CBD side effects and long-term toxicity

CBD or cannabidiol is a natural compound extracted from cannabis that does not produce a high, and has become the focus of attention due to its therapeutic potential, ranging from pain relief to anxiety reduction.

While products such as CBD oils are generally considered safe, it is important to understand that, like any other substance, CBD can have side effects and safety and toxicity considerations that vary by individual and form of administration.

Does CBD have side effects?

Yes, CBD can have side effects, although they are usually mild, infrequent, temporary and mostly CBD dose-dependent (1). In addition, it is essential to note that side effects may vary according to individual sensitivity.

Frequently asked questions about CBD side effects

¿El CBD afecta a la fertilidad o salud reproductiva?

En adultos sanos, el CBD no afecta la salud reproductiva. Es decir, tanto en hombres como mujeres, el CBD no afecta en la posibilidad de concebir (8). 

¿El CBD da sueño?

Aunque algunos pueden experimentar somnolencia al tomar CBD, es importante destacar que el CBD puede ser estimulante también. Este efecto se ha sugerido que se debe al efecto bifásico del CBD, donde dosis muy bajas tienen un efecto opuesto al de dosis altas. Así, el cannabidiol tiene un efecto estimulante cuando se administra en dosis mínimas (10, 11) y un efecto de somnolencia a dosis altas de CBD (12).

¿El CBD da hambre?  

La respuesta del CBD en el apetito varía de persona a persona. El CBD puede estimular el hambre en algunas circunstancias, pero no suele aumentar el apetito de la misma manera que el THC. Los estudios sugieren que el cannabidiol puede reducir o aumentar el apetito, aunque se desconoce cuál es el factor determinante para los efectos opuestos. No es común que cause un aumento significativo del hambre, pero como mencionamos anteriormente, las respuestas pueden variar según la persona.

¿El CBD produce paranoia como la marihuana? 

El CBD no produce paranoia ni efectos psicoactivos como el THC. De hecho, el CBD puede contrarrestar algunos de los efectos psicoactivos del THC, como la ansiedad y la paranoia (14). Por ello, algunos grupos de investigación sugieren que los productos de marihuana que no contienen cannabidiol son más psicoactivos que aquellos con una proporción más equilibrada de THC y CBD.

¿El CBD mejora el estado de ánimo?

El CBD (cannabidiol) puede tener un efecto positivo en el estado de ánimo de algunas personas ya que puede estimular los receptores de serotonina (13). Esto resulta potencialmente beneficioso para aquellas personas que experimentan ansiedad, estrés o depresión, afecciones para las cuales se está investigando el uso de CBD.

¿Se puede conducir bajo los efectos del CBD?

El CBD no debería afectar negativamente la capacidad de conducir. Sin embargo, al ser una sustancia cuyos efectos pueden depender de la sensibilidad individual y de la dosis de CBD, es  como con cualquier sustancia, es importante estar alerta y asegurarse de estar en condiciones adecuadas para conducir antes manejar un vehículo.

Is CBD addictive?

No, CBD is not an addictive substance. Unlike THC, cannabidiol is not habit-forming and does not lead to physical or psychological dependence.

Possible side effects that can occur with CBD

The following are some of the possible side effects that may be experienced when consuming CBD:

Changes in appetite

Some people may feel an increase or decrease in their appetite after taking CBD. This can vary from person to person and is due to the way CBD interacts with the endocannabinoid system (2).

Some studies suggest that cannabidiol may have an anorectic effect and decrease appetite (2). Some other studies believe that it results in the opposite effect and CBD stimulates appetite (3), so more research is needed on CBD and its effects on hunger.

Dizziness

Dizziness is an occasional side effect of CBD (5). It is possible that the decrease in blood pressure is related to the dizziness.

Diarrhea

In some cases, CBD can cause diarrhea, but this is rare. In some studies it has been linked to high doses, and therefore its incidence increases with increasing cannabidiol dose (6).

* You may be interested in: How CBD affects the gut

Fatigue

Some people experience fatigue after taking CBD, which may be due to its relaxing effect. On the other hand, some studies have linked the presence of fatigue with the use of CBD in combination with other drugs (1).

Dry mouth

Dry mouth, also known as cotton mouth, is one of the most common side effects of THC. THCthe psychoactive component of marijuana. Although some people have reported this effect as an effect of CBD, it is possible that it is due to factors such as dehydration or consumption of other cannabinoids.

Cannabidiol has no effect on salivary glands, and may even reverse the effect of THC on these glands, resulting in less dry mouth effect (7). Therefore, CBD would not produce the dry mouth effect associated with marijuana use. However, it is worth considering that the use of products with residual THC content (such as Full Spectrum CBD oil) could have these effects.

Decrease in blood pressure

Cannabidiol may cause a slight decrease in blood pressure in some people when administered acutely in high doses (4). Although this could be beneficial for some patients with cardiovascular problems such as hypertension, in healthy people it could lead to dizziness or fainting.

* You may be interested in: CBD for hypertension: How does it affect?

In case of experiencing any side effects with the use of CBD, it is advisable to stop using it and consult a professional.

Contraindications of CBD

Like any substance, CBD is not free of contraindications and certain precautions must be taken to avoid unwanted effects.

Medical advice and supervision is recommended before using CBD, especially if you are taking other medications, due to possible interactions between CBD and medications. In addition, taking CBD during pregnancy is strongly discouraged. The same for children without professional advice: the lack of data on the effect of cannabis on minors underlines the need for caution.

Long-term toxicity and safety of CBD

Is CBD safe?

To date, no cases of serious toxicity associated with cannabidiol consumption at normal doses have been documented. Studies have shown that CBD is a relatively safe substance. However, more research is needed to fully understand its long-term safety.

Can CBD be taken for life?

One study reviewed all available studies on CBD toxicity and concluded that a maximum daily CBD dose of 1.42 mg/kg does not represent a risk for daily use (9), provided there are no contraindications.

There is no evidence to suggest that CBD is dangerous when used long-term, but more research is needed to determine the long-term effects of continued use. If you plan to use CBD long-term for medical reasons, it is essential to speak with a healthcare professional to assess the risks and benefits as, to date, there is no specific research on the long-term use of CBD.

Explanatory note:

Last update: September 2023. Please note that new scientific evidence may appear after the publication date of this post. If in doubt, consult a professional before using CBD.

This is an informational post, based on ongoing research, which cannot and is not intended to diagnose, prevent or treat any disease or symptom. Its content can complement, but never replace, the diagnosis or treatment of any disease or symptom. Cannactiva products are not medicines.

In most European countries, CBD is not regulated for domestic use. Cannactiva products are intended for external use. Consult a professional before using CBD.

Referencias
  1. Huestis, M. A., Solimini, R., Pichini, S., Pacifici, R., Carlier, J., & Busardò, F. P. (2019). Cannabidiol Adverse Effects and Toxicity. Current neuropharmacology, 17(10), 974-989. https://doi.org/10.2174/1570159X17666190603171901
  2. Pinto, J. S., & Martel, F. (2022). Effects of Cannabidiol on Appetite and Body Weight: A Systematic Review. Clinical drug investigation, 42(11), 909-919. https://doi.org/10.1007/s40261-022-01205-y
  3. Hussain, S. A., Zhou, R., Jacobson, C., Weng, J., Cheng, E., Lay, J., Hung, P., Lerner, J. T., & Sankar, R. (2015). Perceived efficacy of cannabidiol-enriched cannabis extracts for treatment of pediatric epilepsy: A potential role for infantile spasms and Lennox-Gastaut syndrome. Epilepsy & behavior : E&B, 47, 138-141. https://doi.org/10.1016/j.yebeh.2015.04.009
  4. Jadoon, K. A., Tan, G. D., & O’Sullivan, S. E. (2017). A single dose of cannabidiol reduces blood pressure in healthy volunteers in a randomized crossover study. JCI insight, 2(12), e93760. https://doi.org/10.1172/jci.insight.93760
  5. Hundal, H., Lister, R., Evans, N., Antley, A., Englund, A., Murray, R. M., Freeman, D., & Morrison, P. D. (2018). The effects of cannabidiol on persecutory ideation and anxiety in a high trait paranoid group. Journal of psychopharmacology (Oxford, England), 32(3), 276-282. https://doi.org/10.1177/0269881117737400
  6. Szaflarski, J. P., Bebin, E. M., Comi, A. M., Patel, A. D., Joshi, C., Checketts, D., Beal, J. C., Laux, L. C., De Boer, L. M.., Wong, M. H., Lopez, M., Devinsky, O., Lyons, P. D., Zentil, P. P., Wechsler, R., & CBD EAPD, Wong, M. H., Lopez, M., Devinsky, O., Lyons, P. D., Zentil, P. P., Wechsler, R., & CBD EAP study group (2018). Long-term safety and treatment effects of cannabidiol in children and adults with treatment-resistant epilepsies: Expanded access program results. Epilepsia, 59(8), 1540-1548. https://doi.org/10.1111/epi.14477
  7. Andreis, K., Billingsley, J., Naimi Shirazi, K., Wager-Miller, J., Johnson, C., Bradshaw, H., & Straiker, A. (2022). Cannabinoid CB1 receptors regulate salivation. Scientific reports, 12(1), 14182. https://doi.org/10.1038/s41598-022-17987-2
  8. Henderson, R. G., Vincent, M., Rivera, B. N., Bonn-Miller, M. O., & Doepker, C. (2023). Cannabidiol safety considerations: Development of a potential acceptable daily intake value and recommended upper intake limits for dietary supplement use. Regulatory toxicology and pharmacology : RTP, 105482. Advance online publication. https://doi.org/10.1016/j.yrtph.2023.105482
  9. Dong, C., Chen, J., Harrington, A., Vinod, K. Y., Hegde, M. L., & Hegde, V. L. (2019). Cannabinoid exposure during pregnancy and its impact on immune function. Cellular and molecular life sciences : CMLS, 76(4), 729-743. https://doi.org/10.1007/s00018-018-2955-0
  10. Murillo-Rodríguez, E., Millán-Aldaco, D., Palomero-Rivero, M., Mechoulam, R., & Drucker-Colín, R. (2008). The nonpsychoactive Cannabis constituent cannabidiol is a wake-inducing agent. Behavioral neuroscience, 122(6), 1378-1382. https://doi.org/10.1037/a0013278
  11. Piomelli, D., & Russo, E. B. (2016). The Cannabis sativa Versus Cannabis indica Debate: An Interview with Ethan Russo, MD. Cannabis and cannabinoid research, 1(1), 44-46. https://doi.org/10.1089/can.2015.29003.ebr
  12. Chagas, M. H., Crippa, J. A., Zuardi, A. W., Hallak, J. E., Machado-de-Sousa, J. P., Hirotsu, C., Maia, L., Tufik, S., & Andersen, M. L. (2013). Effects of acute systemic administration of cannabidiol on sleep-wake cycle in rats. Journal of psychopharmacology (Oxford, England), 27(3), 312-316. https://doi.org/10.1177/0269881112474524
  13. Linge, R., Jiménez-Sánchez, L., Campa, L., Pilar-Cuéllar, F., Vidal, R., Pazos, A., Adell, A., & Díaz, Á. (2016). Cannabidiol induces rapid-acting antidepressant-like effects and enhances cortical 5-HT/glutamate neurotransmission: role of 5-HT1A receptors. Neuropharmacology, 103, 16-26. https://doi.org/10.1016/j.neuropharm.2015.12.017
  14. Englund, A., Morrison, P. D., Nottage, J., Hague, D., Kane, F., Bonaccorso, S., Stone, J. M., Reichenberg, A., Brenneisen, R., Holt, D., Feilding, A., Walker, L., Murray, R. M., & Kapur, S. (2013). Cannabidiol inhibits THC-elicited paranoid symptoms and hippocampal-dependent memory impairment. Journal of psychopharmacology (Oxford, England), 27(1), 19-27. https://doi.org/10.1177/0269881112460109

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