Cannabis Science

Low Doses of Cannabis Improve Sperm Count

In Summary:

A recent study has found that “Men who had ever smoked marijuana had higher sperm concentration and count and lower serum FSH concentra- tions than men who had never smoked marijuana; no differences were observed between current and past marijuana smokers.” Cannabinoid receptors are found in several components of the male sexual reproductive system, including the testes, vas deferens, and human sperm cells, and the activation of the receptors seems to be dose-dependent (greater action follows greater dosages.) Participants who had consumed lower doses had higher sperm count and concentration but participants who had consumed high doses had lower sperm count and concentration. Further research is needed to confirm causation.

There is a body of research supported by the National Institute for Drug Abuse, in humans and animal models, that has shown that so-called “abusive exposure” to marijuana smoking may adversely impact spermatogenesis. Data is less clear for moderate consumption levels and multiple studies have found higher serum testosterone concentrations among marijuana consumers.

Some important notes in the article:

The results may not be generalizable to all men. They used self-report as a tool of assessing cannabis exposure, which comes with fair reason to question the precision of the data collected. They also note that “these findings are not consistent with a deleterious effect of marijuana on testicular function. Whether these findings are reflective of the previously described role of the endocannabinoid system in spermatogenesis or a spurious association requires confirmation in further studies.”

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Benjamin Caplan, MDLow Doses of Cannabis Improve Sperm Count
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Medical Cannabis for Adults Over 50

In Summary:

As with all elements of the aging process, the human endocannabinoid system loses tone over time. Whether it is a reduction in the numbers of cannabinoid receptors or a slow waning of the machinery used to create the signaling molecules that bind to the receptors or the natural senescence of the system that supports all of these normal signaling processes, the fact remains that adults over 50 are best-suited for external support for the endocannabinoid system.

Indeed, the average age at dispensaries is surprising to most who are not familiar with the modern medical cannabis arena. Baby Boomers, perhaps more than any other age group, tend to dominate the medical cannabis dispensaries. This is no new phenomenon, however. Through the ages, across cultures and around the globe, cannabis has been consumed primarily by older adults. Whether by tribe elders, wise councilmen, spiritual leaders, or the educated elite, cannabis has been an integral part of human aging for as long as we have recorded history.

Here, a review out of Israel followed at 184 patients over 65 (average age was 81.2) beginning cannabis treatment. 63.6% were female. “After six months of treatment, 58.1% were still using cannabis. Of these patients, 33.6% reported adverse events, the most common of which were dizziness (12.1%) and sleepiness and fatigue (11.2%). Of the respondents, 84.8% reported some degree of improvement in their general condition.”

Appropriately, the authors advise caution for older adults related to those adults who may be consuming multiple pharmaceuticals, for potential medication interaction effects, as well as nervous system impairment, and increased cardiovascular risk for those who may quire the concern. Wisely, they recommend that “Medical cannabis should still be considered carefully and individually for each patient after a risk-benefit analysis and followed by frequent monitoring for efficacy and adverse events.”

Dr. Caplan and the #MDTake:

At CED Clinic, we have long seen that the average age of medical patients is over 50. Whether for concerns related to sleep, pain, mental or physical health, it seems as though Baby Boomers have either weathered enough politics to have developed a healthy cynicism for the misinformation campaigns of the 1930s and 1970s, or they have direct or indirect experience with cannabis to have learned of its safety and efficacy. Either way, it is quickly reclaiming its historical place in the care of older adults, although oddly… it seems to be a demographic skipped over by the marketing systems of most establishments in the cannabis arena, at least for now.


suggested dose for elderly and cannabis
direction of action for cannabis treatments
bar of significant improvement with cannabis

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Benjamin Caplan, MDMedical Cannabis for Adults Over 50
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An Analysis of Sudden Cardiac Death Exposes the Danger of Tobacco and Cocaine

Sudden cardiac death associated to substances of abuse and psychotropic drugs consumed by young people- A population study based on forensic autopsies

In Summary:

A recent study out of Spain has revealed alarming trends among cases of sudden cardiac death associated with substances of abuse consumed by young people. Half of the 15-36-year-olds who suffered sudden cardiac death were found with illicit substances in their bodies, primarily cannabis, tobacco, and cocaine. Researchers found that although cannabis was the most common substance found in the deceased systems, cocaine and tobacco are known to have a stronger impact on the cardiovascular system and lead to ischemic heart disease, which is often the more acute causes of sudden death. It was also mentioned here that the duration of cannabis is far longer in the body than that of either tobacco or cocaine, and this duration may easily confuse people to associate it as a trigger for sudden death.

However, on the other hand, there are several tragic cases of young, otherwise heart-healthy individuals who have died with cannabis as the only substance discovered. Fortunately, these cases are extraordinarily rare, but unfortunately, no reproducible association has been established, so the mysterious concerns are not easily relieved or forgotten.

Dr. Caplan and the #MDTake:

While the return of medical cannabis to modern medical care seems to bring with it a return of appreciation for more naturalistic care, it is critical for us all to recognize that we still have much to learn. The tools and high standards of scientific evaluation have only recently been applied to cannabis, and there are reasonable arguments that the usual tools may not actually apply (for example, some are suggesting that the placebo effect, a cornerstone of randomized control trials may be a facet of effects related to the endocannabinoid system.)

For these, and a great many other unknowns, it is important for the discerning consumer to consult with trusted resources, including friends, family, scientists, and where possible, doctors, to ensure the appropriateness of use on an individual basis.




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Benjamin Caplan, MDAn Analysis of Sudden Cardiac Death Exposes the Danger of Tobacco and Cocaine
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Headache and Migraine Relief Using Cannabis

“Short- and Long-Term Effects of Cannabis on Headache and Migraine “

In Summary:

There are many headache and migraine medications on the market that advertise how they can make you feel better. But what happens when they make you feel worse? Medication overuse headaches occur in 15% of patients taking conventional migraine medication, so it’s no surprise that people are looking for alternatives that bring them relief without reduced risk.

A team of physicians from Washington University wanted to see if cannabis could be a contender. By reviewing data from about 2,000 patients who logged the details of their smoking sessions with the app StrainPrint, researchers were able to see if inhaling cannabis Flower or concentrate could be a solution for headache and migraine relief. They learned that there was, in fact, good reason to be hopeful for the herb.

While concentrates did have a larger reduction in severity rating, there haven’t been enough studies to say it is certainly better than Flower. Overall, inhaled cannabis reduced the severity of migraines and headaches by 50%. Some patients did report needing to use a larger dose for future sessions, indicating the development of tolerance, but the severity of the headaches or migraines wasn’t getting worse or more frequent like what can happen with conventional medications.

In a time when plant-based and all-natural medicines are becoming more sought out, it’s exciting to see medical cannabis is being considered more seriously as a contender. With the positive results from this study, and similar related work will hopefully encourage more physicians (and patients) to explore this centuries-old option.

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Benjamin Caplan, MDHeadache and Migraine Relief Using Cannabis
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Flavonoids Proven to be Safe and Effective Treatment for Chronic Venous Disease

Recommendations for the medical management of chronic venous disease- The role of Micronized Purified Flavonoid Fraction (MPFF)

In Summary:

A recent review has affirmed that treating chronic venous disease with Micronized Purified Flavonoid Fraction (MPFF) therapy is safe and effective. After reviewing 250 papers, the authors have found a large body of supportive evidence that the MPFF treatment, known as Diosmiplex, is effective for healing venous ulcers on its own or in combination with compression therapy. Diosmiplex, the only MPFF prescribed in the United States, as of 2017, is derived from orange rinds and favorable among patients due to its high safety rating. 

Dr. Caplan and the #MDTake:

Flavonoids are one of the categories of natural compounds produced in nature, including within the innate production system of the cannabis plant. Several patients have reported using strong cannabis topical agents to help venous insufficiency and disease, including conditions such as varicose veins, phlebitis, and post-surgical venous incompetence.

varicose veins picture

Process of leukocyte trapping to tissue degradation
contributing factors to  skin pathology and edema
Genetic and environmental risk factors for CVD
US and European Guideline Recommendations that include flavonoids  and MPFF
Cellular Molecular pathology of venous hypertension
CVI Symptom Assessment
WBC adhesion  with venous hypertension
Recommendations for the use of MPFF in the management of chronic venous disease

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Benjamin Caplan, MDFlavonoids Proven to be Safe and Effective Treatment for Chronic Venous Disease
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Should Oncologists Recommend Cannabis?

Oncologists Should Recommend Cannabis-Based Medicine for Palliative Care

Oncologists are encouraged to recommend cannabis: cannabis-based medicine for palliative care and more

In Summary:

Earlier this June, a review was published that encourages oncologists to recommend cannabis products to their patients as a safe and effective method of palliative care. The opinion piece highlights how cannabis is a useful treatment for a variety of illnesses (nausea, vomiting, sleep, mood, anxiety), and encourages practitioners to prescribe cannabis for their patients so that they can appreciate the safety and effectiveness of the product.  

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Benjamin Caplan, MDShould Oncologists Recommend Cannabis?
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A Synthetic Flavonoid Derivative May Treat Triple-Negative Breast Cancer

Regulators and mechanisms of anoikis in triple-negative breast cancer (TNBC)- a review

In Summary:

Researchers are always exploring new methods to treat highly aggressive forms of breast cancer. As the scientific culture opens up to cannabis as a natural pharmaceutical factory, eyes have been drawn to the individual chemical components born inside cannabis, namely cannabinoids, terpenoids, and flavonoid compounds. Recently, a group stumbled upon a promising synthetic flavonoid derivative. This derivative, named GL-V9, has been found to have an inhibitory effect on the growth of triple-negative breast cancer (TNBC) tumors and has shown other anti-metastatic properties. The growth-stopping and anti-spreading effects would address two of the central aspects of TNBC that have thus far made it difficult to treat. The growing understanding of flavonoids and their potential therapeutic benefits seem all but sure to enshrine its place among future research regarding cancer treatments. 

Dr. Caplan and the #MDTake:

In scientific and medical circles, it’s not uncommon to hear the phrase, “everything causes cancer.” It’s often repeated contemptuously, a tongue-in-cheek expression that calls attention to unknowns associated with the spawning and growth of cancers but also bends to the hurricane force of nature’s impact on living organisms. As living biology, cancers are born and thrive while provided sustenance by particular inputs and supports. Because of this fact, there are also innumerable opportunities to stifle or prevent the birth of tumors and many avenues to interrupt its growth or end the life of cancer cells.

The human cultural history has taught all cultures that sleep, exercise, fruits, vegetables, fiber, and water are all required ingredients for sustained, healthy growth. What is it about fruits and veggies that is healthy? They have fiber that is healthy for the human digestive tract, but they also have natural components, terpenes and flavonoids, which support wellness, healing, and the normal cycling (features of both living and dying) of our cells. Cancer represents the inappropriate over-replication of cells. In a sense, the body’s natural ability to end the cells which are not responding to normal signals is lost. If we know that the cannabis factory happens to produce many of the same compounds that are found elsewhere in vegetation and fruits, is it so surprising that we would see cancer-fighting effects?

Breast cancer & flavonoids: current research and treatments
Graphical Abstract: anolkis resistance; breast cancer-related chemsitry

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Benjamin Caplan, MDA Synthetic Flavonoid Derivative May Treat Triple-Negative Breast Cancer
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Recent Study Reveals Natural Method for Improved Crop Growth (Microbiome!)

Plant-derived coumarins shape the composition of an Arabidopsis synthetic root microbiome

In Summary:

While investigating plant molecules that inhibit parasitic growth, researchers have uncovered a new method for improving crop growth and overall yield. Small molecules, such as flavonoids and coumarins, improve the microbiome of plant roots in order to help them grow and maintain their health. While investigating how the absence of coumarins and flavonoids affect the growth of a common weed the authors stumbled upon a molecular mechanism that will facilitate efforts to grow crops in iron-deficient soils.

Dr. Caplan and the #MDTake:

The natural machinery of Cannabis supports the production of tremendous numbers of flavonoids, coumarins, and microbiome-supporting compounds. Over millennia, cannabis has evolved fastidious attention to detail, and an integral role in the animal ecosystem. Although this natural role has historically been disagreeable to many oppressive movements (religious and cultural), it is nonetheless, self-evident as modern society returns to embrace the science of cannabis. The scientific, medical, textile, farming, nutrition, recreational, and materials construction industries are all wishing only that they had come back to cannabis sooner.

plant microbiome image

the gnotobiotic platform used to investigate the effect of plant metabolism on root microbiome composition
root coumarins shiting the microbial community of plants
root-excluded purified coumarins shiting the microbial community of plants
purified coumarins shiting the microbial community of plants

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Benjamin Caplan, MDRecent Study Reveals Natural Method for Improved Crop Growth (Microbiome!)
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Are medical patients victims of #vapegate?

A popular (and welcome) take on the vaping situation is coming out to support medical consumers as a type of victim of the circumstances. There is a level of scientific understanding that is a necessary, and still incomplete, part of the discussion. For example, some of the dominant methods of lab testing for cannabis (plate culturing) are based on food safety protocols that are generations old, incorporates a system of understanding that is not the only means of testing or understanding (genetic sequencing, for instance) and, while we have learned a great deal mastering the current testing, we may be missing important safety concerns.

Another critical area of growth at hand is the clinical understanding of the implications of mainstream cannabis consumption. We have some information, but there is always more yet to learn. In order for Cannabis Medicine to catch up with the accomplishments and accolades of modern Medicine, we must overcome generations (and engrained systems) of academic road-blockages. Still more stands in the way of a well-oiled, safe cannabis-consuming culture, and that is reproducibility of clean product and the assurance that a consume is obtaining (and consuming) clean, safe product. These are solved, perhaps with regulatory oversight and technology, either within the public or private sectors.

Forbes photo of medical cannabis as victims of vaping ban

For example, one of the elements of the current medical market that is still in need of close inspection and consideration is the potential contamination of vaporized products related to the construction materials of vapor technology itself. Devices are often made with metal solder which can contain and propel cadmium and/or other metals that are unhealthy for consumption. Similarly, heated plastics and other construction materials may be unsuitable as conduits for consumption by inhalation.

See https://www.cedfoundation.com/2019/09/05/vape-gate-2019-review-of-the-risks-of-vaping/ for a more complete review of some of these elements.

Nevertheless, it is wonderful to see public interest and discussion on this subject, which seems to touch on never common to many. Open-minded discussion, incorporating differing viewpoints will help us all grow to become a healthier and safer, cannabis-consuming culture.

https://www.forbes.com/sites/kevinmurphy/2019/11/14/medical-cannabis-patients-should-not-be-victims-of-vaping-bans/#30f70a783a6f

Benjamin Caplan, MDAre medical patients victims of #vapegate?
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Cannabis testing: Plating vs genetic testing

Cannabis testing uses the same tech that has been used for ages. There are great benefits and lessons learned, relative to newer options, but also many concerns w/ this dominant technology and enticing benefits to the alternative, genetic testing.

Benjamin Caplan, MDCannabis testing: Plating vs genetic testing
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