Cannabidiol has been linked to early onset of puberty in a toddler boy.
Cannabidiol (CBD) that was purchased by a mother online has been linked to early puberty in a two-year-old with intractable epilepsy. Previous studies have shown that CBD can be beneficial in managing seizure disorder symptoms in children and adolescents. However, there are also hormonal consequences.
A preliminary study to be presented at the American Academy of Neurology’s 72nd Annual Meeting in Toronto, Canada, April 25 to May 1, 2020, found that youth who suffer from seizures faired better when using CBD than those who did not take it. In the study, led by Nathan T. Cohen, M.D., of Children’s National Hospital in Washington D.C., researchers reviewed the “medical charts of 31 children and teens with an average age of 10 who were followed for an average age of one year.”
Cohen said, “The use of medical cannabis to treat various medical conditions has grown in recent years. While not always legal, artisanal CBD has been available longer, so some people have been using it to treat epilepsy for years. The difference in seizure control is dramatic and is definitely of concern since many people continue to use artisanal CBD. However, a limitation of our study is that it was small. More research is needed to see if similar results are found in larger groups of people.”
The authors noted that some of the study participants reported they had stopped taking CBD due to side effects. However, these effects were less severe than what was reported in the recent case. Common unwelcome symptoms of cannabinoid use range from mild to moderate and include rapid heartbeat, dizziness, low blood pressure, paranoia, panic attacks, and food cravings, among others.
In the case of the toddler taking CBD for a seizure disorder, the boy developed signs of precocious puberty just seven months after his mother had started administering CBD. Central precocious puberty is “the onset of puberty below the age of 9 years in boys, attributed to premature activation of the hypothalamo-pituitary-gonadal (HPG) axis,” the authors explained.
The investigators, led by Aditya Krishnan of University Hospitals NHS Foundation Trust in Birmingham, United Kingdom, wrote, “Cannabis and cannabis-related products are increasingly used for treatment of pediatric-onset epilepsy, but studies determining the impact of these products on the HPG axis have shown conflicting results.” Their report was published in the April 15 online edition of BMJ Case Reports.
Previous evidence of the prevalence of this in children and youth with a seizure disorder have yielded mixed results. On one hand, some studies have suggested that CBD use in youth can delay the start of puberty or lead to pubertal arrest. Other studies have indicated that it elevates testosterone levels in male users in the long-term.
“This boy undoubtedly had central precocious puberty by clinical and laboratory findings,” said Dr. Alan Rogol, a professor emeritus of pediatrics and endocrinology at the University of Virginia. He added this is “quite uncommon in boys.”
“Until a more robust evidence base is established,” the Krishnan and colleagues concluded, “clinicians should be cautious of hormonal consequences of cannabis-related products, particularly as children with brain abnormalities may be more susceptible to these effects.”