I’ve been getting a new question from clients lately: does CBD cause liver damage? To be honest, it’s caught me off guard: Did I miss a 60 Minutes exposé on the topic? A politician’s empty rhetoric? Or valid medical science?
With millions of Americans either swapping CBD for traditional pain medications like ibuprofen or adding them to their established medication regimen, it’s reasonable to be concerned about whether these medications are interacting with and causing damage to our bodies.
But is there a basis in science to be concerned? Today we are going to examine this question.
I’m not a medical professional, and I’m not going to give you medical advice. But I can present what we know and what we don’t know about whether CBD can cause liver damage so that you can make your own informed decisions about whether and how you use CBD.
What we know: Let’s review the recent studies on whether CBD can cause liver damage.
Study 1: It does if you take 1000 times too much!
The alarm about CBD’s potential to cause liver damage seems to stem from a 2019 study conducted at the University of Arkansas. In it, researchers found that giving mice an extremely high dose of CBD led to liver toxicity in the mice.
The main problem with that study is that they gave the mice A. LOT. OF. CBD. Like, a lot, a lot. An amount that a human would never take.
Although there is not a clinically established “correct” dose of CBD, a typical dose is 5-50mg/day. Most of my clients have landed in the range of 7-15mg/day. In this study, they dosed the mice with the equivalent of a 150-lb adult taking 13,600 mg of CBD (that’s right, 1000x a standard dose!) every day for 10 straight days.
You don’t need to be a pharmacist to know that ANY substance taken at 1000x its recommended dose will cause adverse side effects.
1000 apples a day for 10 days does NOT keep the doctor away.
While it’s necessary for medical research to establish an upper limit on dosage for any substance, it does not follow that a reasonable dose of that substance taken under medical supervision will cause the damage that a 1000x dose causes.
But as with any sensational study, the media took this one and ran with it, omitting the 1000x “detail,” which may be why you have heard that CBD causes liver damage.
Study 2: In people taking normal doses, it doesn’t!
In response to that study, a much larger study of 28,000+ people already taking typical human doses of CBD was conducted. That study concluded there was no association between self-medication of CBD and liver toxicity.
It’s useful to note that most of the participants were using broad-spectrum CBD, which contains more of the beneficial compounds of the cannabis plant than CBD isolate. Broad-Spectrum CBD has been shown to have a broader therapeutic window and is something I always recommend to my clients as a Cannabis Coach.
Study 3: Surprise twist! CBD actually helps your liver!
To add to the mix, a third recent study that gave patients with liver damage caused by alcohol abuse or high-fat diets (the two most common reasons for liver transplants), showed that CBD actually helped PREVENT liver damage.
What’s the deal?
Cannabis, including CBD, has been incredibly difficult to study in the U.S. until recently due to federal prohibition. CBD was *just* removed from the Schedule 1 drug list in 2018, and THC still remains there. So like all things cannabis, clinical research has been stymied for years. Compound that with the media’s insatiable drive for clickbait titles, and the result is that reliable, factual information about cannabis in the U.S. requires a lot of diligence to find.
However, many countries around the world have federally legal cannabis, and there is ample clinical evidence of the safety and efficacy of CBD. At this point, there does not seem to be compelling data to suggest that normal doses of CBD cause liver damage.
Drug Interactions with CBD: Cytochrome p450
One thing we DO know is that your body uses an enzyme called Cytochrome p450 to metabolize (break down) CBD. Certain medications, like blood thinners and certain chemotherapy drugs, are ALSO broken down by Cytochrome p450. This means that if you’re taking CBD along with one of those drugs, they are competing for the same enzyme in your body. Your body may not be able to break down enough of the medication, leading to too much residual medication in your system.
If your doctor has ever told you to “avoid grapefruit” when you take your medication, that’s an indicator that the medication uses this metabolic pathway, and you should work closely with your doctor to determine an appropriate dose of CBD.
Complicating Factor: the CBD Marketplace
As I’ve written about on my site, not all CBD products are created equal. Due to a lack of regulation and standardization, the CBD bottle you buy off the shelf may not contain what the label says it does and could contain dangerous contaminants. In fact, study after study, including by the FDA itself, has found that CBD products are not accurately labeled.
That means you need to be incredibly diligent about sourcing your CBD. Your safest bet is to source Broad-Spectrum CBD from growers who follow organic practices and offer a Certificate of Analysis, showing there are no toxic chemicals riding along.
So what does all of this mean? Advice from a Certified Cannabis Coach
Okay, so that was a lot!
Here’s the TLDR, and my advice as a Certified Cannabis & Health Coach:
- We know to avoid large doses of CBD if we’re taking a “grapefruit” medication.
- We know that the U.S. CBD marketplace is largely unregulated, so careful sourcing of your CBD is necessary.
- And hopefully, we’ve all learned today to NEVER take 1000x your recommended dose. Of anything.
- We have loads of research from the U.S. and abroad suggesting that CBD in moderate doses is helpful for a range of ailments. If you want to dig in, you can search PubMed, a massive free online database of biomedical literature.
- While there is no clinical standard, a dose of 5-50mg/day is generally considered reasonable. Be sure to track your dose, symptoms, and experience to find the right dose for you.
- If you want personalized advice on how to use CBD to optimize your health, Certified Cannabis & Health Coaches are here for you!
Curious about becoming a Certified Cannabis & Health Coach so YOU can help people feel better with cannabis?
Check out the program and sign up today!
Guest blogger and proud CCI graduate Kate Johnson, JD is a Certified Cannabis Educator, Certified Cannabis & Health Coach, and the founder of Your Kush Coach. Cannabis has been her lifeline managing the symptoms of Complex PTSD, and now she’s dedicated her life to helping people feel better with this magical plant. Your Kush Coach helps people curious about CBD and THC find their cannabis fit through practical advice and quality product recommendations. Get in touch! yourkushcoach.com
