Additionally, depending on your method of consuming CBD, it may not need to be processed by the liver at all.
With smoking or vaping, the rate is much higher — roughly 35-40% reaches your veins directly. Tinctures are also more effective than oral consumption, resulting in about 20% absorption rate.
That isn’t to say CBD at normal doses doesn’t present some risk to the liver. For people with very serious epilepsy or pain conditions requiring high doses of CBD, there is a risk. In clinical studies of Epidiolex , a prescription CBD extract used to treat epilepsy, nearly 16% of users had elevated liver enzymes, which can indicate stress to the liver and can be a warning sign of toxicity.
However, those incidents were dose-dependent. At its high end, Epidiolex dosage may be as high 20mg/kg twice a day, which translates into an average daily dose of 3,040 mg for women, or 3,560 mg for men. That’s many times the typical dose most CBD users take. For example, for a man weighing 175 pounds (about 89 kg), Papa & Barkley recommend a maximum dose of 350 mg for treating chronic pain or epilepsy.
So how much should you worry? Unless you have existing liver damage or are taking extremely high doses of CBD, probably not much.
Every medication has risks. In the case of CBD, high doses, existing liver damage, and drug interactions can compound those risks. You should consult your doctor before trying CBD, and monitor liver enzymes if you’re at risk. However, for most patients, CBD is a safe supplement with very low risks of liver damage or other harmful health effects.
The FDA sent letters warning 15 companies for illegally selling CBD-containing products. The federal agency also updated its position to clarify that the substance increasingly infused in pills, lotions, food products and wellness beverages “has the potential to harm you, and harm can happen even before you become aware of it.”
The compound can cause liver injury, interact with other drugs, and increase the risk of drowsiness and sedation when used with alcohol, the FDA said. Studies using lab animals have also shown negative impacts on the male reproductive system, though the takeaway for human patients remains unclear, the FDA said.
The FDA issued a warning to consumers about potential health effects from CBD, including liver damage.
What’s more, the FDA is concerned about “a lack of appropriate processing controls and practices”: Many products tested by the FDA have contained different CBD levels than what manufacturers claimed, and there have been reports of products containing unsafe levels of pesticides, heavy metals and THC, the agency said.
“ ‘We remain concerned that some people wrongly think that the myriad of CBD products on the market, many of which are illegal, have been evaluated by the FDA and determined to be safe, or that trying CBD ‘can’t hurt.’ ”
And many CBD users use the compound for its health potential, though their outcomes tend to be mixed.