What to Tell your Doctor if you use CBD or THC

It’s a good idea to tell your doctor about anything you are taking that might influence other medications. If you have been told to avoid eating grapefruit with a medication, for example, then you may need to use caution with CBD as well. A recent study looked at the in-depth issues when taking CBD with other drugs. They explore the cytochrome P450-complex enzymes in particular. It turns out that the interactions are complex but usually mild. The authors conclude that CBD is usually a very safe substance.

My doctor was supportive of my taking CBD.  She reported that it has helped some of her patients and that she has even recommended it at least once. I see other doctors for a couple of chronic illnesses, and they showed no interest in the fact that I take CBD.

shutterstock_164571476Many physicians are not familiar with the fact that our bodies produce natural cannabinoids that seem to help maintain balance or “homeostasis”. The endocannabinoid system has been studied since the first endogenous cannabinoid was discovered in 1992.  Anandamide was discovered by Raphael Mechoulam (the scientist who earlier discovered THC and CBD) along with NIMH researchers William Devane and Lumir Hanus.  It attaches primarily to the CB1 receptor in our bodies.  In 1995 Mechoulam discovered the second major endocannabinoid “2-arachidonoylglycerol” or “2-AG” which attaches to both CB1 and CB2 receptors.

Supplementing our natural endocannabinoid system with phytocannabinoids (plant-based cannabinoids) has some risks.  These risks are seen mostly with THC. It’s probably even more important to tell your doctor about any THC use. Heavy users of marijuana can develop tolerance, with higher and higher doses needed over time to get the same effect.  Very heavy THC use can also lead to a rare disorder called cannabinoid hyperemesis syndrome. The most troubling symptom of this disorder is severe bouts of vomiting.  Persons susceptible to psychosis should probably avoid THC because there is evidence that it can contribute to a psychotic episode. As noted above, CBD has not been found to have such risks.

Many people who live where marijuana is illegal do not report THC use to their doctor. They may fear that such a disclosure will become a part of their medical record and that the information will eventually make its way to their insurance company or someone else.  It’s probably a good idea to report THC use in any case, but it is especially important if you have any symptoms that may be related to such use.

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