Does Cannabidiol Affect Liver Enzymes in Healthy Adults?
Cannabidiol use at 5 mg/kg/day in healthy adults resulted in liver enzyme levels exceeding three times the upper limit of normal in 5.6%, with no significant changes in endocrine hormone levels compared with placebo.
METHODOLOGY:
A randomized controlled trial was conducted in Wisconsin from January to August 2024 to evaluate the effects of daily use of cannabidiol on liver enzyme levels at a dose similar to that reported for consumer use with unregulated products.
A total of 201 healthy adults (median age, 36 years; 44% women; 49% White individuals) who were nonsmokers, weighed at least 50 kg, and had normal health records were randomly assigned to receive either a 2.5 mg/kg oral solution of cannabidiol twice a day (n = 151) or an inactive placebo solution (n = 50) for 28 days.
Levels of liver enzymes and endocrine hormones were assessed at multiple timepoints from baseline until day 35.
The primary outcome was the percentage of participants with serum alanine aminotransferase (ALT) or aspartate aminotransferase (AST) levels exceeding three times the upper limit of normal.
The secondary outcomes included the percentage of participants meeting the withdrawal criteria for potential drug-induced liver injury (characterized by elevations in ALT, AST, alkaline phosphatase, or bilirubin levels accompanied by symptoms or eosinophilia) and changes in endocrine hormone levels.
TAKEAWAY:
In the cannabidiol group, eight participants (5.6%) had elevated levels of the liver enzyme ALT that exceeded three times the upper limit of normal, while no such cases occurred in the placebo group.
Seven participants (4.9%) in the cannabidiol group met the withdrawal criteria for potential drug-induced liver injury; two stopped taking cannabidiol on day 21 and five on day 28. These participants had elevated ALT levels with accompanying eosinophilia.
No substantial differences in the levels of endocrine hormones, including testosterone (in men) and thyroid-stimulating hormone, were observed between the groups.
No serious or life-threatening adverse events were reported. Adverse events, including increased hepatic enzyme levels and eosinophilia, occurred in 29% of participants in the cannabidiol group, while 18% of the placebo group experienced events such as insomnia and upper respiratory tract infections.
IN PRACTICE:
'The findings suggest that CBD [cannabidiol] use at doses representative of currently available unregulated consumer products can lead to liver enzyme level elevations in healthy adults. As CBD users may not notice these changes on their own, this study highlights the need for caution and potentially routine monitoring in CBD users,' the authors of the study wrote.
'Overall, results of the trial by Florian et al underscore that clinicians should be aware of CBD-associated hepatoxic effects and screen patients with elevated liver enzyme levels for CBD use,' experts wrote in an accompanying editorial.
SOURCE:
The study was led by Jeffry Florian, PhD, of the Center for Drug Evaluation and Research, US FDA in Silver Spring, Maryland. It was published online on July 7, 2025, in JAMA Internal Medicine.
LIMITATIONS:
The cannabidiol dosage was on the higher end of what consumers typically used. The age range of 18-55 years excluded older adults who often used cannabidiol. The monitoring frequency was insufficient to determine if liver enzyme elevations would return to normal without discontinuing the treatment.
DISCLOSURES:
This study was funded by the US FDA. One author reported that Spaulding Clinical received payment from the FDA to carry out the clinical study.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Yahoo
4 minutes ago
- Yahoo
Childhood vaccination rates fall for 5th straight year, CDC data shows
Childhood vaccination rates for the 2024-25 school year fell for the fifth year in a row, according to data from the Centers for Disease Control and Prevention (CDC) published Thursday. Vaccine coverage for shots that protect against measles, polio, chickenpox, whooping cough and hepatitis B have now been under 95% -- a threshold many experts consider herd immunity -- since at least the 2020-2021 school year. Exemptions for vaccines also hit a record high, increasing to 3.6% for the 2024-25 school year compared to 3.3% during the previous school year. The number of kindergarteners exempt from one or more vaccines was about 138,000. MORE: Members of CDC vaccine panel ousted by RFK Jr. say committee has 'lost credibility' "That gap, combined with concentrated pockets of exemptions, is exactly how sustained outbreaks gain a foothold," said Dr. John Brownstein, an epidemiologist and ABC News medical contributor. "Kindergarten vaccination rates are an early warning indicator. Persistent declines predict conditions for more frequent and larger outbreaks are already in place." Exemptions increased in 36 states, with 17 states reporting exemption rates exceeding 5%, according to the CDC data. Nearly all the exemptions were listed as non-medical, typically related to religious or personal reasons. "The surge in non-medical exemptions reflects a growing influence of misinformation and shifting policy. When these beliefs concentrate geographically, they erode the very network of immunity that protects all children," Brownstein said. An estimated 92.5% of kindergarteners were vaccinated with the polio vaccine as well as the measles, mumps and rubella vaccine, leaving an estimated 286,000 vulnerable to the diseases. It comes as the U.S. is seeing the highest number of measles cases since 1992, with dozens of outbreaks reported across the country, CDC data shows. About 94% of kindergartners were vaccinated against hepatitis B. Even fewer children were vaccinated against chickenpox and whooping cough with rates at 92.1%, according to the data. MORE: Medical groups sue HHS, RFK Jr. over 'unlawful' vaccine changes Last year saw a record level of whooping cough cases, with more than 35,000 cases reported -- roughly six times as many cases compared to 2023. Federal health officials in the Trump administration have also recently shifted messaging around vaccination, now pushing for personal choice -- advocating that parents should decide whether or not to immunize their kids. "Public health messaging has shifted in ways that place personal choice ahead of community protection. When federal leadership softens its stance on vaccination, it can accelerate hesitancy and legitimize non medical exemptions, further weakening population level immunity," Brownstein said. "As pediatricians, we know that immunizing children helps them stay healthy, and when everyone can be immunized, it's harder for diseases to spread in our communities," Dr. Susan Kressly, president of the American Academy of Pediatrics said in a statement. "By making sure all children can access immunizations before entering school with their classmates, children are best able to stay healthy to play, learn, and grow."
Yahoo
4 minutes ago
- Yahoo
Hunger strike at Alligator Alcatraz reaches Day 9 as inmate protests conditions
A detainee at the Florida immigration detention center known as Alligator Alcatraz has been on hunger strike for at least nine days, the latest in a string of detainees to allege being mistreated at the prison in the Everglades. 'Since my life no longer belongs to me, it's up to them to decide whether I live or die,' detainee Pedro Lorenzo Concepción, 44, told El País from inside the facility. State officials run the Florida detention camp, housing migrants in a series of hastily assembled tents and chain link enclosures on a converted airstrip as they await federal immigration court and potential deportation by U.S. Immigration and Customs Enforcement. The Independent has contacted the Florida Division of Emergency Management, one of the state agencies overseeing the facility, for comment. Concepción, who came to the U.S. from Cuba in 2006 but lost his permanent resident status after going to prison, has been in detention since being arrested on July 8 after a check-in at a Florida Immigration and Customs Enforcement office, according to his family. The Independent has contacted ICE for comment. On July 22, he went on hunger strike and has collapsed multiple times inside Alligator Alcatraz. During the strike, he was taken to Miami's Kendall Hospital, according to his family, where he said he sat in handcuffs as doctors tried to get him to eat, but he refused. 'I don't want food, I refuse any treatment,' reads a document he signed about his protest, obtained by El País. 'I didn't even ask to be taken to the hospital, because I'm fighting for my family and all Cubans, and I belong where my people are, in prison, suffering the same hardship they are.' The Independent has contacted Kendall Hospital for comment. Concepción's wife said she's worried he could be deported back to Cuba without her or the couple's two children. 'In a minute, your life falls apart,' she told the paper. 'It's been 19 years of being together.' Concepción, who said he was shackled and left on a floor at Alligator Alcatraz for more than 10 hours upon his arrival, is not the only one to complain of alleged poor conditions at the facility, which federal officials say they plan to support with millions in reimbursement funds and use as a model for future detention centers. Other inmates say they have faced poor sanitation and other brutal conditions inside the facility, which sits in the middle of a sweltering swamp. 'They only brought a meal once a day and it has maggots,' Leamsy 'La Figura' Izquierdo, a Cuban artist who was housed at the facility, told CBS News. 'They never take of the lights for 24 hours. The mosquitoes are as big as elephants.' The facility is facing lawsuits on environmental and civil rights grounds, with lawyers accusing officials of largely barring them from being able to speak with detainees. Deportation flights for detainees held at the facility have begun, state officials announced last week. Earlier this month, Florida news outlets found that among those held at Alligator Alcatraz, only about one-third had a past criminal record, despite officials touting the prison as being designed to hold the worst of the worst.
Medscape
5 minutes ago
- Medscape
Think of Exercise as a Vaccine for Your Body
This transcript has been edited for clarity. Let's talk today about how exercise can be viewed as a type of vaccine. With a traditional vaccine, there is a controlled exposure to something harmful, which is typically a viral particle. That exposure, though, allows the immune system to be prepared to deal with that virus if it sees it again later on. Exercise also has the appearance of harm on the surface. It doesn't always feel good in the moment. The whole body is working harder to meet the demands of the exercise. As a result of that extra stress during the exercise activity, the body is then better prepared to deal with stress that can occur from disease processes later on. As a result of the aging process,organ systems are going to decline a little bit in function, and exercise is the best way to combat those declines. Let's think about something like pneumonia, where somebody might have a fever; they're going to be breathing heavy, and their heart's going to be working harder. For someone who's been exercising on a regular basis, their organ systems are better prepared to meet the higher demands associated with a disease process such as pneumonia. In contrast, for someone who has not been exercising frequently, their organ systems have declined in function, and then as a result, they're more likely to be overwhelmed during the disease process. Someone might need medications to support their blood pressure during a pneumonia situation. Someone else might need a mechanical ventilator. In this way, you could view exercise as training for the worst day of your life from a medical perspective. You want to make sure your organs are equipped to deal with stress when it's occurring in an uncontrolled environment, like from an infection such as pneumonia. Vaccines may be a controversial topic for some, but I think exercise is one type of vaccine whose benefits we can all agree upon.
