Supplement Series | CBD Oil

There’s been a lot of chatter within the fitness world lately about the potential benefits of CBD oil.  It’s a topic that we’ve been paying close attention to here at M2 Performance Nutrition, and we thought we’d give you our opinion on whether CBD might be right for you.

 Full disclosure: We like the stuff and have partnered with Pure Spectrum to provide M2 clients with a 10-20% discount code (M2PN). Why Pure Specturm?  1) Its really pure… no THC at all. This is important for athletes getting drug tested 2) It doesn’t taste like dog-poop.  Many CBD oils smell like a frat house on Sunday morning and I don't need that in my life 3) Price is pretty legit for the quality of product. We fully recognize that this partnership will cause some bias on the topic, but we have tried to present a full picture and not cherry-pick the data.

 They've also partnered with the Crossfit Games as well!

They've also partnered with the Crossfit Games as well!

What is CBD?

CBD stands for Cannabidiol, a naturally occurring compound that can be derived from both cannabis and hemp based products, originally discovered in the 1940s. Interestingly scientists originally thought it was pretty much biologically inactive but over time we’ve discovered that it can have a number of therapeutic benefits.  As time progressed, we learned that the body has a complex neurotransmitter system that is based around compounds that are similar in structure to CBD. Researchers are still learning how to exploit this system, but a significant amount of progress has been made. Of interest, there are several prescription based medicines that are essentially pure CBD.  Sativex is prescribed to patients with Mulitple Sclerosis for pain management, while Epidiolex is approved for the treatment of several forms of epilepsy.  We’ll dive more into this, but pain management, anxiety and neurological conditions are all targets for CBD therapy.

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While CBD has a number of effects on the body, it does not make you feel “stoned” in any sense of the word. Its cousin, THC, is fully responsible for those affects.  So, if you’re looking for a nice high… you’ve come to the wrong place.

Nowadays, you can find CBD in oils, creams, gummies and vape pens.  Personally, I’ve been testing out oil tincture that goes under the tongue and a cream/salve that I put onto a chronically inflamed elbow. 

Let’s dive down into some of the ways that people are exploring CBD for therapeutic benefits.

CBD for the treatment of muscle and joint pain

There are a dozen different reasons that a body part can be painful, and while CBD has not been shown to be effective for all of them, there certainly is evidence that creams and oral consumption can help with body pain. In athletes, most of the time, pain is caused by over-use causing micro-tears in the tissue.  This results in the immune system being locally activated and a feedback loop of chronic inflammation begins.  Of course, rest or some corrective exercises can typically solve this problem, but let’s be honest with ourselves… you’re not gonna do that now are you? No, you’re most likely looking for some way to continue to train and minimize discomfort.

Can CBD help you in this quest is the big question. CBD does appear to be able to provide therapeutic benefit for inflamed joints in these situations.  The exact mechanism that this happens is a little unclear, but the receptors for CBD are expressed on white blood cells, indicating the potential for both direct and indirect effects. Additionally, as we’re about to talk about, there are receptors expressed on neuronal cells that CBD appears able to modulate as well.  So… whether be either breaking the feedback loop, or just minimizing your sensation of pain, there does appear to be some benefit.  Full honesty, I think more research is needed… Personally, I’ve been using a CBD balm on my elbow and can notice a reduction in localized pain about 15-20 minutes after application.  I also have some fairly serious inflammation deep in my knee. The balm does not really touch this sadly, but I think the oral tincture has helped.

CBD for anxiety

Anxiety is something that we all deal with on some level, but for people diagnosed with an anxiety disorder, it can be totally debilitating.  Current medical treatment can involve benzodiazepines, anti-depressants, beta blockers and serotonin reuptake inhibitors… all pretty serious meds with a litany of side effects.

Of late, people have been studying how CBD can play a similar role as these meds using a “natural” compound. So while it’s not exactly an encyclopedia, there’s a solid amount of scientific literature supporting the idea that CBD can help manage anxiety based symptoms.  Probably one of the better studies was done in 2017, which showed that CBD had a significant benefit in individuals with social phobia and anxiety. Not to get all geeky, but several receptors expressed highly in the brain (GPR55, the serotonin 5-HT receptor and several opioid receptors) have shown the ability to interact with CBD indicating the potential mechanism of action.

There are a few other decent studies, but it’d be great to see more research on CBD on anxiety type conditions. One impediment to getting more research done is that until recently, CBD was a banned substance because of its association with THC. Luckily though, its moved fully off the USADA and WADA banned substance list, opening the door to more and more research. Talking with a few friends in the medical community, it does seem like the use of CBD could allow for the dose of other medications to be reduced at minimum.  However, each said that simply replacing prescription meds with CBD, or going “cold turkey” would be a really bad idea.

CBD for neurological issues

 There’s probably more sound data on this topic than any of the others.  Its rather difficult to get a drug approved by the FDA, and like I said Epidiolex is approved for the treatment of several forms of epilepsy. On top of that there’s some sketchy evidence around symptom relief for Huntingon’s, Parkinson’s and Alzheimer’s.  To be clear, not cures… just in theory helping with some of the symptoms.

The exciting research for me though is with the effects on concussions. Considering that about 1 million people are diagnosed with concussions every year, anything that can help with the effects is worth checking out. There was some motivating evidence that showed CBD consumption was correlated with reduced brain cell death after a concussion.  Sure enough, some research indicates that CBD somehow activates receptors that trigger a cellular repair mechanism. Researchers at the University of Miami have begun to conduct a thorough 5-year study to see what affect CBD really does have a larger level.  You can read more about the biology and the study here. Can’t wait to see the results here.

Potential side effects

So this review nicely summarizes the known literature and says that up to 1500 mg/day of CBD are well tolerated in humans.  Having worked in this field for years, when they run clinical trials (like they did for Epidiolex) anything they see even once is reported as a possible side effect.  In this case it mentions the potential metabolism of other drugs through the cytochrome P450 enzyme (sorry, geeking out hard right now), dry mouth, and in rare cases some symptoms associated with low blood pressure.  At the end of the day, it’s a pretty small list compared to what else you’d find for something like Aspirin.  For reference, grape fruit juice ALSO impacts the P450 pathway… but of course we don’t really list it as a “side effect” since its just fruit, right?

Needless to say, take some personal responsibility and the first time you try ANYTHING, pay attention to any unwanted effects.  I’ve not heard of much from clients using it, but you should always make up your own mind about things like this.

Personal use and experience

So at the end of the day, I’ve been doing two things with CBD.  The first I already mentioned, which was the cream on some minor chronic inflamed sites I’ve been trying to resolve. 

The second is that I’ve brought CBD oil into my bedtime routine and have had some really nice results.  Here’s what I’m currently doing:

I take this adrenal supplement every morning with breakfast, every single day of the week. It’s basically a mixture of adaptogenic herbs that help spike the appropriate morning response of cortisol production.

In the evening, I do a few things as well

1) 30 minutes of NO screen time (usually…).

2) I take 1 tsp of Natural Calm which is a magnesium supplement.  Magnesium has been shown to help calm the nervous system.  Fun side fact: Most Americans are deficient in magnesium so… win win.

3) I take ~ 500 mg of CBD oil, again using the Pure Spectrum brand.  Again, I chose this one because of the absurdly high quality and lack of shitty taste.

4) I run COLD water over my hands and face for 60 seconds to drop my core body temp a little and (in theory) improve HRV as well.

If you have any questions, hit us up in the Contact Us tab and we’ll get back to you.

Supplement Series | Omega-3s

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Let's talk about Omega-3s...

Almost everyone who pays attention to their overall health these days has heard of Omega-3's and/or fish oil, and has some idea that they're helpful in combating inflammatory disease, achy joints, etc. 

On top of that, most people also are aware that our current diets don't give us nearly enough Omega-3's. 

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What is a bit more of a mystery to people is that the typical American diet is LOADED with pro-inflammatory Omega-6 fats which appear to contribute to diseases such as heart disease, obesity and diabetes. Unfortunately, omega-6 fats are pretty ubiquitous in the modern American diet. #ThanksVegetableOil

Taking this all in, one can assume that a smart goal is to try and balance out our intake of Omega-3's to Omega-6's by using supplementation and/or eating fish. Its important to note though, that not all fish and/or fish oils are created equal.

BUT FIRST, let's work through some basic information...

  • The important Omega-3 fats are called EPA and DHA.  DHA seems to have the more potent anti-inflammatory effects.  EPA can be converted into DHA though too and seems to block inflammation as well.
  • Fish and fish oil crushes flax seed oil.  Flax seed oil has high levels of a molecule called ALA and your body can convert ALA into EPA and DHA... but its a very inefficient process with less than 0.5% of the initial ALA forming DHA.  So basically you'd have to take a full bottle of flax seed oil each day... thats not a great idea for obvious reasons.
  • Dose. Its hard to make a general recommendation on dose, but I'll say this; You can't simply take all the Omega-3's you want and still eat like an asshole.  You've got to work on reducing your intake of crappy vegetable oils and limit other high Omega-6 foods (hello walnuts!!).  If you do manage to reduce your Omega-6 intake, then you can also take less Omega-3s. 

    That said, I know some of you will want a general recommendation, so here it is: 

    ~100-200 mg of EPA and DHA (combined) per 10 lbs of body weight.
 So 1 tsp of this supplement gives you 850 mg of EPA and DHA.  For a 180 lb male we'd want about 2 tsp per day.

So 1 tsp of this supplement gives you 850 mg of EPA and DHA.  For a 180 lb male we'd want about 2 tsp per day.

OK, so how should we supplement this?

Well if you can afford it, buying wild caught fish a couple times a week would be a great start (AKA eat real food).  Realistically though, I get that this can be an expensive endeavor so lets work through some supplement options as well.   

What should we look for in a supplement?

  1. Freshness. Omega-3 fats are susceptible to oxidation, which makes them rancid and also taste terrible. Worse news is that a rancid fish oil is pro-inflammatory defeating the whole purpose of supplementation!  If you can get a liquid fish oil (versus a capsule) you'll always know if the product has gone off.
  2. Potency. You want a nice high amount of EPA and DHA out of the total fat content. DHA is the more important of the two.
  3. Vitamins and bio-availabiity. Fish liver oil (from cod as an example) contains  fat-soluble vitamins that are difficult to obtain from other foods and has a better bio-availability due to the confirmation (#sciencedork). The more natural the structure the better.
  4. Price: Because athletes are broke AF.

Recommendations:

Again, if you can handle a liquid version, then its the way to go as you don't have to pop a ton of pills, its actually more cost-effective and you can guarantee that you're not taking anything thats rancid.  This is the brand that I recommend:

Liquid Omega-3 supplement

If you just can't do the liquids, then pills are the way to go.

Omega-3 pills

So there you have it.  Omega-3's are a solid supplement for health and performance.  Taken in moderate doses, they've been shown to be incredibly safe, making them an easy recommendation for the general population.

Supplement Series | Vitamin D3

We're going to go for a deep-dive on Vitamin D3 biology, but if you're looking for the cheat-sheet, here's the take home messages:

  • Over-supplementing with Vitamin D can have seriously negative side effects due to calcium issues.  Do not blindly supplement with 5000-10000 IU/day.
  • Take 1000-2000 IU/day of Vitamin D3 or better yet, get 30 minutes of sun exposure 3-5 times a week.
  • Make SURE to eat leafy greens (vitamin K rich) along with colorful fruits and veggies, eggs and butter (Vitamin A rich) to allow for appropriate calcium deposition and metabolism.

Vitamin D is a molecule that is typically made by skin cells, called keratinocytes, when we are exposed to the sun.  It can also be found in relatively high amounts in fish, egg yolks, and cheese. Interestingly, its estimated that a large percentage of the US (and World) population is "deficient" in Vitamin D, more accurately a molecule its converted to called calcitriol, or 1,25 dihydroxyvitamin D. 

Vitamin D has been shown to be important in the optimal function of MOST organ systems, including but not limited to:

  • Appropriate function of the immune system
  • Absorption of dietary calcium
  • Recovery from training
  • Body composition

Needless to say, we want to make sure we're dialed in with our levels.

One of the major issues is that there's very little consensus on what makes someone "deficient" in VD3.  Medically, people think of numbers below 25 ng/ml in blood, however other researchers believe that optimal levels fall below 50-80 ng/ml. Clearly the medical world hasn't quite made up their minds yet.

It's estimated that direct sunlight for as little as 30 minutes, three times per week can induce the production of more than enough vitamin D. However, considering that up to 40% of Americans are deficient, either we're doing a terrible job at getting outside, this amount of exposure isn't cutting it, or there is another underlying biological issue.

The typical response to low VD3 levels is to supplement the crap out of people with 5-10,000 IU/day.  People then come back after a few months and if their blood levels are not improved, the prescription goes even higher.  Someone once told me a fun analogy using the "check oil" light in a car.  If the light kept going on despite filling the oil regularly, would you simply continue to dump more oil in, or would you maybe search for another issue???  Thats probably what's going on here with your low vitamin D3 levels, as we keep adding more and more through supplementation, but not really making an impact.

Additionally, we need to consider if massive supplementation is a really smart idea to begin with. There are a handful of studies that show a correlation with lower VD3 levels and higher risk of basically all mortality.  So thats not good and we should clearly supplement with it, right??

BUT...

Another set of studies correlate that mortality increases once you VD3 levels exceed 40 ng/ml.  If you're like me you're probably thinking "Jesus, my head hurts... what the hell is going on here?"  Well we're going to get to the bottom of this.

There is a risk factor called hypercalcemia, or high levels of calcium in the blood, thats been associated with fairly strong doses of vitamin D supplementation.  On top of that, looking in the blood alone can be misleading. Calcium based kidney stones, as well as deposition into other soft tissues and... the big problem child, arterial deposition of calcium, have all been reported with Vitamin D3 supplementation as well.

Is this really about Vitamin D or is it about calcium???

So while you're probably ready to throw your supplement in the trash, we need to take a bigger picture look at this and figure out what the real culprit here is.  One strong possibility is that our calcium levels are TOO HIGH, and that as a result, our body is trying to shut down one of the major calcium absorbers (the product of Vitamin D, calcitriol, or 1,25 dihydroxyvitamin D) to normalize out the levels. 

Why might our calcium levels be too high???  Well there's a ton of reasons, but the most obvious ones involve inappropriate levels of other vitamins and minerals.  The big players here being magnesium, vitamin A and Vitamin K. 

Just to give you an example of WHY its important to balance out your micronutrients, lets look at Vitamin K as an example.  Vitamin K does a ton of things in the body, but one of the most critical is to allow for calcium deposition into bone (AKA taking calcium out of the blood stream, arteries, etc).  Fun fact, if you supplement rats with Vitamin K2, it inhibits artery calcification quite nicely.  So the basic idea goes that if you don't have enough Vitamin K, then your blood calcium levels rise. To combat bringing even MORE calcium into your body, feedback mechanisms prevent the conversion of vitamin D3 into its active calcitriol form.  As a result of this, you end up "low" on vitamin D3 when you test for it.  Your doctors see this and just supplement the shit out of you, but this doesn't really solve the problem, if anything it just worsens it.

What SHOULD you do?

OK, so most of you probably don't care about the biology, you just want to know the end game.  Here's the best general recommendations we can make:

1) Try and get some sun when you can.  The body does a good job of shutting off vitamin D production when it doesn't need to make it.

2) Take 1000-2000 IU/day, especially in the winter.

3) Eat some mother trucking veggies.  Vitamin K is found in dark green leafy veggies like kale, spinach and swiss chard.  Vitamin A is found in colorful fruits and veggies eggs and butter.

4) Take a good probiotic (more to come on this later) as Vitamin K conversion happens in the GI tract