Increased Liver Enzyme Levels Seen With Use of Cannabidiol in Adults
THURSDAY, July 10, 2025 -- Use of cannabidiol (CBD) within the range consumers are taking with unregulated CBD products is associated with increased liver enzyme levels, according to a study published online July 7 in JAMA Internal Medicine.
Jeffry Florian, Ph.D., from the U.S. Food and Drug Administration in Silver Spring, Maryland, and colleagues examined the effects of four weeks of twice-daily CBD use on the liver and endocrine hormones using a dose within the range consumers are taking with unregulated CBD products in a trial involving 201 healthy adults. The participants were randomly assigned to receive CBD (5 mg/kg/day) or placebo for 28 days.
The researchers found that 5.6 and 0 percent of participants in the CBD and placebo groups, respectively, had elevation of liver enzyme (aspartate aminotransferase or alanine aminotransferase) levels greater than three times the upper limit of normal. Seven participants met the withdrawal criteria for potential drug-induced liver injury, which was detected at day 21 and day 28 in two and five participants, respectively. Between the CBD and placebo groups, no differences were seen in change from baseline for total testosterone and inhibin B in male participants or thyrotropin, total triiodothyronine, and free thyroxine in all participants.
"As CBD users may not notice these changes on their own, this study highlights the need for caution and potentially routine monitoring in CBD users," the authors write.
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