Introduction

Rob Gronkowski, George Kruis, Nate Diaz, Bubba Watson. These are just a handful of currently active athletes who are publicly advocating for the use of cannabidiol (CBD) in professional sport.

CBD is just one of over 100 different cannabinoids that are found within the cannabis plant. The number of potential benefits of CBD, particularly when it comes to ailments typically associated with athletes, such as inflammation, pain relief and anxiety, are innumerable. There is also a wide range of delivery formats when it comes to CBD, including CBD oils, topical CBD creams and transdermal CBD patches. This article will focus on CBD capsules, which are soft gel capsules containing CBD oil and can be consumed orally, just like any other tablet or supplement.

There is obviously a great deal of research still required and CBD is still in a cautiously nascent period compared to other medications, but the anecdotal evidence grows on an almost daily basis. 

Athletes put their bodies under tremendous amounts of stress on a weekly basis in order to eek the highest level of performance out of their finely tuned bodies. While elite training can of course build up a great deal of resistance in the bodies of athletes, physical trauma and prolonged wear and tear will still ravage even the fittest.

Current methods of pain management, such as over-the-counter pain relievers (NSAIDs, ibuprofen, naproxen etc), are effective to a point, but also ultimately kill thousands every single year. CBD promises the same positives in terms of pain relief but does not come with the added baggage of the horrendous, often life-altering side effects.

This article will aim to outline why more and more athletes are moving towards CBD as a form of supplement in order to enhance performance.

What is CBD?

Cannabidiol, or CBD as it is more commonly known, is one of the most dominant active components of cannabis. It is generally derived directly from the hemp plant, which is a close cousin of the marijuana plant but with far lower THC content.

CBD is a non-psychoactive component of the plant, meaning it doesn't provide the ‘high' often associated with cannabis. According to the World Health Organization, “there is no evidence of public health related problems associated with the use of pure CBD”.

This explains why CBD is growing in popularity among athletes in particular. The actual range of potential benefits is still unknown, which has been the cause of great excitement among medical circles.

This explosion of popularity in recent years has naturally led to rampant innovation and a plethora of available delivery methods. You can now buy CBD in tincture form, in creams, in e liquids and, as we will discuss in this article, CBD capsules.

What are CBD Capsules?

CBD Capsules are developed using a similar method to CBD oils, in traditional tincture format. The key ingredients are extracted from the hemp before being suspended in a soft gel capsule. There are three different types of CBD that are generally used in the extraction process:

• Broad Spectrum CBD – Broad spectrum is a medium between full spectrum CBD and CBD isolate.
• Full Spectrum CBD – CBD that has been extracted from the cannabis plant alongside other compounds.
• CBD Isolate – This is the purest form of CBD, with all other elements of the cannabis plant removed. Often comes in a crystal or powder form.

CBD capsules are consumed in exactly the same way one would consume any other form of supplement. Simply place one in your mouth and swallow with water.

Why are Athletes choosing CBD Capsules?

There are a number of reasons why athletes are opting for CBD capsules over alternative delivery methods.

Primarily, CBD capsules are incredibly easy to consume. They can be worked into your daily routine seamlessly, just like any other form of supplement. Furthermore, the dosage is even more simplistic. There is no faffing about with dropping oil under your tongue in different sized drops as there is with CBD tinctures. The dosage has already been measured out in each capsule, removing any guesswork.

CBD capsules are also ideal for when it comes to travelling – something which many an elite athlete has to deal with on a regular basis. They are a very discreet product, which often appeals to those who are wary of the opinion of others. Finally, there is no taste when it comes to CBD capsules, as many often dislike the earthy undertones that come with consuming oils.

Are CBD Capsules Legal for Athletes?

The World Anti-Doping Agency (WADA) removed CBD from its list of prohibited substances in 2018. That said, the vast majority of sporting bodies still prohibit the use of THC amongst athletes.

Provided you are taking compliant, well produced CBD products, then you are not at risk of testing positive for THC. To be on the safe side, it is recommended to choose products that use CBD isolate.

There have however been cases in the past where athletes taking poorly manufactured CBD products have tested positive for THC. It is important to remove this risk by always reading product labels and seeking independent, third party lab reports.

What are the Benefits of CBD Capsules?

They are not NSAIDs or Opioids

Dissenting voices around NSAIDs (Non-steroidal anti-inflammatory drugs) and opioids have grown increasingly louder in recent years, with burgeoning evidence suggesting that the acute side effects of such potent medication can have devastating effects on the lives of its users.

When used for prolonged periods, NSAIDS such as ibuprofen and naproxen can put athletes at a greatly increased risk of renal damage, including heart attacks and strokes. CBD is seen as a viable alternative as it has similar pain-relieving properties but is shorn of the negative side effects.

Opioids paint an even more morbid picture. In 2018, the most recent statistics available, there were 46,802 deaths attributed to opioid overdoses in the United States. This was 69.5% of all drug overdose deaths in the US. Furthermore, these statistics do not capture the millions of lives effected in some adverse manner by opioids. The risk of addiction and death by overdose is clear for all to see and the situation appears to be deteriorating.

CBD capsules offer a viable alternative to the aforementioned pain management prescription drugs. There is also the added benefit of, at worst, benign side effects such as nausea or dry mouth.

Improve Sleep Quality

There is no doubt that one of the most popular reasons for taking CBD is the improvement in sleep quality. In elite level sport, sleep is an essential component of any successful recovery and routine, helping to facilitate optimum performance levels.

Adenosine triphosphate (ATP) is broken down while you burn carbohydrates for energy and adenosine steadily builds up in your brain. The more adenosine that bind to neurons, the slower your brain activity and the calmer you feel. This is because adenosine inhibits the release of neurotransmitters. While you sleep, your body then breaks down adenosine, which eventually reaches a low enough concentration to help you wake up.

CBD binds to the same receptors that adenosine would potentially bind to. The theory is that CBD may inhibit adenosine reuptake, helping your brain activity to slow down and making you feel tired sooner.

A 2019 study by Shannon, Lee, Hughes and Lewis (Cannabidiol in Anxiety and Sleep: A Large Case Series) looked into the effects of CBD on sleep and anxiety. The study involved 72 subjects, who were each given a 25mg CBD capsule each day. In the first month, 66.7% of participants reported an improvement in their quality of sleep.

Reduces Inflammation

CBD is well known for its powerful anti-inflammatory properties. While a degree of inflammation can be beneficial for elite athletes, an excessive amount will hamper both performance and recovery.

While CB2 receptors are typically associated with the brain, they are in fact more concentrated in our immune tissue. The anti-inflammatory effect of CBD is caused by a reduction in cytokine (small proteins involved in cell messaging) production. Essentially, CBD bound to CB2 receptors facilitate a moderation of the responses of the immune system to challenging workouts.

A 2017 study by Genaro, Fabris, Arantes et al (Cannabidiol Is a Potential Therapeutic for the Affective-Motivational Dimension of Incision Pain in Rats) found that CBD was effective in the treatment of inflammation in male Wistar rats.

CBD Capsules are Effective Pain Relievers

Athletes will naturally encounter pain on a regular basis. This can be from excessive training, or perhaps an inhibiting injury. If the correct treatment is not received, then injuries may exacerbate over time and the pain will becoming overwhelming for the athlete.

Unfortunately, the vast majority of studies into CBD and pain relief also incorporate THC in some way, which has a burgeoning amount of evidence of effective pain relief. That said, a robust meta review conducted by Vuckovic, Srebro, Vujovic et al in 2018 (Cannabinoids and Pain: New Insights from Old Molecules) studied existing research published between 1975 and 2018 into CBD and chronic pain. They ultimately concluded that CBD was indeed effective in chronic pain relief, while also not causing any negative side effects.

CBD Strengthens your Immune System

Steering clear of illness and disease is crucial to the availability of any elite level athlete. Availability is certainly one of the most underrated traits of any athlete and CBD can help to achieve this.

A novel study conducted in 2019 by James M. Nichols and Barbara L.F. Kaplan (Immune Responses Regulated by Cannabidiol) found that “the data overwhelmingly demonstrate that CBD is immune suppressive and anti-inflammatory.”

As an immunosuppressant, CBD reduces the immune system's inflammatory responses, prevents rapid cellular growth and promotes apoptosis (cellular death). The aforementioned role that CBD plays in the functioning of cytokines also has a prominent impact on immuno-defence.

CBD Reduces Stress and Anxiety

Mental health is becoming an increasingly prominent facet of high-level sport. The cognitive and emotional aspects of athletes are being taken more seriously than ever, from both a mental health and performance enhancement perspective.

Performing every week at the highest level, under rigorous scrutiny for every action taken, can be an incredibly stressful experience, even for the most robust and experienced individuals. There is no doubt that CBD support athletes in this aspect.

This has been brought to light by a number of studies across recent years. One of the most renowned of these was a comprehensive meta review of studies, conducted in 2015 by Nora D. Volkow of the National Institute on Drug Abuse (Cannabidiol: Barriers to Research and Potential Medical Benefits). She referenced a study by Guimaraes et al in 1990 (Antianxiety effect of cannabidiol in the elevated plus-maze. Psychopharmacology) which found that CBD reduced both behavioural and physiological measures of stress in rats.

Conclusion

The emergence and, perhaps more crucially acceptance, of CBD in elite level sport could signal a turning point in how athletes manage their own performance. There is no doubt that they are a far superior alternative to NSAIDs and opioids, with high efficacy and benign side effects.

CBD capsules in particular are likely to appeal to athletes, who will already be taking a range of supplements and can easily work these into their daily routine.

CBD can also provide benefits in many other facets of an athlete's life from recovery, to sleep, to mental health. The main concern of athletes at this moment will undoubtedly be the legitimacy of the CBD products that they are acquiring. A poorly manufactured product could lead to a failed drug test due to the presence of THC. Besides that, the lack of side effects and huge potential benefits mean that there is little reason for athletes not to try CBD.

In a wider sense, the main caveat that leaps out is the lack of scientific research around CBD. Anecdotally, there is growing evidence of all the aforementioned benefits, but we are still waiting for the science to catch up.

That said, this may not be as big an issue as first thought. For example, the emergence of carbohydrate packed sports drinks pre-dated the scientific research behind them. They were widely adopted, despite the imperfect formulas and initial lack of clarity around function.

The future indeed looks bright for CBD and it appears only a matter of time before it becomes commonplace in sporting circles.