Finding Relief Through Cannabinoid Ratios

BY KATHLEEN BRADLEY PA-C ILLUSTRATION BY KATIE WEITMAN

Many of us are familiar with the effects of THC and CBD alone; however, there is much to be learned regarding the benefits of combining these two cannabinoids together. When combined, this dynamic duo has been proven to be extremely effective at managing pain and improving sleep as well as mitigating undesirable effects from THC. Different ratios of THC and CBD can produce different effects, giving the user a variety of options including functional daytime use or sedative nighttime therapy. Furthermore, the combination of these two cannabinoids helps amplify the positive effects that both have to offer. In this article, I’ll discuss the entourage effect, therapeutic THC:CBD formulations, and the benefits of using THC and CBD together.

THE ENTOURAGE EFFECT The benefits of combining THC and CBD begin with the entourage effect. The entourage effect, first described in 1998 by Shimon Ben-Shabat and further refined by Raphael Mechoulam in 1999, describes the additive effect between all the compounds in the cannabis plant. These compounds include cannabinoids, terpenes, and flavonoids. Terpenes are responsible for the aroma of the plant, whether it smells skunky, fruity, or earthy, and flavonoids are the compounds responsible for the color of the plant—some plants being deep purple while others are a lime greenish-yellow.

The combination of all of the compounds provides more therapeutic benefit than any of the individual parts alone. In other words, 1+1 gives you 3! This means that due to the entourage effect, less medicine is needed to achieve a therapeutic result. By using less medicine overall, the risk of undesirable effects also decreases. CBD and THC have a unique synergy that amplifies positive results while mitigating negative side effects.

RATIOS A ratio is a term used to describe how one quantity relates to another. If you have two equal quantities of two substances, you have a 1:1 ratio. If you have twice as much of one substance compared to the other, you have a 1:2 ratio. If you have three times as much, you have a 1:3 ratio, and so on. Combining cannabis and hemp together in specific ratios can help tailor to specific therapeutic needs.

hemp throughout the day for symptom relief without feeling negatively altered. Healthy, middle-aged individuals on no other medications can begin to feel slightly altered by between 1-2mg of THC. If a patient who is new to cannabis/THC, or who is sensitive to their effects, combining 1-2mg of THC with 5-10mg of CBD may help significantly reduce any unwanted effects. Low doses of CBD alone, such as under 20mg, have been shown to have a stimulating effect. Small doses of THC with larger doses of CBD, or a broad THC:CBD ratio, are well suited for daytime use as they are nonintoxicating and not sedating. As with any medication, start low and go slow. Dose requirements can vary greatly depending on patient tolerance, weight, metabolism, and overall health status.

Combining CBD with THC can make for a safer, more comfortable experience. Anxiety, paranoia, elevated heart rate, and short-term memory impairment can all occur with THC consumption. A patient may decrease most of these undesirable effects by consuming between 5-10 times as much CBD as THC, or a 1:5 or 1:10 THC to CBD ratio.

NIGHTTIME USE Ratios of THC to CBD can be used at nighttime to help achieve better sleep through a variety of ways. This dynamic duo can help with anxiety, pain, and muscle relaxation—all major contributors to insomnia. The combination of THC and CBD is more effective at treating any of these ailments than THC alone.

Thirty to 40mg or higher of broad spectrum CBD alone has been shown help with sleep. But due to the entourage effect, smaller 1:1 doses of THC:CBD, such as 10mg or more, can be sedative in patients with some tolerance to cannabis/hemp. When selecting a THC:CBD formulation, it is also important to select for sedating terpenes like myrcene and beta-caryophyllene. In addition, using CBD in combination with THC can help reduce the “brain fog” feeling that can occur the day after consuming THC.

THC and CBD have both shared and unique properties in and of themselves, and when combined these compounds have a synergistic effect that provides substantial therapeutic benefit. Cannabinoid ratios provide a way for patients to use cannabis/ hemp formulations while making the medicine safer and the experience more comfortable. They also provide an option for using a natural medicine to treat pain during the day without feeling altered. By combining these two cannabinoids, patients can amplify the positive effects while minimizing the undesirable ones.