Your access to this site has been limited by the site owner If you think you have been blocked in error, contact the owner of this site for assistance. If you are a WordPress user with Can you take CBD and levothyroxine together? Let’s talk about the CBD-drug interactions with your endocrine system. Thyroid disorders affect an increasing number of the global population. CBD interacts with the cannabinoid receptors located on the thyroid gland — can it help with hormonal imbalances?
Your access to this site has been limited by the site owner
If you think you have been blocked in error, contact the owner of this site for assistance.
If you are a WordPress user with administrative privileges on this site, please enter your email address in the box below and click “Send”. You will then receive an email that helps you regain access.
Block Technical Data
|Block Reason:||Access from your area has been temporarily limited for security reasons.|
|Time:||Thu, 15 Sep 2022 5:28:41 GMT|
Click here to learn more: Documentation
CBD and Levothyroxine: What Happens When You Mix Them Together?
Levothyroxine is a popular thyroid medicine that serves as a substitute for a hormone that the thyroid gland should naturally produce to regulate the metabolism, growth, and development of the body. When the thyroid is unable to do this on its own, this disorder is called Hypothyroidism
CBD oil is an alternative treatment for hypothyroidism. Like most other diseases, inflammation is also a significant contributor to hypothyroidism, and CBD is famous for its anti-inflammatory properties.
Levothyroxine and Hypothyroidism Treatment
Levothyroxine may be the most commonly known treatment for hypothyroidism, which means an under-active thyroid gland. The primary job of the thyroid gland is to secrete thyroid hormone which helps to regulate the body’s metabolism and growth. Once the gland has become incapable of producing this hormone, levothyroxine acts as a substitute for the missing thyroid hormone.
Levothyroxine comes in either an oral or injectable form, and it is strictly on prescription. The oral form could either be a tablet or capsule. Oral levothyroxine tablets may need to be taken with other medications as they are primarily for part of combination therapy. Levothyroxine also helps in the treatment of goiter and certain types of thyroid cancer.
CBD and Hypothyroidism Treatment
A study evaluated the clinical significance of CB1 and CB2 expression in the human body and found out they are highly concentrated, especially in the thyroid gland. These receptors showed the potential for serving as a blocker to the spread of malignant cells present in the thyroid gland.
Another study has found that CBD may be effective in easing chronic inflammatory and neuropathic pain. These receptors in rat thyroids seemed to be capable of influencing the T3 and T4 hormone release. The study was conducted on rats and, as such, hasn’t been verified in humans.
There is a significant need for more studies on how CBD oil helps with the thyroid in humans. However, the research conducted so far has shown a lot of promise on CBD’s effect on hormonal activities. CBD may also help treat the symptoms associated with thyroid conditions, such as pain, weight gain, fatigue, depression, and anxiety.
Interaction Between Levothyroxine and CBD oil
Knowing that both levothyroxine and CBD oil serve the same purpose, which is treating hypothyroidism, you may wonder if it’s appropriate to use both forms of medication simultaneously. This is where you need to consider potential CBD-drug interactions. CBD oil and levothyroxine compete for metabolism, and they both require the same pathway to metabolize, which is the cytochrome P450.
A study in 2017 discovered that if a patient takes both levothyroxine and CBD oil simultaneously, this may result in a case where more thyroxine becomes compiled before the body metabolizes it due to the aforementioned interaction. When this happens, it results in another disease called Hyperthyroidism. Other risks involved with the interaction of levothyroxine and CBD oil involve anxiety and mild nausea.
However, if a patient spaces out the time frame between the use of Levothyroxine and CBD oil, there may be minimal or no effect at all, as found in a couple of patients. Nonetheless, you will need to consult your doctor to establish the right routine for both compounds.
Choosing Between Levothyroxine and CBD oil
Now you know that using both levothyroxine and CBD oil is not entirely risk-free, except when it is well-spaced — and even at that, you may need a doctor’s supervision.
So, before you go on with deciding on whether or not you should include CBD in your supplementation plan, let’s take a look at the pros and cons of both substances.
Like every other medication, both levothyroxine and CBD oils have their advantages and disadvantages. We will be looking at some of these, starting with levothyroxine.
Pros of Using Levothyroxine
- Safe for all ages and pregnant women: Levothyroxine is certified safe for adults and children, even as young as one to five years. It is also safe for pregnant women, unlike some drugs that are not advisable for women to use during pregnancy.
- Easy to use: Using levothyroxine is relatively easy compared to some other drugs, as you only have to take it once a day. Also, it’s not necessary to use it in the morning alone; if you have busy morning schedules, you can choose to use your levothyroxine at night.
- Affordability: For a substance that is quite beneficial in treating a crucial disorder, levothyroxine is somewhat cheap and affordable.
Cons of Using Levothyroxine
- Interaction with food and other medications: It is best to use levothyroxine on an empty stomach as other drugs or even food may interact with it and, as a result, hinder it from being effective. Patients should use levothyroxine an hour before eating or using other medications.
- It takes a long time to figure out the correct dose and see the result: The right dose for levothyroxine varies from one person to another. As a result, it might take weeks or even months to find the correct dose because you can’t figure out if the medication is working for 6-8 weeks, which is the time frame to see the full effect of levothyroxine. Sometimes, you may require a routine blood test to ensure you are using the correct dose.
- You have no liberty of missing doses: If you forget to use your medication a few times, you will start feeling all the symptoms associated with hypothyroidism again. These symptoms include fatigue, constipation, dry skin, and weight gain.
Pros of Using CBD oil
- CBD is a versatile therapeutic compound: It modulates the endocannabinoid system (ECS), resulting in the regulation of hormonal activity. Therefore, it has the potential to help with thyroid disorders and associated symptoms.
- Easy to get: CBD oil is legal in most places in the world. You can buy CBD without a prescription from a doctor.
- It is non-addictive: A study proved that CBD is not habit-forming, unlike the whole cannabis itself. This makes CBD safe for daily consumption.
Cons of using CBD oil
- Not enough practical evidence: There are limited studies on the effect of CBD oil when it comes to treating thyroid disorders in humans.
- Interaction with other drugs: CBD tends to often interact with other medications, thereby bringing a counter-productive result. This theory was deduced in a 2017 research. Hence, it is essential to consult with a doctor who has vast experience in cannabis use before you embark on starting a CBD product.
- Most CBD products are unregulated: Most CBD products sold randomly online are not regulated, and as such, it may be difficult to find out if the product contains what the label claims.
How to Choose the Right CBD for Hyperthyroidism and Other Thyroid Diseases?
Cannabinoids aren’t the only beneficial compounds in cannabis. Other phytonutrients include terpenes, flavonoids, amino acids, essential oils, and tetrahydrocannabinol (THC). If you want to enjoy the benefits of all these nutrients, then you should opt for full-spectrum CBD.
However, if you don’t want to ingest even trace amounts of THC, you can go with the broad-spectrum CBD. This option has a similar phytochemical profile to the full-spectrum CBD — except for THC.
Isolates are the purest form of CBD because they don’t contain other compounds from hemp. They’re flavorless and odorless and contain the highest amount of CBD per serving. However, unlike the two above formats, CBD isolate doesn’t leverage the whole-plant synergy, making it the least desired type of cannabidiol.
Once you’ve decided on the type of CBD you want to go for, there are still a few details to keep in mind. These include:
- Buying only from reputable manufacturers. CBD brands are sprouting every month, and it may be hard to figure out which ones produce high-quality products; hence, it is necessary to do your research before making a purchase.
- Request a Certificate of Analysis (CoA) of the product you want to buy. Companies that fail to provide these documents aren’t worth your trust because they might have something to hide about the quality of their products.
- Consult a doctor experienced in using CBD or cannabis with their patients. Doing so will help you avoid negative interactions with thyroid medications and figure out the right dosage for your situation.
- When purchasing from an online store, be sure to check user reviews, as this will give you insight into how good the product is. Also, if you are making a physical purchase, find out if the store is legally authorized to sell CBD products.
How to Use Levothyroxine?
Here are some useful tips for taking Levothyroxine if you have a thyroid disorder:
- For maximum effect, you should take levothyroxine on an empty stomach. Doing this will make the absorption process go on smoothly without interference of any form.
- Please pay attention to your diet while on levothyroxine because some particular food may work against it in the body. These foods include soybean flour, walnuts, and cottonseed meal.
- Conduct blood tests to figure out if you are on the correct dose because anything short of that will cause levothyroxine to be ineffective in your body.
How to Use CBD Oil?
CBD can be taken in many different forms. If you’re new to CBD, you may want to consider oral forms, such as gummies or capsules. They offer a fixed dose of CBD per serving and provide longer-lasting effects despite a delayed onset.
For a faster effect, you can go for tinctures and drops. This format works by placing a dose of CBD under the tongue with a dropper; after 60 seconds, you swallow the oil. You will start seeing the effect in 15–30 minutes, and the results should last for about 4–6 hours.
Vaping offers the fastest and most effective way to deliver CBD to your system because it uses the lung tissue for absorption. The effects are almost instantaneous — kicking in after 5 minutes — but they last shorter than other forms. On the other hand, vapes come with the highest bioavailability of CBD.
The time it takes for CBD oil to work on your system depends on how you consume CBD. Some need anywhere from a few minutes while others a couple of hours.
Over the years, Levothyroxine has been a reliable treatment option for hypothyroidism and will continue to be. However, CBD oil is showing the potential of being worthy competition for levothyroxine, and if there is more research on how effective CBD oil can be in treating hypothyroidism and other thyroid disorders such as chronic lymphocytic thyroiditis, it will become even more popular among patients with hypothyroidism.
While both substances may effectively treat hypothyroidism, you shouldn’t take them simultaneously. If you do this, it may lead to another dysfunction like hyperthyroidism. However, if you space out the usage, the risk of both drugs interacting and becoming counterproductive can be reduced to a bare minimum.
Regardless of your choice, make sure to consult a doctor before starting your CBD treatment. A qualified health professional will be in the best position to help you figure out the right dosage and establish a safe routine to avoid interactions with medications.
- Eleftheria, L., Constantinos, G., Maria, T., Paraskevi, A., Ioanna, D., Ioanna, G., George, K., Efstratios, P., & Stamatios, T. Clinical significance of cannabinoid receptors CB1 and CB2 expression in human malignant and benign thyroid lesions. 2015. (1)
- Wei, X., Tanxing, C., Kejung, C., Fei, Y., Shao-Rui, C., Dan, W., Yun, G., Hui-Lin, P., Ke, R., Yan, X., & Li, Zhang. Cannabinoids suppress inflammatory and neuropathic pain by targeting g3 glycine receptors. 2012.
- Researching marijuana for therapeutic purposes: The potential promise of Cannabidiol (CBD). 2015.
- Kimberly, L., & Susan, L. CBD for Thyroid health. 2021.
- Echo. Can CBD help with thyroid disorders? 2017.
Nina created CFAH.org following the birth of her second child. She was a science and math teacher for 6 years prior to becoming a parent — teaching in schools in White Plains, New York and later in Paterson, New Jersey.
CBD For Thyroid Health: Can It Help As Alternative Medication?
The thyroid is a critical endocrine gland that is situated at the base of the neck, wrapping around the front of the trachea. The thyroid produces a variety of hormones that influence bodily functions, such as metabolic rate, bone density, heart health, and muscle strength.
The gland connects with the brain, establishing a state of hormonal homeostasis. The thyroid regulates processes like emotional control, body temperature, heart rate, mood, metabolism, and more.
Thyroid dysfunctions can result in a range of symptoms that stem from imbalances in the above functions.
Scientists have found a link between the human endocannabinoid system (ECS) and brain/thyroid communication. The ECS is a potential therapeutic target for the management of hormones production, which suggests that using cannabinoids could improve thyroid health and effectively manage thyroid disorders.
In this article, we elaborate on the benefits of CBD oil for thyroid health; we’ll touch on the subject of hormonal imbalances, different types of thyroid disorders, and how to use CBD for the side effects of thyroid dysfunctions.
CBD and Thyroid Health: What You Need to Know
The research into CBD and thyroid health is in the early stage, but some studies suggest that CBD may be an effective therapeutic agent for the management of thyroid disorders.
Humans and all animals — except for insects — have an endocannabinoid system (ECS). The ECS is our major regulatory network that controls a variety of biological processes, including mood, memory, immune response, body temperature, appetite, fertility, sensory perception, neuroprotection, and more.
Let’s take a look at the current state of scientific knowledge when it comes to using CBD for thyroid health.
Studies on CBD and Thyroid Health
A 2015 study found significant concentrations of CB1 and CB2 cannabinoid receptors in the thyroid glands. These receptors were associated with the shrinkage of thyroid tumors, showing promise as potential blockers of the spread of malignant cells on the gland (1).
Researchers are still trying to figure out the role of CBD and cannabinoid receptors in the management of conditions like Hashimoto’s Disease or Graves’ Disease. Nevertheless, these receptors and their interaction with the thyroid gland and function sheds new light on using natural resources to take care of thyroid health.
A growing number of studies suggest that CBD and other cannabinoids can be used for dealing with the symptoms associated with thyroid conditions, including skin problems, inflammation, pain, anxiety and depression, weight gain, and low energy levels.
In a study published in the Journal of Experimental Medicine, the authors found that CBD and its modified equivalents were effective in easing chronic inflammatory and neuropathic pain in rats (2).
Scientists believe that oral forms of CBD — such as CBD oil or capsules — produce better effects from the symptoms caused by internal imbalances, especially when it comes to anxiety and depression. On the other hand, topical products are more effective for problematic areas on the body.
Effects of CBD Oil on Thyroid Disorders
The thyroid often suffers from nutrient deficiencies, lacking iodine, selenium, and zinc. Specific environmental factors, such as excessive stress, can also cause the underperformance of the land.
Another risk factor for thyroid disorders is an autoaggressive immune system. When the immune system attacks the thyroid glands, it can cause autoimmune disorders, such as Hashimoto’s Disease or Graves’ disease.
Symptoms of thyroid disorders include:
- Small lumps on the thyroid gland that may cause excess production of hormones
- Hyperthyroidism, which happens when there are too many thyroid hormones
- Hypothyroidism, which is associated with low levels of thyroid hormones
- Thyroid storm, which is a rare type of hyperthyroidism
- Swelling of the thyroid (goiter)
- Thyroid cancer
Overproduction or underproduction of the thyroid hormones may ravage a person’s health over time. Thyroid disorders are challenging to treat due to the difficulties in diagnosis. Thyroid conditions can have several underlying causes associated with physical functions.
Doctors use special tests to diagnose thyroid imbalances, including biopsies and imaging scans, such as ultrasound or iodine screenings. Patients are also asked to run a test for T3, T4, and thyroid-stimulating hormone (TSH) to search for thyroid imbalances.
The THS is a figure that measures the amount of thyroxine (T4) that the thyroid gland should release.
Below we cover the potential benefits of CBD for thyroid health.
CBD Oil for Hormonal Balance
The endocrine system is made of a number of glands in the body that produce and secrete hormones for different functions.
These hormones affect a variety of physiological processes, such as growth, movement, respiration, sensory perception, and fertility.
A 2018 study performed by the Polish Society of Endocrinology investigated potential interrelations between the ECS and the functioning of the endocrine system (3).
As mentioned, the ECS is involved in regulating a wide range of critical functions, including the performance of the thyroid.
The potential benefits of CBD for thyroid health are expressed through their interaction with the body’s ECS and its two types of receptors — CB1 and CB2.
Researchers have discovered the presence of CB1 receptors on the thyroid gland of animal models. These receptors regulate the production of two thyroid hormones, T3 and T4.
These hormones play an important role in modulating energy levels, body weight, temperature, as well as the growth of hair, nails, and skin cells.
Cannabinoid receptors have also been found within the hypothalamic paraventricular nucleus (PVN), which is a region in the brain that connects with the pituitary gland and stimulates it to produce different types of hormones to adrenal glands, gonads, and the thyroid.
CBD indirectly engages with these receptors, which would explain their potential for managing thyroid disorders, especially the problems of hormonal imbalances.
However, we still need more quality studies on humans to support preclinical findings.
CBD Oil for Anxiety
CBD has remarkable anxiolytic (anti-anxiety) properties due to its interaction with several mechanisms that control our responses to stress.
One of such mechanisms is the agonism of the 5-HT1A receptor, which controls serotonin secretion. Serotonin is a neurotransmitter that manages feelings of happiness, well-being, and relaxation (4).
Moreover, CBD changes the shape of the GABA-A receptor, which acts as a handbrake for the brain to prevent overexcitation (5). The administration of CBD causes this receptor to use the GABA neurotransmitter more effectively, keeping us calm during stressful events.
CBD can also temporarily lower blood pressure, allowing the user to take deeper breaths. This, in turn, can have a positive effect on our physical response to stress (6).
CBD Oil for Sleep
Anxiety is one of the major contributors to sleep deprivation, which is one of the reasons why people use CBD oil for sleep disorders. Aside from that, CBD influences the functioning of our circadian rhythm.
In other words, CBD regulates our sleep-wake cycle. Taking lower doses in the morning may not only reduce anxiety but also improve energy and focus, thus increasing productivity (7). With heightened daily alertness throughout the day, our body starts to receive signals that it has done enough work for the day and it’s time to go to bed. Consistent supplementation with CBD can help the body manage its melatonin levels, which is a hormone that helps the body set the right gears in motion to fall asleep faster
On the opposite side, higher doses taken in the evening may promote sedation on top of the aforementioned lowering of the blood pressure. Many people use CBD oil an hour or two before going to bed to help themselves get more restful sleep (8).
Studies have shown that CBD also helps us stay longer in the deep sleep stage while reducing REM disorders.
CBD Oil for Metabolism & Low Energy Levels
As mentioned, low doses of CBD taken throughout the day can stimulate our energy levels, which is a common problem among people with thyroid disorders. Another issue with compromised thyroid health is disrupted metabolism, which results in weight gain and feelings of tiredness.
CBD is known to regulate metabolism through its interaction with the ECS. One positive effect worth mentioning is CBD’s ability to promote the fat browning effect.
Fat browning refers to the conversion of white fat cells to brown fat cells (9). The brown cells are more effective when it comes to converting fat to energy, helping individuals burn more calories as a result. On top of that, cannabinoids may have a positive effect on metabolism through improving the body’s sensitivity to insulin and reducing blood sugar levels as a result.
A 2013 review of the existing studies on cannabis and metabolism showed that regular cannabis users have lower fasting insulin resistance, lower blood sugar levels, and smaller waist circumference. However, the review looked into the efficacy of cannabinoids on metabolism in general, not CBD alone (10).
CBD Oil for Pain
Problems with thyroid health often involve episodes of pain, especially in the joints and muscles. CBD has been shown to mitigate pain signaling through the indirect interaction with opioid and vanilloid receptors in the brain, which modulate pain perception (11). CBD also has strong anti-inflammatory properties, which could potentially help reach the underlying cause of pain (12).
Does CBD Oil Help with Inflammation in Thyroid?
A high-quality CBD oil may address a variety of thyroid dysfunctions. This underperformance includes hypothyroidism, hyperthyroidism, goiter, thyroiditis, and thyroid storm.
All of the above conditions are triggered by chronic inflammation of the thyroid gland due to the body’s autoaggressive actions on this organ.
CBD is a powerful anti-inflammatory compound. Multiple studies have proven the role of cannabinoids in reducing organ and tissue inflammation.
Although research on the efficacy of thyroid disorders is in its infancy, current studies regarding CBD’s influence on hormonal activity is promising.
However, the amount of research is insufficient to define CBD as an effective treatment for thyroid health problems; we need more clinical trials to come to this conclusion.
CBD and Thyroid Medication Interactions
The topic of CBD-drug interactions is a complex one. CBD is known to inhibit the activity of the Cytochrome p450 system, a set of enzymes responsible for metabolizing the active ingredients in medications. This applies to both prescription and OTC meds.
When you take CBD along with thyroid medication, the aforementioned interaction may result in either subtherapeutic effects or toxic levels of the drugs in the bloodstream.
In the first scenario, your primary medicine may lose efficacy and thus fail to provide the desired effects.
The second scenario is more negative because it entails the risk of experiencing the second-hand side effects that don’t result from CBD alone but rather from the above interaction.
If you want to avoid CBD-drug interactions, we encourage you to consult a doctor before buying a CBD product for thyroid health.
Does CBD Oil Interact with Levothyroxine?
Having read about potential CBD-drug interactions might have you wonder whether you should totally ditch CBD when taking thyroid medications, such as levothyroxine.
Levothyroxine is the most popular thyroid medication. Like many other pharmaceuticals, it is processed by the same group of enzymes as CBD.
In simple words, when you take CBD oil with levothyroxine at one time, they will likely compete for the place in the liver. Therefore, using these two products together may be counterproductive.
We have looked into many forums for patients with thyroid disorders who also take CBD for their conditions. The vast majority reports little to no side effects, but they underline the importance of having a 2-hour gap between one compound and the other.
Again, the only person qualified to rule out any recommendations in this subject is an endocrinologist, preferably one with sufficient knowledge about cannabis. No two individuals are the same, so what works for you (or is safe for you) won’t necessarily provide the same results for another person.
Final Thoughts on CBD and Thyroid Health
Due to its interaction with the endocannabinoid system (ECS), CBD allows individuals to take on an alternative route to managing the level of thyroid hormones in the blood. This, in turn, holds promise for patients with thyroid disorders who are apprehensive about conventional methods.
Most hypothyroidism or hyperthyroidism cases can be dealt with a properly adjusted dose of thyroid hormone. Healthy nutrition and an active lifestyle can also contribute to the mitigation of symptoms.
CBD oil can support thyroid treatment by helping the body regulate its critical functions. However, CBD for thyroid conditions is a subject that still requires more research.
Those interested in trying CBD should seek medical advice from a doctor. Making changes to one’s health care routine without the supervision of a qualified physician can do more harm than good. Doctors also have to be notified if a person is already taking thyroid medications or any other prescription meds that could potentially interact with CBD.
- Lakiotaki, Eleftheria et al. “Clinical Significance of Cannabinoid Receptors CB1 and CB2 Expression in Human Malignant and Benign Thyroid Lesions.” BioMed research international vol. 2015 (2015): 839403. doi:10.1155/2015/839403
- Xiong, Wei et al. “Cannabinoids suppress inflammatory and neuropathic pain by targeting α3 glycine receptors.” The Journal of experimental medicine vol. 209,6 (2012): 1121-34. doi:10.1084/jem.20120242
- Borowska, Magdalena et al. “The effects of cannabinoids on the endocrine system.” Endokrynologia Polska vol. 69,6 (2018): 705-719. doi:10.5603/EP.a2018.0072
- Russo, Ethan B et al. “Agonistic properties of cannabidiol at 5-HT1a receptors.” Neurochemical research vol. 30,8 (2005): 1037-43. doi:10.1007/s11064-005-6978-1
- Pretzsch, Charlotte Marie et al. “Effects of cannabidiol on brain excitation and inhibition systems; a randomised placebo-controlled single dose trial during magnetic resonance spectroscopy in adults with and without autism spectrum disorder.” Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology vol. 44,8 (2019): 1398-1405. doi:10.1038/s41386-019-0333-8
- Jadoon, Khalid A et al. “A single dose of cannabidiol reduces blood pressure in healthy volunteers in a randomized crossover study.” JCI insight vol. 2,12 e93760. 15 Jun. 2017, doi:10.1172/jci.insight.93760
- Murillo-Rodríguez, Eric et al. “Potential effects of cannabidiol as a wake-promoting agent.” Current neuropharmacology vol. 12,3 (2014): 269-72. doi:10.2174/1570159X11666131204235805
- Babson, Kimberly A et al. “Cannabis, Cannabinoids, and Sleep: a Review of Literature.” Current psychiatry reports vol. 19,4 (2017): 23. doi:10.1007/s11920-017-0775-9
- Parray, Hilal Ahmad, and Jong Won Yun. “Cannabidiol promotes browning in 3T3-L1 adipocytes.” Molecular and cellular biochemistry vol. 416,1-2 (2016): 131-9. doi:10.1007/s11010-016-2702-5
- Penner, Elizabeth A et al. “The impact of marijuana use on glucose, insulin, and insulin resistance among US adults.” The American journal of medicine vol. 126,7 (2013): 583-9. doi:10.1016/j.amjmed.2013.03.002
- Russo, Ethan B. “Cannabinoids in the management of difficult to treat pain.” Therapeutics and clinical risk management vol. 4,1 (2008): 245-59. doi:10.2147/tcrm.s1928
- Nagarkatti, Prakash et al. “Cannabinoids as novel anti-inflammatory drugs.” Future medicinal chemistry vol. 1,7 (2009): 1333-49. doi:10.4155/fmc.09.93
Nina created CFAH.org following the birth of her second child. She was a science and math teacher for 6 years prior to becoming a parent — teaching in schools in White Plains, New York and later in Paterson, New Jersey.