What is the efficacy of Cannabidiol (CBD) for reducing inflammation?

From the Guidelines

Cannabidiol (CBD) has shown potential as an anti-inflammatory treatment option, but its efficacy for reducing inflammation is not strongly supported by the provided evidence. The most recent and highest quality study, 1, does not specifically address the anti-inflammatory effects of CBD. However, it does discuss the potential risks and side effects of CBD use, including liver enzyme elevation and drug-induced liver injury, which are important considerations when evaluating its potential benefits.

Key Points to Consider

• The study 1 highlights the importance of monitoring liver enzymes and considering possible CBD effects in the setting of new or worsening hepatotoxicity.
• Another study, 1, discusses the mechanism of action of CBD and its potential uses, including chronic pain, chemotherapy-induced nausea and vomiting, and spasticity associated with multiple sclerosis.
• The evidence suggests that CBD may interact with the body's endocannabinoid system, particularly CB2 receptors found in immune cells, and may have antioxidant properties that help reduce oxidative stress contributing to inflammation.

Recommendations

• Start with lower doses of CBD (5-10mg twice daily) and gradually increase as needed, under the guidance of a healthcare provider.
• Consider topical applications for acute inflammation and oral forms for systemic inflammation.
• Be aware of potential side effects, including fatigue, diarrhea, and changes in appetite or weight, and monitor liver enzymes regularly.
• Consult a healthcare provider before beginning CBD, especially if taking other medications, as CBD can interact with drugs metabolized by the liver's cytochrome P450 enzyme system.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Efficacy of Cannabidiol (CBD) for Reducing Inflammation

• The efficacy of CBD for reducing inflammation has been studied in various research papers, with some studies suggesting that CBD may have anti-inflammatory effects 2, 3, 4.
• A study published in 2019 found that CBD differentially regulated basal and LPS-induced inflammatory responses in macrophages, lung epithelial cells, and fibroblasts, and attenuated LPS-induced NF-κB activity, IL-8, and MCP-1 release from macrophages 3.
• Another study published in 2016 discussed the anti-inflammatory actions of phytocannabinoids, including CBD, and mentioned that cannabinoids may act on inflammation through mechanisms different from those of nonsteroidal anti-inflammatory drugs (NSAIDs) 4.
• However, other studies have noted that the evidence for the use of CBD in reducing inflammation is largely preclinical, and more clinical studies are needed to fully understand its effects 2, 5.
• Additionally, the quality and consistency of CBD products can vary, and patients should be cautious when using CBD products, ensuring that they obtain a product with certification of Good Manufacturing Practices and follow proper treatment guidelines 2, 6.

Key Findings

• CBD may have anti-inflammatory effects, but more clinical studies are needed to confirm its efficacy 2, 5, 3, 4.
• CBD products can vary in quality and consistency, and patients should be cautious when using them 2, 6.
• The mechanisms of CBD's anti-inflammatory effects are not fully understood, but may involve the regulation of inflammatory responses in various cell types 3, 4.

Studies with Relevant Findings

• 2: Cautious Hope for Cannabidiol (CBD) in Rheumatology Care
• 5: The Role of Cannabidiol (CBD) in Chronic Pain Management: An Assessment of Current Evidence
• 3: Cannabidiol differentially regulates basal and LPS-induced inflammatory responses in macrophages, lung epithelial cells, and fibroblasts
• 6: The current understanding of the benefits, safety, and regulation of cannabidiol in consumer products
• 4: Cannabinoids, inflammation, and fibrosis