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CBD and Liver Health: Should you be concerned?

cbd and liver health

CBD, short for cannabidiol, is widely recognized for its potential therapeutic benefits, including pain relief, anxiety reduction, and anti-inflammatory properties. However, as its popularity grows, so do concerns about its safety, particularly its effects on the liver. This article explores the existing human studies on CBD and liver health. We will provide insights into dosing ranges and potential risks and compare CBD to other commonly consumed medications and supplements that affect liver health.

Understanding CBD and Liver Health

The liver plays a critical role in metabolizing substances, including CBD. Concerns about CBD’s impact on liver health primarily stem from its metabolism through the cytochrome P450 enzyme system, which is responsible for processing various drugs and toxins. To understand the potential risks, let’s examine the findings from human studies on CBD and liver health.

cbd and liver health

Human Studies on CBD and Liver Health

1. Study by Chesney et al. (2020)

In a 2020 study published in Molecular Neuropsychiatry, Chesney et al. evaluated the safety and efficacy of CBD in adults with anxiety and sleep disorders. Participants received doses ranging from 25 mg to 175 mg per day over three months. The study found no significant changes in liver function tests (LFTs), suggesting low to moderate CBD doses are well-tolerated without adverse liver effects.

2. Study by Taylor et al. (2018)

Taylor et al.’s study, published in The New England Journal of Medicine (2018), investigated the effects of CBD on patients with epilepsy. Participants received 20 mg/kg of CBD per day for 14 weeks. While some participants showed elevated liver enzymes, the increases were typically mild and reversible. Notably, most of these patients were also taking other medications known to affect liver function, complicating the interpretation of CBD’s direct impact on liver health.

3. Study by Huestis et al. (2019)

Published in Clinical Pharmacology & Therapeutics, the study by Huestis et al. examined the safety profile of Epidiolex, an FDA-approved CBD medication for epilepsy, in doses up to 50 mg/kg/day. While higher doses showed more frequent liver enzyme elevations, these effects were dose-dependent and often resolved with dose adjustments or discontinuation. The study emphasized that liver issues were more prevalent at higher doses, particularly in combination with other medications, highlighting the importance of understanding CBD and liver health.

CBD Dosing and Liver Health

Based on the human studies, it appears that:

– Low to Moderate Doses (25-175 mg/day): Generally safe with no significant impact on liver health.

– High Doses (20 mg/kg/day or higher): Potential for mild, reversible liver enzyme elevations, especially when combined with other hepatotoxic drugs.

For an average adult weighing 70 kg (154 lbs), a dose of 20 mg/kg would equate to 1400 mg of CBD per day, far exceeding typical over-the-counter CBD products. Therefore, the majority of users consuming adequate CBD doses (up to 250-500 mg/day) are unlikely to experience liver issues based on current evidence of CBD and liver health.

Why the Liver Metabolizes CBD

The liver is the body’s primary detoxification organ and metabolizes various substances, including CBD. CBD passes through the digestive system and enters the liver via the portal vein when ingested. In the liver, CBD is processed by cytochrome P450 (CYP450) enzymes, specifically CYP3A4 and CYP2C19. These enzymes convert CBD into metabolites, which circulate through the bloodstream.

Here are the key liver metabolites of CBD:

1. 7-Hydroxy-CBD (7-OH-CBD): This is the primary active metabolite of CBD. It is formed when the liver enzymes hydroxylate CBD. 7-OH-CBD is believed to have similar therapeutic effects to CBD itself and is considered one of the primary active forms in the body.

2. 6α-Hydroxy-CBD and 6β-Hydroxy-CBD: These metabolites are formed through hydroxylation at different positions on the CBD molecule. They are less abundant than 7-OH-CBD, and their specific roles and activities are less understood.

3. CBD-COOH (Cannabidiol-7-oic acid): This is a carboxylated form of CBD and represents a further step in the metabolism of 7-OH-CBD. It is an inactive metabolite and is eventually excreted from the body.

4. 11-Hydroxy-CBD: Similar to the metabolism of THC into 11-Hydroxy-THC, CBD can also be metabolized into 11-Hydroxy-CBD. However, this metabolite is less prominent than 7-OH-CBD—the specific effects of 11-Hydroxy-CBD need to be better studied.

The metabolic conversion of CBD into its various metabolites is crucial for its bioavailability and activity in the body:

Bioavailability: Metabolites such as 7-OH-CBD are more water-soluble, which improves their ability to circulate in the bloodstream and reach target tissues.

Activity: Some metabolites, particularly 7-OH-CBD, retain pharmacological activity and can interact with cannabinoid receptors and other targets in the body, contributing to CBD’s overall therapeutic effects.

Understanding the metabolites of CBD and their respective roles helps elucidate how CBD affects the body and how it is processed and eliminated.

For more detailed information, here are some references:

1. PubMed – Metabolism of Cannabidiol in humans

2. PubMed – Metabolism of Cannabidiol in liver microsomes

3. Frontiers in Pharmacology – Overview of Cannabidiol Metabolism

Other Medications and Supplements Affecting Liver Health

Various medications and supplements can influence liver health. Here are ten commonly consumed substances with potential liver effects:

1. Acetaminophen (Tylenol): Overuse or high doses can cause severe liver damage.

2. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Medications like ibuprofen and naproxen can lead to liver enzyme elevations.

3. Statins: Used to lower cholesterol, these can sometimes cause liver inflammation.

4. Antibiotics: Certain antibiotics, such as amoxicillin-clavulanate, are known to cause liver injury.

5. Antifungals: Medications like ketoconazole can have hepatotoxic effects.

6. Methotrexate: Used for cancer and autoimmune diseases, it can cause liver fibrosis and cirrhosis with long-term use.

7. Antidepressants: Drugs such as sertraline and fluoxetine can impact liver enzymes.

8. Vitamin A: Excessive intake of vitamin A supplements can lead to liver toxicity.

9. Kava: An herbal supplement used for anxiety associated with severe liver damage.

10. Black Cohosh: A supplement often used for menopausal symptoms linked to liver toxicity in rare cases.

CBD and liver health

Conclusion: CBD and Liver Health

Current human studies suggest that low to moderate doses of CBD are generally safe for liver health. Adverse effects occur primarily at very high doses or in combination with other hepatotoxic medications. For most users, the standard doses of CBD found in over-the-counter products pose minimal risk to liver health.

As with any supplement or medication, it’s essential to consult with a healthcare professional before starting CBD, especially if you are taking other medicines that affect the liver. By staying informed and cautious, you can safely explore the potential benefits of CBD for your health and well-being, keeping a close watch on your liver health.

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