Liver Disease & CBD Oil: Risks, Benefits, & Research

Written by Jason Brett — Edited by Cathy Rozyczko on September 24, 2021 — Reviewed by Dr. Rosie Carey, GP

The seriousness and prevalence of liver disease, particularly in the western world, is real, and underrepresented. It is difficult to treat and has a progressively damaging nature. Liver disease often goes unrecognized until serious complications arise. Effective medical treatments are few and far between but CBD oil may be able to provide some relief.

The liver plays a significant role in the healthy functioning of the human body. The liver is responsible for transforming food nutrients into substances the body can use and for releasing the enzymes, blood clotting substances, vitamins, and proteins necessary for proper immune system functioning. In the presence of liver disease, the liver can no longer properly perform these essential functions.

While there are instances where the liver can regain healthy function or be repaired through surgery or transplant, the majority of cases are treated through disease management. This is where CBD oil comes in.

CBD oil’s functions in the body may be able to help manage symptoms and provide relief, restoring a better quality of life in liver disease patients.

Benefits of CBD Oil for Liver Disease

Unfortunately, there are no specific medical treatments for liver disease. How the disease is managed will depend on what has caused the decrease in liver function. CBD oil may be able to help address some of the symptoms and side effects of the condition, but it will not act as a cure.

In most cases, a change in lifestyle and diet will be required. For liver disease and cirrhosis caused by alcohol consumption, complete abstinence is necessary. A low sodium diet, coupled with limited protein intake will help to slow disease progression and enable a return to some liver function.

CBD oil’s anti-inflammatory, pain-relieving, antiemetic, and mood-elevating properties can help increase the quality of life for patients with liver disease.

Risks of CBD Oil for Liver Disease

It is impossible to talk about CBD oil and the liver without also mentioning the potential risks. In June of 2019, Forbes released an article detailing a study that found CBD oil contained in the FDA-approved CBD-based epilepsy drug Epidiolex caused liver damage in mice test subjects.

Compared to humans, mice are quicker to metabolize CBD, and their dosage was scaled accordingly: the maximum dosage of Epidiolex for humans is 20 mg per kilogram of body weight; the mice received a maximum daily dose of 615 mg per kilogram of body weight. The mice taking the maximum dose were found to have liver damage as early as 24 hours into the study and by the end, 75% of those mice had died or were near death.

While these findings are significant, they do not necessarily mean that using CBD oil will produce the same results. As mentioned, the maximum dose of Epidiolex for humans is 20mg of CBD per kg of body weight. This means that a 100-pound person would have to take 900mg of CBD a day to hit that maximum dose and potentially generate the same liver-damaging results found in the mice. That is a lot of CBD and most people will not require anywhere near that amount.

The liver is the organ the body uses to process toxins, drugs, and medications by way of the P450 enzyme system. Anything that follows this pathway, including CBD oil, when used in incredibly high amounts can damage the liver. In this regard, CBD oil is no different than any other supplement. If you consume only what you need, you are likely to remain safe. Even the World Health Organization has stated, “CBD is generally well tolerated with a good safety profile.”

At the end of the day, the only way to truly guarantee your safety is to speak with your doctor before using CBD oil products. A prudent way to keep a check on your liver functions would be to do blood tests for liver function prior to starting CBD and then at regular intervals during treatment.

Since CBD uses the liver’s P450 enzyme pathway, it could interact with other medications you’re taking that also use the P450 enzyme system. A physician will be able to best identify the potential risks and the severity of a CBD oil regimen to your personal health.

Effects of CBD Oil for Liver Disease

While CBD oil cannot cure or directly treat liver disease, it can help manage many of the associated symptoms and side effects.

CBD Oil for Pain Relief

For people with liver disease, pain relief may be hard to come by. With drugs like acetaminophen (Tylenol) and Vicodin causing damage to the liver, sufferers are forced to find alternative relief.

CBD acts indirectly on the CB1 and CB2 cannabinoid receptors located throughout the body. But it also works on non-cannabinoid receptors. For example, glycine receptors are inhibitory receptors that play a role in pain perception. CBD has been found to increase the effects of these receptors, decreasing the experience of pain.

CBD oil’s ability to fight inflammation also plays a role in its pain-relieving properties.

CBD Oil for Inflammation

CB2 receptors are found most prominently in the central nervous system and help to regulate the immune system. Through regulating the immune system, CB2 receptors regulate inflammatory responses.

Reducing inflammation is important when it comes to liver disease. Cirrhosis, which is the final stage of the disease, often comes with systemic inflammation and an immune deficiency.

CBD oil may be able to prevent inflammation from happening in the first place through its effect on cytokines. Cytokines are small proteins produced by the immune system when the body experiences stress. Some cytokines are responsible for the initiation and continuation of inflammation. CBD oil has been found to prevent this response, stopping inflammation before it begins.

CBD also works as an adenosine reuptake inhibitor. Adenosine is a neurotransmitter that impacts inflammation. By inhibiting adenosine reuptake, CBD increases the amount of adenosine available in the brain, thereby impacting adenosine receptors. Through its action on these receptors, especially the A2A receptor, CBD can help reduce inflammation throughout the body.

CBD Oil for Hepatic Encephalopathy

Hepatic encephalopathy (HE) is a decline in cognitive function connected to advanced liver disease. It is caused when the liver is unable to properly remove toxins from the blood, causing them to build up and cause brain damage. In fact, HE is found in 70% of patients with cirrhosis and 30% of patients in end-stage liver disease.

HE is characterized by “personality changes, intellectual impairment, and a depressed level of consciousness.” A 2011 study found that CBD may be able to improve HE and potentially restore some healthy functioning. CBD’s effects are wide-ranging and the study’s results are likely due to CBD’s impact on both the brain and the liver. As the study says, “cannabidiol restores liver function, normalizes 5-HT [serotonin] levels and improves brain pathology in accordance with normalization of brain function. Therefore, the effects of cannabidiol may result from a combination of its actions in the liver and brain.” While the study was done in mice, but suggests potential for similar results in humans.

CBD Oil for Nausea

One of the common symptoms and side effects associated with liver disease is nausea and vomiting. A variety of cannabinoids have been found to be effective in preventing nausea, with tetrahydrocannabinol (THC) being one of the best performers. One of the approved medications for use in cases of chemotherapy-related nausea is Nabilone, a synthetic version of THC.

THC is not CBD, obviously, but its use for nausea indicates that cannabinoids and their impacts on the endocannabinoid system may be effective for reducing nausea.

The exact causes of nausea are unknown but it is believed that excessive amounts of serotonin can lead to nausea and vomiting. CBD oil may reduce nausea by impacting the 5HT1A serotonin receptors in the brain. When cannabidiol binds to these receptors, the brain receives signals to reduce serotonin production, potentially stopping nausea at its source.

CBD Oil for Mood

While serotonin may play a role in causing nausea, when it appears in the proper amounts, it can also play a role in mood regulation and stabilization.

Liver disease can diminish serotonin production making some mood disorders like depression and anxiety worse. CBD is known to behave in a way that is similar to antidepressant medications like selective serotonin reuptake inhibitors (SSRIs) by preventing serotonin reuptake. By binding to the 5HT1A receptor mentioned above, CBD can help stabilize mood and keep healthy levels of serotonin in the brain.

How to Use CBD Oil for Liver Disease

There are many ways to use CBD oil for liver disease.

The most popular ways to use CBD oil are via capsule, edible, and CBD tinctures or drops.

Capsules and edibles are a great way to get a consistent therapeutic dose. They make a convenient addition to a daily supplement routine. With these delivery formats, CBD is processed through the digestive system before being absorbed into the bloodstream. Typically, it takes about an hour to see the effects of CBD but these effects can last between 4 to 6 hours.

CBD tinctures and drops allow users a little more control over their dose. Administered sublingually (under the tongue) through a dropper, adjustments can be made right down to a single drop. With this format, CBD is absorbed through the skin of the mouth, bypassing the digestive system and going to work within 30 minutes. The effects are usually felt for up to 4 hours. Tinctures and drops come in small portable bottles making it easy to take CBD oil on the go or take another dose during the day when needed.

When you need fast-acting results, CBD vape oils, e-liquids, and CBD flower are a useful choice. These inhaled formats are absorbed through the lungs, and show effects within minutes. Unfortunately, these effects are short-lived and typically gone within an hour. Because inhaling CBD leads to near-instant effects, these formats are great for sudden pain relief. However, it might not always be appropriate to vape or smoke, so using another format along with CBD vape or flower can be useful.

For targeted relief of aches and pains, using a CBD oil topical or transdermal patch may be effective. A CBD oil topical can provide targeted relief to the site of pain while a transdermal patch can deliver time-released CBD, providing an effective longer-term solution. With both of these formats, the CBD must be absorbed through the skin and the timing of its effects can vary. It will depend on a number of factors like the amount of hair on the skin and the amount of fatty tissue below it. But, in general terms, the onset is slow. However, the effects can last a long time: a topical can last over 5 hours while a transdermal patch can be effective for 24 to 48 hours.

Before trying any of these CBD oil delivery formats, it is important to speak to your doctor. CBD oil is generally safe but, as mentioned above, it can be an issue for the liver when taken in high doses. Having this important conversation with your health care professional will help you find the safest path forward. Furthermore, there are many commonly prescribed medications that can lead to hepatotoxicity and using these drugs in combination with CBD oil can increase the chances of experiencing it.

CBD might exacerbate some of the complications of liver failure such as prolonged bleeding time, so in patients with liver failure, CBD needs to be taken under the close monitoring of their doctor.

CBD Oil Dosage for Liver Disease

There is no universal dose of CBD oil for liver disease. Unless your doctor suggests a starting dose, it is best to begin with the lowest recommended dose listed on your CBD oil product. Once you determine how your body will respond to CBD oil, you can adjust the dose up or down as needed from there.

To get you started, we at CBD Oil Review we have analyzed hundreds of CBD oil products and come up with a standard suggested serving:

The CBD Oil Review Serving Standard is 25 mg of CBD, taken twice daily

If this amount does not provide the desired effects, you can slowly increase your dose by 25 mg every 3 to 4 weeks. The caveat is that liver toxicity from CBD is dose-dependent, so it would always be prudent to discuss dosing with your doctor and to start low and increase very slowly.

To better understand CBD oil dosage, see our dosage guide or speak to a naturopathic doctor.

Best CBD Oil for Liver Disease

There is no singular or “best” CBD oil for liver disease. Discuss your options with your physician and choose the one that works best for you and your personal needs.

What’s important when buying CBD oil is finding a quality product. Here are some shopping tips to help you find the right CBD oil product:

• Know the law. While hemp-derived CBD oil with a THC content at or below 0.3% is legal federally, it may not be legal in your state. Some states have restricted or no access to CBD oil and/or THC, so be sure to check the laws before you make a purchase.
• Check THC Content. Some CBD oil products will contain THC concentrations higher than 0.3%. In states with legal access to cannabis, these products will be okay to purchase. But, in states with tight cannabis laws, or if you prefer not to consume THC, look for a CBD oil isolate or a broad-spectrum CBD oil.
• Read the Certificate of Analysis (COA). Look for brands that share a COA for each batch of CBD oil products they produce. These lab test results will help you verify the CBD and THC concentrations listed on the product label and help you avoid any contaminants like heavy metals and pesticides.

Liver disease is a complicated illness with a wide variety of causes. Treatment is difficult and mostly relies on symptom management. While further study is required to determine how effective using CBD oil for liver disease really is, some of the currently available research suggests that CBD oil may be able to reduce complications and provide sufferers with some much-needed relief.

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