Can CBD oil help with thyroid problems, and if so, how? Are there interactions between CBD and other thyroid medications that should be a cause of concern?
The American Thyroid Association (ATA) describes thyroiditis as a general term that refers to inflammation of the thyroid gland.
Taking CBD can help alleviate inflammation and can have a positive impact on the body’s well-being, as well as the patient’s mental and emotional health.
The interaction of cannabinoids and some thyroid medications may be due to how these substances compete for metabolism in the cytochrome P450 pathways. This action would most likely cause hyperthyroidism, as more thyroxine would accumulate before the body breaks it down.
However, given that there have not been any studies with adverse results on CBD for thyroid issues, CBD may benefit thyroid health.
For those looking at including CBD in their therapy, this article lists some CBD products that may help with inflammation and other symptoms of thyroid disorder.
Thyroid and Thyroid Disorders
According to the American Thyroid Association, at least 12 percent of the U.S. population could develop a thyroid condition during their lifetime.
- Roughly 20 million Americans have some type of thyroid disorder, and about 60 percent of those are unaware of their condition.
- Undiagnosed thyroid disease may put someone at risk for certain severe conditions, such as cardiovascular diseases, osteoporosis, and infertility.
- Although a small percentage of thyroid cancers can be very aggressive, most thyroid cancers respond to treatment.
- Most thyroid diseases are lifelong conditions, but they can be managed with proper medical attention.
Thyroid Disorders and Pregnancy
- Pregnant women with undiagnosed or untreated hypothyroidism have an increased risk of miscarriage, preterm delivery, and severe developmental problems in their children.
- Women tend to develop thyroid troubles five to eight times more than men, with this disorder also contributing to early complications in pregnancy.
- Women who have difficulty in getting pregnant are usually tested for thyroid problems because hyperthyroidism can lead to problems with fertility.
The Thyroid and Its Functions
The thyroid is an endocrine gland located around the front of the trachea at the base of the neck.
The thyroid gland releases thyroid hormones, such as thyroxine (T4), to regulate body functions.
The thyroid controls metabolism and impacts several systems in the body, including the nervous system, digestive tract, cardiovascular system, appetite, body weight, hair, skin, and nail growth.
Thyroid activity also influences body temperature, heart rate, muscle functions, and brain development, particularly during infancy.
The thyroid is sensitive to deficiencies in nutrients like iodine, zinc, and selenium, as well as specific environmental contaminants, which can cause it to over function or under function.
Also, the immune system can start attacking the thyroid gland, resulting in autoimmune thyroid conditions, such as Hashimoto’s thyroiditis and Graves’ disease.
Thyroid disorders include the following:
- Thyroid nodules, which are small lumps that may cause excessive hormone production
- Goiter, which is a swelling of the thyroid
- Thyroid storm, which is a rare type of hyperthyroidism
- Thyroid cancer
When thyroid glands release too much or too little hormones, the results can be damaging to organ functions and can impact one’s health and well-being.
It can be challenging to detect and identify a specific disorder as thyroid conditions can cause several problems related to bodily functions.
However, specific tests are available to check for thyroid imbalances. These procedures include biopsies and imaging scans, such as ultrasound and iodine scans. Blood tests that check for healthy levels of T3, T4, and thyroid-stimulating hormone (TSH) can also assess thyroid imbalances.
A TSH is a blood test that measures the amount of thyroxine (T4) that the thyroid is being signaled to make.
Traditional Treatments for Thyroid Disorders
Several conventional treatment options for thyroid conditions are available, and most often, they include pharmaceutical medications.
For an underactive thyroid (hypothyroidism), medical experts usually prescribe thyroxine replacement medications, such as Synthroid and levothyroxine.
To treat an overactive thyroid (hyperthyroidism), antithyroid medicines, such as propylthiouracil (PTU) and methimazole (also known as Tapazole), help to reduce hormone secretion. While the drugs are effective, they can cause severe side effects in the immune system and liver.
Beta-blockers may also be prescribed to slow down the heart rate while the other drugs begin to take effect.
Radioactive iodine treatments also combat hyperthyroidism. Patients may take radioactive iodine by mouth in pill or liquid form.
In some cases, surgery is an option to treat thyroid problems. Surgery may address thyroid nodules, which are solid or fluid-filled lumps that manifest due to cancers.
An individual’s specific treatment may depend on the cause and severity of his or her condition. A doctor, most probably a specialist in endocrinology or the endocrine system, may review any potential allergies one has, one’s age, and other conditions, such as heart disease or pregnancy, before recommending treatment.
CBD and Thyroid: What Research Says
Research suggests that CBD has regulatory effects on the endocrine gland.
In a study, researchers examined the role of the endocannabinoid system and the significance of cannabinoid receptors CB1 and CB2 expression in malignant and benign thyroid lesions.
Results supported evidence that both CB1 receptor and CB2 receptor interfere with molecular pathways and influence the formation of thyroid tumors. Thus, these receptors could be considered as potential therapeutic targets to inhibit tumor progression.
Another study looked at the evidence for functional CB1 receptors in the rat thyroid, and the authors found that the CB1 receptors of the endocannabinoid system regulate rat thyroid hormonal activity.
Since CBD stimulates these receptors, CBD may also influence thyroid conditions through this mechanism.
However, researchers need to do more studies on human models as there has not been much research on CBD for thyroid conditions as of yet.
Meanwhile, CBD is not recommended for pregnant women. The U.S. Food and Drug Administration (FDA) strongly advises against “the use of cannabidiol (CBD), tetrahydrocannabinol (THC), and marijuana in any form during pregnancy or while breastfeeding.”
CBD Oil for Graves’ Disease (Hyperthyroidism)
Graves’ disease is named after Dr. Robert J. Graves, who first described it in a patient in 1835.
Graves’ disease is a form of autoimmune disease that causes hyperthyroidism, which is a condition when the thyroid gland generates too much thyroid hormones. Graves’ disease is usually the underlying cause of hyperthyroidism.
Some common symptoms of this thyroid disorder include anxiety, heart palpitations, irregular menstrual cycles, goiter, muscle weakness, weight loss with increased appetite, and vision problems. Current medical science suggests adjusting lifestyle habits to mitigate some of these symptoms.
CBD oil helps one make some of the suggested lifestyle adjustments, such as:
- Reduce stress. Research suggests that CBD helps alleviate stress and anxiety. Getting enough sleep and exercising regularly also combat stress.
- Consume more anti-inflammatory foods like berries, fatty fish, broccoli, avocados, turmeric, and olive oil. Data from a study demonstrate that CBD is anti-inflammatory. One may consume CBD through CBD-infused foods and beverages.
- Improve overall immunity to fight environmental toxins. Research shows that phytocannabinoids deeply influence the immune functions of the body. Maintaining a diet that includes plenty of vegetables and fruits, as well as taking steps to avoid infection, such as frequent washing of hands and cooking meats thoroughly, help increase immunity.
CBD Oil for Hashimoto’s Thyroiditis (Hypothyroidism)
Also known as chronic lymphocytic thyroiditis or Hashimoto thyroiditis, Hashimoto’s disease is a common cause of hypothyroid symptoms. Most patients are middle-aged women, although the disease can affect anyone at any age.
This autoimmune thyroid disorder, which was first described by the Japanese physician Hakaru Hashimoto in 1912, triggers the immune system to attack and reduce thyroid function, impeding its hormone production.
As symptoms are mild, one may not be able to recognize that he or she has this disease. These symptoms include constipation, dry skin, fatigue, intolerance to cold temperatures, irregular menstrual cycles, weight gain, thinning hair, and changes in body temperature.
CBD interacts with and helps to maintain the body’s homeostasis. As symptoms of hyperthyroidism and hypothyroidism are indications of an imbalance in bodily functions, CBD can be an effective treatment for both conditions.
CBD may play an essential role in balancing communication between the thyroid and brain, meaning that your endocannabinoid system and one’s cannabinoid receptor network could directly promote the active thyroid hormone release. This action is vital for general homeostatic health and the proper functioning of organs.
CBD and Inflammation
In a study published in 2009 by the National Center for Biotechnology Information (NCBI), researchers found that cannabinoids have exhibited the significant potential to be used as new anti-inflammatory agents.
Results also indicated that specific targeting of CB2 receptors might facilitate immunosuppressive effects without inducing psychotropic side effects.
The authors of the study also explained that cannabinoids have been tested in numerous experimental models of autoimmune disorders and have been shown to protect the patient through the induction of multiple anti-inflammatory pathways.
With CBD’s anti-inflammatory properties, it can provide patients the much-needed pain relief without having to rely heavily on over-the-counter or prescription-grade pharmaceuticals.
In addition to seeking professional medical help and taking thyroid prescription medications, people with thyroid problems might want to hasten their healing and recovery process by supplementing their diet with natural ingredients that possess innate healing properties, like CBD oil.
Best CBD Products for Inflammation
CBD can provide relief from inflammation regardless of one’s specific lifestyle needs. Due to its bioavailability and how it interacts with the body’s biological systems, CBD can be used both topically or internally for inflammation relief.
Finding high-quality CBD products that are potent and safe is essential. Thus, to help patients decide on which CBD product is best for them, a list is given below of the top recommended products that work best to ease inflammation.
- Mellowment High-Impact for Inflammation Phytocannabinoid (PCR) 25 mg + Curcumin softgels
Each bottle contains 30 softgels, and each gel contains 25 mg of CBD and 10 mg of curcumin.
The CBD and Curcumin blend provides the body with relief from swelling and pain that inflammation often causes.
The active nanoemulsion in each softgel contains 25 mg of CBD-rich broad-spectrum hemp extract and 10 mg of Curcumin C3 Complex, the anti-inflammatory compound in turmeric, making for a uniquely advanced, water-soluble CBD + antioxidant formula.
- Medterra CBD Rapid Cooling Cream
This product is an excellent combination of either 250mg or 750mg of CBD and organic ingredients, such as menthol and arnica. It comes in a 3.4 fluid ounce spray bottle, which contains 100 milliliters of CBD topical cream.
Medterra topicals are made with isolated hemp and utterly free of THC.
This topical cream provides a rapid cooling effect, which is perfect for joint and muscle support.
- cbdMD CBD Inflammation Formula 4 fl. oz Tub — 1500mg
This product features a broad-spectrum cannabinoid extract which contains other natural phytocannabinoids, such as cannabidivarin (CBDV) and cannabigerol (CBG).
This cream contains 1500 mg of USA Grade-A premium CBD, together with some supplemental natural compounds that have pain-relieving and anti-inflammatory characteristics.
cbdMD products are THC-free and sourced from USA hemp. They are also third-party, ISO-certified lab-tested to ensure safety and effectiveness.
Interactions Between CBD and Thyroid Medications
Given that CBD research is relatively new, scientific evidence needs to be collected to fully understand how CBD and thyroid medications interact with our endocrine systems. Meanwhile, research continues to examine a possible inhibition of thyroid cell destruction due to the favorable characteristics and effects of cannabidiol.
One must be able to differentiate CBD from hemp oil for thyroid treatment, as CBD and hemp oil are not the same. While CBD oil is extracted from marijuana or hemp plants, the hemp seed oil is extracted specifically from hemp seeds.
Hemp oil alone does not interact with the receptors in the brain that are responsible for the benefits one may experience with CBD.
However, in a study, researchers were not able to observe any correlation between marijuana and thyroid function and autoimmunity
There is no high-quality clinical evidence proving or disproving the favorable or adverse effects of CBD or medications used in its management, like levothyroxine.
Still, the interaction of cannabinoids and levothyroxine competing for metabolism in the cytochrome P450 pathway would most likely cause hyperthyroidism, as more thyroxine would accumulate before the body metabolizes it.
Having seen over 200 patients with hypothyroidism in almost three years of practice, Dr. Salimpour of Apollo Cannabis Clinics said that he had not noticed any change in their symptoms, TSH, or doses of prescription medications that could be credited to their use of CBD or cannabis.
However, Dr. Salimpour said he would never recommend for a patient to smoke medical cannabis or medical marijuana while much safer alternatives like CBD edibles, oils, capsules, and tinctures are available.
Due to its properties, CBD allows patients an alternative option for treating symptoms of various conditions, including thyroid disorders.
A properly adjusted dose of thyroid hormone is essential in dealing with hypothyroidism or hyperthyroidism. Adequate nutrition and a healthy lifestyle can lead to a reduction in symptoms.
CBD oil may also help treat the underlying causes of these symptoms and assist the body in regulating its functions. However, CBD for thyroid conditions is an area that still necessitates more research.
A consultation with a doctor is excellent advice to those interested in trying CBD. Making changes to one’s health care regimen without the supervision of a trusted medical professional is not recommended. Doctors also have to be informed if one is already taking thyroid medication or any other prescription medications.
Managing Hypothyroidism During Pregnancy
Maternal hypothyroidism affects between 0.19% and 2.5% of pregnancies, depending on race and geographic area. Many hypothyroid women (>70%) have anovulatory cycles and, when they conceive, have high rates of fetal loss in the first trimester (more than twice as many spontaneous abortions as normal women).
Studies have shown that the fetuses of hypothyroid women have 10% to 20% more congenital anomalies, 20% more perinatal mortality (stillbirth and neonatal death), and 50% to 60% higher rates of impaired mental and somatic development than those of non-affected women. Maternal complications include overt anemia, preeclampsia, abruptio placentae, cardiac dysfunction, and hypertension.
Effects of Hypothyroidism During Pregnancy
Two recent studies have shown that low maternal thyroid hormone concentrations during early gestation might be associated with substantially lower IQ scores in children when tested at school age.
Also, the children of hypothyroid women with high concentrations of TSH due to inadequate doses of levothyroxine have impaired psychological development compared with carefully matched control children.
It is important to note that the IQs of children of women who had high TSH concentrations but did not exhibit clinical hypothyroidism were also affected. Eventually many of these women developed clinical disease. Table 1 shows the range of results of thyroid function tests in nonpregnant, pregnant, and hypothyroid pregnant women.
All women with hypothyroidism during pregnancy require daily, lifelong treatment. Levothyroxine is the treatment of choice. Administration of levothyroxine alone is preferable because the hormone content of the synthetic drug is more reliably standardized; this medication has replaced desiccated thyroid tablets as the mainstay of therapy.
Thyroxine (T4, levothyroxine) is de-iodinated to T3 in the extrathyroidal tissues, so it most closely duplicates the normal physiologic process. In hypothyroidism during pregnancy, many women need more thyroxine than they did before they were pregnant, so it is important to monitor TSH and thyroid hormone levels periodically for correct dosage and biologic effectiveness.
When to Take Levothyroxine
The best time to take levothyroxine is early in the morning on an empty stomach. Some women, particularly during the first trimester, might not be able to tolerate medications at that time of day due to morning sickness, and it is probably better to allow them to take levothyroxine later when they are not experiencing nausea and vomiting. Insisting on administration of the medication early in the morning (regardless of patients’ symptoms) might lead to skipping this important medication too often.
Maintenance of thyroid hormone levels within the normal range is vital for pregnant women to ensure optimal maternal and fetal health. Improved outcomes in women with hypothyroidism during pregnancy have been achieved through efforts to identify and treat these women.
Euthyroidism must be reached and maintained in a timely fashion. Levothyroxine is the treatment of choice. Levels of both TSH and thyroid hormone need to be monitored periodically, and concurrent administration of other medications should be carefully followed.
Hypothyroidism occurs during pregnancy relatively frequently. A nation-wide US survey showed that 4.6% of the population 12 years old and older had hypothyroidism and that 4.3% of all women suffered from thyroid disease or goitre, or were taking thyroid medication.
Routine prenatal screening showed that 2.2% of pregnant women in their second trimester had thyroid-stimulating hormone (TSH) levels at or above 6 mU/L.2 Pregnant patients with hypothyroidism are at increased risk of obstetric complications, such as fetal death, gestational hypertension, placental abruption, and poor perinatal outcome. Adequate treatment with thyroid hormones greatly reduces the frequency of these maternal complications.
Two thyroid hormones, levothyroxine (L-T4) and liothyronine (L-T3), are available in Canada. Liothyronine can be used occasionally when quick onset of action is required, but is less desirable for chronic replacement therapy because it requires frequent dosing and because it produces a transient elevation in triiodothyronine concentrations.
It is generally accepted that severe maternal hypothyroidism during the second trimester can result in irreversible neurologic deficits. Maternal hypothyroxinemia (fT4 below the lowest 10th percentile and TSH within the reference range of 0.15 to 2.0 mU/L) at later stages can lead to less severe, and partially reversible, fetal brain damage.
Even partial treatment of maternal hypothyroidism during pregnancy appears to be beneficial for offspring. A recent cohort study found that infant neurodevelopment was not adversely affected by hypothyroxinemia during the first trimester if fT4 concentrations were subsequently corrected.9 Should we then treat all pregnant women with high TSH levels but no clinical hypothyroidism? We believe this decision must await results of randomized controlled trials of treatment.
Dose adjustment of L-T4 during pregnancy
Several studies have now confirmed that L-T4 requirements in most women with existing hypothyroidism increase substantially during pregnancy. Absorption of T4 occurs in the small intestine; it can absorb from 50% to 80% of the dose.10 An empty stomach improves absorption. Sucralfate, cholestyramine resin, and aluminum hydroxide can interfere with L-T4 absorption.
Concomitant administration of drugs that induce hepatic cytochrome P450 (CYP) enzymes, mainly CYP3A4, such as phenytoin, carbamazepine, and rifampin, enhance biliary excretion of L-T4. Hormonal and physiologic changes could indicate a need to adjust dosages during pregnancy.
Special attention should be paid to prenatal vitamins because they contain iron and calcium, both of which potently inhibit absorption of L-T4.11,12 A recent study found L-T4 dosage adjustments were not required if prenatal vitamins were taken 4 hours after ingesting L-T4.
Levothyroxine and breastfeeding
The quantity of thyroid hormone transferred into human milk is too low to affect plasma thyroid hormone levels in neonates.15 The American Academy of Pediatrics considers L-T4 compatible with breastfeeding and has reported that no observable change is seen in nursing infants whose mothers are taking L-T4.
Pharmacologic Treatment of Hyperthyroidism
Pharmacologic Treatment of Hyperthyroidism with Methimazole and Propylthiouracil
Methimazole and propylthiouracil are selective inhibitors of thyroid peroxidase–mediated iodination of tyrosine residues in thyroglobulin, which reduce the production of thyroid hormone. They are effective in the treatment of different etiologies of hyperthyroidism.
Methimazole has a longer elimination half-life and can be given once daily. At low doses, adverse effects are less commonly described with methimazole and carbimazole when compared with propylthiouracil, and the infrequent drug-related hepatitis and vasculitis appear to occur relatively more commonly with propylthiouracil. Certain adrenergic antagonists (not including atenolol or acebutolol), such as propranolol, can be safely used as adjunctive therapy during breastfeeding.
Pharmacologic Treatment of Hyperthyroidism with Thioamides
Thioamides also inhibit the coupling of these iodotyrosyl residues to form iodothyronines.2 In addition to blocking hormone synthesis, propylthiouracil, unlike methimazole, inhibits the peripheral deiodination of thyroxine (T4) to triiodothyronine. These drugs—including carbimazole, a prodrug of methimazole—belong to the thioamide group. All drugs in this class have similar efficacy and safety but differ in potency and duration of action.
Absorption of thioamides through the gastrointestinal tract is rapid; these drugs appear in the blood within 30 minutes of administration of oral doses and have a quick onset of action. Thioamides are metabolized in the liver to inactive metabolites that are excreted renally.
The half-life of propylthiouracil in plasma is about 75 minutes, whereas for methimazole it is 4 to 6 hours.8–10 Mean peak plasma concentration of propylthiouracil after a 200-mg dose is 6.5 µg/mL9,11; a 40-mg oral dose of methimazole produced a peak plasma concentration of 0.54 µg/mL.10
Pharmacologic Treatment of Hyperthyroidism and Breastfeeding
For many years breastfeeding was strongly discouraged if treatment with antithyroid drugs was required. Both propylthiouracil and methimazole can be detected in milk; however, studies have shown that propylthiouracil crosses into milk only in minute amounts, leading to a milk-plasma ratio of approximately 0.1.
A woman taking 200 mg/d of propylthiouracil and feeding a baby daily with 150 mL/kg of breast milk would transfer less than 3% of her weight-adjusted dose of propylthiouracil to her infant.16 No adverse effects on neonatal thyroid status in breastfed infants were reported even at high maternal doses of 750 mg/d of propylthiouracil.
Methimazole, on the other hand, has a milk-plasma ratio close to 115; a woman taking 40 mg/d of methimazole and breastfeeding a volume of 150 mL/kg daily to her baby would transfer a maximum of 12% of her weight-adjusted dose through breast milk.