I would like to share something I read this week that surprised me not because it was new although I did not know it had a name. Way back when we first learned about the Endocannabinoid system, we learned that if you abuse it with too much cannabis, it can shut down.
Well, Mrs. Conaway is convinced that this article is a description of the Endocannabinoid system and what happens when it shuts down. So, let me start at the beginning. As usual there is lots of technical jargon which is passed because we need laymen’s terms to really grasp it’s importance. Big words sound like showing off.
I will post the link to the article if you are interested, at the end of my post.
THE BEGINNING OF THE STORY
The amount of suffering the human body is truly amazing. A fact Big Pharma knows because they tend to create issue after issue resulting in more sales of drugs … but that is not what this is about. This is about a man who suffered chronic nausea and episodes of something called “cyclical vomiting” for 12 years! And, although he had dozens of doctors, they couldn’t nail a diagnosis.
CANNABINOID HYPEREMESIS SYNDROME aka CHS is what he had. This condition was figured out by researchers in 2004 and mainly experienced by daily/frequent users.
Things to look for: Chronic nausea and cyclical vomiting relieved by exposure to hot water.
This man figures he went to the emergency room 30 separate times and was in the hospital 2 times. He had an iffy gallbladder removal and had so much radiation procedures performed that he can’t do them anymore. It’s too risky.
He was only 20 years old when he started having symptoms. CHS had only been recognized months before by a team of doctors in Australia and this was in 2005. It was 10 years later that their discovery would make it to America. By then he’s spent 200 thousand in medical bills!
In his words, “I would consistently wake up in the morning with nausea,” Greg Lontchar explains of the symptoms he’d come to associate with CHS. “It was like a pit in my stomach, almost like a feeling of extreme hunger.”
Managing his symptoms meant eating light and consuming cannabis, as he’d done daily for two years, both before and after meals—first to stimulate his appetite and later to ease the discomfort related to having put down some food.
“The mornings where the nausea could not be controlled typically meant I was going to have an episode,” remembers Lontchar.
A CHS episode, or attack, means ceaseless vomiting. Lontchar describes physically demanding periods of violent and painful regurgitation followed by fevers, chills, cold sweats and, eventually, more vomiting. Rinse and repeat.
So, he figured out that hot water made it stop. He’d eventually just sit in the shower until the hot water ran out. That had to be crazy! What makes this story worse is he never went longer than about 30 minutes before it would happen until he couldn’t take it and went to the emergency room.
You would think that at some point he would figure out that no pot equaled no pain, but my guess is he never stopped long enough to see that happen.
Some history on the research. The researchers became aware of the daily use of cannabis and cyclic vomiting syndrome in 1996 and 8 years more before they named it and 20 years until it was added to the 2016 revised version of the ROME IV – a reference to all thing’s functional gastrointestinal disorders. This whole period saw an increase in hundreds of daily users who had the chronic nausea, vomiting and relief from hot showers. And quitting cannabis of course so if the users knew this why did they keep using it? No answer here.
At first they thought it was a psychological reason. Once they noticed the way the misery stopped with showers and no smoking, they reasoned it must be physical. So the bulk of the research revolved about diagnosing and treating and not why it happened.
Dr. Jeff Lapoint is one of the few who are aware of CHS. And of course, cannabis lovers will deny this is true but his determination, like most things happened when working on something else. His theory is that a receptor known as vanilloid 1 which responds to heat may be involved. Capsaicin, the heat in hot peppers, activates the vanilloid 1 receptor. (Sorry about the tech talk but it’s needed here.) He tested his idea using the capsaicin in 2013 and in 2017 wrote that in 20 cases symptoms were successfully relieved when using a topical capsaicin treatment.
Here’s the beauty of his hypothesis. CHS results from derangements of the endocannabinoid system’s CB1 receptors following overstimulation.
- My memory was nudged when I read this because in my certification course, I I read about other issues with using it too much. In our book, Cannabis for Chronic Pain by Dr. Rav Ivker, DO, ABIHM he said something similar.
- On page 25 he warns, … b. Avoid using any high-THC product on a daily basis. The following documented adverse effects are Chronic and result from marijuana with relatively high THC content that has been smoked daily, unless otherwise stated.
Dr. Ivker goes on to state the reasons he has for this but my connection of this warning by him and the hypothesis posed by Dr. Lapoint is that they are similar in that both point to chronic use of THC daily as the culprit.
We know that the strains of marijuana are much more powerful today as they are specially bred to be high in THC. This might also contribute to the problems. Right now, I can’t recall where I read or heard that the Endocannabinoid system is fragile and what I mean is you can disable it if you ingest too much cannabis. When I do come across it, I will update this post with the details so you can read it for yourself. It’s your body’s guard so please take care of it.
This is taken from the article about Dr. Lapoint where he says it’s over stimulation and might be because of the powerful strains of todays chemovars. “We know that in laboratory settings, if you bombard the CB1 receptor, it just goes inside the cell,” explains Lapoint. “If you keep hitting it and hitting it, it just disappears. It goes inside the cell.”
“So that, I believe, is the core pathophysiology of cannabinoid hyperemesis syndrome,” he continues. “You’ve hit this cannabinoid receptor so many times and… your body is looking for another way to hit that system. That’s what [the vanilloid 1 receptor] does. That’s why the hot bath works. It’s remodulating this nerve transmitter regulatory system that’s gone totally haywire.”
Just in case you think you can abuse your system, here is a cost breakdown of a CHS related ER visit. It rose from $2,758.43 to $4,647.62 over 8 years, 2006-1013. In 2019, for 17 patients treated the total cost of ED visits and radiologic evaluations – the average cost per patient was $76,920.92 and that was before the diagnosis was made!!!
Balance in life is so important so be careful of your cannabis use and alter it every so often or give it a break to enable the endocannabinoid system to recover. The astronomical medical bills will hurt longer than the CHS once it’s figured out that’s what it is. You don’t want to end up on opioids, cat scans and cameras in pills in your body. If you are going to need it when you develop true work related or age related chronic pain and can’t use it because you burned out your Endocannabinoid system, you will be in a world of hurt.
Enjoy your cannabis responsibly!
*Matt Stangel, June 20, 2019 Real or Not, Cannabinoid Hyperemesis Syndrome Is a Costly Diagnosis
*Dr. Rav Ivker, Cannabis for Chronic Pain Touchstone 2017
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