Your Good Health: CBD oil risky for anyone on heart medication
Dear Dr. Roach: I am a 49-year-old woman who had a massive heart attack in April of this year. My father died of a massive heart attack at 49 when I was three.
Dear Dr. Roach: I am a 49-year-old woman who had a massive heart attack in April of this year. My father died of a massive heart attack at 49 when I was three. I have four stents in three arteries and am on Brilinta, low-dose aspirin, blood-pressure medication, etc.
I have had essential tremor for all of my life, first noticing the tremors in middle school. The tremor is in my hands, making writing nearly impossible, and I have head bobs. I have an internal tremor that never stops.
A previous practitioner prescribed a month’s trial of beta blockers several years ago. I noticed no relief with the tremor, but was physically ill for the first 30 minutes of the morning in the first two weeks of the trial. Recently, while doing some research, I found an online blog regarding essential tremor and CBD oil. Nearly all of the bloggers found some level of relief using this treatment.
If I choose to try CBD oil to assist with my tremor, is there a risk of it interfering with my heart and blood-pressure medications?
Cannabidiol, or CBD, is a nonpsychoactive substance found in cannabis, as opposed to tetrahydrocannabinol, or THC, the best-known psychoactive component.
CBD is typically sold as an oil, and has been receiving press as a potential treatment for a wide variety of medical issues. Many or most of these claims have no data to support them. Anecdotal reports, such as most blogs, are neither reliable nor scientific (and may or may not be true).
There is also an issue with proving the dosage and purity of products said to contain CBD.
However, in the case of essential tremor, there is some evidence: Studies in mice have shown benefit with CBD, although a single case report showed effectiveness of THC but not CBD in essential tremor.
The issue of drug interactions is a significant one. CBD inhibits two powerful pathways the body uses to detoxify drugs, the CPY3A4 and CYP2D6 systems. This is a serious issue for you. Ticagrelor (Brilinta), an anticoagulant, is metabolized by CYP3A4, as are some of the statin drugs usually prescribed to people with heart blockages.
The effect of the anticoagulant could be much higher than expected, leading to bleeding risk. Other commonly used heart medications are metabolized by CYP2D6, and the effect on these medications is unpredictable.
I can’t recommend CBD products given the medications you are taking, but would suggest you consider alternative treatments.
You might have read about deep brain stimulation and ultrasound, two powerful and effective treatments for people whose symptoms have not responded to standard treatments.
Dear Dr. Roach: This question is for my husband. How safe is drinking tea while on warfarin?
He has his INR checked monthly, and for the most part, it stays between 2 and 3.
He watches his vitamin K intake regularly. He has read conflicting stories about how tea interacts with warfarin by making INR levels high.
Tea comes in two major types: black tea, which is fermented, and green tea, which is not. Black tea has no known interactions with warfarin (Coumadin). Green tea contains small amounts of vitamin K, which could make the INR lower and the warfarin less effective. However, the effect is likely to be small. Further, if he drinks a consistent amount per day, his dose can be adjusted to reflect his vitamin K intake.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers can email questions to [email protected]
CBD and Congestive Heart Failure: Can It Help?
In the United States, around 655,000 people die each year from heart failure.
That’s a lot of people.
As with most things, prevention is better than a cure. CBD isn’t the cure for congestive heart failure, but studies suggest it may help prevent it.
So, how can CBD help, and what’s the best type of CBD for preventing congestive heart failure (CHF)?
Can CBD Prevent Congestive Heart Failure?
Congestive heart failure happens after many years of blocked arteries, high blood pressure, or damaged chambers. This can be caused by a number of different health issues, the main of which are listed above.
CBD can help prevent congestive heart failure by treating a number of the conditions raised earlier. If these conditions can be controlled, the risk of heart failure can be decreased.
It’s not 100% clear if CBD will help prevent heart failure completely. However, several benefits may help in conjunction with lifestyle changes, and in some cases, other medications.
It’s important to note that CBD may interact with prescription and over-the-counter medications, so you should always consult your doctor before using CBD to treat a condition that could lead to congestive heart failure.
If you’re suffering from obesity, diabetes, heart disease, or high blood pressure, CBD may help reduce symptoms and even aid in getting better. This could be a huge factor in reducing the chances of heart failure.
What is Congestive Heart Failure?
Congestive heart failure, also known simply as heart failure, occurs when the heart cannot pump enough blood around the body.
Certain conditions and diseases can leave the heart too weak or stiff to pump blood effectively. This will eventually lead to a heart attack.
The Symptoms of Congestive Heart Failure
There are a number of early warning signs for heart failure. Below are some of the more common symptoms leading up to CHF:
- Extreme fatigue & weakness
- Rapid or irregular heartbeat
- Shortness of breath
- Difficulty exercising
- Persistent cough with bloody phlegm
- Abnormal weight gain from fluid retention
- Reduced appetite & nausea when eating
- Brain fog and difficulty concentrating
- Edema (swelling in the legs, ankles, and feet)
- Chest pains
It’s important to note that these symptoms do match up with other conditions and are considered normal in some circumstances.
Don’t overthink if you’re experiencing one or two of these symptoms mildly, but make sure to check with your doctor if you’re concerned about your heart health. It’s better to be safe than sorry.
What Causes Congestive Heart Failure?
There are several conditions that can eventually lead to heart failure.
Some of these conditions are incurable but the risk of heart failure can be decreased. Some other conditions that can potentially lead to heart failure are curable and can be defeated with a few simple lifestyle changes.
Below are some of the more common conditions that are associated with heart failure.
1. Heart Disease
Heart disease is a broad term that categorizes a number of preventable and unpreventable heart conditions.
Some types, such as congenital heart defect, are genetic defects of the heart that are present for life. This can include abnormal heart valves, septal defects (holes in the heart’s chambers), and atresia (a missing heart valve).
Coronary artery disease is the most common type of heart disease. The arteries that supply blood to the heart can become clogged with plaque, causing them to narrow and reduce the efficiency of the heart.
In some people, coronary artery disease is preventable and curable with some lifestyle changes. For others, it’s something that must be treated for life.
Arrhythmia is when a person has an irregular heartbeat. When the electrical impulses that coordinate the muscle’s pumping function don’t work properly, the heartbeat can become irregular or pump too fast or slow.
Dilated cardiomyopathy is where the heart’s chambers become dilated. With dilated chambers, the heart becomes weaker and struggles to pump blood properly. This type of heart disease usually comes prior to heart attacks and arrhythmia.
If left untreated, heart disease can lead to heart attack and heart failure.
2. High Blood Pressure (Hypertension)
High blood pressure, also known as hypertension, is where your blood pressure is higher than normal.
High blood pressure strains the heart and other organs. When you have hypertension, your heart works overtime to pump blood around your body.
The higher your blood pressure, the more risk you face for other conditions and health issues. Left untreated, high blood pressure can lead to heart disease, stroke, or a heart attack.
Put simply, diabetes affects how your body processes food into energy. It’s a chronic health condition that can be treated and controlled but has no cure.
When you eat a meal, most of the food is broken down into glucose (sugar) that is then released into the bloodstream. When blood sugar levels rise, the pancreas releases insulin to help the body use the glucose as energy.
Diabetes sufferers either don’t produce enough insulin (if any at all) or can’t utilize the insulin in the same way as a normally functioning body.
When the body has a lack of insulin or the insulin present isn’t functioning as it should, glucose can build up in the bloodstream. Over time, the excess glucose, if left untreated, can cause serious health issues including eventual heart failure.
Over 40% of the U.S population is considered obese. It comes primarily from over-eating. Obesity is mostly preventable and if you’re suffering from obesity, with the right lifestyle changes, you can combat it.
You’re considered obese when your BMI is over 30.
Subcutaneous fat is visible fat. It forms under the skin all over the body with the most common areas affected consist of the hips, buttocks, and abdominal region.
Visceral body fat (also known as hidden fat) is much more dangerous. It’s stored deep inside the belly and around the organs. It’s this fat that causes the most health implications.
Obesity puts a strain on all of your organs and the excess fat around your heart can lead to serious health issues.
Obesity can lead to heart disease, and eventually, heart attack and heart failure.
What are the Benefits of CBD for Congestive Heart Failure?
So, what are the potential benefits of CBD for congestive heart failure?
As mentioned, CBD alone isn’t going to prevent heart failure, but it can be used to treat some conditions that could lead to it.
1. CBD May Regulate Blood Sugar Levels
There is evidence that suggests some cannabinoids, including CBD, can help regulate blood sugar levels and help resolve diabetic complications .
Although the cannabinoid THC seems to regulate blood sugar more effectively than CBD, full-spectrum oil may have the same desired effect.
Lowering blood sugar levels will help reduce the damage caused by diabetes. This could be what prevents congestive heart failure in a diabetic patient.
2. CBD Helps to Fight Obesity
CBD can aid in weight loss.
Some studies suggest that supplementing a weight loss routine with CBD can help shed excess pounds . CBD promotes the browning of white fats, which makes it easier to convert the fat into burnable calories.
Obesity is one of the leading causes of congestive heart failure. If you’re obese, losing weight is essential in enhancing your health and reducing the risk of many health complications — including congestive heart failure.
3. CBD Decreases Inflammation
CBD is renowned for its anti-inflammatory benefits. This desirable trait could help prevent heart failure in the long term.
Diabetes and heart disease can cause damage to the walls of the blood vessels. This damage can cause inflammation. One study found that glucose-triggered inflammation can be relieved by CBD .
Inflamed blood vessels make it harder for the heart to pump blood around the body. Reducing this inflammation will help ease the strain on the heart, ultimately preventing further damage and potential heart failure.
4. CBD Lowers Blood Pressure
CBD lowers blood pressure.
Studies suggest that even low doses of CBD can significantly lower blood pressure .
High blood pressure (hypertension) has been directly linked to congestive heart failure. Reducing blood pressure and keeping it down consistently will help prevent congestive heart failure in the long term.
How to Use CBD For Congestive Heart Failure?
Using CBD to lose weight, control blood sugar levels, lower blood pressure, or decrease inflammation may help prevent congestive heart failure.
How you use CBD for congestive heart failure will affect the results you get. Choosing the right CBD product is vital to reaping the rewards that this cannabinoid sows.
It’s important to note that you shouldn’t use CBD alone to treat certain health conditions. A combination of lifestyle changes and other medications may be needed to get on top of some conditions.
1. Full-Spectrum, Broad-Spectrum, or Isolate?
You may have heard the terms isolate, broad-spectrum, and full-spectrum, but what’s the difference? And which is best for congestive heart failure?
CBD isolate is a pure extract of the cannabinoid CBD (cannabidiol). Oils, edibles, and topicals that are made using isolate contain only CBD with no other cannabinoids or terpenes present.
CBD isolates are great if you want to avoid THC or any other cannabinoids entirely. They’re perfect for people that react badly to other cannabinoids and they have no chance of showing up on a drug test.
The only downside is you won’t get the full entourage effect as you would with a full-spectrum product. Research suggests that CBD is more effective when consumed as part of a full cannabinoid profile .
Broad-spectrum products contain CBD as well as a wide range of other cannabinoids.
Broad-spectrum oils, edibles, and topicals contain a cannabinoid profile similar to what’s in the raw hemp flower. The only cannabinoid that broad-spectrum products don’t contain is the psychoactive cannabinoid THC.
Broad-spectrum CBD is perfect for people that want to reap the benefits of the entourage effect without consuming THC. Broad-spectrum products have no chance of showing up on drug tests.
Full-spectrum CBD products contain a full cannabinoid profile. They have an identical profile to the raw hemp flower including THC in percentages lower than 0.3%.
This type of CBD is the most valuable to use for multiple health conditions and holds the most potential for preventing congestive heart failure. This is because it provides the full entourage effect.
Full-spectrum oils and edibles have THC levels that are too low to provide a “high”, but depending on how much you’re consuming, they may show up on drug tests.
2. CBD Consumption Method
There are many ways to consume CBD. Some are better than others for treating conditions that are associated with congestive heart failure. It’s important to know which products are best.
You will find all of these CBD products in isolate, broad-spectrum, and full-spectrum options.
CBD oil provides you with the most flexibility in terms of dosage. It’s also one of the best ways to consume CBD for heart failure because it’s highly bioavailable and has few additives that will trigger any undesirable effects.
You can add drops directly under the tongue or supplement meals and drinks by adding a few drops into your meal routine.
CBD edibles come in many forms. You’ll find CBD-infused honey sticks, gummies, lollipops, and more.
Edibles are fantastic if you can’t stand the taste of raw CBD oil. However, they’re not ideal for treating some conditions related to congestive heart failure.
Because of the high sugar content, you should avoid CBD edibles if you have diabetes or are struggling with obesity.
Technically edible, capsules give you a tasteless way to consume CBD without the sugar found in chewable edibles.
Capsules provide you with an accurate dosage per capsule and medicating is as easy as swallowing a pill.
CBD capsules are a great option for congestive heart failure because they contain no sugar and are relatively bioavailable.
Topicals are CBD products such as gels, creams, and balms that can be applied directly to the skin.
Although they’re great if you’re suffering from a skin condition, they pose no real value for conditions that are related to heart failure.
CBD vape liquid is heated up and inhaled as a vapor. Using CBD in this way provides maximum bioavailability as it absorbs lung tissue quickly and efficiently.
Unfortunately, there’s little known about the negative effects of vaping CBD, so if you’re suffering from a severe health condition it isn’t the first consumption method you should look at.
3. CBD Dosage for Heart Failure
CBD works differently from person to person.
The right dosage for one person won’t be correct for another, so there is some level of self-experimentation needed to find out what’s right for you.
Generally speaking, a dose between 20 and 100-milligrams per day will be effective for most conditions but it could be significantly higher or lower depending on your body weight, metabolism, and age.
As with most supplements, you should start with a low dose and work your way up until you find out what’s effective for you.
If you’ve never used CBD before it’s especially important that you test the waters with a low potency product at a low dose to find out how your body reacts to the cannabinoid.
Once you’re sure there are no negative effects, you can increase the dosage slowly until you get the desired effects.
Make sure you consult your doctor before using CBD to supplement other medications for your condition.
Final Thoughts: Can CBD Help Prevent Congestive Heart Failure?
In short, yes CBD can help prevent congestive heart failure.
CBD can help with weight loss, diabetes, heart disease, and high blood pressure. Controlling these conditions may reduce the chances of heart failure.
If you’re looking at CBD as a treatment for congestive heart failure it’s important to first speak with your doctor. CBD may negatively impact other medications and treatments, so it’s of paramount importance you seek professional advice.
When looking for the best CBD product for your condition, we advise you to research the brand and check the independent lab reports. This way, you’ll be certain you’re receiving the best possible treatment.
References Used In This Article
- Horváth, B., Mukhopadhyay, P., Haskó, G., & Pacher, P. (2012). The endocannabinoid system and plant-derived cannabinoids in diabetes and diabetic complications. The American journal of pathology, 180(2), 432-442.
- Parray, H. A., & Yun, J. W. (2016). Cannabidiol promotes browning in 3T3-L1 adipocytes. Molecular and cellular biochemistry, 416(1), 131-139.
- Rajesh, M., Mukhopadhyay, P., Bátkai, S., Hasko, G., Liaudet, L., Drel, V. R., … & Pacher, P. (2007). Cannabidiol attenuates high glucose-induced endothelial cell inflammatory response and barrier disruption. American Journal of Physiology-Heart and Circulatory Physiology, 293(1), H610-H619.
- Jadoon, K. A., Tan, G. D., & O’Sullivan, S. E. (2017). A single dose of cannabidiol reduces blood pressure in healthy volunteers in a randomized crossover study. JCI insight, 2(12).
- Russo, E. B. (2019). The case for the entourage effect and conventional breeding of clinical cannabis: no “strain,” no gain. Frontiers in plant science, 9, 1969.
Nina created CFAH.org following the birth of her second child. She was a science and math teacher for 6 years prior to becoming a parent — teaching in schools in White Plains, New York and later in Paterson, New Jersey.
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CBD: What is it, and can it help the heart?
CBD is the latest health craze to sweep the high street, with claims it can help everything from chronic pain and inflammation to anxiety. But what is CBD, and can it really help the heart? Emily Ray finds out.
What is CBD, and is it legal in the UK?
CBD, or cannabidiol, is a chemical that’s extracted from the leaves and flowers of the cannabis plant. Cannabis itself is an illegal class B drug, as is the compound THC (tetrahydrocannabinol) which it contains. But pure CBD isn’t illegal, as it doesn’t cause the intoxicating effects of cannabis.
What CBD products are available?
The choice of CBD products has exploded recently: you can buy oils, capsules, muscle gels, sprays and oral drops, as well as beer, tea, sweets, hummus and even CBD-infused clothing.
Many of these can be easily picked up from reputable high street stores, such as Holland & Barrett or Boots.
Prices can be high: a 500mg bottle of CBD oil oral drops could set you back as much as £45. Not that this has put people off: over the past two years, sales of CBD have almost doubled in the UK, putting regular users at an estimated quarter of a million.
What is CBD used for?
A 2018 report by the World Health Organization suggested that CBD may help treat symptoms relating to conditions such as cancer, Parkinson’s disease, multiple sclerosis (MS), anxiety, depression, insomnia and Alzheimer’s disease.
However, it also notes that this research is still in the early stages, and that more studies are needed before conclusions can be drawn on whether CBD is effective.
CBD’s popularity has been given a boost by the fact that two CBD-containing medicines have been approved for prescription use by the NHS in England: Epidyolex, which has been found to reduce the number of seizures in children with severe epilepsy, and Sativex, which contains a mixture of CBD and THC, and is licensed for treatment of muscle stiffness and spasms in people with MS.
Does CBD work?
Harry Sumnall, Professor in Substance Use at Liverpool John Moores University, says: “In terms of the products found in shops, there’s virtually no evidence to support the claims made for a lot of them. There’s a lot of marketing that says CBD is a ‘miracle of the modern age’; however, the marketing has actually overtaken the evidence of what it’s effective for.”
“In terms of the products found in shops, there’s virtually no evidence to support the claims made for a lot of them.”
Harry Sumnall, Professor in Substance Use at Liverpool John Moores University
Professor Sumnall argues that while it could be effective for some people, in some of these cases the results could be caused by the placebo effect (where the patient’s belief in a treatment makes them feel better). The placebo effect can be powerful, but Professor Sumnall warns that if people try CBD oil instead of speaking to their doctor, it could cause a problem.
The biggest difference between CBD used in clinical trials and in stores is the dose. Research has shown that some products contain very little CBD (or even none at all). Others contain THC or other illegal drugs, or even alcohol instead of CBD. By contrast, in clinical trials the CBD is purified, manufactured to a very high standard and given at a much higher dose. It is also taken regularly and under medical supervision.
Since 2016, any CBD product that is presented as having medicinal value must be licensed and regulated as a medicine, regardless of whether it is actually effective. Manufacturers must follow very specific and robust rules around production, packaging and the information provided.
But so far, Professor Sumnall points out, CBD products in shops are marketed as food supplements, not medicines, so none of them have gone through this process.
Can CBD help the heart?
Inflammation is part of the process that leads to many diseases, including coronary heart disease, high blood pressure and stroke, and there is some evidence that CBD has anti-inflammatory properties. Other studies have suggested that CBD can have a protective effect on the heart: this has been proven in rats after a heart attack and in mice with some of the heart damage associated with diabetes. But because these studies are often based on findings in a lab or in animals, not in humans, we cannot yet be confident that CBD will benefit the human heart.
There is ongoing research into the use of purer forms of CBD for a variety of conditions, including heart and circulatory diseases and, in particular, diseases of the heart muscle, including myocarditis and some types of cardiomyopathy.
Some of this work is still in animals, and much more research is needed before we can definitively say that CBD can help in this area.
“It’s clear that CBD has potential,” says Professor Sumnall, “but we’re at a very early stage of that research.”
- Always talk to your doctor if you’re thinking about taking a CBD product to supplement your existing treatment.
Meet the expert
Harry Sumnall is a Professor in Substance Use at the Public Health Institute, Liverpool John Moores University. He was a member of the UK Government’s Advisory Council on the Misuse of Drugs between 2011 and 2019.