If you’ve had your eye on cannabidiol (CBD) products to help with asthma symptoms, you’re in good company. Interest in and use of CBD and cannabis as alternative treatments for chronic conditions like asthma has grown significantly over the past few years. In an Allergy & Asthma Network survey, 18 percent of respondents reported using some form of cannabis. Among the general population, a 2019 Gallup survey found that 14 percent of Americans were using CBD products.

MyAsthmaTeam members have also reported benefits from using CBD. “CBD oil seems to help me,” one member wrote. Others report using CBD gummies and topicals.

Severe asthma is difficult to treat, so there is a growing interest in finding new therapy options. Researchers have investigated cannabinoids like CBD as potential asthma treatments. However, because hemp-derived CBD was only legalized in most U.S. states in 2018, research about its safety and effectiveness is still lacking.

This article will review the current understanding of how CBD may affect people with asthma and its safety for those with asthma and people in general.

Importantly, this article doesn’t endorse using CBD or cannabis to treat asthma. Talk to your doctor if you have questions about CBD.

What Is CBD?

CBD is one of hundreds of cannabinoids found in cannabis plants. Cannabinoids include any compound found in the body (endocannabinoid) or the cannabis plant (phytocannabinoid) that interacts with cannabinoid receptors. Receptors are proteins on the surface of cells that attach to various substances.

CBD and delta-9-tetrahydrocannabinol (THC) are the two most common and most- studied cannabinoids in medical research. Unlike THC, CBD is not mind-altering, meaning that it doesn’t cause a high.

Hemp-derived CBD is extracted from any part of the cannabis plant that contains less than 0.3 percent THC. CBD also comes from non-hemp cannabis plants, but only hemp-derived CBD is considered legal in the United States. Importantly, this legal status varies by state.

After CBD became legal in 2018, the U.S. Food and Drug Administration (FDA) approved Epidiolex, the first CBD-containing drug to treat two rare forms of epilepsy. With ongoing research into CBD, more approvals like this are likely to occur in the future.

Is CBD Safe?

CBD products are mostly treated like supplements in the United States because CBD products, except for Epidiolex, are not FDA-approved. This means that there aren’t federal standards for their content or strength and that the amount of CBD safety information available to the FDA is limited.

Additionally, because the FDA doesn’t regulate CBD products the way it does medications, some products may contain a higher amount of THC than the label may indicate. This is important to bear in mind, not only in terms of how the product may affect you but also if you’re required to undergo regular drug tests for work or other reasons that check if you have THC in your system.

Although researchers have conducted studies to evaluate CBD safety, more clinical trials are needed to better understand CBD and its effects. The side effects, drug interactions, and asthma considerations discussed here are based on currently available research.

Side Effects

CBD is generally well tolerated, but it does have several known side effects. These include:

• Diarrhea
• Appetite changes
• Drowsiness or sleepiness
• Irritability
• Liver damage
• Problems with male reproduction

Additionally, for people who use THC regularly, CBD may cause psychotic effects or cognitive changes.

Drug Interactions

CBD can also interact with other drugs. A drug interaction happens when two drugs react with each other, changing how one or both affect the body. Many of these interactions are related to how the body breaks down CBD.

CBD is mainly processed by the liver, like many other drugs. Therefore, any drug also broken down by this enzyme may interact with CBD, increasing or decreasing the effects of CBD.

CBD can also affect levels of other drugs. For example, warfarin (Coumadin), a blood thinner commonly used to prevent and treat blood clots, may have an increased effect when taken with CBD, increasing bleeding risk.

Importantly, combining CBD and drugs with similar side effects may cause worse symptoms. Due to the risk of breathing problems, special caution should be used when taking CBD and other medications that cause drowsiness and sleepiness. These include:

• Antidepressants
• Opioids
• Antipsychotics
• Sedatives

Some of these interactions could become life-threatening, so it’s always important to review all your current medications with your doctor before trying CBD.

Asthma Considerations

Although there isn’t enough evidence to determine if asthma medications interact with CBD, people with asthma using CBD should be careful with how they take it. The forms of CBD available for use include:

• Edibles, including candies and baked goods
• Tinctures
• Vapes
• Topicals
• Capsules
• Extracts

The term “CBD oil” refers to CBD that has just been extracted from a cannabis plant. While CBD oil can be added to gummies, candies, topicals, capsules, food, drink, or vapes, a tincture refers to CBD oil placed directly under the tongue.

Health experts recommend that people with asthma avoid vaping cannabis products. Hot vapor and chemicals added to CBD oil used in vapes are lung irritants and may cause asthma symptoms, like coughing, shortness of breath, and wheezing. It can also increase the risk of asthma flare-ups or an asthma attack.

Researchers have not determined the safest way for people with asthma to use CBD, but taking edibles, tinctures, and topicals may be safer than smoking or vaping.

Can CBD Help Asthma Symptoms?

Currently, there is not enough research to know exactly if or how CBD can help alleviate asthma symptoms. Understanding how CBD may affect asthma symptoms requires an understanding of CBD’s interaction with the body’s endocannabinoid system. The endocannabinoid system consists of two main receptors, cannabinoid receptor 1 (CB1) and cannabinoid receptor 2 (CB2).

CB1 and CB2 receptors are found throughout the body and are activated when certain substances attach to them. When activated, CB1 and CB2 have various effects on body functions, including stress response, pain, mood, sleep, and hunger. Cannabinoids of the cannabis plant interact with both endocannabinoid receptors to exert many of its effects. CBD also affects the body’s serotonin (mood) and opioid (pain) systems.

Potential benefits of CBD include:

• Reducing anxiety and depression
• Reducing seizures and inflammation
• Reducing pain
• Protecting the brain

CBD may benefit inflammatory lung diseases, like asthma, because of its anti-inflammatory effects. Researchers think that CBD’s effects on cytokines — chemicals released by cells that change immune system activity — may explain its ability to reduce inflammation.

One 2019 study in mice found that CBD reduced airway inflammation caused by allergic asthma. Studies in humans and animals have also found that the endocannabinoid system is involved in the development of asthma.

These study results suggest a potential for CBD to help with asthma-related inflammation, but many more human studies are needed to know if the use of CBD is safe and effective for treating asthma.

Talk With Your Doctor

CBD could potentially help people with asthma by reducing inflammation. However, more research is needed to say whether it helps and is safe. Clinical trials are ongoing that are looking at the effects of CBD, hopefully expanding the understanding of its effects.

If you have asthma and are considering trying CBD, you should talk with your doctor before starting. Whenever you are thinking of starting a new treatment, make sure that your doctor knows all the medications you’re already taking. This will allow your doctor to review your current medications and help you avoid dangerous drug interactions. They can also help decide the safest way to use CBD.

Talk With Others Who Understand

MyAsthmaTeam is the social network for people with asthma and their loved ones. On MyAsthmaTeam, more than 10,000 members come together to ask questions, give advice, and share their stories with others who understand life with asthma.

Are you living with asthma and want to try CBD? Have you ever discussed using CBD with your doctor? Share your experience in the comments below, or start a conversation by posting on your Activities page.