CBD oil has been gaining traction among cannabis doctors and patients as a potential remedy for ailments ranging from arthritis to epilepsy. Taking CBD oil generally causes few side effects compared with many prescription medications and over-the-counter painkillers. There are possible side effects associated with CBD, though these may be rare and/or only occur in high oral doses.
Can using CBD oil help diarrhea? Or can CBD oil cause diarrhea? In this article, we'll take a look at the effects of the cannabinoid on the body and highlight the most current research on CBD oil and diarrhea.
Research overview
In 2019, the Mayo Clinic reported that CBD is generally well-tolerated but may cause a number of side effects — among them, diarrhea. At least two studies have confirmed a possible link between CBD oil and diarrhea, but research is still emerging and it's important to consult your physician about starting a regimen and determining appropriate dosages.
The studies
Can CBD oil help diarrhea?
For some people, CBD oil and other cannabis products may help alleviate diarrhea and other symptoms of inflammatory bowel disease (IBD). According to a 2016 literature review published in the journal Gastroenterology & Hepatology, cannabis and CBD may be used therapeutically to treat IBD. The authors of the review expressed concern for the side effects of cannabis on IBD patients, but ultimately concluded, "A significant portion of IBD patients, particularly those with severe disease, use cannabis to relieve symptoms of pain, nausea, and appetite and to improve their overall mood." It is worth noting that the researchers focused on cannabis overall and not specifically CBD products.
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One 2018 randomized control trial examined whether a CBD-rich botanical extract could help people with ulcerative colitis, a type of IBD with a litany of symptoms including diarrhea. Results, published in the scientific journal Inflammatory Bowel Diseases, determined that “CBD-rich botanical extract may be beneficial for symptomatic treatment of ulcerative colitis.”
Can CBD oil cause diarrhea?
One 2019 report, published in the journal Current Neuropharmacology, discussed the effects of CBD based on clinical trials of the FDA-approved drug Epidiolex, which is derived from CBD and prescribed to treat severe cases of childhood epilepsy. It also looked at the use of Epidiolex to treat psychiatric problems. The researchers determined that diarrhea was among the most common adverse effects for individuals taking Epidiolex to treat epilepsy and psychiatric disorders. They noted, however, that the incidence of any side effect was low compared to other drugs used to treat such conditions.
In 2018, results of randomized CBD trials were published in the journal CNS Drugs. In these trials, CBD was found to have a high level of tolerance with minimal adverse effects. Similar to the Epidiolex trials, these studies showed that diarrhea was among the most common side effects of CBD and occurred more frequently in individuals on a regimen of the cannabinoid than those taking a placebo. Researchers reported that the effects ranged from mild to moderate, with no severe cases.
Patient perspectives
Brooke Bogdan has been using medical cannabis since 2012 to address symptoms of ulcerative colitis. In a 2019 article published in Everyday Health, Bogdan shared how medical marijuana helped her find relief from chronic pain. When she started using cannabis, Bogdan's condition was so severe that she needed to have a total colectomy, a surgical procedure to remove the colon.
Prior to the surgery, Bogdan had endured constant discomfort and nightly insomnia, but with the integration of medical marijuana into her treatment, she has witnessed vast improvements. Bogdan wrote, “Cannabis helped provide an outlet of relief for me when I was close to losing my life. When prescription medication doesn't help my ulcerative colitis symptoms, I turn to cannabis.”
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Specifically, Bogdan mentioned that CBD oil vape pens, as well as tinctures and dabs, have relieved her symptoms. She advised against the consumption of edibles for people coping with ulcerative colitis because, “Our digestive tracts don't function well, therefore we may not be able to absorb the medication into our systems via chewing and swallowing.”
Other patients have described experiencing minor diarrhea after consuming high levels of CBD. Curt Rollins is a retired florist who lives in Brunswick, Georgia. For more than 30 years, he worked with his hands designing intricate floral arrangements for weddings and baby showers. "I loved the work, but my hands paid the price," Rollins revealed in a phone interview with Weedmaps.
When Rollins developed debilitating arthritis in both his hands, he turned to over-the-counter painkillers and cortisol shots, but nothing brought relief. Then, his doctor suggested CBD oil and his hands started to improve. "The pain got a lot better without too many side effects. But I did find that my stomach would get a bit upset if I had too much CBD oil every day," Rollins shared.
How many milligrams of CBD would qualify as excessive? That depends on the individual, but a rule of thumb is that 500 milligrams or more is a high dose of CBD. Rollins continued, "When I reduced the dose or just rubbed the CBD oil on my hands instead of swallowing it too, I didn't have any problems with nausea or diarrhea anymore."
So, does CBD oil cause diarrhea? The answer is probably not, as long as you're using CBD at lower levels under a qualified physician's care. But elevated doses of CBD (or any medicine) may be problematic and affect the digestive system. Vaping or dabbing CBD can help users avoid the issue completely.
What the experts say
A link between CBD oil and diarrhea may exist, but only at high oral doses, according to Dr. Adie Rae, a neuroscientist at Legacy Research Institute in Portland, Oregon, and a scientific adviser to Weedmaps. "Yes, CBD causes diarrhea at high oral doses, as reported in the Epidiolex clinical trials and randomized clinical trials in adults," said Rae, referencing the two trials cited in this article.
Rae was quick to add that "most people will not take enough CBD to cause diarrhea; this usually happens at very high doses of 500 milligrams or more."
Of course, a lower oral dosage of 400 milligrams, for example, could still trigger diarrhea in some individuals. Height and weight may also play a role. In addition, dietary habits, exercise frequency, and general health may influence whether taking CBD oil leads to diarrhea or not.
CBD oil interacts in different ways with the endocannabinoid system of each unique individual. Before you take CBD, discuss your best treatment options with your healthcare provider and always listen to what your body is telling you.
In terms of CBD easing diarrhea, especially acute bouts, Rae noted that there is little evidence that CBD is a directly useful tool. She asserted, however, that “CBD could still improve the quality of life for patients suffering from chronic bowel disorders, even if it doesn't improve some specific symptoms like diarrhea.”
Other researchers agree. Dr. Timna Naftali, a gastroenterology specialist at Tel Aviv University's Meir Hospital in Israel, studied the effects of a treatment with 15% CBD and 4% THC on patients with Crohn's disease. Naftali found that 65% of patients experienced clinical remission and improved quality of life after eight weeks of cannabis treatment.
Bottom line
Mild to moderate diarrhea may coincide with using oral CBD at elevated doses, but no studies currently indicate that such effects are serious or result from taking CBD oil in lower doses or in different forms. As for whether CBD can help gastrointestinal issues such as diarrhea, the Israeli study is promising but more human trials are needed. For those who want to try it, an inhalable route is probably best.