CBD safety and efficacy

Is CBD Safe? The Truth Uncovered

CBD is the darling of wellness that everyone and their dog are embracing. It comes in all sorts of forms and flavors, and it’s often offered as a miracle drug. But CBD is booming with very little research to support its safety and efficacy.

Clear guidelines and regulations are still NOT in place, and the market is flooded with an enormous variety of products without any oversight from the FDA. As a result, consumers are on their own when shopping for a CBD product.

Since we know so little about this compound, whether it’s safe and effective is still up for debate. In this article, I will shed some light on these important topics, including a helpful checklist to shop smarter and use CBD safely.

Table of Contents

You know CBD is popular, but do you know… 

What Is CBD?

CBD is the moniker of cannabidiol—one of several chemicals from the cannabis plant known as “cannabinoids.”

The cannabis family includes both hemp and marijuana. These two varieties may look similar, but they have some fundamental differences; the most important one is their THC content.

THC is the cannabinoid that alters your mind and the reason cannabis has been stigmatized and reviled for decades. Plants with less than 0.3% THC content are defined as hemp, while plants with significant levels of THC are considered marijuana.

Hemp has been federally legal in the U.S. since December 2018. Marijuana, on the other hand, remains a Schedule 1 controlled drug, and you could face charges for possessing it in some states.

What does this mean? Well, hemp-derived CBD is sort of legal to purchase, but due to 81 years of prohibition, little research has been conducted on the qualities of this compound and how they translate into real benefits for the human body.

So what do we actually know about CBD? Despite prohibition, a few diligent scientists have been studying cannabis for decades, and they can give us better insights about…

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How CBD Works in Your Body

Classified as a cannabinoid, CBD is kind of a mystery molecule. Experts still don’t know all the nuances of how this compound benefits human health. It’s believed that CBD hits 65 targets in the body, but the course of action of each is still unclear.

Researchers have found that cannabinoids can interact with specific receptors in your body called “cannabinoid receptors.” So far, two receptors have been identified: CB1 and CB2.

They’re widespread throughout your body and are deeply involved in achieving homeostasis. Simply put, homeostasis is a state of perfect balance within the body that is indispensable for optimal health.

When homeostasis isn’t successful, disease and sickness may appear.

But here lies the catch, CBD doesn’t interact with these receptors in the same way other cannabinoids do.

While THC strongly binds them—unleashing a series of intoxicating and therapeutic effects—CBD tones down their activity. This action is called “allosteric modulation.”

CBD acts as an allosteric modulator in two unique ways:

BY ACTIVATING OTHER CHANNELS

With a very weak affinity for the cannabinoid receptors, CBD is unable to bind them directly. But it can still modulate them externally by binding to other channels in the body—the TPRV receptors.

When CBD triggers TRPV, the activity of the cannabinoid receptors is dampened. As a result, the psychoactive CB1 can’t be overstimulated. This explains why CBD can counterbalance the mind-altering effect of THC.

The activation of TPRV also modulates the CB2 receptors, which in turn, can help reduce pain, fight inflammation, and improve your body’s ability to fight off infections.

BY INCREASING THE SUPPLY OF ENDOCANNABINOIDS

The other way CBD modulates the cannabinoid receptors is by promoting the production of your body’s own cannabinoids. Yes, your body produces its own cannabis-like molecules called “endocannabinoids.”

They interact with the receptors in a similar manner as THC does to help your body achieve homeostasis.  

ANOTHER INTERESTING FEATURE OF CBD IS THAT....

CBD is a “promiscuous molecule,” meaning it triggers different receptor channels and enzymes within the body. These interactions may lead to a wide range of diverse outcomes.

Scientists believe CBD interacts with:

  • The serotonin receptors that play a role in pain, depression and anxiety.
  • Gene expression receptors—PPARs—which are related to CBD anti-inflammatory and neuroprotective effects.
  • Pain receptors α3 glycine that are known to mediate chronic pain. 
  • The enzymes FAAH and MAGL responsible for degrading the endocannabinoids.

With so many different targets, and research still so young, experts can’t draw any definitive conclusions about the benefits of this compound. It’s undeniable that CBD science is years away from its popular uses. However its wild popularity has increased the need for more research and the National Health Institute (NHI) is now funding clinical trials.

CBD Safety & Efficacy

In a critical review report from June 2018, the World Health Organization (WHO), revised the available evidence for the safety and effectiveness of CBD.

Review about CBD by the WHO

The WHO concluded that “CBD is generally well-tolerated with a good safety profile.” The organization also noted that adverse effects might not be caused by CBD itself but as a result of interactions between the compound combined with other medications.

The organization also reviewed its effectiveness and noted that CBD has been proved to be an effective treatment for epilepsy in several clinical trials, and preliminary research is showing that it holds promise to treat a wide range of other conditions.

But recently, the FDA issued warnings about the safety of CBD products that completely contradicts the WHO statements:

“Many unanswered questions and data gaps about CBD toxicity exist, and some available data raise serious concerns about potential harm from CBD,” the agency claimed.

These concerns emerged during the development of Epidiolex—the only FDA-approved CBD drug that treats rare forms of childhood epilepsy. This drug passed the phase III clinical trials process, which means these are the most comprehensive CBD studies done on people to date.

Mild side effects and abnormal results on liver-function tests emerged during these trials, where young patients between 2 and 18 were taking high amounts of an extremely purified CBD.

The FDA is correct about the lack of evidence proving the efficacy and safety of CBD.

What the Feds are NOT addressing in this update is that the isolated products available on the market are different from the extremely purified molecules used in trials.

The market is also offering products that combine CBD with the many other compounds that comprise the hemp plant. These whole plant extracts affect the body differently than the isolated formulas.

In addition, the daily dosage using during clinical trials are way too high compared to what the general population is taking for everyday wellness.

The FDA health concerns shouldn’t be ignored, but nothing about CBD is “gospel” just yet. The truth is that we know too little about this compound, and more research is needed to assess its overall safety.

SO....

IS CBD ACTUALLY SAFE?

No one can say with absolute certainty. What we know is that CBD is a plant-based compound that’s well-tolerated for most people, and doesn’t appear to be a risk for abuse or dependence.

Even though CBD has been considered safe by the WHO, not enough research has been done to conclude this compound is safe or unsafe for any particular demographic. Like any other drug, CBD may carry some risk and it’s NOT 100% free of side effects—notably at high doses.

Let’s take a look at the reported….

Side Effects of CBD

There are two main reasons that may cause you to experience side effects after taking CBD, and they are:

YOU’RE TAKING TOO MUCH CBD

As already discussed, during Epidiolex clinical trials, the likelihood of side effects increased at very high doses of purified CBD. The most common side effects that appeared were:

  • Diarrhea
  • Lethargy
  • Dizziness
  • Upset stomach
  • Dry mouth
  • Fatigue
  • Lower blood pressure

This effects are not severe by any means and can disappear in a few hours, but who wants a lousy day, right?

The heart of the matter is that CBD—same as alcohol—has a biphasic action. This means the dose you take determines its effects. Thus, the right amount of CBD will work wonders to make you feel better. However, if you take too much, the chances to have untoward effects will increase.

YOU'RE USING A CRAPPY PRODUCT

Woefully, most of the products out there aren’t reliable. In a market with unclear regulations and guidelines, anyone can put whatever in a bottle and label it as CBD.

Today, you can find products even in gas stations, and their content is often far from what’s printed on their labels.

Extracting high-quality CBD is not cheap, and vendors that prioritize profit don’t care about putting people’s health at stake when using poor extraction methods.

The Feds’ actions to regulate CBD aren’t moving as fast as the growth of the market. But the agency has done a number of studies to test the quality of products.

What has surfaced in these studies is that about 70% of the products offered are mislabeled. Many of them contain nasty chemicals, pesticides, and heavy metals. Some don’t contain CBD at all. But what’s even more worrying is that products were found containing a dangerous synthetic street drug.

VAPI, a fatal lung disease that became a public-health emergency in 2019, was associated with THC cartridges from the black market. After testing hundreds of these illicit cartridges, it was detected that they contained a range of contaminants from mercury and cyanide to pesticides and toxic flavor additives.

Many people suffered lung injuries, and dozens died after vaping these crappy products.

Your health is your wealth. Be savvy and always go for top-quality.

Other Concerns About CBD

There are other concerns associated with the safety of CBD that you should keep in mind:

CBD INTERACTS WITH OTHER DRUGS

CBD is a botanical, signifying that it’s a natural compound with drug-like effects. Therefore, the human body metabolizes it in the same way as any other drug. This process occurs in the liver by the Cytochrome P450 enzyme system, and CBD is a potent inhibitor of these enzymes.

Whether it’s decreasing or exacerbating their effects, mixing CBD with other drugs may NOT be a good idea, especially with medications that could be dangerous at irregular dosage such as blood thinners.

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THERE’S NO STANDARD DOSE

CBD works where your body needs it most, depending on diverse factors like your health goals, weight, body chemistry, and even your DNA. So the amount of CBD you need to get the desired effect depends on your individual needs.

That’s why experts haven’t come out with a standard dose, which leaves you on your own to find your serving size instinctively. 

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RESULTS CAN BE INCONSISTENT

It’s estimated that over a thousand CBD companies are offering products these days in the U.S. alone. This explains the huge amount of different items springing up everywhere.

Products aren’t created equally, quality and prices vary wildly. One thing that makes a big difference between them is how much CBD in a given product becomes active in your body after consumed. This variation of effectiveness is known as “bioavailability.”

Different rates of bioavailability mean that CBD absorption also differs, and the effects can be pretty inconsistent from one product to another. Your metabolic system and usage habits are also important factors involved in the absorption and effects of this cannabinoid.

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CBD MIGHT DAMAGE YOUR LIVER

There’s no strong evidence to prove this, but the FDA is warning consumers about the safety of CBD and updated the list of risks the compound poses. One of those risks is liver damage.

The research about this is limited. One study was done on mice and suggests that CBD modulates the activity of the enzymes involved in the metabolism of drugs like acetaminophen. On its own, acetaminophen has demonstrated to damage the liver, and CBD may increase this ability.

The CBD used in this study was Epidiolex, the FDA-approved drug with higher CBD concentration than most CBD products out there.

During Epidiolex clinical trials, 5 to 20% of the patients showed elevated aminotransferases enzymes on tests, after taking crazy high amounts of purified CBD.

These liver enzymes are important in the synthesis of amino acids, and increased levels may indicate liver damage.

Interestingly, there are other studies that suggest CBD may reverse liver scarring in patients with cirrhosis, and also improves liver and brain function.

Too many unknows surround this substance but it’s clear that high quantities and interactions with other drugs are a real concern.

So, if you have liver complications, it’s better to be cautious with CBD.

IT’S NOT RECOMMENDED FOR PREGANT AND NURSING WOMEN

The FDA has also warned pregnant and breastfeeding women about the harmful effects of cannabis products—including CBD—for the developing fetus, the mother, and the breastfed baby.

But studies on this topic are minimal. Experts tend to avoid using pregnant and nursing women in clinical trials for obvious reasons. One study conducted by the American Academy of Pediatrics found that CBD consumption increased the permeability of the placental barrier. This could be detrimental for the developing fetus.

How to Use CBD Safely

In the Wild West of CBD, determining what’s safe from the laundry list of products available is like searching for a four-leaf clover in a field of…..You guessed it, weeds!

But you’re not defenseless. Follow this checklist so you can buy reliable products and use them safely.

FIND A TRUSTWORTHY BRAND

In this uncontrolled market, unbacked health claims about the benefits of CBD are the current state of affairs. Do your homework and look for brands that take their clientele seriously, offering things like:

  • A good website that’s not only easy to navigate but also provides education and transparency.
  • Helpful customer service
  • Good manufacturing practices
  • Allow all types of reviews

Reach out and ask questions. Good brands are always ready to help.

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READ EVERY LABEL

Make sure you read product labels closely to identify the amount of CBD your product contains. Also, check the CBD to THC ratio and the good manufacturing practices (GMP) logo.

ASK FOR TEST RESULTS

The Certificate of Analysis (COA) is a third-party report from an independent lab that thoroughly vets the content of CBD products.

The most important things to look for in a COA are:

  • DATE

    The report should be up to date.

  • BATCH NUMBER

    Companies make products in batches. The number in the product should be the same in the COA report.

  • CANNABINOIDS PROFILE

    The CBD and THC percentage on the product’s label should match what the COA says.

  • OTHER INGREDIENTS

    CBD products fall under three categories, full and broad spectrum, which come with other compounds from the plant, and isolated CBD, which is a pure extract that contains CBD solely.

  • HEAVY METALS CONTENT

    The product should be free of metal elements that can be toxic for your health.

  • SOLVENTS CONTENT

    Solvents are used to extract CBD. There’s not such a thing as “the perfect solvent” but some are safer than others. Stay away from products with chemicals like naphtha or propylene glycol.

  • PESTICIDES

    CBD products should be sourced from organic hemp, so don’t forget to check for the presence of pesticides in the report.

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PASS ON PRODUCTS THAT MAKE HEALTH CLAIMS

Health claims are unallowed in the eyes of the FDA, but this hasn’t stopped companies from marketing CBD as a cure-all drug. Only prescription drugs that have passed the extensive process of testing for effectiveness and safety are allowed to make health claims.

The only proven benefit of CBD to date is to reduce seizures from two rare forms of childhood epilepsy. Health claims for any other condition are unlawful. 

LOOK FOR PRODUCTS SOURCED FROM ORGANIC HEMP

It’s worth asking how the hemp was grown and where it comes from when purchasing your CBD.

Due to decades of prohibition, many CBD products are from hemp harvested outside the U.S., which is NOT ideal since foreign hemp might contain pesticides, herbicides, or heavy metals. Look for CBD that’s organic, non-GMO, and preferably made with American-grown hemp.

You should find this info in the batch testing results of the product’s COA.

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CHECK ONLINE REVIEWS

Allowing reviews and responding to them is a way to prove how legitimate a brand is. Thoroughly check the comments from customers, especially the negative ones and pay attention if the company gave any helpful answers.

However, don’t rely on reviews alone to judge a brand. It’s easy these days to fake them. 

DISCUSS THE BENEFITS AND RISKS OF CBD WITH YOUR DOCTOR

I encourage you to go over the potential risks and benefits of this compound with your doctor and take his recommendations seriously.

Don’t quit your medication cold turkey or mix it with CBD without professional guidance. Experts believe that CBD interferes with drugs like antidepressants, benzodiazepines, blood thinners, and pain killers.

If your doctor isn’t well-versed in CBD, ask him to give you a referral to one who knows better. Doctors know doctors, and not all of them are CBD experts. You can also find a professional with a medical cannabis practice online.

START SLOW AND GO SLOW

This is your golden rule when trying CBD for the first time. Start with the lowest dose possible and gradually increase it until you feel the desired outcome. This method can prevent you from having unappealing effects. Once you find your “sweet spot,” stick with it as CBD works better over time.

LOWER YOUR DOSE

Side effects are most likely related to your dosage and the quality of your product. Thus, if you’re using only top-notch products and still experiencing side effects, it’s a good idea to lower your serving size.

Listen to your body and remember that CBD is like coffee. Just because many swear by it that doesn’t mean it’s right for everyone, so if side effects persist, maybe it’s time to ditch it.

Make sure you read product labels closely to identify the amount of CBD your product contains. Also, check the CBD to THC ratio and the good manufacturing practices (GMP) logo.

Final Words

CBD is an understudied molecule, and scientists still need solid evidence to prove that this compound is safe—or not—in the long-term.

I praise the use of CBD to treat anxiety and promote restful sleep. However, what might be effective to me may not be to you, so it’s always a good idea to consult with your doctor first. With guided and controlled use, you can surely enjoy the benefits of this remarkable compound.

Be a responsible CBD user, take dramatic health claims with a grain of salt, and learn as much as you can. To make a smart shopping decision, compare your options and don’t settle for cheap prices. Your health deserves better.

Although you still can find fantastic products with valuable discount codes, legal cultivation of hemp is heavily taxed, good extraction methods are expensive, and lab testing adds to the final price. This means that a cheap bottle of CBD oil from imported hemp and unknown quality is unlikely a good pick.

Wishing you success on your wellness journey.