CBD and Metformin: Which Is Better & Should You Take Both?

Cannabis compounds are more often prescribed by doctors to treat serious chronic conditions. Cannabinoids like CBD and THC have been highlighted as potent anti-inflammatory agents, neuroprotectants, painkillers, and antioxidants.

CBD can also regulate our blood sugar levels and help with metabolism on many levels, according to recent research. Not only does CBD promote fat-browning, but it can also curb cravings for high-calorie food and reduce stress levels, preventing people from eating compulsively.

But does CBD have a direct impact on diabetes? Can you take it as a diabetes treatment instead of conventional medications? Are CBD and metformin a good match?

Metformin is a common anti-diabetes medication that doctors prescribe to lower blood sugar levels in their patients. The idea of combining these two compounds is tempting, especially if your current treatment doesn’t bring satisfying results.

Let’s take a look at the current situation of CBD in treating diabetes — and how it interacts with meds such as metformin.

What is Metformin?

Metformin is an FDA-approved medicine commonly prescribed to treat type 2 diabetes. Doctors often recommend this drug on its own or prescribe it along with other diabetes medications to manage high blood sugar levels.

Metformin has proven to be an effective treatment for the majority of diabetes complications; it can also prevent diabetes in high-risk individuals. Despite some adverse reactions reported by individual patients, the benefits definitely outweigh the potential side effects.

What is CBD and How Does It Impact Glucose Levels?

CBD is short for cannabidiol, a phytocannabinoid present in the Cannabis sativa plant. Unlike THC, CBD is non-intoxicating, so it won’t get you high. However, it still has a plethora of therapeutic properties, some of which are related to CBD’s impact on our metabolism and blood glucose levels.

In a 2016 study conducted on diabetic mice, CBD treatment showed to be capable of lowering the chances of diabetes in the subjects. The research team administered a daily dose of 5 mg/kg CBD to the mice for ten weeks at least five times a week (1).

Another study, from 2018, has analyzed the mechanism of action of phytocannabinoids as anti-obesity and anti-diabetic compounds. The study highlighted CBD as the potential aid in the treatment of insulin resistance triggered by obesity and diabetes (2).

CBD and Metformin: Potential Interactions

Considering what we’ve said about Metformin and CBD so far, one could assume that it would be beneficial to combine them. However, no study has yet confirmed whether or not these products are compatible with one another.

CBD is metabolized by the same system of enzymes that breaks down active ingredients in medications. In past research, CBD has been highlighted as a potent inhibitor of cytochrome P450 enzymes. In other words, CBD can compromise the liver’s ability to process other drugs when taken along with them.

The above interaction could result in increased or decreased levels of active drug ingredients in the blood, causing problems associated with being subtherapeutic or, on the contrary, toxic.

CBD’s interaction with CYP450 can change the way it affects the endocannabinoid system (ECS). The ECS is the major regulatory network found in humans and animals that regulates the activity of other systems and organs, including the central nervous system.

Metformin has a few side effects on its own, so the more medication circulates in your bloodstream, the higher the risk you will experience adverse reactions. Although these side-effects are not severe, they may lead to a condition known as lactic acidosis. This disorder includes symptoms like muscle pain, dizziness, drowsiness, chills, and breathing difficulties.

Since there is no clear indication of whether using CBD and metformin is dangerous, it’s always better to err on the side of caution and consult your doctor about applying CBD in your routine before buying any CBD product.

A doctor experienced in treating people with cannabinoids should be able to point you in the right direction.

Can You Substitute Metformin with Another Antihyperglycemic to Take CBD Oil?

Insulin is another antihyperglycemic commonly used to lower high blood sugar to diabetics. Doctors often prescribe special injections to administer the compound intravenously.

In a 2010 study conducted on 62 participants with type 2 diabetes, scientists have found that a combination of THC and CBD can lower insulin resistance while increasing its potency in the body. These same patients weren’t treated with insulin and tolerated both CBD and THC well (3).

A study from 2018 shows that low-dose CBD can increase glucose uptake, decrease fat accumulation, and reverse insulin resistance in rats (4). This may be an indication of further clinical trials in humans. Despite being effective in rodents, CBD may not work the same in human subjects, so it’s necessary to test its efficacy on a broader scale.

Can You Replace Metformin with CBD?

Research has yet to prove whether or not CBD is a safe alternative to metformin use in diabetic humans. Most of the studies on CBD’s effect on diabetes were conducted on rodent models.

For example, one 2016 study on non-obese diabetic mice has shown that CBD can lower the risk of diabetes by altering the response in the immune system in rodents. The non-treated mice had an 86% probability of developing diabetes, while subjects that took CBD only had 30% (5).

The administration of CBD also significantly lowered plasma blood levels of the pro-inflammatory cytokines, while also lowering the possibility of inflammatory liver damage — the underlying cause of type 1 diabetes.

Finally, a 2019 study on diabetic rats tested the therapeutic properties of CBD in both ischemic disease models and diabetes (6). The study revealed that CBD reduces neuropathic pain, improves memory performance, and reduces hippocampal levels of inflammation markers (6).

According to cannabis experts, CBD-rich products can be used to target the symptoms of diabetes. Since there are limited data on CBD’s efficacy in the human models of type 1 and type 2 diabetes, it’s always best to seek professional advice from a doctor before considering replacing metformin with CBD oil or edibles.

Drugs That Can Interact with Metformin

Metformin consists of positively charged molecules (cations) that can be processed by the same enzymes as similarly charged drugs for renal secretion through cation transporters found in the kidneys.

Cationic medications that can interact with metformin include quinidine, procainamide, trimethoprim, digoxin, and vancomycin. These drugs can be purchased over the counter for heartburn and may contribute to a case of metformin-associated lactic acidosis (MALA).

Here’s the list of other medications that can interact with metformin:

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

Combining the aforementioned drugs with metformin may result in too-low blood sugar levels in the body. Patients need to monitor their glucose levels frequently to avoid sudden changes.

The following drugs can reduce the kidneys’ capacity to flush metformin from the blood and thus cause lactic acidosis:

• Cimetidine
• Dolutegravir
• Ranolazine
• Vandetanib

We encourage you to consult a doctor to determine if these drug combinations are worth the risk. There may be a safer alternative that doesn’t entail the same risk of danger.

If you want to avoid increasing the risk of lactic acidosis when using metformin, it’s better to abstain from taking carbonic anhydrase inhibitors such as topiramate or acetazolamide.

Lactic acidosis may be detected early if patients taking CAIs together with metformin are monitored during their treatment.

Your doctor can also change the dosage or even suggest a safer, alternate medication to manage your blood glucose levels if metformin itself has too heavy side-effects on your health.

People changing immediate-release to extended-release metformin pills may experience fewer cases of diarrhea, as reported by a study in 2004.

Anemia and vitamin B-12 deficiency are also possible in people who have been taking metformin for at least a few months. Supplementing iron and vitamin B-12 may help prevent these problems if they occur in long-term metformin users.

What Experts Say About CBD and Metformin

Allan Frankel MD, an experienced physician and expert in GreenBridge Medicinal in Santa Monica, believes that CBD and metformin can be taken in tandem, but it requires proper care from your doctor. He also claims that patients can become able to ditch their type 2 diabetes medications thanks to using CBD.

“We have seen a substantial lowering of their [CBD patients] glucose levels in those with Type II Diabetes including several patients’ Hemoglobin A1C levels normalize so they are able to stop their Type II Diabetes medications, he said.”

However, CBD can cause blood glucose levels to drop too much due to their combined effects.

 “The first time I saw this with a Diabetic, he called me after having some hypoglycemic episodes while taking CBD in addition to his Metformin, Frankel continues. “I told him to stop his Metformin and continue his CBD. His glucose levels normalized and he remained off Metformin.”

According to Frankel, CBD can also raise good cholesterol levels, while lowering bad cholesterol levels by stabilizing a patient’s blood sugar levels. He says he has seen patients ditching the statin once they have seen consistent improvements in their cholesterol levels.

On top of that, CBD — especially when combined with THC — can improve the side effects caused by poorly managed diabetes, including neuropathic pain.

“We have also seen improvements ranging from apparent stabilization of macular degeneration and help with neuropathic pain. Sometimes combined with THC, CBD is an avascular and renal protectant.”

To sum up, using CBD provides a multipronged approach for treating diabetes. It can be taken in tandem with metformin, but only under the observation of your doctor. Monitoring blood glucose levels is essential for avoiding unpleasant side-effects, such as hypoglycemia. On top of blood sugar management, CBD can balance cholesterol levels and speed up metabolism.

“I believe this is all happening on a number of metabolic levels, such as bringing the sensitivity of insulin back to normal,” Frankel concludes.

Final Thoughts on CBD and Metmorfin

Metformin is an FDA-approved prescription drug for the treatment of type 2 diabetes. Patients take it on its own or with other prescription drugs with high sugar levels in the blood.

While metformin can effectively prevent diabetes in high-risk individuals, while also addressing most of its symptoms, it may cause a few adverse reactions. Fortunately, most users report that the benefits outweigh the potential side-effects.

People seeking natural treatments for diabetes often turn to CBD as their go-to supplement. CBD interacts with the human endocannabinoid system whose receptors are known to regulate blood sugar levels on top of many other metabolic functions.

Studies from animal models have demonstrated CBD’s efficacy in treating the symptoms of diabetes and managing the condition itself. While more human research is needed to confirm these findings, they are, at least to say, promising when it comes to contemporary diabetes treatments.

CBD and metformin can interact with one another because they are processed by the same system of enzymes. CBD is the inhibitor of these enzymes, meaning it can either increase or decrease the concentration of metformin in the bloodstream. This, in turn, can result in toxicity or subtherapeutic effects depending on the scenario.

As there’s no clear indication regarding the risk of taking CBD with metformin, it’s best to consult a physician who is experienced in complementary treatments. Medical advice from a professional will help you avoid potentially dangerous interactions and get the most out of your diabetes routine.

Do you take CBD and metformin together?

References:

1. Lehmann, Christian et al. “Experimental cannabidiol treatment reduces early pancreatic inflammation in type 1 diabetes.” Clinical hemorheology and microcirculation vol. 64,4 (2016): 655-662. doi:10.3233/CH-168021
2. Clark, T et al. “Theoretical Explanation for Reduced Body Mass Index and Obesity Rates in Cannabis Users.” Cannabis and Cannabinoid Research, vol 3,1 (2018): 259–271.
3. Frisher, M et al. “The Role of Cannabis and Cannabinoids in Diabetes”. The British Journal of Diabetes & Vascular Disease, vol 10,6 (2010): 267–273.
4. Ramlugon, S., Levendal, R.A., and Frost, C.L. “Time-dependent Effect of Phytocannabinoid Treatments in Fat Cells”. Psychotherapy Research, vol 32,3 (2018).
5. Lehmann, Christian et al. “Experimental cannabidiol treatment reduces early pancreatic inflammation in type 1 diabetes.” Clinical hemorheology and microcirculation vol. 64,4 (2016): 655-662. doi:10.3233/CH-168021
6. Santiago, Amanda Nunes et al. “Effects of Cannabidiol on Diabetes Outcomes and Chronic Cerebral Hypoperfusion Comorbidities in Middle-Aged Rats.” Neurotoxicity research vol. 35,2 (2019): 463-474. doi:10.1007/s12640-018-9972-5