Written by: Henry Emmons, MD and Tim Culbert, MD

Low to moderate doses of CBD are considered quite safe and well-tolerated. Nonetheless, it's important to understand some basics about common dosages, side effects, and interactions with other drugs.  

CBD Dosage and Use

It's important to know that there are no proven guidelines for dosing CBD oil in kids, teens, or adults. A doctor will usually suggest the method—START LOW, GO SLOW. 

The typical dose range for CBD in adults is 15-30 mg daily. With some conditions, such as those involving pain or inflammation, the recommended dose is often higher, but I find it is best-tolerated and most effective for anxiety, sleep, and mood in this moderate range. It may be taken in doses of 10-15 mg twice daily, with or without meals, or in a single dose of 20-30 mg daily. If used to help with sleep, some folks take the full 20-30 mg dose at bedtime.

Interestingly, some individuals find CBD to be more activating. There's good evidence of this in the research as well (see this study for more). In those cases, individuals who are having sleep struggles and anxiousness may want to take CBD earlier in the day.

It's also important to recognize how many poor-quality CBD products are on the market. That's why it's essential to find a good quality product that provides exactly what is written on the label (i.e., amount of CBD and THC). 

CBD Oil Dosage Chart

The table below is NOT a treatment recommendation but provides general guidelines that many doctors use. The dosages are based on as-needed use for general concerns related to anxiousness and also sleep issues related to anxiousness. Most doctors will also use these guidelines as daily max doses (i.e., high dose range).

It's important to work with your doctor before starting any supplement, including CBD. If a doctor suggests a higher dose, show them this table and ask if lower may be better at the start. If they suggest lower, great! 

CBD Side Effects 

Though it's generally considered well-tolerated, CBD can cause side effects. These side effects can be more confusing given the unreliability of the purity and dosage of CBD in products (which is why purchasing a high-quality product is essential). 

Side effects of CBD may inlude:

• Drowsiness
• Dizziness and lightheadedness
• Dry Mouth
• Diarrhea
• Increased Appetite 
• Lowered blood pressure

In my practice, I find that the most common side effect is very mild sedation, though that is usually not a problem for those with high anxiety, and may be a welcome effect for those with sleep trouble. Like most things that are calming, adding CBD to other sedating medications, or combining CBD with alcohol, may cause excess sedation. 

There is too little information about the safety of CBD during pregnancy or while breastfeeding, so it is not recommended. 

CBD Interactions

Research suggests many side effects that occur with CBD use are likely the result of drug-to-drug interactions between CBD and other medications an individual may be taking. That's why it's so important to speak with your doctor before starting any supplement, and this is particularly true with CBD.

Here's how these interactions occur: CBD is broken down by the body via the same pathway as many prescription drugs. If multiple compounds are competing in this pathway (e.g., CBD and a prescription drug), then something called "altered concentration" can occur. This means that too little or too much of the drug is left in the body. When too little remains, a drug may no longer work as intended. When too much remains, side effects may increase.

This altered concentration should be considered when taking CBD with any other prescription, supplement, or over-the-counter product that causes sleepiness. These include (but are not limited to):

• Antidepressants
• Antipsychotics
• Benzodiazepines
• Opioids
• Antihistamines
• Herbal products to support sleep
• Alchohol

Additionally, there are other medication interactions with CBD that can be serious. Penn State College of Medicine has a really handy list of medications that may be impacted by altered concentration due to a combination with cannabinoids. Unfortunately, this list does not make any distinctions between CBD or THC, but it provides some guidance. Bring this list to your doctor before starting any CBD product.  

Penn State also found potentially serious interactions between prescription CBD and THC products and the following products:

• Warfarin and other blood thinners
• Amiodarone (heart medication)
• Levothyroxine (thyroid medication)
• Seizure medications (clobazam, lamotrigine, valproate)

CBD Supplements at Natural Mental Health

• Sleep CBD is a blend of broad-spectrum CBD (30 mg per serving) combined with 5 mg of CBN (cannabinol) and 3 mg of melatonin. CBN is a form of phytocannabinoid shown to be more specifically helpful for sleep, and melatonin is nature’s internal timekeeper, helping set a more consistent bedtime. CBD Sleep may improve a variety of challenging sleep issues, and is especially helpful for those who have trouble falling asleep. 

• Calm CBD combines 30 mg of broad-spectrum CBD with 200 mg of l-theanine, an amino acid that can also help reduce anxiety and stabilize mood. Together, they may improve stress resilience and calm anxiety without sedation. Taken at bedtime, CBD Calm may also be helpful for those who tend to wake in the middle of the night.

• Restore CBD gummies are infused with the highest quality, all-natural, US-grown hemp. Each gummy offers a precise dose of broad-spectrum CBD to support your endocannabinoid system with naturally occurring, plant-based ingredients. This synergy of multiple cannabinoids work together for the greatest impact to restore your natural resilience. 

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