Introducing Dr. Elizabeth Clark, MD RVT FACS! Our physician consultant and CBD advocate.

Introducing Dr. Elizabeth Clark, MD RVT FACS!  Our physician consultant and CBD advocate.

General Statement:

As a traditionally, or Western-trained physician with 35 years of experience as a practicing vascular surgeon, I am struck by the hesitancy of doctors to utilize homeopathic (AKA natural and/or herbal, organic medications, or therapies) to address medical conditions. My sense is that there is general unfamiliarity with using these alternative options which have been used for centuries in Eastern medicine. Unfortunately, this often results in the overuse of Big-Pharma produced medications that carry with them a multitude of side effects, allergy issues, and interactions with other “modern”, FDA-approved medications. There are striking reminders that Eastern cultures (Asian, Indian for example) have led long, healthy lives without the interjection of modern technologies and medicines.

 

Personal Career Highlights:

After completing college at Wake Forest University and UNC-Charlotte, I was fortunate to receive my medical education at UNC-Chapel Hill. While studying there, I was one of two students in my class to receive the grade of Honors in all of my clinical rotations (Surgery, Internal Medicine, Pediatrics, Obstetrics and Gynecology, Psychiatry, and Family Medicine) during my third year. I went on to complete my General Surgery residency at the University of Chicago, during which I spent two years in basic science research as the recipient of an NIH Surgical Scholars Training Grant. My primary project won Best Basic Science Research in the Metro Chicago area and was presented at the Society of Vascular Surgery annual meeting in 1988. I then completed fellowship training in Peripheral Vascular Surgery at the University of Chicago, one of the top ten Vascular Fellowships in the country.

 

CBD Experience:

The use of CBD products to manage chronic pain and inflammatory conditions first came onto my radar with anecdotal patient inquiries and use in 2004-2005. At the time, I had no experience in prescribing CBD products and minimal education in its indications and clinical use. My patients’ questions prompted me to explore what was, at that time, very little medical literature on the subject. 

My own experience with CBD started in 2016, when I ordered CBD oil from an on-line source to help control chronic back pain. I was not initially impressed with the effects of CBD, and looking back, I believe this was the result of unreliable labelling of the concentration of the product and the lack of availability to ask questions or provide feedback to the manufacturer of the product.

It was not until I began using The Mother’s Best products in 2020 that I achieved striking positive results in treating my back pain as well as the chronic hip arthritis that my 12-year-old black Labrador, Kasey, was experiencing.

 

Medical Community Hesitancy:

Traditionally trained, or Western-educated physicians have historically received little to no education in homeopathic or naturopathic medicines and treatments. This has led to general fear and distrust of these alternatives to more traditional FDA-approved and regulated medications. Without a historical precedent or clinical results published in peer-reviewed journal, the average physician has been conditioned to be wary of any natural, or homeopathic alternatives to large pharmaceutical company-produced medications. Big Pharma has one of the strongest lobbying presences both in governmental regulation and physician education of their products.

Most physicians treat a specific group of conditions (i.e., neurology, rheumatology, pain management, GI medicine) and their knowledge of treatments “outside their wheelhouse” is limited. 

CBD has such a wide group of applications in many different types of medical and psychological conditions that its use and indications appear overwhelming to most medical clinicians.

 

Facilitation of CBD Use and Acceptance in the Global Medical Community:

Education of the medical community in the appropriate use of CBD products is the cornerstone of successful integration of these natural remedies into the prescribing armamentarium of physicians. As familiarity and experience increases, so will general acceptance and increased use of CBD products. Publication of well-designed clinical trials in peer-reviewed journals will also go a long way towards general acceptance of CBD as a viable addition or replacement to more traditional medication usage.

 

Personal Experience with CBD:

My initial experience with CBD was not a positive one, likely due to reasons I have outlined above. It was when I learned about The Mother’s Best/Hemptonicx products that I became a strong advocate for their CBD products and their benefits. I have found that the availability and accessibility to educational resources and feedback about the product line to be excellent. From a quality standpoint, the organic CBD products are clearly identified in terms of ingredients and concentrations of CBD and meet all regulatory compliance standards.

On a more personal note, I have achieved significant benefit with the use of CBD tinctures (1500mg and 3000mg strengths) in treating my chronic back pain. I have been able to reduce my use of pain medication and non-steroidal anti-inflammatory medication by well over 50% since I began using the CBD tinctures on a regular basis. Understanding that a steady state of CBD is achieved after approximately 10-14 days of use was important in gauging benefit of use.

I have seen remarkable benefit of CBD use in my 14-year-old Black Labrador Kasey as well. She had been losing function and mobility due to chronic hip arthritis for the past several years and had experienced a significant side effect when I gave her Cosequin, a traditional veterinary medication used to treat the problem. When She began using the peanut butter-flavored pet CBD tincture, I saw amazing benefits after two weeks of CBD use. She began behaving more like a puppy, with sprints chasing squirrels in the backyard and renewed ability to quickly climb the two flights of stairs to sleep in her bed at night. She has had no side effects with the CBD use, and I truly believe her quality of life has been extended by several years when I see her puppy-like energy.

 

Precautions with CBD Usage:

When compared to the potential side effects of traditional FDA-approved medications, use of CBD preparations is remarkably safe. As long as a CBD product is clearly labelled in terms of THC concentration, the incidence of potential side effects is rare, less than 2-3%. A THC concentration of less than 0.3% minimizes the possibility of diarrhea, fatigue, weakness, skin rash, decreased appetite, and elevation of liver function tests. These issues are seen primarily with inappropriate dosage or overdose. It is important to establish an optimal safe dosage to prevent these issues. If too much THC (tetrahydrocannabiol) is present in the CBD product, psychoactive effects, anxiety and possible addiction may occur. 

If untested or unregulated CBD products are used, concern about the presence of dextromethorphan (most commonly used in cough medicines to decrease the cough reflex) is warranted.

 

Pertinent Publications:

 “The Athlete’s Guide To CBD” by Dr. Scott PalmerHigh recommendation for the use of CBD cream as it “more selectively and robustly reduces pain and inflammation and penetrates deeper into tissues.” The CBD a-rich compound is Chylobinoid, and benefit may be increased with the addition of  lavender and/or menthol.

“Medicinal Cannabis:  History, Pharmacology and Implications for the Acute Care Setting” MB Bridgeman PhD, Abazia DT cannabis use documented 400 AD, debate re: potential abuse, gateway drug. Renewed interest with the opioid epidemic.

“Ingestion of a THC-rich Cannabis Oil in Fibromyalgia”, Arkell, et al, Pain Medicine, 2020 Fibromyalgia symptoms improved with minimal side effects.

“The use of cannabinoids for sleep:  A critical review of clinical trials”, Kuhathasan et alMultiple studies document THC/CBD benefit in Multiple Sclerosis, PTSD, chronic pain with better sleep quality, fewer sleep disturbances.

“Frontiers in Public Health”, Cahill, Lunn et al, 5/2021, 214 pts, 58% male, 57% > 50 yrs. old, treated for recurrent pain, PTSD, anxiety, sleep disorders, restless leg  syndrome, arthritis, > 60% patients reported improvement after 6 weeks of  treatment.

“Mayo Clinic Proceedings”, vol 94, issue 9, 9/19, VanDolah, Bauer et al 

**BEST COMPREHENSIVE REVIEW OF CBD AT PRESENT*** 

This publication is a very comprehensive review of CBD pharmacology, trials documenting benefit, discussion of phytocannabinoids and endocannabinoids, full spectrum preparations, legal and regulatory considerations, hemp oils vs. CBD and terpenoids, safety and adverse effects.