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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Thrombosis In The Internal Jugular Vein After Smoking Marijuana?

I don t know if you can answer this question as I m having a hard time for understandable reasons finding a physician who has much practical experience with marijuana and there are no true studies I can find to answer my question. My 59 year old husband was recently diagnosed with stage 4 prostate cancer which has spread to all the bones in his back including the cervical ones. Normal even high dollar antiemetic s were not controlling the nausea from the disease as well as the recent chemo. He started some pot and the most effective was when he smoked vs took an edible product. Unfortunately due to the port placement he developed a thrombosis in his entire internal jugular vein. He was placed on lovenox and Coumadin. His INR is only 1.6 after 10 days on the BID injections. All the research I found would indicate the opposite should be happening. Any ideas or past patients you have had in a similar situation? I am tending to believe the pot is not interacting much. Also to note my husband is 6 5 and 250 pounds if that makes a difference.
Mon, 2 Jul 2018
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General & Family Physician 's  Response
Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice.

It is not likley the marijuana. Cancer itself causes an increase in blood clootting and so does having a port in a vessel. The clotting is likely due to a combination of the port placement and cancer. The INR reflects the coumadin effectiveness and does not reflect the lovenox. Lovenox is based upon weight and is meant to provide adequate anticoagulation until the Coumadin is therapeutic. In most cases a therapeutic INR for coumadin is between 2 and 3.

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What Causes Thrombosis In The Internal Jugular Vein After Smoking Marijuana?

Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. It is not likley the marijuana. Cancer itself causes an increase in blood clootting and so does having a port in a vessel. The clotting is likely due to a combination of the port placement and cancer. The INR reflects the coumadin effectiveness and does not reflect the lovenox. Lovenox is based upon weight and is meant to provide adequate anticoagulation until the Coumadin is therapeutic. In most cases a therapeutic INR for coumadin is between 2 and 3. Regards