Observed Impact of Long-term Consumption of Oral Cannabidiol on Liver Function in Healthy Adults
Introduction: Previous studies have suggested that prescribed cannabidiol (CBD) products may cause elevations in liver tests (LT). This study compared the prevalence of elevated LT in an adult population self-administering CBD with the normal and general adult population prevalences. Materials and Methods: Adults 18-75 years of age across the United States taking CBD orally for a minimum of 30 days were recruited from 12 individual CBD product companies in this decentralized, observational study and sent their standard CBD regimen from the company of their choice. An app-based, 21CFR Part 11 decentralized clinical study platform (ValidCare Study) was used to securely automate consent inclusion/exclusion criteria and collect all the data for this study, including: demographic information, medical history, reasons for taking, dosage, current medications dosage, adverse effects, and efficacy. At the end of 30 days, LTs were obtained. Follow-up LTs were offered to all individuals with elevated alanine transaminase (ALT) values. Results: A total of 28,121 individuals were invited to participate in this study, 1475 enrolled, and 839 (female: 65.3%, male: 34.7%) completed the study. Full-spectrum hemp oil was used by 55.7%, CBD-isolate by 40.5%, and broad spectrum by 3.8%. The mean±SD daily dose of CBD was 50.3+40.7 mg. The prevalence of elevated ALT was 9.1%, aspartate aminotransferase (AST) 4.0%, alkaline phosphatase 1.9%, total bilirubin 1.7%, with 85.5% of the ALT elevations <2×the upper limit of normal (ULN) with only 0.3% having ALT levels >3× ULN. The prevalence of ALT and AST elevations (9.1% and 4.0%) were not significantly different from known adult general population prevalences (8.9% and 4.9%). There was no significant association between CBD dosage and LT values. Thirty-three individuals with elevated ALT levels had follow-up LT performed with 21 having normal LT, 8 having the same severity of ALT elevation, and 4 having an increase in severity, 1 of which ultimately became normal. Conclusions: Self-medication of CBD does not appear to be associated with an increased prevalence of LT elevation and most of the LT elevations are likely due to the conditions/medications for which the individuals are taking CBD.
Keywords: ALT; AST; CBD; LT; cannabidiol; liver function test.
CBD, Liver Damage – Rebutted
Forbes recently released an article called Marijuana Study Finds CBD Can Cause Liver Damage. It focuses on a recent research article from the journal Molecules, called “Hepatotoxicity of a Cannabidiol-Rich Cannabis Extract in the Mouse Model.” The researchers made their own CBD extract and took findings from GW’s Epidiolex clinical trials to give equivalent dosages to mice to observe the short-term effects. Keep in mind that their COA showed residual hexane, which is a known hepatotoxin.
The author uses this study to claim that CBD might be just as dangerous as alcohol or acetaminophen (Tylenol). These substances both have safe daily recommended amounts that do not harm the liver. But while alcohol’s abuse is well known and acetaminophen toxicity has replaced viral hepatitis as the most common cause of acute liver failure in the US, CBD has zero abuse potential because it is non-intoxicating, so its users have no incentive to approach similar levels.
GW observed that 20 mg/kg is the safe maximum daily dose of CBD. That’s 9 mg/lb. For a 100 pound person, that would be 900 mg a day. That’s between 1-2 grams for most adults.
The mouse researchers tested the effects of giving this max dose in a single day, and separately, the effects of giving it for fourteen days in a row. They then went on to perform the same test using triple the recommended safe daily dose and then once more using 10 times the limit.
In the same-day phase of testing, all of the detrimental effects occurred at the 3x and 10x levels. No negative effects were reported for the recommended safe maximum dose.
In the two-week phase, detrimental effects occurred only at the highest level. The author leaves a strong implication that CBD killed some of the mice, however, that isn’t the case. Some mice in the highest dosage group became so lethargic and anemic that the researchers decided to kill them on the third day. Mice in the lower two levels exhibited no visible signs of toxicity throughout the two weeks.
Because GW Pharma already determined a maximum recommended dose, it should come as no surprise that amounts higher than that can cause problems. Most people who regularly use CBD can’t or won’t ever come close to the “maximum” recommended amount due to cost, access, or simply needing less because of using whole plant extracts.
The author goes on to point out the warning on Epidiolex packaging that there is a risk for liver injury because 5-20% of patients in recent clinical trials experienced elevated liver enzymes. The overwhelming majority of increases in enzymes were at the 20mg/kg dose in combination with Valproic acid, another known liver toxin. Their published article cites three specific studies to support the case for elevated enzymes. In all three studies, the risk of elevated enzymes mostly applies to users who are also taking other medications, the risk isn’t severe, and the problem resolves itself for most. The author somehow conflates that to say all CBD users will develop a disease.
The fact that CBD can interact with other drugs in the liver is well-known and practices are already in place to avoid or minimize negative reactions.
As long as a reasonable amount of CBD is taken, and it isn’t taken at the same time as other medications, then there is a minute chance of a negative reaction occurring.
The author begrudgingly concedes that there is research on the positives of CBD. He brings up a study showing that cannabis users have a significant dose-dependent reduction in the odds of developing each of the four major stages of alcoholic liver disease. He quotes a doctor who said cannabis can lead to progression of liver disease in patients with hepatitis C, however, “cannabis” isn’t defined here and there is no citation provided by Healthline. The RoC Research Library has more studies showing the positives of cannabinoids for the liver.
One of his final warnings about CBD is actually a testament to its therapeutic potential. “CBD regulates 50 genes.” The keyword here is “regulate.” CBD works to regulate the rest of the body and help bring it to homeostasis. CBD actually has over 80 mechanisms of action.
The author concludes by saying that due to all the harms that CBD poses, users may as well be taking vodka to ease what ails them. Equating CBD to vodka is not a fair comparison. This article highlights why it’s important to do your own fact-checking and not accept everything you read at face value.
Is CBD Oil Bad For Your Liver? Here’s What You Need To Know
Any new supplements you are considering adding to your diet should be looked at carefully. Do they fit with your lifestyle? Will they interact with any prescription medications you’re on?
Our extensive research – and that of scientists across the globe – has proven that CBD oil is well tolerated by the human body and that it has very few, if any, side effects.
Taken by itself, there is no negative impact on core functions such as digestion, heart rate or glucose levels, even with higher doses of CBD oil (up to 1,500mg per day).
But one lone study on mice has led to some scrutiny over whether CBD Oil could be harmful to the liver, affecting how it functions.
So, should you be worried? Is CBD oil bad for your liver?
What Is CBD?
CBD is short for cannabidiol, the non-psychoactive chemical compound found inside the cannabis plant. It’s used as a supplement to help support a balanced diet and a healthy lifestyle, and is most commonly taken as oil drops under the tongue, but can also come in other forms such as absorption drinks and creams.
Despite its roots in the cannabis plant, CBD oil is legal to buy in the UK and in many other countries across the globe, and many consumers claim it’s effective for pain relief, combating nausea, stress, with more than a third of CBD oil users claiming it helps with their anxiety.
Cannabidiol interacts with and supports the human endocannabinoid system by binding to the receptors found in the body’s nervous system.
These receptors pass messages through pathways in the human body to keep the body well balanced, and the endocannabinoid system helps to regulate hormones, sleep patterns and mood, as well as things like appetite and immune response.
What Does Your Liver Do?
The liver is a metabolically active internal organ in the human body. It holds more than 10% of your total blood supply and actually has more than 500 different functions. The three main functions are that it cleans the blood, produces a digestive liquid known as bile and stores energy.
Bile aids digestion in the small intestine by breaking up fats into fatty acids. The liver works to transform all the nutrients we ingest into something the body can use, stores these substances and then distributes them around the body when and where they are required. It also converts toxins into harmless waste products that the body can then get rid of.
To keep your liver healthy you should eat a balanced diet, keep to a moderate alcohol consumption, exercise regularly, maintain a healthy weight and avoid recreational drugs.
The liver is the only organ in the human body that can regenerate itself. If the liver is healthy and a quarter of its tissue remains in place, it can regrow to its original size within just a few weeks.
Excessive intake of alcohol, fatty food, sugar and salt can all be damaging for your liver. Overindulging in these things can result in numerous problems, including liver failure.
Signs that your liver isn’t working properly include yellow skin or eyes, known as jaundice, abdominal pain or bloating and swelling of the legs and feet.
Will CBD Oil Hurt Your Liver?
Following a single study on mice last year, there have been concerns about CBD oil possibly being damaging to your liver if it is used in high quantities.
However, in the study in question, the doses used for the mice were much higher than humans would take, so the small daily drop of CBD oil which is advised for people is highly unlikely to cause the same effect. Therefore the study doesn’t mimic the typical intake of a CBD user. Scientists have instead said the findings can give an indication of the consequences of a potential CBD oil overdose.
It is the same with any drug or supplement. If you take more than the recommended dose there are always possible consequences, whether it be an excessive dose of grapefruit extract or ibuprofen. Studies have shown that using more than the recommended dose of ibuprofen, for example, can cause stomach ulcers and other gastrointestinal problems as well as greater risk of cardiovascular concerns.
And – obviously – a mouse is not a human being. Although they share very similar genes, which is why mice are frequently used for testing purposes, they are physiologically very different and this must be taken into consideration.
Further research into the findings has shown that using the correct dosage of CBD oil is safe for widespread use, and is well tolerated by the vast majority of people.
This is backed up by the World Health Organisation, no less. Not only that, but conflicting research has shown that the therapeutic properties of CBD oil could actually help improve liver function because of the way it interacts with endocannabinoids to create anti-inflammatory and antioxidant effects.
Can CBD Cause Liver Failure?
As CBD Oil is so new to the market, there is still much research to be done into what it can do, how it can potentially help users and any undiscovered risks involved.
However, initial findings suggest that side effects are minimal and it is only if you take a comparably huge dose of CBD Oil that your liver could be affected.
There are three main things to cause liver failure – obesity, alcohol misuse and hepatitis. CBD is not one of these and nor is it currently deemed to be a contributory factor.
The Bottom Line
Taking the correct, recommended dose of good quality CBD pil as part of a general wellness routine is unlikely to cause any side effects, including liver damage. Any side effects reported in humans up to now are very rare – and very mild if they do occur.
Vitally, if you are a CBD consumer, ensure you buy from a reputable source with lab certified products who can verify their contents. If you are already taking any form of medication we advise that you consult your doctor or healthcare professional before taking any CBD Oil or related products.