CBD and Lupus: Latest Research, Benefits & Side Effects
The recently-discovered connection between CBD and lupus shows great promise.
The pursuit in trying to find the cure for lupus continues as the therapeutic potential of CBD is yet to be fully discovered. Nevertheless, there is ample evidence today to begin engineering a novelty lupus medication.
Therefore, the main goal of this article will be to provide the answer to the question — “ does CBD help treat lupus ?”
What Is Lupus?
Lupus is associated with the inflammation of almost any part of the body. It is a chronic condition with an autoimmune mechanism — in other words, the organism starts producing altered antibodies that attack healthy human cells.
Inflammation is a complex physiological process that occurs in damaged or infected tissue. It entails a multitude of biochemical reactions, including immune cells, tissue cells, and signaling molecules.
As a result, the main perk of using cannabis for lupus lies in the plant’s anti-inflammatory traits.
Causes of Lupus
Lupus has no known roots. Nonetheless, the many testimonies of modern medicine have recognized the main factors that contribute to the onset of lupus:
- Genetics — Autoimmune diseases can be inherited.
- Hormones — Hormone fluctuations can trigger inflammation, especially estrogen.
- Gut microbiota — Due to a dysfunction of the gut bacteria, intestinal cells tend to produce more inflammation and overstimulate the immune system.
- Environmental influences — Like heavy metals, chemical toxins, pathogens, emotional stress, and drugs.
We will try to uncover whether using extracts of medical marijuana for lupus influences any of these factors and whether CBD falls into the category of lupus treatment options.
Lupus is not just a single disease but a collection of conditions with the same biological response to a hyperactive immune system. Medically, there are four main types of lupus:
- Systemic lupus erythematosus (SLE) — The most prevalent and most severe case.
- Cutaneous lupus erythematosus (CLE) — Affects the skin, mostly in the form of rashes and lesions.
- Drug-induced lupus — Passes with the elimination of certain drug treatments.
- Neonatal lupus — Hereditary and extremely rare.
The use of CBD for lupus can be considered in both SLE and CLE cases .
Major Lupus Statistics
- There are at least 5 million lupus patients worldwide.
- Lupus develops between the ages of 15 and 44.
- 90% of lupus patients are women.
- There are 16,000 new cases of lupus diagnosed each year in the US.
- Approximately 1.5 million people have multiple lupus symptoms, but not the diagnosis.
- There is no connection between the cultural use of marijuana and lupus incidence.
Diagnostic guidelines for lupus define that if a person has at least 4 out of the 11 known criteria, a doctor may confirm the diagnosis:
- A butterfly-shaped rash that covers the cheeks and nose (malar rash);
- A series of red patches that raise above the skin (discoid rash);
- Oral or nasal ulcers, or soreness of the mouth;
- Inflammation on the heart or lungs; “lupus lungs” are expressed by piercing chest pain while breathing;
- Non-erosive arthritis;
- Kidney disorder (lupus nephritis);
- Presence of seizures or cognitive problems;
- Low blood cell count;
- Positive immunologic disorder test;
- Positive antinuclear antibody test.
However, the most prevalent use of CBD for lupus is to treat flare-ups — they are considered exacerbations and are defined as joint and muscle pain, fever, fatigue, eye inflammation with eye dryness, and a higher risk of blood clotting.
- Coronary heart disease — Decreases blood flow to the heart, causing heart attacks in most severe cases.
- Brain diseases — Impaired vision, cognitive and behavioral problems, including higher risks of strokes or seizures.
- Kidney disease — Kidney failure is one of the leading causes of death in SLE patients.
- Blood vessel inflammation — Restricts blood flow causing organ and tissue damage.
- Lung disease — Often results in respiratory failure.
Lupus symptoms can hide behind different diagnoses for years. What’s more, it’s safe to say that the extensive use of recreational cannabis for treating lupus symptoms helped popularize the many health benefits of CBD and spurred further research into the matter.
Lupus Treatment Options
Is there a cure for lupus?
No, there is not. On the other hand, some treatments can help alleviate the symptoms, treat pain or slow down the progression of the disease.
Certain life habits, such as avoiding sunlight, practicing meditation, and physical activity, can prolong remissions and delay lupus flare-ups.
Natural Treatment for Lupus
Natural remedies include the use of ginger, coconut oil, Epsom salts, and flaxseed. Some preparations contain cannabis, yet there is still no concrete evidence on the effects of CBD and lupus outcomes.
Nonsteroidal anti-inflammatory drugs (NSAIDs)
These are OTC preparations, such as ibuprofen creams or naproxen tablets. They are the most common lupus pain medications used to treat joint, muscle, and head pain.
Their continuous use often leads to indigestion, stomach erosion, lower immune responses, and additional complications.
They are used for pain, rashes, and lung inflammation. The most commonly used medication is hydroxychloroquine (Plaquenil). This drug, however, can cause headach es, weight loss , and stomach pain.
Can you take CBD oil with hydroxychloroquine ? It seems so since it shows no interactions with cannabis. However, you should always consult with your doctor.
They are used for lupus flare treatment and can be used orally or in a topical form, in the case of rashes. The most frequent steroid used is prednisone.
Prolonged external use of steroids leads to skin thinning and skin cracks. In contrast to CBD oil, lupus steroid treatment in the long-term can seriously harm the immune system.
Other medications include B-lymphocyte specific inhibitors (belimumab) and immunosuppressants (methotrexate, azathioprine, cyclophosphamide).
Lupus Disease Outlook
Severity and outlook depend on the organs that are involved in the autoimmune response. Most people with lupus can expect to live an average lifespan. However, the quality of their lives can vary.
What Is CBD?
Cannabidiol (CBD) is a non-psychoactive substance abundantly found in cannabis plants, proven to have intense physiological activity and great therapeutic potential.
CBD oil — the most commonly used form — was medically studied in the form of a purified hemp extract that can be standardized and adequately dosed. Overall, a large variety of CBD oil-infused health products are available on the market today.
There are also edibles (g ummies, chocolates, brownies, chewing gum, etc.), liquid drops, pills, smokables, eye drops, suppositories, and topical products (ointments, cremes, gels, salves, and balms). Most of these are neither produced nor regulated as drugs.
Epidiolex is the only cannabis-based drug on the market today; it was the first FDA-approved CBD epilepsy treatment.
How Does CBD Oil Work?
CBD binds with the cannabinoid receptors in the body that control our homeostasis through multicellular activity. There are two types of cannabinoid receptors:
- CB1 — Primarily located in the nervous system, connective tissues, and glands.
- CB2 — Prevalent in the immune system, heart, bones, kidneys, lymph nodes, liver, and spleen.
These receptors and their human ligands comprise the endocannabinoid system. Isolated CBD strains bind mainly to CB2, therefore regulating the overall immune system and inflammation.
CBD oil enhances the homeostatic activity in the organism by regulating movement, energy, the immune system, bone metabolism, and endocrine functions. The main therapeutic potential of cannabis oil for lupus is found in its anti-inflammatory effects.
Health Benefits of CBD
As mentioned before, CBD can be used for a variety of indispositions and symptoms:
There is also data that supports the use of CBD oil for inflammation , sleep, stress, nervousness, and irritability. More studies suggest using pure CBD oil for autoimmune diseases.
Regardless of the growing amount of data on similar health topics, the status of CBD oil for lupus is still far from being official. Nevertheless, lupus CBD treatment can still fall upon its former laurels, namely, the evidence of its antirheumatic use.
Antirheumatic Properties of CBD
Rheumatic diseases are autoimmune in nature. Health benefits of CBD have been confirmed in treating inflammatory rheumatic conditions, such as acute arthritis and osteoarthritis . Researchers clearly state that there is potential in treating other chronic rheumatic diseases associated with inflammatory pain, like lupus.
Various case studies have confirmed the efficiency of CBD in treating pain with other autoimmune diseases, including systemic sclerosis and fibromyalgia.
Different CBD and Lupus Treatments
As previously mentioned, there is no permanent cure for lupus, and the disease has multiple symptoms and a variety of comorbidities, making it hard to treat. However, given the variety of CBD oil’s health benefits, there is massive potential in its use in both direct lupus symptom treatment and as complementary medicine.
There is also evidence that implies that CBD is a potential lupus medicine. It can be used as an independent remedy to treat lupus symptoms directly or as a form of support to the existing treatment.
Joint and Muscle Pain
In 2017, researchers quantified the efficiency of CBD on chronic pain by emphasizing its use in autoimmune diseases.
The link between CBD and lupus i s found in its anti-inflammatory properties, which influence immune system cells via CB2 interactions. CBD suppresses the intestinal inflammation that triggers an autoimmune response.
In addition, the anti-inflammatory effects in mean tissues can also inhibit multiple organ flare-ups.
Furthermore, topical creams can be used as a quick pain relief for lupus back pain.
When used without steroids or NSAIDs, CBD can prolong the period of lupus remissions, thus increasing the quality of life.
In mild to moderate cases , calculating the CBD dosage for lupus pain begins with smaller doses and increases over time. To achieve a systemic anti-inflammatory effect, you’ll need 100 mg daily doses and higher.
In severe cases of SLE, you should use CBD oil in titrating doses. However, when adjusting the dosage, consider multidrug interactions. In concomitant use, the CBD doses needed for immunosuppression are also lower.
Systemic weakness is a state that usually follows lupus flare-ups . In the case of possible drug interaction, CBD oil can be used solitary for total system recovery.
Homeostasis maintenance is the link between CBD oil and lupus fatigue treatment. This is based on the anti-anxiety effects of CBD .
Using it can help lupus warriors cope with pain, stress , and nervousness. Furthermore, CBD balances the homeostatic processes in the organism via CB2 receptors, shortening the recovery time and rebalancing the neurotransmitter levels in the brain.
CBD proved effective for migraine treatment as well and has certain neuroprotective effects in people with multiple sclerosis .
You can achieve the same neuroprotective effects with smaller doses of CBD to treat headaches, memory problems, dizziness, and neurology-related behavioral problems. In severe cases of lupus, cannabis products can lower the incidence of seizures.
CBD is considered preventive medicine for cardiovascular events in lupus treatments as it reduces heart inflammation and lowers blood pressure. Overall, cannabidiol in combination with Plaquenil could prove extremely beneficial.
You can also accomplish the protective effects by using lower doses of CBD for more extended periods. Still, you should not use CBD oil with high THC content for this effect.
CBD-containing eye drops can reduce corneal inflammation in patients with eye injuries.
You can use sterile CBD eye preparations for dry eyes and eye inflammation, which accompanies lupus. This way, interactions are minimal or non-existing.
CBD Oil for Lupus Lungs
There is evidence with promising results for treating lung cancer patients with CBD. “Lupus lungs” is predominantly an inflammatory condition. It develops through a period of consistent autoimmune inflammation.
The long-term use of low CBD doses could result in chronic suppression of inflammatory immune components.
A 2014 research defines the cannabinoid structure of the skin as extremely sensitive to exogenous cannabinoid stimulation. Therefore, the anti-inflammatory effects of CBD could be efficiently applied to inflamed skin tissue.
The difference between cannabis oil and lupus topicals (steroids) is that CBD-based products have significantly fewer side effects.
Depending on the skin surface that is afflicted, you can use different topical preparations. As a general treatment, you can use creams or ointments with 5 to 10% CBD .
Limitations of CBD and Lupus Treatment
The most frequent side effects of CBD include symptoms such as a dry mouth, drowsiness, lightheadedness, and drops in blood pressure. If any of these do occur, you should exclude CBD products from therapy.
CBD drug interactions happen in liver cells. Cannabidiol inhibits the expression of certain liver enzymes that are responsible for the metabolism of many foods and drugs.
Most of the NSAIDs used for lupus and CBD oil should not be taken together!
The main problem with this therapy concerns drugs that treat pain and inflammation, such as ibuprofen, naproxen, diclofenac, ketorolac, and ketoprofen.
When taken together, CBD can elevate the blood levels in the body, inadvertently causing heart problems, stomach erosion, lung problems, and even cause bleeding.
What drugs should not be taken with CBD?
Given that CBD can alter the effects of other medications, which can result in them not working, you need to stay away from 57 drugs . Some of them are:
CBD interacts with steroids, but not with prednisone.
Taken together, they can lead to liver damage, kidney damage, and immune suppression. On the other hand, there are no known reactions between commonly used, lighter steroid prednisone and CDB.
CBD oil and Plaquenil can be used together.
Both Plaquenil and CBD oil are known to lower blood pressure and cause a dry mouth. If the treatment is based upon the two, these symptoms need monitoring.
As lupus has many accompanying conditions with its own set of drugs, you should always consider possible interactions.
Are There Any New Treatments for Lupus?
The FDA approved two drugs for the treatment of lupus. The first one is a calcineurin inhibitor called voclosporin that will be used as the new treatment for lupus nephritis.
The second one is the intravenous form of belimumab . As this drug has been approved in the US, Canada, and Europe for the treatment of systemic lupus erythematosus (SLE) since 2011, in late 2020, the FDA approved belimumab (Benlysta) for the treatment of active lupus nephritis.
Other studies show daratumumab can also be helpful as an alternative therapeutic approach since it managed to induce remission in 2 patients with lupus nephritis. Be that as it may, more studies are necessary to determine daratumumab’s efficacy in treating lupus.
When it comes to cannabis and lupus , a study from 2017 shows that lenabasum , an experimental cannabinoid drug that binds to CB2, can reduce the inflammatory cytokines TNF-alpha and interferons.
In the second phase of the clinical trial, lenabasum reduced dermatomyositis and skin inflammation in two months.
This practically means that if there is proof that cannabinoids (like lenabasum) can reduce inflammation and are safe to use, they could potentially help with autoimmune disease treatment.
How Can You Calculate CBD Oil Dose for Lupus?
Considering that most CBD-containing products are not FDA-approved as medication, there is no defined dosage or even a recommended daily allowance table for lupus. According to research , the best dosing strategy in general includes the appliance of CBD dosage for inflammation.
The initial anti-inflammatory dose of CBD is 10 to 20 mg per day, which could be increased by 5 mg per week until the desired symptom relief is reached.
In other words, CBD dosage for lupus entails introducing the substance in smaller doses and then gradually increasing the dosage until the desired therapeutic effect is achieved.
There is no official concern about overdosing. CBD is sometimes used in doses of 200 mg per day for epilepsy symptoms. A safety study from 2011 claims that humans can tolerate doses as high as 1500 mg per day.
How much CBD oil to take for lupus? — if your doctor agrees, you should discover your own dosage gradually, so long as there are no conflicting drug interactions or emerging CBD oil side effects.
Which Is the Best CBD Oil for Autoimmune Disorders?
Fortunately, there are plenty of CBD brands on the market offering CBD oil of the highest quality . In order to recognize them, when purchasing CBD oil, make sure to:
- Get a certificate of analysis
- Make sure it’s legal in your state
- Buy only industrial hemp CBD
- Consult with your doctor
What Strain Is Good for Lupus?
Each strain provides different treatments, so if you need to choose one, base your decision on your symptoms. Some of the most common lupus symptoms are:
- Chronic pain
- The best CBD strain for lupus pain could be Afghan Kush (Indica) because it’s one of the purest Indica strains with a strong pain-relieving effect.
- Good strain for lupus inflammation could be Harlequin (Sativa) because of its extremely high CBD content.
- A nice strain for lupus fatigue could be Charlotte’s Web (Sativa) — because of its high levels of CBD and high quantities of pinene.
Supportive and Preventive Use
In contrast to symptomatic use, CBD products can be effective as a supportive treatment, treating the side effects of other drugs, thus promoting detoxification during remissions. You can achieve favorable effects with lower doses of CBD.
In predisposed people, emotional stress can be a potent inducer of lupus, and cannabis products have been long used in relieving stress. Neurophysiological effects of CBD could help delay the disease onset.
Furthermore, you could use CBD oil for its digestive stimulating properties. Healthy digestion not only helps lupus patients but also prolongs the quiet phase and lowers the autoimmune response.
There is a copious amount of evidence that supports the use of CBD as an anti-inflammatory substance. It is well tolerated and produces clinically relevant health effects. In addition to that, you can use cannabidiol products to prevent and treat lupus symptoms.
However, due to the complex nature of lupus symptomatology, we can make no universal recommendation because every case has its own calculation.
Lupus patients should always consider consulting their physician or pharmacist to assess risks, benefits and calculate the correct dosage.
Regarding the relationship between lupus and CBD , it is safe to say that we can expect to see more clinical data in upcoming years.
Does CBD help lupus?
CBD has many physiological effects that can relieve lupus symptoms. For example, you can use it to prevent a flare-up. Moreover, its anti-inflammatory and neuroprotective properties help reduce pain and other accompanying health problems.
Can CBD worsen lupus treatment?
There is no evidence that CBD products can worsen lupus symptoms or onset lupus flare-ups. They are considered helpful but not officially prescribed by doctors. In fact, people who take many medications for lupus need to be cautious because of the possible CBD-drug interactions.
Can CBD help with autoimmune disease?
CBD helps reduce the hyperactivity of the immune system that is responsible for autoimmune disease development. There is clinical evidence that supports the benefits of CBD in treatments of rheumatoid arthritis and fibromyalgia, which are considered autoimmune diseases.
Conversely, cannabis does not always aid the immune system.
Can medical marijuana help lupus?
There is empirical evidence that marijuana can help with lupus symptoms, such as nervousness, pain, indigestion, seizures, and eye problems. However, there are higher chances of psychoactive side effects with the use of THC preparations.
On the other hand, CBD products have more benefits and fewer contraindications.
How much CBD oil should I take for lupus?
There is no defined CBD dose for lupus. You should calculate it according to the symptoms and in consideration of other drugs used. If you plan to use CBD products, always consult with your doctor about the proper dosage.
What foods trigger lupus flare ups?
You could avoid some types of foods to quiet down lupus flare-ups.
Alfalfa sprouts and garlic are considered immunostimulants and could fuel the autoimmune response.
Additionally, processed meat and additive-infused bread and bagels could acidify the digestive composition in the gut and induce an intensive immune reaction.
Can I use meds with lupus and marijuana?
The majority of lupus medications are metabolized in the liver. Therefore you should thoroughly reconsider the use of cannabis.
For example, you shouldn’t use steroids, other than prednisone, with marijuana, along with most NSAIDs. On the other hand, Plaquenil appears to have no interactions on this level and could be considered a safe choice regarding CBD and lupus treatment.
About the Author
I think in milligrams every day; how much is enough, and what amounts can cure you or hurt you. My morning dose of caffeine gives me focus. And for the rest of the day, I think about herbal remedies, medical devices, supplements, nutrients, and heavy medication. By day, I work with drugs behind the counter. By night, I think about apostrophe misplacements. By day, I try to explain substances to others, and by night, I explain complex sentence structures to myself. I am a pharmacist and a writer.
Is CBD Oil for Lupus Safe or Effective?
Adrienne Dellwo is an experienced journalist who was diagnosed with fibromyalgia and has written extensively on the topic.
Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more.
Riteesha G. Reddy, MD, is a board-certified rheumatologist and internist at a private practice in Dallas, Texas.
CBD oil, which is derived from marijuana, has become a trend when it comes to treating diseases involving pain and inflammation. But is it effective for lupus?
So far, we don’t have conclusive evidence that CBD oil can safely treat lupus, but research is currently being conducted to help make this possible.
Because medical marijuana is still fairly controversial, and the laws are confusing, there’s a lot of confusion and misinformation out there about CBD. That can make people hesitant to try it. Good news though—a new law is simplifying the matter for many of us.
What Is CBD Oil?
CBD is short for cannabidiol. While it comes from cannabis, it doesn’t get you high because it doesn’t have psychoactive properties. The high comes from a different chemical in the plant called THC (tetrahydrocannabinol).
Marijuana growers focus on strains and techniques that increase THC levels. Cannabis that’s grown for hemp tends to have a lot more CBD than THC.
If you look online, you can find a lot of claims about using CBD oil for medicinal purposes. Claims are so glowing, in fact, that you might start to wonder if they can possibly be true. Certainly, when they come from websites that promote marijuana legalization and use, you may be wise to question the veracity.
It’s too early in the research process for us to be able to say “yes” about many of the claims. However, we’re learning enough to be able to say “it’s possible,” or even, “we think so.”
CBD oil is used to treat a host of different conditions, although it’s not approved for any of these conditions, as of mid-2018:
- Chronic pain and inflammation pain
- Sleep disorders, including insomnia and nightmares
- Bipolar disorder
- Movement disorders (Huntington’s disease)
- Assistance with smoking cessation
- Stopping the growth of cancerous tumors
When it comes to taking CBD oil, you have a lot of options: smoking, taking capsules, drops or sprays under the tongue, and as a topical ointment. Research in the United States is in the early stages, though, since for decades, legal restrictions made it extremely difficult to study the medical benefits of marijuana.
CBD Oil for Lupus
With a lack of research on CBD oil for lupus, we have to go on what we know about CBD in general and can understand from research into conditions with similar symptoms or pathology. This potential treatment is likely to get attention from lupus researchers eventually, though, for several reasons.
- Lupus contributes to an epidemic of pain, including untreated and undertreated pain. Current treatments are far from perfect, so drug companies have a sizable financial incentive to find more effective medications.
- The opioid addiction/overdose epidemic is a huge problem for society and puts a lot of strain on the resources of the medical community, as well as law enforcement. Meanwhile, several studies have shown that when marijuana becomes legal in a state, the number of opioid prescriptions—and overdose deaths—drops. That’s bound to get the attention of healthcare providers who want to protect their patients, law enforcement agencies battling the problem, and lawmakers seeking solutions.
- A wealth of research suggests that CBD oil is effective against pain and inflammation, both characteristics of lupus. In its pure form, CBD oil is generally regarded as safe.
- We have abundant anecdotal evidence from people with lupus who say it’s effective. That can’t substitute for scientific proof, but it’s one more thing that gets healthcare providers interested.
Additionally, a 2018 study published in Cellular Immunology found that CBD may alter T-cell activity after spinal cord injury. Abnormal activity of T-cells—which are part of the immune system—are believed to be involved in lupus.
Lupus can include pain from neuropathy (nerve damage), and multiple studies suggest that CBD can alleviate that type of pain from diabetes, HIV, and other sources.
CBD Side Effects
We probably don’t yet know all of the possible side effects of CBD. Some side effects that have been reported are:
- Changes to liver enzymes used to process drugs
- Dry mouth
- Low blood pressure
- Increased tremor in Parkinson’s disease (at high doses)
The World Health Organization says CBD oil may also:
- Alter hormonal levels
- Stimulate the immune system at low levels, and suppress it at higher levels
CBD doesn’t appear to lead to addiction or abuse. It’s also believed to have a low toxicity level, which means it takes a lot to cause an overdose.
Is CBD Legal?
You’d think the question of whether CBD is legal would get a straightforward, yes or no answer, but the legality issue can be confusing.
A lot of pro-marijuana websites have long claimed that it’s legal in all 50 states as long as it doesn’t have more than 0.3% THC. They based that argument on the provisions of a specific farm bill. But in 2018, the 9th Circuit Court of Appeals ruled that the old bill didn’t apply to hemp or products derived from it.
Then came the 2018 Farm Bill. This piece of legislation was wildly popular in both the Senate, where it was passed in June of 2018, and the House, where it was passed in December of 2018 and then quickly signed into law. It re-classifies hemp as a legal agricultural product, which makes CBD products legal at the federal level.
In states where marijuana and/or CBD is legal, there’s no longer a clash between state and federal law, so the products are legally safe to use. Still, some states have specific laws on the books banning hemp products. So what does the Farm Bill mean for those states?
Technically, federal law overrules state law. However, that doesn’t mean those states will stop arresting and trying people for CBD use, especially if they want to challenge the new federal law. If you’re in one of those states, talk to an expert about any possible trouble you could get into for using CBD products. The website ProCon.org has information about which states have laws specific to CBD oil. A site called Governing maintains a map of where marijuana is legal in some form.
The only form of CBD that is FDA-approved is Epidiolex, a purified formulation of CBD used for rare forms of epilepsy. All the other CBD sources being enthusiastically marketed today are unregulated. They often contain amounts of CBD that are substantially different (too much or too little) than the labels indicate, and frequently contain higher levels of THC (the intoxicating chemical found in marijuana) than is permitted in a legitimate CBD product. Anyone choosing to use CBD should be cautious about the product they select and ideally consult with their healthcare provider before using it.
A Word From Verywell
Treatment decisions should never be taken lightly, and that applies to “natural” treatments like CBD as well—especially when you take the law into account. Consider the pros and con carefully, and be sure to discuss this option with your healthcare provider. As with any treatment, it’s important to watch for side effects.
With legal changes in store and lots of research coming out, we can probably expect a lot of change, and quickly, when it comes to CBD oil.