Choosing the right CBD product: A guide for Maltese users

Since the introduction of the new law in December 2021 allowing importation and sale of cannabinoid products with less than 0.2% THC, the Maltese market has been flooded with hundreds of products available from all kinds of shops including health shops, clinics, vape stores, grow shops, food stores and wellness centres and online through local webites and express delivery couriers. It’s overwhelming for a person who has heard about the health benefits of cannabidiol (CBD) and wants to try it but has no idea where to start.

One may be looking to try CBD because they may be suffering from symptoms where they heard that it may help, or just to reap many of the health benefits it can provide. Numerous research articles show that these cannabinoids have a unique effect on the body by optimizing the function of the endocannabinoid system (ECS). This system is one of the most important in the body since it regulates homeostasis, keeping all systems in the body working in optimal condition. But as we grow older, dysfunctions in the endocannabinoid system may arise due to a number of causes and this may lead to pain, anxiety, digestive issues, allergies or problems sleeping.

The discovery of the ECS in the early 1990s helped us understand many symptoms that were previously dismissed and undertreated. Most commonly, chronic pain, affecting 20% of the adult population is poorly managed and most medications can cause unwanted side effects. It is a common symptom of endocannabinoid dysfunction and can be effectively managed using methods that improve the function of the endocannabinoid system.

To look after the ECS, a good 7-9 hours of restful sleep daily are important together with a diet low in sugar, dairy and gluten, limiting alcohol and caffeine and getting 150minutes of physical exercise a week. Diets low nutritionous food may need supplementation. Cannabinoids such as CBD and CBG (cannabigerol) can optimize the function of the endocannabinoid system through various pathways. People respond very differently to CBD and CBG but their high safety profile gives room for experimentation until the optimal dose and method of delivery is achieved.

When choosing a cannabinoid product, you should aim for something that you think will improve your quality of life. The commonest symptom that it can help with is chronic pain. This could include headaches, neck pain, upper back pain, lower back pain, leg pain or joint pain. It can also help with anxiety issues such as fear of going out, meeting people, stress at work, panic or loss of focus. If you are looking to try and manage another condition or you are taking medication, we suggest you book an appointment so we can discuss further.

If you are always in pain or you have been diagnosed with a chronic pain condition such as fibromyalgia, migraines or irritable bowel syndrome (IBS), or you suffer from chronic anxiety but you are not taking medication, you would benefit from a long-acting CBD product such as drops or a patch. Drops work for 6 hours and patches work for 8 hours making them great options if one needs long-term relief.

If you are looking for a convenient, effective, twice daily dosing, the Phenopatch Body works great during the day and Phenopatch Sleep works great at night. PhenoPatch Mind would be the choice if your primary complaint is anxiety. Alternatively, Ekati 15% CBD oil black can be used as an alternative and this is applied under the tongue with a pipette, starting with 1 drop 2-3 times a day (every 8-12 hours) and tailing up until you feel your best. A maximum of 20 drops per day is recommended. If you don’t like a bitter taste of the black, Ekati 15% CBD white is a better-tasting alternative but is only recommended if you are using it to help with anxiety, not pain.

If you have tried CBD for pain or anxiety and weren’t happy with the results, it would be worth trying CBG oil. CBG is known as the mother cannabinoid and it’s use is more versatile. It has a more potent effect on the ECS and some people respond better to CBG. The commonest conditions where it can help with are anxiety, chronic pain, glaucoma, bladder dysfunction and cancer. CBG is safe, non-intoxicating and can be administered as an oil taken under the tongue or vaporized and inhaled. It comes in 2 doses, 5% and 15%.

When cannabinoids are combined, they act synergistically and provide a more potent therapeutic effect. This is known as the entourage effect. This is the reason why at Medifood, we only choose full-spectrum formulas, all of which contain less than 0.2% THC. However, that 0.2% THC, together with higher percentages of cannabinoids such as CBD, CBG and CBN (cannabinol), terpenes, flavonoids and other minor cannabinoids, make the Ekati combination oils a great choice when there is no response with CBD or CBG alone.

In 2020, Ekati came up with a formula containing full-spectrum CBD 10% and CBN 5% to help patients who needed a stronger alternative to CBD alone. Since then, it has been the most potent formula that has been recommended for pain. We called it Ekati Forte (CBD:CBN 2:1) and recommend it in a dose of 1-5 drops 3 times a day under the tongue, starting with 1 dop twice a daily and tailing up slowly until the desired effect is achieved up to a maximum of 15-20 drops daily.

Two years later, Ekati developed more formulations now combining CBD with CBG in a ratio of 1:1 which they called the Elixirs. These formulations come in two options, a 10% and 20%. Depending on the severity, one can use these Elixirs for pain, anxiety, stress and problems sleeping.

Besides the oils and patches, capsules also offer long-term relief lasting up to 8 hours and are available in doses of 20mg or 50mg per capsule. Suppositories provide a quick onset and long-lasting effect providing a high dose of CBD directly into the blood stream through the rectal mucosa.

If one is looking for quick and effective relief from symptoms, vaporizing is the preferred method of consuming CBD and CBG. PhenoPen Mind is the product of choice if CBD is being used to manage anxiety conditions such as panic where a rapid onset of effect is important. If CBD is being used to quickly relieve pain, PhenoPen Body would be more appropriate. For those insomniacs that cannot fall asleep or need to fall back asleep when waking up in the middle of the night we would recommend PhenoPen Sleep. Sufficient restful sleep is not always achieved with CBD and CBG. Sometimes a formulation with CBN may be more effective. However, if sleep is not optimal, we suggest checking if you are eligible for medical cannabis so we can apply for a permit to access THC (tetrahydrocannabinol).

For topical relief from nerve pain or some other form of muscular discomfort, Ekati have formulated a pain relief cream called Algos using a combination of CBD and Capsaicin. They also have another formulation called Derma which helps with skin conditions such as eczema and psoriasis.

We hope this gives you a better understanding of how you can choose the best cannabinoid product to help you achieve the best version of yourself by minimizing your symptoms and improving your health and well-being. If you need further guidance, feel free to reach out to us by phone, message or email or make an appointment and we can guide you to find the best product for your needs.

Dr Andrew Agius is the founder and medical director of The Pain Clinic and the co-founder of Medifood Malta. He has been recommending CBD products to his patients since 2016 and has seen a lot of benefits over the years. His aim is to help his patients manage their symptoms better and achieve their optimal state of well-being.