Marijuana Cannabis Allergy

Cannabis sativa (hemp) is a plant that thrives in diverse environmental conditions. It is used as industrial hemp (low THC cultivars) in manufacturing of yarn, fiber, installation and rope. Hempseed is also touted as a super food rich in protein and promoted for general good health.

Higher THC cultivars are grown for medicinal use generally in the treatment of nausea, anxiety and pain. It is consumed as a recreational drug commonly known as marijuana. It is generally smoked, vaporized or eaten. This industry is growing at a rapid pace particularly with the legalization and relaxation of the laws governing marijuana use.

Allergy and Sensitization

Cannabis exposure is common. In the southwest United States pollination of female plants by the males of the species results in airborne dissemination with inhalation and resulting sensitization. Marijuana sensitization can also occur in workers involved in the flourishing marijuana industry.

Hempseed exposures can be inadvertent as it is found hidden in foods and drinks.

Allergic sensitization including the development of specific IgE can result from inhaling, smoking, touching, and eating marijuana or cannabis allergens.

How do I know if I have a marijuana allergy?

The symptoms of marijuana allergy include many clinical manifestations depending on how a person was exposed. Contact or touching the plant can result in breaking out in rashes, hives, or swellings called angioedema. Breathing or inhaling marijuana allergens can result in nasal or ocular or eye allergy symptoms. This includes runny nose, sneezing, itching, and swelling and watering eyes. Asthma with the development of wheezing and shortness of breath also can occur. Anaphylaxis has also been reported. This most commonly occurs with hempseed ingestion.

In addition there is reported cross-reactivity between marijuana and certain foods. Cannabis cross-reacting foods that have been reported to cause allergy include tomato, peach and hazelnut. This is due to cross-reacting proteins or allergens found both in marijuana and these foods. This cross-reactivity can potentially cause serious allergic reactions. The important and relevant allergens still require research and clinical definition.

Diagnosis

There is no standard way to test for marijuana allergy, at present, and a careful history is typically used. Skin testing could be considered for patients who have histories of cannabis allergic reactions. The allergist can prepare an extract or slurry using the buds, leaves and flowers of the marijuana plant. A standard prick skin test, similar to that which is done in any standard allergy testing can then be done. While these tests are not standardized they can be used generally to predict allergic sensitization.

Summary

With the increased use of cannabis or marijuana by industry, medicine, and the general population as well as legalization there will be more reports of allergy. The symptoms although usually benign include nasal, ocular and pulmonary complaints. However life-threatening reactions have occurred but are generally limited to hempseed in marijuana allergic individuals. The definition and importance of the associated food allergies still need to be defined by research. Vigilance and awareness are paramount. Treatment is generally avoidance to insure there are no severe consequences. Hopefully it will also include immunotherapy in the future with the development of new research.

Find out more about asthma.

Find out more about eye allergies.

Find out more about hay fever.

Podcast Episode 10: Marijuana, Asthma and Allergies: A Changing Landscape

In this CME episode, expert William Silvers, MD, FAAAAI, discusses the evolving trends of marijuana use and its derivatives. From terminology to legalization and review of the evidence, this episode offers great insight into understanding how recreational and medicinal marijuana can impact those with asthma and allergies, as well as the increasing prevalence of allergic reactions to marijuana products. 1.00 AMA PRA Category 1 Credit™ is available with this episode through 7/09/2020. Click here to complete the assessment and claim credit. Also available in the above link is a discussion board, professional resources and resources for patients.

Click here to listen to the podcast.
Read the transcript of the conversation.

Reviewed: 9/28/20

Allergic to Marijuana: Symptoms, Causes, and Prevention

Cannabis allergies have become more common in recent years. Although the plant is known for its anti-inflammatory properties, cannabis can cause a number of different allergy symptoms if it’s inhaled.

Cannabis is a plant used to create a euphoric high. It’s commonly used recreationally, although in recent years it’s become popular as a medicinal treatment for certain conditions.

Despite its reported benefits, cannabis is also an allergen that can trigger pollen-like allergy symptoms. Read on to learn more about cannabis allergy risk factors, diagnosis, and prevention.

Language matters

We use the term “cannabis” instead of “marijuana.”

We avoid the word “marijuana” because it has racist roots and connotations. The word “marijuana” first became popular in the United States during the cannabis prohibition movement, as it appealed to the widespread xenophobia against Mexican immigrants at the time.

Considering that members of historically marginalized races are more likely to be arrested for cannabis possession than their white counterparts, it’s especially important that we’re mindful about the language we use and how it can add to, or stem from, racist stereotypes.

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If you smoke and you have a weed allergy, you may experience:

• red eyes
• watery eyes
• hay fever
• runny nose
• congestion
• sneezing
• nausea
• vomiting

Cannabis allergies can also resemble contact dermatitis if the plant is tampered with or handled. In an older 2007 study evaluating cannabis allergy symptoms, a skin prick test revealed that cannabis can cause specific skin irritation. Some of the most common irritations include:

• itchiness
• inflamed, red skin
• hives
• dry, scaly skin

In more severe cases, an allergic reaction to cannabis can cause anaphylactic shock, a life threatening condition that causes your blood pressure to suddenly drop and your airways to close. If left untreated, a cannabis allergy could be fatal.

Your body views allergens as a threat. While it works to protect against foreign bacteria and threats, your immune system will also cause a number of reactions or allergic responses. There are a few risk factors that could increase your likelihood of developing a cannabis allergy.

Allergen cross-reactivity

Cannabis allergies can become more prevalent if you’re allergic to a food or substance with similar protein properties. This is also called allergy cross-reaction. Some foods with similar allergen properties as the cannabis plant are:

• tomatoes
• peaches
• grapefruit
• almonds and chestnuts
• eggplant
• apples
• bananas

Sensitization

Increased cannabis exposure can also make you more likely to develop a sensitivity to the plant. This is more common in areas where cannabis is grown.

Pollen from the cannabis plant can trigger allergen symptoms. As a result, cannabis sensitization has increased since its legalization.

Increased THC content

Cannabis is dioecious, meaning that it grows male and female plants. Cannabis growers prefer female plants because their flowers produce THC and other psychoactive compounds.

Tetrahydrocannabinol (THC) is the chemical found in cannabis flowers that creates a euphoric high.

Growers isolate female cannabis plants from being pollinated in order to control the quality of the crop. When the female plant’s flowers come into contact with pollen from a male or hermaphroditic plant, seeds will develop. This lowers the quality of the flowers.

Female cannabis plants that are grown in isolation tend to have higher levels of essential oils and terpenes in their flowers. Although this is prized by growers, it could affect your sensitivity to the plant.

In order to identify an allergy, a doctor or allergist can perform a skin prick test. This test can help you figure out whether or not you’re sensitive to a particular substance.

There’s currently no standard skin prick test for cannabis allergy, but a doctor or allergist may be able to prepare a test for you.

During this procedure, your doctor will prick your arm or back with a small amount of an allergen. If you’re allergic, your body may react and trigger an allergic response like swelling or itching within 15 to 20 minutes. If you aren’t allergic, you’ll probably show no symptoms.

But these tests are not perfect. Having a reaction during a skin test does not necessarily mean that you’ll have allergy symptoms when exposed to the substance in another context.

It’s also possible to be allergic to a substance but have a negative result (no reaction) on a skin test.

While blood tests like ELISA and RAST can help diagnose certain allergies, there’s no specific test to check for a cannabis allergy.

An IgE allergy test is a blood test that looks for signs of a general allergy response, not an allergy to a specific substance. It measures the total amount of IgE antibodies in your blood. Your IgE test result may help you find out if you have allergies in general, but it cannot tell you what’s causing your allergy.

In general, a blood test is considered a safer option for allergy testing because it comes with a lower risk of having a severe allergic reaction. But the options for cannabis allergy are not conclusive, and results aren’t available for several days.

The best way to prevent having an allergic reaction to cannabis is to avoid it. If you’re using medical cannabis, smoking it recreationally, or consuming edibles, doctors recommend you stop to avoid a severe reaction.

If you work with the cannabis plant regularly for work, doctors recommend wearing gloves, face masks, and using allergy medication to help reduce or prevent symptoms. Doctors also recommend carrying an inhaler in case the cannabis pollen affects your breathing.

If you’ve become severely allergic to cannabis or if you begin to experience irregular breathing symptoms, visit your doctor’s office immediately.

Sun allergy or photodermatitis

What is photodermatitis (photodermatosis or sun allergy)?

Photodermatitis or sun allergy is an inflammatory skin reaction that is caused by sunlight and occurs as an allergic reaction. This form of allergic dermatitis appears only when the skin is exposed to sunlight, resulting in a skin rash, eczema, hives, or other elements of a skin rash.

Causes of photodermatitis

Some people have a hereditary type of sun allergy. Others develop signs and symptoms after taking certain medications, physical contact with plants such as wild parsnips or limes, or using cosmetics. People with fair skin and light eyes are more prone to “sun allergies”.

Under the influence of exogenous and endogenous factors substances are formed, photosensitizers , which increase the sensitivity of the skin to ultraviolet rays.

Risk factors for an allergic reaction to sunlight include:

Race. Anyone can be allergic to the sun, but they are most common in people of a certain racial background. For example, the most common type of sun allergy (polymorphic rash) occurs mainly in Caucasians. Sun allergy is less common, but more severe, in Native Americans.

Exposure to chemicals. Sun allergy symptoms can occur when the skin is exposed to a certain substance and then to sunlight. Here are some well-known substances responsible for this type of reaction:

• fragrances,
• perfume,
• essential oils of bergamot, sandalwood, rose,
• disinfectants,
• furocoumarins – substances that are secreted by some meadow grasses, settling on the skin, can cause “meadow photodermatitis”,
• and even some of the chemicals used in sunscreen.

Certain drugs. A number of drugs can cause phototoxic skin reactions when combined with sunlight, eg tetracycline antibiotics, sulfate-based drugs and pain relievers such as ketoprofen, hormonal drugs, oral contraceptives.

Dermatitis, which is accompanied by a violation of the integrity of the epidermal skin barrier. The presence of dermatitis and other pathological skin conditions, such as prurigo, atopic dermatitis, increases the risk of sun allergy.

Presence of relatives with sun allergy . Often photodermatitis is a genetically determined condition.

Metabolic disorders and diseases, fermentopathy. Conditions in which the human metabolic system cannot function effectively. The most common of these is porphyria: the accumulation of porphyrins in the skin.

Genetic diseases. Very rare conditions where photosensitivity is caused by genetic disorders that include Bloom’s syndrome, xeroderma pigmentosa, Rothmund-Thomson syndrome, and others.

Autoimmune and connective tissue diseases. Conditions associated with various autoimmune and connective tissue disorders, including psoriasis, Darier’s disease, lupus, rosacea, and others.

Symptoms of “sun allergy” or photodermatitis:

• Rash on exposed skin
• Itching, pain or burning at the site of the rash
• Peeling
• Redness
• Serous fluid blistering

Signs and symptoms usually only occur on skin that has been exposed to the sun and usually develops within minutes to hours of sun exposure.

Is allergy testing required for sun allergies?

Allergological examination is carried out if the allergic nature of photodermatitis is suspected. This may be meadow photodermatitis or another, in the development of which allergens play a key role ( grass and tree pollen, drugs ).

Types of allergy tests for photodermatitis:

• skin prick tests with plant pollen, drugs (antibiotics), etc.
• allergen tests (molecular allergy diagnostics).

What to do if you are allergic to the sun?

If you have a sun allergy or sun sensitivity, you can prevent a reaction by taking the following steps:

• Limit sun exposure. Stay out of direct sunlight between 10 am and 4 pm when the sun is at its strongest.
• Limit the use of perfumes and cosmetics while in the sun.
• Do not carry out cosmetic procedures for deep cleansing of the skin before the sunny season (peeling).
• Exclude medications that cause photosensitivity.
• Avoid sudden exposure to large amounts of sunlight. Gradually increase the amount of time you spend in the sun to give your skin time to adapt to the sunlight.
• Wear sunglasses and protective clothing. Long-sleeved shirts and wide-brimmed hats can protect the skin from sun exposure. Avoid thin, loose fabrics with a mesh or a hole – ultraviolet rays can pass through them. You may want to consider wearing clothing specifically designed to block UV rays, which can be found in sporting goods stores.
• Use sunscreen frequently. Use a good quality broad-spectrum sunscreen with an SPF of at least 50. Apply sunscreen in a thick layer and reapply every two hours or more after every swim in the sea or pool. Some sunscreens contain chemicals that can cause photosensitivity. Choose a quality sunscreen. Of course, variants of individual intolerance to the components of sunscreens are not excluded.

Consult an allergist for timely assistance and prevention of photodermatitis complications.

Weed pollen allergy What you need to know and how to prepare?

Weed pollen allergy is the last wave of hay fever that begins in mid-summer and can continue until the first snow. The group of weeds includes plants of several families: haze, Compositae, plantain.

Weeds are ubiquitous, and their species composition differs in different geographic regions. Even in the conditions of urban life, due to the flowering of weeds, many people feel worse.

Weed allergy symptoms

Conjunctivitis, watery eyes, nasal congestion and discharge, and sore throat occurring at certain times of the year are characteristic signs of seasonal allergies. Also, allergic reactions can manifest as peeling, dryness, skin rashes, itching and redness.

Weed allergy is confirmed when two conditions are present:

• Symptoms on exposure to pollen allergens
• Positive test results

In the CMD laboratory, you can order a laboratory test in one click to confirm your allergy to weed pollen and get an accurate quantitative result.

w15, Quinoa, IgE, ImmunoCAP®

Code: 160055

w10, White Gauze, IgE, ImmunoCAP®

Code: 160056

w8, Dandelion, Ig E, ImmunoCAP®

Code: 160057

w5, Wormwood, Ig E, ImmunoCAP®

Code: 160058

w6, Wormwood, IgE, ImmunoCAP®

Code: 160059

w206, Chamomile, IgE, ImmunoCAP®

Code: 160060

w2, Ragweed, IgE, ImmunoCAP®

Code: 160061

w1, Ambrosia high, IgE, ImmunoCAP®

Code: 160062

w4, Ambrosia false, IgE, ImmunoCAP®

Code: 160063

wx209, Ragweed, mixture, IgE, ImmunoCAP®

Code: 160064

Examinations are performed using the ImmunoCAP method

Competent diagnostics, a properly selected treatment regimen and regular monitoring by an allergist-immunologist give stable positive results.

ImmunoCAP technology is the international “gold” standard for laboratory diagnosis of allergies, recognized by the World Health Organization (WHO). Studies will help to identify causally significant allergens, select effective elimination measures, prescribe symptomatic therapy and, if necessary, resolve the issue of allergen-specific immunotherapy (ASIT).

Possible cross-reactions

If sensitized to the pollen of any weed, cross-allergic reactions to allergens of other types of weeds and meadow grasses, some trees, latex, honey, sunflower and its seeds, pears, apples, melons and some others are possible food of plant origin.

Allergic cross-reactions between weeds and plant foods are predominantly mediated by allergenic molecules called profilins. These molecules are found in all types of pollen and in all types of plant foods. Thus, if you are allergic to these molecules, you can expect cross-allergic reactions with any food of plant origin.

However, there are products that are most likely to have cross-allergic reactions with pollen:

Bee products

Sunflower seeds

Chicory

Melon

Watermelon

Herbs and spices

Citrus fruits

Bananas

Garlic

Carrot

Allergy to haze pollen may cause reactions to beets and spinach.

People who are allergic to weed pollen may also have allergic reactions to herbal medicines. You should refrain from using preparations from wormwood, chamomile, calendula, coltsfoot, succession, elecampane, yarrow, tansy, dandelion.

One of the manifestations of cross-allergy can be oral allergic syndrome – the appearance of swelling, tingling and itching in the gums, tongue, lips when eating the above herbal products.

Treatment of weed allergy

The only treatment that addresses the cause of IgE-mediated allergy-related diseases and can prevent their further development is allergen-specific immunotherapy (ASIT).

Allergen-specific immunotherapy (ASIT) is the use of small doses of the allergen that causes the reaction to treat a patient. Allergens in ASIT preparations are prepared in a special way. The introduction of drugs is carried out according to the scheme, with a gradual increase in the concentration of the allergen. The task of ASIT is specific hyposensitization – a gradual decrease in the patient’s sensitivity to the natural exposure of an allergen (or a group of allergens) in the environment.

ASIT allows:

Reduce the severity of clinical manifestations, reduce the dose of antihistamines or completely abandon antiallergic treatment

Reduce the severity of clinical manifestations, reduce the dose of antihistamines or completely abandon antiallergic treatment

Provide long-term remission

Reduce the risk of developing hypersensitivity to other allergens, prevent the expansion of the allergic spectrum

Will ASIT be effective?

The development of an allergic reaction is determined by individual proteins in the composition of the allergen source – the allergen component. Sensitization to different molecular allergens of weed pollen is associated with different clinical manifestations and requires different approaches to treatment. Before starting ASIT, it is necessary to use molecular allergy diagnostics to determine the true sensitization and confirm the diagnosis.

Ragweed, originally from North America, is now widespread in Europe. Since ragweed and sagebrush have nearly the same flowering time, cross-reactivity between the two can be an important consideration for patients with weed allergy. Amb a 1 ragweed is a specific allergen marker to distinguish between true ragweed sensitization and cross-reactivity.

Artemisia pollen is one of the main causes of allergic reactions in Europe. Botanical relationships and cross-reactivity with other plants, such as ragweed, may cause the patient to experience symptoms in other geographic regions. Art v1 of mugwort is a specific allergy marker suitable for distinguishing between true mugwort sensitization and cross-reactivity.

Art v 3 is a lipid transfer protein (LTP) in mugwort pollen that is cross-reactive with related plant food proteins. Patients with food allergies sensitized to LTP may experience systemic and severe reactions. The Art v 3 component helps to better understand the sensitization profile in patients with pollen allergy.