The Potential Side Effects of CBD
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Generally speaking, CBD is considered a safe substance when applied topically or taken orally. There are, however, some potential side effects to keep in mind when using this substance, the majority of which are mild.
Common Side Effects of CBD
The most comment side effects of CBD include drowsiness, gastrointestinal issues, dry mouth, reduced appetite, nausea, and interaction with other medications. Those are outlined in detail below.
Some common side effects when using CBD include drowsiness and sedation. This is also considered a benefit, but Dr. Jas Matharu-Daley, a physician and chief medical officer for a CBD brand, notes that the effects might be too strong if you’re also taking CBD with other sedating medications.
Some people may get diarrhea or liver problems [when using CBD]. This is dependent on the individual and their medical history, so monitoring is important,” says Dr. Matharu-Daley.
Also known as “cotton mouth,” CBD can potentially cause your mouth and eyes to feel very dry. Though this side effect is more likely to occur with THC, it can happen with CBD as well.
Can Interact With Other Medications
CBD might interfere with the other medications you take. Dr. Matharu-Daley says it’s important to talk to your doctor about whether CBD could affect your existing prescriptions.
In some cases, those who ingest CBD supplements might experience nausea, says Dr. Matharu-Daley. This depends on how sensitive the person is to CBD, as well as the amount they ingest.
Because CBD supplements come in so many different forms—such as oils, gummies, tinctures, and vapors—the amount that’s actually absorbed can vary drastically. This, combined with each person, will ultimately affect which (if any) CBD side effects you might experience.
What Is Cannabidiol (CBD)?
CBD—the abbreviation for cannabidiol, a substance that’s generally derived from the hemp plant—has skyrocketed in popularity over the last five years. In fact, according to research, “CBD” as a Google search term remained stable from 2004 to 2014 but has since ballooned by up to 605%.
CBD is one of the many chemical compounds that is found in the cannabis plant—referred to as cannabis sativa. There are two primary parts of the plant that humans use. One is THC, or Delta-9-Tetrahydrocannabinol, and the other is CBD. Though they’re from the same plant, THC and CBD are quite different from each other.
“CBD is not an intoxicating substance, whereas THC is a psychoactive that can get you high,” explains Dr. Jas Matharu-Daley, a physician and consultant for a brand that specializes in CBD production.
Are There Any Benefits Associated With Using CBD?
There are several reasons why someone might want to use CBD. The substance can be found in a multitude of products ranging from pain-relieving creams to edible tinctures to skincare. Research is still underway, but over the last few decades scientists have become more aware of how CBD might be beneficial when applied either topically or ingested.
“Since discovering the endocannabinoid system (ECS) in the body in the 1990s, CBD has been researched more extensively. The ECS is a central regulatory system restoring normal balance and homeostasis in a range of human physiologic systems throughout the body and brain and has cannabinoid receptors and chemicals in its function,” explains Dr. Matharu-Daley.
CBD benefits include the following:
- CBD can have positive impact on the brain. In fact, Dr. Matharu-Daley says that the substance is legally prescribed in a specific medication for certain severe forms of epilepsy in children.
- It has also been shown to have anti-inflammatory properties, which is why you often see CBD in topical products such as oils, creams, and lotions.
- Some research points to CBD’s ability to relieve stress and anxiety.
- It has been used as a nausea treatment in some countries.
- CBD may potentially reduce pain symptoms.
- It has antioxidant properties, which means it can help fight off free radical damages that leads to premature aging.
- Regarding skincare, CBD may help reduce excessive oil production in those with very oily skin types.
Ultimately, the primary reasons why people use CBD is because it tends to have calming, relaxing, pain-reducing effects. It has been used to alleviate joint pain and nerve pain, reduce anxiety and stress, treat insomnia, improve migraines, and address nausea.
CBD Is Still an Unregulated Substance
It’s important to point out that CBD is not regulated by the FDA and therefore dosages might not be accurate. It’s also difficult to know what an appropriate dose is the first time you try a new product.
“If the CBD is from a reputable source and one that has been inspected by a third-party independent lab, the content of CBD is more reliable,” notes Dr. Matharu-Daley. “The CBD should be organically grown, free of pesticides and heavy metals, and not sourced in food which can affect absorption. Generally, CBD is safe and side effects are few at low doses.”
A Word From Verywell
CBD is technically an unregulated substance in the United States and therefore it ought to be used with caution. This is especially important for those taking additional medications and/or those with ongoing medical issues. That said, preliminary research on CBD and its benefits are promising in relation to helping with mild to moderate health concerns and it is generally considered a safe substance. Health professionals do not consider CBD a cure-all for serious medical issues, including cancer.
As with any sort of supplement, we recommend speaking to your medical doctor about whether using CBD makes sense for you. Your doctor can also recommend certain products that align with your needs and help ensure you get the correct dosage.
How To Use CBD To Help Alleviate Anxiety
Dr. Bindiya Gandhi is an integrative medicine physician with expertise in functional and holistic medicine based in Atlanta, Georgia.
Commissions we earn from partner links on this page do not affect our opinions or evaluations. Our editorial content is based on thorough research and guidance from the Forbes Health Advisory Board.
Table of Contents
- CBD for Anxiety
- How to Use CBD for Anxiety
- CBD Dosage for Anxiety
- Potential Risks and Side Effects
While delta-9-tetrahydrocannabinol (THC) can have a bad rap for being intoxicating and anxiety-inducing, cannabidiol (CBD) can actually be used to relieve anxiety. Research supports this benefit, with several studies reinforcing the positive effects CBD can have on various anxiety conditions. In fact, 51% of U.S. adults who use CBD do so to help alleviate their anxiety, according to a recent Forbes Health survey of 2,000 U.S. adults conducted by OnePoll.
CBD isn’t yet legally cleared as an anxiolytic, or anxiety relief medication. Therefore, it’s up to you—and, ideally, a doctor who specializes in cannabis administration—to determine whether CBD is a safe treatment for your anxiety.
Here’s what the science says regarding CBD’s anxiolytic properties, along with experts’ dosage guidelines and advice on how to take CBD safely.
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CBD for Anxiety
The Food and Drug Administration (FDA) has yet to approve any CBD-based medications for anxiety. However, many studies indicate the substance can be an effective anxiolytic.
CBD for Generalized Anxiety
In 2011, a small trial-tested CBD on participants with generalized social anxiety disorder (SAD) and healthy control patients undergoing a simulated public speaking test (SPST), which is a common anxiety testing method  Bergamaschi MM, Queiroz RH, Chagas MH, et al. Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naïve social phobia patients. Neuropsychopharmacology. 2011;36(6):1219-1226. . Compared to a placebo, CBD significantly reduced anxiety and discomfort in the participants with SAD. In fact, their reduced anxiety levels were comparable to those of the control participants.
Eight years later, a 2019 test compared the efficacy of three CBD doses (150 milligrams, 300 milligrams and 600 milligrams) and a placebo in men taking an SPST  Linares IM, Zuardi AW, Pereira LC, et al. Cannabidiol presents an inverted U-shaped dose-response curve in a simulated public speaking test. Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999). 2019;41(1):9-14. . Compared to a placebo, 300 milligrams of CBD significantly reduced participants’ anxiety during the speech, but the 150-milligram and 600-milligram doses did not. These results highlight how dosage can be highly variable and that more CBD isn’t necessarily more effective.
Meanwhile, another 2019 study tested CBD in much lower doses than most other clinical studies—some participants consumed 25 milligrams a day while others consumed 50 milligrams or 75 milligrams a day  Shannon S, Lewis N, Lee H, Hughes S. Cannabidiol in Anxiety and Sleep: A Large Case Series. Perm J. 2019;23:18-041. . Researchers thought higher doses might be too expensive for participants to maintain in their normal lives and that low doses would still prove effective. Indeed, anxiety decreased within the first month for most participants and remained low. Sleep quality also improved, although it fluctuated more than anxiety. Only three patients reported side effects.
CBD for Anxiety and Depression
In 2020, researchers tested the effects of CBD oil at varying doses across 397 patients with a variety of ailments  Gulbransen G, Xu W, Arroll B. Cannabidiol prescription in clinical practice: an audit on the first 400 patients in New Zealand. BJGP Open. 2020;4(1):bjgpopen20X101010. . Participants with non-cancer pain or mental health-related symptoms experienced significant improvement in anxiety and depression, as well as in their abilities to complete their usual activities. The use of CBD oil suggested significant pain relief in these groups as well.
CBD for PTSD and Phobia Therapy
A small 2019 study of 11 patients found that, when consumed orally and administered alongside routine psychiatric care, CBD decreased patients’ posttraumatic stress disorder (PTSD) symptom severity  Elms L, Shannon S, Hughes S, Lewis N. Cannabidiol in the Treatment of Post-Traumatic Stress Disorder: A Case Series. J Altern Complement Med. 2019;25(4):392-397. .
Other studies suggest CBD can reduce PTSD symptoms when consumed with THC  Bitencourt RM, Takahashi RN. Cannabidiol as a Therapeutic Alternative for Post-traumatic Stress Disorder: From Bench Research to Confirmation in Human Trials. Front Neurosci. 2018;12:502. . When taken together, the two compounds create what’s known as the “entourage effect,” where THC enhances the effects of CBD as CBD tempers the effects of THC, resulting in a more well-rounded experience  Ferber SG, Namdar D, Hen-Shoval D, et al. The “Entourage Effect”. Terpenes Coupled with Cannabinoids for the Treatment of Mood Disorders and Anxiety Disorders. Curr Neuropharmacol. 2020;18(2):87-96. .
Some studies also suggest CBD can enhance the effects of exposure therapy—which assists patients in dissociating certain cues with a fear response—and cognitive behavioral therapy  Das RK, Kamboj SK, Ramadas M, et al. Cannabidiol enhances consolidation of explicit fear extinction in humans. Psychopharmacology (Berl). 2013;226(4):781-792.  Blessing EM, Steenkamp MM, Manzanares J, Marmar CR. Cannabidiol as a Potential Treatment for Anxiety Disorders. Neurotherapeutics. 2015;12(4):825-836. .
How to Use CBD for Anxiety
Without clear FDA guidance, optimal CBD use for anxiety varies from person to person. You may find one method works better for you over another. You can consume CBD in the following forms:
- Oils and tinctures, which come in dropper bottles and are consumed by mouth
- Gummies, which are chewable, sweet and often fruit-flavored
- Sprays, which come in bottles with a nozzle to be sprayed in the mouth
- Capsules, softgels or tablets, which are taken individually by mouth like a pill
- Vapes, which heat CBD oil without igniting it, resulting in an inhalable vapor
- Flowers, which are dried hemp plants that are typically ignited and smoked
- Creams and gels, which introduce CBD topically (through the skin) as a more localized treatment
You may have to try different forms to determine what works best in addressing your anxiety. For instance, when it comes to the absorption of CBD in your bloodstream, vaping and smoking are more effective than edibles like gummies.
CBD Dosage for Anxiety
You also have to find the right CBD dosage for your anxiety. Experts suggest starting small and working your way up depending on how your body reacts.
Many clinical trials jump right to testing high doses. Successful doses evaluated for anxiety relief specifically include:
- 600 milligrams in patients with SAD in a speech simulation  Bergamaschi MM, Queiroz RH, Chagas MH, et al. Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naïve social phobia patients. Neuropsychopharmacology. 2011;36(6):1219-1226.
- 300 milligrams in male patients in a speech simulation  Linares IM, Zuardi AW, Pereira LC, et al. Cannabidiol presents an inverted U-shaped dose-response curve in a simulated public speaking test. Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999). 2019;41(1):9-14.
However, other trials suggest much lower doses are also quite effective in treating anxiety.
- 25 to 75 milligrams for generalized anxiety and/or sleep problems  Shannon S, Lewis N, Lee H, Hughes S. Cannabidiol in Anxiety and Sleep: A Large Case Series. Perm J. 2019;23:18-041.
- 33 to 49 milligrams a day for PTSD, in addition to routine psychiatric treatment  Elms L, Shannon S, Hughes S, Lewis N. Cannabidiol in the Treatment of Post-Traumatic Stress Disorder: A Case Series. J Altern Complement Med. 2019;25(4):392-397.
Another study involving hundreds of patients noted success with doses from 40 milligrams to 300 milligrams a day, further supporting the idea that CBD dosage varies significantly, depending on a person’s symptoms and physiology.
Potential Risks and Side Effects
The World Health Organization deems CBD a safe and generally well-tolerated substance. Studies report very few adverse effects, if any.
However, taking CBD while on other medications may pose a risk, as these substances may interact and cause unwanted effects, such as weight gain, drowsiness, upset stomach and change in appetite.
Cheryl Bugailiskis, M.D., a cannabis specialist at Heally, a telehealth platform for alternative medicine, also warns people with preexisting liver injuries and people taking medications that can cause liver injuries should practice caution when using CBD.
Can CBD undo the anxious side effects of THC?
“If you accidentally consume too much THC and feel anxious or paranoid, counteract it by taking some CBD.” That’s what my budtender told me to do once, and ever since, I’ve wondered to what extent that’s true.
The answer for many people is yes, it can, but with the caveat that there are many factors that can impact how one responds to anxiety and CBD. Some of those variables include:
- The type of CBD product used
- Your unique biology and genetics
- The intensity and nature of anxiety
- The THC/CBD dose ratio
There are, however, mechanical truths about CBD that might help you understand why it tends to alleviate anxiety whether it was induced by THC or other external stressors.
The relationship between THC and CBD
Cannabidiol, better known as CBD, is an excellent anxiety-fighting compound. It occurs in trace amounts in most varieties of cannabis, but recent years have seen a surge of high-CBD strains and products. CBD isn’t psychoactive like THC – when isolated from its THC counterpart, it does not produce the obvious euphoria.
“Cannabidiol balances the buzz and softens the euphoria–or, in some cases, the dysphoria–induced by THC, which can make people feel very loopy and weird. CBD is the yin of THC’s yang.”
Although THC and CBD are two distinctive compounds, they work together in interesting ways. For example, CBD has been found to enhance THC’s painkilling properties while diminishing the paranoia it can cause.
“CBD interacts with THC in complex ways, diminishing certain effects (the munchies, sleepiness, the high) while augmenting others,” writes Martin A. Lee in his book, Smoke Signals. “Cannabidiol balances the buzz and softens the euphoria–or, in some cases, the dysphoria–induced by THC, which, in concentrated form, can make people feel very loopy and weird. CBD is the yin of THC’s yang.”
You’ve probably experienced this yin-and-yang balance with strains that contain both THC and CBD. Take the Pennywise strain, for example. With a one-to-one ratio of CBD and THC, Pennywise provides milder effects than THC-dominant strains. As one Leafly reviewer put it, “It was a very mellow feeling….no racing heart just calm. No heavy headed feeling either.”
Just last week, I took a THC-packed dab in an attempt to stave off some morning nausea, but I got so foggy headed and anxious, I felt like crawling right back into bed even though it wasn’t even 10 a.m. yet. My to-do list was far too long to lay around waiting for the side effects to pass, so I popped a 10mg CBD capsule and hoped for the best. Within 20 minutes, I was clear-headed enough to tackle cognitively demanding tasks, and the anxiety dissolved soon after.
It makes you wonder: how do CBD’s profound anti-anxiety effects actually work?
CBD and its anti-anxiety mechanisms
Project CBD, an organization dedicated to the dissemination of CBD information, has compared the chemical to a “dimmer switch.” It has a way of calming excess signaling and activity in the brain’s endocannabinoid system.
Before we get into that, it’s important to understand what that big word means. Also referred to as the ECS, the endocannabinoid system refers to a network of receptors and compounds that bind to them. Think of it like a series of keys and locks. Cannabinoids like THC bind to these receptor sites to induce a variety of effects from euphoria to anxiety. But cannabinoids from cannabis aren’t the only compounds that interact with our system. Our bodies actually produce their own marijuana-like compounds – known as endocannabinoids – that interact with this system. In other words, cannabinoids and endocannabinoids are two different sets of keys that unlock the same locks.
Many conditions and diseases can be characterized by underactive or overactive endocannabinoid systems. PTSD brains, for example, are known to produce insufficient levels of anandamide, a natural endocannabinoid that is structurally similar to THC. Introducing underwhelmed receptor sites with cannabinoids that act like endocannabinoids can, in a sense, correct the deficiency and result in a therapeutic effect.
CBD modulates the receptor signaling associated with THC, which is why their co-presence has become so important in the field of cannabis therapeutics. Relevant to this particular discussion is CBD’s ability to modulate excess cannabinoid activity in the brain, which can result in anxiety. In this way, CBD can certainly mitigate the anxious, paranoid side effects associated with THC overconsumption.
Which CBD product is right for you?
If you’re fortunate enough to live in a state with legal cannabis, you have an ever-growing selection of CBD products to choose from. Finding the right one will rely heavily on your unique circumstances, but there are some key ideas to keep in mind while narrowing down your search.
are the only way to guarantee their cannabinoid content. Without testing, you don’t know how much CBD, THC, or other cannabinoids are present.
- Smoking or vaporizing CBD-rich strains is the fastest way to achieve relief, but keep in mind that these may still contain THC and other cannabinoids. Dabbing a high-CBD oil, for example, may not do much for your anxiety if THC is still present. Pay attention to the THC:CBD ratios of your product. can be a fantastic way to get a more concentrated dose of CBD, and these are my personal favorites for treating anxiety. Keep in mind that CBD capsules can take a lot longer to kick in, as ingested oils are absorbed by the body differently than smoked or vaporized product, which absorb through the bloodstream directly.
Although CBD has demonstrated a high safety margin, always take care when medicating with any of these products. Notify your doctor if you decide to use CBD and consult with medical professionals educated in therapeutic cannabis applications, especially if you’re using CBD in conjunction with other medications.
We want to hear from you! Have you had success in counteracting THC-induced anxiety with CBD? What are your favorite products for doing so? Let us know in the comments section!