Very high urine THC levels above 100 ng/mL could help doctors diagnose cannabinoid hyperemesis syndrome faster
In 15 adolescent/young adult patients with cannabinoid hyperemesis syndrome, 14 of 15 had urinary THC metabolite levels above 100 ng/mL, suggesting this threshold could serve as a diagnostic aid.
Quick Facts
What This Study Found
14 of 15 CHS patients had urinary THC-COOH concentrations above 100 ng/mL, with 7 exceeding 500 ng/mL. The one exception had not used cannabis for 2 weeks. All had normal GI workups. All reported frequent cannabis use for at least 1 month and intractable vomiting for at least 2 weeks.
Key Numbers
15 patients; average age 17.7; 14/15 had THC-COOH >100 ng/mL; 7 had >500 ng/mL; 12 reported weight loss; all had normal GI workups; p<0.0005 for association
How They Did This
Retrospective case series of 15 patients referred to a pediatric gastroenterology service for intractable vomiting, found to have CHS with urinary THC-COOH measured by gas chromatography mass spectrometry (January 2018 to April 2019).
Why This Research Matters
CHS can be difficult to diagnose, often leading to extensive and expensive workups. If urinary THC-COOH above 100 ng/mL proves to be a reliable biomarker, it could shorten the diagnostic process significantly.
The Bigger Picture
As cannabis use increases among adolescents and young adults, CHS is becoming more common. A simple urine test threshold could prevent unnecessary endoscopies, imaging, and hospitalization.
What This Study Doesn't Tell Us
Very small case series (15 patients), single center, no control group of heavy cannabis users without CHS, retrospective design, THC-COOH levels depend on timing of last use.
Questions This Raises
- ?Would this 100 ng/mL threshold hold up in a larger validation study?
- ?Do all heavy cannabis users have these levels, or only those with CHS?
- ?Could serial THC-COOH monitoring track CHS treatment progress?
Trust & Context
- Key Stat:
- 14 of 15 CHS patients had urinary THC-COOH above 100 ng/mL
- Evidence Grade:
- Small retrospective case series without controls from a single pediatric center
- Study Age:
- Published in 2021. CHS recognition and diagnostic approaches continue to evolve.
- Original Title:
- Urinary Cannabis Metabolite Concentrations in Cannabis Hyperemesis Syndrome.
- Published In:
- Journal of pediatric gastroenterology and nutrition, 73(4), 520-522 (2021)
- Database ID:
- RTHC-03073
Evidence Hierarchy
Describes what happened to one person or a small group.
What do these levels mean? →Frequently Asked Questions
How is cannabinoid hyperemesis syndrome diagnosed?
Currently through clinical history and exclusion of other causes. This study suggests urinary THC-COOH levels above 100 ng/mL (measured by mass spectrometry) could serve as a diagnostic biomarker.
What level of cannabis use leads to CHS?
All 15 patients in this study were frequent cannabis users with urinary THC metabolite levels indicating significant chronic exposure. The high levels (most >100 ng/mL, nearly half >500 ng/mL) suggest heavy, regular use is typically involved.
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Cite This Study
https://rethinkthc.com/research/RTHC-03073APA
Cordova, Jonathan; Biank, Vincent; Black, Elizabeth; Leikin, Jerrold. (2021). Urinary Cannabis Metabolite Concentrations in Cannabis Hyperemesis Syndrome.. Journal of pediatric gastroenterology and nutrition, 73(4), 520-522. https://doi.org/10.1097/MPG.0000000000003220
MLA
Cordova, Jonathan, et al. "Urinary Cannabis Metabolite Concentrations in Cannabis Hyperemesis Syndrome.." Journal of pediatric gastroenterology and nutrition, 2021. https://doi.org/10.1097/MPG.0000000000003220
RethinkTHC
RethinkTHC Research Database. "Urinary Cannabis Metabolite Concentrations in Cannabis Hyper..." RTHC-03073. Retrieved from https://rethinkthc.com/research/cordova-2021-urinary-cannabis-metabolite-concentrations
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.