Cannabis use is rising exponentially, but research shows that between 0.1% and 1% of Americans are allergic to this therapeutic plant and the number is rising. A study in Allergy found cannabis allergy prevalence is even higher among those with conditions like pollen allergies or atopic dermatitis. If you experience sneezing, congestion, rashes, or worse when exposed to cannabis, you may be one of the unlucky few with this allergy. This ​comprehensive ​guide covers everything ​from identifying ​symptoms to ​exploring effective ​treatment options ​recommended by medical ​professionals including ​allergists. Follow ​along as ​we dive into ​the science behind cannabis ​allergies, proper ​diagnosis, personalized ​management strategies, ​and potential treatment options ​through immunotherapy ​so you can continue ​enjoying cannabis safely and comfortably.

Understanding ​Cannabis ​Allergies

Cannabis allergies occur when immune cells erroneously identify compounds in the cannabis plant as harmful invaders. This triggers an overzealous immune response involving antibody production, histamine release, and activation of mast cells, leading to bothersome allergy symptoms.

Studies show the main allergens are proteins called Bet v 1 and Bet v 2, also found in birch pollen. These immunogenic proteins are most concentrated in the pollen, leaves, seeds, and flowers of cannabis plants. When inhaled, consumed, or contacting the skin, they can provoke an allergic reaction.

The human body naturally produces endocannabinoids like anandamide which control immune function. One ​theory suggests ​irregular endocannabinoid ​signaling may ​underlie cannabis allergies. More ​research is ​exploring this ​link.

Genetics likely play a role, as allergy diseases often run in families. Environment is another factor, as exposure to cannabis at a younger age may increase allergy risk. Cross-reactivity between ​cannabis proteins ​and other plant ​antigens also ​promotes ​sensitivity.

Cannabis allergies differ from cannabis hyperemesis syndrome and cannabinoid hyperemesis syndrome, which cause severe vomiting from heavy long-term cannabis use. True cannabis allergies involve an abnormal immune reaction, not toxicity.

Unfortunately, allergy prevalence is rising generally, including cannabis allergy as use increases. According to research in Clinical & Experimental Allergy, reactions can range from mild to severe. Respiratory symptoms are most common, but skin, GI, and ocular issues also frequently arise.

Woman smelling cannabis budsWoman smelling cannabis buds

Symptoms of Cannabis Allergies

Cannabis allergies commonly manifest through:

Respiratory symptoms:

  • Sinus congestion, runny nose, sneezing
  • Coughing, wheezing, shortness of breath
  • Chest tightness, difficulty breathing
  • Worsened asthma

Inhalation of cannabis smoke or vapor is the primary route triggering respiratory allergy symptoms.

Skin reactions:

  • Hives, welts, reddening
  • Swelling of the face, lips, tongue
  • Rashes, eczema flares

Topical skin contact with cannabis plants, leaves, oils or resins leads to skin manifestations. Reactions are localized to areas of contact.

Digestive issues:

  • Nausea, vomiting, diarrhea
  • Abdominal pain and cramping
  • Decreased appetite

Consuming cannabis edibles, drinks, tinctures, or oils can provoke GI issues due to digestion of allergens.

Eye irritation:

  • Bloodshot, watery, or itchy eyes
  • Swelling of the eyelids
  • Reduced vision

Ocular symptoms arise from direct contact with hands or cannabis smoke after exposure. Similar to seasonal allergy eye problems.

Other:

  • Headache, dizziness, lightheadedness
  • Anxiety or altered mental status
  • Anaphylaxis (rare) – low blood pressure, trouble breathing

According to AAAI, respiratory symptoms like wheezing, coughing, and chest tightness are most prevalent. Skin flushing and eye redness are also frequently reported. The onset and severity of symptoms is highly individualized, ranging from mild irritation to severe systemic reactions.

Doctor writing a prescriptionDoctor writing a prescription

Diagnosis and Allergy Testing

If you suspect you may have a cannabis allergy, see an allergist or immunologist for proper testing and diagnosis. Your physician will ask about your medical history, including:

  • Description of symptoms – timing, duration, triggers, severity
  • Relation of symptoms to cannabis exposure
  • Environments and methods of cannabis use
  • Other known allergy diagnosis
  • Effectiveness of prior treatments tried

Allergy testing can confirm or rule out cannabis as the allergen source:

  • Skin prick test – introducing small amounts of cannabis extract into the skin’s surface to check for a localized reaction.
  • Blood test – checking for the presence of cannabis-specific IgE antibodies signaling an allergic response.

These diagnostic tests help identify which parts of the cannabis plant you react to – for example, pollen, leaves, or flowers. This informs proper treatment approaches. Testing may need to be performed periodically, as allergy sensitivity can change over time. Accurate diagnosis is the first step in cannabis allergy management.

Relief and Management

The most effective cannabis allergy relief is strict avoidance, if possible. But for some, eliminating cannabis entirely may not be feasible or desired. In that case, take measures to reduce exposure:

  • Use protective equipment like gloves, long sleeves, face masks when handling raw cannabis materials
  • Thoroughly wash hands, arms, clothing after exposure
  • Shower and wash hair after contact to remove lingering allergens
  • Choose low-allergen varieties if continuing cannabis use
  • Avoid rubbing eyes and touching mucous membranes
  • Use HEPA air purifiers with carbon filters in indoor spaces
  • Have others handle raw cannabis flower/plants when possible
  • Only visit well-ventilated, clean cannabis dispensaries

Additionally, the AAAAI recommends over-the-counter oral antihistamines like Diphenhydramine, Loratadine, or Cetirizine to control mild symptoms. Nasal steroid sprays like Fluticasone can relieve nasal and sinus congestion, runny nose, sneezing, and postnasal drip. Hydrocortisone creams manage minor skin reactions.

Avoid triggers for any comorbid conditions like asthma or seasonal allergies, which may worsen with cannabis exposure. Follow an allergy action plan created with your doctor specifying when and which medications to use if exposed. Carry emergency epinephrine if you have a history of anaphylaxis.

For moderate to severe cannabis allergies, immunotherapy offers long-term treatment and desensitization. Sublingual drops or tablets provide incremental cannabis allergen doses under the tongue to retrain the immune system’s responses over months to years. Allergy shots work similarly, directly injecting increasing allergen levels over time. Though more research is needed, these methods can provide lasting relief for cannabis allergies when properly administered under medical supervision. Lifestyle modifications should also be maintained.

Treatment and Immunotherapy 

Allergy shots involve incremental injections of a customized cannabis allergen extract. This slowly retrains the immune system to tolerate specific cannabis proteins.

The buildup phase starts with a low dose, which increases over weeks to months until reaching the maintenance concentration. Maintenance shots continue for 3-5 years. With this regimen, allergy shots can desensitize the immune response to cannabis allergens long-term.

Sublingual immunotherapy (SLIT) is an alternative option, delivering liquid cannabis allergen extracts in small doses under the tongue daily. The dosage incrementally increases until reaching the maintenance amount. SLIT reprograms immune cells to control inflammatory responses to cannabis.

Studies suggest SLIT could effectively treat cannabis pollen allergies. It is associated with fewer side effects than shots, but requires strict daily adherence. Downsides include cost and off-label use for cannabis allergy.

Discuss these immunotherapy options with your allergist to decide if appropriate for your situation. Though data is limited for cannabis allergies specifically, these methods show efficacy for environmental allergies by inducing immunologic tolerance over time.

Don’t Let Allergies Ruin Your High: Recognize and Actively Manage Your Cannabis Allergies

Cannabis allergies can be bothersome, but with proper precautions and treatment, you can still use cannabis safely. Work closely with healthcare providers to diagnose, manage, and treat cannabis allergies appropriately. With vigilance, protective measures, medications, and immunotherapy where warranted, you can pinpoint your triggers and reduce symptoms to safely use cannabis. Don’t let allergies prevent you from experiencing cannabis’ benefits. 

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