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    #75 Cannabis as Medicine (Part 2 of 2) - Cannabis and Treating Chronic Pain with Dr Attam Singh

    enOctober 28, 2020
    What products do Blue Nile and 1800 Flowers offer?
    How does Blue Nile allow customization of engagement rings?
    What role does CBD play in pain management?
    What are the concerns about THC and CBD products?
    How does the regulatory landscape for CBD vary across countries?

    • Shopping for special purchases online with ease and qualityBlue Nile customizes rings and delivers them, 1800 Flowers puts love into every product for special occasions, and the Doctor's Kitchen podcast discusses cannabis as a potential alternative to opiates for pain management with CBD's role in chronic pain treatment.

      When it comes to making a special purchase like a unique engagement ring or celebrating life's occasions with thoughtful gifts, both online platforms, Blue Nile and 1800 Flowers, offer ease, convenience, and high-quality products. Blue Nile allows you to customize your ring with ease and get it delivered right to your door. Meanwhile, 1800 Flowers puts love and care into every product they offer, ensuring a smile for your special occasions. On a different note, during the Doctor's Kitchen podcast episode, the discussion revolved around cannabis as a potential alternative to long-term opiate use for pain management. The safety profile and good risk of serious side effects make cannabis a promising area of exploration. CBD, a useful chemical from the cannabis plant, has a role in treating chronic pain patients due to its complex needs. The podcast also touched upon the difference between synthetic and natural sources of CBD, the endocannabinoid system, and the entourage effect. Overall, the podcast offered valuable insights into the potential benefits of cannabis and CBD for pain management.

    • A rewarding career in anesthesiology for this speaker due to its impact on chronic pain patientsAnesthesiology, with a focus on pain management, offers a fulfilling career for this speaker due to its immediate impact and complex nature, particularly in managing chronic pain for patients with multiple conditions.

      Anesthesiology, specifically pain management, proved to be a rewarding and fulfilling career path for this speaker due to its immediate impact and the complex nature of chronic pain patients. Growing up with a family of non-medical background, the speaker felt a strong pull towards medicine and eventually specialized in anesthesiology. He found that the presence of an anesthetist during critical situations brought significant relief to the entire department. After recognizing the importance of pain management in anesthesiology, the speaker was drawn to the practical aspects and his background in medicine, which allowed him to effectively communicate with patients. Chronic pain patients, who often have multiple conditions and difficulties, can be particularly complex. Throughout his career, the speaker has encountered a consistent group of patients, including the elderly with various arthritic conditions. The rewarding nature of his work comes from seeing the positive impact of his interventions on patients who often face significant challenges in dealing with their chronic pain.

    • Location and demographics impact chronic pain managementThe location and demographics of a patient population influence the approach to chronic pain management, with older, communicative patients in West Hertfordshire typically seeking relief for long-term pain, while diverse patients in North West London may require a more holistic approach due to complex psychological and social issues.

      The type of patients and the approach to treating chronic pain varies significantly based on the location of the practice. In areas like West Hertfordshire, patients are often older and more communicative, with a strong support system. They typically have chronic pain that has been present for a long time and are motivated to find relief. In contrast, in areas like North West London, patients may come from diverse backgrounds and have more complex psychological and social issues contributing to their pain. These patients may require a more holistic approach to treatment, including medication, exercise, and psychological input. Treatment tools for chronic pain can include simple analgesics, anti-neuropathics, physiotherapy, acupuncture, osteopathy, chiropractic care, and injection therapy. The choice of treatment depends on the individual patient's needs and the potential side effects and complications. Overall, the location and demographics of the patient population play a significant role in determining the approach to chronic pain management.

    • Exploring the Effects of CBD on the Endocannabinoid SystemCBD interacts with the endocannabinoid system to potentially alleviate certain conditions, and the UK recognizes it as a tool for pain management.

      CBD, a naturally occurring substance derived from the cannabis plant, interacts with the endocannabinoid system in the human body to produce various effects. This system, which has only recently been discovered, is responsible for regulating a range of functions and conditions in the body. The plant contains two main active compounds, THC and CBD, with different percentages leading to varying effects. CBD does not produce the psychoactive effects associated with THC, making it a popular alternative for medical use. The CBD extract is typically processed into an oil and combined with a carrier oil for easier absorption. By introducing plant-derived endocannabinoids into the body, we can potentially influence the endocannabinoid system and alleviate certain conditions. The UK has recently added CBD as a tool for pain management when other methods have not been effective.

    • The endocannabinoid system and its role in pain perceptionThe endocannabinoid system is regulated by endocannabinoids that attach to receptors in the nervous system and brain. Over 100 compounds in cannabis, including THC, CBD, terpenes, flavonoids, and other phytocannabinoids, may contribute to the entourage effect, enhancing the benefits of the plant extract.

      The endocannabinoid system, which plays a crucial role in pain perception, is regulated by endocannabinoids that attach to receptors found primarily in the peripheral nervous system and the brain, but also in other parts of the body. Currently, we have only identified and focused on two main endocannabinoids, THC and CBD, but there are over 100 compounds in the cannabis plant that have yet to be fully researched and understood for their potential effects. These other compounds, including terpenes, flavonoids, and other phytocannabinoids, may contribute to the "entourage effect," which refers to the combined benefits of all the compounds working together. Our current understanding is that the synthetic components of THC and CBD do not have the same effect as the plant extract itself due to this entourage effect. More research is needed to fully understand the mechanisms of how these compounds interact with the body.

    • Understanding the complexities of CBD's effectsThe benefits of THC and CBD in treating chronic pain are clear, despite incomplete knowledge of their full impact. Ongoing research is necessary to fully understand their complex mechanisms and potential role of other compounds.

      While there is still much to be discovered about the mechanisms of action behind THC and CBD in treating chronic pain beyond the endocannabinoid system, the benefits of these compounds are clear and should not be denied to patients. The anesthesia community, known for its technical precision and understanding of mechanisms, acknowledges the effectiveness of these substances despite incomplete knowledge of their full impact. Ongoing research is necessary to fully understand the complexities of CBD's effects and the potential role of other compounds like flavonoids and terpenes. The analogy of the entourage effect, where various compounds work together synergistically, highlights the importance of considering the whole picture rather than just focusing on individual components.

    • Combining THC and CBD for Optimal BenefitsTHC and CBD, the active components of cannabis, work best together, with THC activating CB1 and CB2 receptors and CBD providing therapeutic benefits without psychoactive effects. Finding the right balance is crucial for optimal results.

      Both THC and CBD, the active components of cannabis, have their unique benefits, but they work best together. THC, which causes the psychoactive effects, activates the CB1 and CB2 receptors in the body, leading to various beneficial effects. However, the psychoactive effects can be unwanted for some individuals. CBD, on the other hand, doesn't have psychoactive effects but has therapeutic properties. The combination of THC and CBD can be particularly effective, as seen in the treatment of multiple sclerosis-related spasticity. It's essential to find the right balance between the two for optimal results. In the market, CBD products with low THC content are widely available, while THC-dominant products are typically only available through prescription. The correct dosage and timing of THC administration are crucial to avoid anxiety and ensure it aids in sleep.

    • Distinguishing Between Recreational and Medical Use of THC and CBDWhile THC and CBD levels can vary greatly in prescription meds, recommended doses for THC are lower due to psychoactive effects. Safety concerns stem from recreational use, not medical use under supervision.

      While THC and CBD content in prescription medications can vary greatly, with higher THC levels being desirable for certain conditions like anxiety, sleep disorders, and chronic pain, the recommended doses for THC are significantly lower due to its psychoactive effects. The safety concerns around THC and CBD products stem from the long-term effects observed in recreational users, whose usage may be influenced by other drugs and confounding factors. However, with the refinement and organization of cannabis medications, it's important to distinguish between recreational use and medical use under medical supervision. The studies that have raised safety concerns were primarily based on recreational users and may not accurately reflect the safety profile of carefully controlled, GMP-recognized medications.

    • Cannabis is safer than opioidsCurrent evidence indicates that cannabis is safer than opioids, especially regarding cardiorespiratory risks, due to the absence of cannabinoid receptors in the brain stem where opioid receptors are prevalent. Physicians in countries with long-term experience report its extreme safety, but mental health screenings are necessary before prescribing.

      While long-term safety studies on cannabis are still lacking, current evidence suggests that cannabis is much safer than opioids, especially regarding cardiorespiratory risks. The absence of cannabinoid receptors in the brain stem, where opioid receptors are prevalent, significantly reduces the risk of respiratory and cardiac complications. Furthermore, physicians in countries with long-term experience in prescribing cannabis report its extreme safety. However, it's essential to screen patients for mental health conditions before prescribing due to the psychoactive components. Overall, cannabis's safety profile is promising, and it may be a viable alternative to long-term opioid use.

    • Cannabinoids: Benefits and Cautions for PractitionersCannabinoids offer benefits for various conditions but require careful consideration due to potential risks and contraindications. Approach patients with caution for substance abuse, mental health issues, and certain medical conditions. Licensed producers provide education and resources for practitioners. Approach media information with a critical mindset.

      While cannabinoids, including CBD and THC, can offer benefits for various conditions such as anxiety, depression, sleep issues, and PTSD, their use requires careful consideration. Patients with a history of substance abuse or mental health issues, including psychosis, should be approached with caution. Other potential contraindications include uncontrolled angina, cardiovascular disease, and age less than 25. As the legal landscape evolves, licensed producers are stepping up to provide education and resources for practitioners. The abundance of information available on the media can be helpful, but it's crucial to approach it with a critical and informed mindset. In essence, cannabinoids can be valuable additions to the therapeutic toolkit, but their use should be guided by a thorough understanding of their potential risks and benefits.

    • Understanding CBD: Regulations and SafetyCBD, a non-psychoactive cannabis component, is popular for pain relief. Its regulatory status and accessibility differ. In the UK, it's over-the-counter but safety/efficacy depend on concentration/quality. Side effects are mild. As the market grows, consumer education and healthcare professional collaboration are crucial.

      CBD, a non-psychoactive component of cannabis, is gaining popularity as a safe and effective alternative treatment for various conditions, especially chronic pain. However, the regulatory landscape and accessibility to CBD products vary, with some countries considering it a food supplement while others require a prescription. Currently in the UK, CBD products can be bought over the counter, but their safety and efficacy can depend on the concentration and quality. While CBD is generally well-tolerated, it may cause mild side effects such as dry eyes, dry mouth, and drowsiness. As the market for CBD products continues to grow, it's important for consumers to educate themselves about the potential benefits and risks and consult with healthcare professionals before use. With the potential for closer collaboration between GPs and specialists in the future, the prescription and continuation of CBD by GPs may become more common.

    • CBD vs THC: Legalization and Societal Impact in the UKThe UK's approach to CBD and THC legalization is complex due to societal, cultural, and regulatory differences. CBD is generally considered safe, but THC poses challenges regarding regulation, driving, and societal impact.

      While the effects of CBD are generally considered safe and legal in the UK, the psychoactive component THC poses more complex issues when it comes to legalization and societal impact. In countries like America and Canada, where THC is used recreationally, initial studies suggest minimal negative effects on society. However, the UK is not comparable to these societies, and potential issues such as regulation, culture, and inner-city use must be considered. Regarding driving, CBD is currently considered safe, but THC remains a concern. Legislation regarding driving under the influence of THC is not clear-cut, and there is a gray area that needs to be addressed. In terms of pain management, CBD's effectiveness is still being explored, and various modes of delivery, such as oils, capsules, and topicals, are being investigated. Overall, the legalization of cannabis in the UK is a complex issue that requires careful consideration of societal, cultural, and regulatory factors.

    • Cannabis-based medications come in oil format for ease of use and adjustable dosingStart with low doses of cannabis oil, gradually increase, and optimize symptom relief while the body builds endocannabinoid receptors

      CBD and THC are primarily delivered in an oil format due to its ease of use and titratable dosing. The use of oils allows for easy adjustment of dosages and can be taken sublingually or with food, depending on individual preference. The effects of cannabis-based medications take time to fully manifest as the body needs to build up its endocannabinoid receptors, which can take several weeks or even months. While there are potential applications for alternative modes of delivery like inhalation or aerosolization, the current focus is on oils due to their safety, efficacy, and ease of use. It's important to start with low doses and gradually increase them to minimize side effects and optimize symptom relief. The body's response to cannabinoid medication can also improve over time, leading to enhanced effects even at the same doses.

    • Quick relief through vaporized CBDVaporizing CBD flower provides quick relief for pain and anxiety, making it beneficial for breakthrough pain or social situations. However, further research is needed and proper guidance from a healthcare professional is recommended.

      The use of CBD, particularly through vaporization, can provide quick relief for certain types of pain and anxiety. This method is particularly beneficial for those experiencing breakthrough pain or specific spasmodic pains that come on and off. Vaporizing CBD flower allows for a quicker onset compared to oils, which require time to pass through metabolism before taking effect. CBD can also be used in social situations or high-stress environments to promote calm and relaxation. However, it's important to note that this is not a substitute for medical advice, and further research is needed to fully understand the potential applications and benefits of CBD in various settings. Additionally, the consumer products available may not yet be of a high enough standard for long-term use without proper guidance from a healthcare professional.

    • Choosing a Reputable CBD Brand is KeyBe cautious when buying CBD over the counter, ensure it's from a reputable brand, and consult healthcare professionals for personalized advice.

      When it comes to purchasing CBD products over the counter, it's essential to be cautious and choose a reputable brand. The speaker likens the process to buying a car, where not all products are created equal. It's crucial to ensure the product contains what it claims and is sourced from a reliable supplier. Despite potential side effects like taste or mild reactions, many people report positive experiences with CBD, particularly for managing stress and sleep issues. However, long-term safety and potential interactions with THC are still under investigation. Interestingly, if aspirin were introduced to the market today with its known side effects, it may not be approved for sale due to modern regulations. Ultimately, the decision to use CBD should be based on personal research and consultation with healthcare professionals.

    • Exploring the benefits of medicinal cannabisHistorical reluctance towards medicinal cannabis is fading, offering significant pain relief benefits for chronic patients. High cost remains a barrier, but improvements in production and regulations are bringing prices down.

      Despite the historical reluctance towards medicinal cannabis due to its past associations, it offers significant benefits, particularly for chronic pain patients. Pharmacists are recognizing this opportunity and becoming more knowledgeable about it. However, the high cost is currently a major barrier to wider use, with a month's supply costing around £2,300. This price is coming down as more companies produce it in the UK and regulations improve. Overall, the situation is improving, and the benefits of medicinal cannabis are worth exploring further.

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    #260 Helping ease the menopause using food, lifestyle and supplements with Dr Rupy Aujla

    #260 Helping ease the menopause using food, lifestyle and supplements with Dr Rupy Aujla

    Today’s episode is a dive into the evidence-based diet and lifestyle habits to ease the menopause transition.


    This is based on research we did for our latest health goal on the Doctor’s Kitchen app that has now launched! Due to huge demand our internal and external research team reviewed the nutrition literature to identify beneficial foods and nutrients specifically to help with the “Menopause”.


    You can now find a large selection of recipes and personalised suggestions based on your dietary preferences on the Doctor’s Kitchen App specifically for menopause. And this complements the many other health goals we have including heart health, brain health, anti-inflammation and many more!


    Just click on the link in the show notes to check out the app.


    For more about HRT treatment options, navigating early menopause, the physical, emotional and psychological signs/symptoms of menopause and tips for choosing herbal remedies, we’ve done a few deep dives with Menopause experts that you can find in the show notes too.


    HRT - https://thedoctorskitchen.com/pod-lp/menopause-with-dr-louise-newson

    Herbal remedies for menopause - https://thedoctorskitchen.com/podcasts/157-natural-menopause-remedies-with-dr-anne-henderson


    🎬 Watch the podcast on YouTube here

    📱 Download The Doctor’s Kitchen app for free*

    🌐 View full show notes, including guest details, on our website


    *The Doctor's Kitchen App gives you access to all of our recipes, with specific suggestions tailored to your health needs and new recipes added every month. We’ve had some amazing feedback so far and we have new features being added all the time - check it out with a 14 day free trial too.


    Do check out this week’s “Eat, Listen, Read” newsletter, that you can subscribe to on our website - where I send you a recipe to cook as well as some mindfully curated media to help you have a healthier, happier week.


    🥗 Join the newsletter and 7 day meal plan

    📷 Follow on Instagram

    🐦 Tweet me


    We would love to get your feedback on the subject matter of these episodes - please do let me know on our social media pages (Instagram, Facebook & Twitter) what you think, and give us a 5* rating on your podcast player if you enjoyed today’s episode



    Hosted on Acast. See acast.com/privacy for more information.


    #259 Why you should drink 2-3 cups of coffee everyday with Alex Higham

    #259 Why you should drink 2-3 cups of coffee everyday with Alex Higham

    Today we’re diving deep into the wonderful world of coffee with my good friend Alex Higham. 


    In this episode we talk about the attributes of coffee and why it seems to have benefits for brain and heart health. We also talk through the healthiest brewing methods for coffee from espresso, to aeropress, to cafetiere and Alex’s experiments looking at the caffeine content of different brewing styles.


    We talk about how sourcing and roasting methods can affect the polyphenol concentration of the coffee beans and hence the health benefits and how you can choose the best tasting coffee with these in mind. I also ask Alex the questions that I get asked all the time such as how often should I change the beans, when should I drink coffee and what if I can’t tolerate caffeine?


    Alex is co-founder of Exhale Healthy Coffee, the UK’s first coffee crafted for health. After 8 years grappling with auto-immunity, Alex is now on a mission to help others regain control of their health starting with the thing most people consume vast quantities of, their coffee.


    As a disclaimer, I must mention that I am an advisor to Exhale coffee the company, and I sincerely love everything that Exhale is about. From rigorous sourcing and independently lab testing their beans to ensure no contaminants, it’s how food products should be made, and it’s a privilege to be part of their incredible journey.



    🎬 Watch the podcast on YouTube here

    📱 Download The Doctor’s Kitchen app for free*

    🌐 View full show notes, including guest details, on our website


    *The Doctor's Kitchen App gives you access to all of our recipes, with specific suggestions tailored to your health needs and new recipes added every month. We’ve had some amazing feedback so far and we have new features being added all the time - check it out with a 14 day free trial too.


    Do check out this week’s “Eat, Listen, Read” newsletter, that you can subscribe to on our website - where I send you a recipe to cook as well as some mindfully curated media to help you have a healthier, happier week.


    🥗 Join the newsletter and 7 day meal plan

    📷 Follow on Instagram

    🐦 Tweet me


    We would love to get your feedback on the subject matter of these episodes - please do let me know on our social media pages (Instagram, Facebook & Twitter) what you think, and give us a 5* rating on your podcast player if you enjoyed today’s episode



    Hosted on Acast. See acast.com/privacy for more information.


    Mixed Heritage and its Impact on Identity, Happiness and Self Worth. Both Not Half with Jassa Ahluwalia

    Mixed Heritage and its Impact on Identity, Happiness and Self Worth. Both Not Half with Jassa Ahluwalia

    This podcast is a deeply personal one for me. Not just because I resonate so much with Jassa and his experience of not having a true sense of identity, but because I’m expecting a child with my wife late this year who will be of mixed heritage. 


    My wife is Italian and I’m Indian so our child will be both Indian and Italian, rather than half Indian and half Italian. I never really thought of being half something and half something else as ever really something to pay attention to, but recording this podcast with Jassa and reading his story has made a real impact on me.


    In the same way John Agard educated us all with his wildly popular poem “half caste”, about the impact of words on people's sense of worth, I feel Jassa has educated me on the use of my words and thoughts, regardless of whether there is ill intent or malice behind them. Words mean so much and I’d never want anyone, let alone my unborn child, to feel anything other than a whole person.


    Jassa Ahluwalia is a British actor, writer, filmmaker and trade unionist. Born in Coventry to a white English mum and a brown Punjabi dad in 1990, he attended school in Leicester and was raised in an extended family environment. He spoke English in the playground, Punjabi with his grandparents, and spent various summer holidays in India. He came to prominence as Rocky in the hit BBC Three series Some Girls, followed by starring roles in Unforgotten, Ripper Street, and Peaky Blinders. He’s also one of the funniest comedians I’ve ever come across on social media. Please watch some of his sketches online!


    Jassa created the hashtag #BothNotHalf to explore mixed identity in light of his own British-Indian heritage. His TEDx talk on 'How Language Shapes Identity' has clocked up over 170k views and his BBC One documentary Am I English? won an Asian Media Award in 2022.



    🎬 Watch the podcast on YouTube here

    📱 Download The Doctor’s Kitchen app for free*

    🌐 View full show notes, including guest details, on our website


    *The Doctor's Kitchen App gives you access to all of our recipes, with specific suggestions tailored to your health needs and new recipes added every month. We’ve had some amazing feedback so far and we have new features being added all the time - check it out with a 14 day free trial too.


    Do check out this week’s “Eat, Listen, Read” newsletter, that you can subscribe to on our website - where I send you a recipe to cook as well as some mindfully curated media to help you have a healthier, happier week.


    🥗 Join the newsletter and 7 day meal plan

    📷 Follow on Instagram

    🐦 Tweet me



    Hosted on Acast. See acast.com/privacy for more information.


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