CBD Oil Dosage (for Pain, Anxiety & Sleep)

Different varieties of CBD products

A variety of recommended CBD Oil dosages are available on websites, product packaging, and word of mouth, depending on product type and administration.

However, the Food and Drug Administration (FDA) has not issued a Recommended Daily Intake (RDI) or Recommended Daily Allowance (RDA) for the use of Cannabidiol (CBD) oils. Unlike its pharmaceutical grade forms like Savitex (for multiple sclerosis) and Epidiolex (for two types of epilepsy, Lennox-Gastaut syndrome, and Dravet syndrome), CBD oils are labeled and marketed as dietary supplements only.

CBD oil dosage then varies from individual to individual. Although some medical practitioners may offer or recommend a certain amount, there really is no “correct” dosage nor can they prescribe it as treatment. The most that can be done is to collate data and common variables to form a cohesive system in administering the supplement.

Factors to Consider in Using CBD Oil

The factors listed below are in no particular order as each one is important to reach the desired results.

  • CBD Concentration and Ratios

The amount of substance, usually in milligrams (mg), can be read in the label. While there are those who have CBD concentrates alone, some CBD oils have a blend of CBD and other cannabinoid or herbal compounds, depending on the purpose of the blend.

The ratio of CBD and other substances must then be taken into consideration. Example, the drug Savitex has 1:1 ratio of THC and CBD.

CBD Oil dosage will depend on the concentration of your chosen CBD oil product. If the label says 25mg/ml and you need 50mg, you’d need a dose of 2ml of that product to meet your ideal CBD amount.

  • Preferred CBD Oil Product Or Route of Administration

There are a variety of CBD Oil products available from solids to liquids. If you’re not comfortable with or are incapable of smoking, for example, you may opt to take the oral route instead.

    1. Orally Taken

Depending on the edible form of CBD, it can be ingested like regular food or capsules. It can also be administered oramucosally, whether sublingual or buccal. Sublingual dosing is when the product is placed under the tongue for a period of time until it dissolves or diffuses into the tissue. Buccal dosing is similar, but the product is rubbed on the gums or against the cheeks.

      1. Liquid hemp oil in the form of tinctures or drops
      2. Concentrated CBD paste also called Rick Simpson Oil or RSO
      3. Ingestible capsules
      4. Sprays and spritzers (for sublingual administration) –
      5. Nano-sized CBD particles in bottled drinks
      6. Dissolvable powders (containing CBD but usually includes a blend of other compounds)
      7. Addition of cannabinoids to cooking oils
      8. CBD edibles (i.e., gummies, chewing gum, brownies, cookies, etc.; generally for individuals who are sensitive to smoking) 
    1. Inhalable Concentrates

Some are more comfortable with vaping or smoking CBD. Through this route, CBD is absorbed through the lungs and straight into the bloodstream. You’d need a vaporizer or water pipe for this method. Sprinkle the concentrates and ignite. Inhale the vapors.

      1. Crystalline isolates
      2. Wax (similar to “shatter,” which are THC-containing concentrates)
      3. CBD-rich eLiquids and/or vape cartridges (akin to an e-cigarette) – You’d need a vape pen for this. Just exhale slowly then inhale through the mouthpiece for three seconds. Breathe out when ready and repeat.
    1. Topical

CBD oil can also be administered transcutaneously for those who are not comfortable with both ingestion and inhalation of CBD products. Simply follow the instructions in the packaging of the product and let the CBD oil seep through the skin.

      1. Transdermal CBD patches (similar to nicotine patches)
      2. CBD-infused salves, balms, lotions, shampoos, or soaps
      3. Bath bombs
  • Bioavailability of CBD

After getting an idea of how concentration and routes of administration work, it’s time to consider how much of your CBD oil dosage would be bioavailable.

Unfortunately, drugs would be broken down and acted upon by enzymes of your body, leaving only a fraction of the drug unchanged for your absorption. Depending on the route of administration, the bioavailability of CBD can be as low as 4% to as high as 90%.

Most products already include instructions and dosage on their packaging. If they did, they have already factored in bioavailability.

If you’re making your own CBD tinctures or CBD blends at home, it’s important to bear in mind that the lowest bioavailability yield is through CBD edibles. Since these products have to go through the digestive system, the CBD is heavily acted upon before reaching your bloodstream. A cookie with a 20mg cannabinoid may give you around 4% bioavailability (0.8mg), that’s a lot of CBD loss.

The highest bioavailability is through inhalation or oramucosal dosing ranging from 2-56% and 35%, respectively.

It is worth mentioning that fast absorption and high bioavailability might not be required for certain conditions. Since it has been reported that long-lasting effects are more prevalent with ingestion, it may be better to take edibles. If, on the other hand, an immediate effect is required, intranasal or inhalation may prove to be more effective.

  • Body Weight and Chemistry

Once you have decided on what type of CBD oil product to use, its route of administration and taking into consideration how much will be left in your system, it’s finally time to think about the numbers.

Many have suggested 25mg as a good starting point, Inclusing Greenthevoteok even has a dosage calculator for their products, which is worth a gander.

But you may be wondering or even be suspicious at the dosage. Why 25mg?

A simple basis that has been used is the intake of 1-6mg of CBD (depending on pain levels) for every 10-lbs of Body Weight. People at 200-lbs would then be advised to start at 20-33mg whereas others at 150-lbs could start at 15-25mg.

Another factor to bear in mind is your body chemistry. There is such a thing as drug-to-drug interactions, and the human body produces its own set of cannabinoids, hormones and the like. People undergoing medical treatment or have recently received the same may experience adverse effects or pronounced effects of CBD. It has been stated that CBD might help patients taking opiates, for example.

  • Reason for Using CBD Oil

CBD Oil dosage also depends on what you’re using it for. Is it for chronic pain? Emergency dose (also called acute dosing)? Dietary supplement? Some instances would require high doses while others target only a specific area.

It’s also important to note that CBD, like other cannabinoids, is biphasic: meaning it can produce different (even opposing effects) at different concentrations.

Lastly, bear in mind the FDA disclaimer since it has not evaluated CBD oils. They are not intended for treatment, diagnosis, cure or prevention in the strict and regulated sense.

For Pain Management

Although there are claims of CBD being effective in pain management, there is no conclusive evidence to support each one. In fact, there are those who seem to have misinterpreted the results of model-based studies (no human subjects) to support CBD as a pain alleviator or suppressant. Cannabinoids have been found to be effective in pain management according to research, BUT not all studies highlight CBD as the principal subject and few human trials available for perusal. We still await the conclusions (and publication for the general public) of several pre-clinical and clinical trials regarding CBD.

  • Chronic Pain. In a study involving advanced cancer patients and the use of Sativex (1:1 of THC and CBD) versus placebo, there is no significant difference between the two treatments (Fallon, Marie T., et al. 2017). Another experiment, using mice and different types of induced pain, showed that dehydroxyl-CBD (DH-CBD) acted as an analgesic, potent inhibitor of chronic neuropathic pain, able to reduce mechanical hypersensitivity, and attenuate acute pain. The study reports that DH-CBD, NOT CBD, is a promising candidate for chronic pain management. (Xiong, Wei., et al. 2012) Still, many testimonials of users have urged others to view CBD as a pain reliever.

A 2014 study by Silveira, João W. et al. showed the effects of the induced disc injury in male Wistar rats was significantly attenuated by CBD.

According to CBDOilReview.org, a 2.5-20 mg of CBD for approximately 25 days is the starting CBD Oil Dosage for Pain.

  • Arthritis. Unfortunately, studies regarding CBD and arthritis used mostly rat models. One study, wherein CBD gel that was transdermally administered, showed the therapeutic potential of CBD in relieving arthritis-related pain and inflammation (Hammell, DC, et al. 2015). A 2017 study by Philpott HT., et al, supports this claim with their own experiment that showed the local administration of CBD (via topical application, three sets of noxious rotation lasting five seconds at five minutes apart) was able to block osteoarthritis-related pain, and prophylactic treatment would prevent pain development and nerve damage in the afflicted joints.

Finally, the first clinical controlled trial for cannabis-based medicine (CBM) in rheumatoid arthritis (RA) was conducted in 2006. Sativex spray (oral intake) was used involving RA in human patients with it producing statistically significant improvements in pain on movement, at rest and sleep quality (Blake, DR. et al. 2006).

  • Multiple Sclerosis. Luckily, there are some studies available for People with Multiple Sclerosis (PwMS) and CBD. It has been proven to lessen MS-related pain and spasticity. In fact, the Department of Health of the Government of Australia had already released a list of suggested cannabinoid product and their dosage, including but not limited to CBD.

For THC:CBD extracts dosage is: 2.5mg and 12.5mg of THC, and 0.8mg to 1.8mg CBD (capsule form to be taken 2-4 times a day) OR 2.5mg THC and 2.5mg CBD (sublingual form up to 48 times per day). Mayo Clinic suggests 2.5–120mg THC:CBD combination (daily for two to 15 weeks, taken orally). For CBD extract alone, the dosage is 2.5mg of CBD (spray form up to 48 sprays per day).

 For Anxiety

Claims have been made that certain CDB oil dosage can reduce anxiety and its symptoms: insomnia, restlessness, etc. This is due to observed interactions of CBD with different receptors that regulate fear and anxiety-related symptoms, like cannabinoid type 1 receptor (CB1R), the serotonin 5-HT1A receptor, and the transient receptor potential (TRP) vanilloid type 1 (TRPV1) receptor among others.

A comprehensive collection of the use of CBD in anxiety has been presented by Blessing, Esther M et al. (2015) with tabulated results of the different diseases and dosage administered by the studies collated.

A case study by Shannon, Scott and Janet Opila-Lehman (2016) presents the effectiveness of CBD oil in the case of a young female patient suffering from Post-Traumatic Stress Disorder (PTSD). At trial doses of one capsule of 25mg CBD per night (with supporting 6-12mg CBD sublingual spray for anxiety during the day), the patient showed a gradual increase in sleep quality and a decrease of anxiety. No side effects were noted.

Other diseases and medical conditions. Mannucci C et al. have collated data from different sources in their 2017 paper to present a comprehensive collection of all pre-clinical and clinical trials that deal with CBD alone. It listed the use of CBD for Parkinson’s disease (PD), Alzheimer’s disease (AD), multiple sclerosis (MS), Huntington’s disease (HD), amyotrophic lateral sclerosis ALS), and cerebral ischemia. They concluded that CBD is a promising agent though more controlled and standardized clinical tests would be required to prove its therapeutic claims.

Epilepsy. As mentioned above, due to the effectiveness of cannabinoids in treating seizures, there is already a protocol and medical grade variety of CBD for the treatment of two types of rare epilepsy: Lennox-Gastaut syndrome and Dravet syndrome for patients who do not respond to the original prescribed treatment of the same.

 Other Recommended CBD Oil Dosage:

For schizophrenia: 40-1,280mg CBD daily (orally ingested up to four weeks).

For glaucoma: 20-40mg of CBD (single dose, sublingual administration). Note: Doses greater than 40mg may increase eye pressure.

For Huntington’s Disease: 10 mg of CBD per kilogram of body weight daily (orally taken for six weeks).

CBD Oil dosage is a topic to be expanded on, and with growing claims and evidence to support its therapeutic use, hopefully, there would be more clinical tests conducted and soon. Before taking any kind of drug, always do ample research and double check the reference material.

 References:

Guidance for the use of medicinal cannabis in the treatment of multiple sclerosis in Australia https://www.tga.gov.au/sites/default/files/guidance-use-medicinal-cannabis-treatment-multiple-sclerosis-australia.pdf

 

https://www.projectcbd.org/science/cannabis-dosing/cannabis-dosing-101

https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm611046.htm

https://www.medicalnewstoday.com/articles/317221.php

https://sepia2.unil.ch/pharmacology/index.php?id=51

https://www.researchgate.net/publication/228425785_Clinical_Pharmacokinetics_of_Cannabinoids

Effect of cannabidiol on sleep disruption induced by the repeated combination tests consisting of open field and elevated plus-maze in rats https://www.sciencedirect.com/science/article/pii/S0028390811003467?via%3Dihub

Cannabidiol as a Potential Treatment for Anxiety Disorders https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4604171/

Effectiveness of Cannabidiol Oil for Pediatric Anxiety and Insomnia as Part of Posttraumatic Stress Disorder: A Case Report https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5101100/

Randomized, controlled trial of cannabis-based medicine in central pain in multiple sclerosis http://n.neurology.org/content/65/6/812.long http://n.neurology.org/content/65/6/812.full

Neurological Aspects of Medical Use of Cannabidiol. https://www.ncbi.nlm.nih.gov/pubmed/28412918

Cannabidiol to Improve Mobility in People with Multiple Sclerosis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5874292/

Cannabinoids in the management of difficult to treat pain https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2503660/

Preliminary assessment of the efficacy, tolerability and safety of a cannabis-based medicine (Sativex) in the treatment of pain caused by rheumatoid arthritis. https://www.ncbi.nlm.nih.gov/pubmed/16282192

Attenuation of early phase inflammation by cannabidiol prevents pain and nerve damage in rat osteoarthritis. https://www.ncbi.nlm.nih.gov/pubmed/28885454

Transdermal cannabidiol reduces inflammation and pain-related behaviours in a rat model of arthritis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4851925/

Sativex oromucosal spray as adjunctive therapy in advanced cancer patients with chronic pain unalleviated by optimized opioid therapy: two double-blind, randomized, placebo-controlled phase 3 studies https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5521351/

Cannabinoids as pharmacotherapies for neuropathic pain: From the bench to the bedside https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2755639/

Does Cannabidiol Protect Against Adverse Psychological Effects of THC? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3797438/

Human Metabolites of Cannabidiol: A Review on Their Formation, Biological Activity, and Relevance in Therapy https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5576600/

Human Cannabinoid Pharmacokinetics https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2689518/

Chemistry, Metabolism, and Toxicology of Cannabis: Clinical Implications https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3570572/

Subjective and physiological effects of oromucosal sprays containing cannabinoids (nabiximols): potentials and limitations for psychosis research https://www.ncbi.nlm.nih.gov/pubmed/22716155

Plasma Cannabinoid Pharmacokinetics following Controlled Oral Δ9-Tetrahydrocannabinol and Oromucosal Cannabis Extract Administration https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3717338/

Cannabidiol: an overview of some chemical and pharmacological aspects. Part I: chemical aspects. https://www.ncbi.nlm.nih.gov/pubmed/12505688/

Safety and side effects of cannabidiol, a Cannabis sativa constituent https://www.ncbi.nlm.nih.gov/pubmed/22129319/

Transdermal cannabidiol reduces inflammation and pain-related behaviours in a rat model of arthritis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4851925/

Pharmacokinetics of cannabidiol in dogs https://www.ncbi.nlm.nih.gov/pubmed/2900742

A protocol for the delivery of cannabidiol (CBD) and combined CBD and ∆9-tetrahydrocannabinol (THC) by vaporisation https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4274767/

Cannabidiol bioavailability after nasal and transdermal application: effect of permeation enhancers https://www.tandfonline.com/doi/abs/10.3109/03639041003657295

Pharmacokinetics of cannabinoids http://downloads.hindawi.com/journals/prm/2005/242516.pdf

http://www.who.int/medicines/access/controlled-substances/5.2_CBD.pdf

https://bpspubs.onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2125.2012.04341.x

Cannabis Sublingual Intake Method + Tutorial https://www.youtube.com/watch?v=dbwjb94BBHo

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