CBD Oil: What to Know Before You Try It
Experts 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 diabetes 1 , 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 study 2 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 Health 3 . 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.
- Peripheral Neuropathy: The 4 Best Exercises
- CBD Oil for Diabetes?
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 Primer 4 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!”
- Efficacy and Safety of Cannabidiol and Tetrahydrocannabivarin on Glycemic and Lipid Parameters in Patients With Type 2 Diabetes: A Randomized, Double-Blind, Placebo-Controlled, Parallel Group Pilot Study” Jadoon et al. Diabetes Care 2016;39:1777–1786. URL:
- “Cannabidiol lowers incidence of diabetes in non-obese diabetic mice.” Weiss et al. Autoimmunity. 2006 Mar;39(2):143-51.
- “Medical Cannabis: Adverse Effects & Drug Interactions.” District of Colombia Department of Health
- “Cannabis Primer” by Eileen Konieczny RN. Editor: Eloise Theisen MSN, RN, AGPCNP-BC. Olive’s Branch, 2018
Part 2 of the OnTrack Diabetes report about cannabis explains why it’s important to proceed with caution if you are considering using CBD oil.
Should You Take CBD While Taking Metformin?
People are increasingly using cannabinoids to help them manage serious health conditions.
Cannabidiol (CBD) is a particularly popular choice since CBD alone does not contain any psychoactive compounds, meaning it doesn’t make you feel “high”.
In addition to its anti-inflammatory benefits, CBD may also help better regulate our blood sugar and improve our metabolism.
Nearly 10% of the population has diabetes. One of the most common forms of treatment is an anti-diabetes medication called metformin. Many people are now asking, “can CBD help with diabetes?” and “can I take CBD and metformin together?”
Read this article to learn everything you need to know about taking CBD and metformin.
What is Metformin?
Metformin is a prescription medication commonly used in type 2 diabetes to help control blood sugar levels. It’s often prescribed on its own or in combination with other drugs and lifestyle changes to reduce complications due to diabetes. It may also be prescribed to prevent diabetes in high-risk groups.
Metformin is an effective medication with benefits that tend to outweigh the risks. The most common side-effects are gas, nausea, bloating, reduced appetite, and diarrhea.
Unlike many other drugs, metformin is not metabolized by the liver. However, due to its action on a liver enzyme called CYP3A4, it may interfere with how your body metabolizes substances like CBD.
Can CBD Oil Help With Diabetes?
CBD has gained a lot of popularity for its ability to alleviate symptoms associated with depression, anxiety, chronic pain, and epilepsy. More recently, scientists have found that it may also be helpful for people with diabetes.
CBD works by influencing our endocannabinoid system. This system plays an integral part in the regulation of energy metabolism by affecting how our fat cells respond to insulin.
There hasn’t been much work investigating CBD for diabetes, but what we do have is promising. Recent research has shown that CBD can curb cravings for high-calorie food, helping people manage compulsive eating. This can make it easier for people with diabetes to stick with healthier diet plans.
CBD has also been shown to promote fat-browning. Brown fat is a good kind of fat that takes up less space, burns energy, and keeps us warm. Increased levels of brown fat are associated with improved metabolic profiles.
A study on mice found that a daily dose of 5 mg/kg of CBD for ten weeks lowered the chances of diabetes. Other work examining the effects of phytocannabinoids on obesity and diabetes found that CBD may aid in the treatment of insulin resistance.
Diabetics may also have other benefits from CBD such as improved sleep and reduced inflammation, which can significantly help them manage their diabetes.
Limitations of Using CBD for Diabetes
The most significant limitation to using CBD for diabetes is individual differences in our endocannabinoid systems. Since people can respond differently to the effects of CBD, one person may have a drastic lowering of blood sugar levels after CBD (which can be dangerous), and another might have no effect. Therefore, make sure you monitor your blood glucose levels if you choose to use CBD for diabetes in order to see how your body reacts.
Another limitation is that multiple cannabinoids can impact the endocannabinoid system. CBD is just one of the hundreds of cannabinoids that may be present in full-spectrum oil. More work is needed to determine the effects of compounds like THC and CBN compared to CBD on people with diabetes.
Not all CBD oils are created equally. Always buy your product from a reputable company that offers organic CBD. Look for companies that provide third-party testing to make sure that the product is accurately labeled and dosed.
Can I Take CBD Oil With Metformin?
Both of these compounds seem to have a lot of benefits for people living with diabetes so it seems natural to put them together, right? Not so fast.
CBD and metformin are both inhibitors of a liver enzyme called CYP3A4. This may interfere with how each of the drugs is metabolized.
No study has been conducted to examine the effect of the two drugs taken together. It’s possible that combining metformin and CBD may increase or decrease levels of the medication in your bloodstream. This can increase side-effects or reduce the efficacy of the compounds. If you decide to take both, you can reduce the side effects by spacing out your doses of the two drugs.
Some people who combine CBD and metformin also find they become hypoglycemic due to the medications’ combined effects. If you’re planning on using CBD to help manage your diabetes, you should always do so under the guidance of a physician.
Can I Replace Metformin With CBD?
CBD has many potential qualities that can benefit a diabetic population. In addition to its potential impact on glucose metabolism, it also has many benefits specific to people with diabetes. CBD is neuroprotective, reduces pancreatic inflammation, and protects the eyes against diabetic retinopathy.
Anecdotally, there are many reports of people who have been able to control their diabetes by switching from metformin to CBD.
Whether or not CBD can stand alone as a treatment for diabetes remains to be seen. Many cannabis experts claim that CBD oil can be used to target symptoms of type 1 and type 2 diabetes. Since there is still limited data on CBD for the treatment of diabetes, you should always seek advice or monitoring from a medical professional before replacing metformin with CBD oil.
Drugs That Interact With Metformin
Metformin does not have any severe drug interactions but does interact with certain compounds to have mild to moderate side-effects.
Metformin may increase lactic acid production, which can put people at an increased risk of lactic acidosis in the presence of certain medications or disorders that increase lactic acid. Lactic acidosis is characterized by symptoms such as stomach pain, diarrhea, fast, shallow breathing, and weakness.
An over-the-counter heartburn medication called cimetidine was linked to a case of metformin-associated lactic acidosis.
Other medications that can interact with metformin to increase the risk of lactic acidosis include:
Additional medications may interact with metformin to cause hypoglycemia:
- Calcium channel blockers (i.e., Norvasc)
- Estrogen and oral contraceptives
- Thyroid medications
Metformin may also increase the risk of anemia and vitamin B-12 deficiency. You can combat this by supplementing with iron and vitamin B-12 if using metformin long-term.
Talk to your physician or pharmacist for a full list of drug interactions.
CBD & Metformin: Final Thoughts
Metformin is a prescription drug that is effective for the treatment of diabetes. Although it may cause some side effects, most users say the benefits outweigh the risks.
CBD has shown the potential to help regulate insulin levels through its action on the endocannabinoid system.
Due to CBD’s array of health benefits, many people with diabetes are interested in combining it with metformin or replacing metformin entirely. Users should practice caution when combining the drugs as they may interact to have unwanted side-effects.
More work is needed to determine whether CBD is an effective stand-alone treatment for diabetes, but it appears to have great potential.
CBD can help treat many symptoms of diabetes but may cause side-effects when combined with metformin. Read this article before combining CBD and Metformin.