Although CBD oil is legal in most U.S. states and is widely accessible to purchase it’s important to understand the potential risks and dangers of CBD Oil. Does CBD Thin Your Blood? A question that has been messaged to me multiple times over the past month, I wanted to cover off whether CBD thins your blood, how different products might affect this
Understanding the Risks of CBD Oil
CBD is short for cannabidiol, a chemical which is extracted from the hemp plant and then diluted with a carrier oil like coconut or hemp seed oil. While both CBD and marijuana are derived from the cannabis plant, CBD does not contain enough tetrahydrocannabinol (THC) to produce mind-altering effects. Hemp contains 0.3% or less THC, while marijuana contains higher than 0.3% THC.
CBD interacts with the body’s endocannabinoid system (ECS), which helps regulate the immune system, appetite, sleep, mood, digestion, inflammation, pain, motor control, temperature regulation, reproduction, and memory.
The FDA and CBD oil
Although CBD oil is legal in most states within the U.S. and can be purchased at your local drug/health food stores, smoke shops, and gas stations, only one CBD product has been reviewed by the Food and Drug Administration (FDA) for safety. That drug, Epidiolex, is a purified form of CBD that was approved by the FDA in 2018 for the treatment of certain seizure disorders. During their review of Epidiolex, the FDA did identify an increased risk of liver injury from the product but determined the risk could be managed provided the drug was taken under medical supervision.
Other than Epidiolex, the FDA warns that no CBD products have undergone a strict evaluation process to determine if they are “safe and effective to treat a particular disease, what the proper dosage is, how they could interact with other drugs or foods, or whether they have dangerous side effects or other safety concerns.”
The FDA also warns that testing of some CBD products has revealed the presence of contaminants like pesticides and heavy metals, and that some did not contain the levels of CBD claimed.
It is illegal for companies to promote their CBD products as a cure, treatment, or prevention of any specific disease or condition. Companies that make such claims are sent a warning letter from the FDA.
Why do people use CBD oil?
Although there have yet to be any large-scale human studies on CBD, there is scientific evidence that the oil may relieve pain, reduce anxiety and depression, reduce side-effects of cancer treatment, reduce epileptic seizures, and lower blood pressure, as well as deliver anti-inflammatory and other beneficial effects.
The Mayo Clinic reports that while CBD is usually well-tolerated, it can cause such side effects as dry mouth, diarrhea, reduced appetite, drowsiness and fatigue. Some users have also reported experiencing nausea and irritability.
Potential risks with CBD oil
Harvard Health Publishing says two of the biggest concerns with CBD use are:
- CBD can increase the levels of other medications in the body the same way grapefruit juice does.
- CBD is sold as a supplement and not required to undergo the same stringent testing as FDA-approved medications.
Agreeing with the FDA, Harvard warns the lack of regulation means consumers can’t be certain what is contained in the product and whether the dose is accurately stated.
While some CBD providers submit their products for independent lab testing, other providers do not and have no verifiable way of proving what is contained within their oil. Since the industry is largely unregulated currently, consumers often have little insight into what the products contain unless they are able to access the results.
And because a large segment of the U.S. population takes one or more prescribed and/or over the counter medications while also taking CBD oil, many are at increased risk of a dangerous interaction. A study published in JAMA Internal Medicine found that due to concurrent use of prescription medications and dietary supplements in 2011, “15% of older adults [are] potentially at risk for a major drug-drug interaction.” This estimated risk had increased from 8.4% in 2005.
Drug interactions not only impact the efficacy of a medication, but they can also cause harmful side effects. Many drugs and toxins are broken down in the body by a vital enzyme called CYP3A4, mostly found in the liver, allowing them to be eliminated by the body. Grapefruit has been found to interfere with the metabolization process, allowing the drug to build up in the body, which can be dangerous.
CBD appears to have a similar effect, which is quite concerning, as approximately 60% of medications on the market interact with CYP3A4 enzymes. Check the FDA website for information about which drugs don’t interact well with grapefruit. And always consult your healthcare provider, prior to using CBD, for medical advice specific to your needs.
Risks of CBD when used with other medications
Research indicates that CBD can interact with medications including:
- Blood Thinners: A study published in the journal Epilepsy and Behavior Case Reportsfound a “clinically significant interaction between pharmaceutical grade cannabidiol (Epidiolex®) and warfarin, one of the most widely used oral anticoagulants.” If CBD disrupts the metabolization of a blood thinner like warfarin, the build-up of drug levels in the body could result in dangerous bleeding. It’s important that patients prescribed Epidiolex are carefully monitored by health professionals.
- Epilepsy Drugs: Even though the FDA approved the CBD drug Epidiolex to treat certain forms of epileptic seizures, incorrect doses can result in more aggressive seizures. This drug should only be used under close medical supervision.
- Chemotherapy Drugs: As with most drugs, chemo drugs are manufactured considering the likely rate of metabolization. If CBD slows down that rate, concentrations of the drug can build up in the body which could result in toxicity.
Other research has also linked CBD to interactions with:
- Antidepressants and Anti-anxiety Medications
- Cold or Flu Medications
- Blood Pressure Medications (Beta Blockers)
Always consult a doctor if you’re taking any of the medications above to understand their interaction risks.
The FDA continues to advise the public to be cautious about using CBD until more scientific research supports its efficacy and safety.
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Does CBD Thin Your Blood?
A question that has been messaged to me multiple times over the past month, I wanted to cover off whether CBD thins your blood, how different products might affect this and why this is important for you.
As you take CBD oil, one of the side effects is it can increase the quantity of coumadin, which is known to thin your blood. Coumadin, also known as Warfarin Sodium, is an anticoagulant, which means it thins the blood and extends the time it takes to clot the blood. As you can imagine, there are many medical reasons why this might be wanted.
CBD has been shown in multiple studies to dilate blood vessels, which in turn helps the circulatory system, such as this test which showed a small quantity had a significant impact on the test subjects blood pressure in stress situations.
Another test, performed on an obese rat (again, another reason why we need more human testing as most of the tests are based on rats currently) showed that the cannabis extract had the anticoagulant effect they were aiming for.
For anyone who hasn’t heard of the grapefruit effect, it is that taking a grapefruit when having a blood thinner medication can have an effect on the medicine working. The main medicines that are affected by eating grapefruits include statins, calcium channel blockers, entocort, cyclosporin and cytotoxic medicines. It should be stated that this isn’t a definitive list, there are many more, which is why you must speak to your doctor.
It affects the medicine by increasing the amount in your blood, which can obviously have side effects or change the way it is meant to work.
The same effects have been seen when taking CBD oil, therefore if you are taking any of these medications then it might not be recommendable to have CBD oil.
Considering all of these factors, this is why it is even more important that the brands are held to account and deliver the quantities they state on the pack. As it stands, they are registered as food supplements rather than medicine, meaning the regulations are more relaxed, so you should read up on the third party lab test results and only opt for reputable brands. Ignore anything which is being produced in China, I promise you that!
Is There A Difference Between Topical & Oral?
Absolutely, in most tests, when taken topically (on the skin, such as a cream), it didn’t thin your blood, meaning you could gain all the benefits associated with a CBD cream without the worry of what it might do if on medication. Having said that, people who are taking CBD oil sublingually are normally after a very different treatment than if they are using a cream.
None Before Tattoo’s
Just the same as being told you can’t take painkillers or drink alcohol before getting a tattoo, as the blood becomes very thin, pours out and makes it much harder for the artist, the exact same has been witnessed with CBD oil. Obviously, this is a frustration for people who were hoping to take it to calm their nerves before getting this procedure done.
Just the same, you might want to consider this if you are having any work done or an operation. It might help to calm your nerves, but the doctor will have to know about this and will most likely to tell you not to take any in the days leading up to this, but once again, you should speak to a medical professional beforehand.
Does That Mean It Is A Bad Thing?
No, absolutely not, this could be opening up huge new opportunities to tackle some of our biggest health issues, such as strokes and heart disease. Having said that, we need a huge amount more test studies to be taken before anyone can state one way or the other.