The popularity of CBD products continue to be on the rise. However, there have been concerns about the interaction of CBD with other substances. CBD’s potential health benefits are well documented, and medical experts are working around the clock to establish the interaction of this cannabinoid with other substances in the human body.
Medical experts have also considered CBD for its potential as an alternative for managing various conditions for a long time. Particularly, CBD has been thought to have similar effects to that of steroids. These remain the first-line treatment for over 100 chronic inflammatory conditions and autoimmune diseases. But how do these two compare? And could CBD replace or lessen the use of steroids? Let’s take a deeper look at CBD vs steroids.
What Are Steroids?
Steroids could have different meanings. However, in this context, they are artificial medicines designed to mimic hormones in the human body and are largely used to manage inflammation. Generally, there are two types of steroids: corticosteroids and anabolic-androgenic steroids (or simply anabolics). Corticosteroids are used to fight inflammation in the body, as they work like the hormone cortisol. Cortisol works by inhibiting the enzymes associated with inflammation after infection or injury.
Anabolic-androgenic steroids are the artificial form of the hormone testosterone, the male sex hormone associated with building muscles. Due to their muscle-boosting potential, these steroids are commonly abused, but the side effects could be devastating. As such, they should only be used on a doctor’s advice to avoid adversities.
How Do Steroids Reduce Inflammation?
The anti-inflammatory effect of steroids is complex. Generally, corticosteroids reduce inflammation by influencing the vasoconstriction and vasodilation of blood vessels, the activity of inflammatory cells, and by releasing proinflammatory mediators. They also help manage autoimmune diseases by reducing the activity of the immune system.
Steroids like prednisone work by mimicking the effects of naturally-occurring steroids (corticosteroids) in the human body. These hormones are secreted in the adrenal gland and influence various physiological functions, including the working of the immune system and regulating the inflammation process.
Inflammation is a healthy and natural response to infection or injury. Through inflammation, the immune system works more efficiently and destroys any invading pathogens. Consequently, inflammation results in pain, redness, and swelling. It is, therefore, a helpful process in the short-term, and only becomes a serious problem when it fails to die off as it should. Steroids like prednisone help treat inflammation by reducing the immune system’s activity.
How Might CBD Reduce Inflammation?
Steroids and CBD may both be useful in reducing inflammation but differ in their mechanisms. While steroids influence the release of mediators and the vasoconstriction and vasodilation blood vessels, CBD mainly works by interacting with the endocannabinoid system (ECS) in the body. Unlike other cannabinoids like THC, CBD does not bind with the CB1 and CB2 cannabinoid receptors in the brain and the immune system. Instead, it alters how these cannabinoid receptors bind with other molecules. In turn, they make these molecules more or less effective.
Specifically, CBD may inhibit the activity of the cyclooxygenase-2 (COX-2) enzyme. This enzyme is responsible for synthesizing proinflammatory mediators, and its activity in inflammatory cells could contribute to tissue damage. CBD may work by inhibiting the enzyme’s activity, therefore reducing inflammation.
Can CBD Be Used as a Steroid Sparing Treatment?
It is now clear that CBD and steroids have a thing in common: they may help reduce inflammation. The question that begs is whether CBD can be used to help manage inflammation in order to reduce the dependence on steroids. Over the years, there have been concerns over the use of steroids for inflammation treatment as some patients are unresponsive to steroid treatments. Further, medical experts warn against the continuous use of steroids for their harmful effects, including:
- Increased risk of infections
- Diabetes Mellitus
- Aseptic bone necrosis
- Growth retardation
- Weight gain
What Does Research Say?
Various studies have been done to further understand the anti-inflammatory properties of CBD. In one study, CBD gel was applied to rats with arthritic knees. After four days, it was observed that the joint swelling on the test subjects had significantly reduced and that they experienced less pain. Plenty of other studies and tests have been conducted, but it remains unclear how well CBD can function as a steroid-sparing treatment.
Mostly, steroid-sparing drugs are tested by using them in transplant procedures to prevent rejection. In an initial clinical trial, researchers used CBD to see whether it could avert graft-versus-host-disease (GVHD) in patients who didn’t respond to steroid treatment. GVHD can be a fatal condition and occurs after a bone marrow transplant. During this procedure, the donated bone marrow may view the recipient’s body as foreign and attack it.
Out of ten subjects, nine responded positively to the CBD treatment, and most of them achieved ‘complete response.’ While these studies may not have been conclusive, the researchers made two conclusions: the CBD treatment could have either enhanced the steroids’ therapeutic effect or reduced the steroid dosage needed while maintaining or boosting its therapeutic effect. Most importantly, it was noted that even steroid-resistant patients showed a significant response to the CBD treatment.
These results indicated CBD’s potential as a steroid-sparing treatment, and with this study, the plan is to test its use in treating autoimmune hepatitis and Crohn’s disease in phase II clinical trials. In these trials, patients are expected to gradually shift from steroids and immunosuppressant drugs to small amounts of CBD daily. With the initial clinical test indicating CBD’s potential as a steroid-sparing treatment, there is hope that it could soon be used in place of steroids or reduce the steroid dosage used to treat inflammation.
However, it’s important to note that any decision to come off steroids or reduce the dosage and use CBD should be backed by a doctor as its effects as an alternative to steroids is not fully known.
Does CBD Interact With Steroids?
By now, it is clear that CBD has anti-inflammatory effects similar to that of steroids. But can these substances be used together? CBD is prominent for its anti-inflammatory properties, and anyone on steroids may be wondering whether they can try CBD as well. While CBD is largely safe to use, it has the potential to interact with other drugs. One should, therefore, be careful when adding CBD to their existing steroid medication.
Whenever you take any medication or even CBD, it ends up in the liver via the digestive system. In the liver, CBD is metabolized by an enzymatic pathway known as cytochrome P450 (CYP450). This process involves various enzymes, including CYP3A4, an enzyme involved in the metabolism of CBD and about 25% of all drugs, including steroids such as prednisone. Other enzymes involved in the metabolism of steroids include CYP2D6 and CYP2C9.
CBD and steroids metabolized by CYP3A4 can compete for this pathway when taken together. Mostly, CBD inhibits the activity of this enzyme, and it might therefore take longer to metabolize the other drugs. This means that the concentration of steroids in the body can increase, which may, in turn, have undesirable side effects.
Before adding CBD to your current routine, it is advisable to consult your doctor. If your doctor advises you to avoid grapefruit juice while on steroid medications, you should also avoid using CBD. This is because grapefruit juice and CBD both interact with many of the same drugs.
Is It Safe to Use CBD and Steroids Together?
CBD interacts with many steroids, including prednisone, citalopram, fluoxetine, and gabapentin. Due to such interaction, doctors advise against using them together as they don’t consider it safe. While some people might favor using CBD and steroids to enhance the effects, it can be dangerous.
If you are already on steroid medication for inflammation and wish to try CBD, it is advisable that you speak with your doctor first.
Is It Possible to Switch from Steroids to CBD?
It may be possible to make the switch, however, we still need more research to fully understand how CBD can be used in place of steroids. Therefore, it is not recommended and you should consult your physician if you are interested in doing so.
Stopping steroid medication suddenly can lead to severe withdrawal symptoms, including:
- Extreme exhaustion
- Muscle stiffness
- Joint pain
Your doctor should tell you if and when it is safe to start using CBD. It is also important that you ask them for ways to manage symptoms in case you experience any.
CBD vs steroids: both may be effective when it comes to reducing inflammation. The effects of both on inflammation are in evidence, as doctors have long used corticosteroids like prednisone to treat it. CBD has also become popular, especially for its anti-inflammatory properties, and has lately been used by some to help manage this condition.
Following various clinical trials, it is clear that CBD might have the potential to be used as a steroid-sparing treatment in the future. However, further research is needed to fully understand CBD’s effects in this capacity. Furthermore, to use CBD and steroids together, one has to be wary of the potential interaction to avoid any adverse effects. A doctor must therefore approve any consideration to introduce CBD into their routine for the best results.