Hello fellow cannabis enthusiasts! It has been quite some time since I have posted anything here while dealing with family and health issues, but I am back and hope to be able to write here more often. Over the past few months I have been focused on learning more about various diagnosis that are beginning to be more common in my family's daily life, namely POTS/dysautonomia, EDS and autism. I still have so much to learn about these conditions and how they relate to every day life. Since I have been doing research on these topics I have found that more and more people are going through symptoms similar to what we have experienced, who are increasingly concerned about treatments that are hit and miss as to whether it works or incredibly cost-prohibitive. In an effort to perhaps help someone else going through this and to help cement the knowledge in my memory by teaching, I'm going to be sharing what I learn about how(if) cannabis could be useful in situations/diagnoses like these. I'd first like to share what I've learned about postural orthostatic tachycardia syndrome, also known as POTS. Let's get into it.
POTS as we know it was discovered in the 1990's by Dr. Phillip Low of the Mayo Clinic, but it has been called by several other names in history (DaCosta's Syndrome, Soldier's Heart, Mitral Valve Prolapse Syndrome).1 According to Johns Hopkins Medicine, POTS is "a blood circulation disorder characterized by two factors:
A specific group of symptoms that frequently occur when standing upright
A heart rate increase from horizontal to standing (or as tested on a tilt table) of at least 30 beats per minute in adults, or at least 40 beats per minute in adolescents, measured during the first 10 minutes of standing
POTS is diagnosed only when orthostatic hypotension is ruled out and when there is no acute dehydration or blood loss. Orthostatic hypotension is a form of low blood pressure: 20mm Hg drop in systolic or a 10mm Hg drop in diastolic blood pressure in the first three minutes of standing upright."2
Even though the diagnosis has been around for quite some time, there is still so much to learn concerning what causes POTS and how to treat it consistently. What adds to the potential for frustration with this diagnosis is the fact that even those in healthcare might not have been educated on this diagnosis yet or may have preconceived notions about what it entails. There is still so much to learn about cannabis in general and even more so to learn about how cannabis can affect those who are dealing with POTS symptoms. However there is research on how cannabis affects the heart, that can help those dealing with POTS make an informed decision when it comes to cannabis. Cannabis is known to have an effect on the heart rate and blood pressure in a dose dependent manner.3 According to the article by Kichloo et al., an increase in heart rate and an increase in blood pressure is the most common cardiovascular side effect when consuming THC.3 For those dealing with an increase in heart rate that comes with the POTS diagnosis, this might not be the most ideal medicine to take. This research article goes on to point out that while consuming THC may lead to an increase in blood pressure (something that those dealing with POTS symptoms are looking for) it tends to lead to a decrease in blood pressure over all.3 Potentially great news for those who have chronically high blood pressure, not the best news for those dealing with a tendency for low pressures.
While this does sound like cannabis (at least THC) might not be a good choice for those who are dealing with POTS, there is research that shows that the side effects of THC can be mitigated in several different ways. From previous posts we know that there is a delay of onset for THC depending on the way it is consumed. For a quick recap: anything that is inhaled will begin to take an effect quickly (within 15 minutes) while taking an edible can take from 45 minutes to 2 hours to take effect.4 Historically it was believed that taking large amounts of CBD could help keep THC in check, but there's interesting research from John's Hopkins that shows that large amounts of CBD can actually keep THC from breaking down in our systems which could lead to higher amounts of THC being available for the body to absorb.5 Going back to the article from Kichloo et al., they state that side effects of THC start at 10 mg.3
So while the research is a bit ambiguous, with the information we currently have about cannabis and our cardiovascular system, as well as talking with your provider about whether cannabis could be useful in your situation or not, an informed decision can be made. Reading through the information here, it's clear to me that the "start low and go slow" method is the best way to consume cannabis if you are going to do so for your symptoms. As always, with any medicine (plant or otherwise) it is best practice to start with a discussion with your primary care provider as well as doing your own research. Sometimes talking with providers can be an intimidating situation. If you or a loved one is having difficulties with talking with your provider about cannabis as a medicine, feel free to reach out to me here we can talk about different points to bring up with them.
Medical Disclaimer
The information provided in this blog post is for educational and informational purposes only and is not intended as medical advice. The content discussed here should not be used to diagnose, treat, or manage any medical condition, including Postural Orthostatic Tachycardia Syndrome (POTS), or to make decisions about medical care.
Consult with a qualified healthcare professional before starting any new treatment, including the use of cannabis or any other alternative therapies. The use of cannabis may have legal, medical, and health implications that vary depending on your location and individual health status. Always follow the guidance of your healthcare provider regarding any medical condition or treatment.
The views expressed in this post are based on current knowledge and research but may not reflect the most up-to-date information. The author and blog are not responsible for any outcomes or actions taken based on the content of this post.
References:
(No date) Dysautonomia international: Postural orthostatic tachycardia syndrome. Available at: https://www.dysautonomiainternational.org/page.php?ID=30 (Accessed: 10 August 2024).
Postural orthostatic tachycardia syndrome (POTS)Â (2022) Johns Hopkins Medicine. Available at: https://www.hopkinsmedicine.org/health/conditions-and-diseases/postural-orthostatic-tachycardia-syndrome-pots (Accessed: 10 August 2024).
Kichloo A, Albosta M, Aljadah M, et al. Marijuana: A systems-based primer of adverse effects associated with use and an overview of its therapeutic utility. SAGE Open Medicine. 2021;9. doi:10.1177/20503121211000909
Codi Peterson, P. (2023) Can you make edibles kick in faster?, The Cannigma. Available at: https://cannigma.com/delivery/can-you-make-edibles-kick-in-faster/ (Accessed: 15 August 2024).
Martinez, M. (2023) CBD may increase the adverse effects of THC in edible cannabis products, study shows, Johns Hopkins Medicine. Available at: https://www.hopkinsmedicine.org/news/newsroom/news-releases/2023/02/cbd-may-increase-the-adverse-effects-of-thc-in-edible-cannabis-products-study-shows (Accessed: 15 August 2024).
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