The Side Effects of CBD

You don’t really need to watch the media frenzy surrounding CBD under a magnifying glass to know that there’s hardly any talk about its adverse effects.

While there’s no denying the fact that CBD is an extremely promising find that is associated with an ever-increasing list of health benefits, it’s a little hard to fathom that it does not cause any side effects at all.

Or does it?

For those who are new to this, CBD is a cannabinoid sourced from the Cannabis Sativa plant.

Not Marijuana mind you. This is a variant of Cannabis that is called Industrial Hemp.

CBD is nothing short of a global phenomenon currently, and is being touted as a panacea of sorts that can help treat a variety of conditions, ranging from anxiety to insomnia to reducing epileptic seizures among scores of others.

Its popularity also stems from the fact that it does not cause the psychoactive effects that its slightly infamous cousin THC is guilty of causing.

So, you can take a dose of CBD any time without worrying about getting high or losing control over your motor functions.  

The question is, is it really as safe as it is touted to be?

In the limited number of human-based clinical trials, CBD has been very well tolerated with little to no side effects.

One of the clinical studies that was conducted to analyze the effectiveness and to gauge the tolerance to the compound, reveals that CBD was well tolerated even at doses as high as 1500mg/day.

But that’s hardly sufficient to come to a conclusion, isn’t it?

Today we will review some of the side effects that CBD is believed to cause, based on science and also on anecdotal instances.

What are the side effects of CBD?

Our endocannabinoid systems are unique to us, which means that we may react differently to near-identical doses of the same cannabinoid.

For example, one person who’s using CBD for relief from anxiety may experience the positive effects at just 50mg/day. Another person may not even feel the effects until they increase the dose to 150mg.

Similarly, the threshold for experiencing side effects will depend on your previous experience with CBD, the concentration of CBD in the product that you are using, the purity of the product and your physiology, which is unique to yourself.

Many a time, side effects can be caused due to bunk products or products that contain more THC than the stipulated concentration, which is just 0.3%. We’ll talk about this in a bit.

Here are some of the side effects that have been commonly reported by people using CBD.

1. Fatigue: Fatigue or Tiredness is the most commonly reported side effect by CBD users. However, this seems to be limited to the first few times one uses CBD or, when you accidentally take a bigger dose than what you are used to. The tiredness tends to diminish as the body gets used to the cannabinoid. However, it must be added that in the human clinical trials that were conducted to analyze the effectiveness of CBD as a potential treatment for epilepsy, almost 21% of the participants experienced fatigue. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5569602/)
2. Diarrhea: Research reveals that CBD can help increase gut mobility, which can have a positive effect on people with GI issues. But it may also trigger a bout of diarrhea, especially when you are using it for the first few times. It is also important to note that Diarrhea can be triggered by an allergic reaction to the carrier oil that CBD oil is mixed in. Switching to a different brand of CBD oil, or one that uses a different carrier oil, may also help address this problem.
3. Nausea: Some users have reported Nausea after ingesting CBD oil. The irony is that CBD is now a proven anti-emetic that is very effective in helping reduce Nausea and Vomiting caused due to chemotherapy and other types of cancer treatments. If you are experiencing Nausea with CBD oil, it may be a good idea to try a different delivery method, like an edible or a tincture and see if that helps.
4. Changes in appetite: Patients undergoing treatment for Cancer have a very low appetite, due to which they suffer extreme muscle loss. Marijuana oil, that contains both CBD and THC is being considered as a potential treatment that can help stimulate appetite. In an animal study conducted in 2012, it was noted that CBD may help suppress appetite by making one feel fuller. While this is a very desirable trait for a lot of people, it may be counterintuitive to what you are trying to achieve with CBD.
5. Dry mouth: Smoking Pot is known to cause severe dry mouth in some people. But it seems that THC is not the only cannabinoid that produces this effect. CBD does it too. This is a manageable side effect though, that is believed to be caused due to CBD’s interaction with the CB1 and CBD2 receptors. Many manufacturers of CBD products advise users to sip a glass of water or juice after ingesting CBD, which seems to help minimize this effect.
6. Low Blood Pressure: Even a single dose of CBD can temporarily reduce your blood pressure. This is usually a beneficial effect that helps limit the damage caused due to constant stress. However, if you have chronic low blood pressure, then this is something that you must consider before using CBD.

Side Effects that CBD does not cause

Just like everything else related to Cannabis, CBD has also been at the receiving end of detractors who associate it with a slew of side effects. Most of these claims are made on the basis of inaccurate information and sketchy studies.

Here are some of them that you may come across:

Liver disease: CBD does not cause liver disease. The infamous, now-debunked, Forbes article that triggered an avalanche of CBD-bashing articles all over the internet, was based on an extremely sketchy animal-study conducted in rats. What’s worse is that rats in the study were fed astronomical doses of CBD which were as high as 2460 mg/kg. If anything, CBD is linked to the inhibition of certain liver enzymes which may reduce the effectiveness of certain pharmaceutical drugs that are metabolized by the liver. You can be rest assured though that it is not toxic to your liver.

Euphoria or the high: As long as you are buying legitimate CBD that does not contain more than 0.3% of THC, it will not cause the high. You may experience a mild sense of calm as it reduces your anxiety levels and increases the levels of dopamine in the brain. Some people mistake this to be the high. But it’s not. You will be in your complete senses and be able to drive as well as handle machinery. Although it would be ideal if you could avoid it until you get a better idea of how you react to CBD.

Who should exercise caution while using CBD?

CBD is generally safe and very well tolerated.

However, there isn’t sufficient research to recommend usage by certain groups of people including children, pregnant or breastfeeding women and people who are using certain pharmaceutical drugs.

Pregnant and breastfeeding women

Most clinical studies exclude pregnant and breastfeeding women due to the possibility of risks for both, mother and fetus. When it comes to Cannabis, it was for long considered Taboo and smothered under legal problems which made it impossible to even consider such a study. In a nutshell, we just don’t know whether using CBD is safe for pregnant women.

That said, Cannabis usage in pregnant women has increased, as indicated by research. More and more women are experimenting with CBD, mainly to reduce stress and anxiety during pregnancy. Topical forms of CBD that don’t enter the bloodstream, nor expose the child to CBD are also gaining popularity for reducing inflammation and preventing tears during childbirth. CBD is also a great alternative to traditional anti-emetics by the way.

So far, there has been just one animal-study that indicated developmental toxicity to the fetus in pregnant rats when they were exposed to Epidiolex. That’s not sufficient though to conclude that CBD usage may be risky. If anything, it warrants larger studies with more participants.

Drug Interactions

A valid concern while using CBD is that it inhibits the activity of a group of liver enzymes called Cytochrome P450. These enzymes metabolize almost 60% of the medications in use currently. CBD has a very interesting interaction with these enzymes. P450 and CBD deactivate each other if used in sufficient doses.

This means that using CBD at a sufficient dose may severely limit the metabolism of certain drugs, which in specific scenarios can be dangerous. Like if you depend on a daily dosage of a drug to control specific conditions.

There’s no established dosage threshold at which CBD exerts this action on these enzymes.

In one study, it was found that 40mg of CBD administered sublingually had no effect on the activity of these enzymes.

In another study, it was found that even 25mg was sufficient to limit the metabolism of an anti-epileptic drug used to control seizures.

This means that the action of CBD in limiting these enzymes will depend on individual sensitivity to CBD, the concentration of CBD in the product, as well as the presence of other phytocannabinoids (Isolate vs. Full Spectrum).

If you are currently using any medications, then it is always better to speak to a doctor about using CBD.

Children

Cannabis usage in Children may sound surprising to a lot of people. But the fact is that CBD has some great health benefits for children, that even border on miraculous.

The FDA approved Epidiolex, a CBD-based medication for the treatment of two rare, but severe forms of epileptic seizures called Lennox-Gastaut syndrome and Dravet syndrome that were resistant to other forms of treatment.

Another clinical study was conducted to examine the possibility of treating Autism symptoms with CBD. 67.6% of the participants reported an improvement in Self-Injury and Rage Attacks. Hyperactivity reduced in 68%. Sleep problems improved in 71.4% of the participants.

In addition to this, there are anecdotal reports of parents having used CBD for the treatment of ADHD in children with great results.

However, there isn’t enough clinical research conducted on children to conclude that CBD may not cause any adverse effects.

If you intend to use CBD for treating any condition in your child, please speak to your pediatrician before you do it.

The CBD safety checklist

Like we said in the beginning, early research indicates that CBD is safe for use and does not cause serious side effects.

Having said that, there are a few tips that will help you avoid any potential side effects, even if you are new to CBD.

Here they are.

1. Read the product label closely: Not everything that is sold as pure CBD contains CBD. Some may also contain THC, often in more quantities than what you’d like. In 2017, the Jama Network conducted a study to gauge the labelling accuracy of CBD products in the market. 84 products were tested for their contents. Only 30% of the products were accurately labelled. The rest were under-labeled or mislabeled. 26% contained less CBD than advertised. 18% of the products contained THC in doses up to 6.43 mg/mL. The concentration of CBD varied significantly as well, ranging from 0.10 mg/mL to a whopping 655.27 mg/mL. THC may cause a lot of the side effects mentioned in the list above making you believe that it was caused due to CBD instead. Buy from a reputed brand only and always ask for a Certificate of Analysis. (https://jamanetwork.com/journals/jama/fullarticle/2661569)
2. Oil is better: In the above mentioned study, CBD oils were found to be the most accurately labelled products. Vapes were the least accurate ones. Enough said. If you are looking to try CBD for the first time, CBD oil from a trusted brand is your best bet. Oil is also easier to dose accurately and is easy to consume too. Just use the dropper and swallow a couple of drops. You can wash it down with a glass of water.
3. Natural is better: Always buy CBD sourced from the Cannabis Sativa plant only. Synthetic ones may be cheaper. But they are associated with a long list of dangerous side effects that you can do without. (https://www.cdc.gov/mmwr/volumes/67/wr/mm6720a5.htm?s_cid=mm6720a5_x)
4. Start low and go slow: Start with the lowest possible dosage according to your body weight. All brands have a dosage calculator that will tell you an apt starting dosage. Stick to it. Or even better, start with a lower dose than what’s recommended. You might not notice any difference in the condition that you are using it for. But don’t rush and bump the dose up. Give your body time to adapt to the cannabinoid. Go slow with it. Once you start to notice the positive effect for the intended use, stop increasing the dose further. You don’t develop a tolerance to CBD. So increasing the dosage unnecessarily will only increase the risk of experiencing side effects, no matter how mild they are.