 everybody, thanks for your patience with us. Both Dr. Hila and I were just getting through some other things today and here we are. And today I'm super excited, not only about my guess, but about the topic. I think you'll find it very, very relevant. Whether or not you use CBD or know much about it, we're going to dive into some of the science behind the effects for brain, for sure, but also for the body. And I have been just very surprised and interested in continuing to learn more about how beneficial it can be for neurological inflammation. So before we do that, just a little background, you know, I'm here most Tuesdays and some Fridays and we always love when you join, I will try to keep track of some questions along the side. So if you have questions in real time or want to say hello, just type into the feed there. If you're watching this recorded on the podcast or on YouTube, you can certainly comment there and subscribe as well. Anything that you want to know as far as old shows can be found on my YouTube channel, which is just under my name, Dr. Jill Carnahan. So go there. We have like 70 plus hours of interviews with great experts like Dr. Cass and so many other things. And then if you want free blog information, that's at my website, jillcarnahan.com. And last thing is if you aren't part of the newsletter, please do subscribe. I'll leave a link there. I have all kinds of free stuff we share every week on the newsletter. So I want to introduce my friend. We have traveled in the same circles with functional integrative medicine for probably over a decade. And I just always have such great respect about the information that Dr. Cass brings to our field. And today will be no different. You will really enjoy hearing from her. I'm going to actually do a formal introduction and then we'll jump right in. So Dr. Hyla is a recognized pioneer in holistic and functional medicine and psychiatry in particular. She's a frequent guest on radio, TV, podcast and documentaries. She's written several popular books, including The Addicted Brain and How to Break Free, Natural Highs with Patrick Holford and Eight Weeks to Vibrant Help. She helps people enhance their mood and mind as well as overcome addiction using targeted nutritional supplements. Her latest addition is CBD, which we'll talk all about today, which enhances the effect of the other nutrients as well as having many positive effects on brain health. So welcome, Dr. Cass. Thank you so much for taking the time to be here. Such a pleasure. I'm just delighted to be here. Me too. And we've tried several times. I just told you before we jumped on, thank you for your patience. I think I canceled twice. And it's just those crazy schedules of ours. And I apologize, but I'm so glad we're here. I'm glad we made it work. And it's so good to see you even virtually. So let's dive in. What I love to start with with guest is story of just how you got into medicine first, and then how you'd navigate it to functional integrative. And then we'll go on to CBD. But tell us just a little bit about your journey. Well, I think I was destined to be a doctor. My dad was a doctor. And from the earliest, my earliest memories are going on calls with him or he also had his office at home. We lived in Toronto and we had this beautiful furnished basement with, you know, it was not a cellar. It was a beautiful office space. And I would be the greeter. Here I am like five years old, six years old. I'd be answering the door and letting them in. And I felt like I was part of the family, part of the club. And as I got older, he would discuss cases with me. And he acted as if I were a colleague. And I just sort of, you know, how you play it fake until you make it. So I just kind of fell into it. He actually took me to Women's College Hospital one time with women doctors and said, see women are doctors. Because this was a time when there were very few women doctors. So a lot of encouragement from my father for the rest in peace. And he really inspired me in inspiring me to be the kind of doctor I am because he was very, very kind, very personable. I'd see people walk in to the office feeling very upset, worried and walk out smiling. So you really modeled that really bedside manner and how cool that from such a young age, you got to witness and see and the power of that, what you're talking about is like that holding space for people, right? Like except making a space for them to feel comfortable. Because what we do in medicine, it's there's a lot of vulnerability. And I realize more and more the more I do it, the more like how precious it is the gift of sitting with a patient and having them like really share some deep, dark stuff. Sometimes happy, but sometimes really difficult with us. It's like sacred, isn't it? Like this thing that we get to. It's sacred for us. Yeah. Yeah. And then, you know, by the way, medical school was allopathic, regular old medicine, but very interesting. I just found it fascinating. What I didn't like, however, was the way patients were treated. Yes. And medications being full of side effects. And I just was always kind of empathizing with the patient and trying to find a better way to do things. And it became clear to me that the medications were not the answer. And I very early on, even in the residency, started looking at alternatives. And that is diet and lifestyle. I love that because you started right in even during education. I did the same before we got out into practice. You actually had, it's almost like you came in and just like you, I think the allopathic model is beautiful. I learned so much great foundation, but then it's like allopathic plus, we've got a bigger toolbox, right? Right. So I expanded my toolbox and continued to always going to conferences and learning, learning new methods. And it's such an evolving, exciting field. You know, there's no end to it. And we see the results. We get results. We get amazing results. We do. And especially, so especially the field of psychiatry, which is your expertise, I love your perspective because it's so needed. And I'm curious as far as you kind of started delving into this very early. But you mentioned alluded this, but I want to talk more because right now, psychiatry, mostly the tools of conventional psychiatry or medications, there's a place for those. We all use them. But tell me more about when you saw that model and the limitations and then how that allowed you to go into other options, because really there's not a ton of allopathic options besides medications. Well, when you work with the body's chemistry, I mean, we have the best chemistry, the best pharmacy inside us. And nature knows how to heal us. So it's ludicrous to think we could take a strong medication and sort of clobber our brain into submission. It doesn't work. Right. It really does clobber you. And the side effects are terrible. Yeah, that's what I've seen, too, is that certainly and often the body is so smart that it will change neurotransfer production or become immune, which is also the changing of the neurochemistry over time so that even if a med initially gave some benefit often over time, I find it to be much less effective. That's exactly it wears off the effect wears off, but going off the medication can be really a problem because there have been brain changes. Yes. So the same brain changes that make the drug not work anymore, also interfere with you being able to get off it. So getting off it suddenly is really dangerous, really bad, and you can have terrible effects that last for months, even years. So the way to do it there is a way to do it and that is do it gradually, but also to support your own chemistry with the right nutrients with starting with diet lifestyle and specific targeted nutrients that help make your neurotransmitters your brain chemicals. Like our brain knows how to do that if we give it the right material. So let's talk just briefly about nutritional interventions and then I want to go mostly of our talk to CBD specifically, but obviously for your decades of practice that the nutrition has been primary. What would you do if someone came in, say depression, anxiety, what kinds of things? I mean, the gut has an effect, toxicity has an effect. Right? Yeah. How would you frame that and kind of start to get them on the path nutritionally? Yeah. The interesting thing is, of course, it doesn't stop at the brain, it doesn't end there. Your mental health doesn't end at your neck. It's a whole body process. Of course, we look at the gut, we look for infections, toxicity, all heavy metals and chemicals. We look for a history of head injury. We look for any source of inflammation, because when the brain is trying to tell us something, when a person shows up with anxiety and depression, those are our symptoms. Those are our conditions. They're symptoms. It's the brain saying, I'm inflamed. I'm missing something. Something's out of balance. So then we test, we take a good history and give them what they need. If it's a gut, and very often it's the microbiome, it's out of balance. And there's a very strong gut-brain connection. So we definitely have to heal the gut. So psychiatry is not really just the study of the brain. In fact, in allopathic medicine, they're not even looking at the brain really. It's probably the only specialty where they don't look at the actual organ. Yeah. So interesting to think that way, right? And something you mentioned really interesting. I was just talking to a friend who's a neurosurgeon for the Denver Broncos, and he's got functional medicine training as well. So I love talking to him because he's got this very conventional. And he was talking about the data on TBI's traumatic brain injuries and concussions, and really talking about how if a human just gets a traumatic brain injury and they really don't have any underlying infections or mold toxicity or anything else, they often recover and do pretty well. But it's like the traumatic brain injury concussion, plus the inflammation from something like Lyme disease or inflammation from autoimmunity or infection or toxic mold. And it really escalates the traumatic brain injury to be an issue, like the long-term consequences of that. So he was almost saying, bottom line, if you just have a head injury and that's it, you can often recover, especially if it's mild. It's that plus the underlying infection, inflammation, things that cause what we could call autoimmune encephalopathy or toxic encephalopathy or whatever other term we'd use. And you're more of an expert than I, and so is he. But I was fascinated to hear him say in this conventional concussion, professional athlete world that it's really not the concussion by itself. It's concussion plus inflammation from an infection, right? I'm sure you see that and would agree. Absolutely. And you take the patient where you see them. You know, I was somebody who's in the accumulation of their lifetime whatever experiences they've had. Yeah. And it could be really, really does matter. So let's talk about CBD. I agree. Like I've been just as I read the neurological benefits and the science and the literature, it's amazing to me how profoundly beneficial that or how many benefits that it actually has. Let's talk a little bit about when did you really find the benefits and start to use it in your practice and take us through some of that with CBD and the benefits and what you're seeing happen and it being used for? Well, a few years ago when it kind of came crashing onto the scene, I looked into it. In fact, I was a little curious because I'm not a particular fan of THC. I know people enjoy getting high, but it was not something that interested me so much. And when I first heard about CBD, I thought, well, yeah, it's probably an excuse to get high. You know, what did I know? So some friends of mine had written a book about it, but I did read the book. And then it's like a light went on. Wow, there is something to this. And the effects it can have on psychiatric conditions is amazing for anxiety, depression, seizure disorders, traumatic brain disorder. So we're just talking about TBI. It's excellent for TBI Alzheimer's. So I took it. I began to take it really seriously. And, you know, it sounds like this is a panacea, you know, is this placebo effect, but it isn't really because you can use it on animals too. And they have a very good result. The reason why it works in so many different ways and doing so many different things has to do with its influence on something called the endocannabinoid system. And once you understand that, when you understand the endocannabinoid system, you can get why CBD works in so many different ways. So do you want me to explain? Yes, let's talk a little bit about that system, because these receptors are all over our body, right? That's what's really cool. We have them in the brain, in our organs, in our immune system, in the gut, in our endocrine system, everywhere. And it's a system of communication and homeostasis. So it helps, it facilitates communication among all those systems. And its job is to help us to rest, to protect us, to de-stress us and to heal. So really important things. Very important system, really important. And the difficult thing is that a lot of people have a low endocannabinoid system, which means it's not doing all of those good things that you want it to do. The two main endocannabinoids, we actually make these endocannabinoids, these feel-good chemicals. One of them is anandamide and the other is 2AG and then a bunch of others, but these are the most studied. Now anandamide was first discovered in connection with THC, tetrahydropevanol, which is what gets you high in weed. And it's the molecule that when THC, it was postulated, THC makes you high. It has to have a corresponding molecule inside us, right? Because there is a receptor for it. And then it was discovered it was the anandamide receptor that THC was going for. And the product that we make is anandamide. So we make our very own THC, as it were. But it's called anandamide. So while THC attaches to that receptor, CBD also facilitates the receptor in just a little different way. So if you're low in your endocannabinoid system, you don't have enough anandamide and you're not feeling good and you're feeling anxious and you can't sleep. You can have GI problems. All of these things are going on because you have a low endocannabinoid system. We can come in and use a phytocannabinoid phytomine plant like cannabidiol. And it comes in and it makes the anandamide work better. So it works with your own inner pharmacy to do what needs to be done. And it does it so much better than a drug because you're working with an already existing system. You just have to feed the system, recognize it and feed it. And you have an amazing treatment. That's what I've seen, Carla. It's basically the different, the patients that come in, their stress system is out of whack and all the the signs and symptoms that you mentioned are really related a lot to the stress hormones and that and it sounds like is there evidence that it decreases cortisol or that it changes some of the stress response? Sure. In the stress response, what is it? It's fight or flight. We're in danger. When we're in danger, what happens? Our heart rate goes up. Our hearing becomes more acute. Our vision becomes more acute. The blood all goes to the periphery so we can run. And we're built for that. We're built for fight or flight because we had to run away from predators. However, these days, we're not running away from predators. We're sitting at a desk and what's going on? We're stressed. There's financial issues or deadlines. There's kids, there's families, all kinds of stuff going on. So our stress response is going, but we're not running. We're not dissipating that cortisol and adrenaline. It's just coursing through us. And what happens? Everything is going to the periphery, the blood flow and the energy. So our more vegetative aspects, our hormones, reproduction, our gut function, digestion, our heart working the right way, our blood pressure being normal, all of that kind of goes by the wayside because we're in fight or flight and our body is acting as if we don't need those other things going on right then. So people having sexual dysfunction and infertility. So everything goes offline and it's a physiological response. It's actually a normal response to an abnormal situation. So you're absolutely right. So the endocannabinoid system is there to de-stress us. The problem is, this is a big problem, when we're stressed, our endocannabinoid system goes low. So we don't have enough of it to counterbalance all this stress. You can actually tap it with CBD and say, hey, come on, help us out. To produce internal endocannabinoids. So there you go. Wow. Very simple and big sense. And the thing that I think you've made really clear, but I know, I was just like you, like I wasn't a prescriber of marijuana. I wasn't a fan of THC. So I initially was very adverse to get into that field. But as I like you, looked at the literature of CBD, I found it to be profoundly beneficial. And especially, let's talk a little bit about the indications that you would use it for. It sounds like a lot of people could benefit, but neurologically or otherwise, I found in my patients, of course, like seizures, brain inflammation, what else, what would be the spectrum of types of patients you would prescribe this for or recommend it for? Well, in form of anxiety. Now, one big issue that is kind of rampant is post-traumatic stress disorder. And people often don't even know they have it because it may have been very early trauma, may have been cumulative trauma. It may have been issues with early attachment. And they don't really know what it is, but they have this just deep anxiety that's going on. Well, what's been shown is that CBD is really good for dealing with it. It goes to the part of the brain, the amygdala, which is an limbic system, and in a way it detoxifies the traumatic memory. So the memory can remain. You can remember, if you do remember it, certainly military people who've seen horrible things in battle and they have post-traumatic stress disorder. So they can maintain the memory, but the fear, the horrible fear that goes with it, is dissipated because that's what it does. That is exactly what the endocannabinoid system does. You support the endocannabinoid system and it works for you. Wow. Now, that makes a ton of sense because I've done a lot of work and I've had a good life, but we all have some sorts of traumas. And so I have dove into those myself. And what I found is, as I deal with those and heal those, I can have a memory, but it no longer has a charge. And that's what you're talking about. I can have an older memory if you have something that seemed my cancer at 25 years old in the diagnosis. And now I can talk about it. And it's like it happened. I realized it and some of it was tough, but there's no charge associated with it once you work through it. And it's all like this system and CBD in general could help discharge a charged memory, right? Yeah, and not only that, you said something interesting too. And that is, I'm sure you did a lot of processing. Yeah, therapeutic processing. When you're in fight or flight under the stress response, your rational thinking and your processing really go south because you don't have to think analytically or philosophically or remember a whole lot when you're running away from a lion or a tiger, right? So you're absolutely automatic. You can't think straight. And that's why, by the way, people do really stupid things under stress. We know, you know, like cops who shoot people when they don't mean to, but they're stressed and they're reacting rather than responding rationally. So as we shore up the end of cannabinoid system, your brain comes online and then you can actually process. So in some ways it actually just dissipates the fear just by virtue of biochemistry, but it also gives you the ability to process and to do the lifestyle things that we know we need to feel better to deal with stress and meditation, dancing, socializing, being in nature, all of these things. So that's interesting because I remember learning years ago, like I was always on the go and I'd run and do activities that were high intensity and I had trouble sitting still. Now you're knowing where I'm going with this because that's trauma-based. So I learned over the years that part of me being still, things would come up and they were uncomfortable. So I would never sit still, just go, go, go, go, go. But as I learned that that was part of a trauma response in order to be still and process some of these things, I can see how that kind of CBD would be helpful or the cannabinoid system because it would allow you to sit with your thoughts, your feelings and those kinds of things in process versus run, which is our fight or flight. So that makes a ton of sense. Now how do you use, say someone has never tried them before and they have a post-concussion injury or they're dealing with trauma or they're just, they can't sleep, they're anxious, how would you recommend they start or try that? Would it be just in the bedtime during the day? What would be a typical recommendation for a patient who is struggling with some of these issues? Well, it depends on the issue. If it's insomnia, you'll want to take it close to bedtime, although some people have a paradoxical reaction. And even though it should make you sleepy and it helps you to relax, occasionally somebody gets a little activated. So I say always start taking it during the day anyway or take it on a weekend when it won't matter. And sometimes people will take it to help them focus, which it does beautifully. And they find it makes them drowsy because that's their setup. That's their internal chemistry. So you never quite know what the average is. It'll do both. If you take a CBD, it'll help you to focus during the day and sleep at night and like that. I actually developed my own line of CBD because I wanted to have certain qualities in it. I wanted a good taste. I didn't like the grassy taste of most of the formulas. So I put an MCT oil, which is healing in its own right, and added some essential oil or organic essential lemon oil for flavor. So that's good and organically grown. And in just different formulas, I have something that's a daytime one, and that speaks to what you just asked also, that the daytime one has specific terpenes that are more activating and focusing and the evening one has more calming and relaxing terpenes. And so in the plant, in the cannabis plant, we have not only CBD and THC, but we also have terpenes. And terpenes are a really important part of all herbs, all plants. And it's what gives them their distinctive smell, like oregano, lavender. We smell it and they have medicinal qualities. So it's the same thing with CBD and we can add specific terpenes to boost it even further. And that's what I was going to ask you about. I knew these terpenes and things have been really important and been studied. And I know that your products are really holistic as would we'd expect because they have a little bit more of a spectrum of those active components in them. I actually recommend that people get a bottle of day and a bottle of night and then they can experiment. So basically you start low and slow and gradually build up. So let's say you get a 750 milligram bottle, which is 25 milligrams per ml, which is a whole dropper, but the dropper is marked off in, so it's a measured dropper. So you can actually titrate, start off maybe a half a dropper, a quarter of a dropper, put it under your tongue, preferably close to a fatty meal, because it's fat and it will be absorbed better and digested better because you've eaten some fat. So avocado, salmon, whatever. And let it absorb under your tongue for 30 seconds to a minute. And notice what happens in sort of the next 10, 15 minutes. And you could actually have an effect on your target symptom. It could be the pain goes away, anxiety goes down, whatever it is. And if it doesn't, if that's not enough, then you do another dose. And you can keep going that day or you wait till the next day and try again and increase it more till you find what your dose is. And then you're usually dosing two or three times a day. Yeah. And I want to be clear because you and I both were a little apprehensive years ago when we first got introduced to CBD and the benefits. But for those of you listening, you don't get high from CBD by itself. It's really THC is the component. And again, Dr. Hasse, you can clarify if I'm saying this wrong. But a lot of people are nervous and they've had the stigma around it. And the science in CBD and our cannabinoids to me, it is far safer than most of the drugs we prescribe. So I want to be really clear there that we're not, there's not a component here that makes you feel high in general. I mean, there are products out there that do that. But what we're talking about is the primary, primarily CBD product. Is that right? Yeah. THC, in fact, the cannabis plant has been bred to contain up to 25% THC. That's a lot. I'm really squeezing out the CBD. They don't want CBD. And that's a little dangerous. A lot of particularly young people, particularly trying it for the first time can end up having some really adverse reactions because it's just too much for their system. In the old days, it was more balanced. It may have been grown to have THC in it, but certainly not to the extent that it is now. It reminds me of gluten. They've a wheat. They've bred it to contain a lot more gluten than it used to. So now the US types of wheat that are grown are typically very high gluten and people can go to Europe and have that and not have a reaction whereas here they do. It's a very similar idea as we've actually hybridized some of these products to be more harmful than they were originally meant to be. Exactly. By the way, when you have this reaction, because people become agitated, they even become paranoid and they end up going to the emergency room and they end up getting an injection of very strong psychiatric medication told that they'll have to be on it maybe forever. These are young people and it's such a shame. What really needs to happen is they need to get hold of some CBD and that will neutralize. It actually comes between the THC and the receptor. Wow. So it forces it out in a really good way and takes its place. It's coming, relaxing. It does the exact opposite of what the THC had just been doing. Yeah. Fascinating. Now one last thing and then I want to be sure and ask where we can find your products and we'll put the links in. But there are differences in CBD receptors genetically with people, right? Because some people have. I know I found out recently that I actually don't have a lot of receptors or there's some reason because I have trouble telling a lot with them. Now in patients, I've seen amazing results, but I've always wondered because I think that my receptors, have you seen that? Are there any specific genes you've seen or any genetic components where people are less sensitive or maybe need different types? Usually it's because their endocannabinoid system is low. So you, what you do is you keep titrating up until you get a dose that really works. Okay. And then after a while, you don't have to keep taking really high doses. After a while, the brain, which is this neuroplasticity, the brain adjusts and you may not need as much. To kind of, I would like to sensitize the receptors in someone like that. And then once they have the effect of sleep or less anxiety or whatever else. Now typically when people use CBD for whatever reason that we've talked about, are they off and on using it long term or is it more short term and then they're balanced and then once in a while? What would you typically do? Really, it really depends. Really depends. I know I take it all the time. Yeah. Yeah. Again, I try patients too with pain or whatever else. It's just profound game changer. And like I said, if we compare it to any sort of oxycodone over the counter for pain or the anxiety benzodiazepines, this is such a safe way to go compared to many of the drugs that we use. And the evidence is very strong. Of course. Yeah. Not only that, over my years of practice, what I did a lot of was help people taper off of these medications, which many people should not have gone on in the first place. But using CBD in the withdrawal process is very, very helpful. It helps to regulate the other neurotransmitters. You know, the GABA, serotonin, which are calming and make you feel good. So it balances your neurotransmitters and helps you in a really easy way to taper off the drug. Fantastic. Well, this is tremendous. Where can people find you and your products? And I know people are dying to know and I'll include the link. Tell us more about that. My website is drcast.com, D-R-C-A-S-S dot com. And you'll find a lot of information, a lot of how-to information, background information. I have some blogs. In fact, I have a blog on traumatic brain injury and CBD. And I'm always there. I see all kinds of great resources. And look at this. There's topicals. Tell us about your topicals. I see some facial products. Oh, yes. And, Sav, I have people who just swear by it. Yeah. Put it on, you know, for their joint pain. And it's amazing. Oh, that sounds super helpful. And then I have some face serum for something for your eyes for those wrinkles that happen to show up as we age. And there's also a nice face oil. So it's not oily like it's heavy oil. It's just a nice healing oil that does a lot. There's a lot that CBD does for your skin as well. Yes. Fantastic. I'm excited to try some of those myself. Very good. Good. Well, we will include that link. It looks like I have all kinds of fun stuff. I'm going to go back and take a look at this. Any last words of advice to our listeners? This is just a really important topic. And I think it's such a great alternative to some of the drugs and even whether it's inflammation, pain. Like I said, we talked about neurological inflammation, seizures. I see so many people nowadays with some sort of encephalopathy, whether it's from trauma or from infection or from inflammation. And we briefly talked about before, there's so many patients now with Lyme disease and mold related illness. And this is something that can be very helpful for them too. Is there anything we didn't mention that you can think of that would be another indication or that people might be thinking about that might be a little unusual? I think we covered a lot of that. I mean, it's very good for dementia. It helps to break down amyloid plaque. And it helps to build up BDNF, which is brain derived nerve growth factor. So it actually helps to regrow neurons and connections. So pretty important in our older population. It is. And that is becoming epidemic, isn't it? The early dementia and Alzheimer's. And then of course, you have to treat everything else that's related to dementia. It could be Lyme and mole and all the rest. So it's pretty complicated. I also want to say that I have a gift for your listeners. And that is a 15% discount with the code word Dr. Jill 15. Awesome. Thank you, Hyla. That's exciting. We will be sure and share that as well. So if you guys want to check out her products, I will include that link. And thank you so much for taking the time and energy to talk to us. This is such an important topic. And really, really appreciate you today. And thank you for the opportunity. I just love educating people about CBD. Don't be afraid of it. You know, you start low and slow. You gradually build up and you'll be really happy you did it. Yeah, I couldn't agree more. Thanks so much.