Cannabidiol (CBD): Benefits, Side Effects, and How to Choose

Cannabidiol (CBD) and CBD-based products have been gaining popularity across the health and wellness industry due to their potential therapeutic benefits. This chemical compound, derived from the hemp plant, does not produce psychoactive effects, and its potential applications include pain relief, sleep improvement, and beauty products.

In this article, we discuss the benefits of CBD and potential side effects to help you decide if CBD products may be right for you.

What is CBD (cannabidiol)?


Cannabidiol (CBD) is one of over 100 chemical compounds that can be found in the Cannabis sativa plant. While CBD has the same chemical formula as tetrahydrocannabinol (THC), each has different atom arrangements and distinct properties; for instance, CBD does not exhibit psychoactive effects (‘a high’).

The CBD can be extracted from either marijuana or hemp — the types of the Cannabis sativa plant. Using hemp plants for CBD extraction is more common as it results in only a trace amount of THC, making CBD extract more suitable for commercial use due to fewer legal restrictions on these products.

What does CBD do?

CBD has been suggested to have potential beneficial effects on the human body without exhibiting psychoactive properties such as THC. It has been reported to potentially alleviate the symptoms of chronic pain, decrease anxiety, or reduce the severity of seizures in different types of epilepsy.

Cannabidiol is also believed to interact with the immune system, and therefore, its therapeutic use has been studied in the context of autoimmune diseases such as rheumatoid arthritis.

While there is some clinical data available, the therapeutic effects of CBD require further investigation to support the claims regarding its benefits.

How does CBD work?


CBD works by interacting with the endocannabinoid system (ECS) of the body. This system is a network of receptors and endogenous signaling molecules that regulate and control many physiological functions such as appetite, mood, sleep, immune responses, and more.

CBD is reported to interact with the receptors of the ECS, and while precise mechanisms of the interaction have not been fully elucidated yet, the current understanding is that it interacts with both CB1 receptors in the central nervous system and CB2 receptors located predominantly in the peripheral tissues and immune cells.

CBD has also been proposed to interact with at least 40 other targets in the human body, including opioid, serotonin, and vanilloid receptors, and a range of different enzymes. However, there is still a lack of research on the functions and incidence of interactions with targets outside of ECS.

Potential benefits of CBD

CBD products have been subjected to various clinical trials assessing their potential benefits. Here, we provide a summary of recent studies investigating the effects of CBD on pain relief, mental health, sleeping disorders, and skin health.

Pain-relief and anti-inflammatory properties

One of the potential therapeutic applications of cannabidiol includes pain management due to potential pain relief and the anti-inflammatory properties of the compound. The potential therapeutic properties of CBD are related to its interaction with the endocannabinoid system (ECS). CBD interacts indirectly with receptors of ECS — CB1 and CB2. CBD is reported to bind to fatty acid amide hydrolase (FAAH), which interacts with CB1; this interaction is proposed to help alleviate pain. By indirectly interacting with CB2 receptors, CBD may promote anti-inflammatory and analgesic effects, which can help reduce inflammation and pain.

Currently, there are no approved pharmaceutical products that contain CBD alone for the management of pain. However, several studies have evaluated the role of CBD, usually in combination with THC, in both neuropathic pain and inflammatory pain management.

The meta-analysis provided in the Journal of Dental Anesthesia and Pain Medicine has analyzed 17 studies evaluating cannabinoid and cannabis-based product administration in over 850 patients with various types of neuropathic pain such as central NP, cancer-related neuropathy, spinal cord injury, etc. While analysis concluded that taking CBD did not show significant differences in pain intensity when compared to placebo, it also reported that patients taking a combination of CBD and THC were more likely to observe a reduction in pain. However, there are many studies that haven’t found any differences between cannabinoid use and placebo.

Due to the interaction of CBD with the immune system, the effects of CBD have been studied in the context of reducing symptoms of autoimmune diseases, including the management of pain. Some studies have suggested the therapeutic effects of CBD in pain relief in patients with multiple sclerosis or rheumatoid arthritis. However, the results are not unambiguous, and further research is needed to confirm these claims.


Some studies have also assessed the effect of topical application of CBD in pain management. For instance, the use of CBD oil on the skin has provided improvements in pain and other disturbing sensations in patients with peripheral neuropathy or chronic back pain. While several studies have assessed the potential effect of CBD products, most of these substances are not FDA-approved. Therefore, it is difficult to attribute the therapeutic properties to CBD as these products lack the appropriate clinical studies to support potential efficacy claims.

Mental health support

CBD products have been frequently marketed to provide mental health support. This includes applications such as anxiety or sleeping disorders.

The review published in the Journal of the American Pharmacists Association compared the results from eight studies that involved human participants. In the studies, the CBD was administered either as a capsule or spray, and the doses ranged from 6 mg to 400 mg per dose. In the trials, the CBD consistently showed improving clinical outcomes in anxiety disorders with minimal side effects. Most of the studies used a small number of participants, and therefore, further research with a bigger number of individuals and standardized dosing protocols are needed to support the claims.

The potential therapeutic effects of CBD have also been assessed in the context of alleviating symptoms of attention-deficit hyperactivity disorder (ADHD), Tourette syndrome, post-traumatic stress disorder (PTSD), or psychosis. The meta-analysis of these studies provided in the journal Lancet Psychiatry has shown that using CBD or a combination of CBD and THC products did not exhibit any positive effects compared to the placebo groups.

Sleep improvement

Several studies have assessed the effects of products containing cannabidiol on sleep improvement. Both THC and CBD interact with the endogenous cannabinoid (endocannabinoid) system, which might influence the circadian rhythm of the human body (a sleep-wake cycle).

A meta-analysis published in Sleep Medicine Reviews has gathered the outcomes of studies administrating CBD to both animal and human participants. The works assessed the effects of CBD, alone or in combination with THC, on various sleep disorders, including insomnia, REM sleep behavior disorder, restless legs syndrome, and narcolepsy.

None of the studies included in the meta-analysis have shown the therapeutic effect of CBD on treating any sleep disorder. It is worth mentioning that clinical trials that evaluated the effects of Epidiolex (a drug for epilepsy treatment containing CBD) on children with severe epilepsies reported increased somnolence and sedation as side effects. However, the drug has not been tested specifically for sleep improvement.

One study has reported the potential effects of CBD on REM sleep behavior disorder in patients with Parkinson's disease. The administration of low and moderate doses of CBD has reduced nightmares and active behavior during the REM phase. None of the studies have reported the therapeutic effects of using CBD for restless legs syndrome.


While some studies have assessed the therapeutic effects of CBD for sleep improvement, there is insufficient evidence to support the clinical use of cannabinoid therapies for the treatment of any sleep disorder.

Skin health

Topical cannabidiol products have been explored for skin health due to their potential anti-inflammatory properties. For instance, one study that tested the effects of CBD on skin cells in laboratory conditions has shown that CBD extract can reduce the presence of molecules responsible for inflammation.

The review presented in the Clinical, Cosmetic, and Investigational Dermatology journal summarizes the effect of CBD on skin. Overall, there is limited information about the effect of CBD on human skin, as most of the research performed so far has tested efficacy using laboratory conditions or animal models. This research has suggested that CBD might have antioxidative properties, which could help lower the levels of reactive oxygen species in skin cells. Cannabidiol might potentially exhibit antibacterial properties, as the delivery of CBD disrupts bacterial biofilm created by Staphylococcus aureus, one of the most common bacteria present on human skin.

Currently, there are several beauty products with CBD on the market, ranging from shower gels and body lotions to face creams. However, there is limited scientific evidence to confirm the potential benefits of CBD for skin health. More rigorous studies with a large number of human participants are required to confirm the claims based on laboratory and animal testing.

Safety and side effects

CBD is generally well-tolerated and has a good safety profile with rare reports of liver injury after daily high-dose administration. However, long-term studies are still needed to fully understand the side effects of prolonged use of CBD products. Potential side effects might include drowsiness, sleepiness, fatigue, or diarrhea.

It is recommended to discuss the use of CBD with a healthcare provider, as it might interact with medications or negatively affect individuals with certain pre-existing conditions. CBD has been reported to inhibit enzymes in the metabolic system in the liver (the CYP450 hepatic metabolic system). This system controls the serum levels of various drugs, and taking CBD might alter the system, leading to drug interactions with the body, which might consequently lead to reduced medicine effectiveness or additional concerns regarding drug safety.

Is CBD addictive?

CBD is considered a non-psychoactive compound, and therefore, it is generally non-addictive. Unlike THC, CBD does not produce the ‘high’ and euphoric effects, which might further lead to dependency. According to the report by the World Health Organization (WHO), clinical data did not report dependence effects (e.g., withdrawal and tolerance) of cannabidiol. The report, based on available human trials, also indicates that CBD is not associated with abuse potential.

CBD and pets

In recent years, there has been increasing interest in using CBD for pets. In many cases, owners who have successfully used CBD aiming to support their health believe that it could be equally beneficial for animals. However, few studies have evaluated the potential benefits of CBD for pets.

A review published in Research in Veterinary Science has summarized the effects of cannabidiol-based natural health products on pets. Most of the studies have evaluated the use of CBD for anxiety disorders and pain management, which are similar indications to those used for humans.

Overall, the research has shown mixed results regarding the potential effects of CBD in alleviating anxiety. One study claimed that CBD oil administration in shelter dogs reduced aggressive behavior toward humans. A study published in Frontiers in Veterinary Science assessed the clinical efficacy of cannabidiol in dogs with osteoarthritis (a degenerative joint condition). The work showed that using 2 mg/kg of CBD twice daily can help increase comfort and activity in dogs with osteoarthritis.

There are fewer types of CBD products for pets than for humans. The most common product is CBD oil, but CBD can also be infused into pet treats or supplements. However, the latter is quite limited due to the current regulations of CBD and its exclusion from the definition of a dietary supplement by the FDA.

Research on CBD's effect on pets has recently started, and therefore, there are several concerns regarding the safety, efficacy, and dosage of CBD products for animals. Currently, CBD is not recognized as a food additive by the Association of American Feed Control Officials (AAFCO), nor is it generally recognized as a safe (GRAS) substance by the FDA. Therefore, CBD and other hemp-derived products shouldn't be included as an ingredient in pet foods. More details on the use of CBD in veterinary medicine can be found in the 2023 report published by the American Veterinary Medicinal Association.

Forms of CBD products

As the interest in using CBD grows, the producers expand the forms of CBD products to meet market demands, tailoring different preferences and applications. CBD can be found in products ranging from oils to capsules and topicals to vapes. Here we include the most common forms:

  • Oils and tinctures. These are some of the most common forms of CBD. They are usually applied under the tongue using a dropper. This is proposed to speed up the absorption of CBD into the system.
  • Capsules and softgels. They provide a precise way of consuming a pre-measured dose of CBD, which can absorbed through the gastrointestinal tract.
  • Edibles. These include various products ranging from gummies to beverages. These products have become popular as they combine flavor with the discreetness of consuming CBD.
  • Topicals. These include creams, balms, or lotions, which can be applied to the skin.
  • Patches. This is another way of applying CBD through the skin. Transdermal patches are proposed to provide a slow release of CBD over a longer time.
  • Vape. These are CBD oils that can be loaded into a vape pen or e-cigarette. In this way, CBD is inhaled and absorbed through the lungs. However, vaping is also associated with negative health effects.

What are CBD gummies?

One form of CBD edible product is CBD gummies. This product is for those searching for convenient ways to combine pleasant taste with the potential benefits of cannabidiol. CBD gummies usually have a fruit flavor and are infused with an extract containing CBD available at different concentrations.

The potential benefits of CBD gummies are that they are easy to carry everywhere and are chewable. However, due to their similarity to sweets, the product should be carefully stored away from children.

Do CBD gummies have THC?

CBD gummies might contain trace amounts of THC. The presence of THC depends on the type of CBD product added to the gummies. Full-spectrum CBD might contain traces of THC, while products with broad-spectrum CBD or CBD isolate will not contain THC. It's advisable to check the label carefully for the list of ingredients, as these might differ depending on the producer.

How to use CBD

While starting CBD consumption, it is good to keep in mind several factors that might make your experience more efficient and pleasant. One of the important aspects to consider is the dosage. Determining the right CBD dosage can depend on your body weight, individual metabolism, sensitivity to CBD, the CBD concentration in the product, and any health conditions you might have. It is important not to exceed the dose recommended by the manufacturer, and to consult your healthcare provider for personalized advice.

It is good to find a more efficient method of consumption that is right for you. CBD oil remains the most popular version for CBD consumption. It is believed to be absorbed relatively quickly into mucous membranes. CBD in the form of capsules or edibles might be a better solution for those who do not like the strong taste of CBD.

It is important to ensure that CBD does not interact with other medicines or supplements. If you suspect that CBD might interact with the medicine that you are currently taking, seek the advice of a healthcare professional.

Here is a short recap for beginners:

  1. Choose quality products from known distributors.
  2. Keep track of your daily consumption of CBD so that it does not exceed the recommended dosage.
  3. Monitor your health and discuss any potential side effects and concerns with your healthcare provider.

How to choose the right CBD product

Selecting the right CBD product might take some time. It is good to get advice from a healthcare professional to ensure that CBD is suitable given your health condition as well as dietary and health goals. The steps below might help you choose the CBD product for you.

  • Specify your goals. Before buying a CBD product, think about what type of issues you want to tackle. This is important as different health conditions (e.g., pain management, anxiety symptom support, etc.) might require different forms and dosages of CBD-based products.
  • Analyze and understand the labels. The products should state the amount of CBD. Usually, you will find this number as the total amount of CBD (e.g., 1,000 mg of CBD per bottle) or the amount of CBD per serving (e.g., 10 mg of CBD per drop). Understanding the concentrations of CBD will help you make informed decisions about the dosage.
  • Understand different forms of CBD. CBD comes in different forms and some of them contain different cannabinoids. The most common forms include full-spectrum products (containing various cannabinoids from the hemp plant and trace amounts of THC), broad-spectrum products (containing various cannabinoids with no THC), or CBD isolate (containing only CBD).
  • Check source and extraction methods. Buy CBD products extracted from hemp plants cultured in known locations. If possible, check how the CBD was extracted. The most common extraction method is CO2 extraction which is reported to offer good quality and diverse profile of cannabinoids present in the product.
  • Verify the quality of the product. Aim to buy CBD products from known and established producers that subject their CBD products to third-party laboratory testing. Independent laboratories might provide confirmation about the quality of the products.

The legal status of CBD varies in different regions and countries. This also depends on whether the CBD was extracted from the hemp or marijuana plant. Usually, the CBD extracted from the marijuana plant contains a higher amount of THC, which is subjected to stricter regulations due to its psychoactive effects.

Hemp-derived CBD products are accepted in many regions, including North America, the European Union, and the United Kingdom. Marijuana-derived CBD is not allowed in several countries due to its high THC content.

Final word

CBD-based products are gaining popularity in the health and wellness industry. Some studies have suggested the potential benefits of using cannabidiol for pain management, anxiety, or sleep improvement. However, most of these have been performed either in the laboratory using animal models or in clinical studies with only a small number of human participants. Therefore, additional clinical trials are needed to confirm potential claims on the therapeutic effects of CBD.

If you consider taking CBD products, remember to source these from established and known distributors. It is good to discuss your goals with a healthcare provider as they might guide you to find the optimal dose and form of CBD optimizing the potential benefits.


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