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By Polite Health Cannabinoid Education
Reviewed by Dr. Sunil Aggarwal, MD, PhD, FAAPMR, FAAHPM, AIMS Institute
Microdosing is an increasingly popular health and wellness practice of regularly consuming trace or low amounts of a substance that would typically have a much stronger psychoactive effect at a larger dose. While there are varying definitions and dosage ranges depending on the compound, mode of consumption, and individual metabolism and tolerance levels, it can be broadly quantified as 1/5 to 1/20 of a perceptible psychoactive dose. Some of the most popular reasons for microdosing include performance enhancement, mood enhancement, symptom relief, curiosity, depression, anxiety and stress reduction, and mental focus.
In the past, this practice was more commonly associated with psychedelics such as LSD and psilocybin (the active component of magic mushrooms), but to a lesser extent with THC (Delta-9-tetrahydrocannabinol - a major cannabinoid found in cannabis and hemp). But in recent years, this measured approach has been gaining the interest of researchers and people wanting to improve wellbeing without unwanted side effects. The key is finding the right dosage for each individual that is small enough to be therapeutically effective but not distractingly psychoactive or intoxicating.
Cannabis sativa, also known as hemp and marijuana, is considered one of the world’s most popular psychoactive drugs today, but for most of human civilization it was primarily used as a medicine, nutrient dense crop, raw material for oil, rope, clothing and paper, and in ceremonial rituals. Scientific analysis of ancient plant remains and wild varieties indicate that most early cultivars likely had low levels of THC and were rich in CBD and other minor cannabinoids. Even prior to the 1990’s, the average dry cannabis flower contained less than 2% THC, but then grew to 4% in the mid 1990s, and now averages between 15-25%.
Highly concentrated extracts are even more potent these days, falling in the 50-90% range, as a result of the recreational industry catering to consumers looking to achieve the maximum psychoactive “high”. But as more markets gain legal access across diverse demographics, more people are looking to experience the benefits of the plant without intoxication or impairment. Even most people who enjoy recreational use also need to manage home, work, and other responsibilities that require them to stay functional and clear-headed for extended periods of time.
From a therapeutic standpoint, very high THC potencies can be counterproductive to many health conditions and leave people experiencing dizziness, paranoia, anxiety, disorientation, impaired cognitive and motor functioning, and with long term frequent use – the increased risk of cannabinoid hyperemesis syndrome (CHS) and other endocannabinoid system imbalances that researchers are only beginning to understand.
Many assume that high THC levels are required to experience adequate relief, but cannabis-trained clinicians and emergent research indicate that consuming full-spectrum cannabinoid products that combine a diverse range of naturally occurring whole-plant compounds like CBD, CBG and CBN (all non-intoxicating), in combination with THC, is key to unlocking maximum benefit while avoiding unwanted effects. This is due to the synergistic relationship between plant compounds called the “entourage effect”, which follows the principle of “the whole is greater than the sum of its parts” and occurs when the complete extract of the plant is used (including cannabinoids, terpenes, and flavonoids) and not just isolated compounds.
“A clearly observed benefit is in the interaction between the two main phytocannabinoids THC and CBD. The combination of CBD and THC helps to reduce potential THC side effects, while the combination of THC and CBD helps to reduce the average dose needed to treat with CBD." - WeCann Endocannabinoid Global Academy
Those familiar with the other major cannabinoid CBD have likely heard an abundance of anecdotal evidence about its myriad of positive effects on everything from pain relief, stress, ADHD, to sleep, but there is also a growing body of clinical research being backed by organizations that include the National Institutes of Health (NIH) and the US Department of Veterans Affairs (VA) to study the therapeutic potential of cannabinoids. Beyond their scientifically established anti-inflammatory, antioxidant and neuroprotective properties (that the US Department of Health and Human services even holds a patent on!), below is a selection of recent more condition-specific research:
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The use of cannabis to help alleviate symptoms of chronic illnesses has been widely recognized since the inception of the medical marijuana industry in the United States and abroad. More recent research has shown the increased benefit of raising the dosages of CBD while lowering the amount of THC. Some of these potentially impacted illnesses include Alzheimer’s Disease, Parkinson’s Disease, and chronic pain.
A 2019 medical review of studies on marijuana use for Alzheimer’s Disease (AD) showed that high doses of CBD could enhance “global network connectivity” in the brain and potentially suppress some of the disease’s main causal factors. The same review found that microdosing THC along with a regular dose of CBD seemed to boost the positive effects of cannabis consumption.
In a July 2023 pilot study performed at the New York Institute of Technology, researchers found that patients with Parkinson’s Disease (PD) who were taking CBD and THC products reported improvement in “pain levels, sleep, and reductions in anxiety.” At the same time, some participants in this study noted some negative effects, including sleepiness and increased cognitive difficulties. These unwanted side effects were relegated to the participants who took higher doses of THC than others. The researchers concluded that future studies should focus on “clinical trials with standardized CBD/THC methods of use.”
Chronic pain sufferers have also been able to alleviate some of their symptoms with the proper mixture of CBD and THC. In a July 2022 study, researchers noted an “enhanced analgesic effect” when combining CBD with THC, as well as a counteraction in the “adverse effects” as the dose of THC was lowered. Another similar study performed in 2021 found that a low THC and high CBD formulation was potentially effective for treating patients with chronic non-cancer pain who had been on long-term high-dose opioids. This is particularly important considering how detrimental opioid-based pain relief can be.
Recent years have seen a dramatic increase in the attention paid to the impact of sleep on our overall health. Unfortunately, millions of individuals suffer from sleep disorders like restless leg syndrome, sleep apnea, and insomnia, preventing them from getting a full night’s rest. At the same time, the majority of prescription-based medications used to treat these disorders often come with grogginess, major side effects, risk for addiction, and were often not intended for long term use.
Fortunately, recent research into the effects of cannabinoids on sleep disorders has shown promising results. A February 2023 study published in the Journal of Education, Health, and Sport concluded that “in the correct doses,” cannabinoids can bring relief to those suffering from sleep complications, particularly restless leg syndrome. Another study from January 2023 found similarly positive results when testing the efficacy of cannabinoids in treating insomnia and other sleep-related ailments.
As its name indicates, Autism Spectrum Disorder (ASD) can present in a wide variety of ways. Still, certain common challenges appear to a large number of individuals diagnosed with ASD, including emotional outbursts, inappropriate behaviors, and social deficits (particularly with regard to communication). Some of the most advanced research studying the effects of cannabinoids on ASD is being led in Israel by pediatric neurologist Adi Aran, MD. He is now carrying out a PhaseIIStudy following promising results of thefirst-ever randomized, double-blind, placebo-controlled clinical trial on cannabinoids for treating children’s AS in 2017. In this previous 12-week trial,patients received a 20:1 ratio of either a whole plant extract with cannabinol (CBD), delta-9-tetrahydrocannabinol (THC), and additional compounds like terpenes and flavonoids, or a purified CBD and THC. Some received a placebo. After a 4-week break, the treatment groups were switched.
In anotherthought-provoking study cited in this post, a nine-year-old boy was treated with a full-spectrum high CBD and low THC oil formulation (specifically containing 20mg of CBD and <1mg of THC). After starting this treatment, the participant’s family noted a significant reduction in self-injurious and inappropriate behaviors, a 200% increase in sleep time and quality, increased communication skills and academic performance, and an overall improvement in emotional stability.
Seeking relief from stress and anxiety is perhaps the most widely recognized reason for consuming cannabinoid products. At the same time, many people report adverse reactions to the “high” that’s associated with regular doses of THC. As we stated above, these negative effects often turn off individuals entirely from cannabis use.
However, when microdosing THC in combination with the appropriate levels of CBD and other cannabinoids, anxiety and stress relief can be achieved while entirely sidestepping any of the adverse reactions. Users frequently experience overall mood and cognitive functioning enhancements as anxiety and stress levels are lowered.
Inone study published in June 2023, researchers found that “CBD may be anxiolytic in "stress-inducing" situations and in individuals with anxiety disorders.” The same study suggested that low doses of THC in combination with CBD provided even more impactful results. On a physiological level, the study found that “the combination of THC and CBD can alter the activity of microRNAs responsible for increasing the biosynthesis of inflammatory mediators, leading to a reduction in the inflammatory profile.” This reduced inflammatory profile has apparent benefits for pain and muscle recovery, with less obvious but perhaps more fascinating benefits for anxiety, stress, and overall mood.
“[CBD] also complements a great number of the effects of THC, in that both are analgesics, painkillers, both are anti-inflammatory, and because cannabidiol has this ability to counteract some of the prominent side effects of THC it’s a very valuable thing to have in any cannabis preparation – whether it’s predominant or in conjunction with THC.”- Dr. Ethan Russo, Leading Global Medical Cannabis Expert
Pictured: Polite whole plant cannabinoid tincture, a physician-developed full spectrum product range that combines CBD, CBD, CBN, functional herbs and trace amounts of THC.
Full-spectrum hemp products are not only easier to access as they are federally legal when made from plants that contain under 0.3% THC (by dry weight) and can be purchased online, but more importantly they allow users to consume a high dose of non-intoxicating cannabinoids while microdosing trace amounts of THC and other beneficial compounds in the process. It should be noted that any products labeled as broad spectrum, isolate or THC-free will not contain these microses of THC, as those extraction processes remove any THC. If a product claims to be full-spectrum, but shows 0% THC on its accompanying Certificate of Analysis (a potency and purity lab test - more on that below), then it is a false claim and should not be trusted.
An important consideration for anyone who is subject to drug testing (typically by an employer or if you are an active duty military member) – full-spectrum and whole-plant CBD or cannabinoid products do come with the risk of testing positive for THC, due to the trace amounts it contains. If you could lose your job or access to benefits for testing positive, you may want to opt for broad spectrum or isolate-based formulations that have been verified by 3rd party lab tests to be free of any THC. Active duty service members are also strictly prohibited from any form of cannabis or hemp use, even federally legal, THC-free, and topical products, primarily due to the risk of accidental exposure and intoxication.
Tinctures are the ideal method of consumption for microdosing because they provide you more control and flexibility over dosage, as compared to edibles like gummies or vaping or smoking. Any quality tincture should come with a graduated dropper, which has visible calibrated markings that allow you to precisely measure out how many milligrams of cannabinoids you are consuming each time. It may take some simple math to calculate how many milligrams of CBD, THC or other cannabinoids you get with each serving (the label should indicate potency per serving), but being able to control and see this information is critical to tracking and figuring out your optimal dosage, taking consistent amounts, or making adjustments in standardized increments.
When CBD oil is dropped sublingually under the tongue and left to sit for 30-45 seconds, cannabinoids can absorb faster than edibles (on average within 15-30 minutes vs 60-90 minutes for edibles) because they enter your bloodstream through mucosal membranes in your mouth. Your body also absorbs more of the “good stuff” you are paying for, scientifically referred to as higher “bioavailability”. From an additive standpoint, there are also more tincture options without any sugar, flavorings, and ingredients or allergens that can often exclude those following gluten-free, paleo, keto, whole30 diets.
Edibles - while much better dosed and portioned these days, still often require further dividing up for microdosing which can be messy and inaccurate and require proper storage. They often come packed with extra calories and sugar and are easy to over consume, feeling more like a snack versus a health supplement. From an onset and bioavailability standpoint, edibles can take as long as 90 minutes to take any effect, since they have to pass through your digestive system and liver before entering your bloodstream, which results in lower absorption of active compounds. This delayed onset can also cause people to think that they did not take enough prematurely, then taking extra servings only to get hit with regretfully strong effects later.
While inhalation via smoking or vaping offers the fastest onset of effects from a therapeutic standpoint, it is nearly impossible to know and track dosage consistently due to variables like how deep your draw and exhale is and the cannabinoid profile and purity of the plant matter. Many people are also concerned about irritation or harm to the lungs and respiratory system, and face limitations on where they can smoke publicly or even in rented properties where landlords, neighbors, or roommates may prohibit or object to cannabis odors.
Consumers should also know that while hemp is federally legal, the FDA has yet to define a clear regulatory framework for hemp products, leaving both consumers and producers in the lurch (cannabinoids are technically not considered a herbal dietary supplement, food, nor medicine despite being FDA approved for certain drugs). The resulting reality is that a frustratingly wide range of quality exists, with no standardized requirements for labeling, potency, purity, or safety testing.
So what can consumers do to protect themselves? The easiest thing to do is only purchase products that come with a publicly posted 3rd party Full Panel lab test, also referred to as a Certificate of Analysis (COA). This extended level of testing not only validates the amount of cannabinoid potency listed on labels, but also goes the extra mile to test that it does not contain toxic contaminants such as pesticides, heavy metals, residual solvents, microbials, and mycotoxins. Any company not willing or able to invest in rigorous testing is likely not a credible option. This is particularly critical for those who are already dealing with health conditions or are immunocompromised.
“Most microdosers experiment with both the specific dosage and how often they dose—e.g., every day, every other day, a few times per week—to find what works best for them… This process often involves a lot of trial and error, and it's common for people to describe accidentally taking too high of a dose and feeling stronger effects than they expected.” - Hailey Shafir, Licensed Clinical Addiction Specialist and Mental Health Counselor
Every individual metabolizes and reacts to cannabinoids differently, and similarly there is no one-size-fits-all standardized approach to microdosing. Clinicians and cannabis health experts always recommend “starting low, and going slow” for those who are trying a new formulation or still figuring out their tolerance levels, which can also change with age and states of health. As is required with any medication or regimen, it takes patience and trial-and-error experimentation to find the “sweet spot” of maximum benefit and minimal to no unwanted effects - which many find successfully with low-THC, CBD-rich options.
Dr. Dustin Sulak, one of the leading US Medical Cannabis Experts who incorporates whole plant cannabinoids in his integrative medical practice and Healer brand of products, suggests that for those who already regularly consume cannabis but want to try microdosing, first prepare their system with an initial 48 hours of THC abstinence in order to reset the endocannabinoid system. Then, generally start with 1mg of THC (typically combined with higher doses of CBD or other minor cannabinoids) and give it at least a 3 day to one week cycle at this dose to observe your response, as it can take time for your system to adjust and react. If there is no desired change after that cycle, gradually increase 1mg at a time per cycle until you notice positive results. Be mindful that once you get into the 5-10mg THC range, it is no longer considered a microdose and you will likely feel psychoactive effects.
If any discomfort or negative side effects are experienced at any time, stop taking the product and consult a healthcare professional that is trained in medical cannabis. If the dose is overall well tolerated, but you feel any mental or physical functioning is being disrupted, take a lower dose in the next cycle. Some research suggests that CBD may have stimulating effects at lower doses and sedating effects at higher doses for some people, so be mindful of what you are taking at what time of day and plan accordingly.
Anyone dealing with serious conditions should consult a cannabis-trained medical expert first, who can help navigate and adjust options and dosage regimes. Some serious conditions or flare-ups may require higher initial doses to get them under control, with mircodosing becoming more useful in the maintenance phase. Overall, the use of any psychoactive or psychedelic substance does come with risks and should be taken with caution and not be used without medical supervision, especially for people facing mental illnesses such as schizophrenia or bipolar disorder.
“If I see someone with multiple sclerosis who is in the middle of a flare-up and having a really hard time, she may need a higher dose to get the symptoms under control... But as she gets well and heals, her daily dose will go down and down and down, until the point where microdosing becomes a maintenance plan.” - Dr. Dustin Sulak, D.O., Integrative Medicine Physician and Medical Cannabis Expert
One of the catch-22’s of using non-intoxicating or microdosed compounds is that the effects can be subtle and require people to observe changes and shifts that they may have overlooked before. Many CBD consumers often express that benefits more often feel like the absence of symptoms, rather than the presence or emergence of a reaction (which is usually the case with psychoactives). It is strongly advised to keep a journal throughout your process of experimentation, noting the specifics of what cannabinoid profile and potency you consumed, dosage, time of consumption, how long it took to experience any effects, and the arc of your mental and physical response. Most importantly, you want to keep a record of what works and didn’t work, and what adjustments you made to experience noticeable differences and improvements. You can download free cannabinoid journal templates such as this one created by Polite, a range of physician-developed CBD, CBG and CBN-rich full spectrum formulations that are all Full Panel tested.
We are living in a promising time where society, politics, and science may once again converge around the much needed mental and physical benefits of cannabis and hemp. Microdosing can be a perfect introduction and long term option for the many seeking relief or maintenance of optimal health, but also want to stay functional and feeling like their best self.
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