Cannabidiol (CBD) is a naturally-occurring chemical compound in cannabis plants that has shown to have potential therapeutic applications for pain, insomnia, and anxiety and depression, and more.
As of 2021, hemp‐derived CBD is commercially available and is commonly used as a health and food supplement for the potential relief of certain issues. That said, in a recent survey, researchers found that 32% of people who’ve used CBD did not find it effective for them at all.
This is most often the case because the consumer is not taking enough CBD to feel a difference in their symptoms, and who could blame them for not knowing what dose is right? According to recent research: “The blurred lines between CBD as a licensed medicine and CBD as an over‐the‐counter remedy contribute to the overall lack of understanding of what dose of CBD may be considered therapeutic.”
CBD is not widely studied, but Leafeport recently spoke with industry experts who shared some general guardrails they use when advising their clients on the use of CBD, based on their anecdotal experience and study of the science.
The consensus? CBD dose is highly dependent: on the CBD itself, the specific issue the consumer is using it for, the CBD delivery method, and even the consumer’s individual physiology. Remember, this information shouldn’t replace consulting with your doctor.
Dr. Zora DeGrandpre, ND practices naturopathic medicine in rural Washington and is a professional medical and scientific writer and editor who specializes in naturopathic, functional, botanical and integrative medicine, including CBD therapy.
Eloise Theisen, RN, MSN, AGPCNP-BC is a board certified Adult Geriatric nurse practitioner who specializes in cannabis therapy and one of Pacific College’s Medical Cannabis program expert faculty members. Thiesen has worked for over 20 years with cancer, dementia and chronic pain patients and has focused on cannabinoid therapies for the last 8 years.
Chase Terwilliger is President and CEO at The CBDistillery, a U.S. Hemp Certified company that focuses on high-quality and easily accessible to hemp-derived CBD products, as well as on consumer education.
Jen Palmer, ND, is a naturopathic doctor and the Director of Education for pioneering hemp-derived CBD brand, Charlotte’s Web, with 20 years experience in integrative medicine and the dietary supplement industry.
When considering how much CBD to take, it’s always important to consider the type of CBD you are taking. CBD products use three types of CBD, including isolate, which is 99% CBD, broad-spectrum, which is CBD can other cannabinoids with the naturally-occurring THC removed, and full-spectrum, which contains everything that naturally exists in the plant, including less than 0.3% THC, the legal limit for hemp-derived CBD.
Each of these types of CBD has different benefits, but usually, experts suggest consumers to use full-spectrum CBD because evidence suggests that small amounts of THC actually help CBD work better in the body—and help them take less CBD overall.
“[The synergy between CBD, THC, and other cannabinoids is] theoretical still in nature,” said Eloise Theisen, a nurse practitioner with a specialty in CBD. “What we understand today is that a little bit of THC is important for the CBD to get to the receptors that help with your pain, anxiety, whatever it is. The CBD needs to essentially jump on the back of THC so it can get to the proper receptors. And that THC level isn’t likely to cause any impairment or euphoric effects.”
As well, because the CBD industry is not regulated by the FDA, there are mislabeled products on the market. This may cause consumers to buy a product that is not as potent as it says it is.
“The Food and Drug Administration (FDA) hasn’t yet approved any non-prescription CBD products. Some scammers take full advantage of that fact by selling low-quality products that aren’t labeled accurately. One group of researchers analyzed 84 CBD products and found that only 31 percent of them contained the amount of CBD that had been advertised,” according to Healthline.
For the purposes of this piece, experts gave their advice on dose in terms of full-spectrum CBD and products that are reputable.
Aside from the type of CBD you’re using, what you are using CBD for can affect the dose you need to take. That’s why, when we asked our experts about finding the best dose of CBD, Theisen, who’s treated over 7000 patients using various cannabinoids through her practice Radicle Health, says she starts with thorough health screening.
“There are a lot of factors that I take into consideration. What are their goals with care – are they looking to try to cure something or treat something? What are their expectations?,” said Theisen. “Sometimes the health condition will help me determine which route might be most appropriate to start with – is it sublingual, is it oral, is it inhalation, is it topical? Sometimes rectal or vaginal suppositories may be considered, depending, but that’s unusual. And then I’m always going to start them low and slow, but I do develop target dosages for them to consider and that is often based in evidence, scientific literature.”
For example, when it comes to severe and complex pain, Theisen tends to suggest starting on a higher dose of CBD, which she defines as 25 mg and up, because research shows it may take a higher milligram concentration to find lasting pain relief.
“I have some patients that require 300mg of CBD a day and they get adequate relief,” said Theisen.
Likewise, naturopath and medical writer Zora DeGrandPre MS, ND, says when it comes to using topicals, she sees consumers needing higher doses depending on where their pain is in the body, due largely to CBD’s fat-solubility.
“If you’re putting it on the thumb joint for example, there’s not a lot of fat around that particular joint to allow for real rapid absorption. I have a bad hip but there’s a lot more fatty tissue in general in those areas. It absorbs more quickly and it lasts longer than it does, say, something like a thumb joint or finger joint.”
Scientific studies support the high variability in dosing depending on the nature of the issue, and the merit of the low-and-slow approach, purely because so much is still unknown about how CBD potentially works in various conditions.
According to a 2019 study, there is a “wide active dosing range of cannabidiol (<1 to 50 mg/kg/d) within a variety of medical conditions including epilepsy, anxiety and graft‐vs‐host disease.” At the same time, the review indicated that “studies that used higher doses tended to have better therapeutic outcomes compared to lower doses overall.”
When we consume CBD, another fact that impacts efficacy is the way the CBD is delivered and how easily absorbed by the body that delivery method makes the CBD. It is common to find a range in absorption rates, or bioavailability, from product to product. That has to do with how much time it takes the CBD to reach your bloodstream and which bodily processes the CBD meets along the way due to the product you choose.
For instance, one widely-cited study found that CBD is absorbed into the bloodstream quickest when intravenously injected. From there, inhalation of CBD through a vape or joint is the next best option for fast absorption from the lungs into the bloodstream. Next, sublingual CBD products are absorbed at 13% to 19% bioavailability because a little more time must pass as the CBD is processed through the sublingual gland before hitting the blood. Then comes oral CBD products like tinctures, edibles, and beverages, which have a rate of bioavailability somewhere in between 10% and 20%, because they must be processed through the digestive system before it can be released into the blood—a process which takes up to 2 hours and can decrease the potency of the CBD. CBD topicals are the least bioavailable, and must be rubbed into the skin thoroughly to penetrate the blood.
Using this variable bioavailability and what they know about the individual’s issues, CBD experts then create a plan of action for the client. For instance, Jen Palmer, ND, a naturopathic doctor and Director of Education for pioneering hemp-derived CBD brand, Charlotte’s Web, often tells consumers to start with topicals because their bioavailability is somewhat lower, making it less likely the consumer will overdo it and experience CBD side effects like sleepiness and diarrhea.
“Everyone has a different experience with using CBD. I always recommend starting with a lower serving size, and increasing it slowly over time, until you get the desired results. Some people notice a benefit immediately, whereas others need to use it consistently for several weeks before they realize the effects,” said Palmer. “I find that topical CBD products are a great place to start, particularly for those who fall into the baby boomer generation. Gummies are an easy delivery system which also taste great, making them the most popular choice currently. Some of our customers like using the oils because they offer greater versatility in serving size, and some people prefer the convenience and consistent serving size of a capsule. I recommend taking hemp derived CBD at least twice daily for maximum benefits and to adjust your serving size as needed.”
While they often let their patient choose which type of delivery method they want to use, Theisen and DeGrandPre give similar information. DeGrandPre has also been known to start some people with topicals, especially for joint and muscle pain. Additionally, both are both proponents of edibles like gummies, because they are easy to divide up into smaller doses if needed.
All this is to say, you can use any of these types of CBD products, but the product you choose may impact how quickly you see relief, or how often you have to take the CBD.
To make matters even more complicated, experts say that an individual’s physiology can also impact the rate at which CBD is absorbed, and thus the amount you take to see relief.
“When it comes to figuring out the correct dose of CBD for you, it is important to note that everybody is different, and CBD dosage is highly personal,” said Chase Terwilliger, CEO of CBD brand, CBDistillery. “Dose depends on body mass, metabolism and what you are using it for. We always recommend to start around 20-30 mg but you may need a higher dose, or to take CBD multiple times throughout the day to feel desired effects.”
DeGrandPre and Theisen also note that diet can impact how CBD is absorbed and how often and much you need to take. Because CBD is fat-soluble, it tends to be better-absorbed after a fatty meal.
Likewise, Palmer says it’s important to not assume that there is a one-size-fits-all dose of CBD and suggests starting at an even lower dose than Terwilliger.
“The amount of CBD that is needed really depends on a person’s individual biochemistry, weight, metabolism, and even genetics. If you’re new to CBD, I suggest starting with 10- 15 mg per day, and increasing it slowly. It’s important to check in with yourself and pay attention to what your body is telling you.”
One top question experts get from consumers about CBD dose is —What CBD dose do you advise for pain? Here’s what the experts say.
Dr. DeGrandPre: “It depends on the delivery system they’re using, it depends on what problem they’re having and it depends on what medication they’re also currently on. I usually start, for example, [by] reducing their prescription medications very slowly, which is actually sometimes more difficult than trying to adjust dosing of CBD. We’re likely going to have to do a scaffolding. We’re going to build in multiple route of administration, maybe multiple cannabinoids to get you the most relief and it’s such an interesting trajectory that they go through because they may – their treatment plan may change drastically once they start to eliminate or even completely stop their other medications, like opioids or other antidepressants that are used for pain for example.”
Eloise Theisen: “With pain, again, it depends. CBD on its own without some THC does not seem to be as effective. With the complexity of pain, I tend to do higher dosages of CBD for pain. I have some patients that require 300mg of CBD a day and they get adequate relief and it depends on their access to other cannabinoids, too. Sometimes a little bit of THC can really help alleviate pain without impairment.”
Chase Terwilliger: “We always recommend to start around 20-30mg but you may need a higher dose, or to take CBD multiple times throughout the day to feel desired effects. We also recommend to keep a journal for the first month of CBD usage, and write down how you feel with different amounts, and times that you are taking it. CBD is not a quick fix, and more like an adaptogen that works to bring your body into balance. To see best results, consistency is key.”
Dr. Jen Palmer: “Everyone has a different experience with using CBD. I always recommend starting with a lower serving size, and increasing it slowly over time, until you get the desired results. Some people notice a benefit immediately, whereas others need to use it consistently for several weeks before they realize the effects. Hemp-derived CBD is so different from other dietary supplements or even medications, both of which recommend a universal dosage for an average adult. The amount of CBD that is needed really depends on a person’s individual biochemistry, weight, metabolism, and even genetics. There is no “one size fits all” and no specific duration of use for CBD to take effect. If you’re new to CBD, I suggest starting with 10- 15 mg per day, and increasing it slowly.”
Because of how new the science is around CBD and because so many factors are known to impact CBD absorption, the general expert advice on dosing is to go “low and slow”—start with a low dose and gradually increase based on how you feel. Keeping a journal in your first month of CBD use to track diet, time of dose, and how certain doses make you feel can help you learn what works for you.
“It’s helpful to journal how you feel as you progress, because it’s easy to forget how you felt before you started taking CBD. Writing it down makes it easier to look back and notice the progress that you’ve made,” said Palmer.
In the end, it’s important to remember that the subjectivity of CBD dose doesn’t mean you can’t find a dosage that may potentially address your issues—so don’t get discouraged! Monitor your CBD experience and don’t be afraid to seek out experts who are well-versed in the most current scientific literature on CBD dosage for support, and you’ll be able to finetune your experience with CBD.
As always, remember that this information does not replace consulting with your primary care physician, but is instead meant to give you a better understanding of what comes into play with dosing CBD.