There is a lot of information to unpack when it comes to CBD dosing. As it pertains to your individual experience, we find what works best is to guide you with a starting point and then a methodology. Narrowing down to two important factors that may impact your journey – Full Spectrum CBD and Titration.
Choosing how much CBD to take can be a complicated process for a number of reasons. When taking CBD, there are actually two distinct factors to take into account. One is the chemical profile of the product, and the other is your own body. Human physiology is not static – it changes constantly over time. This means that a particular amount of a product might affect you one way, one day, and another way on a different day, depending on circumstances. What we eat, our stress levels, our endocannabinoid tone, and a number of other dynamics can influence our biochemistry. This effect is not specific to cannabinoids or CBD – consider the effects caffeine or alcohol has on different people. With many factors to consider, establishing CBD serving amounts can be challenging, but what we found works best is to guide you a starting point, and then a methodology – a program for titrating from that starting point to determine what works best for you based on your individual goals.
What is Full Spectrum CBD?
The goal of a Full Spectrum CBD product is to maintain the complex range of desirable compounds in the hemp plant. By keeping as much of the plant together as possible, Full Spectrum CBD products will contain additional therapeutic constituents, like minor cannabinoids (CBG, CBC, etc), terpenes, and more. The most important detail to note is that Full Spectrum CBD products will contain THC at the legal limits of under 0.3% by dry weight. We are particularly focusing on Full Spectrum CBD, because research has shown that CBD and THC together produces a wider therapeutic window¹ ² ³, and moreover anecdotally, many clinicians report that CBD works better at lower dosages when it is presented in a Full Spectrum form rather than isolated CBD.
More importantly, CBD and THC interacts with our endocannabinoid system (ECS) differently. The ECS consists of cannabinoid receptors, so while THC directly stimulates these cannabinoid receptors in the body, CBD does not interact with cannabinoid receptors very much directly. Instead, CBD elicits effects through a variety of other mechanisms in the body, ultimately indirectly stimulating the body’s endocannabinoid system thus impacting the signaling system that modulates sleep, mood, pain, inflammation, and more. This goes back to the earlier discussion – CBD and THC are better together, because they affect the body differently allowing for a fuller therapeutic range.
Titration – The Methodology
Dosing Journey – Reaching the optimal amount
The concept of Titration is the process of adjusting a serving size for the maximum benefit without undesired effects. We start low and slow before increasing the amount, giving the body time to acclimate and adjust. And continue to slowly increase until the desired relief is reached. Once we reach the optimal amount, we stay at that dose for that particular goal – for example, the optimal dose for daytime will be different from nighttime, the optimal amount to help with anxiety may be different from the amount for pain, and so on. Because human physiology is dynamic, your optimal dose for that individual goal may shift and change over time.
The delivery method is important
In this discussion, we will focus on the two most common ways to take Full Spectrum CBD – tinctures/drops and capsules. Tinctures or drops are taken sublingually, holding under the tongue for up to 1 minute. The active ingredients are absorbed by the blood vessels in the mouth tissue reaching the bloodstream directly. Drops will be better absorbed when taken after a meal containing some healthy fat or oil. Capsules are taken orally, and offer a delayed onset time and longer duration due to the process of passing through the gastrointestinal tract and liver before being absorbed into the bloodstream.
Why is this important? Because it relates to the concept of bioavailability, another factor that may influence serving amounts. Bioavailability is a measure of how much of a compound actually reaches the blood and becomes available to the body. Much of the CBD that is administered in the body becomes bound to fatty tissues or is simply excreted, making its bioavailability low. The good news is that it takes very little CBD to be available in the body to elicit effects. The estimated bioavailability⁴ for CBD tinctures/drops is 10 – 15%, and for capsules 5 – 20%.
How to Measure CBD on Dropper
It’s important to know the amount of CBD you’re taking. With so many product options, the amount of CBD in milligrams and bottle size are not constant. But one relative constant is the dropper size. We will use a starting guide of 5 mg (with a fuller discussion shortly). Please note that 5 mg looks very different on the dropper depending on the brand as demonstrated below. Here are some measurements to establish this marker:
- 1 Standard Dropper = 1 mL
- To know how much CBD is in 1 full dropper: [Total CBD mg in bottle] ÷ [Total mL size of the bottle]
- In the Papa & Barkley example below: 900 mg ÷ 30 mL = 30 mg per 1 mL full dropper
- In the NuLeaf example below: 900 mg ÷ 15 mL = 60 mg per 1 mL full dropper
We need to get to 5 mg. On Papa & Barkley, 1 full dropper = 30 mg, thus .25 of a dropper = 7.5 mg. So 5 mg is about under the .25 marker on the dropper. On NuLeaf, 1 drop is 3 mg. So 5 mg is about 2 drops.
Dosing Journey – How to Start
One of the best ways to reach the optimal dose for your individual goal is to establish a baseline. Start with the recommended amount in our “How to Use” section for each product. If you have reservations about your response to Full Spectrum CBD due to the presence of THC, start at an even lower amount of 5 mg. For most, 5 mg is considered subtherapeutic, meaning you may not have reached your desired effect yet. However, a subtherapeutic amount is a meaningful way to introduce something new, allowing the body to acclimate and respond.
Stay at this starter amount for 3 – 5 days, taking it everyday. If you find that 5 mg is too strong, consider decreasing the amount on the next usage. If you do not feel you have reached your desired effect, consider titrating up slowly over time. After 3 – 5 days, increase the amount by 5 mg, and again after 3 – 5 days by 5 mg until the desired effect is reached. Below is a sample serving guide with a 3-day titration schedule.
If you’re starting with the recommended amount in our “How to Use” section, you can still reference this titration schedule. After 3 – 5 days, consider adding 5 mg to that starter amount, then + 5 mg again after 3 – 5 days, and so on, until the desired effect is reached. As noted earlier, if you find that the starter amount in the “How to Use” section is too strong, consider decreasing the amount on the next usage.
Dosing Journey – Personalized Serving Guide
Here at Artemis, we hope to bring an element of our in-store experience to you – creating a personalized Serving Guide. For every Full-Spectrum CBD drops/oils, there is a “Serving Guide” feature in the “How to Use” section. Simply request a guide using the link and we will create a Serving Guide & Journal tailored to your unique needs. We warmly look forward to supporting your CBD journey with this feature.
Important Considerations – CBD is Cumulative & CBD’s Biphasic Properties
CBD is Cumulative
Working closely with Dr. Junella Chin and Sang Choi, Head Pharmacist and Dispensary Director at Etain, a cannabis dispensary in New York, one point of consideration that may affect our interaction with CBD is that CBD is cumulative⁵ ⁶. CBD is lipophilic, binding to fatty tissues, and interacts directly and indirectly with receptors found in virtually all of the tissues in our bodies. Over time, it accumulates in the body. The effects of CBD tend to be most pronounced when it is taken on a daily basis with a ramp up period of about 2 weeks⁷ ⁸. For some, the effects of CBD can be felt on the first use. For others, it may take up to 2 weeks or more to see full effects⁹. Titration and the cumulative properties of cannabinoids are not unique to only CBD. Consider mood stabilizing and antidepressant drugs. It is common for a doctor to prescribe a particular dose for a patient to start off with, try for a month to allow the body to acclimate and then come back for a follow up visit to have the dose adjusted. This titration process will continue until the patient finds an optimal dose. SSRIs usually need to be taken for 2 to 4 weeks before the benefit is felt¹⁰.
CBD’s Biphasic Properties
How can CBD help promote calmness during the day and promote restorative sleep at night? That may be due to CBD’s biphasic nature¹¹. At a low amount, CBD has been shown to exhibit stimulating effects¹². Some describe this effect as feeling grounded and calm, a sense of clarity yet energizing. At a high amount, one of CBD’s effects is somnolence, which is essentially the feeling of being sleepy¹³. This effect is desired for nighttime.
A meaningful way to use CBD is to establish an ideal amount for daytime (which tends to be a smaller amount) and an optimal amount for nighttime (which tends to be a larger amount). Another way to apply this understanding of CBD’s biphasic nature – if a day amount produces undesired somnolence/sedation, the amount may need to be reduced (you may find that reducing that amount by half will not cause daytime sedation). And if a night amount produces undesired wakefulness, the amount may need to be increased (you may find that increasing the amount by 2x – 3x may help with relaxation and sleep).
Other Considerations
Drug Interactions
Research to date shows that CBD is generally safe and has few, if any, minor side effects. But CBD does have the potential to interact with some medications, including the anticoagulant warfarin, the seizure medications valproic acid and clobazam. Similar to grapefruit, CBD inhibits the cytochrome P450 enzyme, which is involved in metabolizing many drugs. By inhibiting cytochrome P450, CBD can either reduce or increase the effects of other drugs. Please consult your physician if you have a health condition and/or are taking medications before taking CBD.
Touching on the issue of tolerance
It is also important to note that tolerance will build over time, potentially requiring a higher amount. Tolerance can sometimes be broken by switching brands or product formulas. It may be a good idea to identify two or three CBD brands that you enjoy and rotate through those brands every few weeks or few months to limit the build-up of tolerance. Alternatively, occasional abstinence breaks may be necessary to reduce tolerance.
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² https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4566471/
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⁵ Sultan SR, O’Sullivan SE, England TJ. 2020. The effects of acute and sustained cannabidiol dosing for seven days on the haemodynamics in healthy men: a randomised controlled trial. British Journal of Clinical Pharmacology. 86(6): 1125-1138
⁶ Eskander JP, Spall J, Spall A, Shah RV, Kaye AD. 2020. Cannabidiol (CBD) as a treatment of acute and chronic back pain: a case series and literature review. Journal of Opioid Management. 16(3): 215-218.
⁷ Gunasekaran, N., Long, L., Dawson, B., Hansen, G., Richardson, D., Li, K., et al. (2009). Reintoxication: the release of fat-stored Δ9-tetrahydrocannabinol (THC) into blood is enhanced by food deprivation or ACTH exposure. Br. J. Pharmacol. 158, 1330–1337. doi: 10.1111/j.1476-5381.2009.00399.x
⁸ Millar SA, Stone NL, Yates AS and O’Sullivan SE (2018) A Systematic Review on the Pharmacokinetics of Cannabidiol in Humans. Front. Pharmacol. 9:1365. doi: 10.3389/fphar.2018.01365
⁹ Pauli CS, Conroy M, Vanden Heuvel BD, Park SH. Cannabidiol Drugs Clinical Trial Outcomes and Adverse Effects. Front Pharmacol. 2020;11:63. Published 2020 Feb 25. doi:10.3389/fphar.2020.00063
¹⁰ Jakubovski E, Varigonda AL, Freemantle N, Taylor MJ, Bloch MH. 2015. Systematic review and meta-analysis: dose-response relationship of selective serotonin reuptake inhibitors in major depressive disorder. American Journal of Psychiatry. 173(2): 174-183
¹¹ Zuardi, Antonio Waldo. (2008). Cannabidiol: from an inactive cannabinoid to a drug with wide spectrum of action. Brazilian Journal of Psychiatry, 30(3), 271-280. https://doi.org/10.1590/S1516-44462008000300015
¹² Zuardi AW, Guimarães FS, Moreira AC. 1993. HYPERLINK “https://europepmc.org/article/med/8257923” Effect of cannabidiol on plasma prolactin, growth hormone and cortisol in human volunteers. Braz J Med Biol Res. 26(2): 213-7.
¹³ Nicholson AN, Turner C, Stone BM, Robson PJ. 2004 HYPERLINK “https://insights.ovid.com/crossref?an=00004714-200406000-00011” . Effect of Delta-9-tetrahydrocannabinol and cannabidiol on nocturnal sleep and early-morning behavior in young adults. J Clin Psychopharmacol. 24(3): 305-313.
Please use this as a guide and not medical advice.
Written under the guidance of our Chief Medical Advisor, Dr. Junella Chin – a leading cannabis physician and board member of the American Academy of Cannabinoid Medicine, and in collaboration with Jason Wilson, MS, an expert on cannabinoid science, natural products researcher and creator of the Curious About Cannabis Podcast.
