Some recent studies have found mild elevations in liver enzymes in patients using CBD (Cannabidiol) oil.
A recent systematic review and meta-analysis published in March 2023 was conducted to determine the association between cannabidiol use, liver enzyme elevation, and drug-induced liver injury (DILI).
Cannabidiol generally has a very well tolerated side effect profile, compared to other commonly prescribed pharmaceutical medications used for treating anxiety, depression, stress, sleep disorders and the likes of refractory epilepsy.
The systematic review and meta-analysis found:
Cannabidiol use was associated with an increased probability of liver enzyme elevation (N = 12 trials, n = 1229; OR = 5.85 95% CI = 3.84–8.92, p < 0.001) and DILI (N = 12 trials, n = 1229; OR = 4.82 95% CI = 2.46–9.45, p < 0.001) compared to placebo controls.
In participants taking cannabidiol (N = 28 trials, n = 1533), the pooled proportion of liver enzyme elevations was 0.074 (95% CI 0.0448–0.1212), and DILI was 0.0296 (95% CI 0.0136–0.0631). – [1]
Risk Factors For Increased Liver Enzymes & CBD
1. High Doses of CBD – 1 Gram+
High-dose CBD consumption i.e (≥1000 mg/day or ≥20 mg/kg/day) was one of the main identified risk factors in the studies.
Generally speaking, this is a dose far greater than many would use with over the counter CBD products. The above would equate to an entire 10ml bottle of some CBD oils on the market.
However, for those who do enjoy medicating with larger doses of Cannabidiol, monitoring liver function long-term would be highly recommended.
No cases of increased liver enzymes were seen in patients using cannabidiol doses below <300 mg/day.
Plus, no cases of severe drug-induced liver injury (DILI) were reported.
2. Concomitant Anti-Epileptic Drug Usage
Another identified risk factor in the study was concomitant antiepileptic drug use.
Numerous conventional antiepileptic medications have a well recognized association for causing hepatotoxicity, so this isn’t surprising in the slightest.
Conclusion
The systematic review and meta-analysis concluded:
Cannabidiol-associated liver enzyme elevations and DILI meet the criteria of common adverse drug events.
Clinicians are encouraged to screen for cannabidiol use and monitor liver function in patients at increased risk.
References
[1] Cannabidiol-associated hepatotoxicity: A systematic review and meta-analysis
The information in this article has not been evaluated by the FDA and should not be used to diagnose, cure or treat any disease, implied or otherwise.
Always consult a medical professional before taking any dietary supplements, herbs or medication.
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