CBD Side Effects: What You Need to Know

The popularity of products containing cannabidiol (CBD), such as oils, tinctures, edibles, and drinks, has been increasing among the health and wellness community. This natural remedy is proposed to contribute to certain health benefits, such as helping with pain or anxiety.

While the interest in CBD is growing, these products, like any other product containing bioactive compounds, might also have side effects. Here, we discuss potential CBD side effects and everything you need to know to minimize the risks associated with using these products.

What is CBD (cannabidiol)?

Cannabidiol (CBD) is a non-psychotropic substance that is sourced from the Cannabis sativa plant, which contains over 100 chemical compounds.

CBD has the same chemical formula as delta-9-tetrahydrocannabinol (THC), but the compounds have different molecular structures. Because of that, THC can exhibit psychoactive effects frequently known as ‘high,' while CBD doesn't. In industry, the primary source of CBD is the hemp plant, while THC is typically extracted from the marijuana plant due to its higher THC content.

Hemp-derived products can be classified as full-spectrum, broad-spectrum, or isolates. The first one might contain traces of THC, usually below 0.3%, depending on the country’s regulations.

While the mechanisms of action of CBD in the body are not fully understood, it is known that this chemical compound interacts with the endocannabinoid system, particularly with CB1 and CB2 receptors, which contribute to the modulation of mood, sleep, appetite, and immune system function.

CBD side effects

While taking CBD products such as oil, gummies, and drinks is generally considered relatively safe, taking CBD, or any other bioactive compound, might lead to side effects, especially if CBD dosage is exceeded. Potential side effects include:

Drowsiness and fatigue

CBD can have a calming effect that may result in drowsiness or fatigue, which was also reported in multiple clinical studies. For instance, a study published in Epilepsia assessed the effect of cannabidiol on pediatric individuals with epilepsy. Over 50% of participants have reported drowsiness as a side effect.

In a clinical trial assessing the effect of cannabidiol on tremors in Parkinson's disease, 69% of participants reported increased fatigue.

Gastrointestinal issues

Multiple clinical studies have reported diarrhea as an adverse event after CBD administration. According to the controlled trial published in the New England Journal of Medicine, individuals taking cannabidiol have experienced stomach upset such as diarrhea or vomiting.

Additionally, the most common CBD side effects that are listed on the Epidiolex® (a prescription drug that contains CBD) prescription label include diarrhea and decreased appetite.

Dry mouth

According to the study published in the Journal of Cannabis Research, 11% of users have experienced dry mouth. Dry mouth is usually reported among individuals using oromucosal CBD sprays.

Low blood pressure

CBD products might reduce blood pressure, which might be a cause of concern for individuals with hypotension or those taking medication that lowers blood pressure.

Allergic reactions

Certain CBD products might induce allergies, especially when they are administered through inhalation.

Is CBD safe?

CBD is generally reported to be well tolerated by most healthy individuals. The systematic review in the Journal of Clinical Medicine Research has reported that among 22 controlled clinical trials, most studies that provided cannabinoids to participants short-term did not report adverse effects. The studies with chronic administration reported mild to moderate adverse effects.

CBD has been reported to interact with enzymes in the liver, which might affect its functionality and increase the risk of drug and herb interactions. Limited evidence from animal studies also suggests that it may negatively affect the production of testosterone, which might hamper male reproductive health.

If you plan to introduce CBD into your routine, you might consider consulting with a healthcare professional to determine whether CBD products are right for you. This is especially important if you have an existing medical condition, as CBD and other medications might interact with each other.

High doses of CBD that exceed daily recommendations might potentiate side effects.

It is important to note that CBD's long-term effects have not been extensively studied, and further clinical data is needed to confirm the safety profile of CBD when administered long-term. The safety of CBD has not been evaluated in pregnant and breastfeeding women.

Lack of regulation

The legal status of CBD varies between countries. Hemp-derived CBD products that contain trace amounts of THC (below 0.3%) are allowed in most places in North America, Europe, and the U.K.

Since CBD products are frequently intended for recreational rather than medical use, the regulatory framework around these products is very vague and inconsistent.

CBD products might claim beneficial effects despite the lack of supporting clinical data or provide inaccurate labels. According to a study published in Missouri Medicine, among 120 CBD products tested by the FDA, 55% contained different concentrations of CBD than indicated on the label. More concerning is that 49% of these products also contained THC.

It is important to source CBD products from known providers where the content of the products is tested by third-party labs.

Who should avoid taking CBD?

CBD is not suitable for everyone. Under certain medical conditions, people should avoid taking products such as CBD oils, capsules, or other products. These include:

• CBD and pregnancy. The safety profile of CBD has not been evaluated.
• CBD and breastfeeding. The safety profile of CBD has not been evaluated.
• CBD for children. A CBD-based drug has received FDA approval to treat certain pediatric epilepsy conditions, but there is no further scientific proof of the safety and efficacy of CBD for other pediatric conditions.
• CBD and liver disease. CBD inhibits certain enzymes in the liver, which might decrease the effectiveness of certain drugs or affect people with liver conditions.
• CBD and medication. The review published in Expert Opinion in Clinical Pharmacology has suggested that cannabidiols might interact with certain drugs. Individuals taking these medications should consult with their healthcare provider to determine if taking CBD is safe for them.

When to seek medical attention

CBD is considered to have an overall safe profile, and it is rare to observe severe reactions to CBD products.

If you experience an allergic reaction, such as difficulty breathing or swelling around the face or neck area, seek immediate medical attention. Other situations that might require contacting a healthcare provider include slurred speech, low blood pressure, or uncoordinated movements.

Always check the label of CBD products to ensure that you are not allergic to any of the ingredients or haven't had any adverse reactions to them in the past. Aim to source your CBD products from known providers whose products have been certified through third-party testing.

Final word

CBD products have become popular and are consumed by an increasing number of people. They are suggested to offer potential benefits, such as pain management, anxiety reduction, and better sleep. When starting the CBD journey, it is important to understand the potential side effects these products can bring, like dizziness or stomach issues, to make informed decisions.

It is worth remembering that these supplements are not suitable for everyone, as their safety has not been tested on pregnant or breastfeeding individuals or children. CBD might also interact with certain medications, such as blood thinners or anti-anxiety medications. It is good to consult with a healthcare provider before adding CBD to your routine to ensure that it is right for you.