• People who suffer from plant allergies, like tomato allergy, peach allergy, and nut allergy, need to take a skin test to know if they are allergic to cannabidiol (CBD) oil. The possibility of cross-reactivity among these plants’ substances may cause an allergic reaction in some individuals(1).
  • In a study, several patients with rhinitis and asthma symptoms were exposed to the hemp plant(2). The respiratory symptoms and skin test reactivity suggested that cannabis could be an aeroallergen for some patients.
  • Cannabidiol is an industrial hemp derivative that does not give a “high,” unlike tetrahydrocannabinol (THC), the prevalent psychoactive agent in marijuana.
  •  CBD comes in different types and forms that may be helpful in managing different kinds of anxieties, inflammation, and pain(3).

Allergic Reaction to CBD Oil

Like other substances derived from plants, cannabidiol (CBD) oil may contain some aeroallergens from the cannabis plant(4). These allergens may induce allergic reactions ranging from mild to life-threatening manifestations(5)

A study noted the strong association of rhinitis and asthma symptoms to the pollination patterns of cannabis plants(6).

One possible cause of CBD oil allergy is the cross-reactivity between cannabis and other fruits and vegetables or the “cannabis fruit/vegetable syndrome(7). Cross-reactivity in allergic reactions happens when specific proteins in a substance (usually pollen) have similar proteins found in another (usually food)(8).

The food allergies commonly connected to the cannabis fruit/vegetable syndrome are banana allergy, peach allergy, apple allergy, nut allergy, tomato allergy, cherry allergy, orange allergy, grapefruit allergy(9). Other environmental and seasonal allergies may be related as well.

Symptoms and Diagnosis of CBD Oil Allergy

Hemp oil or CBD oil allergy can be diagnosed through blood tests, patch tests, or skin prick tests. 

A skin prick test is done by piercing a needle with allergen extract on the skin. It is used to determine mast cells or the cells responsible for immediate allergic reactions(10)

This test is usually done to identify pollen, animal dander, mold, or particular food allergies. People with positive allergy results may experience redness and itchiness on the part of the skin that was pricked. 

Allergy sufferers may experience symptoms of common allergies, like runny nose, sneezing, watery eyes, itchy throat, rhinitis, and shortness of breath.

Solution for CBD Oil Allergy

A person who suspects a potential CBD oil allergy should visit an immunology doctor and take the necessary tests and allergy medications, like antihistamines, to avoid fatal repercussions.

Seek local personalized medical advice and make sure to read the CBD oil products’ labels before purchasing to prevent allergic reactions. Allergic reactions can become medical emergencies rapidly, and requires contacting local emergency services right away.

CBD Allergy vs. THC Allergy

CBD and THC are very different compounds that come from the cannabis plant. They also have different effects on the body. 

THC comes from the marijuana plant, cannabis with 0.30% or higher THC content, while CBD is mainly derived from industrial hemp that has less than 0.30% of THC. 

Marijuana allergy comes from the airborne dissemination and inhalation of cannabis pollen from its male and female flowers. Cannabis allergy may result in nasal congestion, rhinitis, sneezing, coughing, wheezing, and dyspnea(11).

Side Effects of CBD

Some CBD side effects may cause risks in select individuals, including dry mouth, diarrhea, reduced appetite, drowsiness, and fatigue(12). Special populations need to exercise extra caution under their doctor’s guidance. 

These side effects are different from allergy symptoms and may differ for other people. Proper dosage and physician consultation is advised to minimize the side effects of CBD oil. The long-term effects of CBD, cannabis, or cannabinoids are yet to be fully known.

CBD Oil’s Suggested Benefits

Even though CBD has potential side-effects, it also has possible health benefits(13).

One of the many advantages of CBD oil is that it may help reduce the pain threshold by adjusting neuronal activity levels(14). It may also act as an antidepressant because of its purported ability to work on serotonin receptors(15).

According to a study, CBD oil showed potential to help improve certain conditions such as epilepsy, sleep disorders, schizophrenia, and anorexia(16). Other potential benefits of CBD oil include managing post-traumatic stress disorder (PTSD) and cancer side effects(17). Much more research on a larger scale is needed to confirm or define clear benefits, long term effects, and dosing protocols for CBD and any medical condition that is not yet already FDA approved.

Allergy vs. Intolerance

The body reacts differently to various substances. It is essential to distinguish if these reactions are allergies, intolerance, or substance sensitivity to avoid harmful health impacts. Symptoms for varying cases may be similar to each other. However, outcomes may range from discomfort to fatality from anaphylaxis (serious allergy attack).

Allergy

Allergic reactions involve the immune system(18). The immune system overreacts and produces antibodies that attack allergens, like pollen or dust mites and trigger histamine production.

The most common allergies are food allergies, seasonal allergies, and hay fever or allergic rhinitis. Allergy symptoms can be mild, like sneezing and itching, to severe, like anaphylaxis or difficulty breathing(19)

Anaphylaxis is a severe allergic reaction that releases a flood of chemicals in the body that can result in anaphylactic shock(20). Its manifestations include low blood pressure, airway and mouth area swelling, difficulty breathing, skin rash, dizziness, or nausea. 

Anaphylaxis symptoms need immediate medical attention.

Intolerance and Sensitivity 

Unlike an allergy, intolerance occurs in the digestive system(21), when the body is unable to process or digest certain foods or substances. Intolerance may be caused by enzyme deficiencies or sensitivity to certain chemicals or ingredients.

When dealing with food or substance intolerance, a person can still eat a small amount without experiencing problems. Symptoms may include bloating and stomach aches that can be felt a few hours after ingesting food or a substance that the body cannot tolerate.

CBD Overview

There are two primary compounds in the cannabis plant, tetrahydrocannabinol (THC) and cannabidiol (CBD). Even though these compounds are of the same origin, they have opposite effects. 

Cannabidiol or CBD is a non-psychoactive and non-toxic component of Cannabis sativa(22). A study suggested its potential to treat chronic pain and seizure disorders(23)

Meanwhile, the other phytocannabinoid, THC, is the psychoactive compound of cannabis that gives the feeling of being “high”(24)

Both CBD and THC have suggested medical benefits, like the potential to help with anxiety and pain(25). They both affect the body’s endocannabinoid system (ECS), which is the network of neurotransmitters that regulate sleep, pain, and digestion(26). However, cannabis, with a substantial amount of THC, may produce unpleasant side effects on people(27)

Some of these THC side effects include the risk of tolerance and addiction (dependence). A study stated that adolescent exposure to THC might recalibrate the sensitivity of the reward system to other drugs(28).

Making CBD oil from industrial hemp is legal. According to the 2018 United States Farm Bill, hemp is defined as any part of the Cannabis sativa plant containing less than 0.30% THC and higher CBD content. 

Since the passage of the Farm Bill, the production of industrial hemp has been regulated on a federal level. 

Different CBD products come from the hemp plant, such as CBD oil. This CBD product is made from cannabidiol mixed with a carrier oil(29)

The most commonly used carrier oils include medium-chain triglyceride (MCT) and hempseed oil. 

CBD oil can be classified as full-spectrum CBD, broad-spectrum CBD, and CBD isolates. 

Types of CBD

Full-spectrum CBD oil contains traces of THC lower than 0.30% and strains of active cannabinoids and terpenes that work together to achieve an entourage effect(30). This phenomenon is characterized by CBD interacting with other active cannabinoids to maximize CBD’s beneficial effects. 

Full-spectrum CBD has no psychoactive effects because of the low THC levels (<0.3%).

Meanwhile, THC-free CBD oil is called broad-spectrum CBD. It contains all the other active cannabinoids of the cannabis plant except for THC.

CBD oil isolate contains pure CBD alone. This type of CBD gives a higher dose of CBD among the three types(31).

However, due to the lack of terpenes and other phytocannabinoid in CBD isolates, the entourage effect’s benefits are lost(32).  

Forms of CBD

There is a wide variety of CBD products available on the market. It usually can be ingested directly, sublingually, or under the tongue.

Depending on the format, CBD interacts differently with endocannabinoid receptors because each CBD form has a different bioavailability (absorption in the body). 

The most common format is the CBD oil tincture. These droppers enable easy CBD oil use

CBD oil tinctures may come with carrier oils, like medium-chain triglyceride (MCT) coconut oil, hempseed oil, or jojoba oil.

CBD tinctures may be taken orally, mixed with food and drinks, or applied under the tongue (sublingually) to maximize CBD’s bioavailability. 

Another way to use CBD oil is through vaping. Inhaling CBD oil diffuses it directly into the bloodstream, resulting in faster absorption of CBD in the body(33). It can also be used as an additive to vape juice. 

Another form of CBD is the CBD edibles. The most popular CBD edibles are the CBD gummies. 

These CBD-infused gummies are suitable for people who want to have a precise dose of CBD. This format also aids those who do not like the taste of unflavored CBD tinctures. Other edibles include mints, gums, or cookies

Meanwhile, CBD topicals are used mostly to alleviate muscle pain and inflammation(34). They are directly applied to the skin and do not go directly into the bloodstream. CBD topicals can be salves, creams, balms, lotions, or lip balms

Uses and Applications of CBD

Researchers are studying various possible health benefits and applications of CBD products. They are mainly used for their anti-inflammatory properties and antioxidant properties for improving wellness(35)

CBD, the non-psychoactive component of cannabis, has multiple suggested therapeutic uses.

It is commonly used to manage pain, anxiety, and insomnia(36)

According to Harvard Health, the European Journal of Pain showed that CBD applied to the skin can aid as an anti-inflammatory relief to arthritis(37). CBD oil topicals are widely anecdotally used as a pain reliever for aching muscles(38).

CBD oil can also be used in pets to help them maintain body balance and keep a healthy physical state(39). Always consult a veterinarian prior to giving your pet CBD for any reason.

The use of CBD oil depends on the needs and conditions of the user. The body’s ability to absorb components like CBD and its reaction to the substance varies from person to person.

Conclusion

Many companies inappropriately market CBD products as supplements, despite Food and Drug Administration (FDA) regulation not to do so(40). Despite the possible CBD benefits discussed, some people may still have unpleasant reactions to it. These benefits and risks have yet to be confirmed with larger scale, high quality research studies.

Allergic reactions to CBD oil have a possible connection to the substance’s cross-reactivity from other fruit and vegetable allergies(40). A skin test is recommended for people with tomato allergy, grapefruit allergy, orange allergy, banana allergy, apple allergy, nut allergy, and peach allergy(41).

Contact touching of the cannabis plant may also trigger rashes, hives, and angioedema or swelling(42). Inhaling the cannabis plant’s allergens may induce runny nose, sneezing, itching, swelling, and watery eyes(43).

Children ages one year and older may take CBD under a prescription. Epidiolex, the only FDA-approved CBD product, may be taken daily. The dosage may be up to 25mg/kg of the child’s weight(44).

People with other diseases must consult their doctors first before using any form or type of CBD. 


  1. American Academy of Allergy Asthma and Immunology,(n.d.), Marijuana Cannabis Allergy. https://www.aaaai.org/tools-for-the-public/conditions-library/allergies/marijuana-cannabis-allergy
  2. Stokes, J. R., Hartel, R., Ford, L. B., & Casale, T. B. (2000). Cannabis (hemp) positive skin tests and respiratory symptoms. Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology, 85(3), 238–240. https://doi.org/10.1016/S1081-1206(10)62473-8
  3. Blessing, E. M., Steenkamp, M. M., Manzanares, J., & Marmar, C. R. (2015). Cannabidiol as a Potential Treatment for Anxiety Disorders. Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics, 12(4), 825–836. https://doi.org/10.1007/s13311-015-0387-1
  4. Jackson, B., Cleto, E. & Jeimy, S. An emerging allergen: Cannabis sativa allergy in a climate of recent legalization. Allergy Asthma Clin Immunol 16, 53 (2020). https://doi.org/10.1186/s13223-020-00447-9
  5. Decuyper I, Ryckebosch H, Van Gasse AL, Sabato V, Faber M, Bridts CH, Ebo DG. Cannabis Allergy: What do We Know Anno 2015. Arch Immunol Ther Exp (Warsz). 2015 Oct;63(5):327-32. doi: 10.1007/s00005-015-0352-z. Epub 2015 Jul 16. PMID: 26178655.
  6. Stokes, Jeffrey & Hartel, Rita & Ford, Linda & Casale, Thomas. (2000). Cannabis (hemp) positive skin tests and respiratory symptoms. Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology. 85. 238-40. 10.1016/S1081-1206(10)62473-8. 
  7. Bhatia, P., Chen, M., & Christiansen, S. (2018). Marijuana and stoned fruit. Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology, 120(5), 536–537. https://doi.org/10.1016/j.anai.2018.01.017
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  10. American Academy of Allergy Asthma and Immunology, (n.d.), Mast Cell Activation Syndrome), retrieved from https://www.aaaai.org/conditions-and-treatments/related-conditions/mcas#:~:text=Mast%20cells%20are%20allergy%20cells,them%20or%20made%20by%20them.
  11. Ocampo, T. L., Rams, T. S., (March 2015), Cannabis sativa: the unconventional “weed” Allergen, DOI:https://doi.org/10.1016/j.anai.2015.01.004
  12. Bauer, B. A., (n.d.), What Are the Benefits of CBD- -And Is It Safe to Use?, retrieved from https://www.mayoclinic.org/healthy-lifestyle/consumer-health/expert-answers/is-cbd-safe-and-effective/faq-20446700
  13. Pamplona, F. A., da Silva, L.R., Coan, A. C., (September 2018), Potential Clinical Benefits of CBD-Rich Cannabis Extracts Over Purified CBD in Treatment-Resistant Epilepsy: Observational Data Meta-analysis, https://doi.org/10.3389/fneur.2018.00759
  14. Russo E. B. (2008). Cannabinoids in the management of difficult to treat pain. Therapeutics and clinical risk management, 4(1), 245–259. https://doi.org/10.2147/tcrm.s1928
  15. Andrade, C., & Rao, N. S. (2010). How antidepressant drugs act: A primer on neuroplasticity as the eventual mediator of antidepressant efficacy. Indian journal of psychiatry, 52(4), 378–386. https://doi.org/10.4103/0019-5545.74318
  16. Bruni, N., Della Pepa, C., Oliaro-Bosso, S., Pessione, E., Gastaldi, D., & Dosio, F. (2018). Cannabinoid Delivery Systems for Pain and Inflammation Treatment. Molecules (Basel, Switzerland), 23(10), 2478. https://doi.org/10.3390/molecules23102478
  17. Northwestern Medicine, (n.d.)., What Research Say About CBD Oil, retrieved from https://www.nm.org/healthbeat/medical-advances/science-and-research/what-research-says-about-cbd-oil
  18. Welty TE, Luebke A, Gidal BE. Cannabidiol: promise and pitfalls. Epilepsy Curr. 2014 Sep;14(5):250-2. doi: 10.5698/1535-7597-14.5.250. PMID: 25346628; PMCID: PMC4189631.
  19. American Academy of Allergy Asthma and Immunology, (September 2019), Food Intolerance Versus Food Allergy, retrieved from https://www.aaaai.org/conditions-and-treatments/library/allergy-library/food-intolerance
  20. Mayo Clinic, (September 2019), Anaphylaxis, retrieved from https://www.mayoclinic.org/diseases-conditions/anaphylaxis/symptoms-causes/syc-20351468
  21. American Academy of Allergy Asthma and Immunology, Op. Cit.
  22. Sansouci, J., (2020), The Rebel’s Apothecary, pp 37, retrieved from https://drive.google.com/file/d/1QOnrkUAJQyilcYph8sYNptDtwsi3gZUu/view
  23. Goldenberg M. M. (2010). Overview of drugs used for epilepsy and seizures: etiology, diagnosis, and treatment. P & T : a peer-reviewed journal for formulary management, 35(7), 392–415.
  24. National Center for Complementary and Integrative Health, (November 2019), Cannabis (Marijuana) and Cannabinoids: What You Need o Know, retrieved from https://www.nccih.nih.gov/health/cannabis-marijuana-and-cannabinoids-what-you-need-to-know
  25. Blessing, E.M., Steenkamp, M.M., Manzanares, J. et al. Cannabidiol as a Potential Treatment for Anxiety Disorders. Neurotherapeutics 12, 825–836 (2015). https://doi.org/10.1007/s13311-015-0387-1
  26. Adams IB, Martin BR. Cannabis: pharmacology and toxicology in animals and humans. Addiction. 1996 Nov;91(11):1585-614. PMID: 8972919.
  27. Volkow, N. D., Baler, R. D., Compton, W. M., & Weiss, S. R. (2014). Adverse health effects of marijuana use. The New England journal of medicine, 370(23), 2219–2227. https://doi.org/10.1056/NEJMra1402309
  28. Ibid.
  29. World Health Net, (October 2020), What are the Pros and Cons of Broad-spectrum CBD, retrieved from https://www.worldhealth.net/news/what-are-pros-and-cons-broad-spectrum-cbd/
  30. Pavlovic, Radmila; Nenna, Giorgio; Calvi, Lorenzo; Panseri, Sara; Borgonovo, Gigliola; Giupponi, Luca; Cannazza, Giuseppe; Giorgi, Annamaria. 2018. “Quality Traits of “Cannabidiol Oils”: Cannabinoids Content, Terpene Fingerprint and Oxidation Stability of European Commercially Available Preparations.” Molecules 23, no. 5: 1230.
  31. Evans, J., (2020), The Ultimate Guide to CBD, chapter 1, pp.22, retrieved from https://books.google.com.ph/books?hl=en&lr=&id=V-_RDwAAQBAJ&oi=fnd&pg=PA1&dq=%22cbd+isolate%22+usually+in+the+form+of+powder&ots=aJwh4KQvr3&sig=Iou2Rz56CtFRjh6GjCsigphtrfc&redir_esc=y#v=onepage&q=isolates&f=false
  32. Ibid.
  33. Huestis M. A. (2007). Human cannabinoid pharmacokinetics. Chemistry & biodiversity, 4(8), 1770–1804. https://doi.org/10.1002/cbdv.200790152
  34. Hammell, D. C., Zhang, L. P., Ma, F., Abshire, S. M., McIlwrath, S. L., Stinchcomb, A. L., & Westlund, K. N. (2016). Transdermal cannabidiol reduces inflammation and pain-related behaviours in a rat model of arthritis. European journal of pain (London, England), 20(6), 936–948. https://doi.org/10.1002/ejp.818
  35. Atalay, S., Jarocka-Karpowicz, I., & Skrzydlewska, E. (2019). Antioxidative and Anti-Inflammatory Properties of Cannabidiol. Antioxidants (Basel, Switzerland), 9(1), 21. https://doi.org/10.3390/antiox9010021
  36. Grinspoon, P., (August 2018), Cannabidiol (CBD)- -What We Know and What We Don’t, Harvard Health Publishing, retrieved from https://www.health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont-2018082414476
  37. Ibid.
  38. Jorge, L. L., Feres, C. C., & Teles, V. E. (2010). Topical preparations for pain relief: efficacy and patient adherence. Journal of pain research, 4, 11–24. https://doi.org/10.2147/JPR.S9492
  39.  Kriss, R., (October 2019), CBD Oil for Dogs: What You Need to Know, American Kennel Club, retrieved from https://www.akc.org/expert-advice/health/cbd-oil-dogs/
  40. Bhatia, P., et. al. Op. Cit.
  41. Decuyper, I. et.al., Op Cit.
  42. American Academy of Allergy Asthma and Immunology,(n.d.), Marijuana Cannabis Allergy, retrieved from https://www.aaaai.org/conditions-and-treatments/library/allergy-library/marijuana-cannabis-allergy
  43. Ibid.
  44. Medline Plus, (August 2020), Cannabidiol (CBD), retrieved from https://medlineplus.gov/druginfo/natural/1439.html
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