Longtime cannabis user still tests positive weeks after quitting
Q: I am a 68-year-old male who has used cannabis for 51 years. During that time span, I graduated from high school and college with two bachelor’s degrees and two master’s degrees, and I spent 35 years as an accomplished educator, motivational speaker and author. I have been married to the same person for 31 years and have a wide circle of friends.
Twenty-five years ago, I had my thyroid removed due to cancer, and I currently take medication. I also inject testosterone and take medications for blood pressure and cholesterol, as well as Xanax. I retired to a life that involves little travel, choosing instead to spend my time reading, researching, writing and spending most of my time in my community. Once I began to notice a loss of motivation and diminished memory, I became proactive and decided to give up cannabis.
I have had no trouble quitting cold turkey and have no desire to return to using it. My memory has vastly improved, and I still enjoy all the things that made my retirement enjoyable before I made this decision. After 10 weeks of not using, I still test positive for the metabolites using THC testing strips. I have read that normal detoxing for a heavy user is anywhere from six weeks to two months.
To aid in the process, I drink half a glass of lemon juice in the morning, drink 2 gallons of water or detox tea a day, cut red meat and dairy from my diet, spend an hour a day on the treadmill and spend 40 minutes in a steam bath.
How long should I expect to continue testing positive? Is there anything else I can do to speed up the passing of the metabolites?
A: The active form of THC, the primary chemical in cannabis that causes the psychoactive effects (i.e., the effects for people to feel “high”), accumulates in the fat cells, where it can be stored for long periods of time.
Research in laboratory animals confirms that losing weight over the long term (meaning more than a few days so that a person is using fat as fuel) releases the stored THC
from the fat, making it more likely that a urine test will be positive in people who are losing weight (which might be the case with you, given your exercise and diet). Heavy users have told me that they feel like they are “coming out of a fog” for up to six months after stopping the use of cannabis. However, I can’t give you any evidence-based answer on how long you will continue to turn positive.
I don’t think drinking water and tea, nor the steam bath, are significantly helping you get rid of the accumulated THC in the body, but the diet and exercise changes probably are, if you are losing fat, as I suspect. Even if you aren’t losing weight, you may be getting more muscular from exercise and losing fat.
Q: I read your recent article about migraines. I’m a millennial who started getting brutal migraines beginning in 2001. I saw several neurologists and took different medications, but nothing really helped.
In 2011, I started taking fish oil with high DHA daily. Since then, my migraines
have dropped 95 percent overall, and it helps lower my migraine pain. It’s been a miracle. I’ve been preaching this for years to whomever will listen, hoping to help. There is also a DHA substitute for vegans.
A: I’m glad the fish oil supplements have helped you and appreciate your writing to try to help.
There are not strong studies to support fish oil supplements to prevent migraines. Migraine treatments are divided into those that stop migraines, called abortive, and those that prevent migraines, called preventive. You are describing preventive treatment, and I couldn’t find anything to suggest fish oil as an abortive treatment for migraines.
However, there is a welldone study that showed a diet high in omega 3 reduced about half the number of days with migraines and the hours of migraines, but the study was unable to show an improvement in quality of life measurements. The study recommended 1.5 grams of combined n-3 eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in roughly 1 serving per
day, but the study did not look at the plant-based alpha-linolenic acid, a different type of omega 3 oil.
Your experience goes to show that perhaps supplements may be beneficial, and in any given intervention, some people get more benefit than others. Although most people will not be able to describe the dietary change as a miracle, there may be other benefits from a diet with fatty fish. Further, compared with the medications often used to reduce migraines, this diet has very few side effects.
Q: In various other countries, diosmin is available as a prescription medication for treating varicose veins, hemorrhoids and lymphedema. In the U.S., hesperidia and diosmin only appear to be available as supplements from companies with uncertain reputations.
Is there some way to determine the efficacy, purity and safety of these compounds available here?
A: Diosmin is a type of flavonoid coming mostly from citrus peel that is sold in the U.S. as a medical food by prescription.
There is some evidence that it is effective for varicose veins, but poor evidence that is effective for hemorrhoids. It is generally regarded as safe, with very low risk of serious toxicity, but as many as 10 percent of people who take it will note side effects, such as an upset stomach or skin rash. It costs about $50 per month in the U.S., according to the manufacturer’s website.
I have little experience with it, but my colleagues in wound care and vascular surgery note only modest effectiveness. One colleague compared a varicose vein to a balloon that has been over-inflated; it never returns to its normal shape, and supplements are not likely to be effective against really serious cases of varicose veins. Vascular surgeons have many tools to use in people with symptomatic varicose veins (or even for people who are concerned by their appearance).
Q: Because I had Clostridioides difficile (C. diff), I lost 14 pounds. Now that I am cured of the C. diff — thanks to a fecal transplant, after every other treatment failed — I’m wondering if I’ll ever gain back the weight or if it is gone forever? I didn’t have 14 pounds to lose!
A: In my experience, weight loss that happens during a significant illness usually comes back in weeks. I don’t know how long it has been since you had C. diff, but if it hasn’t been so long, I’d expect you to regain the weight. The body has a “set point” of weight that it likes to stay at.
However, the fecal transplant may affect the set point. In lab animals, and in some preliminary studies in humans, a person’s weight set point can be partially affected by their intestinal bacteria.
The potential of getting someone to lose weight by transplanting the intestinal bacteria is limited, though, as most of the data show, the weight reductions are not maintained. (One review of many studies showed the weight loss was gone by 18 weeks.)
A registered dietitian or nutritionist can give you personalized advice on a healthy diet to help regain weight.