Using CBD to improve athletic performance

The ways cannabidiol (CBD) can support improved athletic performance are still being investigated, but research shows CBD can alter some key physiological and psychological responses to aerobic exercise.  When used in appropriate doses, CBD reduces inflammation and pain, lowers anxiety, and has neuroprotective effects – all of which have the potential to benefit athletes. Additional studies with athletes are needed to better understand how to maximize these effects, but the research done to date provides some guidance. 

A 2023 systematic review of research studies on CBD performance effects found good evidence for using CBD as an athletic supplement (1). The reviewers looked at 127 studies, from which they selected 62 as relevant and well designed. Those included both human trials and the more numerous preclinical studies done with animals.  The review rated the studies for bias and quality of evidence. The reviewers conclude that “cannabidiol exerts some physiological, biochemical, and psychological effects with the potential to benefit athletes.” Specifically, they found that there is “preliminary supporting evidence for the anti-inflammatory, neuroprotective, analgesic, and anxiolytic actions of cannabidiol and the possibility that it may protect against gastrointestinal damage associated with inflammation and promote healing of traumatic skeletal injuries.” The researchers note that most of this evidence was obtained from animal studies using large doses of CBD, so more real-world studies with athletes are needed. 

One such study with trained athletes was conducted recently by Sahinovic and colleagues (2). They recruited nine randomly selected endurance athletes to test the effect of 300mg of CBD on running performance. The runners repeated two trials -- one with CBD, one without –running for an hour at 70% VO2, followed by a more intense run to exhaustion. Neither the athletes nor the researchers knew when the runners were receiving the CBD and when they got a placebo. The study measured the runners’ VO2, Respiratory Exchange Rate (RER), heart rate, blood glucose, lactate, perceived exertion, and how pleasurable/unpleasant they found the efforts. In the 60-minute run, CBD improved the athletes’ VO2, ratings of pleasure, and blood lactate. In the run to exhaustion, CBD improved VO2 and RER (breathing). 

These are not the only identified benefits of CBD for athletic performance. Training effects are a function of both the exercise load of workouts and the ability of the athlete to recover from those efforts. Studies have shown that improved quality of sleep and recovery can have a substantial effect on training gains and athletic performance. 

CBD offers well-established benefits for improved rest and recovery. In a 2023 review of how CBD can enhance performance and recovery, Rojas-Valverde and colleagues looked at a broad range of research showing potential benefits (3). Among the research they evaluated are studies that show CBD can improve sleep latency, sleep continuity, and subjective sleep quality, while also reducing nightmares and insomnia. Athletes are increasingly recognizing the importance of adequate, good-quality sleep for optimal performance, yet studies show that athletes typically sleep less and less well than non-athletes due to training and travel schedules, competition stress, and use of caffeine (6). CBD and other cannabinoids such as cannabinol (CBN) can mitigate all those factors and improve sleep duration and quality. Other studies suggest the anxiety-reducing and antidepressant effects of CBD can also help athletes manage the stress of competition and hard training. 

CBD can enhance performance by acting directly on muscle tissue in helpful ways. The anti-inflammatory properties of CBD can reduce muscle soreness following exercise-induced damage, without risking the kidney damage associated with nonsteroidal anti-inflammatory drugs such as ibuprofen or the liver damage acetaminophen (Tylenol) can cause. Recent investigations of the effects of CBD on muscle tissue suggest that it improves metabolic regulation, and even a modest dose of CBD (60mg) may improve recovery by protecting against the muscle-damaging enzyme creatine kinase and excess amounts of the protein myoglobin (4). 

Insemann and colleagues also found in a study with 16 trained athletes that a single dose of CBD reduced the levels of biomarkers for muscle damage following resistance training and improved a 1-rep maximum squat (5). Those results are consistent with the review of CBD and sports performance conducted by McCartney and colleagues (6), who speculated based on the extensive research with animals that CBD supplementation could help athletes improve by fighting exercise-induced muscle damage, soreness, and injury. They also noted that consistent use of CBD may help protect athletes against head injuries, and that CBD use appears to promote stronger bones and faster healing of fractures. 

The effects of CBD on cardiovacular function are still being investigated, but CBD has been shown to reduce blood pressure by relaxing blood vessels, and animal studies have shown CBD can reduce heart rate in stressful situations (6). This stress-reducing effect may be helpful for athletes who find their hearts racing before competition, as staying calm tends to produce superior performance.   
Even mitochondria, the engines of cellular energy, may be helped by CBD supplementation (6). Animal studies have shown that CBD increases mitochondrial activity. Since exercise is fueled by mitochondrial action, increases should have a positive impact on athletic performance.  

All of these potentially positive effects of CBD on athletic performance are dose-specific and tied to the unique physiology and psychology of the individual athlete. The biologic systems on which CBD and other cannabinoids operate differ considerably between individuals and change over time depending on the demands placed on them. As a result, individualized experimentation is essential to determine an optimal approach to CBD supplementation. In general, the minimum effective dose for any effect from CBD is 25mg, but the doses for athletic performance and recovery are at least double or triple that. 

“Most people are using sub-optimal amounts of CBD due to a combination of a lack of information about effective dosing and the excessive costs of products from many CBD companies,” says Twisted Spoke CBD co-founder Wen Dolphin. “That’s why Twisted Spoke provides considerably more CBD at any price point than competitors. We want everyone to be able to experience the benefits of using CBD at effective doses.”

Twisted Spoke provides CBD supplements in both isolate and full-spectrum formulations. Isolates contain only CBD, while full-spectrum products also include other cannabinoids in trace amounts for a more effective “entourage effect”. For enhanced sleep and recovery, Twisted Spoke offers CBD in combination with CBN, a nonpsychoactive cannabinoid with a pronounced sedative effect. 

1. da Silva Conter, Franciele, Vanessa Nishi Ishikawa, Giovanna Maria Gontijo, Aline Isabela Tiemi Ichikawa, and Paula Bubna. "Effects of cannabidiol on metabolic modulation and improving sports performance: a systematic review." International Journal of Nutrology 16, no. 4 (2023).
2. Sahinovic, A., Irwin, C., Doohan, P.T. et al. Effects of Cannabidiol on Exercise Physiology and Bioenergetics: A Randomised Controlled Pilot Trial. Sports Med - Open 8, 27 (2022). 
3. Rojas-Valverde, Daniel, and Andrea Fallas-Campos. "Cannabidiol in sports: insights on how CBD could improve performance and recovery." Frontiers in Pharmacology 14 (2023): 1210202. 
4. Schouten M, Dalle S, Koppo K. Molecular Mechanisms Through Which Cannabidiol May Affect Skeletal Muscle Metabolism, Inflammation, Tissue Regeneration, and Anabolism: A Narrative Review. Cannabis Cannabinoid Res. 2022 Dec;7(6):745-757. doi: 10.1089/can.2022.0220. Epub 2022 Nov 28. PMID: 36454174. 
5. Isenmann E, Veit S, Starke L, Flenker U, Diel P. Effects of Cannabidiol Supplementation on Skeletal Muscle Regeneration after Intensive Resistance Training. Nutrients. 2021 Aug 30;13(9):3028. doi: 10.3390/nu13093028. PMID: 34578906; PMCID: PMC8469280.
6. McCartney, D., Benson, M.J., Desbrow, B. et al. Cannabidiol and Sports Performance: a Narrative Review of Relevant Evidence and Recommendations for Future Research. Sports Med - Open 6, 27 (2020). https://doi.org/10.1186/s40798-020-00251-0