One of the most frequently asked questions about microdosing is: is it safe? What are the risks of microdosing? After all, we heard disturbing stories about LSD and magic mushrooms, psychoses, acute schizophrenia, “thinking they can fly”, and flashbacks. These stories date to the 1960s. Meanwhile, the risks of psychedelics in a high dosage have been accurately mapped. As it turns out, psychedelics are among the safest substances on the “drugs” spectrum—below weed, alcohol, and MDMA.
Therefore, it’s tempting to assume that when microdosing—taking a tiny amount of a psychedelic— the risk will also become smaller. However, until we know for sure, we cannot make that assumption. Various scientific institutes are investigating the direct physiological effects of microdosing. Until those effects are all mapped, we can only assume what we know about higher dosages, side effects, and contraindications reported by the experimental microdosers.
A provisional starting point for the risks of microdosing
Dr. James Fadiman and Sophia Korb received over 1800 reports of the microdosing experiences from 59 countries. There were only 75 people that claimed not to have a positive experience when microdosing. From this, they’re confident of establishing a provisional starting point for the risk of microdosing; it’s safe. First, because the dosage is so low, there seems to be no danger of a “bad trip”, psychosis, or other acute experiences—positive or negative—that can entail a complete psychedelic trip. Among the gathered responses of microdosers, there was not a single case of psychosis. However, we want to stress that this doesn’t mean there will be no chance of this. As with everything, the risks of microdosing depend on the specific situation, person, and substance, and therefore it’s best to proceed with caution.
The most well-known risks of microdosing are:
- Can increases anxiety. This is why anxious people are more likely to not benefit from microdosing.
- People with paranoia may experience more paranoia and suspicion during microdosing
- Mushrooms can cause mild stomach upset and nausea in sensitive individuals.
- Fatigue. Mainly while microdosing psilocybin. One experiences this as a disadvantage; the other does not and takes the microdose before going to bed (the Nightcap protocol)
- Some men with color blindness reported mild hallucinations or post-imagery, and they stopped their microdosing cycle.
- People diagnosed with bipolar disorder reported that they benefited from microdosing during their depressive phase but would discourage it during a manic phase.
- One potential concern for microdoses of LSD in people with pre-existing heart conditions, which comes from studies demonstrating that fenfluramine, when taken daily, doubles the risk of Valvular Heart Disease. Fenfluramine binds to the same receptors as LSD and psilocybin, but the quantities used for microdosing are extremely low in comparison. More research is needed to know if this potential risk effectively translates to humans who microdose with LSD. The current stance in science is that the microdosing protocols of 10-weeks, with a 4-week pause afterwards, are sufficiently protective for microdosers. If you have a pre-existing heart condition, it’s advised to avoid extended periods of microdosing.
- Psilocybin can cause headaches in some people.
- Tinnitus: People report that their tinnitus (ringing in ears) got worse during microdosing, it didn’t stop their tinnitus, or it the tinnitus stayed the same.
Therefore, for whom is microdosing not recommended?
- For people under the age of 18
- In combination with alcohol or other drugs
- In pregnancy or during breastfeeding
- People who take lithium carbonate medicine (Lithium). This combination is not recommended until more is known about it.
- Experience with psychosis. Although there have been no reports of people who have been diagnosed with psychosis due to microdosing, it’s well known that higher doses of psychedelics can trigger this. Therefore, this possibility should not be ruled out for the time being.
- Men with color blindness. They can start to see tracers in their field of view. This has been reported to Dr. Fadiman by some men. Sometimes those images or lingering colors persisted for days. Not all people with color blindness experience this, but there is a chance that it will occur.
- People with anxiety or an anxiety disorder. The fear can be magnified, or they become more aware of their fear. On the other hand, for people who suffer from depression and have anxiety, it can help to ease their fears.
- People who suffer from paranoia/suspicion. Microdosing can amplify paranoia.
- People who suffer from tinnitus.
General note: the potential risks of microdosing combined with mental or physical disorders are not yet sufficiently known.
What do we know safety and microdosing?
- A lot of types of medication and supplements can be combined with microdosing. NOTE: This statement only applies to microdosing, not for higher dosages. Psychedelics containing MAO inhibitors, such as ayahuasca, should not be combined with some medications.
- “Set and setting” are not microdosing requirements, but when you microdose with a good mindset and proper setting can work to your advantage.
- If you follow a proper microdosing protocol, your body shouldn’t create any tolerance towards the active substance.
- Microdosing throughout your life probably doesn’t cause any harm. Albert Hofmann has microdosed the last decades of his life to his satisfaction. He’s turned 102 with it.
Are these findings and comments decisive when it comes to safety? We don’t think so. The long-term effects are not yet known. Dr. James Fadiman especially wants to emphasize that the benefits far outweigh the risks. And not all disadvantages mentioned are also a risk of microdosing: some might be a point of attention or something to consider.
Other potential pitfalls with microdosing:
- The microdose dose can be a little too high at the beginning. This can be uncomfortable during your daily activities. Hence the advice is to start microdosing on a day off.
- People who had a lot of anxiety or had predispositions to it, reported that they felt okay with microdosing, but they felt depressed again in the weeks they didn’t microdose.
- When microdosing too often (every day), the body builds tolerance, meaning you have to take more to achieve the same effect. Tolerance for LSD, psilocybin, and mescaline has not been demonstrated. Therefore, adhere to a microdosing protocol.
- Without microdosing, you no longer feel cheerful, creative, or productive enough. As a result, you become psychologically dependent on microdosing.
Microdosing in combination with medication
Another frequently asked question related to the risks of microdosing is if microdosing can be combined with medication and supplements. Dr. James Fadiman and Sophia Korb have compiled a list of medications and supplements that—to date—have not been reported to cause any adverse side effects when combined with microdosing.
This list is a result of their long-term research with hundreds of subjects worldwide who have microdosed independently with (mainly) LSD, 1P-LSD and psilocybin For other substances, nothing is known yet. We want to emphasize that this list does not guarantee that you can microdose safely and responsibly while taking any medications listed.
- Always consult your doctor first if you plan to combine, stop or phase out any medication.
- Remember: no one is currently knowledgeable enough in the field of microdosing to be able to advise you on stopping drug use. If you want to phase it out because you suspect that microdosing is a better alternative, consult with your doctor and research the pros and cons!
Have you experienced any problems with microdosing in combination with your medication? Or do you have an addition to the list? Please, let us know.
What do experts say about the risks of microdosing?
David Presti, professor of neurobiology at the University of California, Berkeley, and expert on the effects of drugs on the brain, stated that microdosing is much safer than taking antidepressants. James Rucker, a psychiatrist affiliated with King’s College London, has called for psychedelics to be reclassified—making them better examined and more available to researchers. However, he is cautious. In the interview with BBC, he said: “If you look at the medical side of microdosing, we don’t know anything yet. We don’t know the long-term effects yet”.
It becomes clear that microdosing needs to be recognized by (medical) researchers and the authorities to be further examined. Dr. Fadiman thinks this won’t take very long; “As long as we continue to find that microdosing has a very beneficial benefit-risk ratio, we expect more pressure from the medical world to use this in people with complaints or disorders that we have not been able to help so far”.
The Trimbos Institute is a Dutch independent knowledge institute for alcohol, tobacco, drugs and mental health. They don’t recommend experimenting with LSD itself. “It is very difficult to measure what exactly microdosing is. You may want to take 10 micrograms, but it may also be that the drop of LSD is not evenly distributed over the seal. Then you take a lot more than you think. Also, there are resources that are sold as LSD, but contain other trip products. There is also a risk there.”
More research needed
It becomes clear that microdosing needs to be recognized by (medical) researchers and the authorities and be further examined. In other words, we need more research. Dr. Fadiman thinks this won’t take very long; “As long as we continue to find that microdosing has a very beneficial benefit-risk ratio, we expect more pressure from the medical world to use this in people with complaints or disorders that we have not been able to help so far”.
The content on this website and the other Microdosing Institute channels is for informational and educational purposes only, and does not substitute professional medical advice or consultation with healthcare professionals. If you are seeking medical advice, diagnose, or treatment, we advise you to consult a medical professional or healthcare provider. Equally, we cannot help with the sourcing of illegal substances.
- Johnson, M. W., Sewell, R. A., & Griffiths, R. R. (2012). Psilocybin dose-dependently causes delayed, transient headaches in healthy volunteers. Drug and alcohol dependence, 123(1-3), 132–140. https://doi.org/10.1016/j.drugalcdep.2011.10.029
- Unknown. (December 6, 2019). Everybody Should Understand the Potential Heart Risks of Psychedelics. The Psychedelic Scientist. Retrieved from: https://thepsychedelicscientist.com/2019/12/06/everyone-should-understand-the-potential-heart-risk-of-psychedelics/
- Waldman, A. (2017). A Really Good Day: How Microdosing Made a Mega Difference in My Mood, My Marriage, and My Life. Knopf Publishing Group