CBD oil or cannabidiol oil is the term given to the yellowish fluid derived from the industrial hemp or marijuana plant (Cannabis sativa).
This compound has been shown to exhibit several beneficial and therapeutic properties in diseases such as migraines, anxiety, schizophrenia, PTSD, back pain, fibromyalgia, rheumatoid arthritis, cancer, epilepsy, etc.
CBD oil is free of terahydrocannabinol (THC), which is the psychoactive component of the marijuana plant.
Due to the absence of THC in CBD oil, it does not result in intoxication or euphoria that is generally associated with marijuana. This makes it suitable for all people of all age groups.
The biological properties of CBD are stimulated because of its indirect interaction with the endocannabinoid system including the CB-1 receptor, CB-2 receptor and endogenous cannabinoids such as anandamide, etc.
Liver and its Common Diseases
The liver is an important organ and involved in many functions including detoxification, metabolism of medications and drug, digestive aid, bile secretion, activation of enzymes, storage of nutrients, synthesis of important serum proteins, etc.
The diseases that affect the liver are termed as hepatic diseases. The liver can be affected by various endogenous and environmental agents. Common infectious diseases include viral hepatitis, jaundice, etc.
The liver can also suffer from cancer, hepatic encephalopathy, cysts, cirrhosis, autoimmune hepatitis, storage diseases, deficiency diseases, etc.
It is important to maintain good liver health and prevent the hepatic diseases, as the liver is an essential organ required for survival and optimal functioning of the body.
Benefits of CBD Oil in Liver Diseases
Endocannabinoid system and its receptors have been shown to be a potential target for treatment of liver diseases. CBD interacts with the endocannabinoid system and therefore it can have therapeutic properties. CBD also exhibits anti-inflammatory, anti-oxidant, anti-ischemic, immune-modulatory properties, which can be helpful in liver diseases.
Hepatitis is the disease characterized by inflammation of the liver. Viral hepatitis is one of the most serious infectious diseases of the liver caused by five different types of viruses.
Hepatitis A, B, and C are the reason for many deaths globally. Hepatitis can eventually result in liver cancer and cirrhosis as well.
It has also been reported that global burden of hepatitis is on a rise. Hepatitis C has no vaccine at the moment and thus it lacks any effective preventive methods.
It is also the most common and dangerous kind of hepatitis. It most often results in cirrhosis and liver cancer.
It is important to find novel therapeutics for viral hepatitis and reduce the burden on the global health system.
CBD has been shown to have therapeutic potential in viral hepatitis especially Hepatitis C. In a study published in the journal ‘Pharmacognosy Research’ the effect of CBD on hepatitis B and hepatitis C viruses was evaluated.
The cells carrying the viruses were subjected to CBD treatment and then its activity against the virus was determined. It was observed that CBD (at a single concentration of 10 micromoles) could inhibit the replication of hepatitis C virus by nearly 87%.
CBD showed a dose-dependent inhibition of the virus with little toxicity towards the cells.
CBD did not inhibit the hepatitis B virus but induced death in the infected cells carrying the hepatitis B virus.
The study also reported that CBD is effective in both viral and autoimmune hepatitis because of its effect on the CB-2 receptors.
CBD shows indirect interaction with the CB-2 receptor and induces death in immune cells (splenocytes), which in turn inhibits the growth and proliferation of T cells responsible for an autoimmune attack on the liver cells.
Thus attenuation of immune response helps in alleviating autoimmune hepatitis.
Thus the in-vivo study reported that CBD exhibits anti-viral activity against hepatitis C virus. The researchers also concluded that CBD could be used as combination therapy along with existing therapies for viral hepatitis.
Medication for hepatitis C can have many adverse effects in some people. Use of CBD as an alternative could be helpful in such cases.
Viral hepatitis is a major liver disease with many deaths and complications. CBD was shown to inhibit the growth of hepatitis C virus in a dose-dependent manner.
This indicates its potential use in the treatment of hepatitis C.
2. CBD can protect against hepatic ischemia/reperfusion injury
Ischemia/reperfusion injury is a very common injury that occurs during most liver surgeries and liver transplantations.
It is responsible for deaths in case of transplants and graft rejections. It is characterized by inflammation as large number of neutrophils is directed towards the liver.
Major inflammation is caused by the activation of leukocytes, kupffer cells, etc. present in the liver on arrival of neutrophils and production of pro-inflammatory mediators.
There is also the involvement of oxidative and nitrative stress.
CBD is known to exhibit potent anti-inflammatory and anti-oxidant properties and therefore it could be useful in attenuating the inflammatory response and prevent Ischemia/reperfusion injury.
A study analyzed the effect of CBD in mouse models of Ischemia/reperfusion injury based on inflammatory, oxidative, and cell death markers.
It was observed that CBD could effectively reduce the inflammation, oxidative stress and cell death in the liver. Neutrophil infiltration was also reduced on treatment with CBD.
There was a reduction in the levels of pro-inflammatory mediators such as NF-κB and TNF-α.
Thus the inhibition of inflammation, nitrative stress, oxidative stress and cell death caused by CBD could make it a useful option in preventing Ischemia/reperfusion injury. Visible improvement in liver histology was also observed.
A similar study was conducted in rat models of ischemia/reperfusion liver injury. Induction of ischemia/reperfusion liver injury was associated with increased levels of tumor necrosis factor-α and nitric oxide in the serum along with a reduction in the level of anti-oxidant glutathione.
On administration of CBD to the rats, it was seen that there was significant attenuation of liver damage associated with ischemia/reperfusion liver injury.
There was also a reduction in the levels of pro-inflammatory and oxidative species including cyclooxygenase-2, nuclear factor-κB, etc.
The study concluded that CBD has a potential therapeutic role to play in prevention and treatment of hypoxia-reoxygenation injury (ischemia/reperfusion injury).
Ischemia/reperfusion injury is responsible for many deaths in case of liver transplant rejections.
It is characterized by inflammatory and oxidative damage. CBD has been shown to prevent ischemia/reperfusion injury by attenuating inflammation, oxidative stress, nitrative stress, cell death, etc.
3. CBD can help against hepatic encephalopathy
Hepatic encephalopathy is characterized by a change in consciousness due to damage and failure of the liver.
This is due to the buildup of harmful substances in the blood, which are generally removed by the liver. Some symptoms include movement problems, altered personality, confusion, etc. It can result in a coma in the advanced stages.
Cirrhosis is the most common cause of hepatic encephalopathy and most patients with cirrhosis end up developing it. It can be observed in cases of both acute and chronic liver injuries.
Inflammation (including neuroinflammation) is observed in the pathogenesis of hepatic encephalopathy.
CBD has been shown to exhibit anti-inflammatory properties. It also acts as a neuroprotective agent and reduces neuroinflammation.
It is also an established agonist of 5-HT1A receptors. Thus CBD could be instrumental in the treatment of hepatic encephalopathy.
A study conducted in mice model of hepatic encephalopathy reported positive results. It was observed that administration of CBD could restore the altered cognitive and neurological functions in the mice.
Hepatic encephalopathy is due to the buildup of ammonia as the liver is responsible for its removal. It was observed that CBD administration led to a reduction in the levels of ammonia in the blood as it restored liver function.
The levels of liver enzymes were also normalized.
Another study, which analyzed cognitive and motor impairment, caused in mice due to bile duct ligation (used as a model of chronic liver disorder) reported similar results.
It was seen that CBD administration over a month could reserve the cognitive and motor impairment. This was attributed to the down-regulation of A(2)A adenosine receptor.
Hepatic injury can result in neurological impairment due to an accumulation of toxic substances in the blood.
This is called hepatic encephalopathy. Studies have shown that CBD can effectively reverse the cognitive and motor damage associated with hepatic encephalopathy.
4. CBD could have therapeutic properties in autoimmune hepatitis
Autoimmune hepatitis is an inflammatory disease of the liver. It is characterized by heightened inflammation and increased inflammatory markers in the liver.
It has been reported that activation of TRPV1 vanilloid receptors can activate myeloid-derived suppressor cells (MDSCs). These cells, in turn, inhibit inflammation and autoimmune hepatitis.
A study showed that myeloid-derived suppressor cells (MDSCs) play an important role in attenuating inflammation.
Their activation is a way to protect the liver from hepatitis. CBD is capable of activating these cells by activating the TRPV1 vanilloid receptors.
The myeloid-derived suppressor cells (MDSCs) activated by CBD were shown to effectively inhibit the proliferation of T cells and attenuate inflammation.
Therefore it can be concluded that CBD could have a potential therapeutic role in hepatitis and liver inflammation owing to its interaction with the TRPV1 vanilloid receptors.
CBD has been shown to activate TRPV1 vanilloid receptors and induce the activation of myeloid-derived suppressor cells (MDSCs), which can help alleviate liver inflammation and protect against autoimmune hepatitis.
5. CBD can protect against liver fibrosis and alcohol-induced liver injury
Liver fibrosis is characterized by the accumulation of extracellular matrix protein such a collagen in the liver during chronic liver damage and diseases.
These include excess alcohol use, hepatitis infection, etc. Fibrosis can progress and result in cirrhosis, liver failure, etc.
Major collagen-producing cells such as activated hepatic stellate cells, portal fibroblasts, etc. are responsible for deposition of collagen in the liver.
CBD exhibits anti-oxidant and anti-proliferative properties. It has been shown to prevent the growth of many cancerous cells.
On investigation, it was found that CBD causes death in activated hepatic stellate cells. These cells are responsible for production and secretion of excess collagen, which eventually results in live scarring and fibrosis.
CBD induces death in these cells by activating pathways responsible for cell death (pro-apoptotic). It also enhances ER stress, which in turn causes ER-stress induced apoptosis.
Therefore it can be concluded that CBD could be a therapeutic agent in liver fibrosis by inducing death in cells responsible for deposition of collagen.
Long-term consumption of alcohol can cause a lot of damage to the liver tissue. It can lead to accumulation of fat and eventually induce cirrhosis.
CBD was shown to attenuate alcohol-induced liver injury in mice models that were fed alcohol.
It also reduced the accumulation of fatty acids in the liver and restored other expression-based and metabolic irregularities caused by alcohol intake.
Liver fibrosis is a common occurrence in chronic liver damage. It can result in cirrhosis and liver failure.
CBD has been shown to exhibit anti-fibrosis properties by inducing death in cells that secrete collagen and cause fibrosis. It also reverses changes associated with alcohol-induced injury.
6. Endocannabinoid system is a potential therapeutic target for liver diseases
Endocannabinoid system is involved in many functions in the body. It is distributed throughout the body and brain and has an impact on various organ systems.
The signaling molecules (CB-1 and CB-2 receptors and endogenous cannabinoids) are therapeutic targets for many disorders due to their systemic influence.
It has been reported by studies that the endocannabinoid system undergoes alteration in many liver diseases including non-alcoholic fatty liver disease, an onset of cirrhosis from fibrosis, cirrhotic cardiomyopathy, hyperdynamic circulatory syndrome, etc.
Endocannabinoid system is also involved in chronic liver injuries. It also has an impact on the inflammatory and cell damage caused to the liver during stress situations and diseases.
Endocannabinoid system also involved in the fatty liver diseases (non-alcoholic) and might be a good target for treatment of those ailments.
Therefore molecules that directly or indirectly affect the endocannabinoid system and its receptors could be potential targets for the treatment of various liver diseases.
CBD is known to show indirect interaction with the CB-2 receptors. CB-2 receptors are known to be involved in inflammatory and immune response (especially during ischemic response which occurs during liver surgeries).
This could help in case of immune-related and chronic liver diseases.
The antagonists of CB-1 receptors have been shown to alleviate the fat accumulation in patients with the non-alcoholic fatty liver disease.
These antagonists are also useful in treating liver cirrhosis by slowing down fibrosis and ameliorate the cardiovascular complications associated with it.
CBD is known to inactivate the CB-1 receptors and act as a potent antagonist. CBD also reverses the activating effect of THC on CB-1 receptors.
Therefore CBD could be useful in attenuating the symptoms of fibrosis, cirrhosis, etc. which involve the activation and up-regulation of CB-1 receptors.
Endocannabinoid system is involved in the pathogenesis of many chronic liver disorders. CBD is known to show indirect interaction with the CB-1 receptor, CB-2 receptor, and endogenous cannabinoids.
This could make CBD a potential therapeutic agent in preventing the progression of liver diseases and their treatment.
Dosage and Usage
There is a lot of variation in the dose depending on the person and the disorder along with the strength of the tincture.
tinctures available in the market have a strength varying from 100-600mg.
Based on case studies and personal account of users, it can be concluded that most commonly used dose is 600-1200mg/day.
Doses up to 1500mg/day are well tolerated for short-term consumption and don’t result in side effects.
Users should start with the lowest effective dose and slowly work the dose up over the course of a few weeks.
This can be done by consuming CBD oil and closely monitoring the symptoms for improvement.
Common ways of consumption are sublingual (oil), inhalation (by vaping), topical (creams/patches), oral (candy and other edibles). The usage should depend on the comfort of the user.
CBD users seldom report major side effects.
Regular use over an extended period can cause minor discomfort such as dry mouth, faintness, drowsiness, low BP, change in appetite, etc. More than 1500mg/day of CBD can have other major side effects in the long run.
CBD shows interaction with certain commonly used medications such as beta-blockers, anesthetics, anti-anxiety, anti-epileptics, antibiotics, non-steroidal anti-inflammatory drugs (NSAIDs), anti-depressants, etc. due to its impact on the liver enzyme.
Users should always use a high-quality product obtained from good sources. Cheap oils can be adulterated and result in toxicity.
It is necessary to consult the doctor before starting the use of CBD to prevent unwanted side effects due to dose and drug interaction.
Pregnant and breastfeeding women should use CBD only if prescribed by the doctor. Patients with major disorders such as Parkinson’s and Alzheimer’s should also seek help before consuming CBD.
The liver is an essential detoxifying organ with many important functions in the optimum functioning of the body. It plays a role in metabolism and digestion, detoxification, drug metabolism, etc.
There are many ailments that affect the liver as it is constantly exposed to various environmental agents such as pollutants, drugs, alcohol, medications, etc. It is also affected by infectious agents and autoimmune diseases.
CBD has been shown to have therapeutic potential in many major liver diseases including fibrosis, cirrhosis, autoimmune hepatitis, viral hepatitis, ischemia-reperfusion injury, fatty liver diseases, etc.
Pure and high-quality CBD could be beneficial in a myriad of liver disorders and might help replace the long-term use of other medications.
Patients should seek medical consultation before starting the use of CBD to avoid unwanted side effects.