Dr. Matthew Hill

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614 appearances 1 recordings 1 series first heard Jul 2024 last heard Jul 2024

Dr. Matthew Hill’s voice in public audio — every appearance, attributed to the second.

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Huberman Lab · How Cannabis Impacts Health & the Potential Risks | Dr. Matthew Hill · 8 Jul 2024 podcast

And yet in the wild and people who are using it on their own, we're using doses of 10 to 20 milligrams and reporting these effects. And the thing is that I think a lot of people don't also realize is CBD has absolutely horrific bioavailability.

Like, so if you take it orally in an oil or in a gummy or whatever you consume it in, now this might be different with some of these beverages that are out there. I don't know if anyone's actually ever done the pharmacokinetics on them. At least I've never seen it. But standard roots, we're talking 4%. like very, very little, actually leaves your gut into your bloodstream.

Now we do know from the studies from GW who created the pharmaceutical version of CBD that was used for a lot of the pediatric epilepsy studies that they did, I don't know if it was random or intentional, find that opposite to something like alcohol, If you had just eaten a fatty meal, that actually enhanced the bioavailability of CBD dramatically.

So then it went up to like maybe 20% got into the blood. But that's probably because, again, CBD is a fatty molecule. It likes fatty environments. And for some reason, having fat in the stomach and in the gut seems to promote its ability to get into the bloodstream. You can see it now.

But yeah, I mean, and so because of this, it's like you're taking very low doses of CBD that have very poor bioavailability. And then people really stand by the effects of these. And so I'm like, you know, what I would always say is if it works for you, there's no reason to stop it. because you're having benefit from it. But would I ever recommend someone do this?

No, I wouldn't, because I can't say that I think that this has any biological activity. Because even when we start looking at these potential targets of what CBD could interact with, there's a couple of receptors. People have said, you know, it might interact with serotonin receptor.

There's some of these like random orphan receptors that we don't know a lot of what they do that CBD might interact with. But like the concentrations you need to hit those are reasonable. And you're not getting that in the blood and certainly not in the brain of people from consuming incredibly low doses of CBD. So the whole market that exists for CBD to me is a little bizarre.

And I think for a lot of us in the cannabis field, this has been one of the most bizarre social experiments we've ever watched. Because if you asked me in 2010 to walk into a room and ask How many people knew what CBD is? Like maybe one out of a hundred. Like no one knew what CBD was.

And now it's like 80 to 90% would know what it is because everyone – you can't walk down a street in any city in North America and not see CBD products, whether it's some kind of cream or like – a shake or some random concoction that people have added CBD because now it's going to – you're saying the energy drinks.

It's bizarre to me how much this has taken off because it seems to have somehow migrated into being a health product in some capacity.

Yeah. I mean, again, I think from my point of view, it's an ethical thing as well, because this isn't covered by insurance. People are spending their own money on this. And so I find it really challenging to recommend someone to be spending what can... I mean, especially if you're talking about an actual clinical dose.

I mean, for someone to take CBD at the level where it could actually be shown to have some benefit in some condition, of which currently it really is just pediatric epilepsy. Like, This idea with sleep, pain, anxiety, there's not a lot of super conclusive data. I'd say most of the trials that have been done have not found really good evidence of benefit in any capacity.

So it makes it very challenging to recommend this in any capacity, especially, I mean, if someone, if finances aren't an issue, sure, go for it. But, you know, I understand people are, like you say, looking for solutions. It doesn't sound like CBD is the solution. I am not convinced by the data that exists that it's really doing what a lot of people claim it's doing.

It's a great study of the placebo effect.

Yeah. So health harms, I mean... Someone smoking, obviously there's risks for lung damage. I would say the evidence for things like lung cancer certainly don't hold the way they do with cigarette smoke.

I don't think you could make the argument about fewer carcinogens per se. I think... Probably it relates more to the frequency. I mean, Donald Tashkin, who's in California here, I think he was at UCLA. I'm not 100% sure, but I know he was in California.

He did like very long-term studies tracking cannabis smokers and basically did not find associations with lung cancer the way that you do with cigarette smoking. Why that's the case, I don't think anyone has. Like people have theories. Some suggest because a lot of this in vitro animal work with really high dosing suggests it could have anti-proliferative effects for tumors.

Whether that's real or not, I don't know. But like... I think more likely it's because most people who smoke cigarettes, at least that were, you know, the relationship with lung cancer were people who were smoking regularly throughout the day. And it's very rare someone smokes cannabis at that frequency. Maybe if they isolated that population, they would see relationships with lung cancer.

I just don't think it's been borne out by the data the same way. Certainly lung damage, emphysema, things like that are on par. If you have any combustion product, you're going to have damage there. There's no question about that. So, again, harm reduction perspective would be, you know, oral routes of administration bypass lung damage. They come with their own issues with dosing and whatnot.

But if you're talking about physical harms, that's one thing to avoid that you could bypass that aspect of it with. There is some, I don't think we are at a point where we can say the state of it. There is something with cardiovascular function and cannabis that relates to higher frequency of strokes perhaps, or cardiac events in some capacity. The data is not entirely clear in this sense yet.

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