how much cbd oil for liver disease

How much cbd oil for liver disease

We support health writers who wish to spread their work to a wider audience. This article was submitted by Natalie Shae.

Note, the study cited in the article was very small with children under physician care but if you are a liver patient it is a cautionary note if you are considering CBD oil. We are not aware of any research that would suggest using it more broadly but consult your doctor.

Liver Damage and CBD Oil

June 4, 2019 by Natalie Shae

The FDA has approved a CBD-based drug named Epidiolex®. The drug was researched and made by Greenwich Biosciences, and the company’s vice-president of U.S. professional relations, Alice Mead, has stated to the FDA that CBD is “potentially” a liver toxin. She said this during the FDA’s first public hearing on CBD oil on May 31, 2019.

What is CBD oil?

Cannabidiol oil is extracted from the hemp plant, which is in the same family as marijuana. Unlike THC in marijuana, CBD does not cause a “high” or chemical dependence. CBD that is extracted from the hemp plant is legal, but individual states have laws to regulate it.

Because CBD oil is not considered a drug, it can be a common additive in many products. This includes e-cigarettes (vape oil), lotions and various herbal supplements. It has also been shown to relieve symptoms of different disorders like epilepsy, anxiety and multiple sclerosis.

How does it impact the liver?

The few studies performed on how CBD affects the liver are not clear.

In one study , 10% of the subjects developed high liver enzymes—they had to stop using CBD for this reason. Other research suggests that CBD can improve liver function.

As determined by the studies done on Epidiolex®, CBD is metabolized by the liver. People with nonalcoholic steatohepatitis (NASH) are encouraged to limit over-the-counter (OTC) medications to avoid stressing the liver.

How much CBD is too much?

To further complicate the question, products with CBD oil may not give the exact amount listed on the package . Depending on the brand, the consumer may be using much more or less than they think. This is especially true of OTC supplements and e-cigarettes.

Now that CBD oil is appearing in different products, anyone with liver damage needs to be alert to this. A doctor or specialist should be consulted before adding it to the diet.

Can CBD Cause Liver Damage?

Adrian Devitt-Lee, is the young genius behind the think tank Project CBD. He is reputed to be formidably knowledgeable regarding CBD. Here, Devitt-Lee along with renowned doctor, Peter Grinspoon, weigh in to clarify if cannabidiol really killed four-and-a-half mice in a hotly debated study and will subsequently cause liver damage.

A recent article by Mike Adams for Forbes, asserts that CBD “could be damaging our livers in the same way as alcohol and other drugs.” This and other conclusions drawn by Adams caused the Henny Pennies of Twitter to insist the sky was falling. (Forbes‘ format does not allow readers to comment, so many took to Twitter to vent their anger.)

Of Mice and Men

According to Devitt-Lee this sensational claim was based on a dubious study of CBD and liver toxicity conducted by researchers (Ewing et al) at the University of Arkansas in Little Rock – except the damage discussed in the study was unrelated to alcohol toxicity and “our livers” actually refers to the livers of mice.

The Little Rock study makes no mention of humans beings, “which is a hugely important distinction,” clarifies Devitt-Lee. “Moreover, in the real world CBD consumers are not ingesting 0.25% of their body weight – the maximal dose that Ewing et al used in their study of liver toxicity.”

Nevertheless, according to Mike Adams’ Forbes article “People that use CBD are at an elevated risk for liver toxicity.” And “[CBD] may actually be just as harmful to their livers” as “conventional pain relievers, like acetaminophen.”

“The huge popularity of cannabidiol (CBD), a non-intoxicating component of cannabis, has helped to destigmatize the plant and restore its reputation as an important medicinal herb. But bogus science and inept reporting continue to distort how we understand the benefits and risks of CBD and cannabis,” he asserts.

Mega-dosing mice

Experimental white mouse on the researcher’s hand.

“The breathless reporting in Forbes focuses on a single, flawed, preclinical study and exaggerates it to the point of falsehood. Yet if there’s a saving grace of the Forbes article, it’s that it gets much less wrong than the study itself,” says Devitt-Lee. ( The study is freely available from Molecules , a journal published by the Multidisciplinary Digital Publishing Institute. (MDPI))

Devitt-Lee elucidates that a close examination of the Molecules study “reveals a Pandora’s box of strange statements, problematic publishing and unreasonable experimental design. On the first page, the abstract makes a claim that is fundamentally impossible , stating that, with chronic administration of CBD, ‘75% of mice gavaged with 615 mg/kg developed a moribund condition.'”

However, merely six rodents received this dose. “One doesn’t need an advanced degree in science or math to recognize that something is amiss. Seventy-five percent of six equals 4.5,” he sniffs.

According to the Little Rock researchers, four-and-a-half mice died from CBD, while somehow one-and-half mice survived.

Of Mice and Men

Devitt-Lee surmises that “scientists force-fed mice a single dose of CBD, ranging from the supposedly “low” dosage of 246 mg/kg up to a mega-dose of 2460 mg/kg CBD. That means for every kilogram of body weight, they gave the mice about 2.5 grams of CBD, which had been formulated as a hexane extract from cannabis supplied by the National Institute on Drug Abuse (NIDA). Hexane, incidentally, is a neurotoxin.”

“It is important to remember, that mice are not humans,” says Dr. Peter Grinspoon. “Those poor mice. Someone should call the ASPCA on those researchers,” he adds.

Devitt-Lee explains that in the “preliminary research on panic and anxiety, humans are usually given 300-600 mg CBD. The maximum human dosage recommended for the CBD-isolate Epidiolex is 20 mg/kg, which is over 100x less than what the Little Rock researchers force fed their experimental mice. They also tried smaller doses (ranging between 61.5 to 615 mg/kg) of CBD, which was given daily for 10 consecutive days.

“Despite these ridiculous dosages, Ewing et al. claim their study accurately represents human experience, insisting that the equivalent human dose is 12.3 times lower because of allometric scaling , This is – at best – an unverified assumption. More likely, it’s just plain wrong,” asserts Devitt-Lee.

Dr. Grinspoon concurs.

This column was posted in conjunction with ProjectCBD. To continue reading, please click here.

CBD For Liver Disease (NAFLD & AFLD): What the Research Says

Studies have shown that people who regularly use cannabis have fewer incidences of fatty liver disease.

How does this work?

Can CBD oil support people with liver disease?

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Fatty liver disease is a serious, but common medical condition.

Some studies have shown it to be present in about 16% of the population [1].

It’s a problem that tends to get worse until, eventually, it results in liver failure.

There are currently no known cures for the disease, however, recent evidence has suggested that CBD can be extremely beneficial for the condition.

Here, we investigate these claims, how they may work, and how CBD oil can be used to support fatty liver disease.


Updated on June 05, 2021

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The Benefits of CBD Oil For Fatty Liver Disease

CBD oil has indirect benefits for fatty liver disease. Research has shown CBD protects the liver by preventing overreaction of the endocannabinoid system (ECS). When the liver becomes stressed (due to poor diet or exposure to toxic compounds), the endocannabinoid system becomes highly active in the liver.

It’s this activation of the ECS leads to a buildup of fatty acid particles in the liver. CBD may prevent this from happening and may help slow the progression of the disease.

The only way to effectively treat fatty liver disease is through diet and lifestyle modifications. CBD oil can help support the condition, but won’t offer a cure.

The Best CBD Oils For Fatty Liver Disease

Guide to Using CBD Oil For Fatty Liver Disease

In recent years, there’s been a lot of reports that marijuana users suffered less frequently from obesity, diabetes, and metabolic syndrome [3-5], all of which are key drivers of fatty liver disease.

This is even more interesting when these researchers began looking at the diets of cannabis users and non-users.

On average, cannabis users ate more junk foods, soda, and alcohol than non-users [6], yet still had lower incidences of metabolic disease.

So this had researchers wondering;

“Could marijuana and CBD oil be used to prevent or treat fatty liver disease?”

A large research study analyzed the effects of CBD on 22,366 patients, many of which had active fatty liver disease or earlier stages of metabolic syndrome. Researchers in this study confirmed that the chances of developing fatty liver disease were much lower in those who were active cannabis users, though they were unable to suggest a mechanism for these effects [7].

Other studies have since been published that shed some light on how this works.

In order to get into the details of how this works, let’s discuss the role of the endocannabinoid system in the liver, and how this plays an important role in fatty liver disease.

What’s The Dose of CBD Oil For Fatty Liver Disease?

Dosing CBD for fatty liver disease is very similar to dosing it for other conditions.

Because the cannabinoids affect everybody so differently, it’s recommended that you always start with a lower dose (around 1 mg per day) and increase gradually from there.

Some people will stay at this 1 mg dose, while others may need substantially more, perhaps around the 30 mg mark,

The best way to find out the dose for you is to take 1 mg, then increase by 4 mg each day.

If side effects are noted (such as drowsiness, nausea, or poor appetite) simply reduce the dose to the last one that produced no side effects and stay there.

Fatty liver disease is a long-term, chronic condition, and will, therefore, need to be taken over a long period of time.

We recommend taking a high-quality CBD oil for 6 or 12 months, with regular follow-ups with your doctor to see any progression.

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What is Fatty Liver Disease?

Fatty liver disease is exactly what it sounds like: fat deposits in the liver.

When this happens, the fat deposits will start to interfere with the liver’s ability to function. If left unchecked, it will eventually lead to much more serious health problems.

There are two types of fatty liver disease:

1. Non Alcoholic Fatty Liver Disease (NAFLD)

Non-alcoholic fatty liver disease is caused by metabolic dysfunctions in the body.

Our liver plays a major role in the regulation of both sugar and fat metabolism.

The liver teams up with the pancreas and adrenal glands to control our blood sugar levels and fat burning or storage.

When we eat too much sugar or refined carbohydrates like chips, white bread, or candy, and don’t exercise enough, our body stops listening to one of the hormones secreted by the pancreas — insulin.

This is the starting point for fatty liver disease.

As soon as insulin stops working, the body no longer uses sugar the way it’s supposed to, causing it to build up to dangerous levels in the blood.

The liver needs to work much harder to stop the build-up of sugar from causing damage to the body. It does this by converting the sugar into stored fat.

When this happens, fat droplets accumulate inside the liver cells themselves.

Over time, these fat droplets will grow and take up more and more space inside the liver.

This causes damage to the liver cells, making them less effective at doing the job they’re meant to do. As the liver cells die, they trigger inflammation in the area, causing the liver to swell and become even less effective.

With long-term inflammation, the liver will begin to fill up with scar tissue, known as fibrosis.

These scars cause permanent changes to the liver, making it ineffective, and eventually leading to more serious symptoms.

NAFLD is driven by poor diet and lack of exercise.

2. Alcoholic Fatty Liver Disease (AFLD)

Alcoholic fatty liver is caused by long-term alcoholism.

The body can generally tolerate small amounts of alcohol relatively well, however, large amounts are problematic to the body.

There are 3 different ways the liver can metabolize alcohol, the main one being a pathway called alcohol dehydrogenase. There are many steps to this process, but the most important thing to know is that it requires a lot of energy to function.

This energy comes in the form of something called NAD+.

NAD+ can be thought of as a cellular currency for energy.

In order for the liver to get access to enough NAD+ to fuel alcohol metabolism, it needs to build a lot of fat. This is because NAD+ is a byproduct of building fat.

This leads to a buildup of fatty acids in the liver.

Over long periods of time, this fat can build-up to the point where it starts to get in the way, no matter where the liver tries to put it. There is simply too much.

By the time fatty liver disease symptoms show up in an alcoholic, there’s already a great deal of damage done, and it’s very difficult to repair, even with CBD oil.

CBD oil is best used for people with non-alcoholic fatty liver disease, so this is going to be the main focus of this article.

Diet & Lifestyle Modifications

As you can see, both alcoholic and non-alcoholic fatty liver disease is caused primarily by lifestyle and diet factors.

Diets with too much sugar or refined carbohydrates, poor exercise, and excessive alcohol intake are all key drivers in the condition.

Therefore, anything you take to help the condition is going to come secondary to changing the causes. This means visiting a holistic nutritionist, or dietitian, and working on changing your habits around food and alcohol.

CBD oil can go a long way if used in combination with these changes but will do very little on its own.

The Endocannabinoid System & Fatty Liver Disease

The endocannabinoid system is found in all mammals.

It’s a system of receptors (CB1 and CB2 receptors) and endogenous cannabinoids that are responsible for regulating many of our homeostatic control mechanisms.

In simple English, this means that the endocannabinoid system controls the balance of various systems in the body.

When our organs become damaged, inflamed, or dysfunctional, we find a noticeable increase in the endocannabinoid activity in the area, as it tries to bring us back to normal levels.

In a healthy liver, the endocannabinoid system only has a modest presence. In fact, it doesn’t appear to do much at all in this particular organ.

However, when the liver becomes damaged and inflamed, the endocannabinoid system wakes up and starts to be very active in the area.

Too active, perhaps…

When fatty liver starts and the liver function begins to suffer, the endocannabinoid system steps up to try and make things normal again, unfortunately, it only appears to make things worse, and CB1 and CB2 endocannabinoid receptors play a role in the development of fatty liver disease [8].

Supporting Liver Function With CBD

This is going to get real confusing, so let me get this out of the way.

CBD is a CB1 and CB2 receptor agonist-antagonist.

What does this mean, you ask?

In this case, it means that CBD stops the compounds that are making the endocannabinoid receptors (CB1 and CB2) in the liver go haywire.

It stops the endocannabinoid system from going crazy, establishing balance to the endocannabinoid system itself.

It’s the equalizer for the system that balances us.

This effectively protects the body from things like fatty liver disease and makes it easier for us to resist and recover from this condition more effectively.

It’s important to note that this action alone isn’t going to prevent fatty liver disease, but will make it more difficult for the condition to occur, giving us more time to change our lifestyle habits and diet before any permanent consequences set in.

Key Takeaways: Can CBD Oil Help With Fatty Liver Disease?

The best way to prevent or treat fatty liver disease is through diet modification.

CBD and other cannabinoids are going to go a long way in slowing the progression of the disease, and may even help to reverse it, but they aren’t going to work very well if the causes are still going on.

The primary cause of fatty liver disease is poor diet and lifestyle habits.

Heavy drinking, high junk food diets, and lack of exercise are the main causes of the condition. If they aren’t removed, the problem will persist and eventually get worse.

Combining CBD oil with diet changes – like eliminating processed and refined carbohydrates -, quitting alcohol or cigarette consumption, and spending at least 30 minutes per day on a mild-moderate level of exercise are going to go a long way in addressing the actual cause for the condition.