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MEDICAL DISCLAIMER: The following information is intended for general information purposes only. Individuals should always see their health care provider before administering any suggestions made in this book. Any application of the material set forth in the following pages is at the reader’s discretion and is his or her sole responsibility.
Finding the correct dose of CBD for a particular patient is not an easy task, even for experts, because there are so many different factors that play an important part in the patient’s experience:
- The medical condition or problem
- The condition’s stage or intensity
- The patient’s biology and metabolism and how they respond to CBD
- The patient’s endocannabinoid system and how it functions and acclimates to CBD over time
- The patient’s body weight
- The patient’s sensitivity to cannabis—this is the most important factor
- The patient’s body chemistry, including pharmaceuticals and foods ingested
- How more than one hundred different molecules may impact the body (largely unknown)
CBD is generally considered safe to consume (as long as it’s clean and has no toxins); however, we use the “precautionary principle” in making recommendations. This principle serves as a guide to making wiser decisions in the face of uncertainty. It guides us to act cautiously in the face of the unknown— “do no harm” and prevent harm—while observing outcomes and making small adjustments over time.
“Titration” is a term borrowed from chemistry that means taking small steps over time in order to allow for adjustment slowly. This process lowers the risk of problems such as overdose, overwhelm, or over-reaction. We always recommend titration as the best way to introduce CBD to the body. It means starting off on the low side of a dosage range and adjusting upward slowly over time until the desired effect is reached. This cautious approach has served our patients well, and many experts now recommend it as a dosing protocol for medical cannabis.
Since there is a wide range of dosing possibilities, we have identified three dose ranges that are useful for different conditions: micro dose, standard dose, and macro (therapeutic) dose. These three ranges, combined with the patient’s body weight, determine the recommended starter dose:
1. Micro doses are considered a low level of medication, in the range of 0.5 mg to 20 mg of CBD per dose per day (CBD/dose/day).
- Micro doses can be effective for sleep, headache, mood disorders, nausea, PTSD, stress, and metabolic disorders.
2. Standard doses are the mid-range, between 10 mg to 100 mg of CBD/ dose/day.
- Standard doses have been shown to be effective for pain, inflammation, autoimmune disorders, Lyme disease, anxiety, depression, arthritis, some mental disorders, fibromyalgia, multiple sclerosis, inflammatory bowel syndrome, autism, and weight loss.
3. Macro (or therapeutic) doses are at the high range, between 50 mg and 800 mg of CBD/dose/day.
- Doses at this level are often used to treat cancer, epilepsy, seizure disorders, liver disease, and other severe life-threatening conditions.
Here’s how to use the tables
- First, decide whether you will be using the micro, standard, or macro dose protocol and then locate that table.
- Find your body weight in the left column and read across the row.
- We have provided five ranges of mg of CBD/dose/day in the micro and standard protocol, and ten ranges in the macro protocol.
- The dose of CBD can be the total of CBD+THC. If you are taking a 1:1 product, and the chart says 20 mg, then you would be taking 10 mg of CBD plus 10 mg of THC per day.
- If you are only taking one dose per day, then the number in the chart is your dose. If you are taking two doses per day, take half of the recommendation per dose. If taking three doses per day, take one third of the recommendation per dose. Take your doses seven to eight hours apart.
- Begin at the lowest dose (the left column) and take your dose (see #5 to determine your dose if taking the medicine more than once a day) at least a half hour before a meal. This is your starting dose, not your target dose.
- Continue this dosage for two to four days before increasing your dose. It is suggested that you record all parameters regarding your dosages and how they affect you so that you can make adjustments.
- Watch for any unpleasant or negative reactions. If you experience any- thing unpleasant or negative, cut your dose to half the amount and continue taking this dose for two to four days before increasing your dose.
- Use the next dose level for another two to three days before increasing your dose. If you are not using the tables, increase your dose by 20 percent.
- Continue this pattern, observing your body’s reaction and any changes in your condition.
- You may reach a dose level at which you experience a reduction in the benefit or an unpleasant or negative reaction. If this happens, step back to the previous dose and continue at that dose for at least four days. Then cautiously move up a step again. If your body responds positively to that level, continue at that dose. This is your target dose.
- Continue to monitor and record your body’s needs and wants. Adjust as necessary, upward or downward, whenever your body feedback—or your intuition—indicates that a change is needed.
More from CBD: A Patient's Guide to Medicinal Cannabis
From CBD by Leonard Leinow and Juliana Birmbaum, published by North Atlantic Books, copyright © 2017 by Leonard Leinow and Juliana Birmbaum. Reprinted by permission of publisher.