What is lipid pneumonia?
Lipid pneumonia is the result of chronic (continuous over a period of time) inhalation of lipids (oils, fats, waxes, or free fatty acids). The formation of pneumonia occurs once lipids reach the lung parenchyma (the portion of the lung involved in oxygen transfer) through inhalation. There it is either absorbed by the alveolar macrophages or remain free within the alveoli1. Since the lungs cannot metabolize lipids they are absorbed into the alveoli leading to inflammation and damage and in severe cases formation of giant cells of fibrosis around the large oil masses5. More specifically, it has been found that free fatty acids are responsible for causing the damage, destroying lung tissue, leading to lipid pneumonia6. These can be introduced directly in the composition of the oil inhaled or through the hydrolysis of mono-, di-, and tri-glycerides by lung lipases3.
Typically symptoms only appear in the advanced stages of the illness. Symptoms range from cough and chest pain to dyspnea (severe shortness of breath) and fever. Chronic inhalation of oils, if not stopped or left untreated, can even lead to cor pulmonale; a condition that causes the right side of the heart to fail2.
Cases of lipid pneumonia are rare in the west since inhaled products, such as nasal sprays, switched from oil based to saline based. These cases still remain a major issue in certain parts of the globe where cultural and traditional practices involve force feeding infants fats and oils. There they believe this practice to be beneficial to the infant’s health. Since this remains an issue, lipid pneumonia is continually investigating. These investigations have led to the identification of a few fatty acids directly linked to cause lipid pneumonia. Free fatty acids found in the bronchoalveolar lavage of patients with lipid pneumonia were compared to the fatty acid composition of the inhaled oil. Only three major fatty acids remained in the bronchoalveolar lavage. The rest of the fatty acids in the oil were presumed to be expelled through coughing. The found fatty acids are linoleic (omega 3s and 6s), oleic, and stearic1,4.
How does free fatty acids and lipid pneumonia relate to CBD Oil?
Oils should NEVER be inhaled as inhalation of oil directly causes lipid pneumonia. Particles of oil easily reach the lower part of the lungs through vaping where they cause the most damage. More specifically, it is the free fatty acid components (including omega 3s and 6s) of an oil which are responsible for the damage leading to the illness. While essential fatty acids (omega 3s and 6s) are extremely healthy to ingest as a supplement, they should never be inhaled.
Traditional CBD concentrates, used by nearly every company in their CBD vape products, are in a base of hemp oil and wax which can consist of up to 70% fatty acid. The fatty acids most prevalent in hemp oil are linoleic acid followed by oleic acid with a significant amount of stearic acid. These are the three fatty acids found to be directly linked to the causation of lipid pneumonia. While linoleic acid (essential fatty acids omega 3s and 6s) are healthy to ingest they should never be inhaled. Some companies are even advertising this as healthy while others add in additional lipid based emulsifiers in an attempt to keep their liquid from separating, further compounding the problem. Lungs lack the enzymes to metabolize and cope with fatty acids so they end up remaining in the lungs causing damage. These can easily be identified visually in a CBD product. If there are globs of what look like oil separating out, then the CBD concentrate is oil based and should be avoided. By the same reason that oil and water does not mix, CBD oil and vegetable glycerin/propylene glycol does not mix.
