there are potent cannabis-oil extracts with different ratios of THC and CBD to choose from, as well as various ways to administer them. Figuring out how to harness the curative qualities of cannabis is still a work in progress. It’s the driving force behind the great laboratory experiment in democracy known as medical marijuana that’s been unfolding state by state in recent years.

The Big Breakthrough

For a long time, the illegality of marijuana has acted as a deterrent to scientific research in the United States. Ironically, it was President Ronald Reagan who advanced our understanding of the scientific basis of cannabis therapeutics when he escalated and militarized the War on Drugs in the 1980s. The Reagan administration poured tens of millions of dollars into research that would prove once and for all that marijuana damages the brain—or so they thought. After all, this was the “evil weed,” and it was an article of faith within the Drug War establishment that smoking marijuana causes brain damage.

But rather than showing how marijuana harms the brain, the Reagan administration ended up subsidizing a series of studies that culminated in the discovery of the endocannabinoid system, which actually protects the brain when activated by plant cannabinoids like THC and CBD. This major scientific breakthrough opened up whole new vistas in the understanding of human biology and went a long way toward explaining how and why cannabis is such a multifaceted medicine—and why it’s the most popular illicit herb on the planet.

By the mid-1990s, the endocannabinoid system had emerged as a hot topic among scientists around the world, who shared their findings in highly technical, peer-reviewed journals and at annual meetings of the recently formed International Cannabinoid Research Society. There ensued an avalanche of scientific data attesting to the jaw-dropping therapeutic potential of CBD and other cannabis compounds.

A 1998 preclinical study funded by the National Institutes of Health became the basis for a US government patent on the antioxidant and neuroprotective properties of CBD and THC, which were found to limit “neurological damage following ischemic insults, such as stroke and trauma.” Both compounds were described as having “particular application … in the treatment of neurodegenerative diseases, such as Alzheimer’s disease, Parkinson’s disease and HIV dementia.”

And that’s just for starters when it comes to cannabidiol. Some highlights from the exploding field of cannabis therapeutics:

Cancer: Scientists at the California Pacific Medical Center showed that CBD reduces breast-cancer-cell proliferation, invasion and metastasis in human-cell-line experiments.

Diabetes: Israeli researchers reported that CBD “lowers incidence of diabetes in non-obese diabetic mice.”

Epilepsy: British scientists noted that CBD exerts anticonvulsant effects in animal models of epilepsy.

Mood disorders: Brazilian investigators explored CBD’s potent antipsychotic and anti-anxiety properties.

Acne: The Journal of Clinical Investigation reported in 2014 that “CBD has potential as a promising therapeutic agent for the treatment of acne vulgaris.”

Irregular heartbeat: The British Journal of Pharmacology disclosed in 2010 that CBD suppresses stroke-induced cardiac arrhythmia in animals and reduces the extent of brain damage.

Stem-cell neurogenesis: German scientists discovered that CBD stimulates the growth of new brain cells in adult mammals.

Antibacterial: According to a 2008 report in the Journal of Natural Products, published by the American Chemical Society, CBD “showed potent activity against a variety of methicillin-resistant Staph (MRSA) strains.” The World Health Organization has identified antibiotic-resistant bacteria as a major global health crisis.

Mad-Cow Disease: There is no known cure for mad cow, a deadly infectious brain disease transmitted by misshaped proteins called “prions.” But French scientists reported in the Journal of Neuroscience that “CBD may protect neurons against the multiple molecular and cellular factors involved in the different steps of the neurodegenerative process, which takes place during prion infection.” 

Mad-fucking-cow disease??

And the list goes on and on: rheumatism, PTSD, depression, gut issues, obesity, alcoholism, liver disease …. Extensive preclinical research and mounting anecdotal reports suggest that these and many other conditions may be responsive to CBD-rich remedies.

The Power Couple: CBD and THC

There’s a lot of excitement about cannabidiol—with good reason. Thus far, however, clinical trials that could “prove” CBD’s therapeutic utility have gotten short shrift in the United States because of the War on Drugs. Consequently, most of what scientists know about CBD is based largely on preclinical lab research—animal studies, molecular probes, test-tube experiments and so on—rather than human studies. Some of this research has yielded important insights into the endocannabinoid system and its crucial role in health and disease. But data from animal models are not always applicable to human experience.

Outside the United States, CBD-rich remedies have been subjected to rigorous clinical trials and approved for therapeutic use in more than two dozen countries. Sativex, a sublingual cannabis spray that contains equal amounts of CBD and THC, is available by prescription (though not yet in the US) for treating the neuropathic pain and spasms associated with multiple sclerosis. GW Pharmaceuticals, the British firm that produces Sativex, determined that a combination of CBD and THC is more effective than either compound alone for pain management.

Simply put, CBD and THC are the power couple of cannabis therapeutics; they work best together. CBD and THC amplify each other’s curative qualities by activating different receptors in the brain. This synergistic dynamic is all-important for medical patients. It’s the reason why THC is key to maximizing the therapeutic potential of CBD, and vice versa.

Cannabis-oil concentrates with varying CBD/THC ratios are available in medical marijuana dispensaries, so patients can adjust or eliminate the psychoactive effects to suit their needs. When present in roughly equal amounts, CBD will prolong the THC buzz while lowering the ceiling on THC’s psychoactivity. These days, cannabis patients also have the option of healing without the high by using a CBD product with only a small amount of THC. But a low-THC oil or flower, while not intoxicating, isn’t necessarily the best treatment modality.

One’s sensitivity to THC is a major factor in determining the optimal ratio and dosage of CBD-rich medicine. There’s no single ratio or dose that’s right for everyone. Cannabis therapeutics is personalized medicine; patients may need to experiment, dial in and, if need be, adjust their treatment regimen until they find their own sweet spot with the right balance of CBD and THC. In essence, the goal is to administer consistent, measurable doses of a CBD-rich remedy that includes as much THC as a person is comfortable with.

If you’re lucky enough to live in a state with a robust medical marijuana program, there are lots of possibilities if you want to use CBD-rich cannabis without smoking it. CBD-rich cannabis—like the stony stuff—comes in many non-smokeable forms: edibles, lozenges, beverages, gel caps, sublingual sprays, tinctures, topical ointments, transdermal patches, suppositories and more. But all of these different choices can be confusing, especially for those who are newcomers to cannabis.

Product safety is also a major concern given that the marijuana industry is still largely unregulated. Unfortunately, many cannabis farmers use pesticides and dubious plant-hormone boosters to increase the cannabinoid content and crop yield. Patients should look for CBD-rich products that have been lab-tested and verified as free of mold, pesticides, solvent residues and other contaminants. It’s also better, if possible, to avoid cannabis oil that has been extracted with butane, hexane or other toxic solvents; opt for safer extraction methods, such as food-grade ethanol or supercritical CO2. A high-quality CBD-rich product should include only high-quality ingredients: no corn syrup, trans fats, preservatives or other artificial additives. Products should have clear labels showing the quantity of CBD and THC per dose. And keep in mind that the CBD/THC ratio is not an indication of how much of each compound is actually in the product.

Industrial Hemp

What about CBD oil extracted from industrial hemp? Internet storefronts are peddling unregulated hemp-derived CBD products to all 50 states, despite the fact that cannabidiol has not been approved by the Food and Drug Administration as a dietary supplement. For many people, particularly those living in states where medical marijuana is not yet legal, hemp-derived CBD may be their only practical option for now, even though it’s technically still a Schedule I controlled substance.

The federal government arbitrarily defines hemp—as distinct from marijuana—as a cannabis plant with 0.3 percent THC or less. However, what actually distinguishes hemp from marijuana is the resin content: Hemp is low-resin cannabis, while marijuana is high-resin cannabis. CBD and THC are both contained in the resin. High-resin drug plants include euphoric THC-rich plants and non-euphoric CBD-rich plants, as well as various combinations of both.

This is why low-resin industrial hemp isn’t an optimal source of CBD oil. Hemp fiber is basically useless for extracting CBD, since there is hardly any resin on the stalk. The skimpy foliage of industrial hemp grown for nutritious seed oil (and other uses) maxes out at about 3.5 percent CBD by dry weight, but there’s no CBD or THC in the seeds themselves. Compare this to the ACDC strain, a non-euphoric, high-resin marijuana varietal widely grown in California, which contains 20 percent CBD by dry weight.

The 0.3 percent THC legal limit for industrial hemp is an impractical, scientifically baseless distinction designed to maintain marijuana prohibition. In an effort to circumvent the law, some farmers in Colorado and other states are growing high-resin, CBD-rich marijuana and calling it hemp; they harvest their crop early to minimize the THC content. Growing industrial hemp outside the parameters of strictly implemented, state-sanctioned pilot research is still forbidden by the federal government.

For hemp farmers abroad, CBD paste is typically a byproduct of industrial hemp grown for other purposes. Farmers sell this leftover hemp biomass to businesses that extract CBD oil. It’s not great starter material for making CBD products, because huge amounts of low-resin hemp refuse are required to extract a small amount of CBD. Also, the more plant material one extracts from, the greater the risk of contaminants, because hemp is a “bio-accumulator” that draws toxins from the soil. That’s a great feature for cleaning up poisoned environments—hemp was planted near Chernobyl after the nuclear disaster for this purpose—but it’s exactly what you don’t want in a medicine.

Thus far, CBD commerce proliferates online with little interference from the federal government, other than FDA warning letters that have been sent to several CBD hemp-oil retailers for mislabeling products and making unproven medical claims. (Some “CBD-oil” products tested by the FDA contained little or no CBD.) Even more disconcerting is what’s actually in these items. Many, if not most, CBD hemp-oil vape cartridges contain propylene glycol, a thinning agent that is carcinogenic when overheated and inhaled. Flavoring agents are also ubiquitous in CBD hemp-oil cartridges, yet few of these ingestible food additives have been safety-tested for inhalation. Some are known to be toxic.

You might find serviceable products marketed as CBD hemp oil if you’re willing to take a chance on the vagaries of online meds. It’s something of a crapshoot, but some of these products may provide health benefits. Low-THC cannabis-oil extracts have been a godsend for a number of children with intractable seizure disorders. There are accounts of epileptic kids who experience a near-complete cessation of seizures when they utilize CBD-oil products. But for many other seizure-disorder sufferers, adults as well as children, CBD doesn’t do the trick. It’s not a miracle cure for everyone.

The therapeutic range of CBD hemp oil is significantly limited by the small amount of THC and other cannabinoids contained therein. Many medical marijuana patients have learned through trial and error that augmenting CBD-rich oil by adding some THC—or THCA, the unheated, non-psychoactive form of THC that’s present in raw cannabis flowers and leaves—helps to keep seizures and other symptoms at bay. Low-THC cannabis-oil products don’t work for everyone; this is why people of all ages need access to the full spectrum of whole-plant cannabis remedies, not just low-THC oil.

Molecule Versus Plant

CBD will soon become a single-molecule pharmaceutical. When Epidiolex, an almost-pure CBD anti-seizure remedy developed by GW Pharmaceuticals, gets a green light from the FDA, cannabidiol will join single-molecule THC (Marinol) as a legally available prescription medication. But the cannabis plant itself will remain federally illegal for the foreseeable future. Go figure.

Project CBD recognizes that single-molecule CBD is not the same as whole-plant CBD-rich cannabis, which includes hundreds of medicinally active components. Whether synthesized in a lab or heavily refined from industrial hemp paste, “pure CBD” products lack the full array of medicinal terpenes and minor phytocannabinoids found in marijuana. These compounds interact with CBD and THC to create what scientists refer to as an “entourage” or “ensemble” effect, so that the therapeutic impact of the whole plant is greater than the sum of its parts.

It’s not that single-molecule CBD won’t work—pure CBD might be helpful in certain cases, but whole-plant CBD has a much wider therapeutic window than CBD as an isolate. This was underscored in a 2015 experiment by Israeli scientists, who found that single-molecule CBD required a much higher dose to be effective compared to whole-plant CBD-rich oil. Moreover, if one missed the mark slightly—either too high or too low—then single-molecule CBD had little impact on pain and inflammation, unlike whole-plant CBD-rich oil, which was effective at a much lower and broader dosage range. Problematic interactions with other drugs are also more likely with high doses of single-molecule CBD.

“The therapeutic synergy observed with plant extracts results in the requirement for a lower amount of active components, with consequent reduced adverse effects,” the Israeli researchers concluded. Other scientists have reported similar findings.

CBD is a mighty molecule, to be sure—but the whole plant is mightier.

Martin A. Lee is the director of Project CBD and the author of several books, including Smoke Signals: A Social History of Marijuana and Acid Dreams: The Complete Social History of LSD: The CIA, the Sixties, and Beyond.

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