Marijuana Study Finds CBD Can Cause Liver Damage
Hemp oil, Hand holding bottle of Cannabis oil against Marijuana plant, CBD oil pipette. . [+] alternative remedy or medication,medicine concept
There is no denying that cannabidiol, more commonly referred to as CBD, is rapidly becoming more popular in the United States than sliced bread. It is a hot trend that got started several years ago after Dr. Sanja Gupta showed the nation in his documentary ‘Weed 2’ just how this non-intoxicating component of the cannabis plant was preventing epileptic children from having seizures.
Since then, CBD, a substance often touted as being safer than popping pills, has become highly revered as an alternative treatment for a variety of common ailments from anxiety to chronic pain. But a new study suggests that CBD may spawn its fair share of health issues. Specifically, scientists have learned that this substance could be damaging our livers in the same way as alcohol and other drugs.
Researchers at the University of Arkansas for Medical Sciences recently rolled up their sleeves to investigate CBD hepatotoxicity in mice. What they found was while this cannabis derivative is gaining significant recognition as of late in the world of wellness, people that use CBD are at an elevated risk for liver toxicity.
The findings, which were published earlier this year in the journal Molecules, suggest that while people may be using CBD as a safer alternative to conventional pain relievers, like acetaminophen, the compound may actually be just as harmful to their livers.
It is the methods used in this study that makes it most interesting.
First, researchers utilized all of the dosage and safety recommendations from a CBD-based drug known as Epidiolex. If this name sounds familiar, it should. Last year, the U.S. Food and Drug Administration approved it as a treatment for certain kinds of childhood epilepsy. It was a development that marked the first time in history that a cannabis-based medicine was approved for nationwide distribution in the United States.
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Researchers then spent some time examining mice under the influence of various doses of CBD. Some of the animals received lower doses, while others were given more. The dosage is said to have been “the allometrically scaled mouse equivalent doses (MED) of the maximum recommended human maintenance dose of CBD in EPIDIOLEX (20 mg/kg).”
Shockingly, researchers discovered that the mice given higher doses of CBD showed signs of liver damage within 24 hours. To that end, 75 percent of these animals in the sub-acute phase had either died or were on the verge of death within a few days.
Regardless of your feelings on this particular study, it is hard to argue with dead mice – even if you are an all-knowing marijuana expert.
The photo of liver is on the man’s body against gray background, Liver disease or Hepatitis, Concept . [+] with body problem and male anatomy
Liver toxicity is an adverse reaction to various substances. Alcohol, drugs and even some natural supplements can all take their toll on liver function – even in healthy individuals. But this is the first study of its kind indicating that CBD might be just as detrimental to the human liver as other chemicals.
But come to find out, there has been evidence of CBD’s havoc wreaking ways on the liver for some time.
Lead study author Igor Koturbash, PhD, recently told the health site Nutra Ingredients USA that the risk of liver damage from CBD is a nasty side effect printed in black and white on GW Pharma’s Epidiolex packaging.
“If you look at the Epidolex label,” he said, “it clearly states a warning for liver injury. It states you have to monitor the liver enzyme levels of the patients. In clinical trials, 5% to 20% of the patients developed elevated liver enzymes and some patients were withdrawn from the trials,” he added.
In other words, anyone taking CBD regularly and in higher doses might unwittingly find themselves on the road to liver disease.
Previous studies have also suggested that certain components of the cannabis plant may be harmful to the liver. Although one study found that marijuana may actually help prevent liver damage in people with alcoholism, in some cases it worsened the condition.
“Patients with hepatitis C who used cannabis had way more liver scarring than those who didn’t and more progression of their liver disease. Something in the cannabis could actually be increasing fatty liver disease,” Dr. Hardeep Singh, gastroenterologist at St. Joseph Hospital in Orange, California, told Healthline.
But wait, it gets worse.
The latest study also finds that CBD has the potential for herbal and drug interactions. “CBD differentially regulated more than 50 genes, many of which were linked to oxidative stress responses, lipid metabolism pathways and drug metabolizing enzymes,” the study reads.
However, Dr. Koturbash was quick to point out that the CBD products coming to market may not pose this particular risk. What he is sure of, however, is that more research is needed on CBD to evaluate its overall safety.
As it stands, none of the CBD products being sold in grocery stores and malls all over the nation have received FDA approval. And the only CBD-based medicine that has been approved, Epidiolex, is apparently stamped with a big, fat warning of potential liver damage.
Although CBD is often revered as a miracle drug, a new study finds that it could be causing liver damage.
Weed Seems to Protect Your Liver From the Effects of Hard Drinking
In January, the California Department of Alcoholic Beverage Control issued new rules declaring that intoxicating drinks cannot be infused with marijuana. Of course, that isn’t going to stop many people from simultaneously consuming weed and booze, especially as more states like California roll back cannabis prohibition.
These people might be interested to hear about a string of recent studies suggesting that cannabis can actually have protective benefits for the liver. Still, they should resist the urge to start slamming shots after taking a dab, or vice versa.
The largest study of the bunch found that drinkers who smoke weed had significantly lower odds of developing liver diseases including hepatitis, cirrhosis, steatosis, and even hepatocellular carcinoma, a type of liver cancer. Researchers at the National Institute of Scientific Research at the University of Quebec looked at the discharge records of nearly 320,000 patients who had a past or current history of abusive alcohol use.
“We found that if people are using cannabis in the dependent manner, they actually are much more protected from alcoholic liver disease,” Terence Bukong, a hepatologist and the study’s lead investigator, tells Tonic.
Alcohol abusers who didn’t use weed had about a 90 percent chance of developing liver disease, whereas light cannabis-using heavy drinkers had about an 8 percent chance. For dependent cannabis users who drink a lot, there was only a 1.36 percent chance. In other words, this study suggests that heavy pot use could mean a better defense against alcohol-related disease compared to light or no marijuana use.
This was a population-based correlation study, so it’s too early to draw strict conclusions. However, it’s consistent with another paper published in October, which looked at more than 8,200 patient records and found that the “lowest prevalence of [non-alcoholic fatty liver disease] was noted in current heavy users of marijuana.” (Some of the participants in this study did drink, but the data was adjusted to account for that.) They also found that cannabis users had worse diets than non-smokers—they consumed more calories, soda, and alcohol—yet they were less likely to be obese.
The researchers, led by a team at the Stanford University School of Medicine, hypothesize this might be related to the link between marijuana use and lower fasting-insulin levels, which could also protect the liver from non-alcoholic liver disease. Liver disease is frequently associated with insulin resistance and is caused when the liver accumulates too much fat, thus impairing glucose metabolism. So, cannabis may protect the liver even from dietary risks.
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The anti-inflammatory properties of cannabis are well established. Your body has an endocannabinoid system, which influences memory, appetite, and immune function. The two best-known endocannabinoid receptors are CB-1 and CB-2, which are found throughout the body, including the liver, where they play an important role in the development of liver diseases. (CB-1 seems to promote liver damage while CB-2 seems to protect against it.)
The liver also metabolizes cannabis to differing degrees depending on how it’s ingested. And the therapeutic effects of marijuana are highly dependent on the ratio of two main ingredients: tetrahydrocannabinol (THC) and cannabidiol (CBD). Researchers had no way of determining this ratio or even the strain type with the data available, so they don’t know to what extent the receptors in the liver would have been activated.
“The principle is creating a balance between the CB-1 and CB-2 agonism,” Bukong says. “How do we create a balance where cannabis use is actually having a therapeutic effect against detrimental effects?…I don’t have an exact mechanism for how that balance is happening.”
On the other hand, drinking has some health benefits, but only in moderation. The minute alcohol hits your bloodstream, it triggers an immune response, binding to receptors on immune cells, sparking the release of inflammatory proteins called interleukins.
Interleukins are a class of molecules called cytokines that are used in cellular signaling. In this case, they cause a cascade of inflammation when specialized white blood cells in the liver encounter toxins released by bacterial cells. Alcohol abuse makes your intestinal barrier more permeable, which allows these bacterial toxins to seep throughout the body.
“If you drink alcohol in an abusive manner, either binge drinking or chronic, excessive drinking, there is a possibility of you creating a leaky gut,” Bukong explains. “The bacteria transfers from your gut into the hepatic portal vein and then into the liver.” The liver then recognizes these pathogens and begins to produce inflammatory cytokines, he says.
The more often this happens, the more inflammation there is, which can cause a type of scarring called fibrosis. Too much scarring and you get cirrhosis, a hardening of the soft hepatic tissue, which can lead to life-threatening liver failure. Cirrhosis and hepatitis B are both leading risk factors for types of liver cancer. So you really don’t want inflammation in your liver.
Cytokines can help us measure how much damage alcohol does to the gut, liver, brain, and other organs, plus they are useful biomarkers for detecting alcohol use disorders. In a study published in December, researchers at the University of Colorado Boulder measured interleukin levels in 66 people who drink, some of whom used marijuana. They found that those who use cannabis had less circulating cytokines, which “suggests that cannabinoids may also have the potential to reduce alcohol-related harm.”
“There’ve been disassociation studies—correlational studies with people who drink having greater pro-inflammatory proteins in their blood versus people that don’t. And then also people who smoke [weed] who tend to have lower inflammatory levels [versus] people who don’t,” Raeghan Mueller, a molecular biologist at the University of Colorado Boulder, and one of the study’s co-authors, explains. “So it’s just one of those things that we just thought, ‘Okay, let’s try it out and see if we see anything,’ and we did, so that was exciting.”
The University of Colorado study was a small one, but it tells us which inflammatory markers researchers should look for when researching cannabis and alcohol use. In the future, science needs to look at pot’s interaction with the liver at the cellular level. It also needs to explore the ratio of THC to CBD, which can vary significantly across different cannabis strains.
“I think that we need to go further and know exactly what is the detailed molecular mechanisms and also what are the potential side effects,” Bukong says, advising that this research should be taken with caution. “It’s a bit premature to make conclusions based on just preliminary data, but we will know more in the next couple of years.”
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