CBD for Performance & Recovery - Medical Journal

CBD to improve sleep quality

Athletes frequently overreact because of high training loads and inadequate recovery between efforts. These conditions can cause sleep disturbances or moments in which the athlete cannot rest comfortably, impacting sleep quality or recovery. CBD appears to regulate the cycle in which the body stays awake or asleep, which is essential for an athlete’s recovery (Burstein, 2015; Hill et al., 2017). One of the advantages of CBD consumption is its potential to enhance sleep in athletes. This includes improvements in sleep initiation, uninterrupted sleep, subjective sleep quality, as well as a reduction in nightmares and insomnia symptoms (Russo et al., 2007; Choi et al., 2020; Mondino et al., 2021; Ranum et al., 2023). In addition, some substances promote sleep controlled by the endocannabinoid system, which we can activate by consuming CBD (McCartney et al., 2020; Rojas-Valverde, 2021).

Sleep management requires a precise balance of neurotransmitters, and CBD’s actions on the endocannabinoid system contribute to this balance. CBD interacts with adenosine receptors, which is significant since adenosine is a neurotransmitter that promotes sleep and relaxation. CBD promotes tranquillity and preparedness for sleep by boosting adenosine signalling. Furthermore, CBD’s effect on GABAergic neurotransmission adds to its sleep-enhancing properties (Kesner and Lovinger, 2020; Kaul et al., 2021). GABA is an inhibitory neurotransmitter that promotes relaxation and drowsiness by lowering neuronal excitability. CBD’s effect on GABA receptors can promote deeper, more comfortable sleep. Furthermore, CBD’s ability to relieve anxiety and stress, which are significant causes of sleep disruption, indirectly supports greater sleep quality (Blessing et al., 2015; Moltke and Hindocha, 2021; Ortiz Rios et al., 2022). CBD provides a biological foundation for its action via modifying endocannabinoid system signalling, increasing adenosine effects, and regulating GABAergic neurotransmission (Zou & Kumar, 2018; Yarar, 2020; Martinez Naya et al., 2023).

CBD to reduce stress and regulate mood

Usually, due to athlete’s significant effort during their sports practice, they suffer from fatigue, which can lead them to situations where they do not feel very well emotionally. The ability of CBD to regulate the athlete’s mood is being studied (Kasper et al., 2020).

CBD can boost anandamide signalling, an endocannabinoid related to emotions of wellbeing, by preventing its absorption and breakdown, resulting in higher levels in the brain (Leweke et al., 2012; Henson et al., 2022). CBD has also been demonstrated to interact with serotonin receptors, including the 5-HT1A receptor, which regulates mood. Research findings indicate that CBD has been found to decrease anxiety levels by activating the 5-HT1A receptors and restoring impaired neurotransmission of the 5-HT1A (serotonin) system (De Gregorio et al., 2019). CBD can help serotonin transmission by attaching to these receptors. Serotonin is a neurotransmitter that is directly tied to mood and emotions. Furthermore, CBD has been shown to influence the hypothalamic-pituitary-adrenal axis, a critical mechanism in the body’s stress response. CBD reduces stress response by inhibiting the production of stress hormones such as cortisol. Overall, CBD’s capacity to modify endocannabinoid system function, increase anandamide signalling, interact with serotonin receptors, and influence stress hormone release all contribute to its potential for pain relief (Viudez-Martínez et al., 2018; Yarar, 2020; Lookfong et al., 2023).

CBD effects on anxiety seem to depend on dosage; 300 mg is more effective than 150 or 600 mg for reducing anxiety-related symptoms (Linares et al., 2019). There is no evidence of reduced anxiety or mood regulation in sports. Still, it seems that CBD could have certain properties that can be anxiolytic and anti-depressive (Murillo-Rodríguez et al., 2020) that some athletes suffer due to the pressure they always have to be better and win, as well as the frustration they may suffer from not achieving certain goals (McCartney et al., 2020; Rojas-Valverde, 2021).

CBD to reduce inflammation and oxidative stress

Inflammation and oxidative stress are two processes that intervene in people’s general health (McPartland et al., 2015). These two processes are normally triggered after exercise in athletes, and as we can control them, the athlete will feel more recovered and be more prepared to exert effort again. Inflammation is caused because, during exercise, the muscles suffer tension that causes damage, and by becoming inflamed, the body initiates the processes to repair that damage (McCartney et al., 2020; Rojas-Valverde, 2021).

Inflammation is necessary to recover from significant efforts. Still, excess inflammation could cause problems in our digestive and musculoskeletal systems and other systems due to the damage to tissues and organs that this causes (McCartney et al., 2020); that is why controlling it is optimal. CBD in athletes could regulate inflammatory processes by reducing substances that usually cause unwanted increases in inflammation, such as cytokines and cortisol (Zuardi et al., 1993). In addition to muscle and digestive inflammation, CBD reduces oxidative stress and neuroinflammation (Atalay et al., 2019; Sahinovic et al., 2022). In this regard, 300 mg of CBD has been shown to induce glucocorticoid regulation, such as cortisol in humans, a key regulator of the inflammatory response to injury (Zuardi et al., 1993).

Based on recent evidence, 10 mg/kg of CBD could attenuate inflammation (e.g., IL-6, IL-1 and tumour necrosis factor α) after fatiguing eccentric exercise by activating cannabinoid receptor two (Stone et al., 2023). This is based on CBD’s interactions with inflammation-controlling receptors (CB1 cannabinoid, CB2 cannabinoid, adenosine A2A), its cytokine level-reducing actions, and its moderation of immune cell activity, thus mitigating collateral tissue inflammation (Booz, 2011; Burstein, 2015; A. J; Hill et al., 2012). Moreover, CBD’s potential to enhance the release of arachidonic acid could improve healing by regulating growth signals mediated by pro-resolving substances (e.g., lipoxin A4 and 15d-PGJ2) (Burstein, 2015).

CBD to reduce the pain

CBD appears to have analgesic properties and bone that can decrease pain (Marques Azzini et al., 2023). Due to exercise, athletes usually feel pain from the effort and the damage caused to their bodies when they reach the limit. Running, pedalling, jumping, changing directions, hitting, and kicking generate muscle breakdown that causes inflammation, which can become painful.

For example, Sativex, THC, and CBD have been licensed to treat central and peripheral neuropathic pain. This pain condition is linked to activated microglia and a subsequent cascade of proinflammatory cytokines, including IL-6, IL-1, and TNF (Booz, 2011). In addition to its neuroprotective properties, this effect was discovered in a recent systematic analysis of the result of CBD consumption in connection to its prospective usage as a performance-enhancing agent (McCartney et al., 2020). It is currently unknown how CBD interacts with the pain cascade and pathways (Anthony et al., 2020). Still, it is suggested that serotonin and opioid interactions could have a great role in endorphins and enkephalins release and reduction of glutamate release via the interaction of adenosine 1 and A2A, leading to pain reduction (Navarrete et al., 2021; Peng et al., 2022). CBD has demonstrated its ability to cure and control pain in illnesses and pain disorders, and based on this information, CBD appears to have a possible effect on reducing swelling and avoiding soreness after hard activity (Sahinovic et al., 2022), but further research is needed to make a definitive declaration.

CBD, in a specific manner, interferes with neuronal communication, preventing the transmission of information related to pain (e.g., inhibition of neurotransmitter activity). As a result, the pain sensation is not perceived as it typically would be (McCartney et al., 2020; Rojas-Valverde, 2021). There is evidence of using CBD for chronic and acute pain management (Alaia et al., 2022; Marques Azzini et al., 2023). CBD can promote analgesia by activating transient receptor potential cation channel subfamily V (TRPV1) and serotonin receptors (Naik and Trojian, 2021). The latest scientific data found a pain-reliever effect of topical application (2*10 mg/day) of CBD in elite athletes with only minor side effects (e.g., dry skin) (Hall et al., 2023).

CONCLUSION

CBD appears to have anti-inflammatory, neuroprotective, analgesic, anxiolytic, and potentially recovery-mediating properties in athletes, but more scientific evidence is needed to confirm these effects. Confirmatory analyses using randomized controlled trials with placebo are necessary to test the acute and chronic effects of different dosage prescriptions. These studies must consider fundamental sport-specific particularities, such as the diverse biological and situational conditions that contribute to fatigue, the characteristics of each discipline during training and competition, the individual peculiarities of athletes, their tolerance and response to CBD intake, and the combined effect of CBD administration with other physical and nutritional aids.

Given the relatively common use of cannabis and CBD among athletes, there is a clear need to improve the scientific understanding of the effects of CBD use on athlete recovery and performance. Further scientific progress is necessary, primarily through the execution of experimental trials, to better understand critical positive and negative outcomes for the ultimate benefit of athlete recovery and performance. Furthermore, resulting evidence could provide new clinical guidance for prescribing CBD during the athlete recovery process and other potential applications. The potential therapeutic benefits of CBD administration have been minimized for years, but the actual scenario could increase knowledge about this natural compound and its effects.

SOURCE: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10556669/