Dosing for cbd oil for arthrits

CBD For Rheumatoid Arthritis

Kimberly is a health and wellness writer with 8 years of experience in healthcare and a special passion for mental health awareness.

Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more.

Scott J. Zashin, MD, is board-certified in internal medicine and rheumatology. He was a volunteer clinical professor of internal medicine at the University of Texas Southwestern Medical School Dallas.

As cannabidiol (CBD) has grown in popularity over the years, major organizations like the Arthritis Foundation have released guidelines pertaining to its use in the treatment of rheumatoid arthritis (RA). CBD is a non-psychoactive component of cannabis. The CBD in most products is extracted from hemp, a variety of cannabis that only has traces (up to 0.3%) of THC, the active compound that gets people high. Studies have shown CBD can help reduce chronic pain by impacting endocannabinoid receptor activity, which may also reduce inflammation.

CBD comes in different forms, including oil, vape, edible, and topical. Oils, vapes, and edibles are taken orally, while topical CBD lotions can be applied to the skin. CBD dosage varies depending on the form, the indication, and other treatments being used.

What Is Rheumatoid Arthritis?

RA is an autoimmune inflammatory disease, in which the immune system attacks healthy cells in the body and causes inflammation. RA commonly affects joints in the hands, wrists, and knees, causing the joint lining to become inflamed and damaging the tissue. This causes chronic joint pain and leads to deformity. RA can also affect other tissues throughout the body, such as the lungs, heart, and eyes.

Vera Livchak / Getty Images

Health Benefits of CBD for RA

Animal studies have suggested that CBD has pain-relieving and anti-inflammatory properties, but these effects have not been validated with quality studies in humans. Anecdotally, some people who have tried CBD for treatment of arthritis symptoms report noticeable pain relief, improved sleep improvement, and reduced anxiety.

The trials that have been conducted in humans have not yielded strong evidence for the use of CBD in managing arthritic pain.

  • A randomized trial of topical CBD for treatment of knee osteoarthritis lasted only 12 weeks, and results were mixed.
  • One of the largest reviews examining the health effects of cannabis and CBD concluded that there is substantial evidence that cannabis is an effective treatment for chronic pain in adults. There was, however, no specific conclusion regarding CBD, as definitive studies were not available.
  • More recently, a new study showed that CBD can potentially help alleviate RA pain and inflammation by acting on immune cells that are attacking healthy cells in the body. It’s important to note that this study was also not conducted with human subjects.

Research in this area is ongoing.

If you are interested in trying CBD for RA pain management, be sure to talk to your healthcare provider first before using any CBD products.

Rising Popularity of CBD for RA

Based on a 2019 national survey of 2,600 people conducted by the Arthritis Foundation, 79% of respondents said they were using CBD, have used it in the past, or were considering using it to help with their arthritis pain.

Health Benefits Related to Arthritis

Given the lack of strong scientific evidence supporting the use of CBD, it is not recommended as the first choice for pain relief in RA.

If you have RA, you should not stop taking your prescribed medications that may be protecting your joints from future damage. You should discuss any changes you want to make to your medication regimen with your healthcare provider.

Additional Health Benefits

The strongest scientific evidence for effectiveness of CBD as a medical treatment is for seizure prevention in Dravet syndrome and Lennox-Gastaut syndrome, which are severe childhood epilepsy disorders that typically don’t respond to antiseizure medications. Several years ago, the FDA approved the first cannabis-derived medicine for these conditions, Epidiolex, which contains CBD.

Other potential health benefits of CBD include:

  • Reduce anxiety, insomnia, and depression
  • Relieve cancer or cancer treatment symptoms
  • Clear acne
  • Slow the progress of neurologic disease like Alzheimer’s disease

Possible Side Effects

Treatment with CBD should be started slowly and under the supervision of a healthcare provider, who will oversee its effectiveness and side effects. There have been reports of mild side effects of CBD.

The most common side effects include:

It’s important to note that CBD may interact with other drugs, including some of the medications that are prescribed for the treatment of RA.

Warnings and Interactions

There are some warnings and adverse drug interactions to be aware of before beginning using CBD for management of RA-associated pain.

Warnings

Do not stop taking any other treatments without consulting your healthcare provider. Additionally, CBD shouldn’t be a replacement for other therapies you are using.

Pregnant people and children should consult a healthcare provider before using CBD since there isn’t enough research on the effects of CBD on these populations. There has been concern about a possible link between inhaled cannabis and lower-birthweight babies, but it’s not clear if this applies to CBD.

Currently, the U.S. Food and Drug Administration (FDA) does not regulate the safety and purity of CBD products, so you cannot know for sure that the product you buy has active ingredients at the dose listed on the label. The product may contain other unknown elements. The most effective therapeutic dose of CBD for any particular medical condition has not been established.

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Are CBD Products Legal?

CBD products derived from hemp are no longer considered schedule I drugs under the federal Controlled Substances Act, but they still remain in a legal gray zone.   There are changes underway on federal and state levels that will ultimately clarify the laws and regulations related to CBD-based products and sales. Despite that, they’re widely available in nearly every state and online. People who want to use CBD should check their own state laws.

Interactions

Studies have found moderate interactions between CBD and medications commonly prescribed for treating RA.

Interactions can occur with these medications:

CBD can increase your level of coumadin, a blood thinner.

CBD may also raise levels of other medications in your blood by the same mechanism that grapefruit juice does.

Medications that interact with grapefruit juice can potentially interact with CBD, including:

  • Cholesterol medications
  • High blood pressure medications
  • Organ-rejection medications
  • Anti-anxiety medications
  • Corticosteroids
  • Heart medications
  • Some antihistamines

Preparation and Dosage

If you’ve decided to try CBD for treating your RA pain, the next step is figuring out how much to take.

Your dosage depends on a number of factors:

  • Body weight
  • Medical indication
  • The concentration and form of CBD that you’re taking

You will likely need to start with a low dose and find what works for you. Studies have found extreme differences in dosages, with some people using 5 milligrams (mg) and others as much as 600 mg.

Your healthcare provider may direct you to start with 20-40 mg per day and increase slowly each day until you feel the relief you’re looking for.

To ensure that you are using CBD safely and effectively for pain management, you should:

  • Choose an oral treatment (rather than inhaled products) and start with a low dose
  • Establish initial goals of treatment within a realistic period of time. For example, a reduction in knee pain that allows you to walk around the block within two weeks of starting treatment; later, if improved, the goals can be adjusted
  • Tell your healthcare provider(s) about your planned and current CBD treatment; monitor your pain and adjust medications with your medical providers, rather than with non-medical practitioners
  • When preparing to take a liquid form, be aware that the CBD extract is mixed with a carrier oil, so there are two measures to know: the amount of the liquid product to take (the dose) and the amount of CBD in each dose

If CBD alone doesn’t work and you are in a state where medical or recreational marijuana is legal, you could consider talking to your healthcare provider about taking CBD with a very low-dose THC product. Be aware that even at low levels, THC may make you feel high, resulting in cognitive, motor, and balance impairment.

If you experience any unwanted side effects when using a CBD product, immediately discontinue use and inform your healthcare provider.

What To Look For

Look for the following when choosing a CBD product:

  • Look for products manufactured in the United States with ingredients grown domestically
  • Choose products made by companies that follow good manufacturing practices established by the FDA for pharmaceuticals or dietary supplements or required by the state where they are manufactured
  • Buy from companies that test each batch and provide a certificate of analysis from an independent lab that uses validated standardized testing methods approved by the American Herbal Pharmacopoeia (AHP), the U.S. Pharmacopeia (USP), or the Association of Official Agricultural Chemists (AOAC)
  • Avoid companies that claim their products have disease benefits
  • Be aware that marketers and people behind retail counters are not health professionals. Your healthcare provider is your best source for guidance and monitoring when using an unregulated product

A Word From Verywell

CBD may sound like an appealing option for pain relief, but do your due diligence before jumping on the bandwagon. A lot of people say CBD can help reduce pain and inflammation for those with RA, but not a lot of strong scientific data have substantiated that claim. That said, serious effects are not commonly associated with CBD use.

If this is something you are interested in, you can work with your healthcare provider to figure out whether CBD is something you can try safely. Remember that CBD should not be used as a first-line treatment for RA pain and that it’s not advisable to stop taking disease-modifying treatments for RA.

CBD Dosage: How Much to Take for Pain, Anxiety & Sleep

This article is going to blow the doors wide-open on dosing CBD.

You’ll understand the ins and outs of dosing cannabidiol, learn how to properly measure your CBD dose with different products, and learn the important differences between dosing CBD oil for different types of symptoms.

CBD Dosage: How Much CBD Oil Should I Take?

A one-size-fits-all dosage for CBD doesn’t exist. Even the FDA doesn’t provide a Recommended Daily Intake (RDI) for CBD.

In simple terms, CBD doesn’t have an official serving size.

CBD acts on 60 different molecular pathways, meaning it has a very complex relationship with the body and the brain. It’s difficult to come up with a definite dosage guideline that would help any person regardless of individual physiology.

Some CBD manufacturers give you their own dosage recommendations, but they do so to provide new users with a general point of reference. It’s impossible to tell if a specific dosage is the right amount for a given person because it doesn’t address a few critical variables — which I’m going to discuss below.

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Important Considerations For Dosing CBD

Finding an effective CBD dosage may depend on the following factors:

  1. The potency of the product
  2. The bioavailability of the chosen product
  3. Your unique biochemistry
  4. Prior experience with CBD
  5. Your weight
  6. Your metabolism
  7. The severity of your condition
  8. Other medications you’re currently taking

Nick Jikomes, an esteemed neuroscientist, says:

“As our body undergoes physiological changes, so do cannabinoid receptors in the endocannabinoid system, which are directly linked to the effects produced by CBD.”

This means that your “best CBD dosage” can change throughout your life, so there will never be a universal or static amount that works for you.

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How to Calculate the Best CBD Dosage for Your Needs

There are steps you can take to find your ideal CBD dosage for your health goals. Let’s go over the process step by step.

1. Decide What Form of CBD to Use

Currently, the most common way to deliver CBD to your system is through CBD oil drops. They’re relatively easy to use and allow you to absorb CBD directly into the bloodstream as opposed to capsules and edibles.

However, pure CBD oil has a distinct earthy taste. Some find this flavor too harsh and somewhat bitter. If you don’t like the taste of CBD oils, something like a capsule, gummy, or vape oil may be a better option.

The above routes of administration are typically preferred by people who need fast relief from anxiety, stress, pain, or inflammation.

Other popular methods include CBD edibles, capsules, and topicals. Topicals are the better option if the area you’re trying to treat is on the skin, joints, or muscles.

Remember when I mentioned the importance of the chosen consumption method on your dosage regimen?

Here’s why it matters.

2. Check the Bioavailability of Your Product

Bioavailability refers to the percentage of ingested CBD that your body absorbs into the bloodstream.

Below you’ll find the bioavailability of 4 different delivery methods:

  • CBD topicals:
  • CBD capsules and edibles: 5-15%
  • CBD Oil drops: 20-30%
  • CBD vapes: ~56%

For example, if you consume 15 mg of CBD in oral drops, you’re going to end up with 4–6 times the amount of CBD in your body than you would with a capsule containing the same concentration.

The bioavailability of CBD topicals is measured at 0% because none of the CBD applied to the skin makes it to the bloodstream. Instead, CBD reaches the cannabinoid receptors in the skin and muscles.

3. Talk to a Physician

Before taking any CBD product, I advise you to consult with a physician. This is the best way to make sure the CBD or other supplements you’re taking won’t interfere with any medications you may be taking. It’s also the best way to rule out any major causes for your symptoms before starting supplementation.

4. Start With a Lower Dose than You Think You Need

Everybody has a different history with the use of certain substances, supplements, and medications. And since we’re all made differently, what works wonders for you, might not work for your friend — and vice versa.

The best way to determine your initial CBD dosage is to count it by your body weight. Experts recommend starting with 1–6 mg of CBD per pound. Low doses allow the user to monitor their body’s reaction more effectively.

This brings us to our last tip.

5. Gradually Increase the Dosage Until You Notice the Difference

Increasing the amount of CBD oil gradually is the best way to figure out the best CBD dosage.

I recommend lower CBD doses at first because if the dose is too high, it may trigger some unwanted effects, such as sleepiness, lowered blood pressure, lightheadedness, or diarrhea. Side-effects are a cue to dial your dose back to the last one that didn’t produce these effects.

On the other hand, if you continue to use a dosage that’s too low, you may not feel anything at all, so again — observation is key. Listen to your body, you’ll soon get a feel for how CBD works for you.

How to Measure Your CBD Oil Dosage

CBD oil drops come in dropper bottles. They’re easy to use and allow you to precisely measure out your serving of CBD.

All you need to do is squeeze the dropper so it draws the oil from the bottle, apply a few drops under the tongue, and hold it there for about 60 seconds. This way, CBD will absorb into the bloodstream through sublingual membranes under the tongue.

But how do you estimate your CBD oil dosage?

To answer this, you’ll need to know how much CBD a dropper holds. Typically, a dropper can carry 1 ml of liquid. If you know the total volume of your oil drops, you can do the math and calculate your CBD dosage using a simple formula.

[Total CBD in the bottle] ÷ [Number of milliliters in the bottle] = mg of CBD in a dropper.

For example, let’s say you have a 30 ml CBD oil that has 750 mg of CBD:

750 ÷ 30 = 25 mg of CBD per ml (per dropper)

How to Measure Your CBD Vape Oil Dosage

With CBD E-liquids, you’ll need to know how much CBD is in the product. As you vape your E-liquid throughout the day, watch the tank and see how long it will work without refilling.

Dosing vape oil is better using qualitative means. The effects appear much faster than from tinctures or edibles, so you can take little puffs at a time and wait about 5 minutes between another dose to see how it’s affecting you.

Once you start feeling the effects you’re looking for, this is your dose.

If you experience side effects, it means the dose is too high, so the next time you vape, useless.

Recommended CBD Dosage for Pain, Anxiety & Sleep

As mentioned, there are some general dosage guidelines for CBD that you can use for certain conditions. After studying CBD for several decades, scientists have finally created some kind of a framework for CBD dosage. This creates a relatively good point of reference for determining the effective amount of cannabidiol.

CBD Dosage for Anxiety

Most studies have investigated the use of CBD to treat social anxiety. One of the first studies, which was replicated many times since the initial publication, points to a dosage of 40 mg of sublingual CBD as an effective treatment for social anxiety. However, specific cases of anxiety disorders may call for an increase of up to 300 mg of CBD.

CBD Dosage for Different Levels of Pain

The optimal CBD dosage for people with chronic pain ranges between 2.5–20 mg of CBD when administered orally, alongside or without THC. Certain individuals may require higher doses, especially those with a greater body mass.

CBD Dosage to Improve Sleep Quality

CBD is known for its ability to reduce stress and anxiety and mitigate both pain and inflammation.

These factors are important when it comes to maintaining proper sleep quality, but there’s also one more benefit you should be aware of. At higher doses, CBD may induce sleepiness, allowing the user to fall asleep faster without experiencing the stream of racing thoughts.

Depending on the frequency and severity of your symptoms, you may need between 25–175 mg of CBD daily to combat them.

CBD Dosage: FAQ

1. Is CBD Safe?

Yes, CBD is generally considered safe for human consumption, with no signs of toxicity at doses as high as 1,500 mg daily.

2. Can CBD Get You High?

No, CBD doesn’t act on the cannabinoid receptors in the brain as THC does. Therefore, this cannabinoid is non-intoxicating — it can’t get you high.

3. Can You Overdose on CBD?

Overdosing on cannabinoids is impossible because cannabinoids don’t affect the brain stem are responsible for respiration.

4. Does CBD Oil Have Any Side Effects?

CBD has a relatively short list of side effects, most of which are considered minor. However, in high doses, CBD can produce an array of unwanted reactions, such as:

  • Dry mouth
  • Dizziness
  • Lowered blood pressure and heart rate
  • Sedation

It’s a small price to pay compared to the list of side effects caused by prescription medications.

5. What’s the Best Way to Consume CBD?

If by “the best” you mean the most efficient, then oil tinctures or vaping products will be your best options. That’s because they offer higher bioavailability than capsules and edibles.

6. Should I Take Full-Spectrum CBD or Isolate?

If you’re not subject to periodical drug tests at work, I would recommend a full-spectrum product because of something called the “entourage effect.” This term describes the synergy between all active ingredients in cannabis, including cannabinoids other than CBD and THC, terpenes, and other plant compounds. They’re believed to require less CBD than pure isolate to produce similar effects.

7. Can I Give CBD to My Dog or Cat?

Hemp-derived CBD products are safe for pets because they contain little to no THC, the intoxicating compound that produces toxicity in animals. Pets can benefit from CBD in similarly to humans.

Final Thoughts: What’s Your Optimal CBD Dosage?

The ideal CBD dosage that would work for everyone doesn’t exist. The nature of cannabidiol is very complex — so is the cannabis plant — and there are too many outside variables that can influence CBD’s absorption.

The potency of your product, its bioavailability, your weight, the severity of the condition, cannabinoid spectrum — they all matter.

You can use some general dosage guidelines for specific conditions, but always make sure you treat it as a point of reference, not the one and the only way to dose CBD.

So, what’s the best way to figure out the ideal CBD dosage?

Start low and gradually go up with the dosage until you experience the desired effects. The way you react to CBD can change over time, so you need to monitor the effects throughout your supplementation.

You should also ask a physician who’s experienced in using CBD or hemp extracts with patients to get professional guidance.

What CBD dosage is best for you? How much do you take daily? Let me know in the comments below!

Livvy Ashton

Livvy is a registered nurse (RN) and board-certified nurse midwife (CNM) in the state of New Jersey. After giving birth to her newborn daughter, Livvy stepped down from her full-time position at the Children’s Hospital of New Jersey. This gave her the opportunity to spend more time writing articles on all topics related to pregnancy and prenatal care.

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