Can CBD Oil Benefit in Hepatitis C ? [Fact Based Analysis]

Cannabidiol (CBD) oil is generated by the mixing CBD extracts with carrier oils such as hemp seed oil.

CBD is a phytocannabinoid obtained from hemp (Cannabis sativa) and has the ability to modulate a variety of physiological responses by binding to receptors of the endocannabinoid system (ECS).

CBD is not psychotropic and has been proven to confer several health benefits as it relieves pain, stress, and anxiety. [1]

Overview of Hepatitis C

Hepatitis C denotes a hepatic infection brought about by the hepatitis C virus. The condition can range from a mild infection that lasts a couple to weeks (acute) to severe, enduring illness (chronic).

Acute infection occurs within six months of being exposed to the causative agent. Around 75-85% of the people infected with the virus will develop a chronic illness which can lead to liver damage, cirrhosis, and cancer. [2]

Benefits of CBD in Hepatitis C

The major benefits of CBD in hepatitis C are linked with its nature as an anti-inflammatory cannabinoid. It helps in lowering liver damage by delaying and halting the progression of cirrhosis.

It also acts as an analgesic and reduces abdominal pain and joint pain that is often observed in people with viral hepatitis.

CBD also helps in reducing fatigue that usually sets in people with chronic infection. As it lowers abdominal pain and inflammation, it also regulates the sensation of nausea. CBD also exhibits antiviral activity against the HCV.

1. CBD Reduces Liver Damage

Hepatitis C brings about liver damage on account of hepatic inflammation. In the beginning, the infection is acute and might persist for a small period of time without causing any serious damage.

Initial infection often has no outward symptoms and hence, the condition might not get treated leading to chronic infection with accelerated damage to the function and integrity of the liver cells. [3]

The level of damage varies with the individual. In certain cases, patients recorded minimal damage with almost no scarring even after several years of being infected.

However, in other cases, individuals suffer from cirrhosis or extensive scarring of the liver. Overall, it takes around twenty years for substantial cirrhosis to occur. [4]

The infection becomes chronic due to weak immune cell responses to the acute phase which failed to curb the viral replication.

Once the disease becomes persistent, liver lesions appear due to local inflammation which is mostly non-specific. This triggers fibrogenesis to stimulate healing of the liver following inflammation. [5]

However, persistent fibrogenesis leads to dysregulation of the normal processes causing excessive accumulation of extracellular matrix (ECM) proteins and fibers.

This results in hepatic fibrosis, a process which has been proven to be the precursor of cirrhosis.

Studies have shown that activation and proliferation of the hepatic stellate cells into fibrogenic populations bring about further hepatic damage. [6]

Liver cirrhosis (LC) refers to a critical stage of chronic hepatitis. In this stage, the scarring of liver tissue and fibrosis is so severe that almost all of the functional integrity of the liver is lost.

The symptoms include easy bruising and bleeding, persistent jaundice, nausea, and swelling of the abdomen and legs.

Additionally, people may also develop hepatic encephalopathy, or hepatocellular carcinoma, or liver failure. [7]

Antiviral therapies are of paramount importance to destroy the infection. However, once the disease has progressed to the stage of cirrhosis, it is important to preserve the liver functioning and delay further damage.

CBD has shown potential in reducing liver damage caused by hepatitis C infection. [8]

A 2011 experimental study by the Hadassah-Hebrew University Medical School showed that administration of CBD improves liver function in a mice model of advanced liver disease, particularly because of its ability to reduce hepatic inflammation. [9]

Summary – As CBD helps in lowering hepatic inflammation, it can be used to reduce the damage caused by hepatitis C on the liver.

2. CBD Relieves Hepatitis C-Related Pain

Some patients suffering from hepatitis C may feel abdominal discomfort or pain in the area of the liver. It may range from a dull ache to a sharp, stinging pain.

This kind of abdominal pain may subside or persist and is often associated with a stretching of the outer edge of the liver. It might not necessarily signal a deterioration of the patient’s condition. [10]

Sometimes, the pain in the upper part of the abdominal region spreads to the rest of the abdomen and becomes severe.

This kind of generalized abdominal pain is often difficult to relieve and can bring about the sensation of nausea. Abdominal pain is often the cause of discomfort in hepatitis C patients. [11]

Occasionally the pains in the upper part of the abdomen spread to the rest of the abdomen. This can cause generalized abdominal pains that can result in severe discomfort.

In the case of chronic infection, the pain is often difficult to localize and some people can even experience a backache. Sometimes, a soreness is felt on the right shoulder. [12]

The abdominal pain felt during a hepatitis C infection can have many causes but, primarily, it is caused due to persistent inflammation in the liver.

While the liver itself has no pain receptors, the membrane surrounding it has plenty. Therefore, when inflammation causes the liver to stretch, it puts pressure on those receptors to cause discomfort. [13]

Patients may also experience pain in their small joints, particularly at the wrists and the ankles. Hepatitis C can often lead to the development of small proteins known as cryoglobulins which can cause joint pain. [14]

Antiviral therapy is widely used to treat hepatitis C viral infections and while they do halt the fibrosis of the liver, the abdominal pain might still persist.

Analgesics offer respite but only for a short while and as the focal point of the pain is difficult to determine, the pain becomes chronic. [15]

CBD has become popular in treating inflammation and has also proven to have analgesic properties.

A 2008 review by GW Pharmaceuticals has shown that CBD helps in the treatment and management of pain as it helps in lowering inflammation and modulating the endocannabinoid system (ECS) which plays a key role in relaxation. [16]

Summary – As CBD helps in lowering inflammation, it helps in treating pain associated with hepatitis C infection.

3. CBD Counters Fatigue

Fatigue or excessive lack of energy is one of the most debilitating extrahepatic symptoms of a hepatitis C infection and is reported in around half of all patients suffering from a chronic infection.

There are also other physical and psychological factors that further degrade the quality of life in such individuals. [17]

Several studies have been conducted to investigate the incidence of fatigue in individuals suffering from chronic hepatitis infections.

It was found that fatigue was observed in a noteworthy proportion (67%) of HCV-positive patients as compared to a mere 44% in HCV-negative patients.

Another study conducted in France showed that out of 1614 HCV-positive patients, 53% experienced fatigue in the initial stages itself. [18]

The exact reason for the development of fatigue in case of an HCV infection remains unclear.

However, several studies have shown that when the body is involved in fighting an infection for a long period of time, fatigue sets in.

Some studies also suggest that fatigue is an outcome of impaired liver functioning. [19]

Many a time, the thyroid may also be affected leading to the development of fatigue.

Long-term HCV infected patients may also suffer from mood disorders like depression which can also lower energy levels. [20]

Ribavirin, a common drug used to treat HCV infections might also cause fatigue in the patients.

Alternative lines of therapy involving cannabis-derived cannabinoids have become popular in the management of symptoms of hepatitis C as they can relieve pain and boost energy levels. [21]

A 2014 study by the Universidad Anáhuac Mayab, Mérida showed that CBD is a potential wake-promoting agent.

It helps in promoting wakefulness and reducing fatigue which, in turn, helps in improving the overall quality of life. It also helps in uplifting the mood and therefore, prevents fatigue related to depressive disorders. [22]

Summary – As CBD helps in promoting wakefulness and improves the mood, it will help in reducing the fatigue experienced by hepatitis C patients.

4. CBD Relieves Nausea

A large number of people infected with the hepatitis C virus (HCV) often remain asymptomatic but some may experience pain in the abdomen along with fatigue.

Excess pain due to inflammation in the liver and gastrointestinal discomfort can lead to increased feelings of nausea. [23]

While the frequency of most symptoms like pain and fatigue fluctuate with time, nausea is persistent in untreated patients as well as those undergoing therapy.

Oftentimes, the nausea is a side-effect of the high dose of antiviral medications which are central to the therapeutic strategy against HCV. [24]

Individuals who feel nauseated may experience discomfort in the abdomen which can range from mild queasiness to an overwhelming urge to regurgitate and vomit.

Patients can also suffer from nausea-related symptoms such as fatigue, loss of appetite, and darkening of the urine. [25]

The results of a cross-sectional study, which compared 53 patients with a chronic liver disease with 64 patients with HCV, showed that the patients suffering from HCV reported a higher incidence of nausea and pain than those patients suffering from a chronic liver disease of a non-HCV origin. [26]

An HCV infection severely affects the liver function which triggers a cascade of events. The liver is unable to produce bile and the body struggles to digest fatty foods which cause an inflammation of the gallbladder.

The liver is also unable to produce albumin which, in turn, causes fluid build-up in the stomach cells resulting in inflammation. [27]

As a result of this persistent inflammatory state, pain is felt in the abdominal region which causes nausea and discomfort.

Interferon and ribavirin therapies targeted to treat HCV infection also have gastrointestinal side-effects such as nausea. [28]

Since CBD offers respite from abdominal pain as well as helps in lowering inflammation in the abdominal region, it can also be used to treat nausea.

In fact, a 2015 study by the University of Calgary stated that CBD can help in the regulation of nausea by moderating the endocannabinoid system (ECS) to generate an anti-emetic response. [29]

Summary – As CBD helps in generating an anti-emetic response via the receptors of the ECS, it can be used to treat nausea in patients with hepatitis C.

5. CBD Exhibits Antiviral Activity Against HCV

Viral hepatitis is brought about by a group of viruses divided into five types: A, B, C, D, and E.

Hepatitis B virus (HBV) and Hepatitis C (HCV) are the most prevalent amongst the five types and result in chronic liver disease.

In fact, chronic HCV infection is one of the primary precursors of liver cirrhosis and hepatocellular carcinoma. [30]

HCV infection also leads to the development of other diseases such as lymphoma, diabetes, and even atherosclerosis. As a result, HCV is a global health problem and continues to affect millions across the globe. [31]

HCV binds to specific receptors on the host cell surface and enters the cells by endocytosis i.e. invagination of the cell membrane to form a vacuole in order to take up an extracellular substance.

The HCV undergoes replication inside the cell from where the progeny particles are secreted outside by means of the Golgi apparatus (cell organelles involved in the transport of proteins). [32]

It is important to understand the replicative machinery of the infective particle as it can be manipulated to obtain a therapeutic measure.

In fact, several host cell proteins have been identified as receptors for HCV. Most antiviral therapies are involved in halting or disrupting the host-cell binding and replicative processes to treat the infection. [33]

A 2017 study by the University of Maryland School of Medicine showed that cannabidiol exhibits antiviral activity against HCV and can be used to halt the spread of the infection.

It was shown to curb host-cell inflammation in viral hepatitis and also prevent the activation of hepatic stellate cells (HSCs), which is one of the key events that lead to fibrosis and scarring in the liver. [34]

Summary – As CBD exhibits antiviral activity against HCV and prevents the activation of HSCs, it can be used in the treatment of hepatitis C.


It is advisable to consult a medical practitioner before consuming medications containing THC. The dosage depends on the mode of delivery as the CBD products can be orally ingested or inhaled by a vaporizer.

There is no prescribed dosage for using CBD oil to treat hepatitis C.

However, to provide symptomatic relief, small doses of 50-60mg should be consumed, initially, and the optimum dose should be decided as per the individual’s tolerance level.

Vaporizers containing CBD oil can be used to relieve abdominal and joint pain as well as nausea. 6-8mg (2 puffs) should be inhaled.


The plant-derived cannabinoid, CBD, has very few side-effects. In fact, daily oral doses of up to 500mg can be had for up to half a year. [35]

CBD products usually contain the psychotropic agent, tetrahydrocannabinol (THC), which is accountable for the side-effects.

While the quantity of THC permitted in medications is quite inadequate but sensitive individuals might still experience the hallucinatory effect. [36]

CBD inhibits the activity of cytochrome p450, a class of liver enzymes responsible for the metabolism of certain and therefore, CBD usage might reduce their efficacies.

Medicines containing an excess of THC might cause confusion, dizziness, disorientation, nausea, fatigue, impaired balance, unsteadiness, hallucinations, and paranoia. [37]

They might also cause tachycardia, a condition wherein the heart rate gets rapidly raised for a short duration. Cannabis products which have a moderate amount of THC should not be accompanied by alcohol. [38]

Pregnant and lactating women should consult a gynecologist before consuming CBD-containing medicines.

Caution should also be maintained while administering THC-containing products to children and adolescents as it might affect their CNS differently. [39]


To summarize, it can be said that, CBD provides many benefits to people suffering from hepatitis C. It helps in lowering inflammatory liver damage and halts the progression of cirrhosis.

It reduces abdominal pain as well as pain in the small joints.

CBD also helps in countering fatigue by boosting wakefulness and energy levels and improving the mood.

It also exerts an anti-emetic effect and prevents the problems related to nausea by modulating the ECS. Finally, it helps in treating HCV infection as it has antiviral activity.