Although CBD oil is legal in most U.S. states and is widely accessible to purchase it’s important to understand the potential risks and dangers of CBD Oil. Does CBD oil act as a blood thinner by itself? How does CBD oil interact with anticoagulants like warfarin? Should you stop taking CBD before an operation? Find out these answers and more in this comprehensive guide on CBD oil and blood thinners! Does CBD Thin Your Blood? A question that has been messaged to me multiple times over the past month, I wanted to cover off whether CBD thins your blood, how different products might affect this
Understanding the Risks of CBD Oil
CBD is short for cannabidiol, a chemical which is extracted from the hemp plant and then diluted with a carrier oil like coconut or hemp seed oil. While both CBD and marijuana are derived from the cannabis plant, CBD does not contain enough tetrahydrocannabinol (THC) to produce mind-altering effects. Hemp contains 0.3% or less THC, while marijuana contains higher than 0.3% THC.
CBD interacts with the body’s endocannabinoid system (ECS), which helps regulate the immune system, appetite, sleep, mood, digestion, inflammation, pain, motor control, temperature regulation, reproduction, and memory.
The FDA and CBD oil
Although CBD oil is legal in most states within the U.S. and can be purchased at your local drug/health food stores, smoke shops, and gas stations, only one CBD product has been reviewed by the Food and Drug Administration (FDA) for safety. That drug, Epidiolex, is a purified form of CBD that was approved by the FDA in 2018 for the treatment of certain seizure disorders. During their review of Epidiolex, the FDA did identify an increased risk of liver injury from the product but determined the risk could be managed provided the drug was taken under medical supervision.
Other than Epidiolex, the FDA warns that no CBD products have undergone a strict evaluation process to determine if they are “safe and effective to treat a particular disease, what the proper dosage is, how they could interact with other drugs or foods, or whether they have dangerous side effects or other safety concerns.”
The FDA also warns that testing of some CBD products has revealed the presence of contaminants like pesticides and heavy metals, and that some did not contain the levels of CBD claimed.
It is illegal for companies to promote their CBD products as a cure, treatment, or prevention of any specific disease or condition. Companies that make such claims are sent a warning letter from the FDA.
Why do people use CBD oil?
Although there have yet to be any large-scale human studies on CBD, there is scientific evidence that the oil may relieve pain, reduce anxiety and depression, reduce side-effects of cancer treatment, reduce epileptic seizures, and lower blood pressure, as well as deliver anti-inflammatory and other beneficial effects.
The Mayo Clinic reports that while CBD is usually well-tolerated, it can cause such side effects as dry mouth, diarrhea, reduced appetite, drowsiness and fatigue. Some users have also reported experiencing nausea and irritability.
Potential risks with CBD oil
Harvard Health Publishing says two of the biggest concerns with CBD use are:
- CBD can increase the levels of other medications in the body the same way grapefruit juice does.
- CBD is sold as a supplement and not required to undergo the same stringent testing as FDA-approved medications.
Agreeing with the FDA, Harvard warns the lack of regulation means consumers can’t be certain what is contained in the product and whether the dose is accurately stated.
While some CBD providers submit their products for independent lab testing, other providers do not and have no verifiable way of proving what is contained within their oil. Since the industry is largely unregulated currently, consumers often have little insight into what the products contain unless they are able to access the results.
And because a large segment of the U.S. population takes one or more prescribed and/or over the counter medications while also taking CBD oil, many are at increased risk of a dangerous interaction. A study published in JAMA Internal Medicine found that due to concurrent use of prescription medications and dietary supplements in 2011, “15% of older adults [are] potentially at risk for a major drug-drug interaction.” This estimated risk had increased from 8.4% in 2005.
Drug interactions not only impact the efficacy of a medication, but they can also cause harmful side effects. Many drugs and toxins are broken down in the body by a vital enzyme called CYP3A4, mostly found in the liver, allowing them to be eliminated by the body. Grapefruit has been found to interfere with the metabolization process, allowing the drug to build up in the body, which can be dangerous.
CBD appears to have a similar effect, which is quite concerning, as approximately 60% of medications on the market interact with CYP3A4 enzymes. Check the FDA website for information about which drugs don’t interact well with grapefruit. And always consult your healthcare provider, prior to using CBD, for medical advice specific to your needs.
Risks of CBD when used with other medications
Research indicates that CBD can interact with medications including:
- Blood Thinners: A study published in the journal Epilepsy and Behavior Case Reportsfound a “clinically significant interaction between pharmaceutical grade cannabidiol (Epidiolex®) and warfarin, one of the most widely used oral anticoagulants.” If CBD disrupts the metabolization of a blood thinner like warfarin, the build-up of drug levels in the body could result in dangerous bleeding. It’s important that patients prescribed Epidiolex are carefully monitored by health professionals.
- Epilepsy Drugs: Even though the FDA approved the CBD drug Epidiolex to treat certain forms of epileptic seizures, incorrect doses can result in more aggressive seizures. This drug should only be used under close medical supervision.
- Chemotherapy Drugs: As with most drugs, chemo drugs are manufactured considering the likely rate of metabolization. If CBD slows down that rate, concentrations of the drug can build up in the body which could result in toxicity.
Other research has also linked CBD to interactions with:
- Antidepressants and Anti-anxiety Medications
- Cold or Flu Medications
- Blood Pressure Medications (Beta Blockers)
Always consult a doctor if you’re taking any of the medications above to understand their interaction risks.
The FDA continues to advise the public to be cautious about using CBD until more scientific research supports its efficacy and safety.
Turning Point of Tampa’s goal is to always provide a safe environment and a solid foundation in 12-Step recovery, in tandem with quality individual therapy and groups. We have been offering Licensed Residential Treatment for Addiction, Eating Disorders and Dual Diagnosis in Tampa since 1987. If you need help or know someone who does, please contact our admissions department at 813-882-3003, 800-397-3006 or [email protected]
Can CBD Oil Thin Your Blood?
Given what it can do, it’s no wonder people are concerned about the possible side effects of CBD oil. Researchers and scientists are steadily building knowledge about CBD and other cannabinoids to find out how and to what extent they relieve pain, help our stress responses, regulate sleep, and more.
More is being discovered about CBD and cannabinoids all the time, which is why questions about its side effects keep coming up. We do know that it can interact with some medications and have dire consequences for people with heart issues and other risk factors.
Does CBD oil act as a blood thinner by itself? How does CBD oil interact with anticoagulants like warfarin? Should you stop taking CBD before an operation? Find out these answers and more in this comprehensive guide to CBD oil and blood thinners.
The Basics Of Blood Thinners
Arteries, veins, and capillaries are the three kinds of blood vessels that transport blood around the human body. The average speed of blood is between 3 and 4 miles per hour – pretty fast considering the average height of an adult human male is 176.5 centimeters, or 0.001 miles.
When your body needs to stem blood flow – for instance, when you get a cut or an injury – it makes cells called platelets that group together to create blood clots. You might have heard of clotting issues like Deep Vein Thrombosis and the buildup of plaque on artery walls that can lead to pulmonary embolisms and other serious health problems.
Blood thinners are meant to address and prevent these issues. Blood thinners don’t actually make your blood thinner or dilute it in any way. They work by stopping the formation of blood clots and preventing existing blood clots from getting any bigger. People who have had heart attacks or a stroke are prescribed blood thinners to prevent future ones.
The human body needs to be able to thin blood and create clots based on new conditions. According to one study , cannabidiol (CBD) “inhibits CYP2C19, increasing levels of the active metabolite of clobazam threefold.” The researchers also add that smoking marijuana could have “serious interactions with drugs like warfarin,” warfarin being a common anticoagulant sold under the name Coumadin among others.
What this basically indicates is that there is very likely a possibility that CBD and other hemp extracts can inhibit the inhibitors, essentially wrecking the efficacy of blood thinners like warfarin. But what about people who aren’t on blood thinners? Should they be worried about taking CBD oil?
CBD Oil & Thinning Blood
The danger with combining CBD oil and blood-thinning medications is that both can act as blood thinners, thinning your blood more than your doctor intended. That would seem to indicate that CBD oil has anticoagulant effects on its own.
A study found that cannabis sativa and the cannabinoids tetrahydrocannabinol (THC) and cannabinol (CBN) “ display anticoagulant activity ” when introduced in an animal specimen. CBD wasn’t singled out with the other two extracts. So do CBD products have the same effect as the two cannabis plant extractions mentioned in that study?
The widely accepted answer is that yes, CBD oil has some effect on the thinness of your blood. Harvard Health Publishing , for example, has said that CBD can “increase the level of blood thinning and other medicines in your blood by competing for the liver enzymes that break down these drugs.”
They do go on to mention that grapefruit is known to have a similar effect. The National Health Service (NHS) in the UK instructs readers taking warfarin to avoid grapefruit juice but also mentions some different blood-thinning medications that present less of a risk when grapefruit juice is present in the body and competing with medication in the liver’s enzyme system.
If we follow the logic backward, it appears reasonable to draw the conclusion that anyone worried about a negative drug interaction, bleeding complication, suffering from heart disease, having a history of strokes, or otherwise concerned or vulnerable to potential complications from CBD products should avoid taking them without discussing them with a medical professional first.
Reduce Risk With Trusted Brands
Follow medical advice from a trusted doctor or qualified professional when you start a CBD oil regimen. If you’ve agreed that CBD is a viable treatment option or that you don’t have risk factors that counter its potential health benefits, you have to make sure you find the right provider that doesn’t include harmful additives in their products.
Whether you’re using edibles, full-spectrum CBD, terpenes, cannabis extract, topicals, hemp oil, or a tincture, make sure you find one with a list of all active ingredients. In case you’re looking for a worst-case scenario, the FDA put out a warning in 2018 that some synthetic cannabinoid products were found to be laced with an anticoagulant called brodifacoum that’s typically found in rat poison.
Since these were described as being sold at gas stations and convenience stores, it’s highly likely they weren’t coming from the most reputable suppliers out there. Do your research and make sure you know exactly what you’re taking before you start taking CBD oil or any similar product. The FDA doesn’t regulate supplements, so shopping around is paramount.
Is CBD Oil An Operation Risk?
Some doctors ask patients to stop taking CBD oil 48 hours or more before a scheduled procedure while others don’t think it’s a serious risk. Doubtless, trained medical professionals know what to look for in individuals so they can make an informed decision about what’s best. It might be comforting to know that, in most cases at least, a history of CBD consumption won’t automatically prevent doctors from getting people the treatment they need.
An example case study from 2017 describes a 44-year old caucasian male who had been having seizures starting when he was 27. The seizures followed a stroke that followed cardiac surgery. The mechanical valve put in place during the cardiac surgery and the nature of his seizures made the 44-year old a bad candidate for surgery, so his doctors opted to refer him to the University of Alabama’s CBD program.
He was taking the blood thinner warfarin in addition to a few other medications to keep his International Normalized Ratio (INR) in line with what was healthy. According to the case study, the patient’s primary care physician slowly lowered his dose of warfarin in tandem with the increase in CBD administered. The final recommendation of the case study is to use INR monitoring when CBD treatment is being administered alongside prescription drugs like warfarin or heparin.
This is a great illustration of an apparently common method of managing the potential risk of CBD’s antiplatelet effects. At the end of the case study, the 44-year old was taking a dose of warfarin that was about 30% lower than when he started and continuing to have CBD administered.
So even if the research about CBDs’ effects on blood thinning and interactions with blood thinners is still far from complete, it’s clear medical professionals are being precautious. It’s best to trust the advice of a trusted medical professional to make sure you’re taking CBD as safely as possible.
Does CBD Oil Lower Your Blood Pressure?
The studies are pretty much across the board on this question. One promising experiment from 2017 indicated that “acute administration of CBD reduces resting blood pressure and the blood pressure increase to stress in humans, associated with an increased heart rate,” which basically means that the 9 participants in the study experienced a drop in their resting blood pressure after a single dose of cannabidiol.
What does that mean for people who have to bring their blood pressure over time, can a regimen of CBD oil accomplish the task? That’s where the research gets a bit less promising. One study from 2020 remarks that CBD “has not affected blood pressure in hypertensive animals.” The same study mentions that most incidents of hypotensive action (low blood pressure) occurred mainly during stress conditions.
Other studies seem to point to some positive results on blood pressure when participants take CBD in moments of stress. However, the evidence either doesn’t support or isn’t conclusive enough to support the idea that CBD is a viable treatment option for lower blood pressure over the long term. You might think that thinner blood automatically creates lower blood pressure, but the two concepts aren’t related.
The beating of your heart creates blood pressure while clotting is meant to stop internal and external bleeding. Adding platelets to the bloodstream doesn’t impact blood pressure. Even when platelets completely block the bloodstream like they do in thrombosis, blood pressure doesn’t change.
But that acute drop in blood pressure could possibly cause problems in certain individuals. If you have problems with your blood pressure being too low in general, it might not be a great idea to consume CBD oil and similar products that source from the hemp plant.
Is CBD Oil Safe?
Ok, so if CBD oil can possibly interact with prescription medications and cause blood to thin and blood pressure to drop following consumption, is it safe to take? Only your doctor can tell you for sure whether it’s a smart treatment option for you. Many have used it to successfully treat epilepsy, anxiety, narcolepsy, and insomnia. By and large, it appears that it is “ a promising candidate of both somatic and psychiatric disorders .”
Many people take CBD oil without any issue. It isn’t psychoactive and there is no indication that it has any addictive qualities. For the majority of people, taking CBD oil from a reputable source where you can see all the active ingredients and none are harmful shouldn’t be a problem.
It’s not as intense as medical marijuana and is available in some places where Mary Jane is not. Many people have used it for pain management or just to relax. People respond differently to these products depending on their individual body chemistry and the context in which they take them.
Some healthcare professionals view CBD oil as a safe alternative to opioids and other prescription treatments for anxiety and sleep disorders. By and large, it is safe. But you should still consult a doctor or another healthcare provider to determine whether you can and are likely to benefit from CBD oil.
Does CBD Oil Thin Blood More Than Other Cannabinoids?
Marijuana as a whole and CBD oil as a part of the whole have both been found to have anticoagulant properties. The best course of action is to avoid hemp-based edible or consumable products if you’re taking heart medication and can’t reach a doctor to get a decision on whether or not CBD oil, edibles, topicals, or even THC products would be dangerous for you to take.
As far as whether CBD oil possesses a blood-thinning capability superior to other extracts from hemp, there’s not much research available on the topic. Out of an abundance of caution, don’t assume that any one product will have less of a blood-thinning effect than another one unless a doctor has told you so.
Despite the indications that CBD oil and other hemp-based products interact badly with blood thinners and could cause your body’s clot-producing ability to fall below where it should be, anecdotal information on the internet seems to indicate that some doctors don’t think it’s a big risk.
Still, an in-person doctor would know best about your health condition and what kinds of factors will have an impact on it. Ask a medical professional before you start taking CBD oil if you’re on blood thinners or at risk for stroke or heart attack. There’s a chance they’ll say it’s fine, but if they say it isn’t you should follow their instructions.
CBD oil has had many positive effects on users’ stress levels and allowed them to sleep more soundly during the night. Doctors have administered CBD oil for epilepsy, narcolepsy, and generalized anxiety disorders. It’s useful for relaxing without the psychoactive characteristics of marijuana or THC.
But marijuana and hemp-derived compounds have been found to interact poorly with blood thinners. For people who take these sorts of prescription medications, anything sourced from the hemp plant could cause some problems.
The danger of taking CBD oil on top of blood thinners is that your blood will become “too thin,” in essence, both of them perform the same function in terms of platelets. So you’d essentially be taking too much of what you need to stay healthy, which can be as disastrous as not staying healthy at all.
Still, the way doctors have balanced CBD administration with steadily decreasing amounts of drugs like warfarin gives some hope that medical professionals will one day know for sure how to organize CBD regimens for people who have had strokes and heart attacks to make sure they can safely take CBD. They’ve already been successful in at least one case study.
For now, users of CBD should check with their doctors to make sure it’s safe for them to start or continue using the product. It’s worth an ask even if you think you’re low-risk. The better prepared and informed you are before you start your CBD regimen, the more beneficial it will be for you in the long run.
Does CBD Thin Your Blood?
A question that has been messaged to me multiple times over the past month, I wanted to cover off whether CBD thins your blood, how different products might affect this and why this is important for you.
As you take CBD oil, one of the side effects is it can increase the quantity of coumadin, which is known to thin your blood. Coumadin, also known as Warfarin Sodium, is an anticoagulant, which means it thins the blood and extends the time it takes to clot the blood. As you can imagine, there are many medical reasons why this might be wanted.
CBD has been shown in multiple studies to dilate blood vessels, which in turn helps the circulatory system, such as this test which showed a small quantity had a significant impact on the test subjects blood pressure in stress situations.
Another test, performed on an obese rat (again, another reason why we need more human testing as most of the tests are based on rats currently) showed that the cannabis extract had the anticoagulant effect they were aiming for.
For anyone who hasn’t heard of the grapefruit effect, it is that taking a grapefruit when having a blood thinner medication can have an effect on the medicine working. The main medicines that are affected by eating grapefruits include statins, calcium channel blockers, entocort, cyclosporin and cytotoxic medicines. It should be stated that this isn’t a definitive list, there are many more, which is why you must speak to your doctor.
It affects the medicine by increasing the amount in your blood, which can obviously have side effects or change the way it is meant to work.
The same effects have been seen when taking CBD oil, therefore if you are taking any of these medications then it might not be recommendable to have CBD oil.
Considering all of these factors, this is why it is even more important that the brands are held to account and deliver the quantities they state on the pack. As it stands, they are registered as food supplements rather than medicine, meaning the regulations are more relaxed, so you should read up on the third party lab test results and only opt for reputable brands. Ignore anything which is being produced in China, I promise you that!
Is There A Difference Between Topical & Oral?
Absolutely, in most tests, when taken topically (on the skin, such as a cream), it didn’t thin your blood, meaning you could gain all the benefits associated with a CBD cream without the worry of what it might do if on medication. Having said that, people who are taking CBD oil sublingually are normally after a very different treatment than if they are using a cream.
None Before Tattoo’s
Just the same as being told you can’t take painkillers or drink alcohol before getting a tattoo, as the blood becomes very thin, pours out and makes it much harder for the artist, the exact same has been witnessed with CBD oil. Obviously, this is a frustration for people who were hoping to take it to calm their nerves before getting this procedure done.
Just the same, you might want to consider this if you are having any work done or an operation. It might help to calm your nerves, but the doctor will have to know about this and will most likely to tell you not to take any in the days leading up to this, but once again, you should speak to a medical professional beforehand.
Does That Mean It Is A Bad Thing?
No, absolutely not, this could be opening up huge new opportunities to tackle some of our biggest health issues, such as strokes and heart disease. Having said that, we need a huge amount more test studies to be taken before anyone can state one way or the other.