The endocannabinoid system, the most prolific receptor system that is responsible for a myriad of human functions, is actually a balancing act. There is a theory, put forth by Dr. Ethan Russo, where a lack of cannabinoids can result in the development of several diseases that current pharmacology has historically had difficulty treating. Among these conditions are migraines, fibromyalgia, and irritable bowel syndrome.
When patients turn to cannabis in order to treat their issues they can’t expect to find a standard protocol. No dosage is given, instead, it’s a “try and see” mentality. For patients wary of using cannabis, this lack of guidance can be the biggest deterrent from considering cannabis as a treatment option.
Cannabis is a personal experience. Many people come into the dispensary and offer good-hearted advice to others about which strains they think this total stranger should try. They are often just being friendly, but being the dispensary is a medical facility, there are often patients who have very complicated issues.
Cannabis, like children, does not come with an instruction manual.
What is the best starting dose?
How often should patients re-medicate throughout the day?
What is considered an excessive dose?
Micro-dosing is a method of “dialing-in” the most effective dose for individual patients. The goal is to receive the medical benefits of cannabis in the form of symptom reduction without the psychoactive or other unpleasant side effects associated with higher dosages. Whole plant cannabis products that contain all of the natural cannabinoids and terpenes of the plant would be the best product to use, if possible.
Micro-dosing of LSD or magic mushrooms is currently being studied for their ability to help elevate our mood. Starting Dose
If we treat cannabis like any other medication, the starting dose always starts with the lowest effective dose which most patients (you can never get a 100% consensus) can tolerate. From there we need to increase the dose very, very slowly until the maximum benefits are observed with minimum side effects. It is up to the patients to determine this endpoint.
To begin to microdose, first step is to choose your delivery method.
Do you wish to consume an edible or do you prefer to inhale?
Do you want to use a sublingual product?
All delivery systems can be used, just be sure to start with a very low dose of your initial product. Ideally, THC doses should begin with 1mg or less for edibles and equally small dosages when inhaled. I have the chart below in my book, although the timing of the doses is not set in stone. If you prefer to use an inhaled product just once or twice a day initially, then go for it. The point of micro-dosing is to be methodical about your cannabis administration so you can dial in the effects. You want to get rid of the guess-work.
Start low.
Increase the dose slowly. Inhalation
Take one (2–4 second) puff every 6 hours. Increase the number of puffs or frequency until effective. Sublingual
Take 1mg of CBD and THC every 8 hours. Increase by 1mg of both THC and CBD every 5 to 7 days. Edible
Take 1mg of CBD and THC every 8–12 hours. Increase by 1mg of both THC and CBD every 5 to 7 days. I always recommend a daily journal while starting a new medication. If your goal is to have fewer migraines, then your journal should record the number of migraines per week or per day, along with their duration and intensity. You can create a simple 1 to 5 grading system.
It can take several weeks to observe the benefits of cannabis, so try to be patient. If you are extremely sensitive to cannabis, you may notice a difference within the first week. When micro-dosing works, patients should experience a decrease in the frequency and severity of symptoms with very tolerable side effects.