“There’s some evidence out there that CBD can adversely affect a damaged liver, and there’s other evidence that shows it can be helpful—it seems to depend on the underlying cause of liver damage,” Capano adds. If you already have liver issues, talk with your doc, keep a close eye on your dosage, and be sure to monitor hepatic enzymes every three months.
“Most people using full-spectrum CBD are taking no more than 40 to 60 mg a day, and we haven’t demonstrated drug interactions at those levels,” says Capano; you’d likely need to use upwards of 20 mg per kilogram of your bodyweight before seeing interactions. But talk with your doctor before combining CBD with any drugs you’re already on, especially if you take blood thinners or antidepressants, advises Capano.
You should also ask if the brand does third-party testing, what level of actives are in the product, whether it contains any microbial contaminants or pesticides. Not only should any reputable company make this info readily available, but they also should include a batch number with every product, so you can see a lab analysis. Don’t be afraid to push for all these details, says Capano: “The more we demand transparency that as consumers, the better the industry will get.”
Can I take CBD every day?
The good news: You likely aren’t taking a high enough dose of CBD that it will cause an adverse reaction with any other medications you might be taking. To lower your risk even more, make sure the CBD you’re using is a full-spectrum product rather than an isolate, so you can get the same benefits at a lower dose. Also, opt for a product that’s not oral, as capsules involve a first pass through the liver that tinctures and other products don’t.
That said, if you’re dealing with chronic pain and are already on medication for it, talk with your doctor about combining those traditional meds with CBD. More than 50 percent of long-term opioid users who added CBD to their treatment were able to reduce their opioid use and 90 percent of them had better quality of life within two months, according to research Capano recently conducted, which is pending publication. “We know that CBD is effective with pain and it’s safe to use with opioids—plus, it can help with withdrawal symptoms as you lower opioid use,” she says. “There’s pretty good data that CBD can be a treatment for substance abuse disorders. We should be motivated to use something that’s safer and doesn’t have the risk of dependency or overdose.”
For oils, creams, and other topical treatments—which are a great option for eczema, burns, or other skin conditions—“dosage depends on the concentration of the product, but generally just apply a small amount, as needed,” suggests Capano. Topicals also can help with headaches or migraines if you apply it at onset. And if getting your CBD with a vaporizer, start small. “You need less from a vaporizer and will have a very rapid onset,” she says. For this reason, she recommends trying just 2.5 mg at first.
But as a general rule? “Start low and go slow,” recommends Capano. “More isn’t always better, it’s like a bell.” Start with 10 mg worth of active ingredient a couple hours before bed. Each day, you can increase the amount slightly and take note of how you feel; dial it back when you don’t feel any extra benefit (or even feel a little worse) from additional milligrams. The sweet spot will likely be between 10 and 40 mg a day.
Here is just some of what the current evidence says.
To use CBD oil, place one or more drops under the tongue and hold the dose there for 30 to 60 seconds without swallowing. Capsules and gummies are easier to dose, although they tend to be more costly. CBD sublingual sprays are available as well.
To avoid interactions, tell your doctor and pharmacist about all prescription, over-the-counter, herbal, or recreational drugs you are taking.
CBD shows promise in the treatment of anxiety disorders, suggests a 2015 review of studies in the journal Neurotherapeutics. According to the investigators, CBD demonstrated potent anxiolytic (anxiety-relieving) effects in animal research, albeit with counterintuitive results.
If you are thinking about using CBD oil to treat a health condition, be sure to speak with your healthcare provider to ensure that it is the right option for you.