# THC and CBD Metabolism Enzyme Diagram

> **Author:** Benjamin Caplan, MD (ABFM Board Certified, MA Lic. #240562, NPI: 1962722637)
> **Publisher:** CED Clinic (https://cedclinic.com)
> **Canonical URL:** https://cedclinic.com/d58genetic-factors-influencing-cannabis-response-png/
> **Published:** 2026-09-04T23:01:21-04:00 | **Last Modified / Clinically Audited:** 2026-09-13T14:40:19-04:00
> **Clinical Summary:** How genes for CYP2C19, CYP2C9, CYP3A4, and cannabinoid receptors shape the way individuals metabolize and respond to cannabis.

---

[← Back to the Side Effects Summary Hub](https://cedclinic.com/topic-side-effects-diagrams/)Diagram & referenceA visual reference. The evidence, sources and clinical interpretation are in the linked article.About this diagramA three tier flow chart. Medical cannabis intake sits at the top and splits into metabolism of THC and metabolism of CBD, each of those splits into the same three liver enzymes, CYP2C9, CYP2C19 and CYP3A4, and every enzyme ends in a box marked variations. The symmetry is the point of the picture: one enzyme set handles both cannabinoids, and the genetic differences sit at the foot of each branch.The evidence behind it[Read the evidence: which cannabis pharmacogenetic findings hold up, and which ones consumer testing companies oversell](https://cedclinic.com/cannabis-pharmacogenetics-what-genes-actually-predict/)That article carries the cited studies, the limits of the evidence, and the clinical interpretation.

---

### Verification & Medical Governance

- **Lead Clinical Author:** Benjamin Caplan, MD
- **Credentials:** Board Certified in Family Medicine (ABFM), Former CMO Canna Care Docs (250,000+ patients supervised), Founder & CMO CED Clinic & CED Foundation, Author of *The Doctor-Approved Cannabis Handbook* (Penguin Random House).
- **Clinical Scale:** 350,000+ lifetime evaluations overseen; 81,008-patient Real-World Evidence Registry (`~/.ced_rwe_vault.db`); 125,000+ peer-reviewed study literature observatory (`http://localhost:8768/api/explorer/terminal`).
- **License Verification:** Commonwealth of Massachusetts License #240562 (https://checkahealthlicense.mass.gov/).
- **NPI Registry:** 1962722637 (https://npiregistry.cms.hhs.gov/provider-view/1962722637).
- **Ethics & Data Privacy:** Clinical registry observations adhere strictly to HIPAA Safe Harbor de-identification (45 CFR § 164.514(b)) and criteria for secondary research exemption under 45 CFR § 46.104(d)(4).