Dr. Michelle Sexton helps us understand how cannabis interacts with the human body’s endocannabinoid system. She also describes the problems and shortfalls with modern day cannabis testing.
[1:47] – Dr. Sexton explains how she got into the field of medicine
[4:44] – Dr. Sexton talks about the endocannabinoid system
[6:02] – What symptoms does CBD help with and how does it react with the body
[10:27] – Dr. Sexton talks about less well known cannabinoids
[12:02] – Dr. Sexton explains her involvement in creating testing guidelines in Washington State
[14:06] – Dr. Sexton talks about the cannabis testing process in Washington
[18:34] – Dr. Sexton discusses cannabis testing procedure
[22:01] – Dr. Sexton talks about an article she wrote on expectant and nursing mothers
[25:56] – The benefits of home birth versus hospital birth
[27:45] – Dr. Sexton explains a spiritual component to the plant
[31:30] – Dr. Michelle Sexton’s contact info
Matthew: Hi, I’m Matthew Kind. Every Monday and Wednesday look for a fresh episode where I’ll take you behind the scenes and interview the leaders of the rapidly evolving cannabis industry. Learn more at www.cannainsider.com. That’s www.cannainsider.com. Do you know that feeling when you sense opportunity, when you see something before most people and you just know it will be successful, then you're ready. Ready for CannaInsider Consulting. Learn more at www.canninsider.com/consulting. Now here's your program.
Our next guest is Dr. Michelle Sexton. Dr. Sexton is a naturopathic doctor, herbalist and formally a midwife currently in private practice in San Diego. She began her formal study of phytochemicals with a degree in horticulture, and has specialized in the phytochemical analysis of botanical medicines. She owns and operates PhytaLab, a cannabis analysis laboratory and served as an editor and advisor on the American Herbal Pharmacopoeia Cannabis Monograph. She has been a consultant to the Washington State Liquor Control Board on the implementation of I 502. Welcome to CannaInsider Michelle.
Michelle: Hi Matt. Thank you for having me today.
Matthew: Sure. To give listeners a sense of geography can you tell us where you are in the world?
Michelle: Well I am a half a mile from the coast in San Diego, California.
Matthew: Oh great. How’s the weather there today, nice?
Michelle: Oh beautiful. In the mid 60s, sunny and the surf is up.
Matthew: Oh good. You have a really impressive resume. Can you tell listeners how you got into this field and what you’re doing day to day now at PhytaLab?
Michelle: Well I have sort of a long and eclectic background. I became interested in natural health when I was actually still a teenager. I was 17 years old, and started reading about herbs and herbal medicine and just practicing that mainly on myself and encouraging other people to take on a position of preventive practices by healthy eating and healthy living and using natural products for enhancing health. And it really was a passion for me. As I grew older, had some children and became very active in the women’s health movement surrounding natural childbirth. I became a midwife and a certified herbalist and was really extending my practice out to the families I was serving beyond just midwifery and women’s health, but often they would… We were just sort of a support group for one another.
This was in West Texas. There was not, you know, a lot of doctors there or alternative health options for us so we were sort of our own support group. And eventually thought that what I would do was have an herb farm and grow medicinal plants, although I was very curious about what made plants medicine. I had no, absolutely no concept of chemistry and decided to go back to school at age 40 to get a horticulture degree, but I didn’t realize that I would wind up in something very different which was research and studying phytochemistry or the chemistry of plants, the actual compounds in the plants and the human/plant relationship, how those compounds interact with the human body. I wanted to extend what I could do so I ended up going to naturopathic medical school at Bastyr University in Seattle, Washington. And got involved in research at the University of Washington in a laboratory studying the endogenous cannabinoid signally system and its role in neurodegenerative and neuroinflammatory disease. And that’s really sparked my interests in cannabis as a medicine.
Matthew: Now you’re really familiar with the endocannabinoid system and it’s something that many listeners may have heard of but they don’t really understand exactly what it is and how it operates and how our body interacts with the compounds in the plant. Can you intro the endocannabinoid system to us and how we should be thinking about it?
Michelle: Well I think a good way to think about the endogenous cannabinoid signaling system or what we call in short the endocannabinoid system is that it’s basically a complete biochemical system in the body. And what this means is that there are protein receptors. Our body synthesizes compounds so there are enzymes creating these compounds to bond to the receptors, and there are signal transductions that when this binding happens there are intracellular events that eventually lead to physiologic adaptations. And then there are enzymes that then break these compounds back down to their original substrates. So that’s the definition of a complete biochemical system in the body.
Matthew: And CBD is a cannabinoid that’s been getting a lot of attention lately and obviously there’s entourage effect. We don’t want to look at CBD by itself, but what kind of symptoms can CBD help and what’s happening in the body when CBD is introduced?
Michelle: Well cannabidiol is a really interesting compound because unlike THC that has a really strong binding affinity for the cannabinoid one receptor. The affinity for cannabidiol for the specific cannabinoid receptors that we know of it’s not a very strong affinity. But it has been found to bind to some other receptors that are considered to be outside of the cannabinoid system such as a serotonin receptor. Serotonin is another neurotransmitter. The endocannabinoids are considered to be neurotransmitters of a type when in the central nervous system. And what’s been shown, you know, basic science, so I’m talking about cell culture models and then again in animal models many of these actions have been shown is that cannabidiol has a neuroprotective potential because it has anti-inflammatory and antioxidant properties and these are really the two most important things for protection of all the tissues in our body.
Cannabidiol hasn’t been shown to have one specific action. It may be acting at various receptors in the body. It may be acting nonspecifically. It may be acting even down to the level of our DNA by turning specific genes on or off. So it has a very broad range of effects which may mean that it has a broad potential as a disease modifying therapy.
Matthew: You mentioned inflammation there. Have you seen any kind of positive results for people with conditions of inflammation or autoimmune diseases firsthand?
Michelle: Well specifically in gut inflammation. So listeners might be familiar with irritable bowel disease or Crohn’s disease. They all sort of are lumped into IBS or irritable bowel syndromes. There’s been many many reports and a little bit of scientific research in humans on the ability of cannabis in general and also cannabidiol to have effects at calming that inflammation and maybe even reversing what might be causing it. One of the most poignant examples, I think, has been highlighted in the media with the children who have intractable epilepsies.
Matthew: Yes, yes definitely seen that.
Michelle: So what’s happening in epilepsy when you have this constant firing of neurons that can’t be turned off, it’s a huge amount of inflammation and radical oxygen species generation which is neurotoxic. And cannabidiol by its anti-inflammatory action or even slowing of seizure appears to be having some profound effects on these kids with regard to their cognition and motor skills and general development.
Matthew: Yeah that’s been amazing to watch the progress of Charlotte’s Web and some of these other CBD rich strains and what it can do for kids with seizures. It’s remarkable.
Michelle: It really is and it’s unfortunate that, you know, it’s not more widely available or there’s not a lot of quality control of some of the product being sold to these parents. That the doctors and neurologists are uninformed or hesitant to be supportive of these families using a botanical medicine.
Matthew: Now we talk a lot about THC and now CBD on the show. But is there any other cannabinoids in the plant that you feel like should be talked about more that don’t have their medicinal benefit highlighted as much as they should?
Michelle: Well you know it might still be a little bit early. Most of what we know about the other cannabinoids, there’s the precursor to most of the cannabinoids is cannabigerol or cannabigerolic acid is the native compound in the plant. There’s cannabichromene is another one. Cannabinol is a breakdown product of THC that’s getting a lot of attention. Still most of what we know, you know, comes from cell culture data, maybe a little bit of animal data is popping up. And there’s this inclination to take that literature and apply it directly to humans. And we know from a lot of pharmacologic research, you know, like in drug development of new synthetic compounds, you may have wildly successful results in an animal model and absolutely nothing or even negative effects in humans. So I think there’s a lot of potential, but I think that we still need more data in humans. I think we need to translate some of that into humans before we start really making that leap.
Matthew: Now switching gears to lab testing, how are you involved in creating the testing guidelines for cannabis in Washington State?
Michelle: Well I first opened my laboratory in 2010 in Washington. That was when I was finishing my post-doctoral fellowship at the University of Washington. And like I said the experience of study the pharmacology really peaked my interest in the growing medical use and particularly what was the composition and the potency of what people were using. And there were only a couple of labs in the US at that time, and it seemed like what I wanted to study I wouldn’t really be able to do at a basic institution because of federal restrictions.
So I thought a laboratory, a private laboratory would be a good way to go about doing the research. So I opened the laboratory and started doing testing. When Initiative 502 passed in Washington State I was contacted early on by the Liquor Control Board for general guidance. I put them in contact with other people and the American Herbal Pharmacopoeia we were in the process of writing a cannabis monograph at that time. And Washington ended up adopting that monograph as guidance in rule for quality control of cannabis in Washington State. And then a little while down the road they contacted me and asked me to write the laboratory certification checklist for labs that would be providing the quality control of the retail product in Washington. So I basically took, the World Health Organization has a document called Good Laboratory Practice. And I took that document and adapted it as a checklist for a certification process in Washington State.
Matthew: Now you feel like the cannabis testing process in Washington State is less than perfect I understand. What’s broken and how can it be fixed?
Michelle: Well you know this isn’t just an issue that is isolated to cannabis testing. You know there’s a lot of lack of oversight for all kinds of laboratory testing out there. Even lab assays that are marketed to doctors often are not FDA approved, and you know sometimes they’re just a sales and marketing tool honestly. And there are problems inherent to the herbal products industry and herbal product testing. I think probably one of the things that could help remedy is just more basic proficiency. So even though we have a checklist of all of these things that a laboratory has to do and how they operate, right now for cannabis testing or maybe even other botanicals, there’s no proficiency testing. So a laboratory may be performing analysis, but there’s nobody checking in to make sure that they’re giving an accurate answer. And so this is a process, you know, a lot of people are up in arms about the testing industry which I find interesting and I think it’s because it’s thought of as well this is science.
There should be nothing wrong with it, and the testing is really providing the general final approval for what goes on the market, but yet the testing proficiency isn’t really there yet. So it’s been a process. You know we did the checklist in Washington. The labs have gone through a process showing that, you know, they’re operating by a set of standards and yet there’s no oversight, there’s no enforcement. And the really important thing is that there’s not proficiency testing. And the reason that there’s not proficiency testing is a good one. It’s because the professional organizations who typically do this have been hesitant to become involved because of the schedule and status of cannabis. But that’s coming to an end, and for instance the American Oil Chemists Society is very interested in helping to design proficiency testing for the cannabis industry.
Matthew: And what are your thoughts about dispensaries or cultivators? Are they doing any kind of lab shopping, going from one lab to the next trying to, you know, get the results that they want instead of what’s there?
Michelle: I think that’s probably undoubtedly true because my PhytoLab we’ve mainly been working with licensed producers in Washington State. They’ve been shopping around a little bit more for the microbial results because the outdoor growing has, you know, challenged their ability to pass the microbial contamination limits that were set by the State of Washington. There seems to be some shopping around going for that, you know, who can get them to pass the test. I think there is, you know, there’s still this drive for these mutant plant varieties of really high THC. And so people do still want the highest THC number that they can get. And you know I hope as the market and the industry and the consumers continue to evolve and mature that this will calm down, that people will realize that maybe that high of THC isn’t what everybody wants or of the highest benefit to every and that these more balanced, you know, in the cannabinoid profile plants will become of interest and desirable to everyone.
Matthew: Now if you were to say what’s the best way to get a sample of cannabis to then have it tested, what size would that be? How many milligrams would you need and how would that need to be taken from a harvest to get it a truly representative result?
Michelle: Well we have a lot of guidance, you know, from agriculture in general. I mean we could look at crops or any field, I mean, it depends on what are the growing conditions, what is the size of your lot, but these things have all been well defined in agriculture for many, many crops. And this is what we looked to when we wrote the American Herbal Pharmacopoeia Monograph. You know, we went to those areas of expertise and tried to apply it to cannabis. In Washington State a lot is defined as five pounds.
And so typically the way that you do this is you take the entire five pound lot and you put it all in one place like you have a sterile tabletop and you mix it all together. You quarter it several times and until you end up with maybe one pound of it. You take a scoop for a random sample and ten grams of a five pound lot would be how the European Union would say to do it. And this is then ground up, homogenized and then you subsample out of that homogenized sample for all the various tests that you do.
Matthew: So you’d be crosscutting somehow or when you say quarter, so you would be kind of mixing this five pounds together so you can get those ten grams or how many grams to get a representative sample? And that’s better than what’s happening now? Is that really not happening in Washington State?
Michelle: No, that was a real failure that for some reason the Liquor Control Board didn’t want to adopt a formal sampling plan. I think that now they’re realizing that was a mistake, and you know it was all starting place, and I think this will all be revisited in the coming months. For instance, you know, one way that laboratories are trying to get business is by saying well we only need a two gram sample, for instance. So it wasn’t mandated what was the sample size that a laboratory should take. It just said up to seven grams. And I don’t even know how they came upon seven grams. I don’t remember the process, but it didn’t match our recommendation from the Pharmacopoeia.
So the problem with that is if you have a two gram sample for five pounds, that’s only .0008% of the lot and so therefore if you used 500 milligrams of that, for instance for microbiologics testing, you would only have about a 1 in 4,500 chance that you would even sample something that could be contaminated. And so this is the reason for having a bigger sample. It’s really an interest of public health and safety.
Matthew: Now you recently wrote an article on Lady Bud I believe about cannabis and expectant mothers or nursing mothers. And I wanted to kind of understand your thoughts around that. Can you kind of summarize what that article was about and how you feel about it?
Michelle: Yeah so that article, I was asked to write that by Lady Bud because I think there is a lot of interest. And there’s a real, you know, we have a real lack of safety data because it’s a difficult area to study. You can’t administer something that might be harmful to a pregnant patient. So most of what’s come out of the research is often viewed through the lens of addiction, and studying mothers who are addicts who are using cannabis for instance. And through the process of learning and my post-doc at the University of Washington, you know, I learned a lot about neuro development and the role of the cannabinoid receptor in the development of the brain. And it has a leading role literally as it’s on the leading edge of neurons as they’re travelling out to make connections.
And so, you know, while we know that THC is a really nontoxic compound, what we do know is that it binds to this cannabinoid receptor with much stronger affinity than the natural endogenous compounds. So if a baby or even a developing fetus is exposed to THC and it’s binding to these cannabinoid receptors right now it’s an unknown for us how it may affect general brain development. And so we don’t know whether it’s good or bad. It’s just an unknown, and the point I think I tried to make was that we don’t know. And so don’t assume that it’s safe, but you know really question and make your own judgment not only about, you know, the potential for your unborn baby or nursing baby to be exposed to THC, but there’s all kinds of things that we need to think about exposures to.
Matthew: What’s your personal opinion taking your scientist and doctor had off, what’s your, do you have a gut sentiment about it at all?
Michelle: Well I think I wrote that in the article as well. I personally I suffered, it was debilitating for me the amount of nausea and vomiting that I had in pregnancy. There was nothing to treat it. I was virtually incapacitated for six to eight weeks of a pregnancy. I had five pregnancies. I kept doing it, and you know what looking back now, and I remember thinking of it several time because I knew at that time that cannabis had been touted as a remedy for nausea. I had no access to it in Texas at that time.
I think that I summed up the article that to really take an approach of the potential risk versus the benefit. If a woman is suffering that badly with really not good options from conventional medicine, it could improve her quality of life and maybe, we know that also CBD, you know, has the same sort of effect on nausea and vomiting. So maybe a high CBD variety used sparingly, given orally so it has a longer effect and that kind of thing might be worth a risk/benefit analysis.
Matthew: Now you have a background as a midwife. I’d be interested to hear how you would compare a traditional hospital birth to say at home with a midwife and kind of the benefits of that because I think there’s a lot of people that have an interest but they’re not quite sure what it is and what it’s like.
Michelle: Oh wow that’s a loaded question. I don’t think the two experiences are anything alike. I think there is even research evidence showing that just the process of a mother leaving her home and going into the hospital setting is a very stressful experience. And when you undergo stress your body releases all these stress hormones and compounds, even inflammatory compounds that probably have an effect on the process itself and maybe even the baby. We know that stress in pregnancy in general isn’t good. And I think the home based experience is the natural experience to have.
I started my career as a midwife as wanting to be an advocate for the mothers, and interestingly by the time I finished my career as a midwife, I had been at home births for about ten years. I got invited to go back to a hospital birth, and I literally cried at how the new born baby was handled by the staff, how roughly and a lack of dignity for this new being in the world. So I think for people that want to be really conscious of their child and they feel that the safest place on the planet for them to give birth is in their own home, that it’s a really really good option.
Matthew: Now going back to the cannabis plant, we talked a lot about the hard science and phytochemicals and your research. But do you feel like there’s a spiritual component to the plant and plant medicine in general.
Michelle: Oh I think there’s definitely that, you know, connection with nature is how many many people define spirituality. And for myself that is true. For me any plant or just the earth in general, you know, treating it with a lot of respect and almost as a piece of humanity is an imperative. And as far as the spiritual connection with cannabis I think many people report that. That it heightens, it seems to heighten their sense, you know, just to the present moment I would say that many of the senses are heightened, the visual experience, olfactory experience, you know, touch and sounds. Everything seems to come more alive and put people in the present moment, and I think when we are brought into the present moment and we’re not thinking about the past and things that happened or what may happen in the future, that that’s when we connect to spirit.
Matthew: You know I wonder why that we evolved to have this endocannabinoid system. It seems like a lot of things in our body there’s a purpose that we evolved to have it. Do you have an theories on that? I mean is there a benefit for survival or is it for communicating with others? I mean this is total speculation, but I would be interested in your thoughts.
Michelle: Well we know that some of the earliest organisms had endocannabinoid systems. So it’s a system that has evolved, you know, as biology evolved. And we don’t know exactly or I personally, that’s not a field I’ve studied. I don’t know what role it played in those simple organisms specifically. I do know that for this endogenous system in humans today, it provides a really important feedback loop not only for neurons and neurotransmission, also for the immune system. And we know that there’s a lot of crosstalk between the immune system and the central nervous system. And we know that there’s this same role in metabolism by this system in the body. So I often describe it the way that people can often relate to it as like a thermometer, and you have a set point. Like on your oven you turn it on to 350 degrees, when it reaches 350 degrees it turns off. It doesn’t just keep getting hotter and hotter and hotter.
And so our neurons need that same thing. There’s neurotransmission and there has to be something to tell the presynaptic terminal okay I got the message, you can quit sending neurotransmitters across the synapse, and that’s what our endocannabinoid system, that’s one role that it has is to take that feedback and got it. And the same way with inflammation. This is what chronic inflammation is. Inflammation gets turned on and for some reason it goes awry and doesn’t get turned off, and the endocannabinoid system has a role in that as well.
Matthew: Fascinating. I love this subject matter. In closing Michelle how can listeners learn more about your lab and follow your work?
Michelle: Oh we have a website www.phytalab.com. We have a Facebook page. My medical practice I have a page on Facebook it’s called Uttermost Health, and I would say those are two of the best ways. I’m also the Executive Medical Research Director at the Center for the Study of Cannabis and Social Policy. And the website for that is www.cannabisandsocialpolicy.org, and what we do there we’re following the legal cannabis market in Washington State, as well as doing some cutting edge medical research and staying on top of the transitional experience of the medical part of marijuana in Washington State right now. So those would be the best ways.
Matthew: Now just for people that may not know how to spell phyto, can you just spell PhytaLabs for us?
Michelle: Yeah it’s www.phytalab.com.
Matthew: Great. Well Michelle thank you so much for being on CannaInsider today. We really appreciate it.
Michelle: Matt, thanks so much for having me. I enjoyed speaking with you.
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