Microdosing Medical Marijuana: What is it & How Does it Work in Ohio?

Microdosing Medical Marijuana: What is it & How Does it Work?

What is microdosing with medical marijuana?

The short answer to this is that microdosing is taking a very small amount of medical marijuana. This is a precision dose, which is tapered specifically to your response. It is based on the idea that “less is more.”  In other words, you are taking the smallest dose, which is effective for you, as an individual.  The purpose of the medical marijuana is for medical benefits, not for “the high” of THC. [1]

If one of our Ohio Medical Marijuana Doctors decides that you may benefit from microdosing medical marijuana, he will explain to you how to find your ideal dosage.

Why would you want to use microdosing?

There are several reasons for wanting to microdose.  For example, you may be like a lot of patients that need to take the cannabinoid, THC, but are still working at jobs.  You may take care of your children at home, and need to be alert. In these cases, you need to have dosages which allow you to continue working, as well as being responsible.   

There is a lot of variability in how much THC and CBD that a person needs to consume, to be effective for the qualifying medical marijuana conditions.  One person may need a much larger dosage than another, for the same effect.  Why is that you ask? This is because of how cannabinoids affect an individual is determined by a number of factors. Your optimal dosage of medical marijuana may be different from others, depending on: [2]

• Changes in the number of cannabinoid receptors in your body.  The receptors are molecules in the cell membranes that respond specifically to another substance, such as THC, CBD, hormones, or even medications.   

• Changes in the sensitivity of the cannabinoid receptors. (How well the receptors respond to cannabinoids.)

• Changes in the amount of endogenous cannabinoids that we make. Endogenous means that we make them.  There are two main cannabinoids that we make internally.

• Changes in the number of enzymes available.  In the liver, the enzymes are responsible for THC, CBD and other cannabinoids being processed for utilization. Also, enzymes assist in making the changes necessary for the ultimate removal of cannabinoids from the body.   

• What medications that you take.  A number of medications are broken down by the same enzyme system (cytochrome P450), as medical marijuana. As a result, some medications compete with medical marijuana to be utilized.   

• Genetic makeup- your genes, plus the genetic material shared from bacteria, viruses, fungi, that live within you (called the biome, virome, etc.).  

• Genetic phenotype- how your genes are expressed, secondary to environment, diet, exercise, and other lifestyle factors.   [2]

• Liver function

• Previous cannabis usage [3]

Low dose medical cannabis can sensitize the endocannabinoid system, allowing it to respond to the illness that you have.  It does this by increasing the number of receptors on the outside of the cell membranes (upregulating), which makes the cells more sensitive to the medical cannabis.  A consistent daily low dose allows you to often take medical marijuana without adverse interactions with your other medications. [2]  With higher dosages, you may see either interactions and adverse effects. An example is the medication, Warfarin (Coumadin), a blood “thinner.”  Consistent and low dosage allows your INR (test that measures the time it takes for your blood to clot) to remain in target range. [2] Even so, close INR monitoring might be ordered during initiation of medical marijuana and with any changes to your medical marijuana dosage.   

Low dose or microdosing can decrease the possibility of developing tolerance to medical marijuana. With tolerance, you may think that you will need more medication for the same effect.  However, because medical marijuana works like a bell curve, eventually the higher the amount will cause LESS effect and will be counterproductive.  Instead, sometimes lowering the dosage might actually make it work better for you.

Microdosing does well with what kind of medical conditions ?

Both chronic pain and cancer pain- The Journal of Pain published a study that took a small group of cancer patients, who were not finding relief with traditional opiate pain relievers.  They were given a CBD/THC compound (Nabiximol). The dosages ranged from low, to medium, to high. Those who were given the lowest dose reported the most relief.  The patients which received the high dose, reported more pain. [4]

PTSD- The Journal of Clinical Psychopharmacology reported a study done in 2014.  This study was of a group of incarcerated individuals who were given 4 mg doses (low) of Nabilone.  (Nabilone is a synthetic form of delta 9-THC.) They were given this medication to help treat their posttraumatic stress disorder (PTSD) and its associated symptoms.  The results of this study showed significant improvements in insomnia, nightmares, chronic pain, and general symptoms. [5]  

Neuropathy- A study was conducted, evaluating the analgesic efficacy of vaporized cannabis in subjects, the majority of whom were experiencing neuropathic pain despite traditional treatment. Thirty-nine patients with central and peripheral neuropathic pain underwent a standardized procedure for inhaling either a medium dose (3.53%), low dose (1.29%), or placebo cannabis with the primary outcome being VAS pain intensity. The analgesia obtained from a low dose of THC (1.29%) had a meaningful outcome and was clinically significant. [6]

There are a number of other qualifying medical marijuana conditions that microdosing may be an effective option.     

How do you microdose?

If one of our Ohio MMJ Doctors decides that you may benefit from micro dosing medical marijuana, he will explain to you how to find your ideal dosage. It normally takes around 6+ days, where you will be asked to fill out a journal of before and after taking medical cannabis.  This will be filled out each time you dose, whether it is daily or four times a day.  [2] This journal will encourage you to listen to your body.  

You will begin by identifying for yourself your current comfort level, using 1-10, with 10 being most comfortable.  Other pertinent factors, such as appetite may also be assessed. You will begin with a small dosage that our physician at DocMJ will recommend. You will check for the effect upon your body. If you have no effect after a certain period of time, then you may take another dose. However, with even a slight effect, you will stop dosing and continue with your day, until the time for your next regular dose. [2]

What about adding CBD to this mix of microdosing?

Although micro dosing is frequently referring to the cannabinoid, THC, adding an equal ratio of CBD to THC, you usually will get a wider therapeutic window.  This means that you would have less side effect “or high” from the THC. [3]   

Finding the Microdosing Dose of medical cannabis that is optimal for you:

It may take some time to figure out the exact dosage that is right for you.  If you are using tincture or oil, you can count the drops. With edibles, it is difficult to have consistent dosing in the lower range of 1 mg or more.  Also, it takes longer to take effect. [2]

The idea is to start low and go slow.  The end goal is to take the dose that gives the most minimal noticeable effect.

Many experts now believe that the threshold for the medical benefits of THC is far lower than many people think. If one of our Ohio Medical Marijuana Doctors recommend that you microdose your medical marijuana, you will find that you will be able to fine tune to your optimal dosage.

References:

1. https://basresearch.com/science/the-benefits-of-cannabis-microdosing/

2. https://healer.com/
3. https://terpenesandtesting.com/microdosing-cannabis-benefits-without-buzz/
4. https://www.sciencedirect.com/science/article/pii/S1526590012000193
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4165471/
6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3566631/

Dr. Marissa Magsino

With over 25 years of specialty training in Internal Medicine, as well as fellowship training in Functional and Sexual medicine, Dr. Maginso added Plant Medicine (Medical Marijuana) to her niche practice as of 2017. She is licensed in the State of Florida and attended the University of the East (UERM) in Quezon City, Philippines as well as the University of Medicine and Dentistry in Newark, NJ.

She joined DocMJ in 2019 to align with a known group of compassionate physicians that empower their patients to be better versions of themselves. Her favorite hashtag is #powerpassionperformance, using the combination of optimized bioidentical hormones, medical marijuana, plasma therapies, and sexual wellness.

She is an author, speaker and community advocate for Medical Marijuana, Sexual Health, and the empowerment of mature women.