How does CBD affect the liver?

Woman taking CBD oil drops

What effects does CBD have on the liver? Can it be harmful? How can we make sure that our liver is perfect? Today in Cannactiva ‘s post we solve these and more doubts with the doctoral candidate and researcher Masha Burelo, who reviews the scientific studies on the effects of CBD on the liver.

What effects does CBD have on the liver?

CBD or cannabidiol is a non-psychoactive compound extracted from cannabis that has gained great popularity in recent years for its benefits, among which are its properties for pain, anxiety and to improve sleep.

Naturally, as a result of the rise of this component, doubts have arisen about its safety, specifically about its effects on the liver.

Overall, current studies show that CBD is safe at low doses, with infrequent and minor adverse effects, including decreased appetite and drowsiness.

When it poses the greatest risk to the liver is when CBD is used in high doses, or when it is combined with certain medications. According to studies, high doses are considered to be 1000mg of CBD per day (the equivalent of two 10ml bottles of CBD). 5% CBD oil) or more than 20mg of CBD per kg per day (e.g. for a 40 kg person, this would be equivalent to 800 mg of cannabidiol per day).

Note: This is an informational article and is not intended to prevent, diagnose or treat any disease. Its contents may complement, but should never replace, any diagnosis or treatment of any disease or symptom. Cannactiva products are not medicines and are intended for external use. Be aware that there may be new scientific evidence. Therefore, consult your doctor before using CBD.

Effects of CBD on the liver

The impact of cannabidiol on liver health has been the subject of numerous scientific studies and research.

The liver is a vital organ that performs many essential functions, such as regulating the chemical levels of different compounds in the blood, so it is responsible for the metabolism of many substances, including CBD. It is also responsible for detoxifying harmful substances, metabolizing drugs, filtering blood from the digestive tract and synthesizing proteins important for blood clotting, among other functions.

Some studies suggest that CBD may offer protective effects on certain liver injuries, reducing inflammation and oxidative stress. However, the use of cannabidiol at high doses has been associated with an increase in liver enzymes, an indicator of inflammation or liver damage.

Here it is important to note that most of the risks associated with CBD occur at very high doses, or in concomitant use with certain medications.

This is of great interest in countries where oral use of CBD is allowed, as it tends to be used without medical guidance and usually at very high doses.

More details: Scientific studies on CBD for the liver

In preclinical studies (i.e., on animals or isolated cells, not in humans), CBD has been shown to have potential hepatoprotective effects against various liver injuries, including reduction of inflammation, oxidative stress and amelioration of metabolic dysregulation in liver diseases.

As for the effects of cannabidiol on the liver in humans, in some studies, it has been shown that CBD can help improve the health of the liver that has been damaged by a medical condition generated by alcohol consumption and associated with liver inflammation, oxidative stress and steatosis. If you want to go deeper into the subject, see the post on combining CBD with alcohol (1).

Other research suggests that the hepatic endocannabinoid system may have therapeutic potential for chronic liver diseases (CLD) such as hepatitis C. The therapeutic benefits of CBD in these conditions are not yet fully validated. More research is needed in this area, focusing specifically on the mode of action of cannabidiol on hepatic metabolism.

On the other hand, the use of CBD at high doses has been linked to an increase in liver enzyme concentrations in the blood. Generally, the increase in these enzymes is due to the fact that they are released in greater quantities when liver cells are undergoing an inflammatory process.

It has also been observed that, in some cases, people receiving high doses of CBD daily may develop abnormalities in liver enzymes, evaluated in blood tests, compatible with liver toxicity.

Can CBD damage the liver?

In general, at normal doses and in healthy people, the risk of liver damage from the use of CBD is low, provided there are no contraindications.

Dosage of CBD oil drops
CBD oil drops have become popular for reducing stress.

However, cannabidiol in high doses can damage the liver, especially when combined with certain medications. High doses are considered, according to the data analyzed, from 1000mg (= 1 gram) of CBD per day (equivalent to half a 10ml bottle of 20% CBD oil) or more than 20mg of CBD per kg per day. On the other hand, a scientific review suggests that the risk of CBD at low doses is low, although not negligible.

Therefore, it is important to consult a physician before using CBD, especially if you are taking other medications.

More information: Optimal CBD dosage: More is always better

High doses of CBD and its effects on the liver: Scientific studies

A systematic review and meta-analysis found a significant association between high-dose cannabidiol use and elevated liver enzymes andDrug-induced Liver Injury ( DILI). Specifically, high doses of CBD (1000 mg/day or more, or 20 mg/kg/day or more) and concomitant use of antiepileptic drugs were observed to be risk factors.

However, no serious cases of liver injury were reported and no cases were observed in adults using doses lower than 300 mg CBD per day (4).

More details: Scientific studies on High doses of CBD and its effects on the liver

One study used a novel approach called “Quantitative Systems Toxicology” to understand how CBD might cause liver toxicity. This approach identified ways in which cannabidiol could cause liver toxicity, especially at high doses.

He concluded that combining CBD with a seizure medication, valproate (VPA), had the same liver enzyme alterations as taking CBD alone in high amounts daily (3). Therefore, special caution should be taken with high doses of CBD.

Can CBD in normal doses cause liver damage?

A study that focused on long-term consumption of CBD and its impact on liver function in healthy adults found no significant association between cannabidiol dose and liver test values.

In addition, most of the elevations observed in liver tests were mild and were probably related to the conditions or medications for which the individuals were taking CBD, rather than to the cannabidiol itself (5).

More information: Interactions of CBD with medications

How do I know if CBD is damaging my liver?

The first thing to keep in mind is to use CBD properly, advised by a health professional.

There is no home way to tell if the liver is damaged. Some liver conditions occur without obvious symptoms and can be difficult to diagnose.

If you have any doubts about the health of your liver, you can ask your doctor for a blood test to measure liver enzymes and other parameters that, together with the professional assessment, will clarify whether the health of your liver is perfect.

What negative side effects can CBD have?

Adverse effects associated with CBD include abnormal liver function tests, decreased appetite, diarrhea, drowsiness and sedation. These adverse events have been more prominent in studies involving other drugs used simultaneously, which could be linked to a drug-drug interaction.

How long does CBD remain in the liver?

Specific studies detailing how long CBD remains in the liver are not available. However, CBD is processed or metabolized in the liver, and for this reason, it is not recommended to use it together with other drugs that are processed in the same way, because it could affect the metabolism of these drugs.

So, is CBD harmful to the liver?

Cannabidiol is generally well tolerated at low doses and no cases of serious liver injury have been reported in studies with low doses of CBD. However, CBD can be associated with elevations in liver enzymes and liver damage, particularly at high doses (from 1 gram per day, or 20mg CBD/kg/day) or when used with certain medications.

Conclusion

In summary, the complexity of the impact of CBD on the liver underscores the need for continued research in this area. While some studies indicate that CBD may have hepatoprotective effects, others suggest that high doses of CBD may be associated with liver impairment.

With the current data, it is safest to use low doses of CBD, but, above all, to consult with a physician before including CBD in a therapeutic regimen.

Note: This is an informational article and is not intended to prevent, diagnose or treat any disease. Its contents may complement, but should never replace, any diagnosis or treatment of any disease or symptom. Cannactiva products are not medicines and are intended for external use. Be aware that there may be new scientific evidence. Therefore, consult your doctor before using CBD.

References
  1. Wang, Y., Mukhopadhyay, P., Cao, Z., Wang, H., Feng, D., Haskó, G., Mechoulam, R., Gao, B., & Pacher, P. (2017). Cannabidiol attenuates alcohol-induced liver steatosis, metabolic dysregulation, inflammation and neutrophil-mediated injury. Scientific reports, 7(1), 12064.
  2. Stohs, S., Ray, S. (2020). Is cannabidiol hepatotoxic or hepatoprotective: A review. Toxicology Research and Application, (4).
  3. University of North Carolina (2023, November 8). CBD effects on the liver. Eshelman School of Pharmacy. Retrieved December 17, 2024.
  4. Lo, L. A., Christiansen, A., Eadie, L., Strickland, J. C., Kim, D. D., Boivin, M., Barr, A. M., & MacCallum, C. A. (2023). Cannabidiol-associated hepatotoxicity: A systematic review and meta-analysis. Journal of internal medicine, 293(6), 724-752.
  5. Kaufmann, R., Aqua, K., Lombardo, J., & Lee, M. (2023). Observed Impact of Long-Term Consumption of Oral Cannabidiol on Liver Function in Healthy Adults. Cannabis and cannabinoid research, 8(1), 148-154.

Masha Burelo
Investigadora en cannabinoides | Doctoranda en Neurociencia

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