Does CBD Interact With Folic Acid?

Is It Safe to Take CBD & Folic Acid Together?

Due to the lack of information about the interactions between CBD and folic acid, it cannot be said for sure that both medications should be taken together.

In pregnancy, due to its possible ability to decrease the uptake of folic acid in the fetus and very high chances of fetal defects, it may be best to avoid taking them both together. You must first consult your doctor and get their expertise regarding this matter.

In other conditions, the most effective thing to do is to finish the course of one drug before beginning the other one to minimize side effects. But if you wish to take them both together, you should put adequate timing between the dosage of both the drugs or take them on alternate days.

Never start taking the medications by yourself, and always consult your doctor for any concerns. If you get any abnormal side effects, get medical attention immediately.

Is CBD a Viable Alternative to Folic Acid?

With the minimum amount of research done about the uses of CBD, it can not be considered a perfect substitute for folic acid. But there are a few notable points.

CBD can reduce symptoms that are associated with anemias. Such as a fast or irregular heartbeat. It has been shown to alleviate irregular heartbeat in cases of ischemic heart disease [3] and may also provide the same benefits for the one caused by anemia.

CBD may act as an antioxidative and also decrease inflammation which could lead to anemia [4].

Despite these benefits, we need more research to verify CBD’s health benefits.

What Is Folic Acid?

Folic acid is an essential vitamin needed by the body. It gets converted into folate or vitamin B9 in the body, and its deficiency can cause anemia and neural tube problems in the fetus. Folic acid is needed for making DNA and RNA and to metabolize amino acids for cell division.

Drug table of folic acid:

What Does Folic Acid Do?

Folic acid is a vitamin required to make purines, pyrimidines, and methionine. It’s necessary for phases of cell division such as infancy, pregnancy, and producing red blood cells. Its synthesis does not occur in the body, so its supplementation in the diet is required. It is present in green vegetables, beans, avocado, and some fruits.

Folic acid is indicated in its deficiency, in megaloblastic anemia, anemias of nutritional origins, pregnancy, infancy, or childhood.

Folic acid is an antecedent of tetrahydrofolic acid. It is a vital component in the biosynthesis of purines and thymidylate enzymes of nucleic acids. Its impairment can cause defective deoxynucleic acid (DNA) synthesis.

This defect leads to megaloblast formation and megaloblastic and macrocytic anemias. Folic acid can also be protective against cancer.

Folic acid must first be reduced by the enzyme called dihydrofolate reductase (DHFR). It converts it into the cofactors dihydrofolate (DHF) and tetrahydrofolate (THF). These structures are transported across cells by receptor-mediated endocytosis.

They will then start producing blood cells, synthesize purine and thymidylate nucleic acids. They can also interconvert amino acids, methylate tRNA, and generate and use formate.

Folic acid is a supplement provided in pregnancy to prevent neural tube defects in the baby. Those with alcoholism also supplement it to prevent the manifestation of neurological disorders.

The deficiency of folic acid can cause many other health problems such as cardiovascular diseases and cognitive deficits.

Side Effects of Folic Acid

• Behavior changes
• Bronchospasm
• Confusion
• Diarrhea
• Erythema
• Irritability
• Malaise
• Metallic taste
• Nausea
• Pruritus
• Rash
• Seizures
• Skin reactions
• Slight flushing
• Stomach upset

Types of Drug Interactions With CBD

CBD can interact with many other medications. These interactions can raise their effects, decrease their effects, or block them altogether. So always be alert about the possible side effects when taking any medications with CBD.

The three ways that CBD can interact with other drugs are:

1. Agonistic Interaction

This interaction happens when two medicines have the same effect on the body by working on the same receptors. It causes the reaction to move in the same direction.

The medications that cause agonistic interaction with CBD are:

• Antihypertensive Medications — CBD can cause a drop in blood pressure while working alongside these medications. These include beta-blockers, calcium channel blockers, central agonists, diuretics, ACE inhibitors, alpha-blockers, and angiotensin II receptor blockers.
• Antidiabetic medications — CBD could increase the blood sugar-lowering ability of these medications. These medications include GLP-1 receptor agonists, meglitinides, SGLT-2 inhibitors, sulfonylureas, insulin, alpha-glucosidase inhibitors, and DPP-4 inhibitors.
• Anti-anxiety medications — CBD could make their effects last longer and cause many side effects. These include benzodiazepines and barbiturates, etc.

2. Antagonistic Interaction

This is the opposite of the agonistic interaction. If taken together, one drug would cross out the effects of the other, causing a decreased efficacy of the second drug.

Drugs that have antagonistic interaction with CBD are:

• Immunosuppressants — CBD has immune-stimulating properties, which may cause diminished effects of these drugs. These include azathioprine, mycophenolate cyclosporine, methotrexate, etc.
• Stimulants — These include amphetamine, modafinil. CBD can cause a drop in its effects.
• Immunomodulators — These include antihistamines like carbinoxamine, desloratadine, levocetirizine. CBD could enhance their sedative action.
• Asthma Medications — These include drugs like albuterol, fluticasone, montelukast, ipratropium bromide, and theophylline. CBD may hinder their abilities, especially that of theophyllines.

3. Metabolic Inhibitors

Some medications need similar enzymes to break down the drug molecules. It leads to both drugs competing against each other, causing their metabolism to slow down.

These include medications like:

• Blood thinners — CBD could cause an increment in the action of warfarin, enoxaparin, heparin, and others that could be very unsafe.
• NSAIDs — These include ibuprofen, naproxen, high-dose aspirin. CBD could make them last longer in the body.
• Opiate analgesics — These include morphine, codeine, hydrocodone. CBD could make them last longer in the bloodstream, creating complications.
• Antidepressants — CBD can make these drugs last longer in the body by diminishing their metabolism. Antidepressants include trazodone, mirtazapine, vortioxetine, and vilazodone, and others.

Key Takeaways: Is It Safe to Take Folic Acid With CBD?

Folic acid can enhance the uptake of cannabinoids and may do the same for CBD as well. However, it can cause ineffectiveness of folic acid if taken in pregnancy, causing neural tube defects in the fetus. Consuming them together may be dangerous in some conditions.

Consult your doctor before you start them out and put adequate timing between their doses. If any concerns arise, seek medical attention immediately.

References

1. Rossia, N., Pighinb, A., Clegga, J., Huia, J., Houlahana, E., & Nga, D. (2002). Stoners eat your broccoli: Folic acid enhances the effects of cannabinoids at behavioral, cellular, and transcriptional levels. European Journal of Pharmacology, 396, 189-198.
2. Friedrich, J., Khatib, D., Parsa, K., Santopietro, A., & Gallicano, G. I. (2016). The grass isn’t always greener: The effects of cannabis on embryological development. BMC Pharmacology and Toxicology, 17(1), 1-13.
3. Walsh, S. K., Hepburn, C. Y., Kane, K. A., & Wainwright, C. L. (2010). Acute administration of cannabidiol in vivo suppresses ischemia-induced cardiac arrhythmias and reduces infarct size when given at reperfusion. British journal of pharmacology, 160(5), 1234-1242.
4. Atalay, S., Jarocka-Karpowicz, I., & Skrzydlewska, E. (2020). Antioxidative and anti-inflammatory properties of cannabidiol. Antioxidants, 9(1), 21.