Dosing Medical Cannabis

Guidelines For Delivering Medical Cannabis for Optimal Medicinal Results

As is true most of the time, getting the most out of your CBD treatment will depend on nailing the CBD dosage (or the dosage of whichever cannabinoids you're using).

Sounds simple enough right? Unfortunately, there's nothing simple about dosing cannabis. Everyone responds differently to these molecules that work to bring you back to homeostasis. In addition to your own body chemistry, how far away you are from homeostasis, your condition, weight, and other factors can make an effective dose for you wildly different from the dose your neighbor uses for the same reasons.

In this article we're going to go over dosing CBD, how to choose your dose, where to start, and what else you need to take into account when trying to find your minimum effective dose.

If you're looking for information on a specific topic, feel free to skip ahead using the table of contents below.

CBD should be treated like any supplement. This means you should follow dosage requirements, rather than consume it as if it was candy. CBD dosage varies depending on multiple factors that we will discuss. First-time users should follow a set dosage; this provides a set point from which they can adjust depending on how well they see results..

There Is No Universal CBD Dosage Guideline

We can’t just say take X mg of CBD oil X times a day. The truth is that various factors determine the proper CBD dosage, such as:

  • Your weight
  • The type of CBD product (e.g. tincture, vape juice, edibles, etc.) will determine the mode of administration.
  • The concentration of the CBD product.
  • The condition you’re taking CBD for (e.g. pain relief, memory retention, etc.), and its severity.

Even doctors cannot prescribe a specific dosage; they can only make recommendations. This is because there is no official recommended daily allowance established by the Food and Drug Administration.

We must also stress that your optimal CBD dosage isn’t likely to remain static. As time goes by, your body physiology changes. As this occurs, the body’s endocannabinoid system undergoes alterations as well. If you’re a long-term CBD user or plan on being one, expect your dosage needs to shift over the course of your life.

Another important note is that even people of similar weight who are taking CBD for the same reason may not have the same dosage needs. Your genetics determine your tolerability, which differs between individuals. Some people have a mutation in a specific gene known as CNR1. This gene codes the CB1 receptor in the endocannabinoid system. Abnormal CNR1 genes can result in less-than-optimal CB1 receptor sites that don’t process phytocannabinoids or even the body’s natural endocannabinoids the way they should.

Finally, before proceeding, we want to point out that our CBD dosage guidelines may differ slightly from the recommendations from other cannabis sites. This isn’t to say that our recommendation is right and theirs is wrong. It’s that it’s difficult to come up with a general guideline. You can use our background research laid out in this article to decide if you want to follow our guidelines or someone else's.

Begin with a CBD Trial Period

CBD side effects are minimal. Nevertheless, they do occur among some individuals sensitive to the effects. This is why first-time users should start with a single drop for the first day. Observe for any irritations or other negative reactions. If all feels well, then increase the dosage to two drops spread over the day. For instance, consume one drop first thing out of bed and another drop early in the evening. Do this for 3-4 weeks to see if the CBD dose helps alleviate symptoms. If not, then gradually increase the dosage by one drop until you reach the dosage according to your weight, which we outline below.

For reference, a single drop from a dropper contains about 2.5 mg of CBD oil.

CBD Dosage According to Weight

A good starting point is 15-25 mg for men and women weighing up to 150 pounds. Increase the dosage by 1-6 mg for every additional 10 pounds of bodyweight. We suggest incremental increases at the lower end. The same applies in reverse; subtract dosage by 1-6 mg for every 10 pounds below 150.

As you can see, the CBD dosage guideline is kind of broad. This provides plenty of leeway for you to find your ideal individual dosage.

We also recommend doses be split over two servings per day. If your total is 15 mg, then that’s 7.5 mg per serving, or three drops from a dropper.

What about CBD for dogs? The same rule applies here. Give your canine 1-6 mg of CBD for every 10 pounds of weight and spread over two servings.

CBD Dosage According to Medical Condition

Does the reason for CBD use affect dosage? Do you need to take more CBD if seeking pain relief as opposed to, say, anxiety? Once again, it comes down to the individual since everyone responds differently. When in doubt, we recommend defaulting to dosage by weight.

We can examine some studies regarding dosage for treating particular ailments.

For Pain

In one study examining CBD for pain, researchers found that dosages anywhere from 6.2 to 62 mg a day were effective for reducing pain and inflammatory markers. Considering that subjects consisted of lab rats, 62 mg is excessive. Even so, both ends of the dosage spectrum yielded positive results with minimal side effects.

In another study involving human trials, daily CBD administration ranged from 2.5 mg to 20 mg.

What Is the Best CBD Dosage for Sleep?

Cannabidiol in known to have a biphasic effect in this area. A lower dose makes you alert, while larger doses have a sedative effect. Your individual needs determine the dosage threshold between alertness and relaxedness. The dosage varies drastically. According to anecdotal evidence, users claim using anywhere from 15 mg all the way up to 1,000 mg to induce sleep. One study suggests dosages of 40 mg to 160 mg daily.

CBD Dosages for Seizures

When it comes to CBD dosage for seizures, one study had patients taking 200-300 mg per day. In another study, children and young adults with epilepsy were administered CBD in gradually increasing increments of 2-5 mg per day until they reach 25 mg or intolerance occurred. There is also a study where patients were given as much as 25 mg for every kilogram of bodyweight. This totaled as high as 600 mg of CBD per day for some patients. Seizure frequency dropped by 39 percent and minimal side effects were observed.

CBD Dosage According to Method of Administration

So far, all the dosages we discussed pertain to CBD tinctures taken orally via ingestion or sublingually. There are also other modes of administration. Many users eventually transition to vaping due to the higher bioavailability. You should consider adjusting dosage when changing methods.

Let’s say you normally consume CBD edibles or capsules, or even take CBD oil via ingestion. If you choose to start taking tinctures sublingually, then start with a lower dosage. Oral ingestion has the lowest bioavailability, as low as 6 percent according to one study. When taken sublingually, the CBD goes straight to your bloodstream. Bioavailability is higher, usually around 15-35 percent. With this in mind, if you consume 100 mg of CBD via ingestion, only about 6 mg reach the endocannabinoid system. If you consume the same 100 mg sublingualy, your body absorbs 15-35 mg. This is why you require a smaller dosage to see the same results by taking CBD sublingually; you get more bang for your buck. Vaping CBD has a comparable bioavailability at 31 percent, according to the aforementioned study.

If transitioning from oral ingestion to sublingual use or vaping, start with a quarter of your normal dosage and gradually increase the dose if needed.

The Inverted-U Effect: Why More Is Different but not Better

Our recommendation is always to stick with the lowest dosage that delivers noticeable results. We know there are always a handful of users that get the idea that if they see results from a small dose, then a higher dose is even better. CBD doesn’t work that way; in fact, most medicines — synthetic or natural — don’t work that way.

CBD has a biphasic effect where a higher dosage may produce an effect opposite that of a lower dose. Similarly, researchers have also noted what is described as an inverted-U effect. A 1990 study, for example, found that CBD had an anti-anxiety effect at doses between 2.5 mg and 10 mg. However, the anxiolytic effects did not manifest in higher doses of 20 mg.

The inverted-U effect is actually observed in many drugs known to influence multiple receptors. Why does this happen? Researchers may have found an answer in a study published in the British Pharmacological Society Journal. Researchers discovered that CBD at low doses activates the serotonin receptor 5-HT1a. This releases neurotransmitters that are involved in mood regulation.

A higher dose, on the other hand, is known to inhibit the receptor site GPR55. Alteration of this receptor is believed to change the brainwave activity responsible for inducing convulsions. At the same time, though, the CBD loses its effects on the 5-HT1a serotonin receptors.

Researchers note that an effective CBD dose for epilepsy is about 25 percent higher than what’s needed for treating anxiety or depression.

Can You Overdose on CBD?

As we outlined, some of the effectiveness dissipates when you exceed a certain dosage. However, is there a point where dosage becomes dangerous and potentially lethal? Remember, CBD is all-natural, and in some trials, subjects have taken doses as high as 1500 mg per day. That’s roughly 30 times the typical daily dose! Even at that mega-high dose, the effects appear to be well tolerated.

Nevertheless, sensitive users may experience side effects when exceeding typical dosage. Remember, stick with the lowest dosage needed for relief. This shouldn’t be a problem; daily dosages in the four-digit range would be cost-prohibitive and unrealistic for the average user.

Dosage Differences Between CBD Isolate and Full-Spectrum

Whether you choose CBD isolate or full-spectrum, follow the dosage guidelines according to weight. Some people who have used both types of CBD have reported different results at different dosages. Some, but not all users, have especially noticed they see results at a lower dosage with full-spectrum. This is likely due to what many industry insiders refer to as the entourage effect. This essentially means that the multiple cannabinoids work synergistically and may have a higher potency compared to CBD alone. The research regarding the entourage effect is sparse and mixed. Some researchers also believe the heightened results may be merely due to a placebo effect.

Nevertheless, some users report the same results at a lower dose than is required when using a CBD isolate oil. With this in mind, if transitioning from an isolate to full-spectrum product, consider starting a few milligrams below your normal dose. Aside from the entourage effect, some of the other cannabinoids may also exert effects of their own.

Possible Drug Interactions with CBD

Speak with your doctor about CBD use if you’re currently on any medications. CBD may interfere with certain prescription drugs. As such, you may have to adjust your normal dosage, or consume CBD and medication at different times in the day.

CBD may interfere with the body’s cytochrome P-450 system. This is an area in the liver that processes over 50 digestive enzymes. It also has a critical role in toxin removal. The cytochrome P-450 is known to aid in the metabolization of 60 percent of common over-the-counter and prescription drugs.

You can visit the American Family Physician to learn more about the inner workings of cytochrome P-450 on medicine metabolization.

The P-450 enzyme regulator also metabolizes CBD. For the most part, the system does a pretty good job at processing CBD or medication — one at a time.

If it has to metabolize CBD and other medication simultaneously, then the process backs up, leading to delayed breakdown and absorption.

Over 600 drugs are known to require processing by the cytochrome P-450 system. Of these, 129 are known to cause a major reaction if taken with CBD. The rest cause a moderate reaction.

Taking Product Concentration Into Account

You may also need to adjust dosage depending on CBD oil concentration. Be especially mindful if you buy from different CBD makers as concentrations may differ. The label should disclose the total concentration of CBD per bottle or fluid ounce. Most tinctures have between 250-1000 mg per ounce. Most tinctures come in 1-ounce bottles. If buying a larger bottle, be sure if the CBD concentration listed pertains to the entire bottle or by ounce. If purchasing a 4-ounce bottle, and it has 500 mg, determine whether the concentration is per ounce (for a total of 2,000 mg) or for the whole bottle (for 125 mg per ounce)?

If taking an oil with, say, 500 mg per ounce, and you later switch to a brand with 1000 mg, then you need to slash your dosage in half.

Conclusion

No matter which product you start out with, start slow. The magic in cannabis is it's innate ability to work with our body in many different ways. It's not a linear substance. Consuming more of it won't continue to amplify effects felt at lower doses. Instead, it will produce an entirely new effect. Often times it's the opposite effect you experienced at a lower dose.

So start slow and slowly raise your dose until you reach your desired outcome.

Browse CBD Products

See our Where to Buy page for a list of vetted CBD suppliers. Be mindful of the concentration if you switch between brands. This applies for both CBD isolate and full-spectrum oils.

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