CBD works better with higher doses, right?
Rarely when you are taking a supplement or medication is the idea to take more for a better result even entertained.
However, that can be the case with CBD.
It really depends on the weight of the person or animal taking it, what type of CBD is being taken, how it will be taken or used, and what it is being taken for.
One of the most challenging things about CBD is dosing. Because there are so many variables at play and every mammal’s endocannabinoid system is different, finding a standard dose is extremely difficult to do with any real certainty. CBD dosing really takes patience, detail and experimentation to get it right. Although researchers are working hard to figure it out.
So, the same CBD can produce different results with different doses?
This is something that scientists are fascinated by and are working to determine. Essentially though, yes.. The same chemical compound can produce different results at different doses.
The theory is because CBD does not directly bind to the cannabinoid receptors, but instead interacts and affects the endocannabinoid system through many other receptors within the body that in turn affect the cannabinoid receptors themselves. The sheer complexity of these mechanisms dictates many more years of research to determine exactly why, how, where and when CBD does what it does and what doses are most effective for particular conditions.
With all the technology available now, they don’t know yet?
You have to keep in mind that for many years, it was almost impossible to do any research on cannabis in the United States. Because of the prohibition of the cannabis plant for the past 80 plus years, research is trying hard to catch up and answer some of these questions.
The problem is, consumers are buying CBD at breakneck speeds and new CBD products are hitting the market everyday proclaiming CBD the cure for almost any health concern imaginable. So, new claims to test, pop-up everyday creating more anecdotal evidence that needs to be researched. Consumer demand and regulators wanting answers have put the pressure on, however, the researchers are simply overwhelmed.
Oh yeah… and there is that pesky global pandemic going on right now… the virus that shall remain nameless.
What does the research say about CBD and dosing?
One research paper, published in June of 2019 in the British Journal of Pharmacology, sought to investigate what dosing ranges have been used during clinical trials using CBD. In this way, they could show what doses have been used, for what they were used for, what the effectiveness of those doses were and what side effects were seen at those doses. This will serve as a baseline of information that will warrant further research into the various doses and help the scientific community get closer to a known and manageable dosing range for specific conditions.
The research team collected 1038 published articles about CBD and dosing. They used a set of strict medical criteria that these papers needed to meet in order to be used for their project. Out of the 1038 papers retrieved, 35 studies met the inclusion criteria and were analyzed. 23 studies showed significant improvement in primary outcomes.
Only 23 studies out of over 1000?
Yeah… the term “research” is used multiple times a day in our society with little to no real understanding of what actual research means. We tend to think of “research” as Google and YouTube… but, looking for the outcome that you already believe in is not “doing research” it is confirmation bias. Real research utilizes multiple independent researchers and employs methods and steps to eliminate confirmation bias.
This research team started a systematic search of PubMed, EMBASE (including MEDLINE) and clinicaltrials.gov, in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines.
They were looking for any paper that mentioned CBD or cannabidiol reporting CBD administration in clinical populations. This gave them the initial 1038 papers. The titles and abstracts of retrieved studies were examined by 2 independent researchers, and inappropriate articles were rejected. They were looking for original, peer-reviewed published papers that involved administration of CBD to a clinical population and included an outcome measurement to assess the efficacy of CBD. Did it help or not?
From there, they used exclusion criteria such as the studies had to be in humans, had to only use CBD isolate (any study that used a broad-spectrum or full-spectrum CBD were eliminated), had to be in english, offer statistical data and had to state the concentration of CBD that was used.
My guess is the vast majority of the initial papers are using full-spectrum CBD, were animal or petri dish (in-vitro) studies or were from brands and had no real scientific contribution. So, as you can see… step one of actual research is quite involved and without bias, but resulted in a data set that could be analyzed in a controlled way.
So, what did they discover about dosing?
They discovered a pretty wide range of CBD dosing, which one might expect because this review included studies of participants of all ages (from infants to adults). So, they discovered doses ranging between <1 mg/kg/d to 50 mg/kg/d. (MG of CBD per KG of body weight per day)
Even at the high end of these doses, CBD was well tolerated and side effects were mild. Here is a summary of their findings as they pertain to dose, condition, delivery method, results and side effects.
Schizophrenia (Adults)
|
DOSE |
DELIVERY METHOD |
RESULTS |
SIDE EFFECTS |
|
16.7 mg/kg/d 1000mg per day |
Oral Solution |
Positive psychotic symptoms reduced. |
Rates of adverse events similar between CBD and placebo groups |
|
10 mg/kg/d 600mg per day |
Oral capsules |
No difference in disease index |
None observed |
|
13.3 mg/kg/d 800 mg per day |
Not listed |
Significant improvement of psychotic symptoms compared to baseline |
Well tolerated |
|
5 or 10 mg/kg) 300 or 600 mg per day |
Oral Capsule |
No beneficial effects on selective attention |
None reported |
|
25 mg/kg/d 1500 mg per day |
Oral Capsule |
Improvements in psychiatric ratings |
Well tolerated; none reported |
|
21.3 mg/kg/d 1280 mg per day |
Oral |
1 patient showed mild improvement to baseline and discontinuing treatment worsened symptoms |
Well tolerated; none reported |
Based on the results of these trials and studies, it appears that for this condition, a higher dose is better.
Seizures (Ages 2-55)
|
DOSE |
DELIVERY METHOD |
RESULTS |
SIDE EFFECTS |
|
20 mg/kg/d 1200 mg per day |
Oral Solution |
Monthly frequency of drop seizures decreased by a median of 43.9% in the CBD group |
Diarrhea, somnolence, pyrexia, decreased appetite, vomiting |
|
10 or 20 mg/kg/d 600 or 1200 mg per day |
Oral Solution |
Significantly greater reduction in CBD groups in drop seizure frequency than in placebo |
9% taking CBD had elevated liver aminotransferases. Somnolence, decreased appetite, diarrhea, upper respiratory tract infection, pyrexia, vomiting. |
|
20 mg/kg/d 1200 mg per day |
Oral Solution |
Reduction in frequency of convulsive seizures compared to baseline, significantly greater reduction than with placebo |
Diarrhea, vomiting, fatigue, pyrexia, somnolence, abnormal results on liver-function: tests were higher in the CBD group than placebo |
|
5 mg/kg/d 200-300 mg per day |
Oral Capsules |
All but 1 patient improved condition |
Well tolerated |
|
2–5 mg/kg/d titrated up to 50 mg/kg/d or intolerance 200-300 mg per day or more |
Oral solution or by gastric tube |
Improvement in quality of life as well as some cognitive functions (memory and control) |
Somnolence (feeling of drowsiness), drowsiness, fatigue |
|
2–5 mg/kg/d, up-titrated to 25 or 50 mg/kg/d 200 mg per day to 3000 mg per day |
Oral solution or by gastric tube |
Monthly motor seizures reduced by a median of 35.5% from baseline |
Somnolence (feeling of drowsiness, fatigue, diarrhea, decreased appetite, weight loss, status epilepticus (6%). |
Epidiolex is a FDA approved CBD isolate drug and they recommend higher doses for standard maintenance with low hepatic impairment (up to 25 mg/kg/d) and lower doses (up to 5 mg/kg/d) for severe hepatic impairment. This is to ensure liver function does not deteriorate, however, it does show that even with lower doses, a positive outcome can be expected.
Crohn's disease (Adults)
|
DOSE |
DELIVERY METHOD |
RESULTS |
SIDE EFFECTS |
|
0.3 mg/kg/d 20 mg per day |
Orally, sublingual |
No difference in disease index |
None observed |
What does it all mean?
As you can see… CBD dosing is a complicated and time consuming process to figure out. The key takeaway is that you should always start “low and slow” with the smallest dose possible and adjust from there. It will take time, patience, paying attention to details and may be a little daunting… however, all is not lost, little camper!
At Mellow Mammals, we tried to simplify this whole process by creating a dosing card that allows you to keep track of the daily dosing so you can make adjustments and “dial in” the correct dose for you or your animal companion.
With a little patience you can quite easily find the correct dose and start enjoying a healthier, happier and calmer life. If you have any questions, we are here to help! Email me at: info@mellowmammals.com or hit us up on Facebook, Instagram, Twitter or YouTube.