Why most CBD products may not help you and how to find products that do

Mind & Matter is a monthly column by Nick Jikomes, PhD, Director of Science and Innovation at Leafly.

Cannabidiol (CBD) is the second most common cannabinoid in cannabis after THC. It’s widely believed to be non-psychoactive, a myth stemming from the fact that it’s not intoxicating – it won’t get you high. Because of how it works in the brain, CBD can affect mood, meaning it is psychoactive. But CBD is not a powerful drug. Most of its scientifically documented effects are only seen when high doses are used.

Are there CBD products that can provide you with high enough doses to be useful without being prohibitively expensive?

Effect and bioavailability of CBD

A number of large-scale clinical studies have been conducted over the years documenting CBD’s ability to treat severe forms of childhood epilepsy, culminating in the FDA approval of Epidiolex (a CBD-based drug). While CBD has been shown to work to treat certain types of epilepsy, doing so requires very large doses. Epileptic children often receive more than 600 milligrams per dose. But what about the average CBD user who doesn’t have childhood epilepsy and is looking for relief from milder, more common ailments like anxiety or inflammation?

There are a number of studies showing that CBD may have anti-anxiety and anti-inflammatory effects. As with childhood epilepsy, these effects are only reliably seen at high enough doses of CBD. Studies showing anti-anxiety effects tend to use ~300 milligrams or more of CBD in pill form. This is because CBD, like other cannabinoids, has low oral bioavailability — your body will only absorb and utilize a small fraction of what you ingest. As a rule of thumb, your body may only “see” about 10% of the CBD you ingest. If you consume 300 milligrams of CBD orally, you should expect that only about 30 mg will enter your bloodstream, circulate through your body, and actually do anything.

The low bioavailability of CBD poses a problem for most people, as CBD products typically contain very small amounts of CBD. A typical oral CBD product, like a capsule or gummies, often contains no more than a few milligrams of CBD per dose. If a CBD gummi contains 10mg, your body may only be absorbing 1mg of CBD, and there is no scientific evidence that such a low dose does anything other than create a placebo effect.

It’s the same with inflammation. Like most cannabinoids, CBD has been shown to have anti-inflammatory effects. But again, these effects are not seen in people taking CBD gummies with just a few milligrams of CBD. They are seen in “test tube” studies, where cells are bathed in high concentrations of CBD, or in human studies using much higher doses than are typically found in consumer products.

A simple rule of thumb is that you shouldn’t expect any effects – anxiolytic, anti-inflammatory or otherwise – unless you’re consuming at least ~300 milligrams per dose. Is this even possible without the dollar cost becoming unreasonable?

High Dose CBD Products Worth Trying

Generally, the CBD product categories that offer the highest doses of CBD are tinctures or orally consumable products like capsules or gummies. Tinctures are liquid forms of CBD designed to be placed under the tongue or swallowed, with many individual tinctures containing hundreds or even thousands of milligrams of CBD per bottle. Capsules and gummies mostly contain very low doses of CBD, no more than ten milligrams each, but can sometimes contain hundreds of milligrams per dose. Again, 300 milligrams per dose is our rough guide for the minimum amount of CBD you want to consume.

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One product that I have personally tried and enjoyed are CBD Gummies from cbdMD. This brand has products like full-spectrum CBD gummies, each containing 100 mg of CBD, that come in bottles of 60 doses. That means one bottle can contain 6,000mg of CBD. At $110 per bottle, that means you’re paying about $0.18 per milligram. Not only are these doses more likely to produce physiologically relevant results, but they may contain more than just CBD. I like cbdMD’s full-spectrum gummies, each containing 100mg of CBD along with 2mg of THC. The presence of low-dose THC makes you realize that something is really happening because you are feeling the psychoactive effects of THC.

Combination of high-dose CBD with low-dose THC

Consuming some THC along with CBD can produce synergistic effects. Both THC and CBD have anti-inflammatory properties, but work through different mechanisms. CBD can also affect the metabolism of other drugs, including THC. It is now recognized that taking CBD and THC orally together in a high CBD:THC ratio can actually enhance the effects of THC. This is likely due to CBD’s inhibition of gut enzymes that metabolize THC. With enough CBD, THC breaks down more slowly.

One product I use is cbdMD’s full-spectrum CBD:THC gummies, which contain 100mg of CBD and 2mg of THC per gummie. I tend to use them at the end of a long day at home, especially after intense workouts. Combining a relatively high dose of CBD with a low dose of THC gives me mild psychoactive effects that last at least a few hours, along with anti-inflammatory effects from both cannabinoids. This helps me to relax and recover after exhausting physical exertion.

Why is CBD a low potency drug?

It would be handy if CBD was more potent and a single milligram was all you needed to experience noticeable health benefits. But that is not the case. In fact, CBD’s low potency may be key to its therapeutic potential. Unlike many potent drugs, CBD does not bind strongly to just one or a small number of receptors in the body. Instead, it weakly interacts with many different receptors. The main disadvantage of such a drug is that you have to consume a higher dose for measurable effects to occur. An advantage of such a drug is that it doesn’t ‘pound’ very hard on one type of receptor, which may be why CBD is well-tolerated with little potential for side effects for most people.

I’ve previously worked with cannabinoid expert Dr. Ethan Russo talked about the potency and pharmacological effects of CBD:

If you’re interested in experimenting with CBD to reduce anxiety or inflammation, consider these simple guidelines:

• Consume at least 300mg of CBD per dose. A lower dose might be effective, but this has not been conclusively proven.
• Consider combining CBD with low-dose THC.
• Identify brands that can consistently offer high-dose CBD + low-dose THC at an affordable price.

Are there other ways to consume CBD?

In general, orally consumed cannabinoids have lower bioavailability than inhaled cannabinoids. While there are many CBD products that can be vaporized, I prefer oral CBD for two reasons: First, it’s convenient. We can all easily chew or swallow a gummy bear or capsule without the strong, bitter taste that often accompanies cannabis oils or tinctures placed in the mouth. Second, due to the chemical nature of CBD, CBD vapor is often more “scratchy” than THC vapor. This can make CBD vapor somewhat uncomfortable or induce a cough, even if you are used to vaping THC. Although inhaled cannabinoids are typically more bioavailable than ingested cannabinoids, inhalable products typically do not contain high enough concentrations of CBD to approach our informal threshold of 300 milligrams.

How to get started with high dose CBD

Here are some brands and products you can check out to get started. (Note: No brands were consulted to create this content. These are just examples I’ve used in my own life and there are probably more out there).

Learn more about the biological effects of CBD

To learn more about what we know about what CBD does, how it does it, and what scientists are still learning, check out these articles and podcast episodes: