CBD Dosing. Here’s Why the Answer is Not So Simple

“You can’t prescribe CBD in milligrams the same way you would with other medication,” said Dr. Perry Solomon, MD, a board-certified anesthesiologist and cannabis expert. This means that while a doctor could tell you to take 400mg of ibuprofen for a headache (or 600 to 800 depending on your height, weight, and severity of symptoms), they can’t prescribe 400mg of CBD. Or 15mg. Or 100mg. It’s not quite a guessing game at this juncture, but there’s no clear-cut formula on dosing, not even for doctors, and not even based on weight.

It actually comes down to your own endocannabinoid system. A brief refresher: the endocannabinoid system (ECS) is a modulating system in your body (comprising receptor cells and neurotransmitters) that manages homeostasis by keeping other systems in check. Your ECS determines your sensitivity to cannabinoids (cannabis compounds, including THC, CBD, CBG, etc.). This explains how you may have had a vastly different experience with CBD milligrams than your significant other/best friend/coworker. You took 15mg and slept like a baby, your sister took 15mg and felt absolutely nothing. Herein lies the issue with dosing.

Think of it this way: your friend eats a piece of toast and continues about her day. You, with celiac, eat a piece of toast and you’re on the toilet for the rest of the day. Or perhaps your cousin comes near a peanut and needs an Epi-pen because they’re severely allergic, but you eat Reese’s cups all damn day without a second thought. Even more nuanced — you could drink a cup of coffee and feel normal, while the person next to you drinks the same coffee and feels slightly jittery. The same kind of concept applies to cannabis and CBD, just as with anything else you’d put into your body. 

So, what the hell are you supposed to do? Well… you have to kind of Bill Nye the Science Guy this thing. You’re your own experiment. The common advice given by doctors and experts is always “start low, go slow.” Start with a very low milligram and don’t try to increase the dose right away. Get used to this new substance in your body and slowly, day by day, increase your dosage until you’re getting the results and therapy you need.

“We tell every single patient that comes through to start low and slow,” said Dr. Solomon. “Wait days, hours, and see how you’re feeling. You may not feel anything! But the general rule is start taking it and figure out when you start feeling something; not high, but you feel comfortable or better than you had before. Stay at that dose for a couple of days; get your body used to it.”

He emphasized, again, that “What works for me may not work for you,” and that even if you have a twin sibling, results will vary between the two of you. “That’s what’s frustrating for physicians,” he said, noting that with antibiotics, he can prescribe an exact amount and schedule to cure an infection, but “cannabis is not like that.” The upside? “You can’t overdose on it,” he said. “You can’t take too much; experiential dosing is very safe to do.”

You know what to do now — get to your personal CBD experiment!