Safety, side effects and quality

Though legal and commonly advertised as safe, CBD has the potential to harm and can cause side effects.

CBD can cause liver injury and drug interactions which may increase or decrease the effect of other medications. CBD induced liver injury can go unnoticed if not monitored by a healthcare provider. In addition, CBD can cause the changes in alertness, somnolence including insomnia, gastrointestinal problems, diarrhea, decreased appetite, upset stomach, frequent mood changes, irritability and agitation. FDA's working group for CBD and CBD products is actively studying the safety of these products and identifying the risks involved in consumption of total CBD exposure (recommended daily dosage, percentage absorbed by skin from CBD topicals), effect of CBD in special populations such as pregnant and lactating women, children and the elderly as well as in pets.

FDA and the Federal Trade Commission does not regulate several CBD containing products including dietary supplements before they are marketed on shelves today for human or animal use. Thus, it is not uncommon for labels of botanical dietary supplements to differ from their actual contents and effects. Some companies were sent warning letters in April 2019 in response to their unfounded medical and health claims on their product's use against cancer, autoimmune disorders, opioid use disorder, and other diseases. Their claims were without sufficient science based evidence (For more information, click here). In addition, there is lack of evidence that the percentage content of CBD in the available products is consistent with the claimed percentage on the label. A study conducted by University of Arkansas and the National Center for Natural Products Research screened 25 CBD products available commercially for their CBD and THC content using mass spectrophotometric methods. Of the 15 CBD products only 1 product contained CBD as labeled (100% of percentage claimed). One CBD product exceeded the percentage of CBD claimed on the label by 2280%. Currently known side effects and unknown effects of CBD in our body raise the risk to the consumer using products with inadequate information (Gurley, FDA media 2019)

Take away

• Check with your physician before starting any CBD products. Every individual has unique tolerance level of these cannabinoids. Work with your healthcare provider and monitor self-dosing to find your optimal levels.
• Check with the veterinarian before administrating CBD products to animals.
• Less toxicity does not mean lack of toxicity. Dietary supplements or addition of CBD to food is still restricted by FDA due to lack of evidence to support safe use and their side effects.
• Remember, hemp is not same as marijuana; CBD derivates from marijuana and CBD derivatives from hemp is not the same. CBD derived from hemp has been removed from the list of controlled substance in the 2018 farm bill; however, CBD and THC derived from marijuana is still classified under Schedule I of the Controlled Substance Act.
• Some CBD products including cosmetics, foods and products marketed as supplements are available widely, labelled with unproven medical and health claims and very little information disclosed about their manufacturing practices.
• CBD as a chemical may have several health promoting properties. However, evidence of these properties to benefit humans and animals is limited, especially regarding knowledge about their dosage and absorption in our bodies. For more information on important aspects of using CBD that are still unknown click here.
• If the claims on the label sound too good to be true, at least for the present, it is not true. Check the FDA website for updates, if you are thinking about their use or have been recommended using CBD containing products.
• Dietary supplements and cosmetics products are not regulated by FDA under DHSEA before reaching the market unlike CBD containing drugs. It is important to note, currently only one CBD containing drug has been approved by FDA.
• There are certain benefits to their use, but do not start using them without consulting a healthcare provider.

Disclosure: Kentucky State University does not endorse or condemn any products and manufacturers mentioned in this factsheet. Their use in this factsheet is merely to communicate current and accurate information available to the community.