Are The Effects Of CBD Cumulative?
As CBD becomes more common, more consumers are getting aware of its potential. They are investigating its possible benefits and are asking questions about drug interactions, side-effects, and other matters related to CBD consumption.
With the increase in people trying CBD, a new conversation point has arisen; one that centres on the frequency of CBD consumption: are the effects of CBD cumulative? And for how long can they take CBD?
People in pain due to chronic inflammation, for instance, often ask whether taking CBD will immediately lessen their pain or they need to consume CBD for several days before experiencing any possible helping effects. And they wonder if they can take CBD for months or even years, if necessary.
Unfortunately, right now we have more questions than answers. Still, initial research has started offering some insight into the question of CBD’s possible cumulative effects.
So, are the effects of CBD cumulative?
There is some evidence that CBD builds up in the body over time and that cumulative dosing of CBD and repeated low-dose CBD treatment can have an effect.
That has led some consumers to experiment with so-called microdosing.
Microdosing CBD involves taking frequently very small amounts of CBD over the course of several hours instead of consuming a high dose once a day. For example, you may take one mg of CBD every hour for twelve hours instead of taking twelve mgs in the morning. This keeps the CBD in their body at constant levels over long periods of time.
Proponents of microdosing believe that it is a great way to better understand the effects of CBD on your body and often suggest that people try it before beginning a full CBD regiment.
They also recommend microdosing for people experienced with CBD who wish to reset their system, as they believe that we can develop a tolerance over time.
Microdosing is supposed to help you find the right CBD dosage for you: when you feel the anticipated effect, you simply measure how many doses you have already taken and stop. In the future, the argument goes, you can consume that dose whenever you need to feel the desired effect.
Crucially, all of these claims assume that the answer to the question, “are the effects of CBD cumulative?” is a resounding “yes.” They also assume that CBD lingers for hours in the body: if not, then the microdose you took in the morning will have dissipated during the course of the day, making it impossible to calculate your ideal CBD dosage.
But does science support these claims?
What do we know about CBD’s cumulative effects?
There is a lot that is still unknown about the potential benefits of CBD. Likewise, there is still uncertainty regarding how the method and frequency of consumption affect the possible build-up of CBD in the body.
At the same time, there is significant evidence that the effects of CBD are more pronounced in smaller doses, as this 2014 study found out.
The study explored the effects of nabilone, a synthetic cannabinoid that has shown promise for the treatment of posttraumatic stress disorder (PTSD)–related insomnia and nightmares as well as efficacy in the management of chronic pain.
The researchers concluded that there was a significant improvement in PTSD-associated insomnia, nightmares, PTSD symptoms, and chronic pain after several months of use. The patients were able to discontinue medications associated with greater risk for adverse effects, such as antipsychotics and sedatives. Importantly, there was no evidence of abuse within this high-risk population.
The study also concluded that “tolerance may be a factor in trials lasting over several months, and this is something that seems to merit further investigation.” This strengthens the claim of a positive answer to the question, “are the effects of CBD cumulative?”
Are there more studies on CBD’s cumulative effects?
There is more evidence that CBD builds up in the body over time.
People suffering from chronic pain, arthritis, Parkinson’s, fibromyalgia, and other conditions often take CBD over long periods with the hope that its hoped-for cumulative effect will activate their endocannabinoid system and stimulate their cannabinoid receptors to work more efficiently.
Recent research seems to support this view.
A 2018 trial showed “that participants reported significantly fewer depressive and psychotic-like symptoms […] and exhibited improvements in attentional switching, verbal learning, and memory. Increased plasma CBD concentrations were associated with improvements in attentional control and beneficial changes in psychological symptoms.”
Another clinical trial concluded in 2019 that “repeated treatment with low-dose CBD induces analgesia predominantly through TRPV1 activation, reduces anxiety through 5-HT1A receptor activation, and rescues impaired 5-HT neurotransmission under neuropathic pain conditions.”
Importantly, the trial specifically mentioned how cumulative dosing of CBD and repeated low-dose CBD treatment could prevent anxiety-like behaviour and pain perception.
Before any conclusions can be drawn, however, we should also mention which other factors affect CBD’s possible cumulative effects.
CBD’s effect depends on several factors
The first thing to remember is that CBD’s effectiveness depends on many aspects that are unique to each individual: age, metabolism, genetic predisposition, weight, the type of condition to be treated, and even the level of exercise the individual takes.
A major point to consider is that CBD effects also depend on how it is consumed.
There are four main methods of consumption:
- topical creams;
Each method has its advantages and disadvantages, mainly in regards to CBD’s bioavailability in the body.
CBD bioavailability refers to the amount of CBD that manages to reach the bloodstream.
Bioavailability is not limited to CBD. It is taken into consideration with all drugs and medication. Pharmaceutical companies calculate the dosage of their drugs based on careful estimations about the real amount of medication that enters the bloodstream upon consumption.
When we take CBD, an important percentage is lost before it enters our bloodstream. The only 100% bioavailable method is intravenous consumption, which is not readily available for most users.
All other methods of consumption have a decreased bioavailability because any substance needs to go through the digestive tract, the lungs, or the skin before reaching the bloodstream.
In the case of CBD, the highest bioavailability is encountered when vaping CBD because it enters the lung capillaries directly. In this case, bioavailability can reach up to 50%, meaning that half of the initial CBD consumed never enters the bloodstream.
Sublingual consumption has an average bioavailability of 30%, CBD edibles and ingested CBD oil offer a bioavailability of 20%, and CBD topical creams have the lowest bioavailability, usually under 5%.
So, the first thing to consider when asking, “are the effects of CBD cumulative?” is that it depends on the way it was consumed. This also affects how long CBD lasts in the body.
How long does CBD last in the body?
A second matter to consider is how long CBD remains in the body before it is broken down by enzymes and discarded by the liver.
Although research is still ongoing, there is evidence that fast absorption of CBD also leads to the rapid removal of CBD from the body.
Also, the speed at which CBD is removed from the body depends on the method of consumption. A 2018 study examined how long it takes for CBD to be reduced to half of its initial value in the body. Surprisingly, this ranged from a little over an hour to five days, depending on the circumstances.
CBD oil, drinks gummies, chocolates, or any other CBD edibles have to pass through the digestive tract. It takes up to two hours for the CBD to enter the bloodstream but can stay in the body between two and five days.
Because of its high bioavailability, vaped CBD enters the bloodstream in a matter of minutes. However, the effects are shorter-lasting, usually up to 31 hours.
Topical CBD creams
Topical CBD takes more than two hours to start working because of the seven layers of skin that it needs to bypass. It usually lasts around six hours and has a localized effect.
Sublingual CBD, i.e. placed under the tongue, takes 15 to 30 minutes to start working and can last from a little over an hour to over ten hours.
Single doses vs. microdosing
Some people choose to take CBD for acute pain or local inflammation. They usually prefer a high dose to maximize the speed in which CBD will work. A migraine, a sore joint after intense exercise, or a headache are acute problems. People facing them use CBD as a means to gain temporary relief.
The effect also extends to psychological conditions. A clinical trial in 2011 examined a group of people suffering from a social anxiety disorder. These were given CBD before speaking in public. The researchers found that “pretreatment with CBD significantly reduced anxiety, cognitive impairment and discomfort in their speech performance, and significantly decreased alert in their anticipatory speech.” In this case, CBD showed efficacy without the need for any cumulative effect.
Other social anxiety sufferers, however, take CBD for months or years because they wish to feel relaxed when in public. These people often prefer to microdose, hoping that CBD’s possible cumulative effect will offer a long-term solution to a long-term problem.
So, CBD’s frequency and consistency of consumption depend on the individual, the condition, and its severity.
Should I be taking CBD over long periods of time?
Unfortunately, it is still too soon to have a definitive answer on CBD’s effects over long periods of time. This is not limited to the question, “are the effects of CBD cumulative?” There’s much we don’t know yet about CBD—for example, how can you calculate the ideal CBD dosage for a specific condition? What are its side-effects? What about its interaction with other medications?
We’re still years—and many human trials—away from answering these crucial questions. It is no surprise, then, that the NHS has not issued any recommended daily allowance or length of treatment for CBD.
What we currently have is indications and anecdotal evidence. Right now, it is up to consumers and their GP to evaluate how much and for how long they could be taking CBD.
CBD is well-tolerated
What we do know is that CBD is generally well-tolerated and with a good safety profile, as the World Health Organization Report established in 2018. This means that consuming CBD over longer stretches of time does not produce serious side-effects for most users and is non-addictive.
Can CBD cure a condition?
People considering CBD should bear in mind that CBD may not be able to cure their health problems.
Can CBD undo arthritis or Parkinson’s disease? We simply don’t know. It may be able to alleviate the inflammation and the pain associated with these conditions since its effect is similar to taking anti-inflammatory NSAIDs medication. NSAIDs, however, only numb the pain without actually curing the underlying cause. It is possible that CBD does the same.
CBD is a novel supplement whose effectiveness is still being researched. Research has shown that we may someday use CBD for anxiety, depression, inflammation, chronic pain, and more.
Until then, CBD is being sold as a food supplement and there is no recommended dosage. Likewise, the NHS has not issued any advice regarding the length of time consumers should be taking CBD, even though the FSA has offered its own CBD guidelines.
Clinical evidence suggests that the effects of CBD are cumulative. This could be particularly beneficial in conditions that are permanent and require constant medication.
Until more is known, however, consumers are advised to check with their GP to establish a proper dosage that fits the patient’s profile and general health before experimenting with CBD.