Cannabis is finally receiving the attention it deserves as a potent plant-based medicine, and now, as a powerful plant-based nutrient source.
With 33 states and Washington, D.C., operating medical cannabis programs and 11 states and Washington, D.C., allowing for recreational adult cannabis use, patients are rapidly gaining access to the cannabis plant in more ways than ever before. Many medical and recreational programs now allow for the home cultivation of cannabis, which gives patients and consumers an increased opportunity to access all parts of the plant.
Traditionally, consumers have been most familiar with dried, cured cannabis flower buds. Today, more and more people have access to raw cannabis in the form of living plants, fan leaves, sugar leaves, raw flower buds, fresh leaf trim, seeds, stems, stalks, and more. This increased access to fresh plant matter and the widespread acceptance of the cannabis plant as a whole has provided us with the opportunity to consider cannabis not only as a plant-based medicine but also as a plant-based superfood. While the dietary use of the raw cannabis plant can be traced back thousands of years, researchers are just beginning to explore the powerful health benefits of cannabis in its raw form and understand how it may play a pivotal role in the realm of plant-based nutrition.
William L. Courtney, MD, the leading expert in raw cannabis, believes that cannabis arguably may be one of the most nutrient-dense plants to exist and that raw cannabis leaves and buds provide many of the nutrients believed to be vital for a healthy life. In addition to having many nutritional benefits that are typically associated with dark green leafy vegetables, the cannabis plant also contains unique phytocannabinoids. It’s believed that these phytocannabinoids provide invaluable contributions to health maintenance and restoration.
Courtney speculates that the raw version of cannabis activates the endocannabinoid system more effectively than does dried, cured, and combusted cannabis.1 Many believe consuming raw cannabis is significantly less harmful and more beneficial than smoking, and many enjoy the plant’s nutrient-dense properties. Another reason patients and clinicians alike prefer cannabis in its raw form is that it presents a low chance of inducing an intoxicating experience. This allows for greater dosages to be administered without causing the patient unwanted side effects.
Following is a discussion about research pertaining to the nutritional value of raw cannabis, various ways to prepare and consume raw cannabis, and what clinicians should know when discussing raw cannabis consumption with their patients.
Nutritional Value of Raw Cannabis
Outside of the frequently studied hemp seed, raw cannabis leaves and flowers could be considered one of the most nutrient-dense foods on the planet. The raw plant material contains essential fatty acids, nine essential amino acids, dietary fiber, enzymes, vitamins, minerals, flavonoids, carotenoids, terpenes, and phytocannabinoid acids, all of which have the potential to benefit health.1,2
Raw cannabis leaves, stems, stalks, and seeds can provide the body with almost all of the essential nutrients including carbohydrates, protein, fat, water, vitamins, minerals, trace amounts of calcium, sodium, potassium, and omega-3 fatty acids.2 Compounds in raw cannabis, particularly the phytocannabinoid acids, could be looked at as essential nutrients, rather than merely as therapeutic drugs. This takes raw cannabis out of the medical domain and transports it into the nutrition domain, where it’s then viewed as a nutrient source similar to a dark green leafy vegetable.
A lack of factual nutrition information for raw cannabis plant matter is likely due to the current illegal status of cannabis but may also be attributed to the fact that there are vast compositional difference among both plants and the locations of the samples taken from the plant. Different strains of the cannabis plant can contain greatly varying quantities of phytocannabinoid acids and phytonutrients. The flowering tops and leaves of the female cannabis plant contain significantly greater quantities of phytocannabinoid acids than do the stalks or stems, and the seeds of the hemp plant contain significantly more protein and omega-3 fatty acids than the stalks or stems. This makes accurate assessment and analysis difficult.
Beyond Essential Nutrients
Raw cannabis contains not only important phytonutrients but also phytochemicals and other compounds that may promote good health. Many of these compounds, eg, chlorophyll and terpenes, can also be found in other fruits and vegetables, but phytocannabinoid-derived acids are unique to the cannabis plant and are not found in other nutritive vegetation.3
Terpenes
All plants contain volatile organic compounds or aromatic essential oils called terpenes. Terpenes not only determine the aroma and taste of the plant material but also have their own medicinal properties, including powerful anti-inflammatory activity.4 Different chemotypes, or strains, of cannabis can have a distinctive composition and concentration of terpenoids. Compared with traditional dried forms of cannabis, raw cannabis retains most of its terpenes, lending to the potential health benefits of consuming raw cannabis.
Chlorophyll
Chlorophyll, the most abundant pigment in plants, is responsible for the bright green color associated with juiced greens such as kale, celery, and cannabis. Chlorophyll has been studied for years for its role in health promotion. With its structure similar to that of hemoglobin in the blood, chlorophyll has plenty of other benefits including preventing DNA damage, promoting detoxification within the body, treating inflammation, and possibly helping prevent certain types of cancer.5 Compared with traditionally dried and cured cannabis flower, raw cannabis leaves and flower buds retain the most chlorophyll.
Phytocannabinoid-Derived Acids
Raw cannabis plant material contains select powerful disease-fighting compounds known as phytocannabinoid-derived acids that aren’t found in other nutritive vegetation. The only other phytocannabinoid that’s been discovered to also exist in plants other than cannabis is beta-caryophyllene.3 Phytocannabinoids can come in neutral (also known as activated) forms of THC or CBD or as acid precursors, called tetrahydrocannabinolic acid (THCA) or cannabidiolic acid (CBDA). The acidic precursors THCA and CBDA are naturally abundant in raw cannabis.
Raw cannabis contains THCA, a nonintoxicating substance that can be converted into the intoxicating substance THC through the decarboxylation process.6 This process also converts CBDA into CBD, although both forms remain nonintoxicating in their respective states. While the cannabinoids CBD and THC have been the focus of evidence-based research in recent years, their phytocannabinoid acidic forms CBDA and THCA are beginning to gain attention for their biological activities and significant potential as a therapeutic agent.
Potential Benefits of THCA
The most abundant cannabinoid acid found in raw cannabis is THCA. It’s devoid of potential intoxicating activity; however, research supports its potential anti-inflammatory, analgesic, and antiemetic actions.
Anti-Inflammatory
In mouse studies, THCA has been identified as an anti-inflammatory agent and it also has the ability to act as a bronchodilator, antipyretic, and antirheumatic agent. While earlier reports suggested that THC and CBD can stimulate the production of proinflammatory eicosanoids, it was then reported that its metabolites, such as THCA, could inhibit this process, suggesting that the acid is an anti-inflammatory agent in and of itself.7
Analgesic
THCA has also been studied for its use as an analgesic. In another mouse study, both THC and THCA were administered orally at a dose of 20 mg/kg. It was shown that after 30 minutes, the acid form of THCA showed an effect twice as potent as the neutral form THC.8
Antiemetic
THCA has also been studied for its antiemetic properties, possibly suggesting that THCA may be a more potent alternative to THC in the treatment of nausea and vomiting in rats. This study further supports the theory that THCA in its acidic form is not intoxicating like it is in its active form, noting that “THCA did not induce hypothermia or reduce locomotion, indicating non-CB1 agonistlike effects.”9
Potential Benefits of CBDA
Like THCA and THC, the cannabinoid acid found in raw cannabis CBDA produces CBD. Research suggests that like THCA, CBDA has potential therapeutic applications that are nonintoxicating in nature.
Anti-Inflammatory
CBDA has many of the same properties as THCA, but it’s also an inhibitor of cyclooxygenase-2 (COX-2), an enzyme that plays a very important role in inflammation. Studies suggest that the naturally occurring CBDA found in raw cannabis is a selective inhibitor for COX-2, similar to common nonsteroidal anti-inflammatory drugs, and can therefore play a therapeutic role in the treatment of acute and chronic inflammation.10
Antitumor
CBDA has been studied for its ability to fight against the mutation of tumoral cells in breast cancer patients. In one study published in Toxicology Letters, it was determined that “CBDA offers potential therapeutic modality in the abrogation of cancer cell migration, including aggressive breast cancers.”11 While more research is needed, this is a promising therapeutic option to explore for the quarter of a million women who are diagnosed with breast cancer in America each year.12
Antiemetic
In a study conducted on rats, it was discovered that CBDA not only offers “promise as a treatment for nausea and vomiting, including anticipatory nausea for which no specific therapy is currently available,” but also displays significantly greater potency at inhibiting vomiting compared with CBD.13 This result is promising and signals the need for further research into CBDA and the role it can play in both chemotherapy-induced nausea and vomiting and cannabis hyperemesis syndrome.
While the evidence is preliminary, phytocannabinoid acids, such as CBDA and THCA, show promising potential for the growth and evolution of cannabinoid medicine.
Cannabis is no doubt a therapeutic tool, but dosages, consumption rates, and quality of life can vary greatly based on a person’s tolerance of activated THC. By eliminating the intoxicating effect, we are able to better utilize THCA at much higher doses for increased therapeutic results without compromising the patient’s quality of life.7 Many patients are unable to tolerate even very small amounts of THC due to its intoxicating effects, which could potentially interfere with their daily activities, even when THC improves several symptoms. The absence of an intoxicating feeling along with the presence of the cannabinoid acids and their potential health benefits allows for very high doses of THCA to be consumed without undesired side effects.
How Does Cannabis Affect the Immune System?
How to Prepare Raw Cannabis
There are many practical consumption methods clinicians can recommend to patients who desire to consume raw cannabis and have access to it. Patients can incorporate cannabis into their daily diets, like any other dark green leafy vegetable, by consuming it in its whole form. Some patients enjoy the taste of fresh cannabis on its own, while others may need to mask the strong taste with other familiar flavors for increased palatability.
Dark Green Leafy Vegetable Preparation
Raw cannabis leaves can be used in the same manner as other dark green leafy vegetables such as spinach, arugula, kale, Swiss chard, or collard greens. The fresh leaves can be washed and added to a recipe whole, for example, in a smoothie or salad, or used to garnish a dish in the way that any other fresh herb might be used.
Fresh cannabis leaves can also be cooked into a recipe, such as sautéed cannabis greens. Many patients prefer to cook their fresh greens, like any other vegetable, for taste and texture. When cooking fresh cannabis leaves, it’s important to remember that enough heat and time will decarboxylate the CBDA and THCA into THC and CBD, respectively.
The higher the temperature, the less time that’s required to reach decarboxylation. Additionally, CBDA and THCA both decarboxylate at a different time and temperature, making the cooking process complex if the ultimate goal is to retain the acidic forms of the cannabinoids. Because THCA begins to decarboxylate first at 220° F, the temperature involved in any cooking method should be kept lower than 220° F for a relatively short period of time.14 Using a digital thermometer in the kitchen can help keep the temperature within a safe range that will not convert the acidic form into the active form.
Juice Preparation
A popular method of consuming raw cannabis is to prepare a juice from the fresh leaves and flower buds of a mature cannabis plant. It’s recommended to use a masticating juicer that will extract the juice from the plant by gently crushing the plant material. This process is slower than that involving the use of a traditional centrifugal juicer and is less likely to result in spontaneous decarboxylation.
One major drawback to juicing is the lack of access to fresh leaves and the number of fresh leaves required to make a single serving of juice. Courtney recommends using anywhere from 15 to 30 leaves to produce a single serving of raw cannabis juice, which may be expensive or unattainable for many cannabis users depending on what state they live in.1
Precautions
There are a few precautions about safety and side effects that must be raised when discussing the consumption of raw cannabis with patients. Educate them about the importance of consuming only clean raw cannabis. Like any lettuce or vegetable, raw cannabis has the potential to carry microbes such as Salmonella and E coli from their growing environment to the point of human consumption. This is especially important to discuss with patients who are immunocompromised.
Courtney recommends advising patients to first ensure their raw cannabis comes from a reliable, reputable source; otherwise, they may risk ingesting unwanted pesticides, fungicides, and other harmful microbes. Once the plant material is obtained, the leaves should then be soaked in a mixture of cold water and apple cider vinegar to help eliminate any potentially harmful bacteria.
Anecdotal patient reports also suggest that raw cannabis can be mildly irritating to the digestive tract. Although this side effect is rare, it may occur and it’s important to inform your patients about it.
Is Raw Cannabis Intoxicating?
It’s generally accepted that phytocannabinoid acids (THCA and CBDA) are nonintoxicating. However, there are many anecdotal reports from patients who consume raw cannabis leaves or cannabis juice and, in fact, have experienced intoxicating effects.
While each individual has a unique endocannabinoid system and tone that accounts for different perceptions of feelings, the explanation for intoxicating effects may be unintentional decarboxylation.15 In decarboxylation studies of the acid CBDA, decomposition of cannabinoid acids can be attributed to light, air, heat, and/or time.14 It’s hypothesized that the heat generated from a centrifugal juicer is enough to decarboxylate THCA into THC and thus produce an intoxicating effect. This is important for clinicians to keep in mind when discussing raw cannabis and various preparation methods with clients.
The Role of the Clinician
As a clinician, your role is to educate and guide your patients to the safest, most effective cannabis application method for their unique situations. As medical and recreational cannabis use grows across the country, it becomes imperative that clinicians are able to discuss the multitude of ways cannabis can be used and consumed and advise patients about how to prepare and consume raw cannabis.
A Multidisciplinary Approach
As knowledge of cannabis expands from plant-based medicine to plant-based nutrition, it’s likely that a multidisciplinary team approach to health care will be most beneficial for both patients and the clinicians. Physicians, nurses, and those in direct patient care can increase quality of life for their patients by consulting with a registered dietitian nutritionist who is cannabis competent.
Continued Research Is Needed
Despite growing state support for cannabis use and mounting scientific evidence about its effectiveness, cannabis is still illegal under federal law and continues to be classified as a Schedule I controlled substance. Thus, cannabis research is harder to come by in the medical realm and virtually nonexistent in the nutritional realm. Up-to-date, factual nutritional information and analysis of cannabis bud flowers, leaves, and roots is grossly lacking and desperately needed.
