- Should I take THC or CBD oil for my atrial fibrillation?
- What Is CBD?
- What Is The Endocannabinoid System?
- Metabolic Enzymes
- Cannabinoid Receptors
- CBD And Your Heart
- 1. High Blood Pressure
- 2. Antiarrhythmic
- 3. Inflammation Of The Heart
- The Silent Killer
- Change Your Habits
- Stop Smoking
- Lose Weight
- Change Your Diet
- When To See A Doctor
- How Should I Take CBD?
Should I take THC or CBD oil for my atrial fibrillation?
Answer – Dr. Richard Kim
Hello! We saw a question similar to this in the past. I have copied/pasted a very thorough answer from Dr. Sank of HelloMD.
Cannabis consumption in a systemic form such as smoking has been associated with heart palpitations and fast heart rhythms. Smoked cannabis should likely be avoided in your case for this reason. Some studies suggest the negative cardiovascular effects of smoked cannabis are related to THC. There has not been enough research on CBD extract products to determine if they are safe for those with atrial fibrillation. There have not been any studies associating localized forms of cannabis with harmful heart rhythms. It is likely safe, from a cardiovascular standpoint, to use topical cannabis infused patches, balms, salves, massage oils, etc. in limited quantities for localized pain control.
You should discuss your particular case closely with your cardiologist and cannabis-recommending physician before use.
A growing number of case reports have demonstrated an association between smoked cannabis consumption and adverse cardiacvascular effects. This includes cardiac dysrythmia including atrial fibrillation and increased cardiac work, which can precipitate cardiac chest pain and even heart attacks. Smoked cannabis has also been associated with low blood pressure upon standing which can increase the risk of fainting. These effects are likely mediated by an effect in which THC triggers the sympathetic nervous system in intermittent users. Chronic users appear to develop tolerance to triggering of the sympathetic nervous system; however, they may suffer from microscopic damage to the arteries that supply the heart.
Interestingly, a recent large case-control study from Denmark demonstrated that NSAID type medications (Ibuprofen/Advil and Naproxen/Aleve etc) are also associated with increased incidence of atrial fibrillation. This is in addition to prior literature that shows NSAIDs can aggravate hypertension. A series of two studies published in 2015 additionally show that opiates are likely associated with a higher risk of heart attack and atrial fibrillation. Unfortunately, there is no ideal option for chronic pain control in the setting of atrial fibrillation.
References: Korantzopoulos P. Atrial fibrillation and Marijuana Smoking. Int J Clin Pract. 2008;62(2):308-313 Jones RT. Cardiovascular system effects of marijuana. J Clin Pharmacol 2002; 42 (11 Suppl.): 58S-63. Sidney S. Cardiovascular consequences of marijuana use. J Clin Pharmacol 2002; 42 (11 Suppl.): 64S-70. Rezkalla SH, Sharma P, Kloner RA. Coronary no-flow and ventricular tachycar associated with habitual marijuana use. Ann Emerg Med 2003; 42: 365-9″
Answer – Content Intern
Hello, Great news!
CBD appears to have benefits to cardio-vascular health. This is because the common fibrillation definition is irregular twitching, which is related to inflammation.
I found a general article where you can learn more about cannabis treatment and heart complications, along with causes. I’m not a medical health practitioner, but there have been recent studies which may relate to your condition.
CBD may be used to ease the symptoms of atrial fibrillation causes, such as blood pressure and anxiety.
CBD comes in your favorite variety of consumption methods such as tinctures, capsules, and even transdermal patches!
TUESDAY, May 8, 2018 (HealthDay News) — If you have suffered a heart attack, getting high on pot won’t harm your heart’s regular rhythm, a new study suggests.
Marijuana users who have suffered a heart attack had about the same risk as nonusers of a rapid and irregular rhythm in the lower chambers of the heart, known as the ventricles, the researchers found.
“We found no difference in the two populations,” said senior researcher Dr. Christine Tompkins, a cardiologist with the University of Colorado School of Medicine.
Further, marijuana users appeared to have lower rates of atrial fibrillation, an irregular rhythm in the upper chambers of the heart (the atria).
Half as many pot users had atrial fibrillation, about 4.5 percent compared with 8.7 percent of nonusers. Atrial fibrillation increases a person’s risk of stroke and heart attack.
Don’t feel free to get baked just yet, though. Both the researchers and a heart expert stressed that the jury is still out on exactly what the heart risks of smoking pot might be.
In fact, earlier research in the same group of patients found that marijuana use appears to increase the chances of having an earlier heart attack, Tompkins added.
The average age of a first heart attack was about 57 for the straight-laced, but 47 for cannabis users, Tompkins said.
“At this point, I have to say we don’t know the full cardiac effects of marijuana use,” Tompkins said. “We need to do additional studies.”
Colorado was one of the first states in the nation to legalize recreational marijuana, in 2012. At this point, a total of nine states have approved recreational pot use.
Given the wave of legalization, Tompkins and her colleagues decided this was the perfect time to assess the heart effects of marijuana use.
“We felt an obligation to look at the cardiac effects of cannabis use,” Tompkins said. “We still don’t know the long-term impact it has on one’s heart health.”
There’s strong evidence that weed has become more popular among people in late middle age and senior citizens. Federal data shows a 455 percent increase in marijuana use among U.S. adults aged 55 to 64 and a 333 percent jump in those aged 65 and older between 2002 and 2014.
What Is CBD?
The leading cause of death for both men and women in the United States is heart disease, taking over 610,000 lives a year. Changing your lifestyle after noticing symptoms and taking heart medication are the best ways to keep your heart healthy, and CBD oil has shown that it may be an extremely viable option for treating heart disease symptoms.
Because CBD interacts with your endocannabinoid system, it may help with the symptoms of heart disease such as high blood pressure, arrhythmias, and myocarditis.
You may have heard of CBD, but did you know that it comes from cannabis? Just like THC, this chemical is packed with healing benefits; the big difference is it doesn’t get you high. This is one of the main reasons CBD has obtained so much attention from scientists, doctors, and patients. CBD has shown in studies to possibly treat so many different symptoms because of its relationship with the endocannabinoid system.
What Is The Endocannabinoid System?
The endocannabinoid system is in charge of regulating your body. This system makes sure that you don’t bleed out when you scrape your knee, and you have a fever when a virus is trying to spread through your body. The three main parts that make up this system are metabolic enzymes, cannabinoid receptors, and endocannabinoids.
Metabolic enzymes create the endocannabinoids in your body, and when they are no longer needed, they degrade them. Without these enzymes, our brains would be cluttered with endocannabinoids, causing blockage in communication between neurons.
For endocannabinoids to work, they need somewhere to go. Your body is covered in cannabinoid receptors, the two we know of today are CB1 and CB2. The CB1 receptors mediate the neurological system, while the CB2 receptors are in control of your immune system. When endocannabinoids bind to these receptors, they help mediate their respective roles and help your body and brain work more efficiently.
Cannabinoids come from the cannabis plant, while endocannabinoids are similar chemicals that are synthesized in your body. The two endocannabinoids that we have studied are anandamide, which binds to the CB1 receptor, and 2-AG, which binds to the CB2 receptor. The endocannabinoids either inhibit or promote the production of neurotransmitters, controlling the conversations that happen between neurons.
CBD And Your Heart
While CBD doesn’t directly interact with the cardiovascular system, the way that it communicates with the endocannabinoid system may be beneficial to your heart health. The top three ways that CBD can help with your heart is lowering your blood pressure, reducing arrhythmias, and reducing inflammation.
1. High Blood Pressure
One of the side-effects we tell you to look out for when taking CBD is lowered blood pressure. For you, this is more of a treatment than a risk. CBD has been found to be a vasodilator, meaning that it widens the blood vessels allowing for more blood flow. This, in turn, reduces the damage that is done to arterial walls from high blood pressure.
In a randomized cross-over study of healthy patients, they found that a single dose of CBD helped lower blood pressure. Nine healthy males were given either a placebo or CBD, and they found that those who took the CBD reduced resting systolic pressure, reduced stroke volume, and reduced blood pressure after cold exposure.
Symptoms of High Blood Pressure
- Blurred Vision
- Shortness Of Breath
- Chest Pain
- Leg Swelling
- Cold Feet
- Heart Attack
A heart arrhythmia is when your heart beats too slow, too fast, too early, or irregularly. Many arrhythmias can be completely harmless. It is when the heartbeat is exceptionally irregular or comes from a damaged heart when you have problems.
Though researchers aren’t exactly sure how CBD treats heart arrhythmias, they have found that in rodent models this medication was very successful. They believe that the endocannabinoid 2-AG plays a pivotal role, though more research is needed to verify this conclusion.
Tachycardia Symptoms (Your Heart Is Beating Too Fast)
- Feeling Faint or Fainting
- Fluttering Chest
- Chest Pain
- Light Headedness
Bradycardia Symptoms (Your Heart Is Beating too Slow)
- Trouble Concentrating
- Chest Pain
- Trouble Exercising
- Shortness Of Breath
- Excessive Sweating
- Feeling Faint or Fainting
Atrial Fibrillation (Your Heart Beats Irregularly)
- Chest Pains
- Feeling Faint or Fainting
3. Inflammation Of The Heart
Inflammation of the heart, or myocarditis, can cause the cells in your heart to become damaged and even die. This can be caused by your immune system, viruses, medications, and certain diseases. If the inflammation goes without being treated, it can result in death.
CBD is well known for its ability to reduce harmful inflammation. The 2-AG endocannabinoid binds to the CB2 receptor, which leads to your immune system sending out less immune cells to attack. CBD has also shown that it reduced the number of cells that die in the heart during inflammation, helping your heart muscle hold onto its strength.
Symptoms Of Myocarditis
- Chest Pain
- Shortness Of Breath
- Liver Congestion
- Sudden Death
The Silent Killer
These three heart issues may come with symptoms or none at all. It’s crucial that you exercise regularly, eat well, and make frequent visits to your doctor. When going shopping at your local drug store, don’t forget that most have a machine to check your blood pressure. Worst case scenario of not looking out for your heart is death, which is as bad as it gets.
Change Your Habits
We mentioned before that changing your lifestyle habits when you notice symptoms is essential for your health. You can try to avoid the symptoms altogether by making those lifestyle changes now. Here are a few things you can do to reduce your risk of heart disease.
If you smoke cigarettes, you are more likely to develop a heart condition that someone who doesn’t. Smoking tobacco cigarettes can damage the lining of your arterial walls which can lead to a build-up of fatty material that narrows the artery. The carbon monoxide in the smoke also reduces the amount of oxygen in your blood, making your heart have to work harder. The nicotine in cigarettes can also raise your blood pressure and make your heart work harder than it needs to.
Taking CBD can help you quit smoking by reducing your cravings. You crave cigarettes because your brain’s reward system is stimulated anytime you smoke. CBD helps lessen that stimulation, helping your brain realize that smoking isn’t something you need to survive.
If you are obese or overweight, you a much more likely to develop a heart condition than someone at a healthy weight. Being overweight has shown to raise blood pressure and increase cholesterol levels. Being overweight can cause more harm to your body than just your heart, making you a candidate for type II diabetes as well.
Losing weight can be difficult, but it may be easier with CBD. White fat is stored to create a reservoir of energy for your body, while brown fat is burned to use that energy. CBD has shown in studies to promote this fat browning process, making it easier to lose weight.
One of the most significant benefits of having an active lifestyle or a healthy workout routine is that it helps you maintain a healthy weight. Exercise also helps strengthen your heart just like it does your muscles. A strong heart is much more efficient at pumping blood through your body than a weak one, making your blood pressure lower if it’s too high. Exercise also boosts the levels of good cholesterol, helping to flush your arteries of the bad cholesterol.
If you have a hard time getting out there and being active because of pain or low energy, CBD can help. Through the fat browning process, CBD is helping your body use the energy it already has stored. On top of that, it raises the anandamide levels which boost your mood helping you feel more energetic. If it’s pain that is stopping you, anandamide also helps reduce your sensitivity to pain.
Change Your Diet
A healthy diet will help you manage your weight, but it does much more than that. Eating foods high in saturated fat raises the bad cholesterol which increases your blood pressure. Eating trans-fat will not only boost bad cholesterol levels but also lowers the good cholesterol. Eating fruits, vegetables, foods with Omega-3 and Omega-6 will help you with your cholesterol levels, which in turn can regulate your blood pressure. Reducing your sodium intake won’t lower your cholesterol, but it will reduce your risk of heart disease by lowering your blood pressure.
When To See A Doctor
If you are experiencing these symptoms, the first thing you need to do is go to the doctor. Heart disease can sneak up on you like a deadly ninja, and a professional diagnostic could be the difference between life and death. While you are talking to your doctor, make sure to let them know you are taking medical cannabis for your symptoms. Your primary care doctor should always be in the loop with medication your taking to assess the improvement.
How Should I Take CBD?
You may find that you get the best results through taking CBD pills because it works just like common medications slowly administering the drug into your system. If you are trying to lose weight through exercising, using tinctures or e-liquid can help get the CBD into your system faster for the activity at hand. Suppositories are also a great option when you need long-lasting relief, and you need it to work quickly. Whatever method you choose, CBD Instead has got you covered.
FAQs Coping with A-Fib: Marijuana
A-Fib & marijuana
“Is smoking medically prescribed marijuana or using Marinol (prescription form) going to trigger or cause A-Fib? Will it help my A-Fib?”
During the past few years an increasing number of case reports indicate an association between marijuana smoking and the development of A-Fib.
Compelling evidence is accumulating that marijuana has significant effects on the cardiovascular system. Studies show that cannabis smoking can result in “an increased risk of of both acute coronary syndrome and chronic cardiovascular disease associated with cannabis use.”
Research data shows marijuana smoking in relatively small doses leads to a slight increase in blood pressure and a decrease in oxygen capacity requiring the heart to work harder. Smoking higher doses of marijuana, especially in older individuals, may result in dizziness, fainting and falls.
Form Matters: The form of marijuana, the preparation and method of consumption affect the biological response and may have a different physiological impact.
Recently marijuana has been implicated in neurological complications such as headache, transient ischemic attacks and stroke. Middle age stroke patients were 2.3 times more likely to be pot smokers than healthy middle age control patients.
About palpitations: Marijuana smoking is independently associated with an increased incidence of palpitations (although the underlying cause of this finding was not yet clear).
(Added 7/30/19: A July 2018 study of heart failure and cannabis use may potentially change our thinking about marijuana and A-Fib. Researchers found that among patients admitted to a hospital for heart failure, those using cannabis were less likely to have A-Fib, “cannabis users have lower odds of (developing) AF when compared to non-users.”)
THC and CBD: From speaking to actual marijuana users, the THC component, such as is found in the marijuana plant Stavia, is what makes you feel “high.” The Sativa strain is better for energy, mood, and appetite.
The CBD component, such as is found in the marijuana plant Indica, works better to reduce pain and anxiety, promote relaxation, and induce sleep.
Best Marijuana Product for A-Fib Patients? Probably the edible forms of marijuana using primarily the CBD component seem to be something that A-Fib patients might want to investigate.
An even better choice might be the sublingual form. (A materials science engineer emailed me that the sublingual form might be “much safer than edibles, since that kind of oil production has a very high safety standard, and having a B2C end product requires a lot of regulations.”
But obviously, talk to your doctor first. (This observation and discussion is, at this time, very speculative. Much more research needs to be done in this area.)
PODCAST For my recent Marijuana report, listen to my Podcast:
Marijuana—Good, Bad or Ugly for Patients with A-Fib?
Go to Podcast
Personal Experiences Advice
JIM: Jim, an a-Fib patient, has kindly shared his personal experiences about how marijuana helps him. He has tried various meds, cardioversion, and had a failed ablation. He owns his own business in California and is under a lot of stress.
“Because of all of this, I was having trouble sleeping and was getting very stressed out. But instead of taking something pharmaceutical, I turned to medical marijuana. It changed my life. I come home at night, have some marijuana edibles, and the stress goes away. I sleep wonderfully at night, waking up fresh and ready for another day. I told my doctor who understands. He says that marijuana edibles shouldn’t have anything to do with A-Fib, and that I can continue to take them.”
JOHN: On the other hand, John writes that “99% of his A-Fib attacks occurred while under the influence of marijuana.”
WILLIAM: “The A-Fib ablation has been very successful, except the two times that I went into A-Fib after smoking marijuana. I’m a lifelong recreational marijuana smoker, also smoke to relieve the pain from six surgeries on my right arm. Both times that I’ve gone into A-Fib since my last ablation have been after smoking marijuana. After the latest episode I’ve quite smoking marijuana because of the evidence that it can lead to A-Fib.”
JONATHAN: “I tried a tiny bit of brownie for the first time since being diagnosed with A-Fib (occasional episodes). It was OK until about two hours later. I went into A-Fib and, a bit later, came the closest I ever have to blacking out. I don’t think it’s for me anymore.”
SCOTT: “I am currently 55 years old and have been through 15 cardioversions due to A-Fib. I smoked marijuana pretty much daily and noticed that, when I smoked, my heart rate went up. So, I stopped smoking altogether. Since quitting smoking marijuana 7 years ago, I have not had a single case of going into A-Fib. I’m positive that the two are related.” (Scott writes that he also stopped drinking which helped. He used to drink a six pack daily.)
More Research Needed on Medical Marijuana
Due to the increased use of medical marijuana in California and other states, we should soon be getting more data on marijuana’s effects on A-Fib.
References for this article Korantzopoulos, P. et al. Atrial Fibrillation and Marijuana Smoking. International Journal of Clinical Practice. 2008;62(2):308-313.
Petronis KR, Anthony JC. An epidemiologic investigation of marijuana- and cocaine-related palpitations. Drug Alcohol Depend 1989; 23: 219-26.
Back to FAQs: Coping with Your A-Fib
Last updated: Sunday, January 5, 2020
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Dear Dr. Roach: I am a 49-year-old woman who had a massive heart attack in April of this year. My father died of a massive heart attack at 49 when I was three. I have four stents in three arteries and am on Brilinta, low-dose aspirin, blood-pressure medication, etc.
I have had essential tremor for all of my life, first noticing the tremors in middle school. The tremor is in my hands, making writing nearly impossible, and I have head bobs. I have an internal tremor that never stops.
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A previous practitioner prescribed a month’s trial of beta blockers several years ago. I noticed no relief with the tremor, but was physically ill for the first 30 minutes of the morning in the first two weeks of the trial. Recently, while doing some research, I found an online blog regarding essential tremor and CBD oil. Nearly all of the bloggers found some level of relief using this treatment.
If I choose to try CBD oil to assist with my tremor, is there a risk of it interfering with my heart and blood-pressure medications?
Cannabidiol, or CBD, is a nonpsychoactive substance found in cannabis, as opposed to tetrahydrocannabinol, or THC, the best-known psychoactive component.
CBD is typically sold as an oil, and has been receiving press as a potential treatment for a wide variety of medical issues. Many or most of these claims have no data to support them. Anecdotal reports, such as most blogs, are neither reliable nor scientific (and may or may not be true).
There is also an issue with proving the dosage and purity of products said to contain CBD.
However, in the case of essential tremor, there is some evidence: Studies in mice have shown benefit with CBD, although a single case report showed effectiveness of THC but not CBD in essential tremor.
The issue of drug interactions is a significant one. CBD inhibits two powerful pathways the body uses to detoxify drugs, the CPY3A4 and CYP2D6 systems. This is a serious issue for you. Ticagrelor (Brilinta), an anticoagulant, is metabolized by CYP3A4, as are some of the statin drugs usually prescribed to people with heart blockages.
The effect of the anticoagulant could be much higher than expected, leading to bleeding risk. Other commonly used heart medications are metabolized by CYP2D6, and the effect on these medications is unpredictable.
I can’t recommend CBD products given the medications you are taking, but would suggest you consider alternative treatments.
You might have read about deep brain stimulation and ultrasound, two powerful and effective treatments for people whose symptoms have not responded to standard treatments.
Dear Dr. Roach: This question is for my husband. How safe is drinking tea while on warfarin?
He has his INR checked monthly, and for the most part, it stays between 2 and 3.
He watches his vitamin K intake regularly. He has read conflicting stories about how tea interacts with warfarin by making INR levels high.
Tea comes in two major types: black tea, which is fermented, and green tea, which is not. Black tea has no known interactions with warfarin (Coumadin). Green tea contains small amounts of vitamin K, which could make the INR lower and the warfarin less effective. However, the effect is likely to be small. Further, if he drinks a consistent amount per day, his dose can be adjusted to reflect his vitamin K intake.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers can email questions to [email protected]