When it comes to the things we put into our bodies, we all want to make sure that the product is safe. This is no different when it comes to CBD oil, and in today’s article, we’re going to explore the potential side effects of CBD. You’ll learn about the safety profile of CBD, what side effects can occur, and why CBD and prescription medications don’t always mix well.
Contents
1. The Safety Profile of CBD
1.1 A Critical Review of CBD by the World Health Organization
1.2 Epidiolex Research and CBD
1.3 A Flood of CBD Safety Studies
1.4 Looking toward 2021
2. The Side Effects of CBD
2.1 Clinical Side Effects
2.2 CBD on an Empty Stomach
3. Interactions with Prescription Medicines
3.1 Medications That Don’t Mix Well with CBD
3.2 A Note on Topical CBD
4. Final Thoughts on CBD Oil Side Effects
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1. The Safety Profile of CBD
Fortunately, we have lots of great news about the safety profile of CBD from reputable sources. Two major reports—one from the World Health Organization (WHO) and the other from the national Canadian health agency (Health Canada)—provide rich detail for our review of CBD safety and side effects.
The report from Health Canada focused on cannabis more broadly while also breaking down the evidence on CBD. They found wide support to back up the claim that CBD is not psychoactive. CBD does not produce a high or lead to any motor impairment. The effects of CBD include the following characteristics: [1]
- Anti-inflammatory
- Reduces pain
- Anti-nausea
- Reduces psychosis (i.e., delusions, paranoia, disordered thinking)
- Counters the effects of THC
- Reduces anxiety
- Reduces seizures
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Want to know the best part?
Further research has helped us learn that CBD is non-toxic for normal human cells and that it does not impact physiological parameters. This includes heart rate, blood pressure, and body temperature. CBD also does not impact the functioning of your gastrointestinal tract, nor does it cause psychological or motor impairments. [2] (Click to Tweet)
1.1 A Critical Review of CBD by the World Health Organization
The WHO released a massive review of CBD specifically in 2018. It found a ton of fascinating findings after their team reviewed the evidence. They found that CBD is generally well-tolerated with a good safety profile. Furthermore, there was no evidence of recreational use of pure CBD at all. They also found no public health-related problems arising from pure CBD consumption. [3]
RELATED: CBD Oil Effects Declared Safe by WHO
The review team determined that CBD does not have any abuse or dependence potential. Moreover, they found no signs of toxicity or serious side effects from the use of CBD. (Click to Tweet)
Finally, they noted that the research into Epidiolex supported the usefulness of CBD in a number of medical conditions. We’ll discuss Epidiolex in more detail now. [3]
1.2 Epidiolex Research and CBD
Much of the safety studies performed around CBD relate to the pharmaceutical Epidiolex. This medicine contains CBD extracted from the Cannabis sativa L. plant. Epidiolex has some of the most rigorously controlled studies to date. This drug has been approved by the FDA in the US to reduce seizures in people with certain conditions. [4]
RELATED: Why the FDA Just Approved Cannabidiol for Epilepsy
More recently, under the name Epidyolex, this CBD drug was also approved in the UK. As the maker of this drug, GW Pharmaceuticals, is based out of the UK, it is great to see that UK citizens can now access this locally created drug formulation. [5]
This article is focused on CBD oils and other products, not Epidiolex specifically. While we have learned much from studies on Epidiolex, we’ll discover some of the fascinating new studies that will add certainty to the safety of CBD oil.
1.3 A Flood of CBD Safety Studies
While federal agencies like the US FDA and the UK’s Food Standards Agency (FSA) continue to point to uncertainty around the effects of CBD, numerous sets of researchers are hoping to rid these concerns once and for all. They are hoping that results will support the findings of the WHO, primarily that CBD is safe.
The UK’s FSA has shifted its position from CBD being safe to one of “show us the evidence” even though a wealth of evidence does already exist. As a response, a consortium of UK CBD companies is looking to deliver this certainty. They hope to add to the work of researchers in France, the US, and elsewhere. One of their aspirations includes getting access to the research data currently held back by GW Pharmaceuticals. [6]
A recently announced research project will become one of the largest CBD toxicity studies to date. This transatlantic study, run by a UK firm called Farmceutica Wellness, will explore the effects of CBD on 15 different animal species. [7]
RELATED: The Known Side Effects of Cannabidiol
The goal of this study is to provide support for the WHO findings that CBD is safe. Additionally, it will hopefully provide further clarity to the US FDA, which has raised concerns about the potentially harmful effects of CBD. [7]
It gets better.
Another study is being performed by the US testing firm VaildCare. They will be assessing the impacts of CBD and claims around liver toxicity. The study will include 1,000 regular CBD users. The researchers hope the outcomes will alleviate concerns around liver toxicity that have been shown to occur from very high doses of Epidiolex (up to 700 mg a day). Blood samples will be taken to assess liver function in these long-term consumers of CBD. [8]
1.4 Looking toward 2021
As we quickly approach 2021, there will be a wave of results from these worldwide efforts to study CBD. While there is enough evidence for the WHO to determine that CBD is relatively safe, these additional findings throughout the globe will only add certainty to the use of CBD. If there are additional concerns or certain groups of people who may be harmed by CBD, we hope this information will reveal itself.
What we do know is that CBD does have side effects. This expansive set of studies will help us learn more about when and why they occur. We’ll be discussing the topic of CBD side effects in the next section.
2. The Side Effects of CBD
While CBD is safe for most adults, this does not mean that there are no CBD oil side effects. Like any other bioactive compound we consume, factors around consumption impact potential side effects.
This is why consumers are encouraged to start with a low dose and gradually increase it. This process is called titration, and it is helpful for reducing CBD side effects when you start taking CBD. The same goes for when you come off taking CBD, as titration can help reduce withdrawal side effects. (Click to Tweet)
RELATED: How Much CBD Do You Need?
Ensuring you stay within the proper dosage can also reduce the chances of side effects, as taking too much can lead to certain consequences. Some of the physiological side effects of CBD may include: [2]
- inhibition of hepatic drug metabolism (liver functioning)
- alterations of in vitro cell viability (damages cells in a dish)
- decreased fertilization capacity (may decrease fertility)
- decreased activities of p-glycoprotein (a protein that pumps foreign substances out of cells inside your body)
Researchers have determined that CBD doses as large as 1,500 mg/day are well-tolerated in humans. This contrasts slightly with the findings from Epidiolex studies that show potential for liver damage with quantities around half of that. Either way, these are doses well beyond the average CBD consumer. [2]
2.1 Clinical Side Effects
Some of the clinical side effects found by researchers include: [1]
- Drowsiness
- Fatigue
- Irritability
- Nausea
RELATED: The Side Effects of CBD Explained
Other potential CBD oil side effects include headaches, gastrointestinal problems, and diarrhea. It should be noted that side effects like diarrhea were far more likely in patients taking more than 15 mg/kg/day CBD. For a 130-lb. individual (59kg), this would equate to a dose of more than 885 mg of CBD per day. This is well beyond what the average CBD consumer would use each day. [1]
2.2 CBD on an Empty Stomach
Another important note in regard to potential CBD oil side effects: gastric distress may occur shortly after consumption. Since CBD oil is made using oils, taking them on an empty stomach can lead to discomfort. If you notice stomach discomfort shortly after consuming CBD, consider taking food before or with your CBD oil dose. (Click to Tweet)
RELATED: How to Take CBD Oil
While all of these side effects fall under the category of minor adverse events, there are some more dangerous situations. As we’ll see, these rare events relate to the co-use of CBD and specific pharmaceuticals. We’ll explore the potential issues with CBD drug interactions in the next section.
3. Interactions with Prescription Medicines
We have learned that CBD impacts certain functions of your liver. This is due to the fact that the liver is responsible for processing and filtering substances before they enter our bloodstream. The liver is filled with enzymes that work on this task of breaking down dangerous substances and altering other ones for better absorption.
An issue can arise when the liver enzymes that process CBD also act upon pharmaceuticals that we take. The activity of these enzymes can be altered by this double-duty, either enhancing or decreasing the amounts of prescription medicines that reach the bloodstream. The time this becomes dangerous is when the drug has what they call a “narrow therapeutic window.”
You might be wondering:
What does that mean? Well, the therapeutic window can be thought of as the optimal range of a drug that should be absorbed into one’s bloodstream. If the actions of this drug impact vital functions, then over- or under-performing can have serious consequences.
The primary example is warfarin, a blood thinner. This drug has a narrow window, and if the dose goes outside this range, then serious, life-threatening situations can arise. CBD has been shown to impact the actions of the liver in processing this drug and thus can lead to changes that push the carefully measured dose toward a dangerous dose.
RELATED: CBD and Blood Thinners
For those wondering, this is also why some prescription meds come with strict warnings around grapefruit juice, as this substance also impairs certain liver enzymes.
Here’s the deal:
The best thing you can do if you are taking any medication—or if you are about to start taking one—is to talk to your doctor and pharmacist about CBD. Your healthcare professionals are responsible for knowing about these interactions and can provide the best possible guidance for you specifically. (Click to Tweet)
3.1 Medications That Don’t Mix Well with CBD
Researchers have explored this topic and provide some insightful information to prevent possible health issues. Check out Table 2 from the Journal of Clinical Medicine below to see a full list of potential CBD drug interactions and suggestions for how to prevent them. Suggestions include reducing your CBD dose or avoiding co-use altogether. [9]
But here’s the kicker:
One hint that will help you identify whether there may be issues with CBD and your pharmaceutical includes the tips you were provided when prescribed that medication. Did they tell you to avoid grapefruit, St. John’s Wort, or goldenseal? If so, you should definitely have a chat with your healthcare professional about CBD. [10]
Some of the drug types that can have potential interactions with CBD include: [10]
- Antihistamines
- Antiarrhythmics
- Anesthetics
- Beta-blockers
- Sulfonylureas
- Immune modulators
- Prokinetics
- Proton-Pump Inhibitors (PPIs)
- Anti-seizure medications
- Angiotensin II blockers
- Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
- Antipsychotics
- Oral hypoglycemic agents
- Benzodiazepines
- HIV antivirals
- Antidepressants
- Antibiotics like amoxicillin and doxycycline
Now:
Another specific type of pharmaceutical that carries additional risks is one called prodrugs. These prodrugs require the liver to perform its duties for them to be effective. Along with drugs with a narrow therapeutic window, these are the primary pharmaceuticals that carry potentially serious interactions. [5]
RELATED: CBD Interactions with Prescription Drugs
3.2 A Note on Topical CBD
One important point to mention: the potential for CBD-drug interactions changes when we talk about topical CBD, such as our CBD Infused Herbal Balm. These topical CBD products are unlikely to impact your liver function, and thus are less of a concern. If you’re taking a topical prescription and want to try an infused cream like our Extra Care Formula, ask your medical professional if there are any potential issues with prescription medicines.
RELATED: Topical CBD: Benefits and Uses of CBD Balms and Lotions
4. Final Thoughts on CBD Oil Side Effects
In summary, we’ve learned that CBD is safe for most adults and does not impact gastrointestinal, motor, or psychological functioning. That said, CBD does have side effects, mainly including fatigue, drowsiness, nausea, and other minor adverse events. [2] (Click to Tweet)
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What’s the bottom line?
Overall, we learned some useful tips, like why we should eat a meal before we take CBD oil and the importance of gradually increasing your daily dose. Having a patient approach to up-titrating your CBD dose will not only help to reduce side effects, but it will also help you identify the point when you’ve reached your goals. Discover the benefits of CBD oil yourself with our Fastest Acting Liposomal CBD.
Sources:
- https://www.canada.ca/en/health-canada/services/drugs-medication/cannabis/information-medical-practitioners/information-health-care-professionals-cannabis-cannabinoids.html
- https://pubmed.ncbi.nlm.nih.gov/22129319/
- https://www.who.int/medicines/access/controlled-substances/CannabidiolCriticalReview.pdf
- https://www.epidiolex.com/about-epidiolex
- https://ir.gwpharm.com/news-releases/news-release-details/gw-pharmaceuticals-announces-epidyolexr-cannabidiol-has-been
- https://businesscann.com/cbd-industry-set-to-launch-joint-trials-to-ease-regulators-safety-concerns/
- https://businesscann.com/will-this-2m-transatlantic-toxicity-trial-of-15-animal-species-prove-cbd-is-safe/
- https://businesscann.com/ground-breaking-trial-with-1000-cbd-users-aims-to-refute-liver-toxicity-claims/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6678684/
- https://www.mydosage.com/cbd-guide/cbd-drugs-interactions-explained
