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CBD and Essential Oils for
Hearing Loss, Tinnitus and Vertigo
Robert M. DiSogra, AuD
Audiology Consultant
Millstone, NJ
www.drbobdisogra.com
Disclosure I
There are no non-financial
relationships to disclose for this
presentation
Disclosure II
Robert M. DiSogra and
Louisiana Speech-Language-
Hearing Association
do not endorse any of the products
mentioned in today’s program
The content of this program is
for educational purposes
Disclosure III
Disclosure IV
Robert M. DiSogra is receiving an
honorarium for
today’s program
Millstone
2 3
1
4
#1
Recognize the Role that the
Food and Drug Administration
has in regulating CBD and
Essential Oils (EO)
Learning Outcomes
#2
Recognize the potential risks
of using CBD oil or an EO
when there is no evidence-based
research to support the
manufacturer’s claims
Learning Outcomes
#3
Use effective counseling techniques
for patients interested in using
CBD oil or an EO
for their auditory/vestibular
complaint(s)
Learning Outcomes
Outline
1. Essential oil (EO) history and overview
2. What’s makes an oil “essential?
3. How safe are EOs?
4. EO internet health claims
5. Marketing EOs
Outline
6. Cannabidiol oil (CBD) history, the law,
public interest and safety
7. CBD oil internet health claims
8. Marketing CBD oil
9. Ethics for Audiologists (EO and CBD)
10. Counseling your patient
Plant Oils
Used in
Traditional
Chinese
Medicine
(TCM)
>3000 years
Extracting the Oil by
Steam Distillation
Necessary? Vital? Critical?
Imperative? Integral? Needed?
Must-Have? Required?
All Important?
What is an Oil?
Paracelsus von
Hohenheim
1493-1541
Swiss Alchemist
Proposed
alternative
treatments for
sickness
Definition of “Essential Oil”
The “essence” of
an oil is its
flammability
(volatility)
“Essential Oil”
Definition of “Essential Oil”
Definition of “Essential Oil”
Complex mixture
of volatile
compounds
Abundant in
aromatic plants
and vegetables
Volatility
“A rapidly evaporating
oil of plant derivation”
Volatile oils are also
referred to as
“aromatic oils”
www.activationproducts.com/blog/what-are-volatile-oils
No FDA Definition for
“Essential Oil”
Introduced into
any natural
opening of the body
Alcohol – Ethanol
- aromatic
- product of
fermentation
Major Components of Essential Oils
Amines – Derived from ammonia
- pungent smell
- found in both pharmaceutical
and cleaning products
Major Components of Essential Oils
Aldehydes – Latin: alcohol dehydrogenatus
Aromatic
- Cinnamaldehyde
- Cilantro
- Vanillin
Major Components of Essential Oils
Esters – Organic compounds
Fatty acids
Major Components of Essential Oils
Ketones - Produced naturally in the liver
- Alternative fuels for the body
- Used in industrial solvents
Major Components of Essential Oils
Oxides - Binary compounds of oxygen
with another element
example: CO2 or H2O
Major Components of Essential Oils
Phenols (Phenolics) – Vapors can be
irritating/edematous to lung
tissue
- Antiseptic use (Jos. Lister)
- Can be used as an anesthetic
(Propofol)
Major Components of Essential Oils
Major Components of Essential Oils
Terpenes – Class of organic compounds
Produced in cone-bearing
seed plants such as trees
Strong odor
How Safe Are Essential Oils?
FDA is not
required to
approve EOs or
cosmetics before
they go on the
market…
How Safe Are Essential Oils?
However…
EOs must be safe
when used
according to the
label’s directions
which means….
How Safe Are Essential Oils?
Mfgrs. have legal
responsibility for
safety & proper
labeling but it is
not required
by federal law!
How Safe Are Essential Oils?
www.fda.gov/Cosmetics/ProductsIngredients/Ingredients/ucm388821.htm#how
Do EOs ‘Go Bad?’
YES!
EOs will degrade
overtime and lose
potency if not stored
properly (according to label
directions and
in a dark location)
(77 F)
No national or
international
organization oversees
or certifies
the quality, purity
of EOs
Some EO Facts
Therapeutic or Clinical Grade?
It’s a marketing term!
Any company can say
their oils are
“therapeutic grade”
Usually it’s an
“in-house”
certification
www.planttherapy.com
Essential Oil Is ‘Graded’
(by whom?)
Grade A – Therapeutic Grade
Grade B – Natural/Food Grade
Grade C – Perfume Grade
Floral Waters (Low Quality)
The correct term should be
“Aromatherapy Grade”
doTerra is a private company that
trademarked this term and seal!
Designed it to resemble the seals that
are from independent bodies
®
"CPTG“
Certified Pure Therapeutic Grade
What to Look for from an EO Mfgr.
Common name
Latin name
(exact genus and species)
Country of origin
What to Look for from an EO Mfgr.
What part of plant was processed?
Type of Extraction
(distillation or expression)
How it was grown?
(organic, wild-crafted, traditional)
Essential Oils Are Classified as FOOD
Because They Are PLANT-BASED!
American College of Healthcare Sciences
Portland, OR
On-line degree
Aroma Therapists Use
the Term
“Essential Oil”
Is an Essential Oil a Drug?
YES!
If it is intended for a therapeutic use (i.e., relieves tinnitus, eases pain,
relaxes muscles,
treats depression or anxiety,
or helps you sleep)
The fact that a
fragrance material or
other ingredient comes
from a plant doesn’t
keep it from being
regulated as a drug
Is an Essential Oil a Drug?
DRUG
intended to treat
a disease or
prevent illness
Is an Essential Oil a Drug?
Biological Activities of EOs
Nychas G.J.E. Natural antimicrobials from
plants. In: Gould G.W., editor. New Methods
of Food Preservation. 1st ed. Blackie
Academic & Professional; London, UK: 1995
Biological Activities of EOs
Koh K.J., Pearce A.L., Marshman G., Finlay-Jones J.J., Hart
P.H. Tea tree oil reduces histamine-induced skin inflammation.
Br. J. Dermatol. 2002;147:1212–1217
Biological Activities of EOs
Aruoma OI. Free radicals, oxidative
stress, and antioxidants in human
health and disease. J Am Oil Chem Soc.
1998;75:199–212
Biological Activities of EOs
Maruyama N., Sekimoto N., Ishibashi H. Suppression of
neutrophil accumulation in mice by cutaneous application
of geranium essential oil. J. Inflamm. 2005;2:1–11
Biological Activities of EOs
Dhifi W, Bellili S, Jazi S, Bahloul S, Mnif W. Essential oils’
chemical characterization and investigation of some biological
activities: a critical review. Medicines (Basel). 2016 Dec; 3(4): 25
Essential oils “represent a new option in
the treatment of inflammatory diseases”
EO Disclaimer
The information is not intended or implied
to be a substitute for professional
medical advice, diagnosis or treatment…
EO Disclaimer
All content, including text, graphics, images
and information, contained on or available
through this web site is for general
information purposes only…
EO Disclaimer
For any health queries,
please consult your doctor or
qualified health care provider…
EO Disclaimer
The MiracleofEssentialOils.com
is not responsible nor liable for
any advice, course of treatment,
diagnosis or any other information,
services or products that you
obtain through this site.
www.themiracleofessentialoils.com/essential-oils-for-vertigo/
“The Publisher
cannot accept
responsibility for
any injury or
mishap to persons or
property from the
use of any methods,
products,
instructions or ideas
referred to within
this publication.”
Yes, It’s
MOLD!
Yes, It’s
MOLD!
The Role of the FDA
“These statements have not been
Evaluated by the FDA…
…this product is not intended to treat,
cure or prevent any disease”
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat or cure any disease.
Australia
(EOs) are classified and regulated under the
same policies as conventional medicines
Dunning T. Applying a quality use of medicines framework to using essential
oils in nursing practice. Compliment Ther Clin Pract, 2005 Aug;11(3):172-81.
So Who Regulates EO
Advertising Claims?
“Consumers should be suspicious
of products that claim to treat a
wide range of diseases…”
FDA Office of
Regulatory Affairs
“Scientific research
indicates that essential
oils cannot treat or cure
any chronic disease or
other illnesses”
Lee MS, Choi J. Aromatherapy for health care: an
overview of systematic reviews. Maturitas. 2012, 3 (71):
257–260
“Personal testimonials
are no substitute for
scientific evidence”
FDA Office of Regulatory Affairs
Searching the
Internet for EO
Information
Deceiving Internet Ads
Deceiving Advertising
SPRAY VIBRATING DEVICE
Approved for Tinnitus Relief?
FDA Registered?
All businesses
wanting to sell
any healthcare
product must
REGISTER
with the FDA
Approved for Tinnitus Relief?
Once
REGISTERED
with the FDA,
the FDA now
allows or
“approves” the
company to sell
their product(s)
Approved for Tinnitus Relief?
The company is
“FDA approved”
for selling the
product but the
product is not
approved for
tinnitus relief!
Marketing
Essential Oil
Amazon.com - Page 1 of 7
75 items/page = 500+ products!
Herbs, supplements
and oils
are exempt from
rigorous federal
regulations and
testing (required for products
classified as
prescription drugs)
REMINDER!
Essential Oil Research
As of 6/3/2020
National Library of Medicine
21,117 Studies
Essential Oil Research Specifically
for HL, Tinnitus and Vertigo
As of 6/3/2020
National Library of Medicine
No Published Research
Abu Ali al-Ḥusain Ebn Abdullah Ebn Sina
(980 –1037 AD)
Known as Avicenna
Medical Writer
“Canon of
Medicine”
Lily oil and Spotted Orchid oil are
mentioned as remedies for tinnitus
Outline
1. CBD Oil Overview and History
2. Why is CBD Oil Such a Hot Topic?
3. Research
4. Health Claims
5. Marketing CBD Products
6. CBD Products
7. Counseling
Cannabidiol (CBD) Oil
A low Tetra-Hydro-Cannabinol
(THC)
Derived from
cannabis sativa
Extracted from flowers, leaves
and buds of Cannabis plants
(marijuana or hemp)
Hemp plants are
similar
to marijuana
plants, but contain
much lower levels
of THC
THC causes a
psychoactive high
in marijuana users
CBD users do not
experience a high
Cannabidiol (CBD) Oil
Why So Much Interest in CBD Oil?
Congress passed the
Agriculture Improvement Act (aka The Farm Bill of 2018)
June 2018
Hemp removed from the
Controlled Substances Act
of 1970
Opened the door
for marketing the
non-narcotic aspects
of hemp
June 2018
Hemp is no longer listed as a
Schedule I Controlled Substance
Chapter and Verse
The first and only CBD-based drug,
Epidiolex,
was approved by the FDA
June 2018
Oral solution
Tx of seizures
associated with two
rare types of
epilepsy:
Lennox-Gastaut Synd.
and
Dravet Synd. GW Research Ltd.
June 2018
Put the spotlight on CBD and hemp oils
CBD and
hemp oils
June 2018
“Although studies examining the specific
therapeutic effects of CBD are increasing,
clinical data do not support the popular
uses of CBD for…
CBD Oil Research
As of 6/3/2020
1 Study (PTSD)
CBD Oil Research for
HL, Tinnitus and Vertigo
As of 6/3/2020
None!
Plant-based herbal products are
not classified as drugs
by the FDA
Classification: FOOD!
They are from the
rigorous regulations and testing
required for prescription drugs
Marketing
CBD Oil
Estimated CBD Oil Sales
$16.32 billion
by 2026
Rose B. CBD marketing 101: strategies for sellers to stand out in a
Sea of green. https://www.bigcommerce.com/blog/cbd-marketing.
Accessed 1/10/2020
Marketing
CBD Oil
What Mfgrs.
Cannot Say
Manufacturers and “Cannapreneurs’’
Cannot Make Health or
Medical Claims
OR
Untested Assumptions (advising pts about
treating HL, tinnitus,
vertigo, etc. with CBD)
WARNING!
Cannot Have
User Testimonials
Cannot Sell CBD
as a
Dietary Supplement
WARNING!
Manufacturers and “Cannapreneurs”
How Is CBD Supplied?
Does CBD Oil Go Bad?
YES
Will degrade
overtime
Will lose potency if
not stored properly
(77 F)
Price Range: $20 - $300+
Books
“…expert in Alternative
and Herbal Medicine”
“…has carried out
expensive [italics added]
research on alternative
medicine” [extensive?]
NOTE
No publications by
Karl Burmer
in PubMEd data base
6/3/2020
CBD OIL FOR
MENIERE'S DISEASE:
Effective Remedy for Vertigo,
Tinnitus and Progressive Deafness
Title Same Topic on PubMed
CBD Oil for…
Alzheimer’s 0
Asthma 0
Back Pain 0
Bipolar Disorder 1 (case report)
Cancer treatment 4 (pain reduction)
Costochondritis 0
Crohn’s Disease 1
Cystic Fibrosis 0
Endometriosis 1 (pain reduction)
Hemorrhoids 0
Hepatitis 0
Neurogen. Disease 1 (Huntington’s
Disease)
Pancreatitis 1
Pneumonia 0
Stroke 0
NOTE
No publications
in the
PubMed data base
for
Vertigo, Tinnitus and
Progressive Deafness
6/3/2020 CBD OIL FOR
MENIERE'S DISEASE:
Effective Remedy for
Vertigo, Tinnitus and
Progressive Deafness 150
User testimonials are not a substitute
for evidence-based research
IT WORKED FOR ME…IT CAN WORK FOR YOU!
1993
MedWatch Program
A voluntary reporting system for adverse
drug and dietary supplements reactions
Can be filed by health
professionals and consumers
EO/CBD Oil Side Effects
www.fda.gov/medwatch
1.800.FDA.1088
Can Audiologists Sell
EOs or CBD Oil To Their Patients
With HL, Tinnitus or Vertigo?
“Can I offer essential oils or CBD
products to my patients for HL,
tinnitus or vertigo?”
“If my patients can buy these
products online why not
let me sell them?”
Code of Ethics
Oils and Ethics
Principle of Ethics I
Rules of Ethics
K. Individuals shall dispense
products only when benefit
can reasonably be expected.
Principle of Ethics III
Rules of Ethics
F. …statements to the public shall
not contain misrepresentations
when advertising, announcing,
and promoting products.
Oils and Ethics
Oils and Ethics
PRINCIPLE 4
Members shall provide only
services and products that are in
the best interest of those served.
Oils and Ethics
PRINCIPLE 5
Members shall provide accurate
information…about the services and
products offered.
Oils and Ethics
Oils and Ethics
PRINCIPLE I
Members shall fully inform
patients of the nature and possible
results of … products sold
Oils and Ethics
PRINCIPLE III
Rules
Members shall provide only those
procedures, products and services that,
according to the member’s best
professional judgment, [italics added]
are in the best interests of the patient.
Oils and Ethics
SUMMARY
How Do EOs Help
HL, Tinnitus or Vertigo?
They Don’t!
Counseling Your Patients
FDA has not
approved any
Essential Oil
or
CBD Oil
for HL, tinnitus
or vertigo
Counseling Your Patients
User testimonials
and
non-scientifically
proven statements
may be very
convincing
however…
Counseling Your Patients
…there is no published
evidence-based research
that shows
EOs and CBD products
are effective for HL, tinnitus,
or vertigo
PubMed – 4/28/2020
“Care must be taken when directing
patients toward CBD products…
…there is little regulation, and studies
have found inaccurate labeling…”
VanDolah HJ, Bauer BA, Mauck KF. Clinicians’ guide to
cannabidiol and hemp oils. Mayo Clin Proc. September
2019;94(9):1840-1851
Grinspoon, P. Cannabidiol (CBD - what we know and
what we don’t). Harvard Health Blog. August 27, 2019
Further Reading
THANK YOU!
www.drbobdisogra.com