The short answer is – no, in most cases cannabis and specific cannabinoids do not seem to act as strong blood thinners. Although CBD oil is legal in most U.S. states and is widely accessible to purchase it’s important to understand the potential risks and dangers of CBD Oil. CBD oil has blood-thinning ability, and many people think that CBD’s blood-thinning property can benefit humans in many ways.
Is cannabis a blood thinner?
Ever wondered how cannabinoids like THC or CBD affect your blood? It may seem like a weird question, but it is a vitally important one for anyone taking anticoagulant medications and considering using cannabis. It turns out that this issue has been under-researched and could have significant impacts on patients who may be at greater risk of heart attacks and strokes.
What is a blood thinner?
It is not uncommon for patients at a high risk of blood clots and strokes to receive medications called “anticoagulants” or “antiplatelet drugs”, often generically referred to as “blood thinners.” These drugs do exactly what you might expect – prevent blood from forming a clot. It is important to note that while clotting is good and necessary when you have a cut or injury, forming a clot inappropriately can be highly dangerous. Blood clots can greatly interrupt blood flow to the surrounding tissue, causing serious damage to important organs, and sometimes death. Some common examples of anticoagulant blood thinning medications on the market include warfarin (Coumadin), heparin, apixaban (Eliquis), and enoxaparin (Lovenox). One of the most common examples of an antiplatelet drug is aspirin.
How do blood thinners work?
Blood thinners typically act in one of two ways – as anticoagulants or antiplatelets. But before we explain how these drugs work, it is important to understand a couple of things about blood clotting in the human body.
Blood consists of several primary constituents including plasma, red blood cells, white blood cells, and platelets. Whenever we injure ourselves and break a blood vessel, causing bleeding, platelets start to attach to the damaged tissue and act as a kind of cork that plugs the hole in the blood vessel. 1
Blood thinners disrupt the blood clotting process in one of two ways. Anticoagulants typically slow down the process of blood clotting by interrupting clotting factors, whereas antiplatelet drugs prevent platelets from coming together to form blood clots in the first place.
Typically, “blood thinners” refer to anticoagulants, though you may find the term “blood thinner” applied to either anticoagulants or antiplatelet drugs.
Does weed thin your blood?
The short answer is – no, in most cases cannabinoids do not seem to act as strong blood thinners. There are very few case studies that report anticoagulant effects in cannabis patients, and the ones that do exist involve using cannabis with traditional anticoagulant medications. 2
While the general concensus is that phytocannabinoids (derived from the cannabis plant) do not cause anticoagulations, there has been only one study that found that THC, CBD and CBN could thin the blood of obese rodents. Preclinical rodent studies are challenging to interpret, however, as the results very often don’t directly scale to the human biological system. In this study the authors speculated that cannabinoids may be inhibiting an enzyme in blood plasma called thrombin, which promotes blood clotting. Additionally, the authors noted that THC (and CBD for that matter) are known to interact with receptors known as PPARy 3 , which are highly present in blood vessels. Lastly the authors note that certain endocannabinoids like anandamide may promote clotting, but these tests were in vitro (aka in a laboratory test-tube), not in a living animal. 4
There have also been reports that synthetic cannabinoids, aka spice or K2, may cause blood thinning due to contaminants found mixed with the cannabinoids. Basically, rat poison designed to work by making rodents bleed to death is occasionally mixed with synthetic cannabinoids, either accidentally or as a cutting agent, which can cause coagulopathy (aka inappropriate clotting). In this case, hundreds of patients were seen in emergency departments in 2018 with signs of bleeding with no known cause. It was later found that many of these patients had been consuming synthetic cannabinoid products, and these products were contaminated with rat poison. This is yet another cautionary tale regarding synthetic cannabinoids and another reason why cannabis regulations allowing for safe access to cannabis are so important. 5 6
Is it safe to use THC with blood thinners?
This is a tricky one given the lack of research. In general patients taking anticoagulants often have cardiovascular issues, which can be problematic with cannabis use as THC is known to cause changes in heart rate and blood pressure. This effect is particularly strong with smoking or vaping THC products, but can also happen with edibles. So it follows that THC should likely be avoided if a patient is taking blood thinners.
If a patient is taking anticoagulants, that could indicate that their cardiovascular system may not be in the best of health to begin with. This can be problematic with cannabis use, in particular THC which is known to cause changes in heart rate and blood pressure. Generally, patients with high risks of strokes, heart attacks and other cardiovascular dysfunction are those most commonly prescribed blood thinners. Since THC carries its own risk of exacerbating cardiovascular issues in susceptible users and should likely be avoided if a patient is taking blood thinners. 7
As far as THC’s anticoagulant effects are concerned, there is very limited evidence that THC may act as an anticoagulant by inhibiting thrombin, but that evidence is in rodents and stems from only one study mentioned previously. The real concern about THC in this population is actually related to blood pressure, heart rate and heart rhythm; an older heart may be even more susceptible to these changes. 8 9
CBD and Blood Thinners
As mentioned previously, CBD is a known PPARy receptor agonist, causing vasorelaxation and lowering blood pressure. CBD is also known to interfere with the normal function of certain enzymes already inside of us, known as cytochrome P450 enzymes. These CYP450 enzymes are all over our bodies and play important roles in metabolizing food and drugs. Cannabidiol is a known inhibitor of some CYP enzymes, leading to an increased risk of pharmaceutical drug interactions. And CBD is not alone in this effect. Many other phytocannabinoids do carry this potential to interfere with liver enzymes – though all of them do so with lesser potency than CBD. In simple terms, CBD can slow the body’s ability to break down common medications – including blood thinners.
There are multiple case reports available which detail situations in which patients have experienced herb-drug or drug-drug interactions between CBD and a common anticoagulant, warfarin (Coumadin). In one instance, a 46-year-old male patient required a nearly 20% reduction in their warfarin dose after beginning Epidiolex, a pharmaceutical containing CBD isolate in a liquid solution. In another instance, a 44 year-old male patient required a 30% dose reduction in warfarin after starting to use CBD oil. There was, however, one case report where this drug interaction did not occur. 10 11 12 13 14
These drug interactions highlight some important lessons. First, it is important to recognize that pharmaceutical interactions with cannabis are very real and can be dangerous if not monitored properly – especially in the context of drugs like blood thinners. However, there is a flip side to this drug interaction issue. Oftentimes, if a patient and their physician are aware of these potential interactions, it’s possible a patient could choose to continue using anticoagulants and cannabis together. This combination would likely warrant close monitoring of the anticoagulant effects, and would certainly require increased communication between the patient and the medical provider. But if monitored properly, it’s possible that the dose of patient’s anticoagulants could be reduced, possibly reducing the risk of serious negative side effects from those medications while still deriving benefit from the cannabinoids.
Bottom line: Talk to your healthcare provider
So what does all of this mean? Is marijuana a blood thinner?
According to the miniscule amount of research that has been performed so far on this topic, it is possible that cannabinoids like THC or CBD could act as anticoagulants, and the endocannabinoid system is involved in platelet aggregation. However, it appears this effect may only be in certain contexts, for instance, in the rodent study that identified anticoagulant effects of THC, CBD and CBN, the rodents were obese rodents in a simulated Type-2 diabetes model. In that scenario, cannabinoids exhibited anticoagulant effects by inhibiting the blood clotting signaling compound thrombin. However, we do not know how that would scale up to humans with Type 2 diabetes or other conditions. 15
We do know that cannabinoids can interact negatively with blood thinning medications, either by inhibiting their breakdown and elevating their concentrations in the body or by preventing their activation. In both cases, this can be extremely dangerous for patients, as coagulation of blood is a fine balance of clotting and bleeding, and the result of managing these medications poorly can be as serious as death. This is why it is so important to talk to a healthcare professional if you plan to try using cannabis in combination with anticoagulant and antiplatelet medications. Your physician can arrange regular blood tests to monitor for interactions with other medications and take appropriate steps as needed to keep you safe.
So for now, the jury is still out. There is a tiny bit of preclinical evidence that cannabinoids may affect blood’s ability to clot, but a lot more research is still needed. However if you combine cannabis products, especially CBD, with your anticoagulant or antiplatelet medication, be sure to take extra caution to monitor the effects with your doctor.
Understanding the Risks of CBD Oil
CBD is short for cannabidiol, a chemical which is extracted from the hemp plant and then diluted with a carrier oil like coconut or hemp seed oil. While both CBD and marijuana are derived from the cannabis plant, CBD does not contain enough tetrahydrocannabinol (THC) to produce mind-altering effects. Hemp contains 0.3% or less THC, while marijuana contains higher than 0.3% THC.
CBD interacts with the body’s endocannabinoid system (ECS), which helps regulate the immune system, appetite, sleep, mood, digestion, inflammation, pain, motor control, temperature regulation, reproduction, and memory.
The FDA and CBD oil
Although CBD oil is legal in most states within the U.S. and can be purchased at your local drug/health food stores, smoke shops, and gas stations, only one CBD product has been reviewed by the Food and Drug Administration (FDA) for safety. That drug, Epidiolex, is a purified form of CBD that was approved by the FDA in 2018 for the treatment of certain seizure disorders. During their review of Epidiolex, the FDA did identify an increased risk of liver injury from the product but determined the risk could be managed provided the drug was taken under medical supervision.
Other than Epidiolex, the FDA warns that no CBD products have undergone a strict evaluation process to determine if they are “safe and effective to treat a particular disease, what the proper dosage is, how they could interact with other drugs or foods, or whether they have dangerous side effects or other safety concerns.”
The FDA also warns that testing of some CBD products has revealed the presence of contaminants like pesticides and heavy metals, and that some did not contain the levels of CBD claimed.
It is illegal for companies to promote their CBD products as a cure, treatment, or prevention of any specific disease or condition. Companies that make such claims are sent a warning letter from the FDA.
Why do people use CBD oil?
Although there have yet to be any large-scale human studies on CBD, there is scientific evidence that the oil may relieve pain, reduce anxiety and depression, reduce side-effects of cancer treatment, reduce epileptic seizures, and lower blood pressure, as well as deliver anti-inflammatory and other beneficial effects.
The Mayo Clinic reports that while CBD is usually well-tolerated, it can cause such side effects as dry mouth, diarrhea, reduced appetite, drowsiness and fatigue. Some users have also reported experiencing nausea and irritability.
Potential risks with CBD oil
Harvard Health Publishing says two of the biggest concerns with CBD use are:
- CBD can increase the levels of other medications in the body the same way grapefruit juice does.
- CBD is sold as a supplement and not required to undergo the same stringent testing as FDA-approved medications.
Agreeing with the FDA, Harvard warns the lack of regulation means consumers can’t be certain what is contained in the product and whether the dose is accurately stated.
While some CBD providers submit their products for independent lab testing, other providers do not and have no verifiable way of proving what is contained within their oil. Since the industry is largely unregulated currently, consumers often have little insight into what the products contain unless they are able to access the results.
And because a large segment of the U.S. population takes one or more prescribed and/or over the counter medications while also taking CBD oil, many are at increased risk of a dangerous interaction. A study published in JAMA Internal Medicine found that due to concurrent use of prescription medications and dietary supplements in 2011, “15% of older adults [are] potentially at risk for a major drug-drug interaction.” This estimated risk had increased from 8.4% in 2005.
Drug interactions not only impact the efficacy of a medication, but they can also cause harmful side effects. Many drugs and toxins are broken down in the body by a vital enzyme called CYP3A4, mostly found in the liver, allowing them to be eliminated by the body. Grapefruit has been found to interfere with the metabolization process, allowing the drug to build up in the body, which can be dangerous.
CBD appears to have a similar effect, which is quite concerning, as approximately 60% of medications on the market interact with CYP3A4 enzymes. Check the FDA website for information about which drugs don’t interact well with grapefruit. And always consult your healthcare provider, prior to using CBD, for medical advice specific to your needs.
Risks of CBD when used with other medications
Research indicates that CBD can interact with medications including:
- Blood Thinners: A study published in the journal Epilepsy and Behavior Case Reportsfound a “clinically significant interaction between pharmaceutical grade cannabidiol (Epidiolex®) and warfarin, one of the most widely used oral anticoagulants.” If CBD disrupts the metabolization of a blood thinner like warfarin, the build-up of drug levels in the body could result in dangerous bleeding. It’s important that patients prescribed Epidiolex are carefully monitored by health professionals.
- Epilepsy Drugs: Even though the FDA approved the CBD drug Epidiolex to treat certain forms of epileptic seizures, incorrect doses can result in more aggressive seizures. This drug should only be used under close medical supervision.
- Chemotherapy Drugs: As with most drugs, chemo drugs are manufactured considering the likely rate of metabolization. If CBD slows down that rate, concentrations of the drug can build up in the body which could result in toxicity.
Other research has also linked CBD to interactions with:
- Antidepressants and Anti-anxiety Medications
- Cold or Flu Medications
- Blood Pressure Medications (Beta Blockers)
Always consult a doctor if you’re taking any of the medications above to understand their interaction risks.
The FDA continues to advise the public to be cautious about using CBD until more scientific research supports its efficacy and safety.
Turning Point of Tampa’s goal is to always provide a safe environment and a solid foundation in 12-Step recovery, in tandem with quality individual therapy and groups. We have been offering Licensed Residential Treatment for Addiction, Eating Disorders and Dual Diagnosis in Tampa since 1987. If you need help or know someone who does, please contact our admissions department at 813-882-3003, 800-397-3006 or [email protected]
Does CBD Oil Thin Your Blood?
CBD is the second most prevalent cannabinoid in the cannabis plant. CBD is touted as a magical ingredient, and almost every other product is CBD infused. For the past ten years, CBD oil is also making headlines for its potential health benefits such as treating heart diseases, regulating the sleep cycle and boosting mood, etc.
According to the world health organization, WHO; CBD is safe and well-tolerated in humans. Additionally, it does not show any abuse or dependence potential. But somehow, there is ongoing controversy about whether CBD can interact with anticoagulants and blood-thinning medications. Does CBD oil really thin your blood? Here is everything you need to know.
Does CBD Oil Thin Your Blood? What Does The Research Say?
CBD oil has many health and therapeutic uses, that’s why it is extremely popular nowadays. Many people use CBD oil to boost their energy, alleviate their mood, regulate their sleep, etc. CBD is extracted from hemp and mixed with carrier oils to make the required consistency of CBD oil. CBD oil is not intoxicating and doesn’t give the “head high” effects.
CBD oil has blood thinning ability, and many people think that CBD’s blood-thinning property can benefit humans in many ways.
Following Are Some Studies Regarding CBD and Its Effects On The Blood:
- According to a study published in the JCI Insight Journal, a single dose of CBD has an impact on the blood pressure of participants. Whenever you take CBD oil for any health reasons, it also dilates blood vessels. As a result, blood flows faster in blood vessels, and then there is less likelihood of blood clots.
- Anticoagulants are also known as blood thinners. These medicines help to prevent blood clotting in veins and arteries. Different blood thinners work in different ways. Some may thin the blood by preventing cells from adhering to your blood vessels. Blood thinners are a lifesaver for people who have issues such as blood clotting. Similarly, CBD has the ability to thin the blood.
- Another study showed that cannabinoids in broad-spectrum CBD oil could prevent thrombosis. Thrombosis is a condition in which blood clots are formed. Moreover, CBD extends the time of blood clot formation. This time is two times longer as compared to the subjects who don’t take CBD, and blood clots formed. This study also suggests that “cannabinoids, THC, and CBN, show anticoagulant activity and may be useful in future the treatment of diseases such as type 2 diabetes. Broad-spectrum CBD products don’t contain THC but all other cannabinoids and terpenes. So, more research is required to unveil the CBD’s effects on the blood thinning.
CBD Oil and Its Interaction with Other Medicines
CBD can interact with other medicines. So, if you are on any medication, then you must consult your doctor before starting CBD. According to some studies, CBD works better with Heparin, Dabigatran, and Edoxaban. These are clot inhibitors or blood thinners.
Want to know something interesting about grapefruit? If you are taking blood thinners, then grapefruit affects the way certain medicines work. Grapefruit can delay medicines’ absorption or excretion from the system.
According to an article published in Harvard Health , “CBD can increase the level of Coumadin in the blood. Coumadin is a blood thinner and its increased level results in blood thinning. Additionally, CBD can “raise the levels of other medications in your blood by affecting the liver enzymes. Furthermore, some studies indicate that there is an interaction between CBD and Warfarin. Warfarin is the most common anticoagulant available in the market.
Frequently Asked Questions
Q. Should I Stop Taking CBD Softgels A Few Days Before My Surgery?
This is something to consult with your doctor or surgeon. Everybody is different, and their body system reacts differently to CBD oil. Similarly, different surgical procedures have the various risks of bleeding. To stay on the safer side and as a precautionary measure, stop taking CBD a few weeks prior to your surgery. Moreover, your doctor can give you better advice in this matter as he knows your history and health issues.
Q. Should I Stop Taking CBD Before Going for A Tattoo?
When you decide to get a tattoo, you stop taking pain killers, blood-thinning medicines, and alcohol a few days prior to tattooing. It is ideal to stop taking CBD oil or any other form of CBD. Thinning of blood makes it hard for artists to draw tattoos, and there are chances of over bleeding. Many people take CBD oil to calm their nerves and for better sleep, so it is hard for them to stop using CBD oil. For more clear guidance, you take advice from your health care practitioner, or sometimes an experienced tattoo artist can guide you well.
Q. Is Topical Use of CBD Also Linked with Blood Thinning?
There is no clear and scientific evidence regarding this matter. Many people massage CBD oil or CBD oil-infused creams on different body parts to reduce pain and inflammation. There is not any scientific research available to prove that topical CBD oil can cause blood thinning.
Wrapping Up The Things
CBD and its blood-thinning ability require more research and human clinical trials. Many other factors such as weight, health issues, and tolerance level can affect CBD’s ability and its interaction with blood thinners. If you are taking blood thinners and want to take CBD oil, then you must consult your doctor. Your doctor and health care practitioners can adjust your dose, and you can safely add CBD to your medicine regime.
CBD’s blood-thinning property is not a bad thing at all; it opens new doors for future research. It also calls for new opportunities to discover new ways to tackle some biggest health issues, such as brain strokes and heart diseases. As you know, blood clots are the common reason for heart attacks and hemorrhage. So, there is a need for more human experiments and clinical trials to unveil the true potential of CBD oil and its effects.