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Science of CBD Continues to Take Shape

By Harris Wheless

There has been a concerted effort in many areas of the country to legalize or decriminalize cannabis in its various forms. With the recent legalization of commercial marijuana sales in Illinois, marijuana is now legal in 11 states recreationally and in 33 for medical use. The passing of the 2018 Farm Bill, which legalized industrial hemp production and removed it from the list of controlled substances, has also triggered the eruption of a new market within the cannabis industry.

CBD, or cannabidiol, is a compound found in cannabis plants that is being used as an alternative treatment for ailments such as anxiety, chronic pain, and sleep-deprivation. Although CBD products are considered relatively safe to use with few side effects, the lack of long-term research has held the FDA back from approving CBD. One exception is the CBD-based oral solution Epidiolex, which has been approved to treat two rare forms of childhood epilepsy. Studies show that CBD could be used to relieve symptoms associated with cancer, opioid addiction, and depression. But a new study suggests people who want to take high doses of CBD for an extended period of time should take the proper safety precautions, and consult with their doctor before trying CBD.

Findings from the study

Earlier this year, researchers at the University of Arkansas for Medical Sciences examined CBD hepatotoxicity, or liver damage, in mice. According to the study, published in the journal Molecules, high doses of CBD may put users at a greater risk for liver toxicity. Researchers gave eight male mice varying daily doses of CBD over a period of 10 days using the dosage and safety recommendations provided for Epidiolex, scaled to the mouse equivalent. The mice given the maximum recommended dosage showed signs of liver damage within 24 hours, and by day four, 75% of them were dead or dying.

Igor Korturbash, PhD, who led the research team on this study, told the health site Nutra Ingredients USA that the risk of liver damage is stated explicitly on the Epidiolex packaging.

“If you look at the Epidiolex 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 In clinical trials, 5% to 20% of the patients developed elevated liver enzymes and some patients were withdrawn from the trials.”

This isn’t something that the medical community is unaware of. An FDA news release from June of 2018, following the approval of the drug, stated that the use of Epidiolex may result in a number of side effects. Specifically, the release said scientists determined that “Epidiolex also caused liver injury, generally mild, but raising the possibility of rare, but more severe injury.” Despite this, there is not enough accessible information on the subject.

What does this study mean for CBD users?

This study isn’t a reason to toss your CBD nor is it something to be overlooked—it’s another piece of information in an emerging space. All information about a subject as popular and lightly studied as cannabis should be taken into account.

For the average CBD user, the dosage used in this study is most likely a lot higher than what might be taken. Extremely high doses—hundreds of milligrams per day—are necessary to treat epilepsy, whereas everyday users will use far less than that. For reference, the CBD dosage many people take for everyday ailments usually amounts to 1–6 mg of CBD for every 10 pounds of body weight. So, someone who is 200 pounds might take 20–33 mg as a starting dose.

The manner of consumption also has a hand in determining how much CBD will get into someone’s system. If administered orally like Epidiolex, the substance will be transported directly into your bloodstream. Epidiolex is a special case among CBD products in terms of dosage, but it’s also more clearly labeled. Epidiolex is an FDA-approved drug with an approved label, the specific effects of which are documented. Because other CBD products aren’t FDA-approved, it’s important for consumers to seek out reputable brands, avoid counterfeit products, and work their way up to an effective dose slowly.

Some have raised concerns about the validity of the study and the subsequent reporting that has been done on it. A Leafly article called the research “one small study, on mice, with a highly questionable methodology, published in a marginal journal, with major flaws.”

According to Leafly, the dosage administered during the study was “astronomically high,” which along with the questionable experimental design led to the mice being harmed in a way that would not occur if different precautions had been taken. Any conclusions that might be drawn from these results regarding any effects CBD may have on humans should be viewed with skepticism.

As the science around CBD continues to take shape, be sure to think critically about what you’re putting into your body, and do research before taking CBD. Take proper safety precautions, and check to see if a brand is doing the same with what they’re selling you.

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