Exercise increases plasma THC concentrations in regular cannabis users

Wong, Alexander; Montebello, Mark; Norberg, Melissa M.; Rooney, Kieron; Lintzeris, Nicholas; Bruno, Raimondo; Booth, John D.; Arnold, Jonathon C.; McGregor, Iain S.

doi:10.1016/j.drugalcdep.2013.07.031

Cited by 35 publications

(33 citation statements)

References 15 publications

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“…The corresponding changes in serum levels after fasting were somewhat lower, but otherwise similar (table ). Our results are in accordance with the small increase in plasma THC levels observed after exercise in the Australian study . Our participants had serum THC levels in the 0–3.6 ng/ml range at the time of admission to the ward, which is similar to those described as ‘baseline’ in the Australian human study and those previously reported in chronic users who have recently stopped taking cannabis .…”

Section: Discussionsupporting

confidence: 92%

“…In the follow‐up study in 14 regular cannabis users, the investigators found similar results: A 35‐min. bicycle workout at moderate intensity resulted in slight (<40%) but statistically significant increase in plasma THC levels . The exercise‐induced THC rise was no longer present 2 hr post‐exercise, and exercise did not significantly affect THCCOOH plasma levels, nor did overnight fasting for 12 hr affect THC or THCCOOH plasma levels.…”

Section: Discussionmentioning

confidence: 92%

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Can Physical Exercise or Food Deprivation Cause Release of Fat‐Stored Cannabinoids?

Westin

Mjønes

Burchardt

et al. 2014

Basic Clin Pharma Tox

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The aim of this study was to evaluate whether physical exercise or food deprivation may increase cannabinoid levels in serum or urine in abstinent chronic cannabis users. The study took place in a drug detoxification ward parallel to study participants receiving treatment. Six chronic, daily cannabis users (one female, five males, average age 30.0 years; BMI 20.8) were exposed to a 45-min. moderate-intensity workout and a 24-hr period of food deprivation. Serum samples were drawn prior to and after interventions and analysed for Δ9-tetrahydrocannabinol (THC) and 11-nor-9-carboxy-Δ9-tetrahydrocannabinol (THCCOOH) by liquid chromatography–tandem mass spectrometry (LCMSMS), and all voided urine was tested for THCCOOH by LCMSMS and normalized to the creatinine levels, yielding ng/mg ratios. There were no major differences in the measured cannabinoid levels in serum or urine before and after physical exercise or food deprivation. We conclude that exercise and/or food deprivation are unlikely to cause sufficient cannabinoid concentration changes to hamper correct interpretations in drug testing programmes.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 92%

Can Physical Exercise or Food Deprivation Cause Release of Fat‐Stored Cannabinoids?

Westin

Mjønes

Burchardt

et al. 2014

Basic Clin Pharma Tox

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show abstract

“…The likelihood for interactions may be of increased significance in instances where the THC constituent of cannabis is amplified. A study published in 2013 identified exercise as a factor that could contribute to elevated plasma THC levels and demonstrated an increase in plasma THC concentrations from pre‐exercise to the immediate postexercise time point . In addition, that study found a positive correlation between BMI and the percentage THC change from before to after exercise .…”

Section: Discussionmentioning

confidence: 94%

Rhabdomyolysis after Ginkgo biloba and cannabis

Strain

Yingling

Kraleti

et al. 2019

Pharmacy Practice and Res

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Background Rhabdomyolysis is a syndrome caused by the death of muscle tissue, which leads to the release of the muscle protein myoglobin into the circulation. The severity of rhabdomyolysis varies widely from asymptomatic to life threatening, and has many possible causes, including a specific classification associated with medications. This report suggests the potential for rhabdomyolysis induction by an interaction between ginkgo (Ginkgo biloba) and cannabis, in addition to recent strenuous exercise. Prompt identification of the aetiology and treatment are crucial in preventing complications and mortality. Clinical details A 26‐year‐old African American female presented to the emergency department (ED) with a chief complaint of worsening muscle pain and weakness, 2 days after exercise without adequate hydration. The patient reported recently starting a ginkgo supplement, in addition to her regular medications and confirmed marijuana use. Urinalysis and creatine kinase (CK) data collected in the ED were suggestive of rhabdomyolysis. Outcomes The patient was admitted to hospital. After rehydration with intravenous normal saline, her CK levels and symptoms improved. Conclusion Ginkgo is an increasingly popular natural supplement with a variety of uses. However, the use of this product, with or without cannabis consumption, may correspond to an increased likelihood for interactions and adverse drug reactions, such as the potential for rhabdomyolysis presented here. It is important for pharmacists and other clinicians to be aware of the prospective risks associated with this supplement in order to properly educate patients and mitigate potential morbidities.

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“…There is also some evidence that fat-stored THC can be redistributed into the blood of chronic users following extensive exercise [41]. These effects can have implications for the interpretation of single positive test results.…”

Section: Bloodmentioning

confidence: 91%

Techniques and Technologies for The Bioanalysis of Sativex ^® , Metabolites and Related Compounds

Molnár

2016

Bioanalysis

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Sativex(®) is an oromucosal spray indicated for the treatment of moderate-to-severe spasticity in multiple sclerosis and is also an effective analgesic for advanced cancer patients. Sativex contains Δ(9)-tetrahydrocannabinol (THC) and cannabidiol in an approximately 1:1 ratio. The increasing prevalence of medicinal cannabis products highlights the importance of reliable bioanalysis and re-evaluation of the interpretation of positive test results for THC, as legal implications may arise in workplace, roadside and sports drug testing situations. This article summarizes published research on the bioanalysis of THC and cannabidiol, with particular focus on Sativex. Common screening and confirmatory testing of blood, urine, oral fluid and hair samples are outlined. Correlations between matrices and current analytical pitfalls are also addressed.

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Exercise increases plasma THC concentrations in regular cannabis users

Cited by 35 publications

References 15 publications

Can Physical Exercise or Food Deprivation Cause Release of Fat‐Stored Cannabinoids?

Can Physical Exercise or Food Deprivation Cause Release of Fat‐Stored Cannabinoids?

Rhabdomyolysis after Ginkgo biloba and cannabis

Techniques and Technologies for The Bioanalysis of Sativex ^® , Metabolites and Related Compounds

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Exercise increases plasma THC concentrations in regular cannabis users

Cited by 35 publications

References 15 publications

Can Physical Exercise or Food Deprivation Cause Release of Fat‐Stored Cannabinoids?

Can Physical Exercise or Food Deprivation Cause Release of Fat‐Stored Cannabinoids?

Rhabdomyolysis after Ginkgo biloba and cannabis

Techniques and Technologies for The Bioanalysis of Sativex ® , Metabolites and Related Compounds

Contact Info

Product

Resources

About

Techniques and Technologies for The Bioanalysis of Sativex ^® , Metabolites and Related Compounds