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Everything You Need to Know About CBD Oil and Bone Health

The first written record of cannabis use dates back to 440 BC. That’s over 2000 years ago! 

The Greek historian Herodotus tells how the Scythians, an ancient Siberian tribe, used hemp as part of their funeral rituals. They would place red-hot stones in a dish and add hemp-seeds to produce a vapor. 

Now, if the Scythians lived in modern times, they’d be right on trend.

Hemp is a variety of the cannabis plant that’s rich in cannabidiol (CBD). So, CBD oil is derived from the hemp plant— and it’s becoming more popular by the day thanks to its potential therapeutic benefits.

These benefits have been at the center of a lot of research in recent years. In fact, studies show that CBD may relieve pain, anxiety, depression, and several other conditions. And some suggest it even supports bone health.

So with all the questions circulating about CBD and it’s potential benefits, we decided to dig into the most recent research to find out what we know— and don’t know— so far…

But first, what is CBD exactly?

What is CBD?

CBD is one of many naturally occurring compounds that come from the flower of the cannabis plant. These compounds are called “phytocannabinoids”, although this is often shortened to cannabinoids.

So, CBD oil is simply a concentrated liquid extracted from a plant!

Fun Fact: “Phyto” is a prefix that stands for “plant”, so “phytocannabinoids” literally means cannabinoids from plants. 

CBD is the second most abundant phytocannabinoid after tetrahydrocannabinol (THC). 

Now, THC and CBD both have therapeutic properties. But there’s one big difference between the two:

  • THC is psychoactive meaning it causes the high associated with cannabis. 
  • CBD is non-psychoactive meaning it doesn’t cause a high.
The Chemical Composition of THC and CBD

In other words, CBD is non-intoxicating, but it still provides a wide range of potential therapeutic benefits. (A fact that explains it’s rising popularity!) 

But why can this simple compound from a plant have such an effect on the human body? The answer lies in the endocannabinoid system…

What is the Endocannabinoid System?

All vertebrate species have an endocannabinoid system. It’s a crucial part of our biology that’s evolved over thousands of years. In large part, this system helps your body maintain homeostasis

Homeostasis is like a balancing act. Your biological systems need to stay within a certain range to function properly. Your blood sugar levels shouldn’t be too high or two low. Your body temperature shouldn’t be too hot or too cold. And so on. 

There are many functions like this throughout the body… and that’s why the endocannabinoid system is so widespread! (And why when a compound like CBD interacts with your system, you can experience diverse effects.) 

Fun Fact: “Endo” is a prefix that stands for “within”, so “endocannabinoid” literally means cannabinoids from inside the body. 

The endocannabinoid system is made up of three parts:  

  • Cannabinoid receptors: These receptors interact with both endocannabinoids and phytocannabinoids.
  • Endocannabinoids: These are the cannabinoids your body makes itself. 
  • Enzymes: These enzymes are responsible for both creating and breaking down endocannabinoids once they’re done their job! 

There are two main receptors called cannabinoid type 1 (CB1) and cannabinoid type 2 (CB2). Recently, GPR55 has also been identified as a third cannabinoid receptor. 

CB1 receptors are expressed mainly in the brain, spinal cord, and nervous system. CB2 receptors, on the other hand, are mostly found in peripheral tissues like your spleen and immune cells. And GPR55 is expressed in your brain and peripheral tissues.

The Body's Endocannabinoid System

Now, you can think of endocannabinoids as the “keys” and receptors as the “locks” in this system. By turning these keys, the system sends signals throughout your body and helps regulate many physiological functions. 

These functions include pain perception, learning, memory, and appetite (to name just a few!). And as we’ll see in a moment, early research shows this system is involved in the bone remodeling process. 

Fun Fact: The endocannabinoid system is actually named after cannabis, not the other way around! This is because the natural compounds in cannabis that interact with this system— phytocannabinoids— are what led to its discovery. But the endocannabinoid system itself existed long before we found out about cannabis.

The Research on CBD’s Potential Health Benefits 

One of the first studies exploring the health benefits of cannabis was published in 1843 by John Clendinning. Clendinning presented 18 case studies where he treated patients with hemp. In the end, he found hemp had many therapeutic benefits like improving sleep and soothing anxiety. 

Of course, Clendinning’s research wouldn’t be considered high quality by today’s standards. His study looked at a small sample, and he used a simple observational method. Yet, it does go to show that CBD has a rich medicinal history. 

Since then, science has come a long way. And though modern research investigating CBD is still in its infancy, there are some interesting findings worth noting… 

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CBD Oil May Help Slow Bone Loss

A number of preclinical studies suggest the endocannabinoid system plays a role in bone metabolism. “Preclinical” means research that takes place before human trials to find out whether a treatment might be useful. 

In other words, the evidence so far comes from cell culture studies and animal studies. If you’re a regular reader of the AlgaeCal blog, you’ll know that preclinical findings need to be taken with a grain of salt because they aren’t always applicable to humans.

That said, animal studies are useful because they can point us in the right direction. And some researchers think that when it comes to the endocannabinoid system, they’re pointing towards possible therapeutic strategies to deal with bone loss. 

But how would this work?

Well, CB1 and CB2 receptors can both be found in your bone cells, including your osteoclasts (bone-clearing cells) and osteoblasts (bone-building cells). And GPR55 is expressed in your osteoclasts too.

Now, most studies on osteoporotic mice show that blocking CB1, CB2, and GPR55 receptors protects against bone loss. In other words, by blocking these channels, the mice in these studies increased their bone mass.

Researchers are hopeful they can harness this discovery to develop new anti-resorptive treatments. But this mechanism is problematic for several reasons… 

As you may recall, CB1 and CB2 are also present on osteoblasts, your bone-building cells. So blocking these receptors may slow bone loss, but it also inhibits bone formation. And since it takes a lot longer to build bone than it does to break down bone, this will tip the balance in favor of bone loss over time. 

That’s why researchers were most intrigued by the third cannabinoid receptor, GPR55. 

A recent study showed that blocking this receptor in adult male mice reduced osteoclast activity and increased bone mass. Notably, the researchers found that blocking GPR55 didn’t interfere with bone formation. And of course, slowing bone loss without inhibiting bone building tips the balance in favor of increased bone density.

The researchers also found that cannabidiol (CBD) was effective at blocking this receptor. Remember the lock and key analogy? Well, CBD is like a “key” that deactivates GPR55. So based on this study, they concluded that CBD could be a tool to slow bone loss. 

But once again, there’s a major issue with this conclusion… and with what blocking any of these receptors does!

Here’s the thing: slowing bone resorption may increase bone mass temporarily, but this strategy is inherently flawed.

There’s a reason your body breaks down bone. It’s getting rid of damaged or worn out bone to make way for new, strong bone. So, if you block this process, your bone density may increase… but really, you’re left with poorer and poorer quality bone that’s more prone to fracture in the long run! 

Of course, it’s unlikely that taking CBD oil recreationally would have a major effect on your bones. However, it could be a problem if scientists leveraged this discovery to create a treatment for bone loss.

Because a treatment for bone loss targeting these receptors would likely just be another band-aid solution.

And slapping a band-aid on bone loss is not a good idea… 

The best course of action is to address the root cause of the problem, and feed your body the nutrients it needs to build strong, new bone. In fact, three human clinical trials show that when you provide your body with 13 minerals and three vitamins, you can build brand new bone and reduce your risk of fracture!

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CBD Oil Helps Relieve Pain

You may have heard stories of cancer patients using CBD to deal with pain. Or maybe you know someone first-hand who uses CBD oil to ease aching joints or to manage inflammatory bowel disease…

But is there research to back up this belief? 

Well, a review of randomized controlled trials (RCTs) investigating the use of cannabinoids in the management of difficult to treat pain came to favorable conclusions. Researchers looked at several different cannabinoids, including CBD. They reported that in addition to having neuroprotective, antioxidant, and anti-inflammatory properties, CBD also works as an analgesic. (“Analgesic” simply means it relieves pain.) 

They concluded that the use of cannabinoids to treat pain shows great promise. 

Other studies investigating the use of CBD with THC in pain management have come to similar conclusions. 

For example, in a review of medical cannabis in cancer pain management, researchers found that a combination of THC and CBD provided significant relief. But they cautioned that due to the limited number of studies and study subjects, more research is needed to determine how effective cannabis-based therapies really are. 

In another study, researchers looked into whether an oromucosal spray containing THC and CBD helped patients with severe chronic pain. They looked at 800 patients and measured their pain at the end of 12-weeks based on nine-factors of symptom relief. In the end, they found that treatment with THC and CBD was effective at relieving chronic pain— especially neuropathic pain, which is caused by damage to the nervous system.

But since these studies looked at THC and CBD together, there’s no way of knowing whether the effects were due to one or the other cannabinoid.

As you can see, there are many limitations when it comes to the research on CBD and pain relief. So at this point, we can’t say anything definitive about the effectiveness of CBD for treating pain. And more quality research is needed to investigate this usage. 

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CBD Oil May Help With Sleep

Another common reason people use CBD oil is to help with sleep. 

And there is some research to back this application. A recent analysis of clinical trials found that CBD did show a positive effect on sleep. Many of the studies reviewed suggested “cannabinoids could improve sleep quality, decrease sleep disturbances, and decrease sleep onset latency”. (That is, how long it takes to fall asleep!) 

But it should be noted that this analysis had its limitations. 

First off, most of the current research on CBD focuses on the treatment of chronic health conditions. So sleep wasn’t the main outcome being measured in these studies, and the measurements weren’t validated as rigorously as a main outcome might be. 

What’s more, many of these studies had small sample sizes. And we can’t draw general conclusions from studies with small sample sizes. 

So the research is interesting when it comes to CBD and sleep, but there’s still a lack of evidence to back this benefit. 

Even though the evidence isn’t conclusive, it’s worth noting that getting adequate sleep is important for bone health! So it’s possible CBD oil could benefit your bones indirectly by helping you achieve higher quality sleep. 

Is CBD Legal in the United States? 

With all these potential health benefits, it’s no wonder CBD is gaining popularity. But despite this surge, many people are unclear on whether CBD is, in fact, legal. 

And unfortunately, the answer isn’t cut and dry.

In the United States, federal law says that CBD oil derived from hemp is legal as long as it contains less than 0.3% THC. (Remember, THC is a psychoactive compound, while CBD is not.)

But state laws are another story. Most states haven’t changed their laws to align with federal regulations which is a big source of confusion for local authorities and residents alike. 

What’s more, federal rules prohibit adding CBD to food products. Yet, there are states like Colorado that have legalized adding CBD to food for sale…

Suffice to say, the legal situation is hazy, and neighboring states might have very different laws concerning CBD than your state!

So even though legislation has come a long way, it’s best to exercise caution and check your local regulations before purchasing a CBD product. 

Safety and Side Effects of CBD Oil 

The popularization of CBD oil raises an important question, “Is it safe?”

And once again, the answer is a little complex. Here’s what the research tells us so far…

The first comprehensive review to look at the safety and side effects of CBD was conducted in 2011. Researchers looked at 132 animal and human studies where CBD was administered at varying doses and concluded that: 

  • It doesn’t cause catalepsy (a condition where your muscles go rigid and you lose sensation in the body).
  • It doesn’t alter heart rate, blood pressure, or body temperature.
  • Psychological and psychomotor functions aren’t affected. 
  • It’s non-toxic in cells and doesn’t affect food intake or gastrointestinal transit. 
  • Chronic use and doses of up to 1500 mg per day are well tolerated in humans. 

A more recent review reported that in studies of epilepsy and psychotic disorder, CBD did have some side effects including tiredness, diarrhea, and changes of appetite and weight. But these side effects were mild compared to those of other treatments.

In the end, their conclusion was in line with the first review. They found that though CBD has a favorable safety profile, there are still knowledge gaps concerning its side effects— especially in the long-term. 

So, more high quality human studies are definitely called for. Until that happens, we won’t have an in-depth understanding of the effects of chronic CBD use. 

In addition, CBD sold online isn’t regulated by the FDA or any outside agency. What this means is the quality and purity of CBD products varies greatly. A label might say one thing about dose or concentration, but the reality could be vastly different. 

In a study investigating the labeling accuracy of CBD sold online, researchers purchased and analyzed 84 products from 31 companies. They found that of the tested products, 26% contained less CBD than labeled and 43% contained more than labeled! 

Although this study used a small sample, it does highlight the inaccuracies in the sale of CBD products, and the need for more rigorous manufacturing and testing standards. 

So it’s little surprise the FDA cautions buyers to beware when purchasing CBD products. 

Basically, the growth of the CBD industry outpaced both science and legislation. We still have a lot to learn about the effects of CBD, and regulations are needed to control the quality of the product on the market. 

So if you’re interested in trying it, just make sure to talk to your healthcare professional first. 

Finally, bear in mind that even though CBD is extracted from a plant, it’s not a natural supplement in the sense that we don’t have cannabidiol circulating in our bodies already. So, it’s best to think of CBD as you would any drug, and take the appropriate precautions. In other words, weigh the benefits against the potential side effects before making a decision.  

Note that our Resident Bone Health Expert, Lara Pizzorno, did a thorough review of PubMed, the PDR, Up to Date, and the physician version of drugs.com, and found no interactions between CBD and any of the nutrients in AlgaeCal Plus, Strontium Boost, or Triple Power. So, you can take CBD oil with AlgaeCal products. 

CBD Oil and Bone Health Takeaways

The CBD industry seemingly sprung up overnight. And like many young industries, it’s going through some growing pains. 

CBD manufacturers have made some bold claims regarding the therapeutic effects of their products. But these claims are largely unsubstantiated by science and have landed them in hot water with the FDA

The truth is there’s not enough high quality, long-term research on CBD yet to back its potential health benefits. 

So if you’re interested in trying CBD, there are a few things you should keep in mind: 

  1. Talk to your healthcare provider first, so they can advise you on possible interactions. 
  2. Check your local legislation to ensure CBD is legal in your state. 
  3. Make sure you choose a quality CBD product from a reputable company. 

And remember, everybody is unique, so success with CBD oil may vary from person to person. So start small, listen to your body, and if it’s not for you, that’s perfectly okay too!

Author: Monica Straith, BS

Monica is the PR and Outreach Manager and Fitness Lead at AlgaeCal. She’s an ACE Certified Personal Trainer and Nutrition Specialist, and has a B.S. and B.A. from the University of Wisconsin-Madison, where she played varsity soccer for four years. Monica pulls from her experience in athletics and health to contribute to AlgaeCal and has also been featured on myfitnesspal blog, Prevention, and Huffington Post.