Can CBD Cause Diarrhoea? It Usually Doesn’t, But It Might

CBD (cannabidiol) and THC (tetrahydrocannabinol) are the two most important cannabinoids — plant compounds that deliver apparent health and wellness benefits — in both the hemp and cannabis plants.

Most readers know that THC is the psychoactive component of marijuana, another name for cannabis. And even if they’ve never used weed, they’re also likely to know about the trademark mind-altering effects that THC delivers.

CBD is best known for its supposed medical benefits, which have driven the recent, immense popularity of CBD products. Those products don’t make users high, and the World Health Organization (WHO) has said CBD is “generally well-tolerated, with a good safety profile” and that any reported adverse effects may be due to drug interactions, not CBD itself.

What are those adverse effects? The occasional and relatively minor side effects of cannabidiol may include dry mouth, poor appetite, fatigue — and diarrhoea.

The news is good for the vast majority of CBD users, though.

Those who do experience side effects are usually new users whose bodies haven’t become acclimated to the cannabinoid, those who use high doses daily, or people who use doses much higher than normal. And the WHO noted they may also use meds that interact with CBD to cause side effects, or they may have existing medical conditions exacerbated by cannabidiol.

But why diarrhoea? CBD helps regulate the operation of the bowels and intestines, and in some cases speeds up gut function. That might be enough to cause the problem, particularly in those already suffering from gastrointestinal diseases or disorders.

That’s the short explanation to our question: CBD may occasionally trigger a bout of diarrhoea in a small number of users. Here’s the longer one.

How CBD Works In the Body

The CBD and THC in hemp and cannabis are extremely similar to chemical messengers called endocannabinoids that are produced in the body. Endocannabinoids are a crucial component of the human endocannabinoid system (ECS), which regulates most important bodily functions. ECS receptors send and receive the messages that the endocannabinoids carry.

Because of that similarity, THC and CBD are able to interact with ECS receptors and affect the body’s activities. THC mostly binds to the so-called CB1 receptors, which are located in the brain and control functions like thinking, memory, and sleep. That’s how THC-rich cannabis delivers its psychoactive effects.

By contrast, CBD interacts with CB2 receptors, which regulate functions like immunity and inflammation. CB2 receptors are mostly found elsewhere in the body — including the stomach. (Remember that last fact. It will come in handy as we move forward).

CBD’s slight structural difference from THC, and its lack of substantive interaction with CB1 receptors in the brain, explains why THC makes you high but CBD does not.

CBD’s Effects in the Body

Except for the approved treatment of rare types of childhood epilepsy, the apparent benefits of CBD haven’t been proven to the satisfaction of any government regulatory agency. That’s why CBD isn’t yet available as a prescription treatment for other medical conditions, and why its benefits are only referred to as “apparent.”

However, CBD products are widely available in the UK, the US, and other Western nations, and they can be purchased online and from all types of shops (including some specializing in CBD). Millions of consumers have already purchased them because of cannabidiol’s reported effects on health and wellness.

Apparent CBD Benefits

Research into cannabidiol’s effects is still in its early stages, but quite a few eye-opening results have already been published.

Here’s a summary of just some research findings about CBD’s potential uses.

• Those suffering from stress, depression, anxiety, or more serious mental health conditions like OCD, PTSD, and schizophrenia may feel their symptoms eased.
• Patients with chronic pain or problems caused by anti-immune and inflammatory diseases such as arthritis, diabetes, inflammatory bowel disease, fibromyalgia, and gout may experience pain or symptom relief. There are some indications CBD may help with other types of pain as well.
• Those dealing with serious neurodegenerative diseases like Parkinson’s and Alzheimer’s may see a slowing of their conditions, and there’s the possibility that cannabidiol use might even provide neuroprotective use for others.
• Users with insomnia or other sleep issues may find relief.
• Patients with acne or similar skin conditions might experience lessening or even elimination of their symptoms.
• Those with heart disease risk issues like high blood pressure and high cholesterol may see those problems eased, and some evidence suggests that CBD may protect against other cardiovascular risks.

Research has also indicated that cannabidiol might help patients with substance abuse issues, and may even help fight some types of cancer.

Here’s why many experts have been so excited by these findings: CBD provides its apparent benefits without making users intoxicated in any way — and without the often severe side effects associated with many prescription treatments.

Possible CBD Side Effects

The WHO report we cited earlier confirms what the research shows and what anecdotal reports say. CBD doesn’t cause any serious side effects for users who don’t take ridiculously high doses, and it poses no risk of abuse.

However, minor side effects are possible for a small number of people consuming CBD. They include tiredness, dry mouth, poor appetite, or diarrhoea. Those experiencing the issues usually fall into one of four categories:

1. Those new to CBD use whose bodies haven’t yet adjusted to the cannabinoid.
2. Those taking very high doses well above normal levels.
3. Those using high doses of cannabidiol every day.
4. Those who are taking medications that interact with CBD, or those with existing medical conditions that may already be likely to cause problems.

The solutions to the first three are obvious.

1. Allow your body to adjust to cannabidiol.
2. Use smaller doses
3. Use CBD less frequently.

Now for the fourth potential category of users experiencing side effects.

Most medications don’t have problematic interactions with cannabidiol, but some that do are relatively commonly prescribed or purchased over-the-counter. They include Zocor and Lipitor; Ativan, BuSpar, Valium, and Xanax; budesonide; Benadryl and Allegra; and some opioids.

That’s far from a complete list, not all who use those medications will experience problems, and not all of those drugs will cause side effects for all users. Anyone thinking about trying CBD products would be smart to talk to their doctor or a medical professional to make sure their medications — and any preexisting medical conditions they have — won’t interfere with CBD use.

What about occasional reports of serious issues among CBD users? The few cases of sedation, agitation, pneumonia, and liver damage that have been publicized were only seen in lab tests that administered doses more than 100 times larger than those consumed by ordinary users.

As an example of CBD’s safety, lab studies have used doses as high as 600 milligrams of cannabidiol without side effects, and other research shows that patients can tolerate as much as 1,500 milligrams with no problem. Doses that caused the very rare serious issues just mentioned were much higher than that.

With the background covered, let’s get to the meat of this article: who’s likely to experience diarrhoea after using cannabidiol, and why would that happen?

CBD and Diarrhoea

Let’s get this out of the way first.

There is some purported evidence that CBD can cause diarrhoea on its own, but as it turns out, there were mitigating factors in each study,

In several, patients were also taking several anti-epilepsy or antipsychotic medications; in another, the patient was suffering from a colon disorder which often causes diarrhoea; in one more, the researchers didn’t determine whether the subjects were dealing with other factors that could have caused the problem.

Now, let’s talk about reality.

We’ve already looked at the users most likely to experience mild side effects like diarrhoea after ingesting CBD. Aside from newbies, those who have preexisting medical conditions or are taking medications that could cause diarrhoea would be most at risk for cannabidiol exacerbating the issue.

Those medical conditions include gastrointestinal diseases and disorders like irritable bowel syndrome, gastroenteritis, celiac disease, ulcerative colitis, inflammatory bowel disease, SIBO, Crohn’s disease, and bowel cancer. Other possible conditions causing diarrhoea are certain types of infections, lactose and other food intolerances, and surgical recovery.

Some medications also qualify as putting CBD users at risk for diarrhoea problems. Among them are metformin, immune system suppressants, heartburn and ulcer drugs, chemotherapy treatments, and even NSAIDs like naproxen and ibuprofen.

Most people with those conditions or taking those meds probably won’t experience diarrhoea, even if they’re concurrently using cannabidiol. CBD, however, does increase the chances that they might be affected.

That leaves one question: even if CBD use doesn’t directly trigger diarrhoea, why would it make some people more susceptible?

The answer can be found way back near the start of this article.

There are many CB2 receptors in the stomach and the rest of the gastrointestinal tract — and as we’ve described, CBD interacts with those receptors once it’s inside the body. That’s why studies have concluded that cannabidiol may ease gut diseases like inflammatory bowel disease and irritable bowel syndrome.

However, one function of the CB2 receptors is to keep bodily systems like the gastrointestinal tract in homeostasis, or proper equilibrium. One of the ways they do that is by increasing gut motility; in simple terms, they ensure that food is moving properly through the digestive system.

Often, that requires speeding up the movement of food and waste. But when too much stool is moved into the colon too quickly, there hasn’t been enough time for the water it contains to be reabsorbed by the large intestine. That results in loose and watery stool, more commonly called diarrhoea.

To repeat, there’s no evidence that simply using CBD can cause that issue — but those whose GI systems are already compromised in some way will be more likely to suffer diarrhoea when they add cannabidiol to the mix.

Can You Do Anything to Avoid Diarrhoea When Using CBD?

Here are several suggestions to help minimize the possibility.

1. Talk to your doctor or another healthcare professional before trying or using CBD. They’ll be able to provide the best advice on whether cannabidiol is suitable for you, and whether your medical conditions or prescriptions might interact negatively with CBD.
2. The general advice “start low and increase slow” applies to anyone using CBD products (or any other substance), but it’s particularly important if you’re at risk for diarrhoea or other side effects. Starting with a low dose and only increasing if you’re not experiencing the desired results minimizes the chances of side effects, and also gives your body time to acclimate to cannabidiol before you move to a larger dose.
3. Eat before taking a dose of CBD, preferably a meal high in fat. That increases the amount of cannabidiol your body can absorb, but more importantly, it can ensure that the CB2 receptors in your gastrointestinal system do the best job of keeping your gut biome in proper balance without triggering diarrhoea.

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