Peptide & Experimental

CBD (cannabidiol)

Non-intoxicating cannabinoid from hemp; in Germany a prescription-only medicinal substance, as a food an unauthorized novel food · cannabidiol, CBD oil, hemp extract, full-spectrum CBD, CBD isolate, Epidyolex, Epidiolex

CBD, short for cannabidiol, is the non-intoxicating main active compound of the hemp plant and is approved as a medicine for rare, severe forms of epilepsy. As an oil for stress, sleep problems and pain it is enormously popular, but there the evidence is considerably thinner. In the EU, CBD is considered an unauthorized novel food, and EFSA sees substantial data gaps on safety.

In brief

CBD is not intoxicating and does not activate the classic cannabinoid receptors; instead it acts at several other sites, among other things slowing the breakdown of the body’s own cannabinoid anandamide. The effect against seizures in Dravet and Lennox-Gastaut syndrome is very well supported; the medicine Epidyolex has been approved for this in the EU since 2019. For anxiety there are positive small studies and a favorable meta-analysis, for sleep hardly any studies in affected people, for pain a mixed picture. The catch is liver values, interactions with medicines and the variable quality of freely sold oils. In Germany, CBD may not be marketed as a food supplement and is prescription-only as a medicinal substance.

What it is

Cannabidiol is one of the many cannabinoids of the hemp plant and, alongside THC, the best known. Unlike THC, it does not get you high. In stores, CBD is available mainly as an oil, as an isolate or as a full-spectrum extract that contains other cannabinoids. The approved medicine Epidyolex, by contrast, is a standardized, purified solution that was dosed by body weight in studies.

The body absorbs CBD by mouth rather unreliably. A systematic review of 24 pharmacokinetic studies found that levels are considerably higher with a meal and in fatty preparations, but absolute bioavailability after swallowing has never been determined in humans. After repeated intake, the half-life is 2 to 5 days, so CBD accumulates.

How it is supposed to work

CBD has no single target. The European prescribing information states that the exact mechanism against seizures in humans is unknown and does not run via cannabinoid receptors. Discussed are the receptor GPR55, the ion channel TRPV-1 and an enhancement of adenosine signaling; together these dampen the overexcitability of nerve cells.

For mood and anxiety, a second pathway is of interest. CBD moderately inhibits the breakdown of anandamide, a cannabinoid the body makes itself. In a study in acute schizophrenia, anandamide in the blood rose under CBD, and the rise was linked to the improvement in symptoms. This is one of the few mechanisms that have been measured directly in humans.

Why the scene uses it

According to a BfR survey, buyers of CBD oils mainly hope for less stress and pain, more relaxation and better sleep. According to the BfR, CBD products are becoming increasingly popular; the most widespread are oils made from hemp extract and edible oil. For precisely these everyday effects, the BfR so far sees no sufficient scientific evidence; the evidence here is considerably thinner than for epilepsy.

What is well supported

The strongest data come from three large double-blind trials in rare, hard-to-treat epilepsies. In 120 children and young adults with Dravet syndrome, convulsive seizures fell from a median of 12.4 to 5.9 per month, on placebo only from 14.9 to 14.1. In Lennox-Gastaut syndrome, drop seizures decreased by 43.9 and 41.9 percent in two trials with 171 and 225 patients, on placebo by 21.8 and 17.2 percent. For this, CBD has been approved in the EU since 2019 as Epidyolex, in the US as Epidiolex.

For anxiety there is a positive overall picture from small studies. A meta-analysis of 8 studies with 316 participants found a large effect, Hedges’ g of minus 0.92, though with a wide range of uncertainty. In 24 people with Parkinson’s disease, a single dose reduced anxiety during a simulated public speech and even reduced tremor. In neuropathic pain after spinal cord injury, a crossover study with 38 participants analyzed showed a small but significant advantage.

What the studies show

Dravet syndrome in the New England Journal

120 children and young adults with treatment-resistant seizures received CBD at a study dose of 20 mg per kg body weight or placebo for 14 weeks, in addition to their usual therapy. The primary endpoint was met. 43 versus 27 percent had at least a halving of seizures, which was not significant, and 5 percent became seizure-free. Diarrhea, vomiting, fatigue, drowsiness and abnormal liver values occurred more often under CBD.

Liver values in healthy people

The US Food and Drug Administration (FDA) had 201 healthy adults take CBD at 5 mg per kg body weight per day or placebo for 28 days, an amount in the range of freely sold products. In 8 participants, 5.6 percent, liver values rose above three times the upper limit of normal, on placebo in no one. 7 met discontinuation criteria for possible drug-induced liver injury. Testosterone and thyroid values remained unchanged.

Fibromyalgia over half a year

In Denmark, 200 people with fibromyalgia took 50 mg of CBD per day or placebo for 24 weeks. Pain fell by 0.4 points under CBD and by 1.1 points under placebo. Placebo thus performed significantly better; side effects were evenly distributed.

Where the data stop

The hard evidence applies to rare childhood epilepsies with high study doses by body weight. It cannot be transferred to everyday stress, sleep and pain. For anxiety, the positive meta-analysis is offset by a study with 80 treatment-resistant patients in which CBD did not improve exposure therapy. For sleep, a systematic review found 34 studies, but only 2 of them in people with insomnia, and one of those was a case report. For pain, the small advantage after spinal cord injury is offset by the negative fibromyalgia study.

Then there is product quality. The BfR examined 26 oils: the measured cannabinoid contents in some cases deviated considerably from the label, and THC was found in 20 samples. For half of the products, the daily amount recommended by the manufacturer would exceed the acute reference dose for THC, for 7 of them just two drops would. What is in a bottle is therefore not the same as what was tested in studies.

Status, approval and legal

In the EU, CBD is considered a novel food that must be authorized before sale, and so far no CBD food has been authorized. EFSA was unable to establish safety in 2022 and again in 2026 for a specific application; in the 2026 update it provisionally named about 2 mg per day for a 70 kg adult as safe, only for purified preparations. The BVL (German Federal Office of Consumer Protection and Food Safety) knows of no case in which CBD in food supplements could legally be marketed; providers switch to aroma oils and cosmetics, which courts have regarded as circumvention. As a medicinal substance, cannabidiol is listed in the German Ordinance on Prescription-Only Medicines and is prescription-only. According to a 2020 ruling of the Court of Justice of the European Union, CBD is not a narcotic. In the US, CBD is excluded from the definition of a dietary supplement. In sports, CBD is expressly permitted on the WADA list, other cannabinoids are prohibited in competition, and NADA advises against CBD products because of possible THC contamination.

Safety

The most important side effect concerns the liver. In the approval trials, liver values rose above three times the upper limit of normal in 12 percent, on placebo in less than 1 percent, and with the antiepileptic valproate plus clobazam in 23 percent. Healthy people are affected too: in a study with 1,500 mg per day, 5 of 16 were above five times the upper limit of normal. An observational study with freely chosen products and an average of 50.3 mg per day, by contrast, found no increased rate. Drowsiness, reduced appetite and diarrhea are common. CBD inhibits liver enzymes such as CYP2C19 and thereby alters the levels of other medicines. EFSA sees no established safety for people under 25, pregnant and breastfeeding women and people taking medication, and found effects on reproduction and the hormonal system in animals.

BK-Score Supported, with caveats

Human evidence		7
Mechanism		6
Safety data		7
Hype gap		4
Track record of use		7

Evidence 7, because three large double-blind RCTs with 120, 171 and 225 patients demonstrate the effect in Dravet and Lennox-Gastaut syndrome (Devinsky 2017, Thiele 2018, Devinsky 2018) and support the approval, whereas for the typical biohacking uses only small, inconsistent studies are available: anxiety positive in a meta-analysis with 316 participants (Han 2024), but no benefit as an add-on to exposure therapy (Kwee 2022, 80 patients), worse than placebo in fibromyalgia (Rasmussen 2026, 200 patients), for sleep only 2 of 34 studies in people with insomnia (Ranum 2023); a 10 would be reserved for the approved indication. Mechanism 6, because the rise in anandamide has been measured in humans (Leweke 2012), but the EMA classifies the exact mechanism of action as unknown. Safety 7, because controlled data from the approval and an FDA study in 201 healthy people are available (5.6 % liver values above 3 times normal, Florian 2025), but EFSA in 2026 still sees data gaps for long-term use in food and classifies only about 2 mg per day as provisionally safe. Hype 4, because CBD oils are marketed for stress, sleep and pain, for which the BfR sees no sufficient evidence, and the epilepsy data with high study doses are often transferred to everyday life. Use 7, because CBD has been sold widely for years without food authorization and is at the same time regulated as a medicine in the EU and the US. Direction mixed: clearly positive in epilepsy, inconsistent in anxiety and pain, barely studied for sleep.

The score rates the state of knowledge, not the substance. “Safety data 9” means well studied – not harmless.
Subjective assessment by Biohacking Kompakt based on published scoring rules – not a scientific rating and not a medical recommendation. Rules and all ratings (German)

Frequently asked questions about CBD (cannabidiol)

Does CBD get you high?

No, CBD is not intoxicating and does not activate the classic cannabinoid receptors. Many freely sold oils, however, contain traces of THC; the BfR found it in 20 of 26 samples. For some products, just a few drops were enough to exceed the acute reference dose for THC.

Does CBD help with anxiety and stress?

Small studies and a meta-analysis with 316 participants show less anxiety, especially in acute stress situations. A larger study in patients with anxiety disorders found no benefit as an add-on to therapy. The signal is interesting but not yet established.

Can CBD help you fall asleep?

A review found 34 studies with sleep measurements, but only 2 in people with a sleep disorder, one of them a case report. Many studies also used CBD together with THC. So far there is no solid evidence for CBD alone in insomnia.

Is CBD oil legal in Germany?

CBD is not a narcotic. As a food or food supplement, however, it is not authorized and therefore may not be marketed, and as a medicinal substance it is prescription-only. Many oils are therefore sold as aroma oil or cosmetics, which courts have regarded as circumvention.

Is CBD harmful to the liver?

In studies with higher amounts, liver values rose markedly in some participants, including healthy people. The risk is higher together with certain medicines such as valproate. Anyone who takes CBD and needs medication should discuss this with a doctor.

Are athletes allowed to take CBD?

CBD itself is not on the doping list, but all other cannabinoids such as THC are prohibited in competition. Because CBD products can contain unknown amounts of THC, NADA advises athletes against them altogether. Even unintentional intake can be a doping violation.

Sources

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Information only, not medical advice and not a usage or dosage recommendation. Prescription-only and unapproved substances belong in the hands of a physician. Last updated: 2026-10-04.