Can CBD Oil Help With Liver Damage?

  • A study published in the British Journal of Pharmacology noted that cannabidiol (CBD) improved the symptoms of acute liver failure on animal subjects. Results showed that CBD might be a potential therapeutic agent for treating human hepatic encephalopathy (1)
  • A 2017 in vitro study posted in Pharmacognosy Research demonstrated how CBD had bioactivities against the hepatitis C virus (HCV) (2).
  • A study released in Scientific Reports has shown how CBD alleviated the abnormal retention of fat within the liver of ethanol-induced animal subjects (3).
  • However, CBD can cause liver damage when used in extremely high doses (4). Before taking CBD, one must consult a licensed physician.   

Why People Are Turning to CBD for Liver Damage

Liver damage treatment depends on the underlying condition. Some liver problems can be remedied with lifestyle modifications, such as losing weight or stopping alcohol. Some may require treatment or surgery (5). Diuretics and lactulose are the most common treatments for advanced liver disease, called cirrhosis.

Medication for autoimmune liver damage often involves corticosteroids. Treatments, such as prednisone, may cause side effects, such as glaucoma, weight gain, high blood pressure, and mood swings (6)

Moreover, surgery or a liver transplant may result in several complications, such as infection, bleeding, seizures, failure, or rejection of the donated liver (7). However, the benefits of a liver transplant are generally greater than the risks and it is potentially lifesaving.

The side effects of these treatments have caused individuals to look for a supplemental approach to treating their livers. 

Moreover, some individuals with liver conditions that cannot be treated with pharmaceutical drugs are also on the lookout to reclaim their health.

CBD is becoming a popular alternative for many health problems. However, there are still many questions about whether CBD can help with liver damage or not. 

While some studies have acknowledged CBD’s potential ability to stimulate liver regeneration through in vitro and vivo experiments, there are studies that link CBD to liver damage in animal subjects.

CBD vs. Hepatitis C

Hepatitis C is a liver condition caused by the hepatitis C virus (HCV). There is currently no vaccine for this infection. Infected individuals may experience fever, fatigue, loss of appetite, joint pain, and jaundice.

In 2019, the World Health Organization (WHO) estimated that there were new 1.25 million HCV infections worldwide (8)

An in vitro study found that CBD might have bioactivities against HCV. The study added that CBD’s direct antiviral activity indicated that it might be effective against viral and nonviral hepatitis (autoimmune hepatitis) (9)

Although the study showed promising results of CBD against HCV, it was also noted that CBD did not affect the hepatitis B virus (10)

Individuals must consult a physician before considering the use of CBD for hepatitis C. Untreated hepatitis C may lead to long-term infection known as chronic hepatitis C, which may result in severe liver damage (11). Also, now there are other safe, effective treatments for Hepatitis C available.

CBD vs. Alcoholic Liver Disease

Alcoholism can induce hepatosteatosis (fatty liver disease), commonly known as alcoholic liver disease (ALD). 

With early detection and lifestyle change, ALD is reversible. If left untreated, however, this can later progress to severe liver problems, such as cirrhosis and hepatitis. 

Researchers found that oxidative stress is one of the primary factors in inducing steatosis. A study demonstrated that CBD reduced ethanol-induced liver injury on animal subjects by reducing oxidative stress (12)

Moreover, the study observed how CBD stimulated autophagy (removal of damaged liver cells) during in vitro and vivo experiments. 

The study noted how all these mechanisms might be essential for alleviating steatosis. 

CBD vs. Non-alcoholic Fatty Liver Disease

As the name implies, non-alcoholic fatty liver disease (NALD) is a condition concerning individuals who consume little to no alcohol. It is caused by excess fat accumulation in the liver.

The causes of NAFLD may be any of the following:

  • Overweight or obesity
  • Insulin resistance 
  • High levels of triglycerides (fat) in the body
  • High blood sugar

Management of NAFLD may be challenging since no prescription treatment has been approved for the condition (13). Health experts will recommend a change in lifestyle and diet habits to lose weight and reverse the fat deposition.

A study posted on Hepatology mentioned that high-fat diets might result in elevated leptin levels and plasma insulin. 

The increase in glucose levels is often accompanied by hyperglycemia, indicating that the body is insulin resistant (14)

Many scientists have tested CBD’s efficacy for weight loss. A recent study posted in the Frontiers in Endocrinology mentioned the positive influence of CBD on the liver. 

The administration of CBD reduced intracellular lipid (fat) content in an in vitro hepatosteatosis model. The review also acknowledged the antioxidant and anti-inflammatory properties of CBD (15)

Moreover, a 2017 study published by Plos One conducted a study on cannabis users and found a strong relationship between cannabis use and reduced prevalence of NAFLD (16)

More clinical studies are needed to verify CBD’s efficacy in reducing lipid content in the liver and its anti-obesity properties. 

How CBD Oil Works to Help With Liver Damage

The human endocannabinoid system (ECS) is composed of G-protein-coupled receptors, such as the cannabinoid receptor 1 (CB1) and cannabinoid receptor 2 (CB2).

CB1 receptors are located throughout the body. The majority of them are located in the central nervous system. CB2 receptors can be found primarily in the immune system (17).

The endocannabinoid system has been studied for decades for its role in modulating various physiological functions and peripheral organs. 

Modulating the ECS activity might have several therapeutic responses to health conditions and diseases (18).

A study released in Pharmacological Reviews mentioned evidence indicating the role of the ECS in the control of gastrointestinal motility and secretion. 

The authors in the study further expounded how the ECS can influence appetite, energy, weight balance, and metabolism. They found that administering a CB1 antagonist reduced food intake and body weight among animal test subjects. 

The study also mentioned that CB1 receptor knockout mice treated with CB1 antagonists were resistant to diet-induced obesity (DIO) (19)

Another study posted in the International Journal of Molecular Sciences discussed how CB1 antagonists reduced obesity in DIO mice (20).

The role of the CB2 receptor was discussed by a study published in Hepatology. This study tested how the CB2 receptor agonist improved fibrogenesis and accelerated liver regeneration (21)

The British Journal of Pharmacology posted a study that explained how CBD might have the ability to behave as a CB2 receptor inverse agonist, which may contribute to anti-inflammatory properties (22).

The British Journal of Pharmacology also published a study that explained how CBD might work as both cannabinoid receptor agonists and antagonists. The study mentioned how CBD, in low doses, might act as CB1 antagonist (23)

This is supported by an independent 2019 study published in the Canadian Journal of Kidney Health and Disease. In the study, the scientists used CBD to block CB1 receptors of insulin-resistant rats, preventing proteinuria and renal function decline. This study has shown that CBD can act as a CB1 antagonist (24).

The study from the British Journal of Pharmacology further explained that CBD might behave as a CB2 receptor antagonist and inhibit immune cell migration and reduce signs of inflammation (25)

Moreover, CBD has been shown to stimulate CB2 receptors during an in vitro study. This interaction resulted in the proliferation of T-cells and macrophages responsible for the release of inflammatory cytokines that cause autoimmune hepatitis (26)

Pros and Cons of CBD Oil for Liver Damage

The Pros

  • CBD might improve symptoms of acute liver failure, thus serving as a potential therapeutic agent for treating human hepatic encephalopathy (27)
  • During an in vitro study, CBD displayed bioactivities against the hepatitis C virus. CBD’s direct antiviral activity indicated that it might be useful against viral and nonviral hepatitis (28).
  • A study has shown that CBD might be useful in reducing alcohol liver injury by reducing oxidative stress (29).
  • An in vitro study demonstrated how CBD reduced intracellular lipid content in the fatty liver model (30)
  • CBD might have antioxidant and anti-inflammatory properties that could help maintain homeostasis in the liver (31). However, very high doses could cause liver damage.
  • Liver damage caused by high-dose CBD is generally reversible when CBD or other medications are reduced or stopped altogether according to the FDA studies on Epidiolex.
  • Many distinguished health agencies, including the World Health Organization (WHO), stated that CBD is generally well-tolerated and safe (32)
  • Prescriptions are not needed when buying CBD oil. 

The Cons

  • According to the U.S. Food and Drug Administration (FDA), CBD in high doses can lead to liver injury (33)
  • The CBD industry remains unregulated. Individuals should research product specifications, third-party laboratory tests, testimonials, and reviews. 
  • CBD might have several drug interactions with other medications. Always consult a physician before taking CBD. Liver disease is serious and treatment should always be medically supervised.
  • CBD cannot treat, prevent, cure, diagnose, or mitigate any disease other than certain rare childhood seizures.

How Does CBD Compare to Other Alternative Treatments?

There are several herbal treatments available for individuals who want to treat their liver conditions naturally. However, health experts have discovered that these may also cause harm if caution is not exercised (34)

Sho-saiko-to is an herbal medicine used for chronic hepatitis in China and Japan. Its use as an oriental classical medicine was first introduced 1500 years ago.  

Various clinical studies suggested that Sho-saiko-to might help protect against the development of hepatocellular carcinoma among individuals with cirrhosis. However, the mechanism for this remains unclear (35)

The Ministry of Health and Welfare in Japan, who had approved Sho-saiko-to as a treatment for liver disease, had to revisit the efficacy of the herb as it caused adverse respiratory effects among patients, resulting in 10 deaths (36)

Silymarin (milk thistle) is another natural herb that is used to treat liver and biliary disorders. The oldest reported use of Silymarin dates back to the ancient Greeks and Roman period when people used the plant to treat snake bites and liver conditions (37)

Holy basil is another plant that is believed to have hepatoprotective properties. The plant contains phytochemicals that have analgesic and anti-inflammation properties (38)

Like most of the herbal treatments mentioned, CBD is also a natural compound derived from Cannabis sativa (hemp). The use of cannabis sativa started during the medieval Islamic period when physicians used the plant to treat various conditions (39)

A study has shown how CBD restored liver and brain function among animal subjects with induced-hepatic failure.  The study also acknowledged the anti-inflammation and antioxidant properties of CBD, which could help in maintaining homeostasis in the liver (40)

How to Choose the Right CBD Oil for Liver Damage

CBD oil comes in three types of concentrations. 

Full-spectrum CBD oil contains all the cannabinoids present in hemp, such as cannabidiol (CBD), cannabigerol (CBG), cannabinol (CBN), and tetrahydrocannabinol (THC). 

THC is the cannabinoid known for producing psychoactive effects. In a full-spectrum CBD concentrate, THC levels cannot exceed the U.S. legal limit of 0.3%. 

Many studies have shown that THC may also have some hepatoprotection properties. 

A study published in Hepatology found that THC attenuated the progression of autoimmune hepatitis in animal subjects. Results indicated the decreased plasma levels of liver enzymes, inflammatory cytokines, and reduced tissue injury (41).

For individuals who want the benefits of all the cannabinoids present in hemp, full-spectrum CBD oil is the best option.

Although the full-spectrum concentrate has very low THC, some individuals prefer not to have THC in their system due to work and other personal reasons. Therefore, their next option can be broad-spectrum.

Broad-spectrum CBD oil contains all the cannabinoids present in hemp, except for THC. 

Lastly, CBD isolate is a concentrate made especially for individuals who want to take CBD into their system. CBD isolates may be good for people who want CBD without the presence of carrier oils and other cannabinoids. 

Since individuals with liver problems may be vulnerable to many substances and compounds, it is advisable to do extensive research before choosing a CBD brand. 

The certificate of analysis (COA) is a third-party lab result presented by legitimate CBD brands who want to assure their customers that their concentrations are the same as what they advertise. 

The COA also indicates that the extract is free from harmful chemicals, such as heavy metals, pesticides, and other contaminants. Moreover, the COA specifies the extraction process used for the CBD oil concentration. 

For individuals with liver problems, it is recommended that they choose CBD oil with CO2-extraction. This is a method that does not use any solvents. 

Here are other factors to consider when taking CBD oil for liver health:

  • Vaping enthusiasts should choose a CBD brand that does not use fillers and other toxic substances, like propylene glycol and polyethylene glycol. CBD vapes that contain nicotine are also harmful.
  • The carrier oil may be an essential factor to consider due to allergy, intolerance, and liver safety issues. Carrier oils can be hempseed oil, MCT (unrefined coconut oil), grapeseed oil, sunflower oil, or avocado oil. 
  • Choose non-GMO organic hemp. This is usually specified by the brand. 
  • Do some additional research by reading testimonials and recommendations from other customers. 
  • Remember that CBD can cause liver damage in very high doses

It is strongly recommended that individuals suffering from mild to severe liver damage consult a hepatologist before adding CBD to their daily regimen. 

Discussing the formulation and ingredients used with your physician may be crucial for one’s liver health. Never attempt to diagnose or treat yourself.

CBD Dosage for Liver Damage

There is currently no universal dosage recommended for CBD users. However, it is recommended that one starts with a low dose. 

A 2019 study released in the British Journal of Pharmacology recommended that CBD be taken from less than 1 to 50 milligram per kilogram a day (42).  Once the system gets used to CBD, the dosage may be increased.

One must also use discretion when using CBD and always discuss their dosage with physicians. CBD may cause liver injury when used in high dosages (43).

How to Take CBD Oil for Liver Damage

The most recommended approach to taking CBD for liver damage is through CBD tinctures. One can use a dropper to put CBD oil under the tongue.

CBD vape is another option to consider for individuals who do not want to take CBD oil orally. Some experts consider vaping to be a more effective and faster mode of delivery (44)

However, one must make sure that the CBD oil or cartridge does not contain harmful chemicals that can further damage the liver (45)

Can CBD Oil Cause Liver Damage?

Epidiolex is the first FDA-approved medication that contains CBD oil. It is primarily used for children with rare forms of epilepsy. However, Epidiolex in doses higher than the recommended 10-20 milligram per kilogram per day may cause liver injury (46)

The University of Arkansas for Medical Sciences posted a review in 2019 that showed how higher doses of CBD oil on 8-week old mice models led to liver toxicity (47). Molecules published this study, followed by Forbes and other media entities.

The dosage amounts used in the study were 246mg/kg, 738mg/kg, and 2460mg/kg. The study later observed that a single dose of 2460 mg/kg exhibited hepatotoxicity and increased bilirubin. They also added that a similar response was observed among monkeys injected with lethal CBD doses. 

The authors explained that the purpose of this experiment was to study the potential effects of lethal doses of CBD among living organisms. They added that the dosage that produced fatal results in the study does not apply to real-life scenarios (48)

The authors also mentioned that more studies are needed to determine the consequences of prolonged use of CBD.

Another thing to note in the study is that scientists used hexane as the extraction solvent for their CBD concentrate. Hexane is a chemical made from crude oil and is a potentially toxic compound when used on animals and humans (49).

Most CBD oil manufacturers use three extraction methods, such as hydrocarbon extraction, ethanol extraction, and CO2-extraction. The extraction method should be indicated in the certificate of analysis (COA). 

Individuals are advised to always research the brand properly before purchasing. The COA is crucial in determining if the CBD concentrate is safe and free from harmful chemicals. 


Studies have shown that CBD might have hepatoprotection properties. It has been indicated that CBD can reduce lipid content and reduce oxidative stress in alcoholic liver injury (50).

It has also been shown that CBD might have bioactivities against the hepatitis C virus (51). Lastly, a study has shown that CBD might potentially restore liver function during hepatic encephalopathy (52).

Individuals with liver damage must always consult their doctors before adding CBD to their daily regimen. It may or may not be appropriate for you.

  1. Avraham, Y., Grigoriadis, N., Poutahidis, T., Vorobiev, L., Magen, I., Ilan, Y., Mechoulam, R., & Berry, E. (2011). Cannabidiol improves brain and liver function in a fulminant hepatic failure-induced model of hepatic encephalopathy in mice. British journal of pharmacology, 162(7), 1650–1658.
  2. Lowe, H. I., Toyang, N. J., & McLaughlin, W. (2017). Potential of Cannabidiol for the Treatment of Viral Hepatitis. Pharmacognosy research, 9(1), 116–118. 
  3. Yang, L., Rozenfeld, R., Wu, D., Devi, L. A., Zhang, Z., & Cederbaum, A. (2014). Cannabidiol protects the liver from binge alcohol-induced steatosis by mechanisms including inhibition of oxidative stress and increase in autophagy. Free radical biology & medicine, 68, 260–267.
  4. Ewing, L. E., Skinner, C. M., Quick, C. M., Kennon-McGill, S., McGill, M. R., Walker, L. A., … Koturbash, I. (2019). Hepatotoxicity of a Cannabidiol-Rich Cannabis Extract in the Mouse Model. Molecules, 24(9), 1694. doi:10.3390/molecules24091694
  5. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. Corticosteroids. [Updated 2014 May 30]. Available from:
  6. The Mayo Clinic. Corticosteroids Overview. Retrieved from
  7. The Mayor Clinic. Liver Transplant Overview. Retrieved from
  8. The World Health Organization. Hepatitis C overview. Retrieved from
  9. Lowe, H. I., (2017), Op cit.
  10. Ibid.
  11. The Mayo Clinic. Hepatitis C Overview.,Bruising%20easily
  12. Yang, L., (2014), Op cit. 
  13. Alswat K. A. (2013). The role of endocannabinoids system in fatty liver disease and therapeutic potentials. Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association, 19(4), 144–151.
  14. Tam, J., Liu, J., Mukhopadhyay, B., Cinar, R., Godlewski, G., & Kunos, G. (2011). Endocannabinoids in liver disease. Hepatology (Baltimore, Md.), 53(1), 346–355.
  15. Bielawiec, P., Harasim-Symbor, E., & Chabowski, A. (2020). Phytocannabinoids: Useful Drugs for the Treatment of Obesity? Special Focus on Cannabidiol. Frontiers in endocrinology, 11, 114.
  16. Adejumo AC, Alliu S, Ajayi TO, Adejumo KL, Adegbala OM, et al. (2017) Cannabis use is associated with reduced prevalence of non-alcoholic fatty liver disease: A cross-sectional study. PLOS ONE 12(4): e0176416.
  17. Alswat K. A. (2013). Op cit.
  18. Pacher, P., Bátkai, S., & Kunos, G. (2006). The endocannabinoid system as an emerging target of pharmacotherapy. Pharmacological reviews, 58(3), 389–462.
  19. Ibid.
  20. Rossi, F., Punzo, F., Umano, G. R., Argenziano, M., & Miraglia Del Giudice, E. (2018). Role of Cannabinoids in Obesity. International journal of molecular sciences, 19(9), 2690.
  21. Teixeira-Clerc, F., Belot, M. P., Manin, S., Deveaux, V., Cadoudal, T., Chobert, M. N., Louvet, A., Zimmer, A., Tordjmann, T., Mallat, A., & Lotersztajn, S. (2010). Beneficial paracrine effects of cannabinoid receptor 2 on liver injury and regeneration. Hepatology (Baltimore, Md.), 52(3), 1046–1059.
  22. Thomas, A., Baillie, G. L., Phillips, A. M., Razdan, R. K., Ross, R. A., & Pertwee, R. G. (2007). Cannabidiol displays unexpectedly high potency as an antagonist of CB1 and CB2 receptor agonists in vitro. British Journal of Pharmacology, 150(5), 613–623.
  23. Pertwee R. G. (2008). The diverse CB1 and CB2 receptor pharmacology of three plant cannabinoids: delta9-tetrahydrocannabinol, cannabidiol and delta9-tetrahydrocannabivarin. British journal of pharmacology, 153(2), 199–215.
  24. Ho, C., Martinusen, D., & Lo, C. (2019). A Review of Cannabis in Chronic Kidney Disease Symptom Management. Canadian Journal of Kidney Health and Disease, 6, 2054358119828391.
  25. Pertwee R. G., (2008)., Op cit. 
  26. Lowe, H. I., Toyang, N. J., & McLaughlin, W. (2017). Potential of Cannabidiol for the Treatment of Viral Hepatitis. Pharmacognosy research, 9(1), 116–118.
  27. Avraham, Y., (2011)., Op cit. 
  28. Lowe, H. I.,(2017)., Op cit. 
  29. Yang, L., (2014), Op cit. 
  30. Bielawiec, P., (2020)., Op cit. 
  31. Ibid.
  32. WHO. Expert Committee on Drug Dependence. (2017, Nov 6-10). Cannabidiol (CBD). Retrieved from
  33. U.S. Food and Drug Administration. What you need to know  (And What We’re Working to Find Out) About Products Containing Cannabis or Cannabis-derived Compounds, Including CBD., Retrieved from,the%20potential%20for%20liver%20injury.
  34. Xiong, F., & Guan, Y. S. (2017). Cautiously using natural medicine to treat liver problems. World journal of gastroenterology, 23(19), 3388–3395.
  35. Ibid
  36. Wu, S. X., Sun, H. F., Yang, X. H., Long, H. Z., Ye, Z. G., Ji, S. L., & Zhang, L. (2014). Zhongguo Zhong yao za zhi = Zhongguo zhongyao zazhi = China journal of Chinese materia medica, 39(15), 2983–2988. PMID: 25423845
  37. Xiong, F., & Guan, Y. S. (2017)., Op cit.
  38. Ibid.
  39. Lozano, I.,(2008), The Therapeutic Use of Cannabis sativa (L.) in Arabic Medicine.  Journal of Cannabis Therapeutics.
  40. Avraham, Y., Grigoriadis, N., Poutahidis, T., Vorobiev, L., Magen, I., Ilan, Y., Mechoulam, R., & Berry, E. (2011). Cannabidiol improves brain and liver function in a fulminant hepatic failure-induced model of hepatic encephalopathy in mice. British Journal of Pharmacology, 162(7), 1650–1658.
  41. Tam, J., Liu, J., Mukhopadhyay, B., Cinar, R., Godlewski, G., & Kunos, G. (2011). Endocannabinoids in liver disease. Hepatology (Baltimore, Md.), 53(1), 346–355.
  42. Millar, S. A., Stone, N. L., Bellman, Z. D., Yates, A. S., England, T. J., & O’Sullivan, S. E. (2019). A systematic review of cannabidiol dosing in clinical populations. British journal of clinical pharmacology, 85(9), 1888–1900.
  43. Ewing, L. E., (2019)., Op cit.
  44. Solowij N. Peering Through the Haze of Smoked vs Vaporized Cannabis—To Vape or Not to Vape? JAMA Netw Open. 2018;1(7):e184838. doi:10.1001/jamanetworkopen.2018.4838
  45. El Golli, N., Jrad-Lamine, A., Neffati, H., Rahali, D., Dallagi, Y., Dkhili, H., Ba, N., El May, M. V., & El Fazaa, S. (2016). Impact of e-cigarette refill liquid with or without nicotine on liver function in adult rats. Toxicology mechanisms and methods, 26(6), 419–426.
  46. The U.S. Food and Drug Administration. FDA Approves First Drug Comprised of Active Ingredient Derived from Marijuana to Treat Rare, Severe Forms of Epilepsy., (2018)., Retrieved from
  47. Ewing, L. E.,(2019)., Op cit.
  48. Ibid. 
  49. National Center for Biotechnology Information., PubChem Database. Hexane, CID=8058, (Updated on July 2020)., Retrieved from (accessed on July 16, 2020)
  50. Bielawiec, P., (2020)., Op cit. 
  51. Lowe, H. I.,(2017)., Op cit. 
  52. Avraham, Y., (2011)., Op cit.
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