CBD Oil: What to Know Before You Try It

In Part 2 of our report on cannabis and diabetes, OnTrack Diabetes explains why it's important to proceed with caution if you're considering using CBD oil.

CBD Oil in a syringe and in capsulesExperts say there's no evidence CBD oil reduces blood sugar in people with diabetes but cannabinoids may help with neuropathic pain. (Photo: 123rf)

There’s no real scientific evidence that CBD oil helps control blood sugar (despite all those Internet claims!) But this compound derived from marijuana or hemp may have other benefits, says Eileen Konieczny, RN, past president of the American Cannabis Nurses Association and author of the book Healing with CBD: How Cannabidiol Can Transform your Health without the High (Ulysses Press, September 18, 2018). “Cannabinoids may help with neuropathic pain,” she told OnTrackDiabetes. “It may ease inflammation, work on pain receptors in the nervous system and possibly do some healing.”  

Before you try it, here’s what you should understand about this popular remedy:

Is CBD Oil Right For You?

#1. Have smart expectations
There’s no evidence that CBD oil reduces blood sugar in people with type 1 or type 2 diabetes. “I have not witnessed blood sugar control or management with CBD alone,”  says Konieczny.  “CBD clearly will help with the inflammation that accompanies diabetes and in that way [can be] a very helpful addition.” And it may help with neuropathy.

Online claims about blood sugar benefits are not backed by research. In the only published study looking at CBD oil’s effects on blood glucose in people with diabetes1, 62 women and men with type 2 diabetes used CBD oil or the cannabis compound tetrahydrocannabivarin (THVC) or a combination of both for 13 weeks. Plain CBD oil had no effect on blood sugar or on the release of insulin from beta cells in the pancreas.

Claims that it helps in type 1 diabetes are based in large part on a 2006 mouse study2 from Israel’s Hadassah University Hospital. That study suggested CBD oil might slow down the destruction of beta cells that leads to the development of Type 1. 

#2. Skip CBD oil if you take the certain medications
Cannabidiol is a “potent inhibitor” of two key liver enzymes—CYP3A4 and CYP2D6—that break down many prescription and over-the-counter medications, according to a report from the District of Colombia Department of Health3.  In fact, one of these enzymes, CYP3A4, metabolizes one-fourth of all drugs according to the report.  “Cannabinoids do interact with some pharmaceutical drugs,” she notes. “It’s important to talk with your doctor or with a healthcare practitioner familiar with cannabis before using it.”  

By interfering with metabolism in the liver, CBD could increase blood levels of these drugs, according to the report: Macrolide antibiotics, blood pressure-lowering calcium channel blockers, the cholesterol-lowering statins atorvastatin and simvastatin, antihistamines used for allergy symptoms, anxiety-reducing benzodiazepines, cyclosporine (an immune suppressant used to prevent transplant organ rejection), erectile dysfunction drugs called PDE5 inhibitors including sildenafil, some antiretroviral drugs, antidepressants including selective serotonin reuptake inhibitors and tricyclic antidepressants, beta-blockers (used by people with heart disease), pain-killing opioids including codeine and oxycodone, antipsychotic drugs such as haloperidol, and the blood thinner warfarin. 

Before You Buy 

Read the lab report before purchasing any CBD-related product. Lab studies of CBD oils have found compounds in some that shouldn’t be there including dangerous synthetic cannabinoids, THC (the psychoactive component of marijuana responsible for making you feel high) and heavy metals like lead. Researchers have also found a too-low and too-high concentrations of CBD in some products. The label may not give you any of this information—so it’s wise to request a lab report before you buy a CBD oil product, Konieczny recommends.

“I think using manufacturers that are submitting to testing or pharmacies that are trying to carry CBD and have done some vetting may be the answer,” Dr. Bhatia says.

(If you’d like to see an example, check out Green Roads, a CBD manufacturer that claims its products are “pharmacist formulated and third-party tested.”

For more help in determining the quality of CBD-related products, the Patient Focused Certification (PFC) program  offers a variety of services designed to promote excellence and accountability in the medical cannabis industry. PFC can assist patients, healthcare providers, companies, and regulators in identifying reliable, high-quality medical cannabis, businesses, products, and services.

Work with your doctor or with a healthcare practitioner familiar with CBD. Your healthcare provider can help you monitor your health, work with you to determine whether CBD is beneficial, spot side effects and help you make decisions about your health. You can also find doctors and nurses familiar with CBD through these organizations:

Watch for side effects. Good to know: According to the book Cannabis Primer4 by Konieckzy, common CBD side effects include dizziness and sleepiness though some people feel jittery and hyperactive. You may also have loose stools and an increased heart rate. Less common side effects may include irritability, a decreased appetite, and heart palpitations.

Never stop your prescription drugs on your own. “I have never seen someone get off diabetes medications with CBD,” Konieckzy says. Dr. Bhatia agrees. “I don’t know that I would recommend CBD oil for diabetes, but we do know the cannabinoid system does lower inflammation, and diabetes is a disease of inflammation and autoimmunity,” she says. “I think it is ok to try CBD Oil, but do not skip or cut back on your medications!”

Updated on: December 19, 2018
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