CBD dosing and retail
CBD’s meteoric rise popularity has created both benefits and harms for people who would use it as a medicine. It is easy to be enthusiastic about so many people discovering and promoting the healing power of cannabinoids, but the profitability and lack of FDA regulation of CBD has created some odd problems that are worth being aware of. I will address some myths and questions about CBD that I have encountered frequently when talking to patients and providers.
First, just some definitions. CBD is cannabidiol and is one of the many compounds found in marijuana. Marijuana and CBD are both schedule 1 drugs federally, meaning that they have no medical use. (paradoxically, the US government also holds a patent on the use of marijuana for the treatment of dementia, indicating that it has quite a bit of medical use.) But because all marijuana products are schedule 1, research is limited and CBD products are not FDA regulated. CBD products are marketed and sold as supplements. This creates two problems for the CBD user. First, there is little research to guide appropriate dosing, frequency, or duration of therapy. Second, there is little guarantee that the product you are purchasing contains what it says it does.
With respect to the available research, it is worth noting that most of the studies that do show a benefit with CBD were using doses of 100-300 mgs 2-3x/day. Most CBD available for purchase is sold in doses of 10-20 mgs. This might be a great dose or it might be a waste of time. There’s no really good data to guide using doses this small. Frequently, when patients tell me that CBD doesn’t work for them, I liken the small doses they are taking to licking an Advil and expecting pain relief.
Also, the available research convinces me that CBD is incredibly safe; definitely safer than most over the counter medications. So, in general, the largest risk with taking CBD is that it will make your wallet lighter. One potential concern is CBD’s affinity for cytochrome p450, which can affect how your liver metabolizes other compounds. Studies in live humans don’t show much of an effect but if you are taking blood thinner or seizure medicines, CBD has been shown affect the levels of both in some individuals.
As far as available preparations go, there are some products that have been evaluated by Consumer Labs, an independent testing agency and their findings are helpful if you are buying CBD on the internet. There is a short video worth watching about their process and findings. I also recommend finding the closest hemp farmer to you and talking to them. Having a local and personal connection can be valuable. The CBD industry is growing quickly and it can be helpful to go straight to the source to avoid misleading marketing.