How does CBD affect the immune system?

We turned to a doctor to get some answers!

Dr. Caroline Hartridge is an Osteopathic plant-based physician, NYS Medical Marijuana Referring Physician and cannabis/CBD pro to say the very least. She breaks down everything you need to know about CBD and immune function in a fun and easy-to-understand way, and even touches on the recent research around CBD and COVID 19. Enjoy!

Let’s talk CBD and the immune system. Overall, data supports both CBD’s immune-suppressing and anti-inflammatory properties. This means that CBD has the ability to get the party started and to shut it down. 

The immune system is complex and multifaceted. I like to think of the system as being a network of bouncers at night club check points: do you belong, or not? Are you “self” or “non-self”?

Who gets in and who gets bounced?

A special handshake is used to determine if you are “self” and allowed into the club, or “non-self” and need to wait outside until the system figures out what to do with you. The immune response to unwelcome visitors varies, resulting in outcomes that range from programmed cell death, to a healing-centered inflammatory response and immune action.

Your immune system offers a hand, or receptor, to interact with the cellular surface markers of another cell. Once the handshake is completed and the “self/non-self” assessment is made, the cell in question is tagged accordingly. “Non-self” cells are tagged with markers called cytokines/chemokines. Those markers are there to let the immune system know that action is needed.

Teamwork makes the dream work

If immune cells are the bouncers, then endocannabinoids and phytocannabinoids can be thought of as additional nightclub staff. They work alongside the bouncers in the interest of ensuring that everybody is having a good time.

Immune cell activity can be altered by interaction, or “handshakes”, with the CB1 and CB2 receptors of the Endocannabinoid System. Enzymes, or “cocktails”, influence immune cell activity as well. For example, the “cocktail” FAAH has a significant impact on the production and activity of endogenous cannabinoids AEA and 2-AG. Endogenous cannabinoids are cannabinoids produced by our own bodies. They can be thought of as the “in house staff” in this scenario. If the “in house staff” is under the influence of “cocktails” like FAAH, the way in which they communicate with the “bouncers”, or immune cells, is going to be affected.(1)(2)

Phytocannabinoids like CBD are like the “hired caterers”. CBD is an exogenous cannabinoid, meaning that it’s coming in from the outside to provide some extra assistance to the “in-house staff” (endocannabinoids). CBD can work with the immune system in two ways, either increasing or decreasing immune activity. These two types of actions can be carried out one at a time, or simultaneously if needed.

Taking care of business: CBD in action

A perfect example CBD’s ability to up-regulate immune activity is its affect on something called apoptosis, or programmed cell death. CBD has been shown to increase the rate of apoptosis in cancer cells, meaning it increases the rate at which our immune system attacks and kills cancer cells. It also promotes activity of regulatory cells like apelin, which plays a role in immune function as well as cardiovascular and central nervous system health. In those two cases, CBD increases immune activity to get the party started. CBD’s ability to shut the party down is just as important, though. Especially when the rowdy cytokine crew shows up.

(LOL @ this pic)

Cytokine production indicates an active immune response; cytokines signal “immune activity here”. In animal studies CBD has been shown to decrease cytokine production in collagen-induced arthritis, corneal inflammation, and spinal cord inflammation. CBD also has the ability to quiet the production of rheumatoid factor – a group antibodies that attack a person’s own tissue. High levels of rheumatoid factor are associated with autoimmune diseases like Rheumatoid Arthritis.

So, CBD can break up the immune party and tell all those wild cytokines to take a hike. It can get the party started by announcing an open house rave at a “club” of cancer cells, or simply send out a bouncer to make sure the party isn’t getting out of hand.

The gut: where the party’s at

Where is the immune party most active? The gut. Nearly 70% of the body’s immune cells are located in the gut, and there are a whole lot of endocannabinoid receptors holding it down alongside them. 

Enteric glial cells (ECG) moderate inflammation in the large and small intestine. In a 2011 study, CBD calmed overactive glial cells in mice models, yielding a decrease in the inflammatory compounds associated with ulcerative colitis. 

CBD and COVID 19

Is CBD invited to the COVID party? Let’s check the guest list.

Apelin is a peptide (small compound) that plays an important role in immune system regulation, as well as CNS, cardiovascular system and metabolic regulation. For now, let’s just focus on its role in the immune response.

In acute respiratory distress syndrome (ARDS), increased apelin activity was associated with limited pulmonary inflammation. Further research is needed, but CBD shows promising biochemical mechanisms to treat COVID related lung symptoms as well as sepsis. 

CBD and chronic lifestyle diseases

Can CBD play a role in managing chronic lifestyle diseases, like diabetes or cardiovascular disease?

Current research suggests that metabolic diseases, like type 2 diabetes, develop in the setting of low-grade chronic inflammation (underground rave party).

The source of the compounds telling your immune system to be on all the time is fat, or adipose tissue. Fat is like the obnoxious club promoter who is constantly sending out flyers and telling you to say their name at the door for free admission. So, fat is creating cytokines to activate the immune system, AND, the accumulation of fat in arteries and liver tissue (a) triggers inflammation, (b) can lead to fatty liver disease, and (c) can cause plaque formation in the arteries.

CBD modulates metabolism of fat and glucose and promotes antioxidant activity (it makes the call to stop serving drinks and get the clean-up crew in).

Don’t let stress crash the party

Stress takes out your bouncers, it wrecks your amps and fog machine. Stress, whether acute or chronic, associated with pain, anxiety or PTSD, is known to have negative effects on immune function. CBD supplementation improves the stress response, due to direct activation of the 5HT1A serotonin receptor , allowing your body to get the immune system back to work. Even if you consider yourself to be healthy but are exposed to everyday stressors, supporting your body with daily CBD supplementation may be beneficial. 

How to incorporate CBD for immune health

Optimal CBD supplementation to support immune function can vary depending on the issues you’re trying to address. Here are some recommendations for different immune-centric use cases:

1. General support of endocannabinoid health, oral consumption: 30-100mg/day
2. Moderate chronic pain/auto-immune management, oral consumption: 100-300mg/day
3. Localized treatment (avoids liver metabolism), topical application: 10-65mg/2-4x/day.
4. Apoptosis/Cancer support, suppository: 1000-2000mg/day

For HIV positive patients, there is an ongoing study assessing CBD and THC on immune cell activation that can be found here if interested in learning more.