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Home > Blog > Pain

CBD Dosage Guide: Everything You Need To Know

March 28, 2022  |  John Malanca

March 28, 2022 by John Malanca

Article Topics

  • What This Guide Covers
  • Key Takeaways
  • How to Get Started with CBD
  • What Are The Benefits of CBD?
  • CBD Rule of Thumb
  • What is CBD Dosage?
  • What is CBD Dosing Frequency?
  • Challenges in CBD Dosing
  • Factors That Affect CBD Dosage
  • Body fat percentage
  • Exercise level
  • Endocannabinoid system
  • Frequency of use
  • The condition being treated
  • The solubility of the CBD product
  • CBD Dosage Guidelines: Pain
  • CBD Dosage Guidelines: Anxiety
  • CBD Dosage Guidelines: Sleep
  • Epidiolex Dosage
  • How You Take CBD Affects How Your Body Uses It
  • Here is the rundown on all three methods:
  • CBD Dosage Guidelines: Edibles
  • CBD Dosage Guidelines: Tinctures
  • CBD Dosage Guidelines: Topical Creams, Lotions, and Balms:
  • How To Calculate How Much CBD is in A Drop
  • What is Microdosing CBD?
  • Is it possible to take too much CBD?
  • Can You Mix CBD With Other Drugs?
  • Drugs that interact with CBD include:
  • Carbamazepine (Tegretol)
  • Citalopram (Celexa)
  • Clobazam (Onfi)
  • Lithium
  • Methadone (Dolophine)
  • Valproate
  • Warfarin
  • CBD Interactions with Herbs and Supplements
  • Does CBD Interact with foods?
  • What Are The Side Effects of CBD?
  • No One Universal Dosage When It Comes to CBD
  • It Is Up To You to Find the Right CBD Dose for Your Unique Body
    • References:

Prescription Pill Container

A 2020 CBD survey that was conducted by the Single Care Team found that 33% of American adults have tried top CBD products while 45% of current users have increased their use since the COVID-19 pandemic started. [1] The same survey found that 32% of the users had not found CBD to be effective, in spite of current research showing that CBD is an effective treatment for several medical conditions. This highlights one problem; most consumers do not know how to choose and use CBD and just how much of it to take.

Consumers are not the only ones who struggle with the question “just how much CBD should I take?”

Question marks

Medical experts who are not well versed in the cannabis industry may also struggle with CBD dosing. Unlike traditional medications and supplements, there is not much literature out there on the ideal dosages for CBD products. In addition, each person may have a different response to CBD products that’s based on their unique endocannabinoid system (ECS). This may sound very complicated, but it actually is not that complicated. This CBD dosage guide breaks down everything that you need to understand the dose of CBD that you should take. But before getting to CBD dosage, we will start with an overview of what CBD is and what it is recommended for, just to clear the air.

What This Guide Covers

  1. How to get started with CBD
  2. What is CBD dosage?
  3. What is CBD dosage frequency?
  4. Challenges in CBD dosing
  5. Epidiolex dosage
  6. Factors that affect CBD dosage
  7. CBD dosage guidelines: Anxiety
  8. CBD dosage guidelines: Sleep
  9. CBD dosage guidelines: Pain
  10. CBD dosage guidelines: Other Conditions
  11. Dosage guidelines for Edibles
  12. Dosage guidelines for Tinctures
  13. Dosage guidelines for Topicals

Key Takeaways

  1. Everyone has a unique endocannabinoid system (ECS) that affects how they respond to CBD
  2. CBD dosage refers to the amount in milligrams or milliliters of CBD that should be consumed by a person at any one given time to achieve a desired effect
  3. CBD dosage is affected by several factors including age, body fat percentage, activity level, and frequency of use affect CBD dosage
  4. When it comes to CBD dosing, there is no one-size-fits-all
  5. Always start with the lowest effective dose and titrate upwards gradually
  6. The effects of CBD may take a while to kick in, be patient
  7. It is not possible to overdose on CBD

How to Get Started with CBD

Female Track Star

CBD, or cannabidiol, is one of the numerous chemical compounds that are present in hemp and cannabis and have bioactive properties. It is classified as a cannabinoid and happens to be one of the two most popular cannabinoids in cannabis.

Cannabidiol, or CBD, comes in many different forms: tincture, tablets, gummies, creams, lotions, and infused pastries. There is even CBD-infused soda pop these days! Depending on the formulation, CBD can be chewed, swallowed, placed beneath the tongue, smoked, and applied to the skin or even inserted rectally or per vagina.

What Are The Benefits of CBD?

CBD benefits

CBD has been proven to help with dozens of conditions, everything from acne to fibromyalgia. [2] According to the World Health Organization (WHO), some of the most common of these include:

  • Pain in general
  • Symptoms of diabetes
  • Cognitive degeneration disorders, especially Alzheimer’s disease, Parkinson’s disease, and Huntington’s disease
  • Many kinds of autoimmune disease, such as M.S., rheumatoid arthritis, and Crohn’s
  • Digestive disorders and symptoms, such as IBS and nausea in general
  • Hypoxia
  • Psychosis
  • Infection
  • Cardiovascular disease

The WHO also determined that CBD helps lower inflammation in general. [3] According to an international study conducted in 2017 sponsored in part by the University of California, San Francisco, “chronic inflammation is an essential component of chronic diseases.” [4]

CBD Rule of Thumb

Thumbs Up!

The very first “rule of thumb” when considering the dose of CBD to take is to make sure your cannabis source is free of pollutants, pesticides, molds, and other toxins. This may seem like a “no-brainer” but actually these kinds of harmful substances are frequently found in many low-grade hemp and medical marijuana products. A recent report put out by Steep Hill Labs in California discovered gram-negative Klebsiella, Enterobacter, Salmonella and Bacillus bacilli and Aspergillus and Penicillium fungi in a large number of samples coming from California medical cannabis crops. [5]

Since legal commercial hemp production has been around for a lot longer, there are currently more regulations in place for it. However, most of these regulations are geared towards industrial hemp and not towards hemp for human consumption. This is why it is extra important to stick with a hemp-based CBD company that is ethical, sustainable, and responsible to its customers and the planet.

It is also imperative that you make sure your CBD comes from a “full spectrum” plant. One of the main reasons why CBD is so beneficial to your body is because of all the “good stuff” in the plant itself. You may find this hard to believe, but that fact is that a single cannabis leaf (hemp or marijuana) may contain up to 500 diverse phytonutrients! A product that clearly states that it is “full spectrum” on the label (not broad spectrum nor CBD isolate) is going to contain anti-inflammatory terpenes, detoxifying antioxidants, brain and heart healing fatty acids, and immune-boosting flavonoids, in addition to CBD and THC (necessary trace amounts of THC are found in hemp too). Full spectrum means more plant healing power for you!

With that basic understanding, we can now proceed to the next section which explains all that you need to know about dosing CBD.

What is CBD Dosage?

CBD dosage refers to the amount of CBD that should be taken by an individual at one time. The dosage also specifies the maximum amount to be consumed in a day. Therefore, the dose of CBD is usually expressed in the form of “amount in milligrams or milliliters” and “per day.” E.g. 20mg/ day or 10mL/ day.

What is CBD Dosing Frequency?

CBD dosing frequency refers to how many times a day the CBD product should be consumed. It is usually expressed in the number of times a day but it may also include special instructions like after meals or at bedtime. For example, 20mg of CBD twice a day, before bedtime. The dosing frequency may also be referred to as the dosing regimen.

Challenges in CBD Dosing

The CBD industry is still largely unregulated, even though effort is being channeled to streamline the industry. This creates significant challenges in dosing CBD products. For one, some producers are insincere which means that the potency and quality of some CBD products cannot be ascertained.

The FDA as well has failed to provide guidance on the labeling of CBD products. A 2020 study that was published in the Journal of the Missouri State Medical Association indicated a gross mislabeling of CBD products that are currently in the market.

Prescription Bottle

Out of 102 products, 18% contained less than 80% of the CBD that they purported to contain while another 37% contained more than they purported to contain. [6] It is no surprise that a number of CBD consumers do not find CBD to be effective as indicated by the Single Care Team survey that was mentioned at the start of this article. [1] The lack of regulation in the industry makes it difficult to come up with a standardized dose of CBD.

Factors That Affect CBD Dosage

Different factors affect how our bodies metabolize drugs and other bioactive molecules. When it comes to CBD, the endocannabinoid system (ECS) also comes into play. These same factors will determine how much CBD you should take. They include:

Body fat percentage

More body fat means that you will need more CBD to achieve the desired effects. This is because CBD is lipophilic and will bind easily to the fat.

Exercise level

Regular exercise will increase the rate at which CBD is broken down and eliminated. Those who exercise frequently will be able to withstand higher doses of CBD.

Endocannabinoid system

Each person has a unique endocannabinoid system that affects their ideal CBD dosage. There is a need to start slow and observe how your body responds to the CBD dose.

Frequency of use

Frequent CBD users may build some level of tolerance for CBD. This means that they will require higher a CBD dose over time.

The condition being treated

Severe conditions will require higher CBD dosages.

The solubility of the CBD product

Water soluble CBD has higher bioavailability and is more readily absorbed. Therefore lower dosages are required for relief.

CBD Dosage Guidelines: Pain

Lower Back Pain

CBD can be used to treat different kinds of pain such as inflammatory pain, neuropathic pain, and pain due to tissue injury. A study was conducted in 2021 to investigate the effective dosage for CBD when used to relieve pain. [7] The researchers found that a dose of up to 40mg/ day of CBD provides sufficient relief from pain. CBD may also be combined with THC to enhance the therapeutic benefits aiming for a THC dose starting from 1mg/day with a maximum of 40mg/ day.

CBD Dosage Guidelines: Anxiety

Female Experiencing Anxiety

Several studies have been conducted to investigate the potential of CBD in relieving anxiety disorders and these studies have revealed varying effective dosages for CBD. More recent studies have shown that a dosage of 33 mg to 49mg of CBD is effective for PTSD and generalized anxiety disorders.

CBD Dosage Guidelines: Sleep

Depressed Girl In bed

When using CBD to treat insomnia the recommended starting dose is 25-40 mg of CBD per day. This is best taken in the evening, giving sufficient time for the effects to kick in based on the consumption method.

Epidiolex Dosage

In 2018, the Food and Drug Administration (FDA) approved a CBD-based drug (Epidiolex) for the treatment of intractable childhood seizures. This drug is on its way to becoming mainstream treatment for Lennox Gastaut, Dravets syndrome and Tuberculosis Sclerosis Complex in children above the age of one. The recommended dosage for Epidiolex is 10mg/kg two times a day. Weekly increments of 2.5mg/kg twice a day are allowed until an ideal dosage is achieved. [8]

How You Take CBD Affects How Your Body Uses It

The specific product that you buy will determine how CBD will eventually go into your bloodstream. The three main ways that most people consume CBD is through edibles, as drops (i.e. a tincture), and as a topical.

Here is the rundown on all three methods:

CBD Dosage Guidelines: Edibles

Sheet of brownies

Oral administration through edibles (i.e. food) is perhaps the most common way people ingest CBD. Edibles include gummies, cookies, brownies, butters, and all other foods that are infused with CBD. Once you eat these foods, the CBD in them must pass through all the regular processes that the rest of the food particles have to go through. It first has to go through digestion, then through the liver, and finally the CBD will be administered into your bloodstream a little at a time.

It may take anywhere from 15 minutes to an hour and half for the effects of ingested CBD to kick in. On the other hand, the effects will last much longer than with other methods of ingestion. How much food you have in your stomach before taking CBD will also determine how long the CBD will last and the strength of the effect.

When it comes to gummies and other edibles, quality is paramount. Lesser quality edibles may have significantly less CBD, as little as 7 mg per serving. Higher quality CBD gummies, cookies and other edibles can have up to 30 mg or more per serving. Be sure to look at the label and know how much CBD is in each serving before you purchase. Also don’t be swayed by fancy (and confusing) marketing when it comes to CBD from hemp.

What is the difference between hemp gummies vs. cbd gummies? In the majority of cases, there is none. It is just that some promotional avenues, especially online, do not allow the word “CBD” to be used, so hemp-based CBD companies on these platforms will opt to use the phrase “hemp gummies” instead.

To recap, gummies and other edibles are great for when you need long-lasting, sustained results. Many people use edibles for pain, for sleeping through the night, and if they are working long hours and may not have the time to monitor results and take additional doses.

There are tons of studies that have outlined the effectiveness of cbd gummies for pain. Studies from over 30 years ago (and through today) have also found that CBD administered orally can help significantly with sleep disorders as well. A 2017 review of CBD and sleep found that CBD can help not with insomnia, but with sleep apnea, REM sleep behavior disorder and, surprisingly, with excessive daytime sleepiness too.

Higher amounts of CBD taken orally have also been shown to reduce cortisol levels. This is great for rebalancing hormones, for unplugging from the stress cycle, and for lowering inflammation. Keep in mind, however, that for some people, high doses of CBD can have a sedative effect.

CBD Dosage Guidelines: Tinctures

Cannabis Oils

Sublingual use of CBD includes using a CBD tincture (usually oil-based) or sucking on a lollipop or piece of hard candy that has been infused with CBD. When administered orally under the tongue in this way, the CBD enters the bloodstream through specific tissues that are located under the tongue. These tissues are actually connected to major arteries.

Sublingual CBD bypasses the digestive process. It is a great method of CBD administration if you need fast relief and are okay with taking multiple doses throughout the day. Unlike ingesting an edible, the effects will be rapid, but they may not last as long. That being said, a 2010 study found that “peak blood levels” of CBD were achieved in about 10 to 15 minutes when administered sublingually through drops under the tongue. [9]

Studies have found that sublingual CBD can help with a variety of conditions, including pain, mood disorders, and digestive disorders. A 2016 comprehensive review found that 5 mg twice a day of sublingual CBD (in the form of oil-based drops) helped significantly with symptoms associated with Inflammatory Bowel Disease. [10]

CBD Dosage Guidelines: Topical Creams, Lotions, and Balms:

Girl rubbing cream on your shoulder

Yes, you absolutely can “eat” through your skin, and that includes CBD as well! When you apply CBD topically, it will enter your bloodstream through the skin. CBD administered this way has been shown to be very effective not just for skin-related conditions. A 2015 animal study found that topical CBD lowered joint swelling and pain caused by arthritis. The dosage was 6.2 to 62 milligrams per day (for mice). [11]

How To Calculate How Much CBD is in A Drop

Some CBD products are easier to dose than others. For example, CBD capsules, pills, or gummies will come in precise dosages such as 5, 10, 20, or 40mg. So if you are told to take 20mgs of CBD two times a day all you will need to do is take one gummy or capsule with 20mg CBD in the morning and another one in the evening. Things may be a bit tricky when it comes to CBD tinctures that come in a dropper bottle.

Most CBD tinctures will specify how much CBD is in the entire bottle but not in one drop. To find the amount in one drop, you will need to divide the amount of CBD in the entire bottle by the number of drops in that bottle.

One drop contains about 0.05 milliliters. Therefore, a 10 mL bottle should have about 200 drops. If the 10mL bottle contains 1,000mg of CBD, one drop will have 5mg of CBD. Therefore if you need to take 20mg of CBD you are going to take 4 drops.

What is Microdosing CBD?

Microdosing refers to the practice of consuming the smallest effective dosage (less than the standard dose) of a drug in order to maximize benefits while avoiding any adverse effects. It is commonly used when dosing psychedelics as well as marijuana products. The side effects of CBD are usually minimal, should they occur. Microdosing CBD is therefore desirable for those who are seeking general wellness from CBD and not a particular therapeutic benefit.

Is it possible to take too much CBD?

With all the “ambiguity” in CBD dosing one might wonder if it is possible to take too much CBD or to overdose on CBD. Several studies have confirmed that it is not possible to overdose on CBD. One study that was conducted in 2011 investigated the safety and side effects of CBD. The researchers concluded that CBD is generally well tolerated, even when it is consumed in very high doses that exceed usual dosages. In the study, dosages as high as 1,500 mg a day were well tolerated, while this is several times higher than what is typically recommended. [11]

Can You Mix CBD With Other Drugs?

prescription pills

It is not advisable to mix CBD with other drugs. CBD interacts with drugs that are metabolized through a pathway known as the CYP pathway. CBD may increase or decrease the activity of these drugs.

Penn State College of Medicine researchers investigated the interaction of cannabinoids (THC and CBD) with several drugs. They found 139 drugs that are affected by cannabinoids, 57 of which caused severe adverse effects when they interacted with cannabinoids. [12]

Drugs that interact with CBD include:

CBD may also interact with caffeine by decreasing the rate at which caffeine is broken down. This means that the levels of caffeine in the body will increase.

Carbamazepine (Tegretol)

CBD reduces the rate at which this drug is broken down and therefore increases the circulating levels. In the process, adverse effects may occur.

Citalopram (Celexa)

CBD decreases the rate at which Celexa is broken down in the body. This increases its circulating levels as well as the side effects.

Clobazam (Onfi)

CBD decreases the rate of breakdown of Clobazam in the liver and increases its concentration as well as the side effects.

Lithium

CBD reduces the breakdown of lithium and may trigger lithium toxicity.

Methadone (Dolophine)

CBD reduces the rate at which methadone is broken down in the liver. Hence, CBD might increase the effects and side effects of methadone.

Valproate

CBD should never be taken together with valproic acid. This may lead to liver damage.

Warfarin

CBD reduces the breakdown and hence increases the levels of circulating warfarin. This may cause internal bleeding.

CBD Interactions with Herbs and Supplements

CBD might increase the effects of some herbal supplements. It is therefore advisable to consult with your pharmacist before mixing CBD with an herbal supplement.

Does CBD Interact with foods?

Ideally CBD can be consumed with or without food. However, consuming CBD with fatty foods will increase the absorption of the CBD and thus the effects of the CBD will be enhanced.

What Are The Side Effects of CBD?

elderly woman in bed with headache

Most people tolerate CBD well. However, some people may experience some mild negative effect after consuming CBD which may include:

  • Headaches
  • GI disturbances
  • Fatigue
  • Diarrhea
  • Weight loss

No One Universal Dosage When It Comes to CBD

So now that we know the kind of hemp or medical marijuana we are looking for, is there a “universal dose” for CBD that we can all rely on?

Unfortunately, the answer is no. In fact, a 2017 comprehensive review published in the journal Cannabis and Cannabinoid Research looked at studies done on both animals and humans. They found that CBD works in very diverse ways depending on who is taking it. In human studies, effective CBD doses ranged from between 20 to 1,500 mg per day!

According to the researchers, some of the factors that determined effectiveness (as well as strength and staying power) included the status of the person’s liver function, neurochemical function, and metabolic function as well as any medications or supplements the person was taking at the time. Other factors that can have an effect on CBD effectiveness include weight, digestive health, and specific pre-existing conditions or diseases.

Even though there isn’t a universal CBD dose that will work for everyone, there is a rubric that many people rely upon when determining how much CBD they will need for their unique situation.

It Is Up To You to Find the Right CBD Dose for Your Unique Body

File cabinet

As we emphasized above, finding the right CBD dosage for your particular situation is not an exact science. Again, that is because everybody is unique and so is every type of CBD product. No matter how you decide to take your CBD – hemp or medical marijuana, edible or drops– our suggestion is to always choose the highest quality, full spectrum, toxin-free product for the most medical marijuana health benefits and the most benefits from your hemp CBD product as well.

Take your time and start slow. And don’t forget to monitor your symptoms and even journal as you go so you can feel the subtle effect CBD is having on you and your symptoms. Doing this, you can lock in to your minimum effective dose and be worry-free with CBD!

References:

  1. Single Care Team. The CBD Survey.  Published in April 2020. https://www.singlecare.com/blog/cbd-survey/
  2. Fasinu, P. S., Phillips, S., ElSohly, M. A., & Walker, L. A. (2016). Current Status and Prospects for Cannabidiol Preparations as New Therapeutic Agents. Pharmacotherapy, 36(7), 781–796. https://doi.org/10.1002/phar.1780
  3. WHO CANNABIDIOL (CBD) Pre-Review Report. (2017)  Retrieved from https://www.who.int/medicines/access/controlled-substances/5.2_CBD.pdf
  4. Liu, Y. Z., Wang, Y. X., & Jiang, C. L. (2017). Inflammation: The Common Pathway of Stress-Related Diseases. Frontiers in human neuroscience, 11, 316. https://doi.org/10.3389/fnhum.2017.00316
  5. Evans D. G. (2020). Medical Fraud, Mislabeling, Contamination: All Common in CBD Products. Missouri medicine, 117(5), 394–399. 
  6. G.R Thompson et al. (2017) A microbiome assessment of medical marijuana. 23 (4), pp 269-270. https://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(16)30605-X/fulltext#relatedArticles
  7. Bhaskar, A., Bell, A., Boivin, M., Briques, W., Brown, M., Clarke, H., Cyr, C., Eisenberg, E., de Oliveira Silva, R. F., Frohlich, E., Georgius, P., Hogg, M., Horsted, T. I., MacCallum, C. A., Müller-Vahl, K. R., O’Connell, C., Sealey, R., Seibolt, M., Sihota, A., Smith, B. K., … Moulin, D. E. (2021). Consensus recommendations on dosing and administration of medical cannabis to treat chronic pain: results of a modified Delphi process. Journal of cannabis research, 3(1), 22. https://doi.org/10.1186/s42238-021-00073-1
  8. FDA. Highlights of Prescribing information for Epidiolex. https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/210365lbl.pdf
  9. Pawar PP, Ghorpade HS, Kokane BA. Sublingual route for systemic drug delivery. JDDT [Internet]. 15Dec.2018 [cited 25 Mar.2022];8(6-s):340-3. Available from: http://jddtonline.info/index.php/jddt/article/view/2097
  10. Larsen, C., & Shahinas, J. (2020). Dosage, Efficacy and Safety of Cannabidiol Administration in Adults: A Systematic Review of Human Trials. Journal of clinical medicine research, 12(3), 129–141. https://doi.org/10.14740/jocmr4090
  11. Hammell, D. C., Zhang, L. P., Ma, F., Abshire, S. M., McIlwrath, S. L., Stinchcomb, A. L., & Westlund, K. N. (2016). Transdermal cannabidiol reduces inflammation and pain-related behaviors in a rat model of arthritis. European journal of pain (London, England), 20(6), 936–948. https://doi.org/10.1002/ejp.818
  12. Taylor, L., Gidal, B., Blakey, G., Tayo, B., & Morrison, G. (2018). A Phase I, Randomized, Double-Blind, Placebo-Controlled, Single Ascending Dose, Multiple Dose, and Food Effect Trial of the Safety, Tolerability and Pharmacokinetics of Highly Purified Cannabidiol in Healthy Subjects. CNS drugs, 32(11), 1053–1067. https://doi.org/10.1007/s40263-018-0578-5
  13. Kocis P, T, Vrana K, E: Delta-9-Tetrahydrocannabinol and Cannabidiol Drug-Drug Interactions. Med Cannabis Cannabinoids 2020;3:61-73. doi: 10.1159/000507998

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