How CBD Helps With Liver Disease
There are several types of liver diseases caused by viruses, genes, and substance abuse. The most common liver diseases include cirrhosis, fatty liver disease, hepatitis, and hemochromatosis, a genetic condition that may be inherited(1).
Although some liver problems may be remedied with lifestyle modifications, some conditions may require treatment or surgery(2).
Treatment for autoimmune liver damage often includes corticosteroids or steroid hormones. Another medication for liver damage is prednisone, which may cause side effects, such as weight gain, high blood pressure, glaucoma, and mood swings(3).
A liver transplant is a treatment option for more serious liver diseases. However, a liver transplant also comes with several complications, such as internal bleeding, infection, seizures, liver failure, or rejection of the donated organ(4).
The drawbacks of these liver damage treatments may cause some individuals to search for more natural approaches to treating their livers. Some patients with liver conditions cannot be treated with pharmaceutical drugs, encouraging them to look for other remedies.
However, there are still questions about whether CBD may help with liver damage or not.
Although some studies have acknowledged the cannabinoid’s potential ability to stimulate liver regeneration, some studies link CBD to liver damage in animal subjects.
The human endocannabinoid system (ECS) is made up of G-protein-coupled receptors: the cannabinoid receptor 1 (CB1) and cannabinoid receptor 2 (CB2).
G-protein-coupled receptors are receptors in the body that link and transmit signals from compounds to a molecule called a G-protein(5).
You may find CB1 receptors throughout the body. However, the majority of them are in the central nervous system. Meanwhile, CB2 receptors may be found primarily in the immune system(6).
Medical researchers have been studying the ECS for decades to manage various physiological functions and peripheral organs.
According to a 2006 study, modulating ECS activity may have several therapeutic responses to various health conditions and diseases(7).
The researchers of the 2006 study observed how the ECS may affect weight balance, appetite, energy, and metabolism. They noted that administering a CB1 antagonist decreased food intake and body weight among animal test subjects.
Receptor agonists are medications that bind to receptors and activate them. Meanwhile, antagonists reduce the receptor’s ability to be activated(8).
Another study found in the International Journal of Molecular Sciences noted how CB1 antagonists reduced obesity in mice with diet-induced obesity(9).
Meanwhile, a Hepatology study observed how a CB2 receptor agonist improved fibrogenesis and accelerated liver regeneration(10).
Findings from the British Journal of Pharmacology discussed how CBD may function as a CB2 receptor inverse agonist, producing anti-inflammatory effects(11).
The 2009 study was supported by a more recent independent study published in the Canadian Journal of Kidney Health and Disease. In the study, the medical researchers used the cannabinoid to block CB1 receptors of insulin-resistant rats, preventing proteinuria (increased protein in the urine) and renal function decline(13).
A recent study highlighted that CBD may function as a CB1 antagonist(14).
Benefits of Using CBD for Liver Disease
According to a 2011 animal study, CBD may restore liver function, normalize 5-HT levels, and improve brain pathology. The researchers observed that the effects of the cannabinoid may be from a combination of CBD’s activities in the liver and brain(15).
Meanwhile, a 2017 study demonstrated that CBD treatment significantly reduced alcohol-induced liver damage in a mouse model. The medical researchers noted that CBD may have therapeutic potential in liver disease linked with inflammation, metabolic dysregulation, oxidative stress, and steatosis (fatty change)(16).
Below are some of the published studies about the effects of CBD on liver diseases.
Hepatitis C is a condition caused by the hepatitis C virus (HCV). Symptoms include tiredness, fever, joint pain, loss of appetite, and jaundice (whites of the eyes turning yellow).
According to the World Health Organization (WHO), there were new 1.25 million HCV infections worldwide in 2019(17).
A 2017 study stated that CBD may have bioactivities against HCV. The study noted that CBD’s direct antiviral activity may be effective against non-viral and viral hepatitis (autoimmune hepatitis)(18).
Although the 2017 study highlighted CBD’s potential benefits against HCV, medical researchers also noted that the cannabinoid did not affect the hepatitis B virus.
You must consult a physician before using CBD for hepatitis C. According to Mayo Clinic, untreated hepatitis C may cause a long-term infection, such as chronic hepatitis C, resulting in severe liver damage(19).
Alcoholic Liver Disease
Alcoholism may result in hepatosteatosis (fatty liver disease), also known as alcoholic liver disease (ALD).
With early detection and lifestyle modifications, ALD may be treated and reversed. However, if left untreated, ALD may progress to severe liver problems, such as hepatitis and cirrhosis.
Researchers noted that oxidative stress is one of the main factors in inducing steatosis. In a 2014 animal study published in Free Radical Biology and Medicine, medical researchers reported that CBD reduced toxicity and oxidative stress, resulting in reduced ethanol-induced liver injury(20).
In a Frontiers of Pharmacology study, animal studies showed that CBD may reduce liver steatosis and fibrosis caused by chronic and binge ethanol administrations(21).
Non-Alcoholic Fatty Liver Disease
Non-alcoholic fatty liver disease (NAFLD) is a medical condition caused by excess fat accumulated in the liver.
The causes of NAFLD may be obesity, insulin resistance, high levels of fat in the body, or high blood sugar.
There has been no prescription treatment approved to manage NAFLD(22). If you have NAFLD, your doctor may recommend a change in lifestyle and diet habits to help you lose weight naturally and reverse the fat deposition.
According to the 2020 study, CBD helped reduce intracellular lipid (fat) content in an in vitro (outside a living organism) hepatosteatosis model. The study also noted that CBD had antioxidant and anti-inflammatory effects(24).
Meanwhile, in a 2017 study published by PLOS One, medical researchers observed a strong connection between cannabis use and reduced NAFLD prevalence(25).
However, further clinical studies are needed to verify the cannabinoid’s efficacy in reducing lipid content in the liver and CBD’s anti-obesity properties.
Other Benefits of CBD for Liver Disease
According to a 2011 study, CBD may help manage acute liver failure symptoms, thus serving as a potential therapeutic compound for treating human hepatic encephalopathy (brain function decline caused by severe liver disease)(26).
Many health agencies, including the WHO, stated that the non-psychoactive cannabinoid is safe and generally well-tolerated(27).
Risks of Using CBD for Liver Disease
The production of CBD remains unregulated. The US Food and Drug Administration (FDA) has only approved Epidiolex, a CBD-derived drug for seizures associated with Lennox-Gastaut Syndrome and Dravet Syndrome(28).
If you plan on buying CBD products, you must research product specifications, testimonials, reviews, and third-party laboratory tests. According to the FDA, high doses of CBD may lead to liver injury(29).
Meanwhile, in a recent study, medical researchers observed that CBD use may affect liver wellness and result in dose-related liver damage(30).
The study also noted that the use of CBD may increase the risk of liver damage when used with other drugs, such as leflunomide (analgesic), mipomersen (medication for high cholesterol), pexidartinib (giant cell tumor drug), teriflunomide (multiple sclerosis medication), and valproate (epilepsy medication)(31).
If you have severe or moderate liver damage, your doctor may advise slow dose titration, which pertains to the slow adjustment of a medication dose for the maximum benefit without adverse effects(32).
According to Mayo Clinic, there have been no proven alternative medicine therapies for liver disease. Although some studies have indicated possible benefits, further research is still needed(33).
Dietary supplements and herbal products may also be harmful to liver health. There are over thousands of medications and herbal products associated with liver damage, including(34):
- Skullcap, a plant from the mint family
- Chaparral, a desert shrub
- Comfrey, a plant used to treat inflammation and chronic pain(35)
- Kava, a perennial herb
- Pennyroyal oil, an oil sourced from a plant in the mint genus
- Vitamin A
- Ma-huang, a Chinese herb
- Germander, a plant from the mint family
- Valerian, a flowering perennial plant
The list above highlights the importance of seeking medical advice before trying alternative medicine, such as CBD. Consult your doctor on the potential risks of these treatments before you opt for complementary or alternative therapies.
CBD Dosage and Consumption Methods
The most common methods of consuming CBD include:
- Sublingual (dropping CBD oil under the tongue) method
- Ingesting CBD tablets, capsules, or other edibles
- Mixing CBD into food or drinks
- Applying CBD topicals or balms directly onto the skin
One of the most common methods to take CBD is through vaping. Inhaling CBD serves as a quick way to ingest CBD since the cannabinoid enters the body through the lungs’ bloodstream without going through the digestive system.
However, some studies also noted that vaping may have detrimental effects on the lungs. According to a recent study, the increased vape use in the US resulted in the rise of vaping-related pulmonary problems(38).
Aside from pulmonary health risks, other vaping hazards include allergic reactions or irritation to the chemicals in the inhaled vapors(39).
Meanwhile, in a 2002 study, researchers noted that sublingual administration of CBD was an efficient way of taking the cannabinoid. According to the study, CBD oil had a sublingual bioavailability of 13% to 19%(40).
Bioavailability pertains to the extent and rate at which a medication is absorbed and becomes readily available for the body to process and break down(41).
According to a 2015 review, researchers observed that with the sublingual route of consumption, most compounds’ peak blood levels may be reached in 10 to 15 minutes. The researchers noted that this was faster than when the same drugs are ingested through oral administration.
If you do not like the taste of hemp oil, some CBD brands provide CBD edibles, like CBD gummies, in delicious flavors. Some companies also offer unflavored options in their CBD oil product line to encourage more individuals to buy.
You may also opt to mix CBD oils into your favorite meals. According to a 2018 study, cannabinoid’s highly lipophilic nature (lipid or oil solubility) allows the compound to dissolve in the fat content of food, which may boost the compound’s absorption and solubility(42).
One of the major advantages of the transdermal application of CBD is that it avoids the first-pass metabolism, which causes more constant plasma levels(43). The first-pass effect pertains to the early metabolization of a drug, reducing drug concentrations before the substance reaches its intended site of action(44).
In a 2018 study, medical researchers noted that CBD’s half-life is 24 hours after an intravenous administration and 31 hours after pulmonary administration(45). Half-life is the time required for one-half of a drug’s concentration to decrease to half of its initial dose in the body(46).
Meanwhile, researchers noted that the half-life of CBD is between 1.4 hours and 10.9 hours after an oromucosal (surface of the mouth) consumption route. The authors of the research recorded that the half-life of CBD is two to five days after an oral administration(47).
Below are some tips to remember before buying CBD products:
- Seek medical advice before using CBD. Learn about possible drug-to-drug interactions and adverse effects of CBD use for liver disease.
- Look for brands certified by the US Hemp Authority or other accrediting organizations.
- Compare the information on the product label to the data from the third-party lab reports.
- Research the state CBD laws applicable in your area.
- Read the reviews of past buyers before purchasing a CBD product.
Legality of CBD
The then President Donald Trump legalized hemp production at the federal level in 2018 when he signed the Farm Bill into law. The Farm Bill removed hemp and hemp-derived products with less than 0.3% of tetrahydrocannabinol (THC) from the list of Schedule I controlled substances(48).
Although CBD is federally legal, you must first research state CBD laws before purchasing CBD products. As of December 2020, the FDA still has not regulated the production and the marketing of CBD(49).