CBD and Exercise: A Fitness Frontier

October 10, 2023

Enter the realm of Cannabidiol (CBD), a non-intoxicating compound sprung from the bosom of Cannabis sativa. While initially hailed for its anticonvulsant prowess, CBD has lured both the scientific and athletic communities with its burgeoning therapeutic potential [1].

The intriguing aspect? Athletes, from golfers to rugby warriors, are quietly incorporating CBD into their routines, even though scientific validation of its impact on sport and exercise performance remains elusive.

The stage has been set, and a cascade of low-dose CBD products, known as "nutraceuticals," have flooded the market, available over-the-counter in pharmacies or health food stores. These offerings span a gamut, including options tailored for both recreational athletes and elite competitors.

As the World Health Organization flirts with the idea of removing CBD from the international drug control conventions, the utilization of such products is poised for further proliferation [2].

For eons, the world of sports has condemned cannabis, banishing it from competition, courtesy of the World Anti-Doping Agency's firm stance. However, a significant shift transpired in 2018 when CBD was gracefully excused from the Prohibited List, a testament to the compound's burgeoning reputation as a well-tolerated substance in humans [4], even at towering doses [5].

While a flurry of recent reviews has explored the influence of cannabis on athlete well-being and performance, the impact of CBD in isolation has remained shrouded in mystery.

CBD Pre-Workout: Unraveling the Intrigue

Factor #1: A Sleep Conundrum

In the realm of optimal performance and recovery, sleep reigns supreme [6]. Paradoxically, athletes and fitness enthusiasts often battle sleep deprivation, logging fewer hours and poorer sleep quality compared to their non-athletic counterparts [7].

A multitude of factors - evening competitions, pre-competition jitters, caffeine usage, and cross-timezone travels - contribute to this sleep turmoil among athletes [6].

CBD's connection with sleep has been investigated. One study, in particular, discovered that a dose of 160 mg of CBD amplified self-reported sleep duration in individuals grappling with insomnia [8]. However, it didn't alter sleep onset times, the frequency of wake-ups, or the perception of "good sleep."

Two case studies chimed in, with one observing the mitigation of rapid eye movement sleep-behavior disorder symptoms in Parkinson's patients through CBD usage [9]. The other reported enhanced subjective sleep quality in a young girl with post-traumatic stress disorder following a daily CBD intake of around 25 mg [10]. Notably, these studies leaned on subjective sleep measures and dealt with limited sample sizes.

Intriguingly, a well-controlled sleep study involving healthy adults detected no sleep-altering effects from a 300 mg CBD dose [11]. Furthermore, CBD might exhibit "wake-inducing" qualities in some individuals [12], and one trial even showcased how a low 15 mg CBD dose counteracted the sedative impacts of Δ9-THC [13].

Consequently, CBD's effect on sleep in healthy individuals remains nebulous, though it might possess sleep-enhancing attributes for certain conditions [10].

Factor #2: Taming Pre-Competition Jitters

The clutch of pre-competition stress, or sports performance anxiety, can crimp an athlete's prowess [16]. It's a hindrance wrought by anxiety, not only directly impacting performance but also fostering behaviors like decreased food intake, elevated energy expenditure, and disrupted sleep [17].

Behavior therapies like cognitive behavioral therapy often serve as the go-to treatment, yet a combination of pharmaceutical and psychological interventions occasionally surfaces as an alternative [16].

A medley of clinical trials has explored CBD's effect on subjective anxiety in both healthy individuals [18] and those grappling with social anxiety disorder [19] or high trait paranoia [20]. These studies unveiled an interesting divide: CBD's influence on anxiety largely hinges on the stress level.

Under "low stress" conditions, CBD seldom alters anxiety levels in healthy participants [18]. However, under "stress-inducing" scenarios, CBD (at 300 mg) demonstrated efficacy akin to a pharmaceutical counterpart during a simulated public speaking test [21].

Despite this, some research, also involving "stress-inducing" stimuli, found no CBD impact [20]. These inconsistencies could be linked to various factors, such as baseline anxiety levels, stress response magnitude, small sample sizes, and CBD dosages and formulations.

While CBD might mitigate anxiety during high-stress periods, the applicability of these findings to pre-competition anxiety, nutritional habits, energy expenditure, exercise perception (e.g., perceived exertion ratings), and athlete sleep demands further investigation.

Factor #3: Cognitive Contemplations

A handful of clinical trials have ventured into the territory of CBD's influence on cognitive and psychomotor function in healthy individuals. These investigations, overall, suggest that CBD exerts minimal sway over these aspects.

One recent study did reveal improved emotion recognition with vaporized 16 mg of CBD, albeit with uncertain relevance to athletic contexts [22]. Furthermore, a study employing 150 μg/kg of vaporized CBD detected no effects on balance or coordination [23]. An additional investigation, using oral and vaporized 100 mg CBD doses, found no cognitive performance changes in the 30 minutes to 8 hours post-treatment window [24].

Hence, the existing data, founded on a limited range of CBD doses and cognitive facets, leans toward CBD not significantly affecting cognitive or psychomotor functions in healthy individuals.

CBD Post-Workout: Rejuvenating or Restrictive?

Factor #1: Recovery, Muscle Soreness, and Inflammation

Strenuous exercises, especially unfamiliar ones or those involving eccentric components, can inflict structural harm on skeletal muscles. This damage sparks an inflammatory response, pivotal for muscle repair, regeneration, and adaptation [25]. Nonetheless, excessive inflammation might lead to protracted muscle soreness and delayed recovery.

CBD possesses the ability to modulate inflammatory processes [26]. In preclinical settings, CBD curtailed immune cell accumulation, spurred anti-inflammatory cytokine production, and stifled pro-inflammatory cytokines and reactive oxygen species [27][28][29][30].

In terms of muscle-specific inflammation, CBD demonstrated reduced gene expression of pro-inflammatory markers in a study employing high CBD doses (60 mg/kg/day) in a mouse model [32]. These CBD-treated mice also showcased enhanced muscle strength, coordination, and diminished tissue degeneration.

However, CBD at lower, though still substantial doses (20-40 mg/kg/day), yielded no discernible benefits [32]. This discrepancy might relate to the distinct underlying mechanisms between exercise-induced muscle damage and muscular dystrophy.

The dearth of studies probing CBD's impact on muscle function post-exercise translates into a nebulous scenario, necessitating thorough research, including pharmacokinetic data, blood cannabinoid measurements, and dose-response insights, to fathom if CBD indeed aids muscle recovery.

Factor #2: Pain Management

Athletes are no strangers to persistent pain, with neuropathic pain often rearing its head due to repetitive mechanical irritation of peripheral nerves, surgeries, or endurance sports [37]. Clinical trials investigating the effects of CBD in tandem with Δ9-THC (e.g., Sativex®) on chronic neuropathic pain have generated promising outcomes [38]. Nonetheless, research on CBD in isolation remains sparse.

Preclinical studies lean toward CBD's analgesic potential [39], albeit often less pronounced than Δ9-THC's effects [40]. CBD's effectiveness appears to hinge on factors like dosage and the nature of the pain involved. Interestingly, low CBD doses may not consistently alleviate pain [40].

Thus, determining a therapeutic CBD dose for pain management and conducting placebo-controlled trials on CBD's impact on pain in clinical and athletic settings seems crucial.

Factor #3: Dietary Matters

Nutrition plays a pivotal role in optimal athletic performance, muscle growth, and recovery [42]. Preclinical investigations in animal models suggest that CBD, at higher doses, might influence food intake for several hours post-administration [43]. Moderate to high CBD doses have been shown to suppress food intake in rats during extended ad libitum feeding windows [46].

Chronic CBD treatment also resulted in reduced body mass gains in growing rats [47], and clinical trials reported that epilepsy patients receiving CBD were more likely to experience decreased appetite [48]. The exact mechanisms responsible for these effects remain uncertain.

Thus, controlled trials exploring CBD's impact on appetite, dietary behaviors, and nutrient intake in humans, especially during the pre- and post-exercise periods critical for nutrition, are warranted.

The Final Note

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As the curtain falls on this exploration of CBD's dance with exercise, one resounding truth emerges: while intrigue surrounds CBD's potential, it remains an enigmatic partner on the fitness stage. A nuanced dance of CBD's effects, dependent on dosage, exercise type, individual response, and perhaps yet-undiscovered facets, awaits further choreography.

In a world where fitness is a symphony, CBD may offer a new instrument, yet its melody still eludes us, hidden among the echoes of scientific inquiry and the rhythms of athletic performance. Time and research will ultimately conduct this performance to its crescendo, revealing the true influence of CBD on the realm of exercise. Until then, the stage remains set, and the questions endure, inviting exploration, discovery, and the pursuit of optimal performance.

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