Twenty-six percent of Americans have tried CBD at least once in the past two years. For patients with conditions that seem to respond to CBD treatment, the numbers are much higher. A recent survey shows that 57% of arthritis patients have tried marijuana and CBD for medicinal reasons.
If you’re considering trying CBD for the first time, read our Beginner’s Guide to CBD.
While more and more people are using CBD, there is limited research into the possible short and long term side effects of CBD oil, although preliminary evidence is pointing to very little, if any, adverse reactions experienced by the general public.
Current Status of Cannabis
People have been using the cannabis plant as medicine for centuries to treat a variety of conditions, such as:
- Anxiety and mood disorders
- Pain (the most common use for medical marijuana)
- Nausea or vomiting from chemotherapy
- Epileptic seizures
- Muscle stiffness or spasms from multiple sclerosis
- Many other uses
Research is starting to turn the tide on the decades old notions that marijuana is the devil’s lettuce, and more and more states are beginning to legalize it for medical and/or recreational purposes.
While people are starting to open up to the idea, there is still a stigma associated with cannabis, especially when it comes to recreational marijuana. This is mainly due to THC. THC is the chemical compound in cannabis that is responsible for making you high.
CBD, on the other hand, seems to offer the best of both worlds when derived from hemp. CBD contains medicinal properties and has been shown to alleviate symptoms of many ailments, without the psychoactive effects of THC.
Even though cannabis derivatives are emerging as safer options over conventional prescription medications, we still have a lot to learn.
What is CBD?
To understand the side effects of CBD, we first need to understand what is CBD. As mentioned, CBD (short for cannabidiol) is a chemical compound found in the cannabis plant. Unlike it’s cousin THC, you won’t get high from CBD.
There are several varieties of cannabis that intensify specific characteristics of the plant. One variety of cannabis that is responsible for the CBD market surge is hemp. Hemp contains a high amount of CBD, and only trace amounts of THC… which makes it the preferred plant for extracting CBD.
Is CBD Oil Legal?
While the 2018 US Farm Bill legalized hemp derived CBD, the details and execution are still in flux. What the farm bill did was removed hemp derived CBD and all hemp derivatives from the DEA’s list of Schedule I drugs. It also allows farmers to grow hemp legally.
The confusion is that marijuana and THC remain illegal, and it’s difficult for law enforcement agencies to distinguish between CBD derived from hemp and CBD derived from marijuana.
The legality of CBD mainly depends on whether the CBD comes from hemp or marijuana.
Another issue is that the FDA has some apprehensions about CBD. The fact that the FDA has approved a CBD-based prescription drug, Epidiolex, it expects that any product that markets CBD for health purposes should go through the same FDA official drug approval process.
In addition, if CBD is added into food, it is considered a “food additive” according to the FDA, and they have not approved CBD for that purpose yet. This has led some jurisdictions to outlaw any CBD added to food.
How Does CBD Oil Work?
CBD takes effect by working on the body’s endocannabinoid system (ECS). Our ECS plays a huge role in regulating various major functions in our bodies such as mood, pain sensitivity and sleep patterns.
Our endocannabinoid systems produces cannabinoids of our own that bind with receptors all throughout our bodies. Cannabinoids from plants (such as CBD and THC) interact with these receptors as well, and can help people who don’t produce enough cannabinoids themselves.
Is CBD Oil Addictive?
There is no known risk of addiction to CBD. The World Health Organization (WHO) states that CBD is well tolerated by most people and is considered safe and that “CBD oil exhibits no side effects indicative of any abuse or dependence potential.”
The report also states that “To date, there is no evidence of public health related problems associated with the use of pure CBD.”
So in other words, there is no evidence that CBD hemp oil is either physically or psychologically habit forming.
That being said, some people can develop a tolerance to cannabinoids in general. Some may even experience side effects of withdrawal if they stop taking CBD oil regularly, such as irritability, restlessness or nausea.
What Are the Side Effects of CBD Oil?
Various studies on the safety and side effects of CBD oil have suggested that CBD is generally safe and non-toxic in humans and animals and that high doses up to 1,500 mg/day of CBD are well tolerated by humans.
While the WHO has also stated that CBD is generally well tolerated by most people and is considered safe, there are some people who may be particularly sensitive to cannabinoids and might experience some minor side effects.
Some of the noted side effects for higher doses of CBD oil include:
- Changes in appetite
- Dry mouth
- Nausea and vomiting
There is a documented list of side effects associated with the specific CBD-based drug Epidiolex. These side effects include:
- Sedation and lethargy
- Elevated liver enzymes
- Malaise and weakness
- Insomnia, sleep disorders
Interestingly, many other herbal supplements can cause adverse side effects including liver damage. These products, like CBD, are not regulated by the FDA and caution should be taken when consuming higher doses.
A big caveat to this study is that the mice were given doses that were the human equivalent to the maximum dose of the drug, Epidiolex. According to website for Epidiolex, a dose of 20 mg per kg of body weight is recommended per day for the greatest reduction in seizures.
To put that in perspective, that would be over 1300 mg of CBD per day for an adult weighing 150 pounds! This is much higher than the typical daily dose of casual CBD oil users. Most people stick to somewhere in the range of 10-80 mgs per day, with slightly higher doses for insomnia, therapeutic effects and “flare ups”.
Some of the more serious side effects listed for Epidiolex include “thoughts about suicide, attempts to commit suicide, feelings of agitation, new or worsening depression, aggression and panic attacks.”
While these side effects sound pretty scary, as we’ve demonstrated above, the hemp-derived CBD products you can find on the market today such as tinctures, capsules and gummies contain much lower doses of CBD than Epidiolex. Therefore, it is not likely that over the counter CBD products will present much, if any, harm to the general consumer.
Can CBD Oil Interact With Other Medications?
The biggest side effect of taking CBD hemp oil is that it can interact with other medications you may be currently taking.
Our liver has a family of enzymes called Cytochrome P450, which breaks down drugs into smaller bits that allow our cells to absorb them better and eliminate them properly.
Although the effects have been shown to be minimal, if you take high enough amounts of CBD, it can inhibit the CYP450 enzyme’s ability to metabolize certain pharmaceutical drugs.
Interestingly, CBD is not alone in CYP450 inhibition. Eating a portion of grapefruit or grapefruit juice have a similar effect. Furthermore, Watercress, St. John’s Wort, and Goldenseal have all been shown to impact the CYP450 liver enzymes and inhibit drug metabolism.
If you are currently taking any pharmaceutical drugs or medications such as NSAID or blood thinners, you should discuss with your doctor before using CBD oil to discuss any potential complications regarding reduced CYP450 enzyme activity.
But Isn’t it All Natural?
You may be thinking that CBD is completely safe because it comes from a plant and it’s all natural. That being said, the reality is we don’t know for sure if adverse reactions are possible in high enough doses.
Even though CBD comes from the hemp plant, many natural herbal supplements have been shown to pose some risks and carry adverse side effects such as St John’s Wort, Echinacea, Ginkgo Biloba, Saw Palmetto, as well as Chaparral, Comfrey, Kava, and Skullcap.
Researchers have also identified over 20 traditional Chinese medicinal herbs that have been shown to possibly cause liver toxicity, despite being used for centuries.
Side Effects of CBD Oil Depends on Dosage
As with any treatment, dosage has a direct correlation not only on the effectiveness of the treatment, but also to the prevalence of side effects.
Since CBD is not regulated by the FDA, there is no standard therapeutic effective dose for specific medical conditions, so many people are left wondering how much CBD oil should I take?
Furthermore, everyone reacts differently to CBD. Several factors influence each person’s optimal dose of CBD including weight, diet, metabolism, sleep patterns, stress levels and genetics and it may take a bit of trial and error to find the right dose of CBD oil for you.
We always suggest starting with a low dose (10-20 mg of CBD) and see how you react. You can slowly increase the dose over the next few days until you find the most effective dose for you without any adverse side effects.
High Quality CBD Oil Products Are Important for Safety and Reduced Risk of Side Effects
Since CBD is not yet regulated, and there is no external body holding CBD companies accountable, there is no guarantee that a product you purchase contains a safe or effective level of CBD.
In fact, a 2017 study published in the Journal of the American Medical Association found that 70 percent of CBD products sold online are incorrectly labeled.
The worst thing you can do is to pick up some random CBD product from your local vape shop, (or God forbid… a gas station!) without doing any research.
It’s up to you as the consumer to educate yourself on what to look for when buying CBD oil products and not put yourself in danger, or waste your money and experience ineffective results.
Here are some tips when considering CBD products:
- Always review certificate of analysis (COA’s) and/or 3rd party lab reports to ensure the products contains what is on the label
- Look for products that are manufactured in a GMP certified (Good Manufacturing Principles) facility and that the lab is registered with the FDA
- Look for CBD from hemp that is organically grown, preferably in the USA
- Make sure you understand the difference between full spectrum, broad spectrum and CBD isolate
- Only purchase from a reputable company that is focused on quality and standing up for the health and safety of the consumer, rather than just making a quick buck
- Cannabis has been used as a medicine for centuries with no history of lethal doses.
- CBD derived from hemp is federally legal, while THC and CBD derived from marijuana is still illegal.
- CBD works with our endocannabinoid system to help regulate various functions such as mood, pain sensitivity and sleep patterns.
- CBD is non addictive.
- Side effects of CBD can include diarrhea, changes in appetite, fatigue, dry mouth, nausea, elevated liver enzymes, sleep disorders and infections.
- Most side effects of CBD oil occur when taken at extremely high doses (10X+) compared to the casual user of over the counter CBD products.
- Purchasing high quality products from a reputable source is the safest option to avoid the dangers of any unregulated products you consume.
- Before taking CBD, make sure to consult your healthcare provider first to discuss whether it’s appropriate for you and your condition.