Ep. 163: CBD Oil: Does It Live Up to The Hype? with Hyla Cass | Vibe Podcast

This transcript has been edited for clarity.

Robyn:  Hey everyone, it’s Robyn Openshaw, and welcome back to the Vibe show.

Today I’m talking about a subject that I think a lot of us are very curious about because there’s so much hype out there about CBD and the cannabinoid system and whether CBD is the white horse to come in and save us from the opioid epidemic.

I was talking to my friend, Dr. Hyla Cass — who’s a medical doctor in LA — this summer and asked her if she would come on my show. We finally put that together.

She’s a physician, she’s a psychiatrist. She’s often quoted in major media. She’s very pro natural approaches to mental health and to physical health.

She isn’t just one of these physicians who hands out the psychotropic meds. She combines the leading-edge natural medicine with modern science in her own clinical practice.

She’s a very experienced physician, and she has been helping people withdraw from psychiatric medications and from substance abuse or to avoid those medications altogether through the use of specific targeted nutritional supplements. She’s got her own line of supplements including hemp oil extract.

Today I’m going to talk to her about CBD. I know that a lot of people get confused, and they think that it’s going to be psychoactive — that it’s going to make you high.

If you haven’t really gone down that trail of studying CBD, today is for you because Dr Cass has written little books — little mini books like Natural Highs and Your Amazing Itty Bitty Guide to Cannabis and The Addicted Brain: How to Break Free.

I’m really excited to have her on the show and clear the clutter of the things you may wonder about or the biases you may have against CBD.

Welcome to the Vibe show Dr. Cass.

Dr. Hyla Cass: I’m so happy to be here.

Robyn:  It’s been a long time coming. I know I’ve been talking to you for a while about coming on the show to talk about CBD. Do you think it’s the great next frontier for psychologists and psychiatrists?

Do you feel like the drugs that psychologists and psychiatrists have been using — the helping professions — have been using for years are broken and that this is going to be a big breakthrough?

How did you come to be this CBD expert, and why do you think it’s so great?

Dr. Hyla Cass: Backing up, as a more holistically oriented psychiatrist, I’ve been taking people off medications or not putting them on them in the first place and using natural supplements. I always go with the body’s chemistry because nature knows best. We know that. It’s really clear.

Rather than covering over symptoms with drugs, people whose practices I do will give the nutrients that help make the neuro-transmitters. That’s the background. I’ve been doing this for many, many years and very successfully.

People do get off medication. They feel much better, and they do better, and that’s the end of it. They don’t need to be on medications.

By the way, people should not just jump off their medications cold turkey. That’s another issue. They need to be weaned off gradually.

Robyn:  I’m going to come back to that in a minute and find out more about people coming off their SSRI’s because I know that can be a total nightmare. There’s lots of people who are on them and want to get off. We’ll table that for a minute but continue.

Dr. Hyla Cass: Great. Along comes CBD. I’ve been using amino acids, vitamins, minerals, essential fatty acids — all really important in the brain building neuro-transmitters enhancing mood. Then along comes CBD.

CBD is like the extra piece, the extra missing piece that makes everything work better. It enhances neurotransmitter production and reception.

Everything that we’re doing in every other way with diet, lifestyle specific nutrients is going to be enhanced with CBD because it works with something called the endocannabinoid system.

It’s the missing link and it’s quite amazing.

CBD working with the Endocannabinoid System

Robyn:  Okay. Talk a little bit about the endocannabinoid system.

Dr. Hyla Cass: This is so interesting because [how] much science has been progressing. We thought we knew everything. It turns out that not very long ago, the endocannabinoid system was discovered.

First of all, in the 60’s Dr. Raphael Mechoulam, who did the original studies on the effects of marijuana, said, “There has to be something made in the body that corresponds to marijuana which acts on a specific receptor.”

What they discovered was a product called anandamide which means bliss in Sanskrit. It turned out that anandamide is part of this system that influences every cell in the body. It’s a master communicator and a master modulator.

It has your brain talking to your gut, your gut talking to your brain. Your hormones are involved. All of the organs of your body, the liver, the pancreas, and so on.

It’s a very elegant, intricate communication system that allows us to feel better, function better, and just be better overall.

Robyn:  Okay. I know that a lot of people who haven’t started looking into this yet are going to want to know [if it is] psychoactive or can it make you high? What’s the difference between the hemp oil you advocate for using that you feel has many, many useful applications and the cannabis plant, the marijuana plant?

Dr. Hyla Cass: I mentioned anandamide and that was the first endocannabinoid — endo means inside, inside us. We make anandamide, we also make 2-AG. That’s another endocannabinoid.

Those are the natural things that actually make us feel good. If we don’t have enough of them, we don’t feel good.

That’s why when people are low in endocannabinoids and — this is historical — they would smoke marijuana. That would give them a feeling of high — of feeling good — because they were lacking their own anandamide.

Along comes CBD, which is also coming from the outside. It’s a phytocannabinoid — phyto meaning from a plant.

CBD is from the cannabis plant, so it’s from the very same plant as weed, the cannabis plant, but it is not psychoactive in the same sense. It doesn’t cause you to feel high.

By the way, the levels of THC in the current weed that’s grown is extremely high, and people actually end up having some kind of negative reactions particularly if they’re not accustomed to it.

CBD will not be psychoactive. It’ll make you feel better, but it won’t make you high. It improves your mood. It’ll relax you if you need that. It’s kind of like an adaptogen for your mood, but it won’t get you high.

Robyn:  It won’t make you anxious or paranoid like a lot of people who smoked marijuana talk about, right?

Dr. Hyla Cass: [I have been] seeing more and more of that clinically. [I] get a lot of young people, particularly in the emergency rooms, [that] have never smoked before or who ended up smoking something that was very high in THC and too high for their system to handle.

These are enormously height percentages. The way it was grown in the old days, the sixties and seventies, was mild by comparison, and the plant had enough CBD in it to mitigate those effects.

Now it’s almost all THC in the plant because it’s grown for recreational purposes.

People become paranoid, even violent, and it’s so scary for them. The worst part is when they go to an emergency room they’re given medication, usually it’s a shot.

They’re given a prescription of psychiatric medication, and then they’re on this whole journey of being on psychiatric medication indefinitely.

Dr. Hyla Cass: They might end up even being diagnosed bipolar. I mean it gets really, really bad. This is the field of psychiatry and medicine in general where people are medicated when they have anything that is of a psychiatric nature as opposed to working with the body’s chemistry.

In this case, by the way, if you have someone who’s tripping out like that on THC, give them high doses of CBD. It will help to neutralize it.

It helps neutralize it at the receptor site. It separates the THC from the THC receptor. In doing so, it mitigates that really negative, scary response.

Robyn:  Okay. I’m going to get into what the science has to say about CBD’s uses. I want to ask you about your opinions on the current state of psychotropic drugs being prescribed here in North America so ubiquitously. So many people are on them.

I want to mention that my two youngest children are managing their anxiety with CBD oil. I send it to them. I buy it for them, and I send it to them, and I consider it a good investment for keeping them off SSRI’s. I do not take an SSRI, but anxiety is my lifelong demon.

I consider it a blessing and a curse because it drives me. It makes me a very driven, hardworking person as long as it’s managed. There have been a number of times in my life where that anxiety gets out of control, where it becomes almost crippling. I have just almost tipped over.

I watch my two youngest children carefully because they have those same tendencies, and I just feel like saying, “I’m so sorry I gave this to you.”

Dr. Hyla Cass: [Laughter] It’s probably a COMT gene. You’re not breaking down catacholamines, and so you get more anxious, but you’re also more motivated. It’s a double-edged sword. However, CBD will absolutely mitigate this, really help. It takes the edge off.

Robyn:  They’ve been singing its praises for about a year. I put them both on it in their freshman year of college. They’re both sophomores now, and it’s getting them by, and I would much rather have them do that than smoking marijuana or taking an SSRI.

I want to say for the record that if my children were spiraling into self-harm and really in a low place, I would put them on an SSRI, but I would consider it a, “getting out of the deep black hole” solution.

I wouldn’t be like, “Take this Zoloft for the rest of your life.” I think [that would be] a terrible idea. How about you?

CBD alleviating Depression

Dr. Hyla Cass: It’s interesting, I hear this all the time. It’s like, “I have a really serious depression, or my child has a very serious depression including self-harm.” The truth is that you can use nutrients for treating all levels of depression, including self-harm.

You add in the essential fatty acids, Omega 3’s. You add in 5-HTP or tryptophan to raise serotonin — very important. You can use lithium orotate. There are quite a few nutrients that I have or that we have.

We practice functional medicine and psychiatry that will really bring your neurotransmitters to the place that they need to be and you’re not feeling those dark, dark feelings.

You’re not in that pit anymore. It’s amazing. It’s chemistry. We really are biochemical beings. Of course, we’re mind, body and spirit, but it’s very hard for your mind and spirit to work when your physiology is working against you.

Robyn:  Yeah. Interesting. I wonder, do you ever put people on SSRI’s? Do you ever use it for the short-term solution for somebody who’s in the bottom of the pit?

What do you think are the problems with them, and then what would you say to somebody who’s on one [and] wants to get off about how to get off of them?

I know you have to do it gradually or you can have a catastrophe on your hands.

Dr. Hyla Cass: Absolutely. I do not put people on psychiatric medications — not on the benzos, not on the SSRI’s. For one thing, people who want to be on medication go to doctors who medicate. I’m known as one who is a non-drug doctor, and I take people off medication.

I do prescribe when I’m helping to wean someone off, obviously, because you have to do it with very gradually decreasing amounts of the medication.

The good news is that with CBD, I’ve noticed that the course has shortened quite a bit.

Before, I was using my usual supplements, and some of them I had developed myself for my patients. They were very successful, but they took a certain amount of time.

I’ve noticed with the CBD it’s faster and smoother. It’s like an adaptogen for your neurotransmitters, and it really helps.

Robyn:  We’re talking about anxiety and depression. What else is CBD used for? What are some of the conditions that people use it for most successfully?

Dr. Hyla Cass: Actually, it’s been used for serious seizure disorders. There are children with something called Dravet syndrome.

In fact, there’s a drug, Epidiolex, which is a CBD isolate — plant-based to their credit — that actually sells for a fortune, which is the drug way. That is its mouthful spectrum, which I’ll explain.

It’s quite expensive, available by prescription, and you have to use quite a lot of it because it’s an isolate. You’re actually better off using the full spectrum CBD where you can use less of [it]. It has fewer side effects and it’s less expensive.

I have to say, to their credit, there is a CBD isolate on the market. It’s a start.

Robyn:  Okay, let’s talk about the CBD isolate thing because I’m sure my audience is seeing tons and tons of brands bringing CBD out.

The crazy thing is right now here at Green Smoothie Girl, we actually have developed an anti-inflammatory CBD product, but we haven’t brought it out.

There’s a couple of reasons why. I’ll tell you a little bit about this history, Dr. Cass. We have like 10 different anti-inflammatory, plant-based compounds in it.

We wanted organic hemp oil. We wanted full spectrum hemp oil, which I’m sure you’ll talk about.

We had the FDA telling our supplier of our raw materials that we could not say anti-inflammatory, which is crazy because we literally have all these compounds in it that have been proven to be as good or better than ibuprofen.

Of course, the pharmaceutical companies are allowed to say anti-inflammatory. [It] definitely makes me wonder about that.

Robyn:  The other issue is we can’t put it in the Green Smoothie Girl store. We can’t put in the Green Smoothie Girl store without compromising our ability to process credit cards.

We’re just paralyzed right now. Completely paralyzed.

We would have to literally set up a separate site. We have to get a different credit card processor who allows that. Of course, then you’re just always in jeopardy.

When people go to buy something in the Green Smoothie Girl store, we can’t say, “We have this organic anti-inflammatory CBD compound.”

Dr. Hyla Cass: You have something really wonderful, but you can’t advertise it, and you can’t sell it.

Robyn:  Yeah. Why is that? What are the political forces? I know you follow all this stuff really well.

Dr. Hyla Cass: Yeah. To begin with, CBD and weed are both from the cannabis plant, so they’re both cannabis.

With the hemp farm bill of 2018, they got separated so that CBD is now legal in all the States, and it’s not considered in the same category as marijuana, which is considered quote, “A drug of abuse with no medicinal value” even though the U.S. Government holds a patent on it for medicinal value — lot of contradictions here.

Also, even though they were separated, the FDA did not separate them. According to the FDA, CBD is still associated with weed, which has a whole different status. It has to be sold in dispensaries and so on. It’s kind of gnarly.

We’re trying to work it all out, and it will get worked out. There’s enough business here; there’s enough benefit here, but it has to be settled.

In the meantime, you’re kind of stuck in limbo. Those of us who are selling full spectrum hemp oil really have to be careful what you say, how you sell it, and so on.

Robyn:  Yeah. It’s like I figured — there’s just a political situation where there are people who want to control the money of it. I’m seeing a lot of people bring out products that don’t say CBD, and they don’t explain at all what the product is, and then they probably just have to explain that in their email marketing or whatever.

Dr. Hyla Cass: That’s third party labeling. You can’t quote, “label” something. You can’t make a drug claim on a natural product. It gets even more confusing than that. I’ll leave it at that.

In 1994, there was a movement to remove all supplements from the shelves. It was really bad, and there was a big, popular protest on that. A compromise was reached with Congress to limit claims to structure and function claims.

You couldn’t say, for example, “St. John’s work treats depression,” [even if you have] great research showing that it treats depression, great research out of Europe particularly.

You could say it helps to maintain a good mood because that’s structure and function.

Now somebody reading that label could say, “Why would I take it if I want to just maintain a good mood?” You see the catch here. That was the only way to get around it.

Robyn:  Yeah. I think eventually maybe there’ll be some inroads, but there have been multiple points along the way where supplement companies can’t make any claims whatsoever, can’t even put a label on it. Whereas the drug companies do have that ability and the OTCs — the over the counters.

Talk about the full spectrum oil versus what you’re seeing a lot of these companies coming out with — a CBD isolate or derivative. There’s a big difference, isn’t there?

Dr. Hyla Cass: Big difference. We know from the herbal world that we don’t isolate one chemical or one vital chemical from an herb. We use the whole herb because that’s how it appears in nature, and that’s where you’re going to get the most bang for your buck.

We want to use full spectrum CBD because — we’re referring it to CBD, but that’s the vernacular. What we really are talking about is full spectrum hemp oil extract. In fact, that’s what I call mine because the CBD isolate takes away all the other cannabinoids.

There are over a hundred cannabinoids. That doesn’t mean that over a hundred cannabinoids are appearing in each plant.

There’s a whole range of cannabinoids. A selection of which will appear in any particular plant as well as terpenes. Terpenes are very, very important medicine.

Robyn:  Talk about that. Talk about terpenes.

Dr. Hyla Cass: Terpenes are what give herbs their particular smell. Terpenes give marijuana that typical kind of skunk smell. Lavender has its own specific smell. All these terpenes have strong scents.

Essential oils are made from terpenes, and they’re very healing. All these oils, all these terpenes in the plant and the CBDs and there’s also vitamins, minerals — a lot of components in the plant that work together synergistically to have what’s called the entourage effect.

With the entourage effect, you’re getting way better effect than simply taking a CBD isolate. In fact, with the isolate, you’re going to get a response up to a certain point, then it’s going to drop off.

You could actually make the situation more [problematic]. If you’re taking it for anxiety, you’ll take it up to a certain point. If you go beyond that point, it’ll stop relieving anxiety and your anxiety is going to return and maybe even worsen.

It’s an inverted “U” shaped curve or a bell shaped curve.

You have to end up taking a really high dose of the CBD isolate as well, which then brings on side effects. [It is] the drug model to isolate things. That’s why Epidiolex is an isolate.

You get a lot more value from a full spectrum product. The full spectrum product can contain a trace of THC or not. That trace of THC occurs naturally.

It has to be under 0.3% in order to be legal. [THC] is from the hemp plant. If it’s over that, then it falls into the category of a THC product, and that goes to the dispensary department.

Robyn:  Yeah, I think it’s 0.03 not 0.3 right 0.03.

Dr. Hyla Cass: Yeah. Point zero three.

Robyn:  Yeah. A tiny amount.

Dr. Hyla Cass: It’s a trace amount and by the way, that very trace amount can actually accumulate in the fat cells.

If people are having drug testing at work, it could show up and they’d have to say that it’s from the CBD that they’re taking, not THC. It could be problematic. There are products that have removed that trace of THC.

Combining CBD with Other Supplements

Robyn:  Interesting. Are you combining it with other supplements in the way that you treat people? I did not know — I’ve never asked you before until this interview — that you don’t put people on benzodiazepines, SSRI’s, and that you treat people holistically.

I love that. That’s courageous. I know you could probably make a lot more money if you were one of the pill pushers. Good job.

What other supplements do you put people on, and are there any contraindications if people are tackling it from different angles?

Dr. Hyla Cass: CBD goes well with everything, so we don’t have a problem. Some sources say, “Take the CBD away from the medication.”

I’d say just to be really cautious. Take it at least two-three hours away from medication particularly if you’re using it to ween off. There’s going to be a period of time where you’re taking both.

Other than that, I use 5-HTP, tryptophan for serotonin or tyrosine to raise dopamine and norepinephrine. GABA and theanine to raise GABA, which is common.

Robyn:  Okay. I want you to say those again for people who struggle with depression or anxiety. I know some of them are like, “Oh my gosh, she’s saying all the supplements that I need to try.” Maybe don’t try all of them at once, y’all.

Go get these on Amazon or go to Dr. Cass’ online store and get these. Give us a little counsel about [trying] two or three of them at a time or just one at a time.

List those all out nice and slowly and clearly because there are going to be people who are getting their phone out right now and writing this down in notes.

Dr. Hyla Cass: It’s an interesting question because you could just take one item and try it.

For example, if you’re feeling depressed and anxious, have trouble sleeping, get the munchies in the evening, that’s usually a serotonin deficiency.

You’ll want to take 5-HTP, which makes serotonin. People report feeling calmer, sleeping better, having a better mood, and not having as much of an appetite — in a good way — not having cravings. That’s the serotonin department.

Then there’s a dopamine department for people who are having trouble being motivated [and] trouble focusing. They may even be ADD.

For them you want to take something that enhances dopamine, like fennel alanine or tyrosine or both. I combined the two of them in my focus product in fact.

You have that and the cofactors together. You either get it as a formula or you get them separately. You can take a multivitamin that will supply the cofactors along with some tyrosine or fennel alanine.

Robyn:  Are there any side effects? You mentioned side effects of taking the CBD isolates. You’re a fan. I am too just like I’m a fan of eating the whole foods instead of the processed foods.

[With] supplement companies, people think, “This is natural. It’s a supplement, so it’s good.”

When we isolate these or make synthetic — even worse — nutrients, they just don’t appear to have the effect that is predicted or that people thought.

You call it the entourage effect. We don’t understand fully why all the different compounds in the full spectrum oil have the effect they do.

Be on the safe side and don’t niche it down and try to pull one aspect of the oil out or pull one aspect of the food out. It just backfires on us. We’ve seen it over and over again.

Now, the drug companies own most of the supplement companies. People don’t know that they’re buying them up — they’re consolidating. We’re going to see more of that. We’re going to see more isolates. We’re going to see more synthetics.

I think that people who are smart and educated about these issues are going to start only purchasing from very small companies who they trust to source correctly.

Talk about those side effects, the warnings, and maybe any drug interactions too. Is there any concern with people taking CBD with other meds?

Dr. Hyla Cass: Very good questions. First of all, side effects. Some people occasionally may get over-amped as opposed to relaxed. They should take it earlier in the day.

That’s the only difference. Most people feel relaxed. Some people feel sleepy, so they should take it at bedtime.

It really depends on your own biochemistry. We are all very individual, and we all have different endocannabinoid levels.

In fact, the sign of a low endocannabinoid system are things like chronic pain, migraines, anxiety, depression — all of the things that CBD treats because it’s replenishing the endocannabinoid system.

It helps your endocannabinoids, your anandamide, and your 2-AG to work better. That’s how that works. It’s actually enhancing your own natural endocannabinoid system, which is a good thing.

In terms of side effects I mentioned sleepiness. Some people may experience nausea. You can have any kind of side effect from anything.

I always believe people when they tell me they’ve had a side effect, and then you just have to be cautious. Take less of it, experiment, and so on. It’s quite safe.

In terms of drug interaction, there’s always that issue. For example, with blood thinners, you want to be cautious. In which case you would just change your dose of blood thinner. It doesn’t mean you shouldn’t be taking the CBD. You just take a different dose of blood thinner. You can adjust it down. It works.

It’s broken down just like the drugs are by the P450 system. It could be competing with a drug, in which case it’ll make the drug more potent. You want to be cautious.

However, under a hundred milligrams a day of CBD, you’re very unlikely to run into any problem with drug interaction.

I have found this. My colleagues — who’ve done together a lot more than simply myself as an individual practitioner — have had no problems at all with combining them with drugs under a hundred milligrams.

Robyn:  Okay. One more question. Some people say that you kind of want to front load with this supplement. You take a lot of CBD at first, and then you can taper down. Can you explain the reasoning behind that?

[Explain] whether you think that the evidence supports that. It’s sort of the opposite of a lot of other substances that you might take — including natural substances — where [you would] take a small amount and build your way up a little bit.

Dr. Hyla Cass:  I’ve been hearing that lately, and I don’t know where it’s coming from.

The professionals who are speaking about CBD and teaching other professionals — such as myself — always talk about starting low and slow because you don’t know where your endocannabinoid system is.

You don’t know how you’re going to react. Caution is always the best approach. I say start low. Start with half the dropper moving up to a dropper, either later that day or the next day.

Just keep building up gradually until you have the result that you’re looking for.

If you have acute pain, it can work right away. I’ve given it to someone in my office with either acute pain or acute anxiety. [I gave them] some under their tongue, and 10 minutes later they were feeling really good. The anxiety went away or the pain went away.

That doesn’t always happen. Sometimes they have to take a second dose, and I may do that second dose fairly close in time because they’re in my office, and I want to know how they’re doing, and what they should leave with.

When you’re doing that at home, I’d say you have to figure it out, but always err on the side of caution.

Robyn:  Okay. For people who want to continue learning from you about hemp oil and natural ways to treat psychiatric issues, where can they find you? Where can they follow you?

Any other final comments you want to make?

Dr. Hyla Cass: Oh, great. Well, my website has quite a bit of information. My website is cassmd.com. For information on hemp oil, it’s cassmd.com/hempoil. One word.

I have a blog on my website. Under the blog section you’ll also find a few blogs on full spectrum hemp oil.

Robyn:  Very good. Well, thank you so much for everything you’ve taught us today.

Dr. Hyla Cass: Oh, my pleasure. I’m always surprised that people don’t know what they need to know about CBD, so I’m so happy to be able to present. Thank you so much for the opportunity.