DEAR DR. ROACH: My son is taking hemp-based CBD oil for depression. He purchased this at a health food store. His doctor prescribed pills that he was unable to tolerate due to suicidal thoughts. He is unable to go outside when taking CBD. We would like to know if it will show up in a drug test as part of a job interview. Should he be taking it? — D.
ANSWER: There are animal studies and some preliminary data suggesting that cannabidiol, a nonpsychoactive substance found in cannabis, might be effective for anxiety and depressive disorders. I hope that CBD will be proven to be a useful treatment for depression, as what we have now certainly isn’t perfect. However, there are not yet high-quality studies supporting this use. The fact that your son can’t go out while taking the CBD suggests to me that it may not be effective. While the pills he had previously cannot be used, there are many treatments available for depression that have better safety and effectiveness data than CBD.
Most forensic drug testing uses THC and its metabolites, so if what your son is taking is truly CBD, then it should not be identified during testing as THC. There is a chance that the “CBD oil” he purchased has THC in it: In one study, 57 percent of CBD oils sold were found to have measurable THC, which would show up on a drug test. Unfortunately, 25 percent of the oils contained no CBD at all.
I remain convinced that these drugs, THC and CBD, need to be properly studied, and when found to be useful, tested for purity and content in the same way as pharmaceuticals.
DEAR DR. ROACH: I’ve been taking an ACE inhibitor and a calcium channel blocker for the past four months for high blood pressure as advised by my cardiologist. In my blood test a month ago, my vitamin D level was at 16. I’m also taking weekly vitamin B12 as advised by my neurologist. Can I take vitamin D2 (50,000 IU) as a weekly dose for six weeks to overcome vitamin D deficiency, or would it interfere with blood calcium balance? — B.S.
ANSWER: Vitamin D will not interfere with the action of your ACE inhibitor or calcium channel blocker. Vitamin D usually has a very small (if any) effect on blood calcium levels, as these are tightly regulated through multiple means, especially the parathyroid hormone level and the kidneys.
I see many people who are given a six-week course of high-dose vitamin D2, such as the 50,000 units weekly for six weeks you were prescribed. I do not prescribe it that way, since many people wrongly feel that this will “cure” their low vitamin D, and they stop monitoring it after the course of treatment. Many people have inadequate vitamin D levels, and although there is some disagreement about what levels need to be treated, yours is in the range where everyone agrees treatment is necessary. For those who need it, ongoing supplementation of vitamin D is necessary, whether through pills, diet or sun exposure. For most people with a level as low as yours, oral supplementation is by far the most effective and safest treatment. I prefer 1,000-2,000 IU of vitamin D3 daily as a starting point for supplementation in most.
Dr. Roach regrets that he is unable to answer individual questions, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu.
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