One Size Doesn't Fit All: The Complexities of Dosing CBD

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To fully unlock all the benefits of CBD, it all begins with understanding the concept of dosing. We’ve collected data and advice from a variety of sources, including medical research and consumer accounts, and we’re here to offer our informal guide to understanding CBD dosing, to help you maximize your experience.

Why take cannabidiol?

Cannabidiol - usually abbreviated to CBD - is one of approximately 113 identified cannabinoids, which are compounds found in, and produced by, cannabis plants. These plants have been known to us for millennia, and in that time have been cultivated by multiple different ancient cultures for a wide range of medicinal, practical, and recreational uses. Traditionally, cannabis plants have been renowned for their intoxicating, soothing and therapeutic effects, and modern-day research efforts have revealed to us, the compounds within these plants responsible for these remarkable effects.

CBD is one of the most abundant cannabinoids in cannabis plants, making up as much as 60% of its extract, and many of cannabis’ effects, such as soothing anxious thoughts or easing pain, have been found by research to be attributed to CBD. Research indicates that CBD may be able to affect the central nervous system to mediate pain reception and mood, modulate the immune system and reduce inflammation, as well as affect the digestive system.

To date, CBD has been highlighted by consumers who use it for a variety of therapeutic benefits, including dealing with anxiety, epilepsy, skin conditions and chronic pain. In particular, CBD has been most widely used for treating symptoms of anxiety and mood disorders, thanks to its ability to alter serotonin signals. Its muscle relaxant properties have also led to it being used as a method of managing conditions with frequent muscle spasms, convulsions or seizures, such as epilepsy.

CBDs attractiveness, as a holistic health method, can be further attributed to its non-toxic and non-neurotropic nature. The latter term refers to the fact that CBD doesn’t induce the “high” commonly associated with cannabis use, where a person experiences euphoria, pleasure and heightened sensory perception. This altered state is actually caused by CBD’s sister cannabinoid, tetrahydrocannabinol (THC), and while CBD itself does affect the brain and mental faculties, it only does insofar as caffeine can affect your mind.

What is dosing CBD?

We define dosing as the precise, measured quantity of how much of a substance you take per serving. Dosing generally applies to the administration of chemicals or medicines, specifically for doses of small amounts, and is most commonly used for compounds in medicine. For CBD, this refers to how much CBD oil or extract is present in the serving you are taking.

In practice, this number is not definite and more variable; it differs a great deal amongst individuals. While the dose you are taking is always exact and can be precisely calculated, the actual amount of CBD that you will effectively absorb tends to vary. The one-size-fits-all strategy is reasonable for many conventional medicines, as the efficacy of the substance outweighs the potential toxicity. This phenomenon is what we call the therapeutic index that is; the ratio of a substance’s efficacy to its toxicity, or the margin of safety between the quantity of a drug that causes the desired effect versus the amount that causes adverse effects. This index is determined early in the process of testing for clinical drugs, as they are a mandatory step in the Food and Drug Administration (FDA) approval process.

However, CBD is not approved as a form of medication by the FDA and in most countries, so its therapeutic index is not very well defined. The effects that we do see from research and consumer accounts indicate that it has few side effects and is by and large safe, but the amount that yields results is dependent on various elements such as the individual, the product, and a myriad of other factors including liver function, variations in metabolism, concentration and more.

Dosing CBD is mostly a situational and personalized experience. It varies a great deal depending on the individual, so figuring out exactly what works best for you will take time alongside some trial and error. Here we’ll further discuss what precisely defines the process of finding your optimal CBD dose, and how to get there.

Dosing: the factors that influence it

There are three primary factors every CBD consumer should be aware of that influence your optimal CBD intake.

Bodyweight is a significant factor - the more you have, the more CBD you will need to take in order to get the effects you want. Your body size is typically defined using the body mass index (BMI), which is calculated using height and weight, but this is an inferior metric to use for dosing because a given BMI can represent several different body compositions. It can, however, be used as a guide - clinicians often use it to evaluate dosing medicine for patients over a certain BMI. Likewise, when it comes to CBD, a taller or heavier individual will need to take more to get the same effect as that of a smaller individual.

The severity of your condition (if you are taking CBD to help manage a condition) also plays a key role. Suppose you are an average layperson, taking CBD to clear your head or deal with stress and aches. In that case, you will naturally need less of it to get the desired result as compared to someone using it for chronic pain, severe anxiety or other chronic conditions.

Thirdly, your sensitivity and your previous exposure to cannabis or cannabis derivatives will prime your body chemistry to react differently to a given amount of CBD. Every individual’s metabolism and tolerance is tuned uniquely, and some people may have a natural resistance against compounds or have an established tolerance from past usage. Frequent users of cannabis and cannabis derivatives like THC will likewise need to consume more CBD than an average person to feel its effects. At the same time, CBD in some studies is found not to cause as much of a buildup of tolerance in users compared to other substances. Long-term and frequent usage will still inevitably cause desensitization and will require you to change your dosage over time.

Genetics and environment also act as significant contributors to dosing - specific mutations can profoundly affect the receptors in your body that correspond to CBD. Mutations on the CNR1 gene, which are responsible for coding the CB1 receptor that interacts with cannabinoids, can result in impaired functioning of your endocannabinoid system, thus heavily affecting how CBD interacts with it.

Beyond personal, physiological, qualities, other factors can influence how effective a dose of CBD can be for an individual. Chief among these is the concentration  of CBD in the product you are using - always make sure to read your labels, understand the delivery method and know what you’re taking in a single dose, as concentrations can heavily differ. Capsules, for example, have a fixed dosage, whereas oils and oral solutions depend on volume. Absorbed dosage can also vary depending on the delivery method, which we will further discuss, later in this article.

Other substances that you consume can also affect how the effects of CBD play out. For example, alcohol and other central nervous system depressants may exacerbate the sedating aspects of CBD, as well as other medications that can cause drowsiness. CBD, in general, may interfere with the metabolism of other prescription drugs and medicines, so it’s inadvisable to mix both.

This factor is in large part due to the adverse effect cannabidiol can have on the functioning of a group of crucial liver enzymes known as the cytochrome P450 enzyme system. Around 60% of all pharmaceutical drugs on the market are metabolized by these enzymes, including steroids, antihistamines, calcium channel blockers, immune modulators, antibiotics, antidepressants, beta-blockers and a great deal more. CBD acts directly against cytochrome P450 enzymes and inhibits their activity.

However, this inhibitory action doesn’t usually cause for alarm - even a common and benign food like grapefruit can elicit much of this cytochrome P540 enzyme inhibition. Still, it needs to be kept in mind, mainly if you regularly take prescribed medication. When the enzyme system is impacted this way, it results in higher levels of certain drugs in your system at a time, which can potentially lead to unwanted side effects. Suppose you’re thinking about taking CBD alongside other medications. In that case, you should research drug interactions beforehand, and consult with your doctor to make sure it’s safe for you to use CBD and adjust any dosage if necessary.

THC also influences the efficacy of CBD and whether or not other cannabis plant compounds like terpenes are included when you consume it. Research and consumer accounts indicate that CBD may mitigate the adverse side-effects of THC when taken together, resulting in a boosted effect to the combined therapeutic efficacy of both compounds. This phenomenon is representative of a broader theory on cannabinoid usage that we call the entourage effect;  the primary school of thought being that cannabinoids are more productive and active when taken in combination with each other, as well as when accompanied by other cannabis plant compounds. Thus, taking a given amount of pure, isolated CBD may have less of an effect than an equivalent dose of full-spectrum or broad-spectrum CBD product.

Lastly, as CBD oil and most CBD products are made from living plants, slight natural variations are perfectly normal and to be expected. Changes in weather, soil, water and nutrients can all impact the biology of raw materials, and there is no way to control every variable in this organic process entirely to ensure perfection. CBD quality, quantity and composition will also differ from product to product, and between different manufacturers, as there isn’t a set industry standard. Even for longtime CBD users, a switch between brands will require some fiddling to recalibrate ideal dosage.

So, how do you gauge your ideal “dose”?

As stated, countless variables, including weight, metabolism, genetics, environment, product consistency, and others, make the concept of a universal, “one-size-fits-all” CBD dosage an impossibility. Thus, rough estimates are about as good as it gets when trying to gauge dosage off the bat.

If you're new to cannabidiol, it is strongly recommended that you begin your journey with the minimum suggested CBD dosage on any product. This method is called titrating  your dose - meaning you start low, ideally with the lowest effective dose, and gradually increase the amount over time so you can find your "sweet spot" where you achieve the results you want. This process allows you a clearer idea of the dosage you need for your desired effect.

Some sites suggest increasing the amount you take every 3 to 4 weeks in increments of 25 mg until you get relief, but other sources differ. We advise that you start small and take it at a slow, measured pace. It's also useful to keep track of your daily experiences with CBD over time so you can clearly and accurately hone in on what works best for you.

Taking too little will net you no results besides disappointment - often people trying CBD for the first time, take such low doses that there are no visible effects, so they stop believing it can work for them.

Taking too much when it comes to CBD isn’t a big issue, so new users shouldn’t worry about potentially getting in over their heads. CBD is generally considered safe to consume, and difficult to overdose on. Chronic use and high doses of up to 1500 mg per day, over thirty times more than what most consumers take, have been shown to be well tolerated by humans in multiple instances. However, this amount is highly inadvisable as a regular dosage, and we strictly do not recommend such high doses of CBD.

While there are adverse effects  rarely associated with CBD use, including nausea, irritability, fatigue, diarrhoea, appetite, and weight changes, these symptoms are not particularly common. Other side effects of dosing too much CBD may include excessive sleepiness or elevated heart rate, or interference with prescription medications as described previously. Besides being non-toxic, CBD is also non-addictive - so long-term usage is less harmful than other alternatives one might use.

Comparing products

Next, let’s elaborate on how dosing can differ across different products and delivery methods. CBD is a versatile ingredient - non-toxic and edible, it is easily worked into food and drink products, topicals, oils and vapes and more.

These products can be sorted by way of several different classifications. Firstly, they can come in one of three general categories pertaining to the ingredients and contents of the product.

Full-spectrum products are those that contain a full range of compounds found naturally in cannabis plants - CBD chief among them, but including THC and other cannabinoids, terpenes, flavonoids and more. Thanks to the entourage effect, these products are thought to give the best experience and have the most potent effects, which is a large part of their appeal.

However, while the THC levels in these products are minimal and don’t induce a “high”, the inclusion of THC means that these products may run into state or government regulations on the amount of THC allowed in a product, depending on the area in question. In the UK, products are not allowed to have anything over the threshold of 0.2% THC. This factor makes acquiring some of these products slightly more of a hassle.

Broad-spectrum products are very similar to full-spectrum products, with the major difference being the exclusion of THC from their ingredients. Thus, these products are not impacted by THC regulations and can comparatively be easily acquired in many countries, while still maximizing the wellness benefits brought by the entourage effect for consumers.

CBD isolate, lastly, refers to products which contain only pure CBD, extracted, and so, there are no additional compounds included. These products are most popular with individuals who want the benefits one can get from CBD alone, without any of the other effects associated with other cannabinoids or compounds. However, this also means that the entourage effect does not come into play, so outcomes may be weaker and thus you may need a higher dosage compared to full- or broad-spectrum products to get equivalent results.

The category that your product falls into can influence the optimal dosage for you. While the difference in optimal dosage between a full-spectrum and broad-spectrum product might be minimal, there might be a noticeable difference for those opting for isolates.

Another factor that can heavily influence the dosage is bioavailability. Bioavailabilitydescribes the amount of a substance that reaches the systemic circulation in the body when administered, as compared to the initial amount taken. By comparing the amount of CBD in a given dose to the CBD levels in a consumer’s blood and plasma after taking it, we can gauge the product’s efficiency and actual effectiveness. After all, no matter how potent or strong a dose of CBD is, it needs to be able to access the cells and receptors necessary for it to have results.

While bioavailability is not the only factor that impacts the efficacy of a substance, it is generally a good measure of the effectiveness of substances which require distribution on a wide, systemic scale across the body to work correctly. CBD topicals, for instance, can be useful by acting on local receptors in the skin and can provide pain relief without entering the bloodstream directly.

While the bioavailability of CBD itself cannot be increased, the method of administration strongly affects it. The immediacy and effectiveness of different CBD products additionally tend to range widely due to differences in design and mechanisms of entry.

Comparing consumption methods

Dosage, as well as how long a dose takes to kick in plus how long the effects last, all vary with each method of use. Many of these figures and data also come from expert researchers, and dosage delivered with great precision so your experience may be considerably different from a clinical or laboratory setting.

Taking CBD orally, in the form of food products, drinks, capsules, is a generally widespread and popular method. Ease of use and familiarity are some of the main reasons for this, and it also helps that cannabis use is also strongly associated with food products - brownies are a familiar concept to most. However, dosage in this method is higher than its counterparts, as it is one of the least effective ways of taking CBD in terms of efficacy.

Our digestive system and liver are particularly effective at breaking down and filtering out foreign, potentially toxic compounds. When CBD is ingested, it has to pass through this entire system before it can enter the bloodstream. Digestion is already a slow process that breaks CBD down significantly, but the liver also ensures that CBD undergoes extensive first-pass metabolism, being broken down with regrettable effectiveness. This is why oral CBD’s bioavailability only comes up to around 10 to 20%, and it also takes anywhere between 30 to 120 minutes to take effect. The flip side is that effects last longer - approximately 10 to 14 hours, giving long-lasting results that can tide a person over for most of the day. However, this still means that oral CBD needs to be consumed in larger doses to garner the same effects as another product, and results are dependent on a person’s metabolism and liver function.

Topicals  refer to products that are applied to an external membrane on the body - typically the membrane in question is the skin, but this can also refer to products meant for the eyes or ears. Topicals usually are unable to access the bloodstream directly, hence their low levels of bioavailability, and instead act by interacting with receptors in the skin or the membrane to which they are applied, producing a local effect rather than a systemic one. Some methods, such as transdermal patches or products used on mucous membranes, will bypass the barrier relatively smoothly. Still, the majority of topicals are meant for skin application, and thus need to face the challenge of passing through this natural barrier. Skin also absorbs CBD at a slow rate, and a large proportion of applied CBD is lost in this process.

For these reasons, dosage for topicals tends to vary widely from person to person. The general rule is to follow the advice on the packaging, which itself can differ significantly depending on product and concentration. Usually, consumers are further advised to apply their topical CBD product until they feel relief. Additionally, topicals can only really be used to effectively provide local targeted pain relief to specific areas of the body, and don’t work to treat more systemic or internal conditions. Despite these limitations and inconsistencies, topicals are suitable for their intended purpose, and a single dose or application can last 4-6 hours.

CBD can also come in the form of sublingual tinctures, tablets or sprays. These products are meant to be absorbed by leaving them under the tongue for approximately 30 to 90 seconds, allowing them enough time to be absorbed via the sublingual gland into the bloodstream. This is one of the faster and more effective CBD absorption methods, and effects can be felt within 20 minutes or so and last for up to 12 hours. CBD oil administered with this method has a bioavailability of 13 to 19%, which is relatively high amongst CBD delivery methods, but whether or not a given dose is useful is also highly dependent on correct technique. It also is a method that may not be ideal for users who aren’t partial to the flavour of cannabis.

Lastly, CBD can be administered intranasally- here, CBD is vaporized into an aerosol and inhaled, such as through a vaporizer or vape device. Travelling through the airways, CBD particles come into contact with the lining of the lungs, be absorbed through this membrane quickly, and from there can enter the bloodstream, travelling around the body to act on the appropriate sites.

This effective mechanism means that intranasal methods have the highest bioavailability at around 34 to 46%, and are the fastest-acting with an onset of effects within minutes. CBD inhaled also leaves the system as rapidly as it enters, however, and it only has a duration of around 2 to 3 hours. This aside, CBD vapes thus only need relatively small dosages to get an effect, but one may need to take more frequent doses to prolong the impact.

Research into dosage

In the U.S.A, the FDA has only approved the use of CBD for two rare forms of epilepsy - outside of this; there is little official clinical research into identifying what dosages are appropriate when using CBD for other purposes. While studies have shown that chronic use and high doses of CBD are well tolerated by humans, narrowing down proper dosage has yet to be done in-depth.

In clinical studies, the dosages and methods of consumption vary widely. Researchers have used oral dosages of CBD ranging from 100-800 mg per day, and some studies have reported results with even higher doses of severe conditions. One review  has an individual reporting an improvement in psychosis following daily doses of 1,200 mg for a few weeks, while another says people with schizophrenia see benefits with increasing dosages of 40 to 1,280 mg per day for a month.

More clinical research is warranted to investigate CBD, especially in terms of dosage, and to see the extent of its therapeutic benefits. Research is also needed to study CBD’s action on liver function and hormones, alongside its interactions with other drugs, considering that CBD is typically used to supplement existing medications rather than to replace them, and also to discuss how both dosages need to be tweaked in order to provide synergy.

Dosing CBD safely

When it comes to figuring out what dose works for you, we begin by taking all primary factors into account. Always consult with a doctor beforehand and make sure that it’s safe for you, and only acquire your products from manufacturers that have a reputation for high-quality products and carry out accredited lab-testing to ensure quality control. And as always, read the labels and check ingredients, concentration, and recommended dosage.

As you continue to take CBD, your dosage will naturally change over time, influenced by the frequency of use, building tolerance, and other factors like body weight, age, metabolism and more. You should always track and observe your dosage plus the effects on your body and alter your dosage according to your needs. Remember that while most sites can offer general ideas of appropriate dosage, it is ultimately something that depends on the individual. One needs to determine what works for themselves.

 

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Written by   Infused Amphora Team 

The Infused Amphora Team is dedicated to creating resources to educate and engage consumers on the growing evidence of CBD benefits and the extensive health and wellness properties of CBD oil.  

Contributors  |  Angus Taylor + Dr Gaylord Wardell 

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Angus Taylor    |    LinkedIn   IPI website
CEO Infused Products International Ltd.


IPI is a pharmaceutical ingredient company that cultivates cannabis strains curated to extract specific cannabinoids, terpenes, and flavonoids for the formulation of 
effects-based health and wellness products. Angus is an experienced public speaker, engaging stakeholders, governments and media. Angus was the co-founder of NewLeaf Cannabis, Canada’s most successful retail brand to date, and has been established as a well-known and recognized expert in the field. 

 

Dr Gaylord Wardell BSc, MD, FRCP    |     LinkedIn   IPI website  
Chair, Infused Products International Ltd., Science Advisory Board       



Dr Wardell is a practising physician with over 40 years of clinical and educational experience in pain managemen
t, medical practices and education.  Dr Wardell is past President of the Pain Society of Alberta, and current President of the Alberta Medical Association, section of Pain. He is a popular public speaker, an active blogger on medical and pain-related issues, and proponent for scientific validation for patients experiencing pain.   

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Infused Amphora “Learn” is intended for informational purposes only and is NOT a substitute for professional medical advice, diagnosis or treatment.