I, like many others, originally tried CBD isolate products, and did not find much relief from them. It wasn’t until I found my first full spectrum product that I was introduced to the amazing pain relieving and anti-anxiety effects of cannabis products. But why exactly is this?
The Entourage Effect
This is due to something known as the entourage effect- a theory that cannabinoids work better together than as isolates. So, THC works better with some CBD, CBD is more effective with a small amount of THC, and cannabis products in general work better with a full range of cannabinoids and terpenes.
If you think of cannabis as a full and complete plant, where all the cannabinoids work together as a team, taking one team member out of the equation is going to make it less effective.
What does the research say?
First- lets focus on just CBD and THC.
In a controlled study, a product called Sativex, which contains both CBD and THC, was given to patients suffering great pain due to cancer. Others in the study were given pure THC extract containing no CBD or other cannabinoids, and another group were given a placebo. Even though the THC levels were the same in both groups, Sativex was found to have twice as potent pain relieving effects, meaning the CBD was increasing the pain killing effect of the THC.
Another 2016 study looked at the different experiences of people smoking pure THC vs those smoking THC and CBD. They found those smoking pure THC experienced memory problems and cognitive difficulties. Whilst those consuming both THC and CBD had no problems in this area. So not only can CBD increase the benefits of THC, but may get rid of some of the unpleasant side effects of it.
When it comes to THC increasing the effect of CBD, there isn’t as much research unfortunately, but there is tonnes of anecdotal evidence that THC even in doses as low as 0.2% (the legal limit of the UK) helps kick the other cannabinoids into action, whilst not causing the intoxicating effects it’s usually associated with.
What about terpenes and other cannabinoids?
Since THC was first isolated and synthesized in 1964 by Raphael Mechoulam most research has focused solely on this chemical.
Interestingly, new research shows there could be benefits from mixing other cannabinoids and terpenes in cannabis, not just from mixing CBD and THC.
The cannabis plant contains more than 120 phytocannabinoids and over 400 terpenes- and those are just what we know of so far. Whilst research is still in the early days, so far it seems that these other compounds have their own benefits and may be responsible for the different effects we get when consuming different strains of cannabis, and could improve the effectiveness of THC and CBD.
What does the research say?
A 2011 review of studies in the British Journal of Pharmacology found that taking terpenes and phytocannabinoids with CBD and THC may be more beneficial for pain, anxiety, inflammation, epilepsy and cancer than taking CBD isolates.
Another study from 2018 found that terpenes may provide neuroprotective and anti-inflammatory effects, which improve CBD’s therapeutic potential.
A meta-analysis of CBD studies found that pure CBD extracts were far less effective in the treatment of epilepsy than extracts containing CBD, other cannabinoids and terpenes. With the pure CBD extracts reducing seizures by 46% and the full spectrum extract reducing seizures by 71%.
What benefits can we get from terpenes?
So what exactly do these terpenes do? Whilst much more research is needed, the studies we have so far are extremely interesting.
In a randomised, double blind trial of 539 adults with Anxiety, they gave one group lavender essential oil, containing limonene, which is a terpene also found in cannabis strains like Sour Diesel, OG Kush and Super Lemon Haze, once a day. Another group was given paroxetine (an SSRI antidepressant) and another a placebo. After 10 weeks the limonene containing lavender essential oil was found to reduce anxiety more than the anti-depressant. Could these terpenes therefore be the cause of people reporting different effects from different strains?
Dr Ethan Russo, cannabis geneticist and long time advocate for more studies into terpenes certainly seems to think so.
Whilst most simply credit terpenes with giving cannabis its wide range of fragrances- with limonene giving off a citrusy perfume and pinene giving off earthy smells, Russo believes they are also responsible for different strains causing different effects.
For example, Cannabis indica strains are rich in the terpene Myrcene, which is known to induce relaxation, decrease anxiety and cause the ‘couch lock’ phenomena. Whilst cannabis sativa strains are mostly rich in limonene, which is more associated with alertness and arousing behaviour. This fits perfectly with cannabis culture largely pitching indica strains as more relaxing, before bed strains, and pitching sativa as more active, social strains.
Additionally- in Russo’s paper ‘Taming THC’ he found that:
- Pine scented terpene pinene may help counteract cognitive problems and memory problems caused by THC
- CBD and the terpene caryophyllene may be helpful in treating addiction
- CBD and limonene work better together to treat anxiety than CBD alone.
- Cannabinoid CBN with THC can give stronger sedating effects than THC alone.
- Limonene has been found to increase serotonin and dopamine production in mice.
With terpenes having all these benefits, why don't we have more research on them?
Russo pitches a beautiful concept in his paper, describing the idea of botanical synergy, in which a dominant substance (THC and CBD) are supported by other chemicals found in the plant (like less common cannabinoids, terpenes and flavonoids) to achieve the best pharmacological effect. With this theory, and almost any cannabis consumer stating that different strains of cannabis effect them differently, why has so little research been done?
Russo has done as much research as possible, doing focus groups through his dispensary where he found 85% of people describe the effects of each strain as they would expect them to.
There are probably hundreds of scientists wanting to do studies comparing the effects of different cannabis strains, and the effects of the terpenes within them- but are currently unable to, as US law states that all cannabis used for studies must come from the National Centre for Natural Products Research at the University of Mississippi. With critics long complaining that NIDA’s cannabis is considerably lower in THC than those found in most dispensaries (with their strongest coming in at 10%), but also that its low quality in general. With plant geneticist Anna Schwabe stating it“doesn’t look like marijuana, it doesn’t smell like marijuana”.
This seems to be repeated all throughout research, with a 2003 study using cannabis containing 2.11% THC, and only 0.05% CBD- too low to see the entourage effect. Whilst street cannabis analysed around the same time had 4.3-8.5 times more terpenes, and far higher CBD content.
So with such low quality cannabis being used in studies, with some claiming it's even genetically different from cannabis available in dispensaries, is it any surprise we’ve not found more proof of the entourage effect that cannabis consumers know and love?
What ratio of CBD to THC is best?
So, if the entourage effect is real, what ratio of CBD to THC should we be consuming? And what terpenes should we be looking out for?
It’s important to remember that cannabis affects everyone differently, and everyone’s goals for cannabis use are different. A person looking to relieve side effects of chemotherapy probably has a very different ideal THC to CBD ratio than someone looking to treat anxiety. Each method of consuming cannabis is slightly different so it's best to experiment and find what works best for you. Whatever the method I’d recommend starting on a low dose and increasing if needed, starting with small amounts of THC in comparison to CBD and upping if needed.
It’s always worth tracking how different products affect you to see if certain ratios or terpenes are better than others. For example, every once in a while I would struggle with paranoia and couldn’t figure out why. When I started paying more attention I realised it was only when I consumed products with high levels of pinene in, and since starting to avoid pinene I’ve had no more paranoia.
Note- this won’t be the case with everyone, high pinene strains are some of the most popular out there, but have been known to affect some people with anxiety negatively.
How having a better understanding of the entourage effect could aid us
Imagine for a second that we’d found one terpene which was very effective against pain, another that was good for sleep, and another that made people more alert. We could then use these terpenes to tailor our cannabis experience, with different products for the treatment of different ailments, or for use at different times of the day. It’s certainly an exciting prospect that could open many doors for us understanding how to get the most out of cannabis as a medicine.
In conclusion, the studies we have so far on the entourage effect and the effects of different terpenes seem to show that taking full spectrum products is far more effective than taking isolates, but much more research is needed. Hopefully some of the legal difficulties around studying different strains will ease, as it seems having better understanding of the entourage effect could revolutionise the way we use cannabis as a medicine.
