Here are some of the best CBD products for Ulcerative Colitis (UC), a chronic inflammatory disease which affects the large intestine and causes ulcers. Learn how people with inflammatory bowel disease (IBD) are using CBD oil to manage symptoms. Best CBD oils for Crohn’s disease & colitis.
CBD for Ulcerative Colitis – August 2022
Can CBD Help With Ulcerative Colitis, and if So, How?
- Ulcerative colitis (UC) is a chronic inflammatory disease in a category known as Inflammatory Bowel Disease (IBD) and is known to affect the large intestine and cause sores, or ulcers, in the digestive tract (1) .
- Aminosalicylates have been the primary means of treating colitis for many years, with doctors aiming to reduce inflammation in IBD patients and improve their quality of life . Physicians may also prescribe medications, such as corticosteroids and antibiotics, to treat the symptoms of UC (2) .
- Studies have shown that CBD’s anti-inflammatory properties may help treat colitis (3) . Several studies report that CBD may prevent colon injury (4) , inhibit disturbances in the large intestine (5) , and reduce intestinal damage overall (6) .
- However, most of these studies were conducted on animal subjects . There is no substantial evidence that CBD can alleviate ulcerative colitis symptoms in humans.
- Seeking advice from a medical professional, particularly someone experienced in cannabis use, is best for individuals who want to take CBD for UC.
Why Some People Are Turning to CBD for Ulcerative Colitis
Ulcerative colitis (UC) is a chronic inflammatory disease that affects the colon and causes long-lasting ulcers, or sores, in the digestive tract.
UC affects the inner lining of the large intestine (microscopic colitis), causing a person to experience bowel movements frequently.
UC commonly affects adults aged thirty to forty years old and is said to account for about $8 to $15 billion in total economic burden in the United States (7) .
The cause of this type of inflammatory bowel disease ( IBD ) is not clear. However, researchers believe colitis develops in genetically susceptible individuals as a response to environmental triggers.
Although there is no known cure for ulcerative colitis, doctors may prescribe treatment to reduce the inflammation that causes its symptoms.
Aminosalicylates have been the main form of treatment for the disease for many years. A physician could also prescribe corticosteroids or antibiotics (8) .
A new approach that could potentially alleviate the symptoms of ulcerative colitis is the use of CBD (cannabidiol). Studies have shown that CBD’s anti-inflammatory properties may help treat UC (9) .
Cannabidiol is one of the many chemical compounds present in the Cannabis sativa plant, which could be hemp or marijuana.
Compared to delta-9-tetrahydrocannabinol ( THC ), which is predominantly found in marijuana, CBD from hemp is non-intoxicating and does not cause a high when consumed (10) . Meanwhile, the use of cannabis (marijuana) induces psychoactive effects.
A study published in 2009 in the Journal of Molecular Medicine found that cannabidiol may have protective effects in rats with colitis (11) .
The researchers examined the large intestines of the subjects and found that CBD was able to reduce injury in the general area.
Another study on rats with ulcerative colitis was carried out the following year to learn about CBD’s effects on this type of IBD.
Results revealed that THC and CBD inhibited inflammation and functional disturbances in the large intestines of the rodents (12) .
The results of these two small studies led another team to continue examining CBD and how it affects colitis in animal models.
In a 2011 study published by the scientific journal PLOS One , scientists once again found that CBD reduced intestinal damage in mice with colitis (13) .
Meanwhile, a clinical trial found that applying CBD as a topical can improve colonic inflammation in mice with UC (14) .
Despite these positive results, most of the studies on CBD’s effects on colitis were carried out on rodents. However, at least one clinical trial attempted to translate the supposed health benefits of CBD on human subjects with UC.
The study compared the effectiveness of CBD oil capsules on individuals with UC to another group that was given placebo pills.
The CBD group participants were given 50 mg of CBD capsules twice each day, increasing up to 250 mg twice daily, if tolerated (15) .
After ten weeks, twenty-four percent of the subjects that took CBD claimed to have improved remission rates , stating that they no longer experience colitis symptoms.
Meanwhile, several participants also reported improved quality of life scores compared to the placebo group (16) .
Although appearing to have potential, CBD’s effects on human subjects with ulcerative colitis are unclear. The lack of human studies is why researchers today could not conclude the efficacy of cannabidiol in adults with active UC.
How CBD Oil Works to Help with Ulcerative Colitis
The endocannabinoid system (ECS) is a system present in most mammals and is responsible for regulating several critical bodily functions. Its discovery in the 90s has led many researchers to believe that it could be manipulated to bring about therapeutic effects in parts of the body it controls (17) .
Knowing how the ECS works is essential in understanding how CBD may help alleviate ulcerative colitis and IBD symptoms .
Cannabinoids, like CBD, express their therapeutic effects in the body through receptors in the ECS (18) . The two primary endocannabinoid receptors are the CB1 and CB2 receptors.
CB1 receptors are primarily distributed on neural tissue and the central nervous system. CB2 receptors mediate the functions concerning the immune system .
A study in 2001 mentioned that CB1 receptors are said to play a role in controlling gastrointestinal motility and gastric intestinal secretion (19) . This statement is supported by at least two studies on mice, which demonstrated that CB1 and CB2 receptors are crucial in modulating colonic inflammation (20) .
Although both CB1 and CB2 receptors are considered mediators of inflammation in the ECS, the CB2 receptor seems to be the primary regulator of inflammation and immune functions (21) .
When CB2 receptors are activated, they trigger a response which fights inflammation in the body. This anti-inflammatory reaction is said to help treat chronic inflammatory diseases, one of which is colitis (22) .
CBD supposedly provides its anti-inflammatory benefits by interacting with the cannabinoid receptors in the ECS. Doing so could help treat inflammation of the colon, which is common in ulcerative colitis.
The Pros and Cons of CBD Oil for Ulcerative Colitis
- CBD is said to have anti-inflammatory properties (23) that could potentially alleviate ulcerative colitis and Crohn’s disease symptoms .
- Several studies on cannabis and inflammatory bowel conditions support the concept that compounds, like CBD, can be used to treat inflammatory bowel diseases (24) .
- CBD intake does not result in a euphoric high, unlike THC, which is the psychoactive component prevalent in medical marijuana .
- People can purchase CBD oil products even without a prescription so long as they do so in locations where they are legal.
- According to a study in 2018, cannabidiol is non-addictive and may even help with substance abuse and drug addiction (25) .
- Most of the findings from the studies mentioned earlier were obtained from clinical trials on rodents. At the time of writing, there is no direct evidence proving that CBD can effectively treat ulcerative colitis.
- Research on CBD’s efficacy on human subjects with colitis has shown limited clinical response , with the results of these studies being generally inconclusive.
- People who take CBD may experience adverse effects , such as dizziness, nausea, fatigue, and headache (26) .
- At this time, Epidiolex is the only CBD product approved and evaluated by the United States Food and Drug Administration ( FDA ) (27) .
- The FDA also warns the public that using CBD and other medications together may affect how these drugs work, potentially causing severe side effects (28) .
How CBD Oil Compares to Alternative Treatments for Ulcerative Colitis
Herbal medicines have been used in treating IBDs, like ulcerative colitis and Crohn’s disease . They are said to be effective in alleviating inflammatory bowel disease symptoms in the gastrointestinal tract .
In Italy, complementary medicines, particularly herbal therapies, are frequently used by patients with inflammatory bowel diseases (29) .
Likewise, Chinese literature recognizes the IBD treatment of ulcerative colitis with herbal remedies.
Herbs, such as aloe vera, Boswellia serrata , and turmeric, are often used in the hopes of alleviating the symptoms of colitis (30) .
This belief is based on the alleged anti-inflammatory effects that these herbs provide upon consumption.
Aloe vera is said to have therapeutic potential in treating IBD, based on the positive results of a clinical trial on patients with the disease (31) . Meanwhile, Boswellia serrata (32) and curcumin from turmeric (33) are also reported to have anti-inflammatory activities.
CBD has been shown to possess characteristics that could combat inflammation and help with IBDs, like colitis. There are CBD products available in the form of tinctures and capsules that are infused with herbal medicines.
Users can find CBD oil mixed with herbs, such as aloe vera, Boswellia serrata , and turmeric. There are also CBD supplements in the form of soft gels that contain Boswellia and curcumin.
How to Choose the Best CBD Oil for Ulcerative Colitis
Choosing the right type of CBD oil is imperative to experiencing CBD to the fullest. Three variants of CBD oil are being manufactured by companies today.
The first is full-spectrum CBD, which has all of the chemical compounds that are naturally found in cannabis. This type also has other chemical compounds, like terpenes that provide the distinctive aroma in cannabis plants and flavonoids, which give their unique colors.
Full-spectrum CBD also contains trace amounts of THC, which cannot cause a psychoactive reaction.
Combining all of these compounds and consuming them provides the user with the entourage effect. This effect means that the cannabis constituents are more effective when consumed together compared to taking them individually.
Cannabidiol is not the only compound of cannabis that is said to have therapeutic effects. When choosing a CBD product, users often decide to select one containing the full range of cannabinoids to maximize their health benefits .
The second type of CBD oil is called broad-spectrum, which is similar to full-spectrum. It also contains all of the phytocannabinoids that are derived from cannabis except THC.
This variety of CBD is ideal for individuals who do not want to consume THC.
The third type of oil is known as isolate, which contains pure cannabidiol. Users that are allergic to specific cannabinoids of the hemp plant, or those who want to take pure CBD, can opt for CBD isolates.
This type of CBD is often available in powdered form but can sometimes be found as crystals.
Regardless of whether a person chooses full-spectrum, broad-spectrum, or isolate, careful consideration is necessary to obtain the best CBD oil suitable for one’s preferences.
Here are several tips to ensure that high-quality, safe, and reliable cannabis products are bought today:
- Look for the certificate of analysis (COA) or the laboratory report of the CBD product selected. This document is especially important since it indicates that the item has undergone thorough testing and contains precisely the specifications listed on its label.
- Read up on product and shop reviews when buying from an online store. If purchasing from a physical dispensary, check if it has proper authorization to sell CBD.
- Only buy organic CBD derived from hemp. The hemp plant is the most reliable source of quality cannabidiol.
- Ensure that the legalities involving CBD are followed in the state where it is planned to be bought and used.
- Consult a medical professional, preferably someone experienced in medical cannabis , before deciding to use CBD for the symptoms of ulcerative colitis.
Additional Tips to Get the Best CBD Oil Products
- Keep an eye out for CBD brands claiming that their CBD is acquired from the stalk and seeds of hemp plants. Cannabidiol is not found in hemp seeds, and there are minimal traces of CBD in the stalks of hemp.
- Do not purchase CBD vape cartridges containing thinning agents, such as propylene glycol and polyethylene glycol, as these can be toxic and harmful to one’s health.
- Avoid purchasing low-quality CBD edibles and gummies that are made of artificial colors and sub-standard ingredients.
- Contact CBD brands directly for any questions or concerns. Try another CBD company if they do not respond.
CBD Dosage for Ulcerative Colitis
There are no official guidelines concerning the consumption of CBD for ulcerative colitis. However, it might help to review the dosage of past human clinical trials to have an idea concerning the safe amount for intake.
From the study mentioned earlier, patients with UC were given 50 mg of CBD oil capsules twice a day. The participants who tolerated it well took increasing amounts, reaching as much as 250 mg twice per day for ten weeks.
The study showed that the subjects who took CBD felt better and claimed to no longer experience colitis symptoms. A few individuals also reported mild reactions, such as dizziness and nausea.
A systematic review of CBD dosing found that patients who took doses between 1 and 50 mg/kg per day reported significant improvements in their conditions (34) . This review took into account the results of twenty-three studies and found that CBD was well-tolerated in all subjects.
Perhaps the best rule to apply with regards to CBD dosage is to start with a small amount and then observe its effects. If there are no severe reactions, users can gradually increase their dosing until they experience the desired outcome.
How to Take CBD Oil for Ulcerative Colitis
When seeking the anti-inflammatory effects of CBD for colitis, users can choose to take CBD sublingually via tinctures and droppers. This approach involves placing drops of CBD oil under the tongue and keeping it there for several seconds before swallowing.
Applying CBD by way of tinctures is probably the fastest way to deliver cannabidiol to the body as the compound can enter the bloodstream immediately.
CBD in capsule form is also another way to take cannabidiol, allowing individuals to take them daily, similar to supplements.
Meanwhile, users can find CBD edibles in the form of cookies and gummies that can be consumed as snacks.
This kind of product is usually available in various flavors and can be a delightful introduction to CBD. However, edibles can take effect longer than other forms of CBD, as it has to travel through the gastrointestinal tract first.
Ulcerative colitis is an inflammation of the colon that primarily affects the lining of the large intestine , causing people to experience frequent bowel movement or flare-ups .
UC commonly occurs in adults between the ages of thirty to forty years old and is reported to be a significant economic burden in the United States.
There is no clear indication of what causes colitis and, as of this time, scientists have not yet found a cure for the disease.
Aminosalicylates are the most prescribed treatment for UC, with doctors aiming to reduce inflammation and improve the quality of life of IBD patients.
Several studies have shown that CBD is a possible medical treatment option for ulcerative colitis and other inflammatory bowel conditions. Researchers discovered that CBD could prevent injury and inflammation to the colon, potentially providing relief for colitis disease activity .
Experts believe that CBD may reduce inflammation by interacting with the CB1 and CB2 receptors of the ECS.
However, most randomized controlled trials were carried out on animals, with no direct evidence showing that CBD is an effective treatment for UC symptoms in humans .
When deciding to purchase CBD for intestinal inflammation , interested cannabis users should consult a doctor to get the right medical advice.
People can benefit from visiting a healthcare provider experienced with cannabis oil and CBD .
CBD for IBD: Can It Help with Crohn’s Disease & Ulcerative Colitis?
CBD is a powerful natural anti-inflammatory supplement.
New research suggests CBD oil as a promising new treatment option for IBD (Crohn’s & Colitis).
Inflammatory bowel diseases (IBD) can be frustrating.
It isn’t just the pain or bowel urgency — it interferes with all aspects of your life. IBD can cause you to miss work and social events when symptoms flare-up.
A compound found in the hemp plant called cannabidiol — or CBD for short — has been shown to offer benefits towards some of the negative symptoms of inflammatory bowel diseases.
In this article, you’ll learn how it works and how to use it effectively.
We’ll also cover some of the best CBD oils to use for IBD.
MEDICALLY REVIEWED BY
Carlos G. Aguirre, M.D., Pediatric Neurologist
Updated on January 12, 2022
Table of Contents
- 1. Ulcerative Colitis
- Four Factors That May Trigger IBD:
- Step 1: Source A High-Quality Full-Spectrum CBD Oil, Capsule, or Suppository
- For More Information on Finding the Best CBD Products, Check Out Some of Our Guides:
- Answer the Following Questions in Your Notes:
$49 – $229
Royal CBD Oil 30 mL
5 / 5
Total CBD: 500 – 2500 mg Potency: 16.6 – 83.3 mg/mL Cost per mg CBD: $0.12 – $0.18 Extract Type: Full-spectrum THC Content:
Best CBD Oils For Inflammatory Bowel Disease
- Royal CBD Oil— Best CBD For IBD Overall
- Phoria Turmeric Curcumin CBD Oil— Best CBD Oil For Inflammation
- Kiara Naturals CBD Pain Oil— Best CBD Herbal Formula For Inflammation
The Benefits of CBD For Inflammatory Bowel Disease
CBD influences many of the chemical messengers involved in controlling inflammation. This fantastic plant extract does this by acting on receptors within the endocannabinoid system.
What is the endocannabinoid system?
The endocannabinoid system (ECS) is a complex set of receptors found throughout the body, tasked with regulating inflammation and peristalsis (movement of intestines) in the gut and stress responses in the brain .
In the case of Crohn’s disease and ulcerative colitis, CBD has been shown to provide the following benefits:
- Reduces gut inflammation
- Supports the health of the microbiome
- Alleviates abdominal pain & cramping
Since CBD has been shown to reduce inflammation and interact with ECS receptors in the gut, it’s a promising supplement to help relieve some of the symptoms of IBD.
1. CBD Reduces Gut Inflammation
CBD has been shown to fight inflammation involved with many different types of inflammatory diseases — including IBD.
One of the ways it does this is by influencing the normal cycle of our cells. It binds to cell receptors known as the adenosine A2 receptors, which control what molecules are produced and secreted by cells around the body . CBD binds to the A2 receptors to stop the cells from releasing compounds that trigger and perpetuate the inflammatory process — effectively halting inflammation at the source.
A second way CBD lowers inflammation with IBD is through its effect on the CB1 receptors of the endocannabinoid system itself. Its effect on these receptors stops the ability of specialized cells known as mast cells to release histamine  — a powerful inflammatory compound associated with allergies.
2. CBD May Support the Microbiome
Some research suggests that CBD can also impact the health of the microbiome. A dysfunctional microbiome is thought to be one of the main causes of inflammatory bowel disease.
Early research has suggested that the endocannabinoid system is involved with maintaining a healthy diversity of microorganisms in the gut lining  — though more research is needed to understand this effect in more detail.
3. THC & CBD May Alleviate Abdominal Pain & Cramping
THC (tetrahydrocannabinol) is also a well-known muscle relaxant — which can be used to stop the painful muscle contractions going on in the intestinal tract with IBD. This lowers abdominal cramping pain and improves motility in the digestive tract — resulting in less bloating, constipation, cramping, and feelings of fullness .
CBD also modulates the sensation of pain by stopping certain neurons from firing.
This occurs between secreted endocannabinoids and their receptors. While endocannabinoids have been shown to indirectly affect opioid receptors, it’s important to remember that endocannabinoids work within their own systems and do not interfere with other pain regulating systems. This is why THC and CBD do not have the same addictive qualities as morphine .
What is Inflammatory Bowel Disease?
Inflammatory bowel disease (IBD) is an umbrella term for two closely related conditions affecting the digestive tract — ulcerative colitis and Crohn’s disease.
What’s the difference between these two conditions?
1. Ulcerative Colitis
Ulcerative colitis (UC) is defined as a long-term inflammation of the large intestine and colon. The inflammation becomes so bad it eventually forms ulcers and erosions in the digestive lining.
The extensive damage to the digestive lining may reduce the number of nutrients we can absorb through the digestive tract and can affect our ability to keep harmful substances out of the bloodstream (leaky gut syndrome).
People with ulcerative colitis tend to have less healthy bacteria and more harmful species compared with healthy people — a condition called dysbiosis.
Dysbiosis in the gut causes disruptions to the intestinal environment due to the metabolites produced by the more harmful bacteria. These metabolites cause inflammation, which then causes more damage to the surface of the intestinal walls.
This all leads to a cycle of inflammation that gets increasingly worse over time .
Symptoms of Ulcerative Colitis
2. Crohn’s Disease
Crohn’s disease is also a result of long-term inflammation. However, the inflammation involved with Crohn’s occurs in patches along the intestinal tract. This is different from ulcerative colitis which can affect the entire digestive tract.
These patches of inflammation from Crohn’s disease is most common at the end of the small intestine where it connects to the large intestine (called the terminal ileum).
The inflammation from Crohn’s disease goes deep. Compared with ulcerative colitis, which affects only the mucosa layer of the intestine, Crohn’s disease extends from the mucosa to the outer layer — causing severe pain and loss of digestive function.
Like UC, dysbiosis of the intestinal environment is present with Crohn’s disease. Harmful species of bacteria are able to outcompete healthy gut flora. These harmful bacteria wreak havoc by producing inflammation-inducing metabolites — making symptoms progressively worse over time.
Symptoms of Crohn’s Disease
How is IBD Diagnosed?
IBD usually takes three to five months to be diagnosed after the first symptoms appear.
Doctors consider your medical history, family medical history, physical examinations, lab testing, and medical imaging to confirm their suspicions before making a diagnosis.
IBD is usually first diagnosed between the ages of 20 and 30 but can remain undiagnosed for years before it’s discovered. Symptoms are often subtle and hard to notice until the disease progresses.
What Causes IBD?
The causes of both ulcerative colitis and Crohn’s disease are still not well understood.
However, four environmental factors have been shown to impact the genes of people predisposed to the condition — this means that certain environmental factors can trigger the condition.
Four Factors That May Trigger IBD:
- Diet low in fiber and high saturated fats
- Bacterial gut infection
- Low vitamin D levels 
Inflammation is a problem in both UC and Crohn’s disease. Therefore, it makes sense that all the above risk factors either cause inflammation directly or cause dysbiosis in the gut. This imbalance of the bacterial population then leads to inflammation, leaky gut syndrome, and even more inflammation.
Genetics play a large role since our genes determine our immune system, and our immune system determines our gut flora. This is why certain people are more at risk than others to develop IBD.
If you add poor lifestyle choices or stress to the mix, it further increases the chances of developing IBD .
How is IBD Treated?
The 5 “R’s” Of Healing Inflammatory Bowel Disease
CBD products fit into the third and fourth points:
- Remove foods that trigger a reaction.
- Reduce inflammation and excessive immune response.
- Repair the intestinal lining by supporting microbiome health.
- Restore the function of the intestinal lining.
- Repletion of vitamins and minerals that are not adequately absorbed through the damaged intestine.
The most recent evidence of CBD’s benefits to inflammatory bowel diseases is focused on reducing inflammation, — which in turn helps to repair the gut lining and restore the health of the intestinal environment.
Here, we’ll explain how CBD works and why IBD sufferers consider using CBD to address their most debilitating side effects.
Supporting IBD With Dietary Changes
The primary goal here is to restore the gut microbiome, allowing beneficial bacteria to thrive instead of harmful ones.
Dietary Changes For IBD May Include:
- Increasing fiber intake
- Eating more fruits and vegetables
- Lowering saturated fat consumption
- Eating more anti-inflammatory foods
Lifestyle Modifications For IBD
Stress and lack of exercise are closely linked with IBD symptoms since both affect immune function. Performing regular movement (circulating more lymph fluid) and stress reduction techniques like meditation reduce the intensity of flare-ups.
Lifestyle Modifications May Include:
- Daily exercise
- Yoga and meditation
- Getting more sun exposure (to build up vitamin D levels)
- Ensure at least eight hours of sleep each night
- Identify and eliminate stress triggers
Prescription IBD Medications
The Main Types of Medications Given for IBD Include:
- Antispasmodics — such as dicyclomine, reduces spasms of the intestinal muscles. These spasms are what cause pain and discomfort for those suffering from IBD.
- Antidepressants —tricyclic antidepressants or selective serotonin reuptake inhibitors are often used to treat IBD. The former is better for diarrhea-predominant IBD and the latter for constipation-predominant IBD.
- Antibiotics — there are some studies that showed that taking the antibiotic Rifaximin reduced the severity of symptoms in some patients .
- Fecal Transplant — feces donated from a healthy individual is transplanted into the colon of an individual suffering from IBD. This process introduces healthy bacteria into the IBD-affected intestines .
What Is CBD?
CBD (cannabidiol) is the primary non-psychoactive compound in the marijuana plant (Cannabis sativa). It works by acting on the endocannabinoid system — a series of receptors that form a communication pathway throughout the nervous and immune systems.
Research has identified two main types of endocannabinoid receptors — the CB1 and CB2 receptors :
- CB1 receptors are located in the mucosal lining and neuromuscular layer of the colon .
- CB2 receptors are found on cells of the immune system .
Endocannabinoid receptors are found throughout the nervous system, either in the brain or on the cells that regulate neuron activity. This is why there is so much interest in using phytocannabinoids to treat any neurologically-related issues, including IBD.
The nervous system is the regulatory system that allows the brain to “talk” the other body systems. Understanding how the ECS works will allow us to take advantage of certain pathways and block unwanted symptoms and/or debilitating issues .
Let’s look more closely at why CBD should be included in the management of IBD.
Tips For Using CBD For IBD
Step 1: Source A High-Quality Full-Spectrum CBD Oil, Capsule, or Suppository
CBD comes in many different forms — so there’s a product for everybody.
If you don’t mind swallowing capsules, these are an excellent option for people with ulcerative colitis or Crohn’s disease.
CBD oil is another good option as it’s easy to measure individual doses, takes a long time to break down in the intestinal tract (ensuring it reaches the target area), and has a very long shelf-life.
Suppositories are also a good option but can be uncomfortable to use. These are best for IBD affecting the colon specifically (the last section of the digestive tract before leaving the body).
Always follow the directions on the packaging when using CBD suppositories.
For More Information on Finding the Best CBD Products, Check Out Some of Our Guides:
- CBD Oils — Best for all-purpose CBD use
- CBD Capsules — Best option if taking other supplements or medications at the same time
- CBD Suppositories — Best for inflammation in the large intestine (delivers CBD directly to the source)
Step 2: Assess Optimal Starting Dosage
Dosing CBD can be a challenge for first-time users. You can use our CBD dosing guide to assess the daily dose of CBD based on desired strength and weight (see chart below).
When using CBD for the first time, we recommend taking the smallest recommended dose and building up slowly over a week. This is a wise thing to do when starting any new supplement to see how it affects you.