The high popularity of CBD and other cannabinoids have helped the people to think they are safe and non-intoxicating.

Despite several CBD benefits, consumers should understand the risks and learn how to use CBD-related products properly.

One of the most important issues is CBD influence upon the liver. This again became urgent due to the review published by the US Food and Drug Administration in November 2019 that CBD use carries “real risks” – some of them potentially unknown. The agency revised recommendations for the consumers concerning the safety of CBD products¹.

Let’s break down what we already know and answer the questions every patient is interested in:

CBD liver in mice

To study CBD hepatotoxicity, researchers conducted two experiments. The first experiment looked at acute toxicity from a single dose. The second one examined lower CBD doses over a more extended period, that means the mice got daily doses for 10 days.

In the single mega dose experiment, the mice became slow, lost their appetite and showed significant increases in liver-to-body weight ratios. This group was found to have higher levels of enzymes ALT and AST which are markers for liver damage.

The mice getting the lower doses daily showed changes in body weight, increase in liver-to-body weight ratio and exhibited smaller increases in the liver enzymes ALT and AST. 2 out of 10 mice taking lower doses didn’t show any signs of toxicity over the course of the experiment.

This experiment helped to reach to the conclusion that some CBD users taking high doses may suffer from liver toxicity².

It is worth noticing that there are not many studies regarding the effect of CBD on the liver. Further, experiments on mice have limited importance for humans as people use CBD in much lower doses. As one can guess, giving mega doses to mice in a lab is not challenging – and extremely high doses can have completely different kind of effects.

Nonetheless, the studies do indicate a need for caution; it is especially true for those living with liver diseases or already taking multiple medications.

How to avoid liver damage for CBD users

To feel safe and obtain the best results on CBD-related products, the users should follow the following recommendations:

• Avoid CBD interactions with prescription medications. The main concern with CBD is its potential interaction with other drugs. CBD and other cannabinoids are metabolised by an enzyme called CYP3A4. There are prescription drugs that hinder CYP3A4 which can slow the breakdown of CBD and increase its rate of physiological activity. If you take CBD while on medication, choose a high-quality CBD product, determine safe dosage and schedule.
• Do not overdose. Much does not mean better. For most health conditions, small doses may help equally better and increasing the dose may not provide any additional benefit.
• Think of topical CBD products. Keep in mind that topical CBD-related products like lotions, creams, and salves may also be an option. Topicals do not enter the bloodstream in large amounts, and so do not harm the liver.
• Quality matters. Verification of the product quality is very important. If you choose CBD from a well-established company, you are less likely to have health problems or face side effects as high-quality products contain natural substances without unwanted chemicals.

To conclude, one study does show that CBD may cause liver damage. However, these findings have limitations and no other researches make similar suggestions. However, you must be careful about which product you choose and what dose you take.

References

1. What You Need to Know (And What We’re Working to Find Out) About Products Containing Cannabis or Cannabis-derived Compounds, Including CBD. FDA. December 2019. http://www.fda.gov/consumers/consumer-updates/what-you-need-know-and-what-were-working-find-out-about-products-containing-cannabis-or-cannabis. Accessed January 12, 2020.
2. Ewing LE, Skinner CM, Quick CM, et al. Hepatotoxicity of a Cannabidiol-Rich Cannabis Extract in the Mouse Model. Molecules. 2019;24(9). doi:10.3390/molecules24091694