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Ask A Doctor – CBD Dosage For Chronic Pain, Anxiety & Pregnancy

Written by Dr. Leah Zachar

With CBD products being unregulated for the most part, how is one supposed to know the correct dose to take for their chronic pain? And what about if it’s just a mild bout of anxiety which you know is only short term?

In yesterday’s ‘Ask A Doctor’ Q & A, we spoke in some detail about CBD dosing for different situations. We also explained how people can know that the CBD in the bottle is the same as the label. CBD for pregnant women was also covered briefly.

Question: How many drops of CBD oil should I take to treat my chronic pain?

What is important is not the number of drops, but the dose that you take. The dose in each drop of oil must be standardized. Thus, two drops of one brand or concentration of CBD oil might be five times more potent than the dose in another brand or concentration of CBD oil. Not all “oils” are same potency.

Each company that produces cannabis must have their own internal audits to make sure that every “batch” they produce is the same potency as the prior “batch”.

CBD dosages and the duration for which they should be given vary with the disease and the patient’s pain threshold. The dose of CBD given to one patient may be inadequate for another patient with the identical disease. For chronic pain, the dose of CBD can range from 2 ½ to 20 mg a day by mouth.

Question: Is there an optimal dose using CBD for anxiety or is it specific to every individual?

Low dose CBD, which is 20-40 mg/day is the range needed for “regular” anxiety, and high dose CBD, which is up to 400 mg/day helps with social anxiety. These are ranges, though and are not “set in stone.” Every person responds a little differently to a given dose, as each person’s anxiety is not exactly like another person’s anxiety.

Question: Is CBD safe in pregnancy?

Yes, however, this is based on preclinical trials which are performed in mice. In these preclinical trials, CBD was found to be safe in pregnancy, and in breast-feeding. There have been no studies yet, performed in humans. You must weigh very carefully the risks and benefits & discuss this with your healthcare provider.

Question: How do I know that the CBD I am getting from CBD testers is 100% plant-derived CBD & that the dose on the label is the exact same dose as what is inside the bottle?

Before we order any CBD, we verify the all the ingredients in the bottle we receive from any supplier with an independent third party. A quality control study is always performed to assure us that the CBD is free of any contaminants, that the dose is the same from bottle to bottle, and that what is printed on the label is exactly what is inside the bottle.

Be careful whenever you order CBD products. Over 70% of CBD products sold on-line are not checked for quality and dose reliability.

I will vouch for the products CBD testers supply you professionally, but I cannot verify any other company or brand. You must use your due diligence and do careful research.

Question: I suffer from anxiety, severe pain from arthritis and plantar fasciitis, and insomnia. I received my sample product, 300 mg/30 mL of CBD oil 2 days after being notified I was a tester. I took 10-mg twice a day and by day three, my anxiety was significantly less & I slept like a baby. I just increased my dose to 15-mg twice a day. The pain from my arthritis & plantar fasciitis is still present, but less severe. Is it safe to increase my CBD dose further?

You can increase your CBD dose as high as necessary. Doses of up to 1500 mg a day have been used with no side effects. Remember, everyone has a “sweet spot”- one dose is perfect in one person, but in another, it may be too strong, or too weak.
I would suggest increasing your dose by 5 mg every two or three days until you can walk with comfort. Please remember to check with your PCP as he knows your body almost as well as you do.

1.Cannabis Cannabinoid Res. 2017; 2(1): 139–154.
An Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies
2. European Journal of Pain. 2015;20:936–948 Transdermal cannabidiol reduces inflammation and pain-related behaviors in a rat model of arthritis.

As per your request, we are moving the weekly In-house doctor session from Thursday at 1 pm EST, to Thursday at 3 pm EST (That’s UK’s 20:00, NYC’s 15:00 and LA’s 12:00)

If you want to read more from Dr Zachar, check out: ‘Ask A Doctor – CBD Safety, Side Effects & Correct Dosing’

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About the author

Dr. Leah Zachar

Dr. Leah Zachar, M.D. is a physician who worked for nearly thirty years in Internal Medicine.
She currently is a scientific adviser to CBD Testers. Dr. Zachar believes that there is much that medical cannabis, and cannabidiol in particular can offer to traditional medicine.