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We Asked a Scientist: What’s the Right Dose of CBD?

Tilray logo Presented By Tilray December 21, 2017
This article is sponsored by Tilray, one of the largest and most sophisticated producers of medical cannabis in the world. Tilray is dedicated to providing safe, consistent, and reliable products to patients and furthering clinical research.


As research into the medical applications of cannabis compounds steadily increases, scientists and doctors are shedding new light on how cannabinoids interact with not only the human body, but with other cannabinoids. New studies are providing further insight on why these substances work, how they can be used most effectively, and what new applications they may have in the future.

Related

CBD (cannabidiol): What does it do and how does it affect the brain & body?

We sat down with Nick Jikomes, Leafly’s in-house neuroscientist, to learn about what researchers are learning about the cannabinoid CBD, and how different doses can be put to use in treating a variety of conditions.

Nick Jikomes (Julia Sumpter/Leafly)

Tilray: Let’s start with the basics: what is CBD, exactly?

CBD, or cannabidiol, is one of the major cannabinoids found in Cannabis—typically the second most abundant after THC. It’s like THC in that it’s a plant cannabinoid with a similar chemical structure, but it’s also very different in terms of physiological effects.

The most obvious way that it’s different is that it’s non-intoxicating—CBD doesn’t get you high the way that THC does. There are also interactive effects between THC and CBD. They can enhance each other, but they can also get in the way of one another. Some of those interactions have potentially interesting medical applications.

What do we understand about that relationship between THC and CBD, and what are we learning about it?

The first thing to understand is how each one interacts with receptors in the nervous system. The major receptor in the endocannabinoid system (ECS) responsible for the psychoactive effects of cannabis is CB1, a receptor found predominantly in the nervous system. For classic psychoactive effects to be felt, THC needs to bind to that receptor and activate it.

CBD also interacts with the CB1 receptor, but in a different manner. It doesn’t activate that receptor; in fact, it makes it harder for the receptor to be activated by other compounds. CBD is essentially getting in the way of THC’s ability to bind the CB1 receptor, which is why the presence of CBD has a significant impact on the psychoactivity of THC-containing products. This is why the ratio of the two compounds is important for anticipating the effects of cannabis products.

Related

Predicting Cannabis Strain Effects From THC and CBD Levels

The other thing to keep in mind is that most compounds, CBD included, interact with many different receptor systems. So, it’s not just the relationship with THC that’s interesting; CBD is interacting with many other receptors and having many different effects through those systems.

CBD droplet bottles from Tilray

CBD is available in numerous forms, including liquid drops. (Courtesy of Tilray)

CBD is recommended for a wide range of symptoms and conditions—are there instances where you’d want some CBD with your THC, and others where you want just CBD?

Basically, yes. CBD may reduce many of the unwanted side effects of THC, such as short-term memory impairment and anxiety, which are more common at higher doses of THC. Often the more CBD you have relative to THC, the less of those things you should expect.

While THC and CBD have different pharmacological properties, they can both have similar physiological effects, probably acting through different mechanisms. For instance, both compounds can have analgesic and anti-inflammatory effects; they may act through different mechanisms, so having THC and CBD could potentially enhance an outcome surrounding pain relief.

Related

Can CBD Undo the Anxious Side Effects of THC?

Are we at the point in research where we can better understand, based on the condition a patient might have, what could be the most useful blend? Or is there still some trial and error involved for patients finding what is going to work best for them?

I don’t think the clinical evidence is currently at a point where you can say you want this particular ratio for this particular condition to a specific patient. If you are a patient who finds that a 1:1 THC to CBD blend is perfect for you, that’s great. But you’re most likely going to have to get there through some trial-and-error, and when you do, there are good reasons to think that blend won’t be perfect for you forever.

That’s because people’s physiologies change over time, including the ECS and how densely receptors are expressed in the brain and the body. These things change over the lifetime of an individual, and so the optimal ratios and doses of these compounds, whatever they may be, are probably going to change as well.

Related

How Strain Genetics Influence THC:CBD Ratios

CBD doses

Medical cannabis providers carefully measure CBD for dosing. (Courtesy of Tilray)

It sounds like the proper dose, in the long run, can be kind of a moving target?

It can, and that’s one reason to be very cautious about being overly prescriptive about doses and ratios. There’s an interesting study on this topic looking at THC in mice, and the results suggest that the same dose of the same compound (THC, in this case) has very different behavioral and cellular effects depending on the age of the subjects.

This is a very common thing in the world of pharmaceuticals—different doses of a drug can have different effects. With substances that bind to a lot of different receptors, like CBD, there’s often a sweet spot around a mid-sized dose. That means you can’t necessarily expect the substance to be twice as strong if you double the dose—in fact, you might see the opposite.

Related

Peak THC: The Limits on THC and CBD Levels for Cannabis Strains

And that article points out that there are also different conditions for which different dosages are effective?

Exactly. And that’s likely because CBD is binding to many different receptors throughout the body. At a fairly low dose, it will mainly hit the receptors it has the highest affinity for, or that are the most densely expressed. At higher doses, those receptors can become saturated, so the remainder of the CBD will interact with other receptor systems, and that’s where you may start to see different effects.

Are we starting to see a ceiling on effective dosages of CBD?

It depends on the condition you’re trying to treat. If you’re using CBD for anxiety, there may be that sweet spot, a middle dosage, that has the best effect, and it can become less effective if you increase the dose.

Related

Why Does Cannabis Cause Paranoia in Some But Helps Anxiety in Others?

In epilepsy, that hasn’t been seen yet. They’re using very high doses in that treatment, and I don’t think anyone has yet observed a diminishment in effect as the dose goes up. But in most clinical studies looking at things like epilepsy, they’re using oral CBD (given in pill form) at very high doses – hundreds of milligrams per day. CBD has very low oral bioavailability, meaning that only a fraction of the CBD one would take in pill form ends up in the bloodstream and hitting the relevant receptors in the nervous system. So when thinking about dosage, it’s also important to consider the route of administration.

So the route of administration can impact how much CBD ends up in someone’s system?

That’s right. Again, CBD has very low oral bioavailability. So if you swallow CBD in pill form, only a fraction of that CBD will end up making it into the bloodstream and exert an effect in the brain or elsewhere in the body. Different routes of administration, such as vaporization, sublingual tinctures, or transdermal patches, provide a more direct route for CBD to enter the bloodstream. This probably allows for a larger proportion of the CBD in those products to enter the bloodstream. So, people interested in CBD products may want to consider experimenting with different routes of administration. A given amount of CBD in pill form could may not lead to the same outcomes as an identical amount taken via another route.

  • Steven the cat scruffer

    I work in the medical field, so obviously I can’t test positive for THC.
    Will CBD test positive?
    I’m interested in CBD for aches and pains.
    I’ve heard of kratom for pain relief.
    Any input anyone?

    • Bert Angelle

      I’ve been drinking Kratom to help with opiate withdrawals and then the cronic pain once the detox was over. I dont know how I would have made it otherwise cause it was torture. I tried to quit three years earlier without help but the withdrawals pulled me back in. I endure unimaginable pain because of a crappy VA doctor that holds me to a letter I signed saying I can’t test postive for THC. This agreement was signed before it became legal for medical even if I’m in a state approved compassionate care program for the terminally ill. However, there is a letter from Nikki Barnes stating the law and the legality of the cannibus program with regard to vets. I haven’t slept in a year, I only pass out from exhaustion for about an hour or two a night due to constant pain. I feel as though my life is slipping away. Can someone please help me because I can no longer think for myself. I feel like my story should be played on locals news if not nationally to garner the attention I’m sure many vets who suffer need to have drawn to their situation. We are be ing tortured by the ignorance of our medical staff.

      • Steven the cat scruffer

        Wow. I wish something could be done for you, veterans.
        I got political last year with the pending DEA Kratom ban. Called my congressman, wrote letters to the DEA.
        From what I have heard and seen a life on heavy opioids is horrible, with it being a pathway to street drugs for some.
        Our current marijuana laws are ridiculous, while legal in many states it’s still a schedule one drug.
        I think you should contact your local news station and tell your story.
        Peace.

      • Ronald Kratz

        Hi, Green relief by Earth Naturals 10 mg cbd pills. I haven’t slept in 50 yrs and one pill I slept 7 hrs!! straight thru, I was still skeptical but every night same thing 7 hrs. I’m not a salesman but feel obliged to share. I’m a 28 yr Hodgekins Lymphoma and a 8 yr Sub arachnoid hemmorage survivor and walk like the Mummy cause of nerve pain and stiffness. I then tried charlottes web advanced oil and it didn’t do anything!! Different products work for different people, the cw was recommended by a friend with lupus, Good luck and ty 4 your service, tc

      • Bonnie S

        You can try buying or making some CBN, which is much better for sleep than CBD. CBN is not psychoactive, just like CBD, so does not show up on drug tests. THC turns into CBN very slowly over time, or more quickly when heated. When people make canna-oil and cook it “too long”, it turns more of the THC into CBD. Basically you can put canna-oil in a Mason jar in a water bath in a crockpot for 12 hours and much of the THC will turn into CBN. But probably not all. A half a teaspoon, 2.5 ml, of that and I can usually sleep through the night despite chronic pain.

      • Char Meaker

        rescind the agreement. What happens if you test positive for THC. Are they going to take some garbage pharmaceutical away from you. You have rights. I have a family member who is a vet with a medical marijuana card. I’m sorry you are in such a state of agony.

    • Tom Jordan

      I have been taking cbd oil for sever sleep issues. I do not smoke. Marihuanna or do drugs. I applied for job at Lowes and failed drug test with a positive use of marihuanna. I did not get the job and they sent me some paperwork that was quite insulting. So yes you can fail a drug test while taking cbd oil.

      • lovingc

        Was it hemp based CBD? If it was”marijuana based there could be detectable THC present and that will show up on your piss test.

        • Alf_vin

          Even hemp has trace thc in it. Only cbd isolate would be free of thc

          • SRMCON

            yes, but the legal amount you define as a trace would not cause a positive test. in legal Hemp that is. so the source of your CBD was probably with THC, which in my opinion also works better and you need less mg of CBD, but then testing positive is a bummer. I would go after the test results and limits, since they are VERY arbitrary. If you research various limits it can go from 10 ng to 100 ng. The limit for ‘doping’ for many athletes is much higher than what the police or work regulations allow.

      • Steven the cat scruffer

        Thanks for the info. I was told it doesn’t show unless you use large doses..grams not mg. But your experience says otherwise.

      • Drew Curry

        poor SOURCE choices….ya get what you pay for

      • Melisa

        Hi Tom, what brand of CBD are you taking?

      • Sarah Peacock

        If I were in that situation, I’d immediately request a copy of the test results.

        “Even though drug tests themselves are not covered by the ADA, the results from such tests are considered medical records …” http://www.twc.state.tx.us/news/efte/drug_testing_in_the_workplace.html

      • SRMCON

        If I were going to apply to a job and had doubts of passing, I would buy a home kit for $30 and test myself first. they are accurate enough to let you know if there is a problem, especially if you test a hour or so after using your normal dose

    • Alf_vin

      Only if you get 99% pure isolated cbd should you be safely free of thc, however some test look for breakdoen metabolites, not sure if that would be triggered by the cbd breakdowns

      • Steven the cat scruffer

        I’ve read the labs do a second test on a primary positive test for THC, that can differentiate between THC and CBD.
        At my stage in life and career I just can’t take the chance.
        I’ll stay with kratom..untill the FDA..DEA makes that a scheduled drug. UGH.
        As Bob Marley said…legalize it..don’t criticize it…or was that Peter Tosh…
        Anyway… Thanks for the responce..
        Rasta fari.

    • DonR

      I also work in the medical field. I have been taking CBD 600mg. 1ml. twice daily with no evidence of THC in urine tests. Recommendation: Make sure you get your CBD from a reliable source from a state that requires third party auditing (analysis) of the product. WA, OR, CO would be good choices.

      • Sherry Ann Gri

        What are you taking the CBD oil for, may I ask?

    • SRMCON

      if you use CBD derived from Hemp you will have no problem passing a test for THC. the labeling is sometimes hard to figure out, since they refer to whole-plant cannabis (which hemp is also), but no mention of the strain. Basically if the company is selling it through the internet openly as CBD oil, then you can probably bet it’s derived from hemp. The product doesn’t have to come from a ‘legal’ state, since there is no ban on pure CBD. In fact, most industrial Hemp is being harvested in previous tobacco states, where Cannabis is still illegal.

      • Steven the cat scruffer

        Thanks for the info. And yes, I saw my first legal hemp crop this year. It was on an old tobacco farm.

    • robertburnsob

      I’d think that the medical establishment would accept CBD and, if not, it should be placed into receivership. I doubt that CBD would trigger a THC test–if it does the test is bunk–but you should check with a tester preferably the one for your employer. I could see an unenlightened tester/employer testing for CBD and TCH.

  • lovingc

    This was no help at all.

    • lori martin

      Exactly!!!! Read this whole article for nothing

    • Brad Forrester

      300-400 compounds within the plant working in concert is the secret. Even Dr. Mechoulam will tell you that it’s the entourage or synergenic effect of multiple cannabinoids used together that create the magic.

      • jerry cross

        exactly, CBD alone isn’t enough. other states need to understand this and there needs to be more published studies. we all know there are plenty of real medical studies but the results are being sat on

    • Summary: It depends. Start slow & low. Add small increments weekly. Consider body weight, symptoms and tolerance. (And the list of meds that could be affected.)

  • Alf_vin

    Not a single mention of mgs… Poor article that basically just has a lot of words to say to experiment with it and see… There should be some info of how many mgs was effective in studies for different conditions. Hard to find any info on that anywhere and was hoping this might actually help inform. I would say for anxiety 20-40mg seems to work. Same with for treating dermatitis (orally)

    • Fsinco Media

      So true…Considering the title is “What’s The Right Dose of CBD”, I come away from this post with NO Answers!!! No Thanks, Tilray.

  • E. A. Becker

    My son has been melting down on and off all week. I have used the CBD Rich Oil to calm him down and stop him from cycling. The oil is what is keeping him level and not having to go to the next highest level of medicine. I cannot thank your company enough. AnnCannMed customer and mother of a child on the Autism Spectrum

  • Finding the right dose of CBD is definitely trial and error. Consider that when you take a prescribed pharmaceutical, the doctor has (hopefully) figured that the dose they are recommending of said medicine is going to suit your ailment. Because CBD and cannabis in general are still so new, it’s definitely not an exact science yet. Connecting with people knowledgeable about doses of CBD would be helpful.

  • Penny

    While I knew that there was no real dosage out there that would work for everyone, I found it interesting to read what he had to say about the route of administration. What this article really got me thinking about was how long it takes the average person to find the right dosage. We’re discussing this here: https://www.greenapple.md/forums/other/cbd-dosage/

  • SRMCON

    All of us that have experimented and recommended CBD for our ‘patients’ know that it’s very variable, but this article does nothing to help the problem. Not even a starting point for new patients with mg dosage. Should one just expect the Budtender to have more knowledge than this staff Dr.? I don’t think so. I’m sure each of us has our own experimental evidence of what works and what doesn’t. And what about this pure CBD hemp-derived oil? It is much easier and cheaper to get, since there is commercial cultivation and it’s basically NOT a schedule 1 drug (of course the DEA pretends to not be too sure about that).

    My experience shows that the benefits of CBD are much stronger when it is derived from whole-plant cannabis and not hemp plants.
    Throwing in some THC also seems to help many patients with their symptoms, so long they don’t get the psychoactive effect, which older patients don’t like much. I like ratios between 20:1 and 1:1 for CBD/THC.

    My non-Dr. recommendation is to start small and work up. with a 1:1 ratio back off more. Using 1:1 I would start with 10mg/10mg or 20 mg total. Most patients are taking this orally, but some like to Vape since it is faster. Be sure to wait if taken orally, since the effect can come on from 1-2 hours later (seems to vary a lot per patient). This may seem very small to regular users, but there is nothing worse than your elderly patient having a first bad experience and giving up entirely.

    • robertburnsob

      I wonder if the story is correct even on bioavailability via oral administration.

    • Miguel

      I would challenge the statement that the benefits of CBD are much stronger when its derived from whole plant cannabis. I’ve seen great results from the full spectrum Hemp based CBD. I think some of it is bias towards the non-hemp CBD. I work in a medical clinic so I see quite a few patients taking the hemp based CBD (topical and tincture) with significant improvement in their condition.Also, if you take the CBD by mouth with a meal or snack that has some fat content it will increase absorption significantly.

  • I know people should not advertise but I go to a very trustworthy company called AnnCannMed to buy CBD Oil. My life, appetite, and overall happiness has improved a lot. You can checkout their site for more infor and medical purchase.

  • Sherry Ann Gri

    Just got CBD oil, comes with a 0.5 ml dropper, does anyone know how much I should be taking for anxiety and is this any good to help me fall asleep? Can’t get an answer from the company.

    • 360dunk

      I’ve found that for me, the best dosage of oil is the size of a grain of rice, placed under the tongue. But I never get just CBD oil….always go for the 1:1 ratio of CBD and THC (including RSO – Rick Simpson Oil), which provides the best anti-inflammatory and even anti-carcinogenic protection.

      Unfortunately, not everyone lives in a state where THC is legal. If so, take a Vegas vacation and stock up on the oil to bring home.

  • If you are looking for information on how many mg’s of CBD you should be using for certain types of problems (ie. anxiety, chronic pain etc) check out this guide we put together, https://www.everydayoptimalcbd.com/cbd-oil-tinctures-dosage

    • Andy B

      But what are these figures based on? Anecdotal evidence? I’ve been trying to find published papers that show the efficacy of CBD (no THC, or 0.2% or less) at various doses for certain conditions. There’s nothing useful I’ve found, other than studies which talk about the human equivalent of 100s or 1000s of mgs *per dose*. Where do the very low mgs suggested here and on support pages come from? ‘Start low and slow’ seems to be the mantra, but where is the evidence for this approach working? Is it all just anecdotal?

  • Pičkin Dim

    Did I miss it or did this guy not once mention daily dosages?

  • Cheri Sicard

    I have a question. You say CBD reduces the unwanted effects of THC such as short term memory loss, anxiety, etc. but does it also reduce the desired medical effects of THC?

  • kim kristianson

    Exactly: We asked a scientist.
    …?
    And didn’t get an answer, why isn’t that surprising!

  • Martha__A

    The article title is “what is the right dose of cbd?” The article never answers that question. The answer would be a number of mg of bio available cbd per unit of time. Such as “between 5-10 mg four times a day”. Lousy article.

  • E Sawyer

    Google this (You might find helpful):
    An Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies
    Short answer: No studies have really reached the point of declaring a minimum effective dose. However, you can take too much (read the conclusion) but likely not enough CBD is available retail for that to happen.

  • peter nelson

    Not a very useful article. Basically Jikomes recited a long list of reasons why it’s a hard question to answer. We get that. in fact there’s even more reasons than he listed. Variations in transporter polypeptides in the gut, based on recent food consumption, can change how much THC and CBD cross the lumen, and cannabinoids also have cytochrome p450 dependencies that can limit the availability of some of their active metabolites depending on other drugs or food recently consumed. (cannabinoids are also potent inhibitors of other cytochrome p450 enzymes, so they can mess up other drugs).

    Fine. We get that.

    But those of us consuming it medically (in my case lower back pain) instead of recreationally need some consistency. One thing I find really frustrating about cannabinoids is that if I take the exact same dose at the exact same time of day several days in a row (typically a CBD and THC combo tincture) I get radically different results. I don’t have that problem with oxycodone. (…yet. I imagine if I take it long enough I’ll develop a tolerance, although I take it with an NMDA inhibitor and so far, no tolerance)

    My background is in neurophysiology so I certainly appreciate the difficulties of coralling a substance with varying bioavailability and possessing a host of active metabolites, all with different pharmacokinetics, competing for receptor sites and for enzyme resources. But to be a useful, effective, everyday drug we need answers to these questions, not just excuses why it’s so hard to answer.

  • Kristy

    “We Asked a Scientist: What’s the Right Dose of CBD?”

    And then never, ever, at any point in this article actually give even a ballpark figure for what dosage someone should be taking a day. You didn’t even answer the question in the title. So yeah, that’s a fail.

  • Stephen Stokes

    garbage article zero info

  • Linda T

    I HAVE CHRONIC PAIN DUE TO OSTEOARTHRITIS. I HAVE BEEN ON MORPHINE SEVERAL YEARS. I STARTED OFF WITH 250 MG A DAY. I NOW TAKE 15MG THREE TIMES A DAY. I ASKED MY MD TO TRY AND WEAN ME OFF COMPLETELY. WELL, I FOUND OUT I NEED THE 15 MG TID. I AM 68. WILL IT BE HARMFUL TO TAKE CBD WHILE TAKING THE MORPHINE? WOULD THE CBD BE HELPFUL IF I WOULD TRY DETOXING OFF MORPHINE? THANK YOU EVERYONE

  • warren22theape

    Virtually ZERO information about dosage.