Is More CBD Better? The Science Behind CBD Dosing for Anxiety and Other Conditions
In 2015, the National Institute of Health allotted $21.2 million of its $111 million cannabinoid research budget towards projects exploring the medicinal potential of these compounds. These projects proposed to manipulate the body’s endocannabinoid system, either by modifying endocannabinoids or with phytocannabinoids from the cannabis plant.
While the primary psychoactive phytocannabinoid, delta 9-THC, has acknowledged medicinal value, cannabidiol (CBD) is widely known for its broad range of potential medicinal uses. In recognition of CBD’s vast potential, over $9 million in grants were awarded in 2015 to fund CBD-specific medicinal research.
Much of this research has centered around the treatment of epilepsy, with studies showing that CBD has significant potential for treating the condition in children at high doses. A daily dose over 600 mg reduced seizure frequency by 39%. While this is a far greater amount than you’d find in many of the CBD consumables available at your local dispensary, many retail CBD products with lower levels of the cannabinoid are reported to be effective at treating anxiety, pain, and a host of other disorders, either through self-experimentation or anecdotal reports.
So why not crank up the CBD dose to reduce your anxiety? If a little is good, shouldn’t a lot be better? It turns out that for CBD, the answer is no; CBD’s medicinal efficacy might require a particular dose range. Call it a “Goldilocks Zone,” where there’s not too much CBD but not too little, either.
Intriguingly, this Goldilocks Zone differs for each disorder. For instance, CBD appears to treat anxiety at relatively low doses compared to the high doses used to treat epilepsy.
Overshooting the Goldilocks Zone when trying to treat a given condition may reduce the efficacy of CBD. An animal study published back in 1990 found that low to moderate CBD doses reduced anxiety, but CBD’s anti-anxiety effect disappeared at higher doses. Importantly, the authors note an inverted-U response to CBD. Out of the four doses tested, the lowest dose had a moderate anti-anxiety effect, the second-lowest dose had the greatest anti-anxiety effect, the third dose had a moderate effect, and the highest dose had no effect.
While it may sound out of the ordinary, this “inverted-U” effect is actually quite common among drugs that affect multiple brain receptors, as CBD does. In fact, 37% of published toxicology articles report some degree of an inverted-U response, indicating that this is not a random event but instead reflects differential drug effects on brain targets.
Different doses of CBD may actually be more beneficial, depending on the ailment or condition being treated. (Leafly)
The wide spectrum of CBD’s medical indications—it is used as a treatment for pain, anxiety, post-traumatic stress disorder, and other conditions—reflects its diverse set of brain and body targets. Since each of these many medical problems is impacted by CBD acting on specific receptors in the brain and body, differences in sensitivity for these targets may underlie CBD’s inverted U-response and define its Goldilocks Zone.
Right: The brain contains a huge a number of brain cells (neurons). Each neuron, represented here as a hexagon, is connected to many others. Left: The synapse is the site where two neurons communicate with each other. The “sender neuron” releases chemical signals called neurotransmitters, which stimulate receptors on the “receiver neuron.” There are many different receptor types in the brain, each one sensitive to different neurotransmitters. (Leafly)
Renowned cannabinoid pharmacologist Roger Pertwee described CBD actions at low, medium, and high doses in an oft-cited review published in The British Journal of Pharmacology. As expected, low doses of CBD impact fewer neural targets than high doses. At relatively low doses, CBD can block endocannabinoids like anandamide and phytocannabinoids like delta 9-THC from interacting with receptors in the nervous system. This blocking action is thought to explain CBD’s ability to reduce the adverse effects that can accompany delta 9-THC exposure such as anxiety.
Left: THC directly stimulates the CB1 receptor. This interaction underlies the major psychoactive effects of Cannabis consumption. Right: CBD reduces, or “antagonizes,” THC’s ability to stimulate CB1 receptors. This can decrease some of THC’s effects, especially negative effects like anxiety and short-term memory impairment. (Leafly)
CBD’s anti-anxiety effects can also be attributed to its activation and enhancement of specific serotonin receptors. Serotonin is an important neurotransmitter involved in mood regulation and stress response; low serotonin levels are thought to contribute to conditions including generalized anxiety disorder and major depression. A common pharmacological treatment for these conditions involves enhancing the amount of serotonin available in an effort to activate the receptors using selective serotonin reuptake inhibitors, or SSRIs.
Rodent studies of CBD in anxiety and stress reveal that CBD similarly enhances serotonin receptor activation. In rats, a low-to-moderate dose of CBD has anti-anxiety effects following a stressful period of restraint (the rat equivalent of being placed in a straitjacket for an hour), but these anti-anxiety effects go away when the serotonin receptor 5-HT1a is blocked ahead of time. This suggests that low doses of CBD near the peak of the rodent’s inverted-U response reduce anxiety by activating 5-HT1a receptors.
Similar CBD doses in humans have been shown to be effective at reducing anxiety in individuals with generalized social anxiety disorder, and low to moderate doses are effective at reducing stress and improving performance in a simulated public speaking event. These positive effects are associated with a restoration of normal brain activity in key regions associated with anxiety and emotional dysregulation.
The positive effects of CBD in treating anxiety are experienced at about 25% of the dose used to treat epilepsy. That higher effective dose level reflects additional CBD brain targets beyond those active in treating anxiety.
While CBD activation of 5-HT1a receptors is insufficient to protect against seizures, a promising target for CBD’s antiepileptic effects is the receptor GPR55, which initiates a cascade of events that can have diverse effects in brain cells. CBD is an antagonist of GPR55, blocking its function and altering brain activity in a way that may protect against seizures. When administered in higher doses, though, the benefits of lower concentrations may be lost. Anti-anxiety effects, for instance, seem to be obstructed while higher concentrations of CBD work to block GPR55 receptors.
Identifying CBD’s many neural targets and their sensitivity is an exciting area of ongoing research. But knowing the optimal CBD dose for treating different conditions is a critical component of successful CBD treatment. The current research suggests that anxiety and depression-related disorders (e.g., obsessive compulsive disorder, autism, acute stress) respond best to low-moderate CBD doses, while epilepsy responds best to higher CBD doses.
Being able to titrate CBD dosing for specific disorders will lead to more efficacious CBD-centric therapies and reveal treatment strategies that may be able to combat multiple ailments at once. CBD’s Goldilocks Zone for treating anxiety illustrates the need for an improved understanding of the compound’s therapeutic mechanisms, while highlighting its vast treatment potential.
CBD Dosage – March 2022
Cannabidiol (CBD) is a cannabis plant compound believed to have several therapeutic properties (2) .
Currently, the Food and Drug Administration ( FDA ) has approved only one cannabidiol product, Epidiolex (3) . This oral solution i s used in treating seizures caused by Dravet syndrome (DS) or Lennox-Gastaut syndrome (LGS), two rare types of epilepsy .
- The starting point is an oral dose of 2.5mg/kg twice each day, or 5mg/kg daily.
- After a week, users can increase the dosage to approximately 5mg/kg twice each day, or 10mg/kg per day.
FDA regulations do not cover any other product that contains cannabidiol . Thus, they do not have official guidelines for CBD dosing .
Identifying the Right Amount of CBD
Body weight, body chemistry, and current health conditions should be considered when deciding on the amount of CBD one should take. There is no one-size-fits-all solution, especially for beginner CBD users.
F irst-time users are advised to consult a doctor for the appropriate dosage of CBD . A physician can give medical advice for any potential risks and drug interactions with existing medications.
It is also best to start with lower doses , increasing gradually to higher doses until the desired results are achieved.
Low doses could mean taking 20 to 40 milligrams of CBD per day as a starting point. After about one week, users can try higher amounts if they do not experience any adverse reactions.
For instance, an individual may be advised to take 40mg of CBD for pain relief. After one week, users can choose to increase this to 45mg, then 50mg by the second week, and so on until the pain becomes bearable.
It is recommended to keep track of one’s use of CBD and how their body reacts to the dosage. CBD users can write their findings in a notebook or mobile app.
Calculating the Right Dose of CBD
Many brands provide labels on their CBD capsules and CBD gummies for users to know how much of the compound they can get in one serving size . For example, the label on a CBD capsule bottle may indicate 5mg of CBD per pill.
For those using CBD oil , the product usually comes with a dropper . Its package may specify how much cannabidiol can be obtained in one drop. Using the recommended number of drops per serving, an individual can estimate how many drops they need.
Sometimes, the CBD content in a product can be challenging to measure. The product’s packaging states the total amount in the entire bottle instead of the amount provided in one serving.
Consider a person who wishes to take a serving size of 40mg of CBD from a 10 ml bottle of CBD oil labeled to have 1,000mg of cannabidiol .
Since one drop is approximately 0.05 milliliters (ml), the 10ml bottle contains 200 drops of CBD. The result can be achieved by dividing the bottle size (10ml) with CBD’s amount per drop (0.05ml).
To estimate how much CBD is in each drop, divide the total amount of CBD (1,000mg) by the total drops (200). This means each drop should contain about 5mg of CBD.
To get 40mg of that CBD oil dosage , one should measure at least eight drops of the product in their dropper .
Reputable CBD brands readily provide the lab results of their cannabidiol products for people to access. Checking these reports is one of the best ways to know how much CBD is in each package.
Research Concerning CBD Dosage
In a review, the World Health Organization (WHO) analyzed oral CBD doses ranging from 100mg to 800mg daily (5) . They noted that these amounts of CBD did not produce harmful effects.
In a study, a patient with schizophrenia took 1,200mg of CBD per day for a few weeks saw a positive change in their symptoms (6) .
The same study also claimed that CBD doses between 40mg to 1,280 mg per day improved the wellness of another patient.
Meanwhile, a study on arthritic patients given 15mg of CBD per day from Sativex, a spray product that contains equal parts CBD and THC, found that the treatment relieved morning pain on movement and rest (7) . These results were better than those achieved with a placebo .
Is CBD Overdose Possible?
According to a 2011 study on CBD’s safety and side effects , researchers noted that subjects who took 1,500mg of CBD a day tolerated the compound well (14) .
A study in 2017 also confirms this finding, adding that no studies reported CBD tolerance despite how much CBD oil they took (15) .
Although there is no proof of CBD overdose, one study in 2019 found that human subjects experienced side effects of CBD. Some of these adverse reactions include fatigue, diarrhea, somnolence (drowsiness), and vomiting (16) .
There are possible adverse drug interactions that could occur for p eople taking CBD (17) . Researchers believe these interactions may be due to how cannabidiol engages with the cannabinoid receptors and enzymes in the endocannabinoid system (ECS).
The ECS is thought to regulate several bodily functions while having a protective role in many medical conditions. In a study, e xperts theorize that drugs modulating the ECS and its receptors may help with diseases involving pain, inflammation, and multiple sclerosis (18) .
In a 2019 clinical trial, 57 healthy subjects were divided into four groups: those who received 150 mg of CBD, 300mg of CBD, 600mg of CBD, and placebo (19) .
Results of the study indicated that the group who received 300mg of CBD experienced a significant reduction in anxiety during a simulated public speaking test.
According to the researchers, the results of the trial are in line with results of animal studies describing bell-shaped dose-response curves in terms of the effectiveness of CBD (20) .
CBD Oil Dosage vs. CBD Capsule Dosage
Various types of CBD products are sold by brands nowadays. When performing research, first-time users should consider the best CBD that suits their lifestyle.
Although there are CBD vape pens, lotions ( topicals ), and CBD edibles, the two most popular products are oils and capsules.
CBD Dosage in CBD Oil
The most prevalent cannabidiol product on the market is CBD oil . With a full dropper , users can get full-spectrum CBD , broad-spectrum CBD, or CBD isolate based on their preference.
Full-spectrum contains all CBD compounds, broad-spectrum has all components except THC , while isolates are pure cannabidiol . The appropriate type of CBD oil depends on the needs of each person.
CBD oil is made after cannabis plants , preferably the hemp variety, are harvested and sent to laboratories for extraction. These plants contain many cannabinoids , with CBD and THC (tetrahydrocannabinol) being two of its major components (21) .
One of the main benefits of CBD oil tinctures is that they are absorbed faster by the body. Taking CBD sublingually, or under the tongue, ensures immediate delivery of the compound (22) .
Another advantage of using CBD oil is that these products often come with droppers . A dropper lets people accurately measure the amount of CBD they need to take for each serving size .
Most CBD products come with recommended dosages. CBD users may follow the recommended dosage or they may start with lower dosages.
If the effects of a CBD tincture are too strong, users can reduce the amount without purchasing a new product.
However, it is still recommended to consult a physician before taking CBD, especially for first-time CBD users. Visiting a medical professional may provide CBD users with more information about safe and effective dosing.
CBD Dosage in CBD Capsules
CBD capsules are cannabidiol placed in a medium intended for easy and convenient intake. However, their manufacturing process is different compared to CBD oils .
CBD capsules are sold in softgel pills containing either type of CBD. Full and broad-spectrum CBD capsules are made similar to CBD oils , except the extracts are placed in softgel capsules.
As for isolates, the CBD capsules are filled with a white crystalline powder, which is pure CBD.
A key advantage of taking CBD capsules is their ease of use and discretion. A CBD pill while traveling can be a convenient way of consuming cannabidiol.
CBD capsules also provide an accurate and consistent CBD dosage to users .
However, a CBD capsule needs to go through the digestive tract, resulting in lower bioavailability than CBD oil drops. Bioavailability is the rate and fraction of a drug when it becomes available to its intended biological destination (23) .
Tips to Determine Safe CBD Dosage
- Users should consider their body weight, the condition they want to treat, and the CBD concentration and potency of the product they are taking.
- It is best to start with small doses of CBD, gradually increasing to high doses until the desired effects are achieved.
- It is recommended to keep a record of how much CBD a user has taken. Monitoring CBD intake may help when adjusting the CBD dosage.
- Tinctures come with a measured dropper for accurate dosing.
- Most importantly, CBD users must talk to their doctors about safe dosage and any potential risks of using CBD.
Methods of Extracting CBD
When people discuss how CBD is made, they refer to the specific type of extraction method performed to create a product. Using carbon dioxide, steam distillation, and natural solvents or hydrocarbons is the most common way to extract CBD oil.
Carbon dioxide extraction, also known as supercritical CO 2 , is a method of separating CBD oil from cannabis plant material. The term supercritical refers to the CO 2 containing both properties of a gaseous and liquid state, which is why it is sometimes called Supercritical Fluid Extraction (SFE).
Although requiring costly and specialized machinery to accomplish, many brands prefer CO 2 extraction in creating high-quality CBD products . One study found that this extraction method produces cannabidiol concentrations with as high as 92% efficiency (24) .
In steam distillation, the vapor in this method causes the cannabidiol oil from the hemp plant to separate. The plant extract is placed in a flask containing an inlet and outlet.
As water is heated, its steam travels towards the flask, extracting the hemp oil vapors. The vapors are then collected in a tube, condensing the byproduct into water and oil. This mixture is finally distilled to draw out the oil from the water.
Although the steam distillation technique is tried and tested for many centuries, it is not as popular as CO2 extraction due to being inefficient. With steam distillation, more hemp plant material is needed while extracting exact amounts of CBD is difficult.
Solvent extraction is similar to steam distillation, except it uses solvents or hydrocarbons to separate the CBD oil from cannabis . This process results in a mixture of CBD that contains the solvent. Once the solvent evaporates, it leaves behind pure CBD oil .
Compared to steam distillation, solvent extraction is less expensive and more efficient overall. However, the solvents in hydrocarbon extraction, such as butane, naphtha, and petroleum, can cause concern. The residue of these solvents can be harmful, increasing the risk of cancer to those exposed.
The downside of natural solvent extraction is that chlorophyll from the plant may be included during extraction, resulting in CBD oil that has an unpleasant taste.
An unexpected flavor may not matter for topicals or capsules. However, CBD products such as vaping oils and gummies are affected by it.
Another problem with using natural solvents is that they do not evaporate immediately. As a result, the CBD derived has lower cannabidiol concentration than other methods.
When buying CBD, it is vital to check which extraction method was used in creating the product. The approach is an essential indicator of the quality and value of a brand’s offering.
CBD products made using CO 2 extraction may be of higher quality but are more expensive than goods created through other methods.
Those that used other types of extraction may be affordable but could pose a risk when consumed. Meanwhile, the low-risk natural solvent and steam distillation processes often result in inconsistent CBD amounts.
How Is Hemp CBD Different From Marijuana CBD?
There are two varieties of cannabis that produce cannabidiol : hemp and marijuana.
CBD from hemp is derived from the industrial hemp plant, a cannabis variety mainly grown for its fiber and seeds. Hemp plants have scarce foliage and are skinny compared to marijuana plants.
Hemp also has different levels of THC compared to marijuana. THC is a psychoactive compound (25) that can cause a euphoric high when consumed. Under US law, hemp plants must not have more than 0.3% THC to be legal (26) .
Meanwhile, marijuana CBD is acquired from marijuana plants known for their thick foliage and flowers. Marijuana is often cultivated for its intoxicating properties.
The federal government defines marijuana as cannabis plants that have more than 0.3% THC . Although THC is the predominant compound in marijuana, some of its strains have high CBD content.
Deciding to purchase CBD either from hemp or marijuana depends on its intended use. The human body does not discriminate where the compound is sourced. With regards to CBD oil , there are other cannabinoids to consider including phytochemicals and terpenes.
According to a study, all cannabis constituents contribute to each other’s capacity when combined (27) . The effects of every component are multiplied when they are consumed together.
This concept is commonly called the “entourage effect.” The presence of CBD, THC , terpenes, and other cannabinoids all determine how a user reacts to cannabis .
People seeking the health benefits of THC may choose marijuana-derived CBD oil . However, they need to purchase and use the product in a state where medical marijuana products are allowed.
For a federally-legal product high in CBD, hemp-derived CBD oil may be the right choice.
The drug Epidiolex is the only cannabidiol product approved by the FDA (fda.gov) with officially recommended dosage guidelines. Any other product that contains cannabidiol is not covered by FDA regulations and does not have guidelines for dosing CBD .
However, many users have identified the right amount of CBD to take by considering body chemistry, concentration of CBD , and current health condition.
Individuals must seek guidance from a doctor to know the appropriate CBD dosage for their needs. Medical advice from a healthcare provider can help people avoid potential drug interactions and risks due to improper CBD use.
Compared to CBD oil , capsules need to go through the digestive system , which results in lower bioavailability . Also, not all CBD products are the same and can have different dosages.