Autism CBD Oil


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CBD oil is derived from hemp or cannabis. It is not recommended by the American Academy of Child and Adolescent Psychiatry as a treatment for autism. Parents of autistic children are turning to CBD oil to manage the symptoms of autism, but does CBD oil really help with this condition? This article explains the potential benefits of CBD for those with autism disorders. An interview with Bonni Goldstein, MD.

CBD Oil as a Treatment for Autism

Lisa Jo Rudy, MDiv, is a writer, advocate, author, and consultant specializing in the field of autism.

Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more.

Stephanie Hartselle, MD, is a board-certified pediatric and adult psychiatrist and Diplomate of the American Board of Psychiatry and Neurology.

Cannabidiol , sometimes called CBD, is a chemical compound found in the cannabis plant. The American Academy of Child and Adolescent Psychiatry does not support the use of any cannabinoids in children or teens for the diagnosis of autism.

In fact, CBD oil has been studied as a potential treatment for autism, but the results do not support its use in treating children or adults who have this disorder. And, according to Harvard Health Publishing, “because CBD currently is typically available as an unregulated supplement, it’s hard to know exactly what you are getting.”

Currently, there are some treatments that may alleviate some symptoms of autism, but there is no cure.

About CBD

CBD can be derived from hemp or cannabis (the marijuana plant) and is now legal in many states in the United States and in many countries around the world. It can be purchased without a prescription as an oil, tincture, pill, or chewable pill online and is also an ingredient in edibles ranging from coffee to pastries. It comes in many dosages and at many price points.

Claims for CBD range from the realistic to the absurd. Some websites and companies claim, for example, that CBD can cure cancer (it can’t). On the other hand, CBD does seem to alleviate some symptoms of disorders such as epilepsy, nausea, and muscle spasticity—all issues that can affect some people with autism. According to Harvard Health Publishing, “the strongest scientific evidence is for its effectiveness is in treating epilepsy disorders of Dravet syndrome and Lennox-Gastaut syndrome (LGS), which typically don’t respond to anti-seizure medications.”

The FDA has approved a cannabis-derived medicine for the treatment of certain types of epilepsy, Epidiolex, which contains CBD.

It’s important for parents to know that CBD is not helpful for everyone who uses it, and it can cause side effects, such as sleepiness or nausea.

CBD and Autism

Neither CBD nor any other drug can remove or cure core symptoms of autism, which include social communication challenges, sensory dysfunction, and restricted, repetitive behaviors.

CBD can, however, help to alleviate epilepsy in some children and adults with autism. Fewer seizures can lessen stress and make it easier to interact socially.

Research Findings

A few full-scale studies have explored the impact of CBD on children with autism—none, however, have explored its impact on adults on the spectrum. One of the largest such studies took place in Israel. The report includes the following finding:

“In 2014, The Ministry of Health began providing licenses for the treatment of children with epilepsy. After seeing the results of cannabis treatment on symptoms like anxiety, aggression, panic, tantrums and self-injurious behavior, in children with epilepsy, parents of severely autistic children turned to medical cannabis for relief.”

Studies are ongoing in clinics and research centers around the world.

Before Trying CBD

Before considering CBD oil, it’s important to follow these steps:

  • Check with your child’s (or your) doctor to be sure that no allergies or sensitivities exist that could cause a reaction to CBD.
  • Check with your child’s doctor to see if the medical benefits of CBD oil are relevant to your child’s symptoms.
  • Check to be sure that CBD is legal in your state, province, or country.
  • Research sources of CBD to be sure the brand you’re using is well-regarded and properly licensed.
  • Take careful notes about your child’s (or your own) behaviors and symptoms so that you can make a useful comparison before and after using CBD.

Using CBD

CBD comes in many forms and at many dosage levels, including candy forms. It’s important to keep candy-like drugs and supplements out of the reach of children.

Lower doses are more easily tolerated than higher doses.

When you start using any new supplement, drug, or treatment, it’s important to be sure your child’s doctor is aware of the new treatment and has no concerns about it relative to your child’s health. Let everyone working with your child know that you’ve started something new and ask them to look for and report any changes in behaviors or skills.

Take careful notes of any changes you see so you can easily review your records to determine how helpful the new treatment really is. Keep an eye open for any troubling side effects. Be sure to communicate any side effects to a doctor or healthcare professional immediately.

A Word From Verywell

Children with autism grow and learn every day, simply because they are maturing. As a result, there is no simple way to determine whether a change in behavior or an increase in skills is due to a particular treatment or to ordinary maturation. This reality makes it very easy to see a change in behaviors and inaccurately attribute them to the newest treatment you’ve tried. By far, the best way to know whether a particular treatment is truly effective is to be rigorous about evaluating your child before and after its use.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Stafstrom CE, Carmant L. Seizures and epilepsy: an overview for neuroscientists. Cold Spring Harb Perspect Med. 2015;5(6):a022426. doi:10.1101/cshperspect.a022426

Bar-Lev Schleider L, Mechoulam R, Saban N, Meiri G, Novack V. Real life experience of medical cannabis treatment in autism: Analysis of safety and efficacy. Sci Rep. 2019 Jan 17;9(1):200. doi:10.1038/s41598-018-37570-y

CBD Oil for Autism: Can Hemp Oil Be Used for Autism & Where to Buy?

CBD is partly responsible for the shift in opinions regarding cannabis use. It all started with the late Charlotte Figi, a young girl with severe childhood-onset epilepsy (Dravet Syndrome) who managed to effectively control her seizures and gain a normal life thanks to CBD oil.

Since then, CBD has become the subject of global debate. As scientists conduct more research on the health benefits of this natural compound, it appears that natural resources can succeed where conventional treatment options fail.

Autism is one such condition.

Some people with autism, as well as the parents of autistic children, use CBD oil to manage the symptoms and improve their daily life.

But what’s the exact mechanism behind CBD’s effects on autism disorders? How do you choose the right product for your needs, and how to tell the difference between a high-quality and low-quality product?

This article will explain everything from roots to branches.

CBD Oil and Autism: Can It Help?

Some people decide to choose natural products over pharmaceuticals because of their growing availability and higher safety profile. CBD is known for helping with the following symptoms:

  • ADHD
  • Addiction
  • Autism
  • Depression
  • Mood disorders
  • Psychosis

Research on the potential use of CBD for autism is in its infancy as of this writing, but what we have learned so far is very optimistic. For example, an anecdotal study published in the Neurology Journal has found that applying CBD sublingually to autistic patients resulted in the improvement of behavioral problems in 61% of the participants. Communication problems, as well as anxiety levels, dropped by 39% and 47% respectively. The study included 120 participants.

The exact causes of the major symptoms of autism spectrum disorder, such as aggressive and repetitive behavior, social communication difficulties, and sensory dysfunction, are still unknown to scientists. However, CBD has been shown to relieve other symptoms linked to autism, including ADHD, anxiety, and sleep problems.

While CBD may not be the cure for autism — autism doesn’t require “curing” directly, by the way — but it may help patients manage the troubling symptoms that negatively affect the way they function on a daily basis.

Benefits of Using CBD Oil for Autism

Here we shed light on the most promising benefits of CBD oil for autism.

More Stable Sleep

In a study published in 2019 in the Permanente Journal, researchers discovered that people with sleep disorders can benefit from taking CBD. The study reported that 48 out of 72 patients (66.7%) experienced better sleep quality within the first month of their treatment. The results varied throughout the tests, but only three people responded negatively to cannabidiol.

Another study from the Journal of Pediatric Neurosciences found that autistic children suffering from insomnia were able to fall asleep faster and spend more time in the deep sleep stage by taking CBD oil.

Lower Anxiety

The said study from The Permanente Journal reported a significant drop in anxiety levels in 79.2% of the examined subjects. More importantly, the results remained consistent throughout the entire study — without serious side effects. Only a few people reported fatigue and sedation. The study also found that patients were more willing to continue the CBD treatment compared to conventional psychiatric methods.

Anxiety is a prevalent issue among autistic adults and particularly difficult to manage in children and adolescents. Changes in their routine, as well as unexpected events and regular social situations, can deteriorate the anxiousness of those with autism, especially those diagnosed with Asperger’s syndrome. Using CBD oil to calm anxiety can lead to improvements in other areas of autism, such as selective mutism or nervous tics.

Better Focus and Attention

Autism can negatively impact one’s focus and attention. Autistic children often find it difficult to cope with distractions, such as background noise or even their own thoughts. For others, it can work the opposite way — they may become laser-focused on one task while forgetting about everything else.

People diagnosed with autism also express symptoms of ADHD. This can lead to disruptions in a person’s ability to focus and ignore distraction triggers. Since CBD promotes the efficient use of serotonin, users may find it eases their anxiety. Lower anxiety leads to better focus.

CBD Oil for Autism: Best Brands and Products

For new customers, it can be difficult to find a trustworthy source of CBD among so many different brands. CBD is a booming market, so it’s no wonder that everybody wants to get their fair share of the hemp cake.

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However, the market is also largely unregulated and liberal about the manufacturing and labeling of CBD products. Buying CBD oil online requires you to do your homework before you trust someone with your hard-earned money. Your research should include information about the source of the company’s hemp, its extraction method, and third-party testing practices.

Going through all of the above is challenging and time-consuming. That’s why we’ve put together a ranking of the best 5 brands offering CBD oil in 2022. We have selected these companies according to the quality criteria such as hemp sourcing, extraction method, third-party testing, and price-to-quality ratio.

1. Royal CBD (Best CBD Oil for Autism)

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Product Details

Potency 250 mg – 2500 mg
Available Flavors Natural, Berry, Mint, Vanilla
CBD per serving 8.3 mg – 83.3 mg

Why Royal CBD is the Best CBD Oil for Autism:

Based in Nevada, Royal CBD is a premium brand that started out in 2017 as a small craft company. Today, Royal CBD makes big headlines in the media as one of the industry’s top CBD sellers.

Royal CBD makes full-spectrum CBD oil that comes from organic hemp and is extracted using CO2 in its supercritical state. The brand’s products meet the highest quality and purity standards, confirmed by Certificates of Analysis from an independent laboratory.

The Royal CBD oil comes in 4 concentrations, including 250 mg, 500 mg, 1000 mg, and 2500 mg. The strongest bottle contains a massive dose of 83.3 mg per milliliter, which is a great potency for anxiety and restlessness in people with autism. The collection of Royal CBD products also includes full-spectrum softgels, THC-free gummies, and organic topicals.

  • Made from locally grown organic hemp
  • Extracted with supercritical CO2
  • Infused with full-spectrum CBD
  • Available in 4 strengths and flavors
  • Up to 2500 mg of CBD per bottle
  • 3rd-party tested for potency and purity
  • Great natural flavor
  • Not available in local CBD stores (this may soon change)
  • The brand doesn’t offer CBD vapes

2. Gold Bee (Best Organic)

Product Details

Potency 300 – 1200 mg
Available Flavors Natural, Honey
CBD per serving 8.3 mg – 33.3 mg

About Gold Bee

The runner up in our ranking of the best CBD oils for autism, Gold Bee is another brand with roots in Nevada. This company offers premium extracts from organic hemp infused with its signature honey flavor, which is both tasty and natural. Staying true to their mission statement, the guys at Gold Bee does a great job at destigmatizing hemp by combining high-quality products with providing education to their customers.

Gold Bee has partnered with local growers from Colorado to create its own blend of CBD-rich strains, which their extract with supercritical CO2 to achieve pure and potent extracts that retain the phytochemical profile of the original hemp plant.

I only wish Gold Bee had at least one high-potency option for its CBD oils. I admire the quality and the natural honey flavor, but the strongest bottle packs slightly over 30 mg/mL, which may be cost-prohibitive for users who need higher doses in their routine.

Gold Bee also sells 25 mg CBD gummies and softgel capsules that carry 40 mg CBD per count.

  • Sourced from US-grown organic hemp
  • Contains full-spectrum CBD
  • Up to 33 mg CBD/mL
  • Great potency range for beginners
  • Third-party tested for potency and purity
  • Great honey flavor
  • No high-strength CBD oils

3. CBDPure (Top Transparency)

Product Details

Potency 100 – 1000 mg
Available Flavors None
CBD per serving 3.3 – 33 mg/mL

About CBDPure

The third place on the list belongs to one of the most renowned brands in the industry. CBDPure specializes in selling low-potency oils from organic hemp, although the company has recently added a 1000 mg option to their lineup.

Just like the two above brands, CBDPure uses US-grown hemp and produces its CBD oil with CO2 in a supercritical state, ensuring high purity. This CBD oil contains the full-spectrum of cannabinoids and terpenes — including 0.3% THC — so you’re getting the entourage effect from other hemp compounds. The entourage effect refers to the synergy achieved by these compounds, which allows lower doses of CBD oil to remain effective, especially when it comes to problems like anxiety or inflammation.

On top of that, CBDPure has a 90-day return policy, so if you’re not satisfied with the results, you can return your product for a full refund.

  • Sourced from organic Colorado-grown hemp
  • Extracted with supercritical CO2
  • Lab-tested for potency and purity
  • 90-day return policy
  • Only two forms of CBD available
  • Low potency
  • Premium pricing

4. Hemp Bombs (Best CBD Isolate)

Product Details

Potency 125 – 4000 mg
Available Flavors Natural, Acai Berry, Orange Creamsicle, Peppermint, Watermelon
CBD per serving 4 – 133 mg/mL

About Hemp Bombs

Hemp Bombs is your best bet when it comes to THC-free CBD oil. This company manufactures broad-spectrum and isolate-based extracts in a variety of different forms, from traditional CBD oil to capsules, gummies, vapes, and products like beard oil or tattoo aftercare.

Hemp Bombs is a good choice for people who use very high doses of CBD to manage the symptoms of autism. The strongest version of Hemp Bombs CBD oil contains 4000 mg of total CBD, which translates to 133 mg of CBD per milliliter. Even if you don’t need such large amounts of CBD in your regime, you can get a few months’ worth of supply with this potency.

However, due to the lack of THC in its broad-spectrum extracts and with no terpenes or trace cannabinoids in the isolate, you won’t be getting the synergy from the entourage effect. This means that you may eventually need to take more CBD.

  • Sourced from organic hemp
  • Extracted with CO2
  • 0% THC
  • Available as broad-spectrum or isolate
  • Third-party tested for CBD and contaminants
  • Up to 4000 mg of CBD per bottle
  • 5 strengths to choose from
  • Infused with synthetic flavorings
  • No “entourage effect” from other cannabinoids and terpenes
  • Most people don’t need such high doses of CBD oil in their routine

5. CBDistillery (Most Affordable)

Product Details

Potency 250 – 5000 mg
Available Flavors None
Potency 8.3 – 166 mg/mL

About CBDistillery

We’re going to close our list of the best CBD oils for autism with another pioneering company. CBDistillery has been selling CBD extracts as one of the first U.S. companies and is now one of the largest brands in North America. Only a few companies can match their selections of CBD products.

CBDistillery offers its CBD oil in two types: full-spectrum or broad-spectrum CBD; the broad-spectrum option is labeled as “pure oil” and has been purged of THC. Broad-spectrum CBD still contains minor non-psychoactive cannabinoids as well as terpenes, so you’re getting some entourage effect without taking any THC in your product.

Whether you’re a new customer or an experienced user, you certainly won’t run out of options with CBDistillery, as the brand covers the entire concentration range for CBD oils. They start at 250 mg and contain up to 5000 mg of CBD per bottle.

However, CBDistillery doesn’t use organic hemp, so if the source of hemp is your top priority, you may want to consider other companies from our list.

What is CBD?

According to WebMD, CBD is “a chemical in the cannabis Sativa plant, also known as marijuana or hemp.” It’s one of the two most abundant compounds in cannabis plants, next to THC, which is the cannabinoid that makes marijuana users feel high.

CBD doesn’t have intoxicating properties. It can actually counter the mind-altering effects of CBD by inhibiting the surface area on cells to which THC tries to bind. The World Health Organization issued a report on CBD in 2017, classifying cannabidiol as a safe substance with no risk of abuse or dependence.

The majority of CBD oils are sourced from hemp plants, which contain less than 0.3% THC and are federally legal under the 2018 Farm Bill.

CBD comes in many different forms; CBD oil is the most common product. You can take it by:

  • Placing a few drops under your tongue for up to 60 seconds before swallowing.
  • Applying it topically to the skin to relieve trouble spots on the body.
  • Infusing it into food and drinks

Edibles are another common category of CBD products. These are usually available in the form of gummies.

There are also CBD capsules, concentrates, and E-liquids. Each of these products offers a different route of administration and unique benefits.

Is CBD Legal?

The laws surrounding cannabis and its compounds are complicated in the USA. Whether CBD oil is legal in your state depends on how it is sourced.

As mentioned earlier, CBD can be obtained from hemp and marijuana. The compound itself remains the same no matter the source, but the chemical makeup of hemp-derived and marijuana-derived extracts is different

CBD oil from marijuana will typically contain a significant amount of THC and can get the user high. Marijuana and its derivatives are legal in states that have legalized recreational marijuana or, at least, have a medical marijuana program for patients.

Currently, 11 states allow marijuana for recreational use, while 33 states run a medical program.

Hemp-derived CBD oil is legal in all 50 states. In 2018, the Federal government legalized hemp by removing it from the list of controlled substances. It’s now legal to grow hemp for any use, including clothes, food, paper, fuel, and health supplements such as CBD oil. As long as the product contains less than 0.3% THC, it is legal under federal law.

You can find hemp-derived CBD products over the counter in health outlets, pharmacies, vape stores, dispensaries, and online stores.

High-quality CBD oil can greatly improve one’s daily life. Recently, researchers have been investigating the potential use of CBD for autism.

The next section explains the possible benefits of CBD for autistic patients.

Is CBD Oil Safe for Autism? A Look at the Potential Side Effects of CBD

CBD has been acknowledged as a safe compound not only by the WHO but also by the Harvard Medical School, which only talks about a few side effects.

Possible adverse effects of taking CBD oil include:

  • Dry mouth
  • Changes in appetite
  • A temporary drop in blood pressure
  • Sedation
  • Diarrhea

On top of that, CBD interacts with a great number of prescription and non-prescription pharmaceuticals. It can also increase levels of Coumadin or Warfarin, two popular blood thinners, so if you’re on these medications and are worried about possible interactions, make sure to consult your doctor. Doing so will help you exclude potential contraindications and safely incorporate CBD into your routine.

Final Thoughts on CBD Oil and Autism

Although we still need more research on CBD and autism to draw conclusions, current findings support the theory that CBD may benefit autistic patients, especially in terms of the management of side symptoms like restlessness, attention deficits, and anxiety disorders.

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If you want to use CBD to ease the symptoms of autism, ask your doctor about including CBD oil in your regime. Your best bet is to visit a holistic physician who will have knowledge and experience in this subject because many doctors are still conservative about cannabis and other natural substances due to various biases.

Above all, make sure that you always purchase CBD from a reputable supplier that sells organic and lab-tested products. You can do your own digging or use our recommendations to get yourself started with no worries about the quality of your CBD oil.

Do you know someone who’s using CBD oil for autism symptoms? Does CBD help control them?

Nina Julia

Nina created following the birth of her second child. She was a science and math teacher for 6 years prior to becoming a parent — teaching in schools in White Plains, New York and later in Paterson, New Jersey.

Research Breakthrough: Cannabis & Autism


An Interview with Bonni Goldstein, MD

(This transcript has been slightly edited for clarity.)

Project CBD : I’m Martin Lee with Project CBD , and today we’ll be speaking with Dr. Bonni Goldstein. Dr. Goldstein is a pediatrician and a pioneering cannabis clinician. She’s the director of Canna-Centers, a California-based physician network that focuses on cannabis therapeutics. And Dr. Goldstein is also the author of the highly recommended book Cannabis is Medicine. Welcome Dr. Goldstein.

Dr. Goldstein: Good morning, Martin. Thanks for having me.

Project CBD : My pleasure. I wanted to talk to you today about an article you co-authored which was recently published in the journal Cannabis and Cannabinoid Research. Let me start by reading the title of the paper: “Cannabis Responsive Biomarkers: A Pharmacometabolomics-Based Application to Evaluate the Impact of Medical Cannabis Treatment on Children with Autism Spectrum Disorder.” That’s an intimidating title, I think, for someone who is not a doctor or a scientist. So maybe you can explain in a broad sense what the findings are and what is “metabolomics”? What does that mean, and how is it related to cannabis?

Dr. Goldstein: Sure. Just the same way that we can draw bloodwork to measure white blood cell count or how much sodium you have in your bloodstream, we can measure different types of chemicals in the body. And these chemicals reflect the pathways and the changing chemical nature of kind of how cells are working.

So, a couple of words that need to be defined: Biomarkers. What we’re using is something called cannabis responsive biomarkers – these are just chemicals in our body that are part of chemical pathways that help our cells functions. For instance, one of the biomarkers that we measured is what’s called “spermine” – funny name, but it’s called spermine – and it has been associated with inflammation and pain. It’s a chemical that can be picked up in saliva, in blood, and it can be measured. By establishing – just the same way when you measure white blood cell count in somebody, any time you get infection or you get a doctor check-up – every year they check what’s called your CBC , your complete blood count. Doctors look at your white blood cell count to make sure your immune system is functioning. It’s a reflection of what’s going on in your body.

If you were to have a bad bacterial infection, your white blood count would be elevated, that’s a tip-off to a doctor, okay, we have to start looking for some serious bacterial infection. If your blood count is low, it may reflect some other pathologic illness. And of course, we have what’s called the physiologic range. So, your white blood cell count will vary, and normally it’s between for most people 4,000 and 12,000 cells. When we measure it, we can see if you are within normal limits. The idea is that you have all kinds of chemicals in cells in your body that can be measured.

Pharmacometabolomics is a way to look at how your body is responding to a particular intervention, to a treatment.

Classically biomarkers are used to look at someone’s response to chemotherapy or to cancer treatment, or even to reflect the presence of cancer. So, in men, a very common test is the PSA (the prostate specific antigen) and you just do a blood test and you can see if that’s elevated – that’s a tip-off, maybe there’s something going on with prostate cancer. And then, let’s say someone has an elevated PSA , they get diagnosed with prostate cancer and they go through treatment. What do doctors follow to see if their patients are doing well? They follow that PSA . And of course, you want your number to be a certain number. You want it to be within that what we call often “within normal limits” or what is really determined to be the normal physiologic range.

What we did in this study was we took children who were what we call neurotypical or typically developing, and we collected saliva looking for various and specific biomarkers. And we measured hundreds of biomarkers and kind of got it down to about 65 total biomarkers that we could really look at. And then we found about 31 biomarkers in our group of patients and we measured their biomarkers for autism that actually showed some relevance to the autism and to the cannabis treatment. And we were able to establish this physiologic range for the children who are neurotypical or typically developing. And then we compared the biomarkers in the children with autism with that physiologic range. Meaning, do their biomarkers fall within this? If they fall outside of it, does cannabis treatment correct it back into the physiologic range?

Ultimately what we found was that all of the children – it was a very small group, and that’s of course one of the limitations, we only had 15 children with autism participate – but we were able to show that with cannabis treatment their biomarkers corrected toward, trended toward shifting to that physiologic range, which was really fascinating.

Project CBD : I think this kind of data that you compiled from the study sort of buttresses what would otherwise be thought of as anecdotal or subjective accounts of improvement, which are considered generally of lesser value than other types of evidence. But here you have actual data showing no, it’s not just the person saying how they feel – there’s some movement in the cells, as you say. So, what would be some of the cannabis biomarkers specifically? You mentioned spermine. Were there others that were particularly relevant?

Dr. Goldstein: In the paper, we have 20-30 biomarkers that were significantly shifted. But, in the paper we were limited word-wise, so we talked about three particular biomarkers. One is called N-Acetylaspartic acid ( NAA ). And if you look at the scientific literature there’s evidence that NAA is – well we know that it’s a very prominent neurochemical, it’s an amino acid, and it is relevant for multiple reasons in that there’s evidence that, in fact, there’s a disease where if you don’t have it you basically don’t do well, it is terminal. You don’t have good brain function. You have some dysfunction within the brain. It’s involved in neuroinflammation, in laying down myelin, which is the coating on the neurons that’s very important for neuronal function.

And so, what we found with NAA was that – and what’s interesting by the way before I get into the findings, is that from my research on NAA , they talk about it’s not good to have too little and it’s not good to have too much. You want to have it balanced. You don’t want a deficiency and you don’t want an over. So, what’s interesting is that in the children that had their NAA measured that was out of whack, whether it was under or over, taking their medical cannabis treatment, an hour and a half later when we collected the saliva and re-measured, it shifted more to the physiologic range. If it was under it came up and if it was high, it came down. Which is so interesting because that’s what we talk about with cannabis, is helping to balance and create homeostasis – that kind of shift – not under, not over but everything leaning toward the middle. That was kind of interesting.

We were able to show that with cannabis treatment their biomarkers corrected toward the neurotypical physiologic range.

There are studies that show that people with a diagnosis of Asperger’s – there’s one study that shows that people with Asperger’s may have higher levels of NAA , and that other people with autism may have lower [levels]. And the only way, by the way, to measure it previously – remember it’s a neurochemical – was they were using functional MRI scans and so on, very high technology. This is from spitting into a tube, which is relatively easy to collect for most patients. It’s interesting because that particular neurochemical, again, has been shown to be an abnormality in this specific group, in people suffering with autism spectrum disorder.

And I mentioned spermine was one of the other ones that we talked about and that has to do with inflammation and pain. And I’ll share with you that I have a lot of families that have non-verbal children with autism, who have difficulty communicating. And many of the parents will say their child – they must have pain somewhere, the child seems uncomfortable, the child is crying or shouting or having a lot of difficulty. And this is very interesting to me that the spermine was high in many of these patients or very low, and then again shifted toward the physiologic range.

Then we looked at another one that we documented, what’s called DHEAS , dehydroepiandrosterone, which is a hormone, like a precursor that leads to male and female hormones. And this has been associated with, especially in males with aggression. And we found this was a cannabis responsive biomarker as well in our patients.

Project CBD : You say the dozen neuro-atypical patients that were part of this study, once they are administered the cannabis-based medicine, whether it was too high or too low in terms of what the biomarker shows, they’re coming toward normal, in either direction. Was it always the same remedy? People talk about CBD of course, that’s been a hot thing now because it’s not intoxicating.

Dr. Goldstein: That’s a great question, Martin. What we did in this study – and the reason I was involved was because I take care of a lot of children with epilepsy, autism, and so on – and when Cannformatics, which does the technology, approached me, they were looking for children to participate in this study who were already on a regimen of cannabis that seemed to be helping with either the child or the parents saying, as you mentioned earlier, anecdotally “my child is better, my child is doing well.” And as we all know the scientific community doesn’t accept this as evidence – someone saying they feel better is not evidence to the scientific community. We want to see numbers, scans, something that shows better or improvement. And that it not only that it’s there, but that it’s statistically significant. And what we mean in the scientific community when we say “statistical significance” is that it’s not some other factor or just random or by chance that we found these results.

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So, what we did in the group is we recruited ages 6-12 with autism who were on a cannabis regimen where they were showing improvement, and at least it had been stable for over a year. Now, we may have made some changes during that year, but the patient was showing ongoing continued benefits from cannabis medicine based on not only parental reports but reports from therapists and teachers. And the reason we recruited these patients was because, as you know, it’s not one size fits all (I steal that from you!), cannabis medicine is very personalized and customized. And when you very first start out on cannabis, what I call the cannabis journey, it can take months sometimes to figure out what works best for any particular individual.

What we didn’t want was in our population of patients, we did not want to have patients who were switching things up and who were having bad days, and here we are coming and trying to measure something, but they’re not showing a response. We wanted to document in these patients that were showing benefits, that it correlated physiologically – that there was a correlation between the chemical underpinnings and what the parents were telling us. And it’s very important to point that out.

It can take time. Some of these patients have been on my treatment for longer than one year – three years, five years – before we really found a nice place. And then you have to remember too, autism is a spectrum disorder. So, there is no one size fits all, because patients have different symptoms. Some children are very aggressive and some are never aggressive. Some patients are fully verbal and some are completely non-verbal. So that’s why it’s a very heterogenous population to study, and it can be difficult to draw conclusions.

I just want to point out that we collected saliva in the morning before they got their morning dose of medical cannabis. And then we collected the saliva again at around 90 minutes, and that correlates to when the parents said we saw a child responding to the medicine. And by the way, in the paper Table 1, which you’ll find on page 3, it lists the children by age and how many doses a day they were taking, and what the cannabinoid makeup was. So CBD , THC , CBG , CBN , THCA , and CBDA . And when you look at that chart, they’re all over the place, because again it’s personalized to them.

Project CBD : There was just a study I think that came out of Israel focusing on autism and I think the conclusion or the upshot was THC works better than CBD . Are we looking for the best cannabinoid here? Or, as you say, it’s really a combination that’s going to work best and the combination may shift from person to person?

Dr. Goldstein: Right. It depends on who you recruit into your study. If you recruit only children who are highly aggressive, I would agree that THC plays a very large role. But if you recruit into your population of patients in your study that half are aggressive and half are not, you’re going to find something that may not run through all the patients. I mean there is some correlation that I use clinically. Somebody comes in and says my child’s tearing up the house and beating us up, and is highly self-injurious, I lean more toward initiating THC earlier unless the parents have some other information or a preference not to use THC . But that would have me lean toward using more THC than not. Or at least as part of the mix.

I’ve never been afraid to use THC in my patients. And you have to remember too that there are now a number of studies that document that children with autism have low levels of anandamide, which is a natural endocannabinoid that we make, which I love that you call your inner cannabis compound. When you have low levels, a deficiency, you have to remember that for anandamide CBD is not a direct replacement for anandamide. It can help make the body’s own anandamide work better, but for some patients they need THC because as we know from Dr. Mechoulam and others, THC seems to be the direct replacement for anandamide.

I’ve never been afraid to use THC in my patients. Children do not have fully developed cannabinoid receptors, so they may be less sensitive to the effects of THC .

I want to make it clear to anybody listening, my patients are not walking around stoned and incoherent and impaired. Some patients, the parents will call me, oh we upped the dose and his eyes are a little red and he seems a little silly right now. We make very tiny changes and we try to avoid any kind of making the child uncomfortable or impaired. But I will tell you that many of these patients because they are deficient in anandamide, they can handle a lot higher doses of THC than most adults. And we also know from a study that it looks like children do not have fully developed cannabinoid receptors, so they may be less sensitive to the effects of THC . And remember, what we’re trying to do is kind of feed the brain just that little bit of trigger at that receptor to help send that message of homeostasis.

Project CBD : You indicated when we talked earlier that you accumulated a lot of data as part of this study, much of which didn’t make it into the paper. Can you give us a hint of what’s in store, of what’s next? Will there be other research papers published based on this work that you’re doing?

Dr. Goldstein: So, we are planning to publish a second paper based on the same group of patients because we measured so many biomarkers and there were so many interesting and significant results that we couldn’t pack it into one paper. The next paper being published is looking specifically at what we call the lipids, the lipid biomarkers, those that fall into the fatty acid category. What’s so fascinating about that, and what’s fascinating about the result is you have to remember that our endocannabinoid system is mostly made up of compounds that are fatty acids, anandamide and so on. And remember the compounds from the cannabis plant, the phytocannabinoids that we’re using to help feed this system are also lipophilic fatty acids. We want to be able to – we’re going to publish that data to kind of show that these compounds that are changing in response to the cannabis treatment, not only does it affect other areas of the brain but also within that endocannabinoid system.

Project CBD : My last question Dr. Goldstein is, what implications does this type of research focusing on metabolomics have for cannabis therapeutics in general. As far as I know, I don’t think there’s been a study done like this. How applicable would this be for other conditions, not just autism?

Dr. Goldstein: We’re hoping to do a study looking at the pharmacometabolomics for those who are using cannabis to treat neuropathy, which is nerve-based pain. Hopefully that is another study that we’re doing down the line. But the way to kind of look at pharmacometabolomics, is it’s a way to look at how your body is responding to a particular intervention, to a treatment. It’s interesting because this technology has been used before, like for instance, it was used to look at one particular cholesterol lowering drug, and how – and it’s pretty technical, so I’m just going to kind of glaze over it – how people with certain gut issues, how they metabolize their cholesterol lowering drug, and why they may not fit with that drug.

So, pharmacometabolomics can look at, not only drugs but also just your own baseline chemistry and your response to drugs. Cannabis here is the drug we’re looking at, right. But really what we’re looking at is the underlying chemical response. I foresee this technology potentially to help with optimizing treatment and measuring response. So, if I have a patient who is brand new to cannabis and has not been using it, I can get a baseline profile of their biomarkers from saliva. And then three months into treatment I can then collect saliva again and look and see what seems to be beneficial, what’s improved. Are there biomarkers that are still off the charts that we should be addressing with certain cannabinoids? Like if we haven’t tried CBDA , am I noticing a trend in patients that CBDA helps to balance a particular biomarker that reflects, let’s say inflammation.

What we’re hoping is to expand this technology, and basically it’s just another way to measure. Am I seeing improvement? Not everybody gets better with cannabis. And one of the things I would love to see is: What are we missing in these patients? Why isn’t their body responding? What is happening? Why do only some people respond? I think this is just a tool. Rather than me sitting here trying to think of why the patient isn’t responding, I can have some objective data that I can look at and say, ‘Oh this is interesting, all the children with this biomarker that’s off the charts are not responding.’ Well, that’s interesting. What does this biomarker reflect in their chemical pathway? What if they’re missing an enzyme? What if they are low on a particular mineral in their body and we can correct that? I mean the whole goal of this is to try to achieve more knowledge to be able to help these patients get a response from cannabis, but also other medicines, as well.

Project CBD : It’s really fascinating. And very encouraging. We look forward to hearing more about what you’re coming up with, and good luck with all of this. Thank you Dr. Bonni Goldstein.

Dr. Goldstein: Thank you, Martin.

Copyright, Project CBD . May not be reprinted without permission.

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