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Mental Health Wellness for the New Year

A new year allows us the opportunity to reflect on the past year to understand what we want to let go of and what we want to prioritize in the year ahead. One priority that many have at the top of their list is improving individual mental health wellness with natural remedies. To aid in that journey to become the best versions of ourselves, we have gathered up key guidance and resources on how cannabinoids such as cannabidiol (CBD) may benefit us from the inside out. 


Being consistent in the short-term for long-term goals


Among the questions we receive, one of the more frequently asked is how and when to take CBD products. When it comes to your therapy, consistency is key to successful results. For CBD in particular, this is for a couple of reasons. 


First, CBD has a low bioavailability and a short half-life. Consistent dosing 2-3 times daily may allow CBD, among other minor cannabinoids, to remain present in your body to offer the beneficial effects you are looking for. While the amount you take and how often you dose is highly dependent on your specific needs and situation, a Realm of Caring care specialist is here to help with free one-on-one support to help find what is right for you.


Secondly, given that CBD has low bioavailability and a fairly short half-life. It may take time for the cannabinoids to fully present themselves and for the benefits to be revealed to the consumer. Therefore it is advised to be patient before increasing the amount you are taking. Increasing too much too soon may lead to undesired effects while taking too little may provide no benefit. The key is to find your individual, therapeutic dose.


Implementing self-care rituals 


Engaging in a self care routine has been clinically proven to reduce or eliminate anxiety and depression, reduce stress, improve concentration, minimize frustration and anger, increase happiness, and improve energy.


There is a continuous need to seek more efficient, safer, and widely available methods to treat medical conditions, skin pathology included. Topical use of cannabis as a form of therapy covers a wide scope of skin disorders due to anti-inflammatory, anti-itching, wound healing, anti-microbial, and anti-proliferative effects. 


Elements of the ECS have been discovered in the skin, to include our skin’s immune system. Through interaction of the receptors in our skin layers, cannabinoids have shown through research to alter pain, stimulate wound healing, and alleviate itch. These studies may add a different dimension on how we see the treatment of several skin diseases. 


Of the cannabinoids researched to date for skin health, CBD is a widespread ingredient in skin care products formulated as body oils, moisturizers, salves, lotions, and balms. Delta-9-Tetrahydrocannabinol (THC), and potentially cannabinol (CBN), may also be responsible for skin benefits such as reducing cytokine production and oxidative stress. Additionally, cannabigerol (CBG) has powerful anti-inflammatory and antibacterial properties that may add benefit to our skin health. 


Keeping your gut in check 


Our gut health is a complex ecosystem, composed of over 1,000 microorganisms. These microorganisms have significant roles in our daily energy uptake by breaking down complex carbohydrates into simple sugars. They also impact our immune system and imbalances of the gut may contribute to weight fluctuations, obesity, food sensitivity and more. 


In addition, you may be familiar with the brain-gut connection (sometimes referred to as gut-brain), which helps us to understand how functional bowel problems and bowel disorders such as Irritable Bowel Syndrome (IBS) may be responsible for sending signals to the central nervous system that trigger mood changes, leading to anxiety and depression. 


The ECS performs protective activities in our gastrointestinal (GI) tract and shows promise as a therapeutic target against bowel disorders such as IBS, Crohn’s disease, irritable bowel disease (IBD), and motility-related conditions. The main role of the ECS in the GI tract is controlling intestinal hyper-contractility, modulating visceral sensations, intestinal inflammation, and brain-gut communication. 


A significant population of individuals suffering with IBD use cannabis to relieve symptoms of pain, nausea, and appetite, as well as to improve their overall mood. THC has been shown through anecdotal evidence to improve abdominal spasms, cramps, and visceral pain; whereas CBD may contribute to the relief of intestinal inflammation, modulating cortisol and metabolism, improve the immune response of the gut, and alleviate the anxiety and stress associated with gastrointestinal discomfort. In a 2021 review of 682 studies of cannabinoid use for IBD patients, clinical symptoms (abdominal pain, general well-being, nausea, diarrhea, and poor appetite) were all improved with cannabinoid therapy. 


Fostering clarity and focus


Proper cognition and energy levels throughout the day can be attributed to healthy sleep. CBD is among those cannabinoids that may help eliminate brain fog during the day, while also improving our sleep quality during the night. 


CBD has therapeutic properties that have the potential to mitigate symptoms that interfere with sleep. It also has the potential to improve sleep-wake cycles leading to an increase in the percentage of total quality sleep overtime.


Prolonged CBD therapy has shown positive improvements in psychological symptoms and cognition. Currently, using cannabinoids to benefit neurological issues and serve as a neuroprotectant is being studied. The antioxidant properties of cannabinoids, such as CBD, may have the ability to provide neuroprotection. As well, research is showing that elevation of cannabinoid receptor activity could potentially slow down the progression of brain aging and alleviate symptoms associated with neurodegenerative disorders, therefore cannabinoids with the ability to activate receptors may provide these additional benefits. 


Additional ingredients in your cannabinoid product may also enhance cognitive function in your day to day. For example, lemon balm is known to improve mood, cognition, and aid as a natural anti-inflammatory, anti-oxidant, and decongestant. Combining CBD and lemon balm may calm the nervous system to ease stress, refocus energy, and relax. The functional mushroom, lion’s mane, is another ingredient known to have a host of benefits for neurodegenerative diseases such as ischemic stroke, Parkinson’s, Alzheimer’s, and depression. It may also promote recovery and enhance nerve regeneration, therefore improving cognitive performance and reducing brain fog. 


Finding support


When looking to cannabis for medical conditions, we always recommend speaking with a healthcare professional. However, if you are in need of support while on your journey we are here to help. From product selection to dosing guidance to answering questions your family has about your decision to choose cannabis – we are here every step of the way. Send as an email to, call us at 719-347-5400 or chat with us at

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Most Frequently Asked Cannabis and CBD Questions of 2023

Just before 2023 came to a close, we featured a webinar where we answered the most frequently asked cannabis and CBD questions of the year. In this blog, we break those questions down for you to use as a helpful resource when starting out. 


What is the difference between milligram (mg) and milliliter (mL)?


A milligram (mg) is a measure of weight for an ingredient while a milliliter (mL) is a measure for the volume of a liquid. When reading the label on a CBD tincture bottle, the mg content tells us the amount of cannabinoids that are concentrated in a given amount of mL of liquid. A label may tell us how many mg’s there are of CBD in an entire bottle or how many there are per every one mL of liquid. In most cases, a full dropper is equal to one mL. 


For example, if you have a 30mL bottle of CBD and it states an amount of mg on the front label, such as 1500mg, that means there is 1500mg of CBD in the entire bottle. Given that it is a 30mL bottle, you would divide the mg by the mL to find that there is 50mg of CBD per every mL of liquid.


What is half-life and why is it suggested to take CBD two to three times daily? 


Half-life describes the amount of time it takes for an active substance in your body to reduce by half. This can vary greatly depending on the individual. CBD’s half life has been researched to last anywhere from 1-11 hours after the first dose. Consistent users of CBD may have half lives up to 2-5 days. 


The half-life and bioavailability may be enhanced by how you administer your CBD. Orally taken CBD bioavailability is fairly low due to the extensive first pass metabolism, so finding ways to enhance the bioavailability of your product may benefit your overall therapy. 


For example, a study published in 2005 showed that one hour after oral capsule administration containing 5.4mg of CBD in males and females, blood samples showed CBD levels averaging 0.93 nanograms (ng) per mL. A subset of participants who consumed a standard breakfast meal one hour after the capsules showed a slightly increased average of 1.13ng/mL. The CBD remained detectable for approximately 3-4 hours after administration. Co-administering CBD with a food high in fat, has shown in research to increase oral bioavailability by almost three-fold. As CBD is a highly lipophilic molecule, CBD may dissolve in the fat content of food, increasing its solubility and absorption, therefore bioavailability. 


Therefore, in order for CBD to provide consistent relief, it is advisable to administer 2-3 times per day, being mindful to space the administration from pharmaceuticals or over the counter medications. To increase bioavailability of the CBD, it is also recommended to take CBD with healthy fat foods. 


How soon can I increase my CBD dose?


Again, CBD has low bioavailability and a fairly short half-life. It may take time for the cannabinoids to fully present themselves and for the benefits to be revealed to the consumer. 


Additionally, if you are using a full spectrum CBD product, the product will contain small amounts of THC. The Cannabis sativa plant has over 500 compounds, with over 100 cannabinoids present. When extracted, a full spectrum product considers all of those parts of the plant, THC included, in a way that is non-intoxicating in a dose that is right for you. However, as you increase the amount of CBD you are taking, that amount of THC will also increase. You want to allow your body the time to adjust to the increased levels of cannabinoids so there are no intoxicating effects. 


It is also important to keep in mind that administration may be made complicated by the non-linear response of cannabinoids. It is non-linear in that our response to cannabinoid administration forms a bell curve. This means that higher amounts do not always equate to more relief. In fact, we should be cautioned to assume that higher amounts of cannabinoids will lead to enhanced therapeutic effects. What you may find is that higher amounts could exacerbate related symptoms. Therefore, it is recommended that if improvements begin to diminish over time, especially after an increase, that you consider reducing the amount as a potential strategy. 


Most will ask when starting out CBD, “will I feel anything?”. Cannabis advocate and researcher, Mara Gordon has explained, “you don’t have to feel medicated to be properly dosed, and if you feel medicated it is likely that you are taking too much”. It is essential to give your body time to adjust and for specific needs, the Realm of Caring Care Team is here to assist with free one-on-one guidance. 


How can I check for potential drug-drug or drug-herb interactions?


When taking other medications, it is very wise to respect the metabolism of everything you are putting into your body and acknowledge that CBD may interact with several medications as it is metabolized by the cytochrome P450 (CYP450) system, which is also responsible for metabolizing several other medications. In addition, CBD inhibits CYP2C19, CYP2C9, CYP2D6 and CYP3A.


One study determined that strong interactions likely occur with high-dose oral CBD (700 mg) and CYP3A substrates. Increasing CBD levels were also associated with changes in serum levels of common anti-epileptic drugs, although levels remained within acceptable serum ranges. Like-findings were also seen with CBD and common anti-anxiety medications with slightly increased serum levels of the medications. 


There are online sources for checking interactions between CBD and medications, however it is best to check with your doctor, a pharmacist, and our care team is always here for guidance as well.


When it comes to THC, what is the difference between sativa, indica, and hybrid?


Here is another classification you may find when in a dispensary or referring to a high-THC cannabis product. There is a lot of conflicting information out there about cannabis strains. Some say strains don’t matter, others say strains may help you achieve a specific feeling or benefit. When used to describe a cannabis plant or product, the word strain is used interchangeably in different contexts.


Some conclude that the genus cannabis comprises a single species, Cannabis Sativa (C. sativa). It is proposed by others that the cannabis genus consists of three species, C. sativa, C. indica, and C. ruderalis. Others will even include a fourth species that can be identified as any hybrid between the aforementioned three. Sativa-types are characterized by their tall and narrow leaves, widely believed to produce a stimulating, cerebral psychoactive effect. Indica-types are short with wide leaves, reported to produce sedative and relaxing effects. Ruderalis is thought to be a descendant of indica, although adjusted to the climate where it originates, resulting in a shorter and stalkier plant. 


A 2015 study found a “moderate correlation between the genetic structure of marijuana strains and their reported C. sativa and C. indica ancestry and show that marijuana strain names often do not reflect a meaningful genetic identity”. The different species may have more to do with the structure of the plant alone, rather than an effect that may be produced. 


When considering the biochemical components, strains do matter. Understanding the quantifiable amounts of cannabinoids of your product is an important step in knowing the quality of your product. Differences in observed effects can be attributed to terpene content versus the strain name of sativa, indica, hybrid. For example, it might not be the fact that a strain is labeled indica as to why one feels sedated. That feeling may actually be attributed to myrcene, a terpene with researched, sedative effects. 


It is equally important to recognize that a strain’s effects on one person could trigger a different outcome for someone else. Factors such as ailments, genetic predispositions, tolerance level, setting, consumption method, and others are all worth consideration in determining the result a product may have.


What is a Certificate of Analysis (COA) and why is it important? 


With a lack of oversight by the U.S. Food and Drug Administration (FDA), it is up to the consumer to check on the accuracy of labels. This involves an extra step, but is worth it to ensure that you are using a safe and quality product. 


For example, CBD labels should include how much CBD the product contains, as well as the carrier oil, other cannabinoids, supplements, terpenes, and/or flavoring. One way to verify the concentration of listed ingredients is to check it with a COA. Each quality company should be able to provide you a COA for the product you purchase, that is verified by a third party lab.


While additional cannabinoids can be listed directly on the label of the product you are purchasing, the cannabis plant has hundreds of minor cannabinoids that may be in your product. Each cannabinoid has potential benefits and works synergistically with the major cannabinoids. To figure out the list of other cannabinoids that are detected, look back to that COA. If you were finding success with one product and then switched to another and were not achieving the same results, you might find that one had a higher/lower concentration of a specific cannabinoid other than CBD. For example your product could yield a higher percentage of THCA, CBG or CBN. 


Many CBD products will have 2-3 ingredients such as: hemp oil, a carrier oil, and (occasionally) a natural flavoring. However, you may recall advertisements for CBD products that promote “best for sleep” or “best for pain”. Typically, these claims can be made if: 

  1. Research supports the claim for the specific product, or 
  2. The product includes an ingredient, other than CBD, a carrier oil and a natural flavoring, that has been researched to affect the normal functioning of the body in that way. 


For example, if a CBD product is labeled for sleep, then it may include Melatonin, L-theanine, or Valerian Root. CBD has researched sleep benefits of its own, but may work synergistically with these added ingredients for an additional boost. Before purchasing, understand what ingredients have been added and if those are right for you. 


What is the difference between recreational and medical cannabis dispensaries? 


Going to a dispensary can be overwhelming, there is a lot to choose from so it is always a good idea to know before you go. Most dispensaries will have their full menu available to look at online. This way you can research product companies, ingredients, and what administration method is right for you. 


For purchasing in a medical dispensary, you will have to have a medical card in the state that you live in and are purchasing in. Each medical state has their own set of rules for obtaining a card, and it is typically something you can search for in your state’s .gov website. 


If you do not have a medical card or you live or are visiting a recreational state, you may purchase if you are at least 21 years old and have valid identification. Whether the dispensary be medical or recreational you can still research your products ahead of time and you should be getting the same, quality customer service by the retailer at the store. If you need help before you go, our care team is here to assist in your decision-making process. 


What happens if I take too much THC?


If you feel you have taken too much, first of all – do not panic. Just as with consuming too much caffeine, it may be unpleasant and uncomfortable, but with time it will pass. You may experience symptoms such as lethargy, anxiety, paranoia, and/or low blood pressure that may lead to nausea. 


To help, you may want to try an isolate CBD, as CBD may reduce the head high effects of THC. Drinking water with lemon or eating black peppercorns may also help to offset those effects. Deep breaths, getting fresh air, and focusing on something you enjoy or talking to a close friend may also help to deter any feelings of anxiety. 


It is good to know that cannabis itself will not cause you harm. There is no realistic lethal dose of cannabis following consumption and the low density of CB1 receptors in the brainstem region means that no damaging effect will be had on cardiovascular or respiratory functions.


In addition to being worried about “taking too much” in the moment, there are what are referred to as Cannabis hangovers, also referred to as “weed hangovers,” which refer to the range of effects that may take place the day after consuming cannabis products. These unpleasant sensations, which range from feeling drowsy and fatigued to headaches and nausea, might ruin the experience or discourage someone from using cannabis.


Research is limited in understanding the consumer complaint of cannabis hangovers. While one report shows that undesirable, residual effects of cannabis consumption can be felt the day after smoking, another reports that any effects are minimal at most. Regardless of the available data, consumers tend to blame the product formulation or overconsumption.


A rich terpene entourage may reduce the likelihood of cannabis hangovers. A traditional Moroccan remedy for cannabis hangover includes a glass of cold, fresh lemonade with black pepper sprinkled on top. This works because of its terpene entourage of limonene from the lemons and beta-caryophyllene from the pepper. Both limonene and beta-caryophyllene possess potent anti-inflammatory activities. Limonene has also been studied for its anti-nausea, anti-vomiting, and uplifting properties, reported to boost mood and metabolism while decreasing stress and anxiety. 


Michael Backes, author of Cannabis Pharmacy: The Practical Guide to Medical Marijuana explains to avoid residual feelings of grogginess the next day, it may be best to pay attention to the terpene content, quality of the product, and how much you are consuming. His methodology is “sip don’t rip”. Most consumers inhale too rapidly. Reducing the intensity of inhalation also reduces the combustion temperature, which results in a smoother, less harsh experience. I advise taking a gentle inhalation (sipping) rather than hitting hard (ripping).


Starting low and increasing slowly enables one to find their therapeutic dose at the lowest amount possible. Finding your individual threshold can also help to prevent effects that carry over into the following day. 


Want to view the rest of the most FAQ of 2023? Watch the webinar recording here.


Questions about your therapy or where to begin? Our Care Team is here to offer you free one-on-one support. Email, call (719)347-5400, or schedule an appointment


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Understanding Cannabis Smoking vs. Vaping

Cannabis consumption has evolved significantly over the years, offering users various methods to experience the plant’s benefits depending on preference and desired results. Two of the most commonly seen today are vaping and smoking. It’s important as a consumer to know the differences between puffing a vape pen or smoking a joint or glass pipe. Read on to learn more about the unique characteristics, potential impacts, and safety concerns.


Smoking 101


Cannabis smoking, a time-honored and traditional method of consumption, involves inhaling the smoke produced by combusting dried cannabis flower. This approach allows individuals to experience the effects of cannabinoids, such as THC and CBD, in a relatively swift manner. 


The process is straightforward: the cannabis flower is ground, rolled into a joint or packed into a pipe, and then lit with a lighter or similar. As the plant material combusts, it releases a flavorful array of compounds and terpenes that contribute to the unique and varied profiles of different cannabis strains. Inhaling the smoke from the combusted flower into your lungs allows the cannabinoids to quickly enter your bloodstream. 


Smoking, appreciated by many for its ritualistic and social aspects, offers users a direct and immediate connection with the plant. It’s important to consider individual preferences and health factors when choosing this method, as it provides a distinct sensory experience that contributes to the rich tapestry of cannabis culture. A downside to consuming this way, is it actually wastes a portion of the terpenes and cannabinoids. However, 77% of cannabis patients still reported this as their favorite method of consumption in 2019.


Vaping 101


Cannabis vaping has emerged as a modern and increasingly popular method of consumption, offering users a more controlled and nuanced experience. Unlike smoking, vaping doesn’t involve combustion; instead, it utilizes specialized devices to heat cannabis concentrates or flower to a temperature that releases the desired cannabinoids and terpenes without creating smoke. It instead turns into a cannabinoid and terpene rich vapor that can be inhaled.


This method provides a cleaner inhalation process, reducing exposure to harmful byproducts associated with combustion. Vaping allows users to savor the flavors and effects of different strains with precision, often featuring adjustable temperature settings for a personalized experience. This more controlled method of consumption helps contribute to a cleaner feeling high.


The discreet and portable nature of vape pens also adds to their appeal, making cannabis vaping a convenient and socially considerate choice for those seeking a modern approach to enjoying the therapeutic and recreational benefits of cannabis. Early studies suggest that the higher potency of cannabinoids produces stronger effects than smoking cannabis for infrequent users.


Safety 101


Whether one opts for smoking or vaping, we always recommend understanding the impact on one’s health. Smoking cannabis involves inhaling combusted plant material, which can introduce harmful byproducts into the respiratory system. Though the long-term health effects of smoking cannabis are still a subject of ongoing research, it’s advisable to be mindful of potential risks, particularly for individuals with pre-existing respiratory conditions. 


While cannabis and tobacco smoke are not equally carcinogenic, studies indicate cannabis smoke contains many of the same harmful carcinogens and chemicals as tobacco smoke. What you smoke cannabis flower with also impacts the effects, as a water pipe or bong may negate some of the issues that burning papers in joints presents.


On the other hand, vaping, when done responsibly with high-quality products (no harmful additives) and a properly designed device, is generally considered a safer alternative as it eliminates combustion-related byproducts. However, some vapes may contain additives and diluents (like PG/VG commonly used in nicotine products), and because cannabinoids vaporize at higher temperatures, this could produce vapor with harmful byproducts. Always avoid shopping illicit products, as they may contain dangerous acetates and can be fatal (vaping associated pulmonary injury).


Lower vape temperatures generally lean towards fewer things being inhaled beyond what is in the starting material. Vapor is also traditionally less hot and dense than smoke, meaning it is likely to be less irritating and physically damaging to your lungs (again, assuming you are consuming quality non additive products). Regardless of the chosen method, moderation, mindfulness, and adherence to safety guidelines contribute to a positive and health-conscious cannabis experience.


Don’t Ignore Expiration Dates


Being mindful of expiration dates is another great way to practice safe cannabis consumption. Just like any consumable product, cannabis and vape products have expiration dates for a reason. Using products beyond their expiration dates may not only compromise their potency and flavor but could also introduce potential health risks. It’s essential to check and adhere to these dates, especially with vape cartridges, to avoid inhaling degraded or potentially harmful substances. 


As cannabis ages, its chemical composition can change. Exposure to air, light, and improper storage conditions can lead to the degradation of cannabinoids and terpenes, impacting the flower’s overall efficacy. Additionally, the potential growth of mold or mildew becomes a concern with improperly stored cannabis, posing health risks when consumed. To ensure safety, consumers should store cannabis in a cool, dark, and airtight environment, regularly inspecting their supply for signs of aging or contamination.


By respecting expiration dates and choosing high-quality, regulated products, consumers contribute to a safer and more enjoyable cannabis experience, minimizing any potential risks associated with expired or compromised products. Education and awareness play a pivotal role in fostering a culture of responsible and health-conscious cannabis consumption.


As always, consulting with a medical professional is recommended. There is a lot to consider when starting cannabinoid therapy and a Realm of Caring care specialist is here to help with your questions. Contact us today by calling (719) 347-5400 or by emailing


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Cannabinoids found in non-cannabis plants

One thing that has become well-known in the last several years of cannabis research, is that Cannabis Sativa is a very complex plant. Through the on-going discovery of compounds, we are becoming more aware of the capabilities of the plant as well as where compounds may appear otherwise in nature. 


The Complexity of the Cannabis Plan


More than 550 chemical compounds have been discovered in cannabis, with more than 100 phytocannabinoids identified to include delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). In addition to phytocannabinoids, over 100 terpenes have also been identified. The many constituents of the plant have been indicated as therapeutic agents across numerous medical conditions. Phytocannabinoids were earlier thought to be exclusive to Cannabis sativa but have now also been discovered in Rhododendron species, some legumes, the liverwort genus Radula, and fungi


Beta-caryophyllene (B-caryophyllene)


B-caryophyllene is a terpene present in many herbs and spices such as black pepper, cloves, basil, and oregano. It is also one of the first cannabis-derived compounds other than THC, CBD, and cannabinol (CBN) shown to bind directly to CB2 receptors in the endocannabinoid system (ECS). As one of the most abundant secondary metabolites in cannabis essential oil, it has the distinction of being known as the first “dietary cannabinoid”. Orally administered B-caryophyllene has shown to produce strong anti-inflammatory and analgesic effects as well as effective at reducing neuropathic pain. 


Cannabigerolic acid (CBGA)


A 2023 study published in Nature Plants showed the presence of more than a dozen cannabinoids in the glandular trichomes of Helichrysum umbraculigerum, an Asteraceae species found in South Africa and more commonly known as “woolly umbrella”. While major cannabinoids THC and CBD were not found, significant amounts of CBGA (the acidic precursor to CBG) were found. 




Even more recently than the previous study, scientists have discovered CBD in a common Brazilian plant known as Trema micrantha blume. Currently the lead researcher at the Federal University of Rio de Janeiro (UFRJ) is gathering a team of biologists, chemists, botanists, and geneticists who will research the most efficient way to extract CBD from the shrub. Once they do, they will analyze the newly found CBD to understand if the CBD found there contains the same properties as CBD extracted from the Cannabis sativa plant. 


The Role of Phytocannabinoids in Mammals and Plants


Phytocannabinoids play significant roles in therapeutic effects in mammals with an ECS. This includes, but is not limited to, antiseizure, anti-inflammatory, anti-tumoral, anti-depressant, analgesic, antiemetic, anti-anxiety, sleep improving, and bone growth activity. In plants, phytocannabinoids defend against pathogenic attack, herbivory, heat and cold stress, oxidative stress, and radiation stress. Antibacterial and antifungal properties have also been discovered. 


Given the versatile use of phytocannabinoids in both humans and plants and benefits realized when appropriately used, further investigations are needed across different plant species to deepen our understanding of their mechanisms of action as well as availability in nature.   

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Grief Awareness and Resources

National Grief Awareness Week takes place each year to provide a dedicated period for individuals, communities, and organizations to come together and acknowledge the varying aspects and complexities of grief. Grief is a natural response to loss, or anticipatory loss, that should be met with understanding and support. This week brings awareness to that and serves as a reminder to address each other with compassion.


In October, Realm of Caring founder Heather Jackson sat with Dr. Cristi Bundukamara (Dr. B) author of Pain & Purpose: My Journey to Mental Strength to discuss the complexities of grief and how one may find purpose through the unimaginable pain. Dr. B is a psychiatric nurse practitioner having earned her doctorate in healthcare education. She is the owner of Mentally Strong Psychiatric Clinic and the creator of the Mentally Strong Method. Dr. B discusses how she finds purpose having endured the devastating loss of her two children, Reggie and Miah, diagnosed with the same incurable, terminal disease that her husband Bundy is living with, Dentatorubral pallidoluysian atrophy (DRPLA). 


Heather Jackson: For me there were two major themes, first is that each person should choose to find purpose in our pain. And the second emergent theme is that we all have this deep within, amazing ability to overcome life’s worst moments. And if that’s not encouraging, I don’t know what is. 


Dr. B: I don’t know if it’s finding purpose in the actual pain, but it’s not giving up on your life, your purpose. Sometimes pain cannot be rationalized, explained, given purpose. Sometimes someone loses a child to cancer and then they spend their life raising money for cancer research and, honestly, I want nothing to do with DRPLA. It feels hopeless. So, the purpose doesn’t necessarily need to come in the pain. But, the point is not giving up on your life, your purpose. Because I do know that we all have a purpose and sometimes pain derails us from that and makes us want to give up on that. 


HJ: For sure, it can be consuming and blinding and doesn’t really allow you to move forward, which is why you’re one of my real life heroes. Because you’ve dug really deep and I want to get to some of how you did that, but I think that the book is extremely vulnerable. You don’t often read when people call out themselves, their spouses, their kids – and not call out but just be like, look this is the raw, honest, transparent book of our life. And it’s beautiful, and it’s brutal, and I’m really curious as to why you wanted to share it. What inspired you to write the book? What’s the purpose? Aside from it being a part of your healing journey, that I know you’ve been a part of lately, and I have been able to come alongside occasionally for that, but why? Why did you write it? 


Dr.B:  I’ve been in, and I think a lot of parents that are in the Realm of Caring, are in a constant fight or flight. And the initial reaction was still in that fight, I have to do something, I have to help somebody else because I wasn’t able to help my own child. So I think it’s just now that I’m trying to get out of that fight or flight. But it’s hard, it’s an addiction. I’ve always been like that – whatever is happening, it’s got to help someone else. And I’m not a writer. The first version of the book was evident of that. It took seven years and a writing coach to get to the first fifteen chapters. But I’ll tell you that the last chapter was written in three hours, and it was 100% all me and it just came out. It’s part of the healing process, not just healing, but how am I going to tell my story? There was a version in between that abruptly ended at Miah’s death and I was like, every good story has a happy ending and when you look at my life from the outside – there’s no happy ending there. And so I sat down to write that last chapter and thought, but I do have a happy ending, there is an eternal relationship. It’s part of my character, whatever is going on in my life I just have to figure out how to reframe it. 


HJ: So I know it’s a part of your personality, but what really struck me over and over again in the book was not just your tenacity but no white flags – there was no giving up. It was another, third theme. Where does that come from? What is your greatest source of inspiration and support? Because, as you mentioned, we serve so many families, my family included, who are just continuously one blow, one challenge after the other and I don’t even know how to do it some days. I don’t know how to get up and put one foot in front of the other. And I haven’t been through what you’ve been through. 


Dr.B: I wish I could say God. That’s the right answer. And I have struggled so much with my relationship with God. I remember a book I read, and I don’t remember if it was before Johnny’s death or shortly after Johnny’s death but it was before I was doing my own Mentally Strong Method, and it’s Viktor Frankl’s Man’s Search for Meaning –


HJ: Yes, your book is very reminiscent of that very famous book


Dr.B: And when I picked up that book, if I had known it was about the Holocaust I wouldn’t have read it because I don’t seek out painful things. And one of the things that I will never forget about that book is that there was a time when they thought that they were going to be released. They were in the concentration camps and the spirit was up and people had energy, but that day came and went. And several months after that, many, tons of people died. And he was talking about how the science of losing hope can actually lead to your death. And that hope is a choice. And it’s hard when life keeps hitting you, but I just had known from that point that it’s a choice, everything is a choice. How you respond is a choice – not what’s happening around you. And it’s just what I’ve always done and this is what I tell anyone because I do know that I have a very distinct gift to be publicly vulnerable with my story. That is not everybody else’s purpose. It is my gift. But how you respond to your pain, you have to figure out how you can respond to your pain. Yes, I do believe you’ll be inspired by my ability to do that, but I always tell people that I struggled with depression before I even had a reason to be depressed. Now I have a reason, but it’s not like I was this really mentally strong person before, it’s a choice, it’s constant, it’s hard. There are days when you feel like giving up, and I will never give up but that doesn’t mean there’s not days where I feel like giving up. 


HJ: Well can’t we just for the morning? It’s a serious question, can’t we just give ourselves – talking to the families who are in fight or flight 24/7 – can I give myself a morning off from the fight? 


Dr.B: Well it depends if your kid lets you. Sometimes, and this is very serious though, you always had that. And now the mornings are literally the hardest times for me. One, my daughter died in her sleep in the middle of the night and the trauma of that morning but also getting up for what? So we might have both types of people here – some that have lost and some whose children are there and they’re struggling – I remember times being irritated that I had to get up because Miah needed me and I just wanted to just lay in bed. So it really depends on if your child will allow you to take a morning off. But that’s why it’s important to schedule them. 


HJ: And we can totally do that, we can prioritize ourselves also, which I think is really important and often overlooked and can lead to depression, anxiety, the decline of our physical health, which I’ve experienced and still experience. I think it’s important to figure out somehow, within your community, and even if it’s trading with another parent with a special needs kiddo and trading off and on.


Dr.B: Another thing that I don’t think mother’s do is figuring out what actually fills your cup. Because, you know, we get four hours off but then we’re thinking and we’re depressed and we’re worried about this and we didn’t actually do anything that fills our cup. And it’s different for everybody, people used to say “go get your nails done”. To me that’s another responsibility. I don’t like getting my nails done, I do it because I want my nails to look okay but that doesn’t fill my cup. I was almost turning 50 before I was trying to figure out what I actually like to do. People would say “go exercise” and this and that but there’s really only two types of exercise I like to do. So why was I wasting my time with all of those other ones? I don’t like the exercise but everyone is saying that’s what is good for depression so that’s what I’m doing. And movement, and it doesn’t have to be intense exercise, but movement, which we talk about in ceremony, we talk about this when we go to sweat lodge, movement is more than just exercise, it’s sitting and sweating. It’s going through ceremony and trying to move things out of the body. Processing the reality of the life of having a disabled child or adult, there’s this constant fear of something happening to them. We have to process that and minimize it. You don’t just act like it’s not a reality, because it is a reality for many people that their child could die. I remember several kids in the community I could not attend their funerals, and this is when my children were alive, it’s just because this was my biggest fear and I was so sorry I could not be there for them. And you are always right there for people in that moment and I know it’s a fear for you too. So that takes strength to be able to be there for other people. It’s just figuring it out for yourself, what actually fills your cup and making sure you take that time. 


HJ: That’s such a great, practical tip. I want to dig in a little bit more – I remember in the beginning your mission was to cure DRPLA, you were going to find a cure. And I noticed that at some point there was this transition into maybe not even acceptance but your goals shifted a little bit. Maybe the goal was mental strength and teaching others how to do that. Am I correct in your shift and that the shift happened? And why do you feel like you made the shift? And then how do you define being mentally strong? 


Dr.B: Managing or regulating yourself and being able to find balance. Joy and pain can coexist and figuring out how to do that practically. We all have pain. I took a personality test that pretty much says I’m a rebel, so even in the beginning where, you know this is a terminal condition, there is absolutely no cure, there’s 20-50 years of research that would have to happen to cure this, I didn’t believe it. And this also goes to my relationship with God. I was like nope God is going to provide something and I’m going to do the actions and I’m going to fly to Canada and fly to Mexico and I’m going to see all of these specialists. I’m going to pick up my family and move to Colorado. And when Reggie died, Reggie’s life was so traumatic. He was in and out of the hospitals, ICU’s, multiple people told me he was dying and I was like no, no, no. And when he did die, it was like, okay, I can do this. But I’m not going to miss opportunities to just be present with Miah. And I’m not going to make her do all of these stupid diets and not eat chocolate cake and I did everything all the ketogenic stuff with Reggie and I think that’s why Miah’s death has just been so much harder, spiritually harder. She was not sick. I don’t think she’s ever spent the night in the hospital, she’s done EMU’s overnight but she was not sick. This was not supposed to happen. I thought I had a lot of time left. This year and a half since her death has been an intense spiritual journey. Because you just want to say “F you, God”.


HJ: I’m glad you’re really honest about that and the spiritual struggle that you’ve had and being able to be honest about raising a fist and saying this doesn’t make sense. I think that is a very common experience. It is one of my greatest honors, to watch you continue to put one foot in front of the other over all of these years and be focused on continuing to help the community and help people, not with some pie in the sky mentally strong like “I’m always okay and my energy is always high” that’s not what you’re teaching and that’s not reality. The practicality that you teach and what you do is so important. What’s alive for me and a lot of our community is this anticipatory grief and I wanted to talk with you a little bit about that. I think about your husband, Bundy, and he’s living with DRPLA, and for those who don’t know DRPLA is a neurodegenerative disease and so he will pass away, and so your son Reggie, your daughter Miah and now your husband, Bundy. There is still this anticipatory grief and for those of us who still have kids with life limiting conditions and our friends kids are passing away and it could happen to us at any point and so I’m wondering what advice you would give to those of us who have this pain present now, daily, who it’s still the first thing we do in the morning is check on our kids in the morning to make sure they are okay, how do we metabolize that or how do we work through the anticipatory grief?


Dr.B: As a professional we have taken your spiritual self out of the equation of mental health and it’s such a huge part, especially in the process of death. And I challenge everyone, regardless of where you are on your spiritual journey, whether you have a strong belief system or don’t believe in God, there is something outside of us. There are other dimensions, there are eternal relationships, and this is one of the things I say all the time – make relationships a priority because they are the only thing that is eternal. How you believe that plays out, it’s not as important as believing that it plays out and that death is not the end and figure that out. Have a pursuit of an authentic spiritual relationship, because that is what will bind you to your child eternally. And that is what I talk about in the last chapter, I accepted Christ many years ago and I was a born again Christian and I still believe in the Christian faith but when Reggie died he spoke to me, and he said “Momma, I’m okay, daddy’s okay, Miah’s okay”. He even said to me “you think you’re so smart” and I rationalized that in my Christian doctrine of God spoke to me in Reggie’s voice, I rationalized it. When Miah died I was like, I’m not taking this and the first time Miah came to me I was ready to be open to that and to experience that. And so, an authentic spiritual relationship. 


HJ: I really love that because it also gives us something to do now. It’s not as if we’re waiting for this inevitable thing to happen, we can do something now. We can work on this authentic spiritual relationship. It’s actually in the epilogue, but I wanted to end with the beginning in mind. It’s a question you ask the reader and I wanted to ask the same question, what kind of joy, peace, or happiness are you longing for? And at this point in your journey, with everything you’ve been through and everything that will come, what kind of joy, peace, or happiness are you longing for? 


Dr.B: I think I find joy and happiness and it’s a choice and sometimes you have to pursue it, peace I’m still working on. Really understanding that the present moment is what we have and I heard someone else say depression is thinking about the past and anxiety is worrying about the future and I spend a lot of time in those two places when I should be enjoying the moment. I do not regret, I made a lot of happy moments with my kids and we did a lot of things. I was just looking at the Hawaii trip and with Miah for her 21st birthday we spoiled her rotten at Disney World and we did, we pursued those moments of joy and happiness. In the midst of it, of raising terminally ill children, you do have to pursue those moments of happiness and joy. But also choosing to find peace and peace is only in the moment.


HJ: I could not agree more, a really big download for me these last couple of years as someone who is really driven and is always focused on the future and what I could have done better. It’s the only place to be. It’s interesting how everything is vying for our attention to go back or go forward. The myth of normal. 


Dr.B: We think that peace is a destination and the only place that you have peace is in the moment.


View the entire interview on Realm of Caring’s Facebook Page


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Crohn’s, Colitis, and Cannabis

Inflammatory bowel disease (IBD) is an umbrella term used to describe disorders that cause chronic inflammation of your gastrointestinal (GI) tract. How IBD differs from irritable bowel syndrome (IBS), is that IBD can cause destructive inflammation and permanent harm to the intestines, can be seen during diagnostic imaging, and may increase the risk for colon cancer. The two most common forms of IBD are Crohn’s disease and ulcerative colitis.


Cannabis has been often used as a form of self-medication by individuals with IBD for symptomatic relief and its cannabinoid derivatives have grown increasingly popular as a potential therapy for IBD. A 2007 study by Garcia-Planella and colleagues in Spain surveyed 214 patients with IBD. They found that nearly 10% of patients were active users of cannabis or its derivatives. In 2011, 291 patients with IBD were surveyed at a tertiary care center in Ontario, Canada by Lal and colleagues. Results showed that 33% of ulcerative colitis patients and 50% of Crohn’s patients who were lifetime users of medicinal cannabis were specifically using for IBD symptomatic relief. 


It is estimated that today, about 15-40% of individuals living with IBD rely on cannabinoids to reduce the needs for other medications, as well as increase appetite and reduce pain. Studies have shown that not only may symptomatic relief be realized, but that by modulating the endocannabinoid system (ECS), which regulates various functions to include the pathogenesis of IBD, there may be a therapeutic effect on the GI tract. 


The Role of the ECS in IBD


The ability of the ECS to modulate inflammatory responses demonstrates its role in preserving gastrointestinal function. A 2011 study by Di Sabatino and colleagues used biopsy specimens from participants with Crohn’s disease and ulcerative colitis to analyze endocannabinoid levels, expression of cannabinoid receptors, and activity of enzymes. Levels of the endocannabinoid, anandamide, were significantly decreased in inflamed IBD mucosa. The different levels of elements of the ECS in IBD models showed that cannabinoids appear to have a clear role in gut pathology, offering a potential target for drug intervention in the treatment of IBD. 


Pharmacological Effects of Cannabidiol (CBD)


CBD is one of the main pharmacologically active cannabinoids of the Cannabis sativa L. plant. It is non-psychoactive and exerts a number of beneficial effects to include anti-inflammatory and antioxidant properties. Several studies have contributed to the understanding of the therapeutic potential of CBD for many diseases, including those associated with oxidative stress. Oxidative stress is a significant pathophysiological factor that plays a role in the initiation and progression of IBD. The use of antioxidants for individuals with GI disorders has been proposed as an alternative therapy to the use of anti-inflammatory or immunomodulatory drugs to both mitigate the adverse effects of traditional treatments and enhance the individual’s quality of life. 


Markers of Improved Quality of Life


Irving and colleagues evaluated ulcerative colitis patients receiving a CBD-rich botanical dose for 8 weeks in 2018. While there was no statistical relevance regarding clinical improvement, the treated group reported an improvement in quality of life compared to placebo. Another study by Mbachi and colleagues in 2019 showed that the use of CBD for ulcerative colitis patients was associated with reduced prevalence of severe constipation and hospital length-of-stay when compared with nonusers. 


Symptomatic Control with CBD and Delta-9-Tetrahydrocannabinol (THC)


A significant population of individuals suffering with IBD use cannabis to relieve symptoms of pain, nausea, and appetite, as well as to improve their overall mood. THC has been shown through anecdotal evidence to improve abdominal spasms, cramps, and visceral pain; whereas CBD may contribute to the relief of intestinal inflammation, modulating cortisol and metabolism, improve the immune response of the gut, and alleviate the anxiety and stress associated with gastrointestinal discomfort. In a 2021 review of 682 studies of cannabinoid use for IBD patients, clinical symptoms (abdominal pain, general well-being, nausea, diarrhea, and poor appetite) were all improved with cannabinoid therapy. 


Choosing a product: Benefits of the full cannabis plant 


When looking for a product, it is first advised to understand that the quality of your product matters. We have developed a guide to help you ensure the product you purchase is of quality and have vetted specific products to help you on your journey. Our care team is also on standby with free one-on-one support to help you get started with product choice and dosing guidance. 


When looking for a product for IBD symptoms, it may be worthwhile to consider a full-spectrum product that includes cannabinoids, terpenes, and flavonoids to further enhance benefits.


As more research becomes available for additional cannabinoids, we further our understanding of the benefits this plant may provide. For example, CBG may reduce effects of IBD and the development and growth of colon cancer. CBDA shows promise by inhibiting vomiting induced by toxins and possibly reducing involuntary vomiting. 


Terpenes are compounds produced by plant species, Cannabis sativa included, that are responsible for determining their distinct scents. They also play a protective role in plants and are known through comprehensive research to have multiple health-promoting properties in humans. Several terpenes have been evaluated in models of IBD and have shown to benefit intestinal anti-inflammatory activity by preventing oxidative stress, combating dysbiosis, restoring intestinal permeability, and improving the inflammation process in different signaling pathways. 


Finding Support


Reported data for cannabinoids and terpenes is promising and suggests therapeutic potential. However, there is still a lot of research to be done especially when considering how much to take. Before beginning any alternative therapies, consulting with a medical professional is always recommended. 


There is a lot to consider when starting cannabinoid therapy and a Realm of Caring care specialist is here to help with your questions. Contact us today by calling (719) 347-5400 or by emailing




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5 Terpenes to Boost Your Thanksgiving Appetite

As we get ready to gather with loved ones for the holidays, the anticipation of a hearty feast is on all of our minds. For those seeking an extra boost in appetite or battling conditions that affect their ability to enjoy meals, cannabis can be a supportive ally. With its well-documented appetite-stimulating properties, particularly strains rich in THC like OG Kush or Girl Scout Cookies, cannabis can enhance the Thanksgiving meal experience.

By incorporating strains and terpenes known for their ability to induce the munchies, individuals can elevate their dining experience, and savor each bite with heightened sensory awareness. Whether you’re a seasoned cannabis enthusiast or exploring its potential benefits for the first time, CBD and THC can help transform the way you approach your next meal so you can sit back in gratitude while you enjoy the flavors and power of connection.


The Science Behind Cannabinoids & Appetite


The ability of Cannabis sativa to promote eating has been documented for many centuries, with it reported by its users to promote strong cravings for, and an intensification of the sensory and hedonic properties of food. These effects are now known to result from the actions of cannabinoid molecules at specific cannabinoid receptor sites within the brain, and to reflect the physiological role of their natural ligands, the endocannabinoids, in the control of appetite.


The Endocannabinoid System (ECS) plays a role with our appetite control – from the suppression of appetite to counter over-consumption to the treatment of conditions that involve reduced appetite and weight loss. This is why cannabinoid receptor antagonists (such as CBD) may manage obesity while agonists (such as THC) may be a therapy option for anorexia. 


Understanding Terpenes


Understanding the significance of terpenes is an important aspect of navigating the diverse world of cannabis consumption. While cannabis strain types (sativa, indica, hybrid) have traditionally been the primary focus, consumers and researchers are coming to find terpenes play an equally, if not more, important role in shaping the overall experience.


Terpenes are aromatic compounds found in various plants, not just cannabis, and they contribute to the distinct flavors and scents associated with different strains. However, their impact extends beyond mere sensory pleasure. Terpenes interact with cannabinoids, such as THC and CBD, as well as with receptors in the human body’s endocannabinoid system, influencing the unique effects of each strain. By paying attention to terpenes, consumers can tailor their cannabis experience based on their desired outcomes, whether that’s relaxation, creativity, or appetite stimulation.


Moreover, the same strain type can exhibit significant variability in its terpene profile, leading to diverse effects within a single category. For example, two indica-dominant strains may have distinct terpene compositions, resulting in differing therapeutic benefits. By prioritizing terpenes, consumers can make more informed choices about the strains that align with their specific needs and preferences. This shift in focus allows for a more nuanced and personalized approach to cannabis consumption, moving beyond broad strain categories to consider the intricate interplay of terpenes and cannabinoids that define the plant’s therapeutic potential. Understanding terpenes empowers consumers to make choices based on the precise effects and aromas they seek, providing a more tailored and enjoyable cannabis experience.


If you are looking to elevate your culinary adventures and savor the joy of eating, here are five terpenes to keep an eye out for when shopping for cannabis products.


Terpenes for Appetite Stimulation


While research on terpenes and appetite stimulation is an evolving field, some terpenes have shown promise in influencing appetite. It’s important to note that individual responses may vary, and what works for you may not work for someone else. Always remember you can ask your budtender for help when shopping for certain terpenes. 


  1. Myrcene: often found in cannabis, lemongrass, mango, parsley, bay leaf, thyme, and more. Aroma: earthy, musky, clove-like, with hints of citrus.

    Myrcene affects the dopamine levels in the brain, which helps regulate feeding behaviors. Myrcene can help promote mental relaxation and alleviate anxiety, showcasing a multifaceted range of benefits. Beyond its role in enhancing appetite, Myrcene serves as an antioxidant, anti-inflammatory, and analgesic, a diverse therapeutic potential.

    Strains dominant in Myrcene: Blue Dream, Granddaddy Purple, Harlequin.


  2. Limonene: often found in many citrus fruits such as lemons, oranges, and more, as well as in rosemary and peppermint. Aroma: strong citrus-like scent and flavor.

    This terpene is known to affect the dopamine and serotonin levels in the brain, which can aid in improving appetite. Scientific research with test animals has proven that just the smell of limonene can impact cravings. It may also help support your overall gut health.

    Strains dominant in Limonene: Banana OG, Do-Si-Dos, Tahoe OG, Wedding Cake.


  3. Caryophyllene: often found in black pepper, oregano, basil, and other herbs and spices. Aroma: spicy and peppery.

    Unlike other terpenes, caryophyllene selectively binds to the CB2 receptors, the ECS receptor responsible for your immune system functions. A study on CB2 receptors in mice revealed that it affects weight gain and appetite.

    Strains dominant in Caryophyllene: Jack Herer, White Widow, Chemdawg, Durban.


  4. Pinene: often found in pine needles, rosemary, and basil. Aroma: as the name suggests, the aroma is similar to pine trees and wood.

    Pinene also affects dopamine and serotonin, contributing to an individual’s appetite, and studies have shown it has anti-inflammatory, antioxidant, and neuroprotective properties as well.

    Strains dominant in Pinene: AK-47, Cannatonic, Pineapple OG, Jack Herer, Blue Dream.


  5. Linalool: often found in lavender, coriander, and other aromatic plants. Aroma: floral. 

    Linalool also helps to stimulate the production of a hormone called ghrelin, which helps regulate one’s appetite.

    Strains dominant in Linalool: Amnesia Haze, Zkittles, Lavender, Tropicanna Punch.


Cannabis Consumption Around the Holidays


With the holidays around the corner, it is likely you will be spending more time with your friends, family, and loved ones. Sometimes the reality of these life-long relationships is that our own beliefs and opinions might begin to differ from some of the people we hold most dear. Cannabis tends to be one of these hot topics, so we have compiled some talking points on how to broach the subject with people in your life who may not have the same opinions about the plant-based therapy. 


Cooking with Cannabis

For those of you with families that are more open-minded to the consumption of cannabis, or are looking for ways to incorporate the benefits of cannabis into your culinary experience, cooking with cannabis can be a fun and therapeutic way to enjoy the season!

Cooking with cannabis offers a host of benefits that are gaining widespread recognition in the culinary world. One of the key advantages is precise dosage control, making it a preferred choice for both medical and recreational users. Unlike traditional methods like smoking, cooking allows users to accurately measure the amount of THC and CBD they consume, ensuring a more predictable and controlled experience. This precise dosing is particularly valuable for those seeking to manage specific health issues or seeking symptom relief, as they can fine-tune their intake to match their needs.


As we continue to explore the vast potential of cannabis, it’s clear that THC and CBD, along with their entourage of terpenes, offer a myriad of benefits. From enhancing appetite this Thanksgiving to creating a more immersive experience, cannabis has the power to transform the way we approach food and well-being. By embracing the science behind these compounds and choosing strains wisely, you can embark on a journey of culinary delight and holistic health. Remember, moderation and mindful consumption are key to unlocking the full spectrum of benefits that cannabis has to offer.

If you have any questions about this topic, a Realm of Caring Care Specialist is here to help. Call us at 719-347-5400 option 1, email us at, or visit our website and sign up for a free client account at


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Federal Raid Impacts CARE Medicinal Cannabis Farm and Disrupts Patient Access

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Epilepsy and Cannabis: Historical Use and Up To Date Research

Our collective knowledge of the benefits of the cannabis plant for epilepsy continues to increase year after year. In addition to seizure reduction, we have learned through the literature that cannabis use may be attributed to an increase in the overall quality of life for one living with an epilepsy diagnosis. These improvements can range from decreased side effects of pharmaceuticals to better sleep and lessened anxiety. 


It has been discovered that approximately one-third of individuals living with epilepsy do not respond well to conventional antiepileptic drugs (AEDs) and are therefore considered to have Treatment Resistant Epilepsy or Drug Resistant Epilepsy (TRE/DRE). This creates a demand for an antiepileptic solution that has reportedly better efficacy and less adverse effects.


In this blog you will find historical uses of cannabis for epilepsy, current research across various epilepsy diagnoses with cannabidiol (CBD), delta-9-tetrahydrocannabinol (THC), and cannabidvarin (CBDV), and additional resources for support. 


Historical Uses of Cannabis for Epilepsy


Historical uses of cannabis and hemp for medicinal reasons date back thousands of years. Ancient Sumerian and Akkadian tablets found in the Middle East from as early as 1800 BCE record the use of cannabis for nocturnal convulsions. Arabic literature from around 1100 CE from Ali ibn al-Abbas al-Mayusi has been translated to state “the juice of the leaves of cannabis instilled in the nostril serves to treat epilepsy”, also suggesting that the active ingredient was tetrahydrocannabinolic acid (THCA). 


The first clinical application for cannabis and epilepsy, however, is known to have taken place in the early 19th century with Irish physician William O’Shaughnessy, an army surgeon who served in India. In what can be considered the first detailed modern study of the use of cannabis-based products for anti-seizure benefits, he published his findings in 1843 after testing the behavioral effects in several mammals, fish, and birds. Among these subjects was a 40-day old baby girl with recurrent convulsive episodes. She initially responded well and after a few weeks of trials with various cannabis tinctures, taken under the tongue (sublingually), her convulsions had stopped. Several months later, O’Shaughnessy had noted that “the child is now in the enjoyment of robust health, and has regained her natural plump and happy appearance.” 


From here, notice was taken across physicians in Europe and North America and by 1850 cannabis had made its way as “marijuana” into the United States Pharmacopeia, listing it as a treatment for numerous afflictions, including: neuralgia, tetanus, typhus, cholera, rabies, dysentery, alcoholism, opiate addiction, anthrax, leprosy, incontinence, gout, convulsive disorders, tonsillitis, insanity, excessive menstrual bleeding, and uterine bleeding, among others. In 1881 Neurologist Sir William Gowers wrote of the use of cannabis for seizure control in his monograph Epilepsy and Other Convulsive Disorders


By the early 20th century, references to cannabis extractions and tinctures began to fall out in favor of Western medicine (notably phenobarbital in 1912 and phenytoin in 1937). With this, and with the soon prohibition of cannabis, the therapeutic claims and those first clinical trials took a backseat. 


Despite this, chemists and pharmacologists began diving into the chemical characteristics of the active ingredients and effects on biological activity. Specifically the molecular structures of THC and CBD were investigated by Dr. Raphael Mechoulam in Israel, famously known as the “father of cannabis research”. 


Researchers began to look more at CBD as potential for anti-seizure therapeutic benefits, as promising results in animal models were reviewed. Anecdotal and pre-clinical evidence increased over the years, and with the discovery of cannabinoid receptors in the late 1980’s and early 1990’s, renewed interest in the understanding of therapeutic potential of cannabinoids in how they may modulate the endocannabinoid system came about. 


While smaller scale studies took place to consider the efficacy of CBD, larger scale studies began to emerge around 2015 when neurologist Orrin Devinksy and colleagues observed the antiepileptic effect of CBD among over 200 participants, ages 1-30. Their findings suggested that CBD may reduce seizure frequency and may also have an adequate safety profile in children and young adults with highly treatment-resistant epilepsy, warranting future trials. 


Realm of Caring Published Research 


It was around this time that Realm of Caring began enrolling participants for an Observational Research Registry in collaboration with Johns Hopkins University School of Medicine. Between April 2016 and July 2020, 1,783 individuals enrolled in this online, self-reported survey. Of the enrolled individuals, 418 participants were identified to understand benefits for epilepsy where 93% had listed epilepsy as their primary medical condition with the remaining noting epilepsy as a secondary medical condition. In this sample size, there were 71 adults and 209 adult caregivers of children or dependent adults who were utilizing CBD products for medicinal use. In addition, there was a control group of 29 adults and 109 adult caregivers who were considering CBD use but had not yet begun. In-depth information from 110 participants in the study helped to conclude that the calculated median dose of CBD was 50mg/day, which equated to 1.4mg/kg/day. 


The purpose of this analysis was to evaluate how CBD product use is associated with quality of life, mental health, healthcare utilization, and epilepsy-specific outcomes within a large, observational group of people with epilepsy. 


Compared with controls, CBD Users had a greater health satisfaction, higher ratings of quality of life, and better scores on psychological health. Taking a deeper look, CBD Users reported lower anxiety and depression and improved sleep scores. 


Other findings that were of significance relate to pharmaceutical use, healthcare visits, and caregiver burden. CBD Users had lower instances of reported prescription medication use, lower medication-related adverse effects, less ER visits, and less missing school and/or work days. In addition, caregivers of CBD Users that noted consistent use through the follow-up period reported significant decreases in the Caregiver Burden total score. 


The strides that have been made in recognizing cannabis compounds for their clinical benefit to epilepsy are evident in that the U.S. Food and Drug Administration (FDA) and the European Medicines Agency have approved a CBD isolate pharmaceutical, Epidiolex, for TRE in patients with Lennox-Gastaut Syndrome (LGS) and Dravet Syndrome. Since the 2018 debut of Epidiolex, it has been approved for additional uses and further research, including that of other cannabis compounds, has taken place.  


Additional, Recent Research From the Last Year


Pediatric neurologist Ellen N. Hurley published findings in early 2022 looking at five female children with Rett Syndrome and, consequently, TRE. As animal studies have demonstrated an anti-seizure effect and favorable safety profile for CBDV, the compound was used in this study to determine the safety and tolerability of it for pediatric Rett Syndrome patients. An oral CBDV solution was provided and all five witnessed a reduction in mean monthly seizure frequency. 


A systematic review published in October 2022 sought to assess the effects of CBD in epilepsy patients. In conclusion, the study showed that CBD is highly efficacious both as a standalone and adjunct therapy with clobazam for controlling seizures while limiting side effects. 


A study published in November 2022 analyzed thirty-five patients who were respectively prescribed CBD isolate oils, CBD broad spectrum oils, and CBD:THC combination oils. Results showed that 65.7% of patients achieved a seizure frequency of greater than or equal to 50%, demonstrating a positive signal of improved seizure frequency in children treated with cannabis-based medicinal products for treatment-resistant epilepsies. 


Observational findings published in Pediatric Neurology in October 2023 support the effectiveness of purified CBD as an add-on therapy in everyday clinical practice, as researched among a mixed population of patients with DRE.


Recap: 5 Things to Consider When Starting Cannabinoid Therapy for Epilepsy


  1. There is published research to support benefits, which you do not have to navigate on your own. Realm of Caring features a library of these findings and a care team on standby to offer free one-on-one guidance as you read through. 
  2. AED interactions are possible. An assessment of data suggests that changes in serum levels of AEDs taken with cannabinoid administration have been generally minor for the majority tested and may be well-tolerated. However it should be taken into consideration that several cannabinoids are processed by the body’s cytochrome P-450 (CYP450) system. Therefore it is best to consult with your doctor when co-administering cannabinoids with drugs that are also metabolized by enzymes CYP3A4 or CYP2C19
  3. Patience and the biphasic response are helpful when setting expectations. Administration may be made complicated by the non-linear response of cannabinoids and we should be cautioned to assume that higher amounts of cannabinoids will yield enhanced therapeutic effects. Realm of Caring care specialists abide by the “start low and go slow” method; a strategy with a goal to find a therapeutic dose at the lowest possible amount. 
  4. There are a variety of administration and extraction methods available. The first and most commonly used administration method would be sublingual or buccal administration with an oil or tincture. Individuals also administer by capsule or tablet, through g or j tube, and rectally as a suppository. For extractions of CBD, we have isolate, broad spectrum, full spectrum as well as formulations that include additional, natural supplements. There are also a variety of processes to extract the plant compounds. When looking for what may be most effective for you, a Realm of Caring care specialist is here to help, starting you with a quality product. 
  5. You are not alone. In addition to the Realm of Caring care team, there is a community to support you. Many resources are available for connecting to services or more information. Reach out to our team by calling 719-347-5400 or emailing
Blog Education Featured

CBD Scams: How to spot them and where to find quality products

Recently, an increasing number of advertisements have appeared online highlighting various CBD products, typically gummies, endorsing benefits such as pain relief, improved sleep, and lessened anxiety. Unfortunately, to the consumer and the legitimate companies, many of those heavily marketed “miracle cure” CBD products may be a part of a larger scam. 


How do these scams work?


Many, reputable, companies will use subscription models as a way to save you money. It has shown to be a great service to offset the cost of your cannabinoid therapy. However, subscription traps do often take place by scammers; unwittingly locking you into costly, repeated payments. These offers often seem too good to be true, for example, receiving a free CBD product where all you have to pay for is shipping.


When (or if) these products arrive, there may be no CBD in them at all or they may have harmful other defects. Numerous times CBD products readily available on the market have been tested by multiple laboratories. In one study only 15% of the products tested were accurately labeled. 


What are the health implications of buying an illegitimate product?


The hemp plant has numerous benefits, including to our environment. One of its specialities is the ability to absorb a vast range of compounds from the soil to include heavy metals, radioactive elements, pesticides, fungicides, and more. So, if hemp is coming from polluted land, it is likely that high concentrations of these compounds can show up in the final product that individuals are consuming. Contaminated products may cause pain, muscle weakness, vomiting, diarrhea, allergic and respiratory issues. Buying from illegitimate companies might not just rob you of your money but of your health. Therefore we cannot stress enough that the quality of your product absolutely matters. 


How to spot the scams.


Often, widely elaborate scams aim to trick consumers with false testimonials and manipulated imagery. Recently, claims were attributed to a fraudulent company as a “miracle gummy”. Scammers even included false endorsements from Shark Tank celebrities in their ads, which is not the first time a CBD scam has used the TV show in their attempt to dupe consumers. It should be known that no CBD products have been aired in an episode of Shark Tank to date. 


Clicking the scam ad will often lead to a sales page with more deceitful claims and countdown timers to create a false sense of urgency to purchase. An initial charge is requested and what may be more downplayed, or missing entirely, is language about this being a recurring monthly charge. After the first transaction, cancellation often becomes incredibly difficult as these “companies” do not respond to phone calls and emails or refuse refunds. 


How do you know if your product is legitimate?


There are several CBD companies that offer safe, affordable, quality products. Because the FDA does not regulate CBD, checking if a company is legitimate falls heavily back on the consumer. You do not want your trust and confidence in CBD to be impacted by scammers, so here are some action steps you can take before you buy:


  • Contact a Realm of Caring Care Specialist. Our team is here to help with free one-on-one support to ensure you find a safe and quality product to help you achieve your goals. We have our own rigorous vetting process, and the products that have passed you may find on our supported brands page. As an organization founded by mom’s who were looking for safe solutions for their children, we take product quality very seriously.



  • Research the brand you are looking to shop from. The most reputable are often the ones who show results from third-party lab testing, are transparent about their sourcing and/or how they manufacture their products. If you have questions, they should have a support team you can contact for more information. 


  • Be skeptical of those products who claim to be a “miracle cure” or offer a free trial while requiring your credit card information. 


What to do if you feel that you have been scammed. 


If you feel that you are a victim of a subscription scam and the customer service team for the company is non-existent or not responding, you may want to contact your credit card provider or bank to inform them to stop charges. If you purchased a product that is causing an adverse reaction and, again, the company customer service is non-existent or not responding, you may want to contact Safety Call to report the event. 


The Bottom Line? Get help in advance of product buying.


Realm of Caring takes part in research and education for safe and responsible use of CBD and cannabis products. We are here to help with quality product selection, administration guidance, and free one on one support. Understand what to look for and how much to take of any CBD product before you head to the store or order online. You can reach our care team by calling 719-347-5400, emailing or scheduling an appointment.