CBD side effects and long-term toxicity

Side effects of CBD

The CBD or cannabidiol is a natural compound extracted from cannabis that does not produce a high, and has become the focus of attention due to its therapeutic potential, ranging from pain relief to anxiety reduction.

While products such as CBD oils are generally considered safe, it is important to understand that, like any other substance, CBD can have side effects and safety and toxicity considerations that vary by individual and form of administration.

Does CBD have side effects?

Yes, CBD can have side effects, although they are usually mild, infrequent, temporary and mostly CBD dose-dependent (1). In addition, it is essential to note that side effects may vary according to individual sensitivity.

Possible side effects that can occur with CBD

The following are some of the possible side effects that may be experienced when consuming CBD:

Changes in appetite

Some people may feel an increase or decrease in their appetite after taking CBD. This can vary from person to person and is due to the way CBD interacts with the endocannabinoid system (2).

Some studies suggest that cannabidiol may have an anorectic effect and decrease appetite (2). Some other studies believe that it results in the opposite effect and CBD stimulates appetite (3), so more research is needed on CBD and its effects on hunger.

Decrease in blood pressure

Cannabidiol may cause a slight decrease in blood pressure in some people when administered acutely in high doses (4). Although this could be beneficial for some patients with cardiovascular problems such as hypertension, in healthy people it could lead to dizziness or fainting.

* You may be interested in: CBD for hypertension: How does it affect?

Dizziness

Dizziness is an occasional side effect of CBD (5). It is possible that the decrease in blood pressure is related to the dizziness.

Diarrhea

In some cases, CBD can cause diarrhea, but this is rare. In some studies it has been linked to high doses, and therefore its incidence increases with increasing cannabidiol dose (6).

* You may be interested in: How CBD affects the gut

Fatigue

Some people experience fatigue after taking CBD, which may be due to its relaxing effect. On the other hand, some studies have linked the presence of fatigue with the use of CBD in combination with other drugs (1).

Dry mouth

Dry mouth, also known as cotton mouth, is one of the most common side effects of THC. THC the psychoactive component of marijuana. Although some people have reported this effect as an effect of CBD, it is possible that it is due to factors such as dehydration or consumption of other cannabinoids.

Cannabidiol has no effect on salivary glands, and may even reverse the effect of THC on these glands, resulting in less dry mouth effect (7). Therefore, CBD would not produce the dry mouth effect associated with marijuana use. However, it is worth considering that the use of products with residual THC content (such as Full Spectrum CBD oil) may be more effective. Full Spectrum CBD oil ), could have these effects.

In case of experiencing any side effects with the use of CBD, it is advisable to stop using it and consult a professional.

Contraindications of CBD

There are some important contraindications and considerations when using CBD:

Drug interactions

In case of taking medication, it is advisable to abstain from the use of CBD products without professional advice and supervision. Cannabidiol may interact with certain drugs, especially those that are metabolized by the liver, and those that have a narrow therapeutic margin.

* See our post: CBD and drug interactions

Pregnancy, lactation and children

It is advisable to avoid the use of CBD, as well as the consumption of cannabis products in general, during pregnancy and lactation. It is not known exactly how cannabidiol may affect the fetus during pregnancy or the infant during lactation. But there is evidence that it may pose a risk if CBD is consumed during pregnancy.

Although there is limited information on the effect of cannabinoids in pregnancy, marijuana use has been linked to neurological impairment and impaired cognitive function in children (9). As a precaution, it is recommended to avoid its use in these circumstances.

It is important to know that the endocannabinoid system is different in children and adults, so children and young people may experience different effects and consequences than adults when exposed to cannabinoids. Therefore, CBD should not be used during lactation (it can be eliminated through breast milk) and should not be used in children without professional indication.

* More information: CBD during pregnancy and lactation

Keep out of reach of children

CBD products should be kept out of the reach of children. In the United States, where edibles containing cannabinoids, such as candy, are quite popular, there have been quite a few cases of cannabinoid poisoning in children. In Europe, on the other hand, we find mostly edibles with synthetic cannabinoids, which are even more dangerous for children.

Mental health disorders

CBD may affect behavior and interact with antidepressant and antipsychotic drugs. It should not be used in people with mental health problems without prior consultation with a specialist physician and professional supervision.

* More information: How does CBD affect our mood?

Long-term toxicity and safety of CBD

Is CBD safe?

To date, no cases of serious toxicity associated with cannabidiol consumption at normal doses have been documented. Studies have shown that CBD is a relatively safe substance. However, more research is needed to fully understand its long-term safety.

Can CBD be taken for life?

One study reviewed all available studies on CBD toxicity and concluded that a maximum daily CBD dose of 1.42 mg/kg does not represent a risk for daily use (9), provided there are no contraindications.

There is no evidence to suggest that CBD is dangerous when used long-term, but more research is needed to determine the long-term effects of continued use. If you plan to use CBD long-term for medical reasons, it is essential to speak with a healthcare professional to assess the risks and benefits as, to date, there is no specific research on the long-term use of CBD.

Frequently asked questions about CBD side effects

Does CBD affect fertility or reproductive health?

In healthy adults, CBD does not affect reproductive health. That is, in both men and women, CBD does not affect the possibility of conceiving (8).

Does CBD make you sleepy?

While some may experience drowsiness when taking CBD, it is important to note that CBD can be stimulating as well. This effect has been suggested to be due to the biphasic effect of CBD, where very low doses have an opposite effect to high doses. Thus, cannabidiol has a stimulant effect when administered in minimal doses (10, 11) and a drowsy effect at high doses of CBD (12).

Does CBD make you hungry?

The response of CBD on appetite varies from person to person. CBD can stimulate hunger in some circumstances, but does not usually increase appetite in the same way as THC. Studies suggest that cannabidiol may reduce or increase appetite, although the determining factor for the opposite effects is unknown. It is not common for it to cause a significant increase in hunger, but as mentioned above, responses may vary from person to person.

Does CBD produce paranoia like marijuana?

CBD does not produce paranoia or psychoactive effects like THC. In fact, CBD can counteract some of the psychoactive effects of THC, such as anxiety and paranoia (14). Thus, some research groups suggest that marijuana products that do not contain cannabidiol are more psychoactive than those with a more balanced ratio of THC and CBD.

Can I drive under the influence of CBD?

CBD should not adversely affect the ability to drive. However, being a substance whose effects may depend on individual sensitivity and CBD dosage, it is as with any substance, it is important to be alert and make sure you are in proper driving condition before driving a vehicle.

Does CBD improve mood?

CBD (cannabidiol) may have a positive effect on mood in some people as it can stimulate serotonin receptors (13). This is potentially beneficial for those experiencing anxiety, stress or depression, conditions for which the use of CBD is being investigated.

Is CBD addictive?

No, CBD is not an addictive substance. Unlike THC, cannabidiol is not habit-forming and does not lead to physical or psychological dependence.

* More information: Is CBD addictive?

Explanatory note:

Last update: September 2023. Please note that new scientific evidence may appear after the publication date of this post. If in doubt, consult a professional before using CBD.

This is an informational post, based on ongoing research, which cannot and is not intended to diagnose, prevent or treat any disease or symptom. Its content can complement, but never replace, the diagnosis or treatment of any disease or symptom. Cannactiva products are not medicines.

In most European countries, CBD is not regulated for domestic use. Cannactiva products are intended for external use. Consult a professional before using CBD.

Referencias
  1. Huestis, M. A., Solimini, R., Pichini, S., Pacifici, R., Carlier, J., & Busardò, F. P. (2019). Cannabidiol Adverse Effects and Toxicity. Current neuropharmacology, 17(10), 974-989. https://doi.org/10.2174/1570159X17666190603171901
  2. Pinto, J. S., & Martel, F. (2022). Effects of Cannabidiol on Appetite and Body Weight: A Systematic Review. Clinical drug investigation, 42(11), 909-919. https://doi.org/10.1007/s40261-022-01205-y
  3. Hussain, S. A., Zhou, R., Jacobson, C., Weng, J., Cheng, E., Lay, J., Hung, P., Lerner, J. T., & Sankar, R. (2015). Perceived efficacy of cannabidiol-enriched cannabis extracts for treatment of pediatric epilepsy: A potential role for infantile spasms and Lennox-Gastaut syndrome. Epilepsy & behavior : E&B, 47, 138-141. https://doi.org/10.1016/j.yebeh.2015.04.009
  4. Jadoon, K. A., Tan, G. D., & O’Sullivan, S. E. (2017). A single dose of cannabidiol reduces blood pressure in healthy volunteers in a randomized crossover study. JCI insight, 2(12), e93760. https://doi.org/10.1172/jci.insight.93760
  5. Hundal, H., Lister, R., Evans, N., Antley, A., Englund, A., Murray, R. M., Freeman, D., & Morrison, P. D. (2018). The effects of cannabidiol on persecutory ideation and anxiety in a high trait paranoid group. Journal of psychopharmacology (Oxford, England), 32(3), 276-282. https://doi.org/10.1177/0269881117737400
  6. Szaflarski, J. P., Bebin, E. M., Comi, A. M., Patel, A. D., Joshi, C., Checketts, D., Beal, J. C., Laux, L. C., De Boer, L. M.., Wong, M. H., Lopez, M., Devinsky, O., Lyons, P. D., Zentil, P. P., Wechsler, R., & CBD EAPD, Wong, M. H., Lopez, M., Devinsky, O., Lyons, P. D., Zentil, P. P., Wechsler, R., & CBD EAP study group (2018). Long-term safety and treatment effects of cannabidiol in children and adults with treatment-resistant epilepsies: Expanded access program results. Epilepsia, 59(8), 1540-1548. https://doi.org/10.1111/epi.14477
  7. Andreis, K., Billingsley, J., Naimi Shirazi, K., Wager-Miller, J., Johnson, C., Bradshaw, H., & Straiker, A. (2022). Cannabinoid CB1 receptors regulate salivation. Scientific reports, 12(1), 14182. https://doi.org/10.1038/s41598-022-17987-2
  8. Henderson, R. G., Vincent, M., Rivera, B. N., Bonn-Miller, M. O., & Doepker, C. (2023). Cannabidiol safety considerations: Development of a potential acceptable daily intake value and recommended upper intake limits for dietary supplement use. Regulatory toxicology and pharmacology : RTP, 105482. Advance online publication. https://doi.org/10.1016/j.yrtph.2023.105482
  9. Dong, C., Chen, J., Harrington, A., Vinod, K. Y., Hegde, M. L., & Hegde, V. L. (2019). Cannabinoid exposure during pregnancy and its impact on immune function. Cellular and molecular life sciences : CMLS, 76(4), 729-743. https://doi.org/10.1007/s00018-018-2955-0
  10. Murillo-Rodríguez, E., Millán-Aldaco, D., Palomero-Rivero, M., Mechoulam, R., & Drucker-Colín, R. (2008). The nonpsychoactive Cannabis constituent cannabidiol is a wake-inducing agent. Behavioral neuroscience, 122(6), 1378-1382. https://doi.org/10.1037/a0013278
  11. Piomelli, D., & Russo, E. B. (2016). The Cannabis sativa Versus Cannabis indica Debate: An Interview with Ethan Russo, MD. Cannabis and cannabinoid research, 1(1), 44-46. https://doi.org/10.1089/can.2015.29003.ebr
  12. Chagas, M. H., Crippa, J. A., Zuardi, A. W., Hallak, J. E., Machado-de-Sousa, J. P., Hirotsu, C., Maia, L., Tufik, S., & Andersen, M. L. (2013). Effects of acute systemic administration of cannabidiol on sleep-wake cycle in rats. Journal of psychopharmacology (Oxford, England), 27(3), 312-316. https://doi.org/10.1177/0269881112474524
  13. Linge, R., Jiménez-Sánchez, L., Campa, L., Pilar-Cuéllar, F., Vidal, R., Pazos, A., Adell, A., & Díaz, Á. (2016). Cannabidiol induces rapid-acting antidepressant-like effects and enhances cortical 5-HT/glutamate neurotransmission: role of 5-HT1A receptors. Neuropharmacology, 103, 16-26. https://doi.org/10.1016/j.neuropharm.2015.12.017
  14. Englund, A., Morrison, P. D., Nottage, J., Hague, D., Kane, F., Bonaccorso, S., Stone, J. M., Reichenberg, A., Brenneisen, R., Holt, D., Feilding, A., Walker, L., Murray, R. M., & Kapur, S. (2013). Cannabidiol inhibits THC-elicited paranoid symptoms and hippocampal-dependent memory impairment. Journal of psychopharmacology (Oxford, England), 27(1), 19-27. https://doi.org/10.1177/0269881112460109

Masha Burelo
Investigadora en cannabinoides | Doctoranda en Neurociencia

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