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Cannabis – why one size doesn’t fit all

We have got used to popping into the doctor and getting a pill for our latest ailment. -“take one of these three times each day and come back in a month if you don’t feel better”. Or when buying a vitamin supplement being advised a set dose to take per day.  Cannabis or CBD, CBG and CBG doesn’t work like that. It is very personalised with care needed to slowly increase the dose, with some people needing tiny doses and some needing really large doses. Children with epilepsy, for example, often need much higher doses of CBD than adults with pain or other health conditions.  Why is this? What lies behind this variation? That is a complex question with a number of answers.

Let’s have a look:

Personal variation 

We all have different genetics and the way we metabolise cannabis is no exception. Essentially, cannabis is metabolised by enzymes in the body, mainly in the liver, called cytochrome P450 enzymes. Take CBD, for example. It is metabolised by one of these enzymes called Cytochrome 3A4 and also by 2C19. Some people have different genetic variations of these enzymes which can speed up the breakdown (and thus the person needs a higher dose) or slow it down (so they need lower doses). In addition, being on other medication can also alter the speed of these enzymes and so people taking another medicine may need more or less of the CBD.

Other cannabinoids and terpenes

A lot of cannabis products on the market are “full spectrum”. That means that they contain all the “minor” cannabinoids and other compounds, such as terpenes and flavonoids, in that particular strain. The exceptions to this are the isolate products that only contain one compound, like only CBD. Each strain will be slightly different from the next. Even a similar product with, say, the same level of CBD or CBC may well have different minor cannabinoids, like different levels of CBG, and different terpene profiles, like more or less myrcene or linalool. All these other components will produce overall different effects and they in turn will be metabolised in different ways. Thus the dose and the effect of one strain can be different from the dose and effect of another strain.

Ways of taking the product

Another variation is the way you take the product. Vaping has a quicker effect, but is not so long lasting when compared to an under-the-tongue product. Taking a product by mouth into the stomach will again have a different effect. The onset is slower than under-the-tongue but the effect longer lasting. The absorption can vary hugely depending on what the person has eaten. Cannabis likes to be absorbed in fatty food so if the person has just eaten a fatty meal than it will be absorbed much quicker than on an empty stomach or just after a non-fatty meal. This can also affect the required dose, so one message is for you to be consistent with meal times and meal types before taking a cannabis product.

Product variation

We should not forget that cannabis is a plant and plants are not pharmaceuticals. They vary in their composition. Each product batch of cannabinoids such as CBD, CBC or CBG may be slightly different from the next batch (usually plus or minus 10% is allowed). Often this variation is not of any consequence but it is another variable.

So what is the message?

The basic message is that cannabis, or one of the other minor cannabinoids like CBD, CBG or CBG, is not like pharmaceutical products. It is inherently variable in composition and the effect will vary according to how you take it and according to your own genetics. It is a natural option; a plant and it works to target our own individual needs and desired outcomes. When adding a cannabis wellness product to your routine you should “start low and go slow”. Start at low dose and increase gradually until the desired effect is reached, whilst also tracking your dose and symptoms. This will ensure that you get to the right dose for you. If you try a different product then it is best to repeat that process, although once you know what rough dose is good for you, you can escalate the dose a bit faster – but don’t assume that you will need the same dose of, say, CBD or CBG with every product. It will vary. One size definitely doesn’t fit all in cannabis.