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If Weed Makes You Extremely Nauseated, You’re Not Alone

In the fall of 2016, I became an egg donor. Following my hormonal treatments and egg retrieval, I began to experience unusual bouts of nausea. I didn’t think much of it at first, assuming it was an interim experience attributed to the hormonal changes my body was undergoing. I also found that cannabis, which I’d typically used to treat insomnia, provided temporary relief from the sick feeling in my stomach.

But as time went on, the rounds of nausea became prolonged and more severe. The smell and sight of food repelled me. I couldn’t bring myself to eat, sometimes for days on end, and I started to lose a lot of weight. I scheduled an appointment with a gastroenterologist to see if we could figure out what was going on.

I had noticed that the more I used cannabis to treat my nausea, the more sick I felt during the hours I wasn’t smoking. It seemed counterintuitive that cannabis might be playing a role in my sickness since it’s often recommended to alleviate nausea, but I felt compelled to tell the doctor I’d been smoking on a regular basis.

To my surprise, he told me that U.S. states that had legalized the medical or recreational use of cannabis, leading to an increase in cannabis usage, had also seen a significant rise in a condition known as cannabinoid hyperemesis syndrome (CHS). I was consistently experiencing prolonged nausea throughout the day—a common symptom of CHS. Because I smoked cannabis on a regular basis, the doctor believed my condition was, in fact, linked to cannabis use. My various test results came back normal, indicating he was likely right.

CHS is a puzzling condition occurring in long-term cannabis users. Common symptoms include extreme nausea, intractable vomiting, and abdominal pain. Many patients report finding relief by taking hot showers. It’s an unusual illness given that medical cannabis is often used to treat the nausea of cancer patients, for example. But it turns out that while cannabis is frequently effective against nausea and vomiting, it can also trigger it.

The symptoms of CHS sometimes take years to surface. The first course of action for cannabis users suffering from severe nausea and/or uncontrollable vomiting should be to cease cannabis use and see if symptoms subside within 2-3 days. I was advised to do this, and within two days, I was completely back to normal.

The cause of CHS is unknown. Because cannabis has complex chemical properties, it makes it difficult to pinpoint what leads to this seemingly paradoxical syndrome. Some research is focused on the body’s receptors which are affected by cannabis use. Heavy, frequent use is thought to deregulate receptors, causing the symptoms of CHS. Cannabis use, however, has been common for centuries in countries like India, and symptoms of CHS have only begun to be reported in the last couple of decades. In addition, there are no reports of CHS by chronic users in some regions, such as South Asia, at least not to the extent we see in the United States. This has led some doctors to be skeptical of the idea that cannabis itself is the problem, theorizing that additives may be the issue instead. In the case of Asia, however, lack of reports may also be due to the fact that weed remains strictly illegal in many of its largest countries, even as it gains acceptance in the West.

In my case, my fertility specialist believed CHS was directly linked to changes in my receptors caused by the hormones I was taking. I was scheduled to undergo a second round of egg donation, and he thought it was possible my receptors would revert back to normal afterward. Sure enough, following the second procedure, I no longer experienced the symptoms of CHS when using cannabis.

Cannabis use is increasing across the country as states not only legalize its recreational use, but also as it becomes increasingly seen as an effective alternative treatment to many commonly used pharmaceuticals, including opioids. Regardless of its cause, doctors expect to see a rise in cases of CHS coinciding with its increased use. Hospitals across the country have already seen more and more cases of CHS in states where weed has been legalized.

Cannabis was illegal in my state, so I was hesitant to tell the doctor I’d been using it. And, because of my unique situation, it would have been easy to blame my symptoms on recent hormone treatments, especially since cannabis provided temporary relief. But if I hadn’t been transparent, I would have continued to be sick. Be honest with your doctor if you use cannabis regularly and begin to exhibit these symptoms. Also be aware that many doctors may not yet be aware of CHS, and you may need to be the one to bring this possibility to their attention. It likely won’t remain under the radar for long, however. As cannabis continues to become more acceptable and accessible across the United States, we’ll need to work toward developing a better understanding of what causes CHS and how to prevent it.

Doctors are seeing an increasing number of cases of cannabinoid hyperemesis syndrome, which has symptoms cannabis is, ironically, often prescribed to treat.

Is Your Marijuana Use Causing Your Vomiting Problems?

“How often do I smoke it? Three times a day. Weed’s the only thing that helps my nausea,” the 24-year-old man who’s excessively vomiting tells his gastroenterologist.

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The specialist orders a SmartPill ® test to examine his GI tract. It’s normal.

The problem? It’s not a rare stomach-emptying disorder, like gastroparesis. It’s the marijuana.

It’s more common than most think

Gastroenterologist Michael Cline, DO, explains that the problem’s called cannabinoid hyperemesis syndrome.

What is it? It’s repeated cycles of nausea and vomiting, often accompanied by so-called “hot water bathing,” or a compulsive need to take hot showers. That’s because the hot showers — which sometimes last for hours — are the only thing that relieves their GI symptoms, though exactly why this happens isn’t entirely understood (but it’s thought to have something to do with the hot temperature’s effect on the part of the brain called the hypothalamus).

Weight loss, abdominal pain and dehydration may also occur. This syndrome, first officially classified in 2004, is on the rise, says Dr. Cline, who now sees multiple patients a day with the marijuana-induced vomiting.

Why the vomiting happens

“We know that marijuana works in the brain to stop nausea and increase hunger,” Dr. Cline says. “But it can also be toxic and cause cannabinoid hyperemesis syndrome. We believe, though we don’t yet have research to support it, that marijuana actually slows gastric emptying, causing the GI problems.”

When your stomach can’t empty normally, food simply sits there. When it sits there too long, Dr. Cline says, it tends to come back up through vomiting.

Medical or recreational use? The result is the same.

“The real question is, ‘You have an underlying problem and you’re using marijuana to help it, but could it really be hurting you?’ That’s a big question. And there’s no way currently to test for what range is therapeutic and what’s toxic,” Dr. Cline says.

How to break the cycle

Symptoms of cannabinoid hyperemesis syndrome typically ease in no more than 48 hours, if no additional marijuana is used.

But a brief hospital stay might be needed to get IV fluids to treat dehydration. And if someone has a difficult time stopping marijuana use, a drug treatment program may be needed.

Dr. Cline says more awareness of the connection between marijuana use and vomiting is needed — both in the public and the medical community.

“Doctors need to ask about marijuana use to avoid expensive testing and more promptly get to the root of a patient’s vomiting problem,” he says. “And patients need to be honest with their doctors about marijuana use, so they can get the relief they need.”

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Even though marijuana works in the brain to stop nausea and increase hunger, it can also be toxic and cause what's called cannabinoid hyperemesis syndrome. Gastroenterologist Michael Cline, DO, explains this growing problem.