Finding the optimal CBD dose for rheumatoid arthritis

Autoimmune diseases are categorised by the body’s immune system attacking healthy cells, and as such, there is no known cure for rheumatoid arthritis. However, there is a wide range of therapeutic and lifestyle treatments available that can help to ease the symptoms. One of the newer and more popular options is cannabidiol (CBD) oil, which has been studied extensively for its potential to reduce inflammation and pain. CBD is one small part of medical cannabis therapy.

But with CBD being the newcomer that it quite simply is, and with some much conflicting advice online, many patients who are looking to try CBD may find themselves wondering what the optimal dose of CBD is.

In this comprehensive guide, we will explore its potential therapeutic benefits, and discuss in detail how you can find the optimal CBD dosage for managing your unique symptoms of rheumatoid arthritis.

The science behind CBD and rheumatoid arthritis

CBD was the very first phytocannabinoid to be isolated from the cannabis sativa L. plant genus, all the way back in 1940, with over 110 more phytocannabinoids having since been identified. THC is the other major player in the phytocannabinoid world, and is the psychoactive chemical behind the “high” that is associated with cannabis consumption.

CBD, on the other hand, does not cause intoxicating effects and has been studied extensively with regard to its potential therapeutic properties.

How does CBD (and other cannabinoids) interact with humans?

To explain this fully, we need to discuss the endocannabinoid system.

The endocannabinoid system (ECS)

The ECS is the largest neurotransmitter network in humans. It consists of endocannabinoids (neurotransmitter chemical messengers that are produced naturally within the body), the receptors CB1 and CB2, and enzymes responsible for synthesising the endocannabinoids and breaking them down. It plays a significant role in regulating many different bodily tasks such as sleep, mood, appetite, inflammation response, pain, memory, and even sexual function.

Now, you may have noticed the similarity in the verbiage of endocannabinoids and phytocannabinoids. This is because phytocannabinoids, such as CBD, are remarkably similar in structure and chemical makeup to the endocannabinoids that the body produces. As such, they can interact with and activate the ECS receptors, modulating the functions that the ECS holds power over.

How does CBD help rheumatoid arthritis sufferers specifically?

CBD offers several key ways to potentially alleviate symptoms for individuals with rheumatoid arthritis (RA).

CBD has, time and again, been shown to have a massive impact on inflammation levels. There are a range of studies that we can point to that explore the effects of CBD on inflammation.

The first, titled “Transdermal cannabidiol (CBD) reduces inflammation and pain-related behaviours in a rat model of arthritis”, came to three specific conclusions:

• The transdermal administration of CBD offers long-lasting therapeutic effects without causing any psychoactive side effects.
• Topical CBD shows promise as an effective treatment for arthritis symptoms.
• Based on the presented data, transdermal CBD appears to be a strong candidate for developing enhanced therapies for arthritis.

Next up, we have the 2020 published paper “Cannabidiol (CBD): a killer for inflammatory rheumatoid arthritis synovial fibroblasts”. The main takeaways from this study were that:

• CBD significantly inhibited the expression of pro-inflammatory mediators in human rheumatoid fibroblasts.
• CBD also inhibited the production of specific inflammatory cytokines and chemokines.
• The authors found that CBD can reduce inflammation and pain in rheumatoid arthritis via its anti-inflammatory properties.

The final, and most recent, study we will look at today is “Cannabidiol as a treatment for arthritis and joint pain: an exploratory cross-sectional study”.

This research paper unveiled a strong correlation between the administration of CBD and the relief of arthritis symptoms. These include reduced pain, improved physical function, and enhanced sleep quality. Moreover, respondents reported a decreased dependency or complete discontinuation of other medications like anti-inflammatories, acetaminophen, and opioids after incorporating CBD into their treatment regimen.

This last point is interesting, as it shows that while CBD holds great promise in reducing the main symptoms of RA, it may also help to reduce the dependence on other medications, such as opioid-based drugs, and also ease the mental burden that often accompanies rheumatoid arthritis. Overall, the research paper highlights the importance of medical cannabis for arthritis. 

What is the optimal CBD dose for rheumatoid arthritis?

Before we go any further, we must stress that CBD should be seen as a complementary therapy for arthritic symptoms, rather than some kind of 'miracle cure’. You should always discuss taking CBD with your doctor before incorporating it into your treatment regimen.

When it comes to determining the optimal dose of CBD for rheumatoid arthritis sufferers specifically, there are a couple of factors that need to be taken into consideration.

The first factor is your body weight, as this will determine the amount of CBD you need to take. Generally speaking, lighter patients will require a lower dose than those who weigh more.

Your specific rate of metabolism is the second factor to consider. Patients with faster metabolisms typically need higher doses of CBD because the active compound breaks down more rapidly compared to those with slower metabolisms.

Cannabinoid tolerance also comes into play here. For instance, if you’ve been taking CBD consistently for more than three months, then you may need to increase your dose as your body may have developed a tolerance.

Finally, the type of CBD product you choose, or are prescribed, is also important. For example, CBD edibles have a much slower absorption rate than CBD oil that is taken sublingually (under the tongue) or inhaled through a vaporiser. We will discuss this in greater detail below.

Now onto CBD dosage sizes…

With the wide range of factors and variables that go into finding the optimal dose, it really should go without saying that the need to seek the guidance and advice of a doctor who is registered to prescribe medical cannabis is paramount. Only they will be able to evaluate the specifics of your situation and determine what dose size is right for you.

But, to help you get started – as an estimate for generalised relief from RA symptoms – it’s best to begin with a dose of 5-10 mg per day, taken either through vaporised dried flower, or sublingually administered CBD oil. While this is what is considered to be a low dose, it is always best to follow the “start low, go slow” approach.

It is important to note that CBD is a cumulative treatment, meaning you may need to increase your dose over time for it to take full effect and create lasting results. Generally speaking, many patients find that taking up to 25 mg per day is sufficient in providing the relief they are looking for, but for more acute cases a higher dose may be necessary.

CBD products for rheumatoid arthritis

CBD comes in many different forms, such as tinctures, topical creams and balms, edibles, capsules, and dried flower for vaporisation.

For those with rheumatoid arthritis specifically, sublingual application of tinctures or oil is the most common way of taking CBD, as this method bypasses the digestive system and delivers cannabinoids directly to the bloodstream for faster absorption.

The same can be said for the vaporisation of either dried CBD dominant flower, or CBD oil. This method is also fast-acting, with effects being felt almost immediately.

Another popular choice is topical creams and balms. These are most often applied to target localized inflammation and joint pain in specific areas of the body. The skin is our largest organ, and has a huge amount of ECS receptors that interact with the CBD, providing relief when applied topically.

Finally, capsules and edibles are slower to take effect but can provide longer-lasting relief due to their slow absorption rate. However, the dosing for these methods is harder to accurately control, making them less ideal for those seeking targeted relief.

Overall, determining the best CBD product for your RA symptoms may take at least a slight amount of trial and error. However, with the advice of your doctor and a dose that is tailored specifically for you, you should be able to find the CBD product and dose size that works best for you.

Does CBD come with any side effects?

All medications carry a certain level of risk, including CBD, but luckily this cannabinoid is considered to be extremely safe and well-tolerated. That said, it is still important to be aware of any potential side effects.

The most common adverse reactions reported by patients are:

• Fatigue
• Nausea
• Dry mouth
• Diarrhoea
• Changes in appetite or weight

It is also significant to note that CBD can interact with certain medications, so make sure to speak with your doctor before taking it.

Final thoughts on CBD and rheumatoid arthritis

Although the need for further research in this area is clear, the early evidence surrounding CBD and its potential benefits for RA sufferers is encouraging. For those looking to add complementary therapy to their treatment regimen, CBD is certainly proving to be a viable option.

However, it is important to remember that CBD is not intended to be used as a replacement for any medications prescribed by your doctor. Instead, it should be seen as a supplement to existing treatments, and administered in combination with lifestyle changes like regular exercise, relaxation exercises, and improved nutrition.

As we have discussed in this article, finding the optimal dose of CBD is tricky, as there is a range of factors that come into play. This is why it is essential that you seek the professional advice of a doctor that has experience in prescribing CBD for rheumatoid arthritis before taking it.

Don't let the stigma surrounding medical cannabis prevent you from getting a suitable treatment. Releaf provides tailored monthly packages, specialist consultations for medical cannabis, and a unique medical cannabis card for protection, all based on your medical cannabis prescription.