Can I Take CBD Oil With Metformin

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CBD has helped many people deal with pain, but can it help you manage your diabetes? Read on to learn about research on CBD and its potential benefits. Since metformin is capable of treating type 2 diabetes, it may be used with CBD to improve the quality of life for people with the condition. Learn more. Cannabidiol (CBD), a nonpsychoactive component in cannabis, may help people with diabetes to manage blood sugar, reduce stress, and more.

CBD & Diabetes

CBD—short for cannabidiol, a part of cannabis (marijuana)—has gotten a lot of attention lately. With changes in the legal status of cannabis, CBD has gone from a criminalized substance to being called a miracle drug. You can find CBD oil supplements, as well as foods, drinks, and lotions in stores and pharmacies across the U.S. and worldwide. However, research on the effects of CBD on the body is still limited and so far no CBD products have been approved by the Food and Drug Administration (FDA).

What to Know

Along with tetrahydrocannabinol (THC), CBD is the major element of cannabis. But CBD does not cause the “high” that many feel from using cannabis. For decades, CBD was considered inactive, but last year, the FDA approved it under the brand name Epidiolex for a rare form of childhood epilepsy (at a much higher dose than is available in supplements). Researchers are in the very early stages of exploring other potential uses for CBD, including relieving anxiety, insomnia, chronic pain, and inflammation.

There’s a lot of hype surrounding CBD oil and diabetes. There is no noticeable effect on blood glucose (blood sugar) or insulin levels in people with type 2 diabetes. Researchers continue to study the effects of CBD on diabetes in animal studies.

Although CBD is well tolerated by most people, there are side effects. It can suppress immune responses, raise eye pressure (which may worsen glaucoma), and increase blood levels of certain medications, such as the blood thinner Coumadin, which can lead to serious bleeding. Talk to your doctor if you’re thinking of trying CBD.

Find Out More

CBD sits in a gray area. While used as a medicine, it’s also a natural compound. Many effective medications are derived from compounds found in nature, but a lot of work goes into identifying the specific, active compound and determining what dose is safe and effective. Researchers aren’t close to that yet with CBD oil.

Its status as a supplement makes things tricky, too. Because CBD is not regulated by the FDA, creators of these supplements often make claims about its effectiveness based on little—or no—evidence. It’s hard to know what you’re getting. The amount of CBD in any product varies widely. The FDA has warned that in some products, lab tests have shown no CBD at all. Under the FDA’s Dietary Supplement Health and Education Act, manufacturers of dietary supplements and dietary ingredients are banned from marketing products that are tainted or misbranded.

Takeaway

Although many claims continue to be made about CBD oil, there is little evidence of any benefit. It’s certainly not an alternative to traditional diabetes management. The safety of CBD is also unknown—it may have dangerous side effects that we won’t know about unless further research is done. But there is a great deal of interest in CBD research, so we should learn a lot more in the coming years about what exactly CBD can and can’t do. In the meantime, it’s best practice pursue optimal health and diabetes management with treatments that have evidence to show they are safe and effective.

CBD and Metformin – August 2022

Metformin is a U.S. Food and Drug Administration (FDA) approved medicine commonly used to treat type 2 diabetes. Doctors often prescribe this drug on its own or in combination with other diabetes medications to manage high glucose levels (6 ) .

The medication has proven to be effective in preventing diabetes in high-risk individuals while also lowering the majority of its complications. Although there are some adverse reactions to metformin use, reports state that these effects are trivial when considering the benefits (7 ) .

Cannabidiol (CBD), on the other hand, is a phytocannabinoid present in the Cannabis sativa plant. It is the non-euphoric component in cannabis that is said to contain therapeutic properties.

A study in 2016 on diabetic mice reveals that CBD treatment is capable of lowering the incidence of diabetes in the subjects. The mice were given a daily dose of 5 mg/kg CBD at least five times a week for ten weeks (8 ) .

Additional research in 2018 investigates the mechanism of action of phytocannabinoids as anti-diabetic and anti-obesity agents. The study shows that cannabinoids can potentially support the treatment of insulin resistance caused by diabetes and obesity (9 ) .

Seeing as metformin can effectively treat diabetes while CBD has possible healing properties, it is only natural to think of combining the two of them. However, there is no study proving that these products are compatible with each other.

There are enzymes in the liver that metabolize the number of active ingredients in medications taken by an individual. These are also the same proteins that the body uses to break down CBD.

In past research, CBD is seen as a potent inhibitor of cytochrome P450 enzymes. As an inhibitor, this means that taking it along with other medications may hinder liver enzymes from correctly processing other drugs (10-11 ) .

Such a scenario could lead to increased or decreased levels of active medicines in the blood, causing problems related to toxicity or being subtherapeutic.

CBD interaction with CYP450 can alter how it affects the endocannabinoid system (ECS). The ECS is a complex system found in humans and animals that regulates the central nervous system, among others (12) .

Metformin use comes with its side effects, and the more this medication enters the bloodstream, the higher the possibility of harmful reactions. Although its effects are not significant, it may cause a condition known as lactic acidosis. This condition brings with it symptoms such as muscle pain, drowsiness, dizziness, chills, and difficulty in breathing (13 ) .

Since there is no clear indication of whether metformin users are at risk or not, if they use CBD, it is always better to err on the side of caution. People using metformin for diabetes should consult a doctor knowledgeable in cannabis before applying CBD in their regimen.

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Only these professionals can provide a concept of the right dosage of these two products to avoid any adverse side effects.

Can Another Antihyperglycemic Be a Substitute for Metformin So CBD Oil Can Be Taken?

Insulin is an antihyperglycemic agent that is used to lower high blood sugar in people who have diabetes. Doctors often apply it by subcutaneous injection, but there are other forms that they can inject intravenously.

Research in 2016 on 62 subjects with type 2 diabetes reveals that a combination of tetrahydrocannabinol (THC) and CBD can decrease insulin resistance while stimulating the effect of insulin in the body. These same subjects were non-insulin-treated and were able to tolerate both CBD and THC well (14 ) .

Another study in 2018 shows that low dosage CBD increases glucose uptake, lowers fat accumulation, and reverses insulin resistance in rats (15 ) . This may be an additional indication that CBD can be used together with insulin to improve its effectiveness.

Although CBD and insulin intake in rodents may not be the same in humans, there is still a possibility that cannabidiol can enhance insulin efficacy. This is especially true since animal models are often used to understand how drugs work in human beings (16 ) .

More research is needed to understand further the effectiveness and safety of using these two to treat diabetes.

Can CBD Replace Metformin?

As of this time, no research proves CBD to be a safe alternative to metformin use in humans who have diabetes. The majority of studies on how CBD can affect diabetes were carried out on rats and mice.

A study as early as 2006 on non-obese diabetic mice shows that CBD is capable of lowering the incidence of possible diabetes by changing the immune response system in rodents. The non-treated mice had a probability of 86% to develop diabetes, while CBD-treated subjects only had 30% (17 ) .

The CBD treatment also significantly reduced plasma blood levels of the pro-inflammatory cytokines, while also lowering the possibility of pancreatic disease.

In 2016, research showed that cannabidiol could delay the onset of type 1 diabetes while remarkably reducing inflammation in the pancreas caused by the said condition. Female non-obese diabetic mice were administered daily intake of CBD for several weeks (18 ) .

Another study in 2019 carried out on middle-aged diabetic rats wanted to test the beneficial effects of CBD on both ischemic diseases and diabetes. It revealed that CBD has effects on neuropathic pain , can improve memory performance, and lowers hippocampal levels of inflammation markers (19 ) .

Experts suggest that perhaps medical marijuana and cannabinoids like CBD gummies can be used to treat the symptoms of diabetes. Since the studies on CBD as an antihyperglycemic are limited, it is always best to seek advice from a medical expert before considering replacing current anti-diabetic medication.

Drugs That Can Interact with Metformin

Metformin contains positively charged molecules (cationic) that can compete with similarly charged drugs for renal secretion via organic cation transporters found in the kidneys.

Quinidine, procainamide, trimethoprim, digoxin, and vancomycin are cationic medications that can interact with metformin. However, only cimetidine, which can be bought over-the-counter for heartburn, is linked to a case of metformin-associated lactic acidosis (MALA) (20 ) .

The following are other medications that can have drug interactions with metformin:

  • Diuretics
  • Corticosteroids medications
  • Estrogen and oral contraceptives
  • Phenytoin
  • Calcium channel blockers

Mixing the drugs listed above, together with metformin, may affect blood sugar control in the body. Patients need to monitor their blood sugar levels frequently and notify their doctors of any sudden changes.

These drugs can reduce the ability of the kidneys to eliminate metformin from the blood and thus lead to lactic acidosis:

  • Cimetidine
  • Ranolazine
  • Vandetanib
  • Dolutegravir

Individuals should consult a doctor to see if these drug combinations are worth the risk. There may be safer options available that do not have the same probability of danger.

Below are medications that may increase the risk of lactic acidosis on metformin users:

  • Carbonic anhydrase inhibitors (CAIs) such as acetazolamide or topiramate

Regular monitoring of patients taking CAIs together with metformin may be necessary as this can aid in detecting early signs of lactic acidosis.

It is always best to consult a doctor to be aware of the possible side effects of metformin use. Physicians can change the dosage or even suggest a safer, alternate medication.

People switching from immediate-release to extended-release metformin tablets may experience fewer instances of diarrhea, as suggested by a study in 2004 (21 ) .

Doctors continually monitor for signs of anemia and vitamin B-12 deficiency in individuals that have been taking metformin for at least a few months. Consuming iron and vitamin B-12 supplements may help prevent these issues if they arise in long-term metformin users.

Conclusion

Metformin is an FDA-approved medication that is prescribed to individuals who have type 2 diabetes. It is often given on its own or with other prescription drugs to manage high blood glucose levels in the body.

The said medication can effectively prevent diabetes in high-risk individuals, while also reducing most of its complications. There may be adverse reactions associated with metformin use, but most reports mention that these are only minor considering its benefits.

Cannabidiol, also known as CBD, is said to contain cannabinoid receptors that can benefit people with diabetes. Several clinical trials on mice and rats reveal the antihyperglycemic potential of the phytocannabinoid.

Since metformin can treat diabetes effectively, most people consider taking it together with the healing properties of CBD edibles. There are no studies, however, that prove these two products can be used together.

In fact, they may not work well with each other due to how the body processes both metformin and CBD products. Lactic acidosis is the most severe side effect that a person may experience with metformin overdose, which has symptoms such as dizziness, muscle pain, chills, and difficulty in breathing.

As no clear indication of whether metformin users are at risk or not when using CBD, it is best to avoid using them together for now. At the very least, seeking medical advice from a healthcare provider knowledgeable in the cannabis plant may be a possible option.

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Insulin may be a potential antihyperglycemic agent that can work well in conjunction with CBD oil help. A placebo-controlled study in 2016 shows that CBD is capable of lowering insulin resistance while improving the effects of insulin in the body.

In 2018, a study on rats revealed that low tincture doses of CBD could enhance glucose uptake, improve weight loss, and reverse insulin resistance in the subjects. All these are potential indications that CBD can be used together with insulin to improve its effectiveness.

CBD for Diabetes

Kelly Burch is a freelance journalist who has covered health topics for more than 10 years. Her writing has appeared in The Washington Post, The Chicago Tribune, and more.

Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more.

Meredith Bull, ND, is a licensed naturopathic doctor with a private practice in Los Angeles. She helped co-author the first integrative geriatrics textbook, “Integrative Geriatric Medicine.”

Nearly 10% of Americans have diabetes, and although lifestyle changes and medication generally help stabilize blood sugar levels, many Americans are considering the use of cannabidiol (CBD) as another option.

In fact, some research shows CBD might help control blood sugar, reduce stress and anxiety, and boost cardiovascular health, all of which are important for people with diabetes. Other studies indicate that CBD could possibly help prevent diabetes.

However, it has only been legal for scientists to conduct human trials with CBD since 2015, so the research is preliminary and there’s a lot still to be learned. Here’s what we know—and don’t know—about CBD and diabetes.

Tinnakorn Jorruang / EyeEm / Getty Images

What Is CBD?

CBD is the nonpsychoactive chemical compound in cannabis.

The Benefits of CBD for Diabetics

CBD can have a therapeutic effect on the brain without causing hallucinations or the psychoactivite effects that most people associate with the “high” from cannabis. Because of this, CBD has a lot of potential for therapeutic uses.

But before the scientific and medical communities can make definitive statements about the health benefits of CBD, they need more thorough and long-term research about the compound and how it affects the body and brain.

That said, there are indications that CBD has health benefits. For example:

  • The endocannabinoid system, which regulates food intake and energy use, is often overactive in people who are overweight or who have type 2 diabetes.
  • CBD acts on receptors in the endocannabinoid system, which is the root of many of its possible therapeutic applications.

Obesity and Insulin Resistance

Type 2 diabetes, the most common type of diabetes, is closely linked with being overweight.

CBD and Weight Gain

CBD shows some promise in fighting weight gain and insulin resistance, both of which can increase the risk for diabetes.

A 2020 medical review found that CBD has the potential to affect a number of factors that contribute to the development of insulin resistance, type 2 diabetes, and metabolic syndrome. These include the potential to reduce inflammation and alter glucose metabolism.

In turn, that can reduce the symptoms of:

  • Insulin resistance
  • Type 2 diabetes

Blood Sugar Control

When combined with a THC-based compound (the chief intoxicant in cannabis), CBD helped people with type 2 diabetes better control their blood sugar levels, according to a 2016 study that looked at blood sugar levels when fasting.

The study found that CBD alone:

  • Decreased resistin: A hormone that can contribute to insulin resistance
  • Increased glucose-dependent insulinotropic peptide: A hormone that prompts the release of insulin

This indicates that CBD could help with some of the hormonal imbalances that contribute to the development of type 2 diabetes.

Nerve Pain

Nerve damage, known as diabetic neuropathy, is a common complication from diabetes. Symptoms can include pain and burning sensations, especially in the hands and feet.

An animal study on rats found that CBD can increase the development of nerves and nervous tissue, possibly alleviating nerve pain.

Although the effect CBD has on nerve pain hasn’t been studied in humans, rodent studies are considered an important indicator of what might be found in human studies.

Anxiety and Stress Management

For some people with diabetes, managing the illness causes stress and anxiety. In turn, stress and anxiety can worsen the symptoms of diabetes.

Stress and Diabetes

When the stress hormones cortisol and adrenaline are released, they prompt the body to release glucagon, which can cause your blood sugar levels to rise.

Managing anxiety and stress can have a positive impact on the physical symptoms of diabetes.

Research shows that CBD can help relieve the symptoms of anxiety. People who struggle to control their blood sugar levels due to the hormonal effects of stress and anxiety might be helped by CBD.

Other Conditions Related to Diabetes

Many people with diabetes have other health conditions as well, and CBD may help control the symptoms of those conditions. These include:

  • Insomnia: CBD has been demonstrated to help treat insomnia, which is experienced by as many as half of the people with type 2 diabetes. Improving your sleep can help control your blood sugar levels, reducing the risk for complications from diabetes.
  • Chronic pain and inflammation: CBD has been shown to effectively treat chronic pain and reduce inflammation, both of which can reduce the quality of life for people with diabetes and accompanying conditions.
  • Blood pressure: CBD can reduce blood pressure and, in turn, reduce the risk of cardiovascular disease, which people with diabetes are at increased risk for.

Forms of Cannabidiol

CBD is available in many forms. If you’re considering taking CBD to help with your diabetes, it’s a good idea to talk to your healthcare provider about what dosage and strength might be beneficial.

Some common forms of CBD are:

  • CBD oil: CBD oil is a popular form of CBD. It mixes CBD extract into an oil like coconut oil, forming what’s known as a tincture. The tincture can be taken orally or applied to the body. Be sure that you know what concentration your CBD tincture is, and whether it’s safe to be taken orally.
  • Edibles: Like cannabis, CBD can be infused into edible products, including chocolate, gummy candy, and other candies and foods.
  • Capsules and sprays: CBD can also be taken as a pill or an oral spray that is given under the tongue.
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The form of CBD that you use will affect how quickly the substance enters your bloodstream.

How Quickly Does CBD Enter the Bloodstream?

Inhaled CBD enters the blood fastest, while edibles take longer to get into your system. It’s not clear how much CBD from topical products like creams and lotions gets into your bloodstream.

Side Effects of CBD

Because there is limited research on CBD, scientists don’t fully understand the side effects of the compound. However, it’s believed that using CBD can cause:

  • Nausea
  • Fatigue
  • Irritability

Research has found that, most often, the compound is generally well-tolerated.

CBD and Diarrhea

CBD can cause diarrhea, which many people with diabetes already struggle with. This is why it’s important to speak with your healthcare provider about whether CBD might make the condition worse and what you can do if it does.

Finally, CBD can have interactions with over-the-counter (OTC) and prescription drugs. It’s important not to underestimate the risk of CBD, especially if you’re taking other medications or supplements.

Interactions and Warnings

There are a few important things to consider when taking CBD.

CBD Is Not Regulated by the FDA

Because CBD is not regulated by the Food and Drug Administration (FDA), there is not a thorough understanding of its benefits and risks, which is information that would come from FDA testing and approval.

Some things to consider include:

  • Dosage: Recommendations widely range and depend on the condition that you’re using CBD to treat.
  • Quality: Since CBD is not regulated, there’s no oversight of the quality and potency of the product. If you’re considering taking CBD, talk to your healthcare provider about where and how to obtain high-quality CBD products.

Even though it is a “natural” product, CBD can still interact with other medications. In fact, research indicates that cannabis-derived products, including CBD, can interact with 139 medication, and can be dangerous for people on 57 medications, including:

    : Taking CBD along with this medication that is used to treat diabetes can increase the risk for diarrhea. : Taking CBD with this blood thinner can increase the amount of medication in your bloodstream, undermining the dosage that your healthcare provider has prescribed.
  • OTC medications including Benedryl: This medication and CBD can cause drowsiness, so taking the medications together can amplify the effect. and other medications that are processed in the liver: Taking CBD could increase liver enzymes. Talk with your healthcare provider before taking CBD. Make sure you’re not taking it with other medications that stress the liver.

What to Look For

Since CBD is not regulated by the FDA, it can take some legwork to find a reputable source for CBD.

Remember that products advertised online aren’t always listed accurately.

One study found that only about one-third of CBD products sold online were labeled correctly and that more than 20% of the CBD products contained THC as well.  

Legal THC Levels in CBD

If a CBD product contains more than 0.3% THC, it is illegal under federal law.

If you live in a state that has cannabis dispensaries, it may be worth buying CBD products in person. The people who work at dispensaries are generally knowledgeable about the effects of CBD and can guide you to a product that does not contain the psychoactive ingredient THC.

If you must order your CBD online, choose an American-made product, which offers a bit of peace of mind about manufacturing and production.

When selecting a CBD product, you’ll have to choose between:

  • Full-spectrum: Contains mostly CBD, but also all the other chemical compounds found in cannabis, including THC
  • Broad-spectrum: Contains some other cannabis compounds, but no THC
  • Isolates: Contains only CBD

Do THC Levels in CBD Show Up on Drug Tests?

If you need to be drug-tested for work or other reasons, the THC present in full-spectrum CBD can show on a drug test.

Talk to your healthcare provider and be sure that you thoroughly understand the laws in your state, as well as policies from your employer when it comes to consuming even low levels of THC.

A Word From Verywell

Living with diabetes can be difficult, and it’s natural to want to seek out any and all treatment options that can make your life a bit more comfortable and healthful.

While CBD could potentially have promise in controlling blood sugar levels and may even help prevent diabetes, the research is preliminary. Healthcare providers don’t fully understand the benefits or the drawbacks of CBD for most conditions, including diabetes.

If you’re considering using CBD and are diabetic, you should have an open and honest conversation with your healthcare provider. Your practitioner should be able to help weigh the benefits and risks of CBD and guide you on how to find high-quality CBD if you choose to take it.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

National Institute of Diabetes and Digestive and Kidney Diseases. What is diabetes?

Blessing, Esther M. Cannabidiol as a potential treatment for anxiety disorders. Neurotherapeutics. Sept. 4, 2015. doi:10.1007/s13311-015-0387-1

Bonn-Miller MO, Loflin MJE, Thomas BF, Marcu JP, Hyke T, Vandrey R. Labeling Accuracy of Cannabidiol Extracts Sold Online. JAMA. 2017. doi:10.1001/jama.2017.11909

By Kelly Burch
Kelly Burch is has written about health topics for more than a decade. Her writing has appeared in The Washington Post, The Chicago Tribune, and more.

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