Episode Transcript
Chasing Life
SEP 27, 2024
A New Era for Cannabis and What It Could Mean for You
Speakers
Dr. Sanjay Gupta, , Paige Figi, Dr. Staci Gruber, Audience Listener Voicemail
Dr. Sanjay Gupta
00:00:01
You know, like many folks, for a long time, I was pretty skeptical about the medical benefits of cannabis. Yeah, I knew it had been talked about for a while. It was touted as this sort of wonder drug. I wrote columns about it for Time magazine. We were told that would help everything from chronic pain to mood disorders, even cancer symptoms.
Dr. Sanjay Gupta
00:00:24
But for me, the evidence just wasn't lining up. And despite the buzz, I wasn't entirely convinced. Well, that skepticism for me began to change over a decade ago. Why? I started to look at the evidence, not just from the United States, but from countries all over the world. I started to look at the data, not just from federally funded labs, but from privately funded labs as well.
Dr. Sanjay Gupta
00:00:48
And I also met a little girl named Charlotte Figi.
00:00:54
'Charlotte was six years old when I met her. She had Dravet syndrome, a rare and extreme form of epilepsy. She'd been dealing with it all of her life, and by the time she was five, she was having three seizures a week. Think about that. That's almost two seizures every hour. She wasn't talking. She wasn't moving. She was basically catatonic. Now, her family tried everything for her, as you might imagine, but traditional treatments were not working, and many of them had dangerous side effects. They could actually stop her heart her parents were told. Doctors at one point considered putting her in a medically induced coma to try and give her brain and body some rest. And it was at that point out of options that her parents decided to try something that was pretty unconventional at the time, a non-psychoactive ingredient from the cannabis plant, something called cannabidiol or CBD. And it worked.
Paige Figi
00:01:53
She didn't have seizures that day. She didn't have a seizure that night...
Dr. Sanjay Gupta
00:01:57
Based on this new evidence, based on my interactions with Charlotte, my perspective on cannabis started to change. I've now made seven documentaries. I've closely followed cannabis research. I've tracked its evolution in our culture. I've even followed the shifting legal landscape, and I paid close attention this April when the United States government made this major announcement that they plan to, quote unquote, reschedule cannabis. That means moving it from a highly restrictive schedule one drug category to a less restrictive schedule three category.
Dr. Sanjay Gupta
00:02:31
It was a move that many in the cannabis community have been waiting for. But what exactly does this change in scheduling mean? And why is it being done now? More importantly, could it lead to significant advancements in medical research? So I reached out to someone I consider one of the leading experts in the field, Dr. Staci Gruber. Some know her as the pot doc, someone who's dedicated her career to understanding the effects of cannabis on the brain. She is an associate professor at Harvard Medical School and Director of the Cognitive and Clinical Neuroimaging Core, as well as the Marijuana Investigation for Neuroscientific Discovery program.
Dr. Staci Gruber
00:03:09
And I try to help and do my best to educate both sides on really what the good, the bad and really the truth, the science of, what we know and what we don't know.
Dr. Sanjay Gupta
00:03:17
Today, we're going to have a really frank conversation about where things stand with cannabis right now. What is hope, what is hype, and what this rescheduling could mean for its future.
Dr. Sanjay Gupta
00:03:28
I'm Dr. Sanjay Gupta, CNN's chief medical correspondent. And this is Chasing Life.
Dr. Sanjay Gupta
00:03:36
You know, Dr. Gruber, we've done seven documentary films about this topic. And despite the fact that the names of the documentaries are WEED, I actually am very careful about the language. And even as we're talking, we're using the term cannabis, not marijuana. What is the importance of that in your mind as a researcher?
Dr. Staci Gruber
00:03:59
So I think it's an incredibly important distinction, and especially since we tend to use one word, whether it's cannabis or marijuana, to describe nearly anything and everything that comes from the plant. Cannabis sativa. L And you know, long ago and far away, it was legal in the United States. People forget that part. In 1850, doctors prescribed cannabis. And through a series of events, you know, it fell out of favor and it became illegal. They pulled it from the pharmacopeia and then it landed the most restrictive schedule of the Controlled Substance Act. But marijuana was actually a rather derogatory term. Cannabis is really derived from the name of a plant cannabis sativa. L is the plant from which the product we know as cannabis comes from.
Dr. Sanjay Gupta
00:04:39
When we first spoke, I remember having this very fascinating conversation with you talking about, you know, the ways in which cannabis can be a medicine. No one is saying it's a panacea and we're not being Pollyannish here, but specifically around things like certain types of pain, possibly cutting down on the number of opioids that would be prescribed for pain. You've been talking about that for for some time. What is the latest evidence specifically with cannabis and pain?
Dr. Staci Gruber
00:05:07
So it's a great question. And, you know, if we just look back to the 2017 National Academies of Science, Engineering and Medicine Report, I think it was called the Health Effects of Cannabis and Cannabinoids. It was designed really to be an exhaustive review of the literature to date to determine what there was real evidence for, because there was a lot of discourse about this and there was evidence for what we would call the big three plus. The top one was chronic pain. The other two were muscle spasticity as a function of mass and chemotherapy induced nausea and vomiting. The plus one, of course, came after that report, which would be pediatric onset intractable seizure disorders. I think that at this point there is an awful lot of evidence suggesting that for some people with some types of pain, certain cannabinoids work relatively effectively. We have certainly seen in our observational studies individuals cut down on their use of opioids on their own after initiating a course of cannabinoids that have. Has to count for something. I have a lot of people who say, listen. Could be the placebo effect. Sure. But they're cutting down on them on their own. No one's asking them to do it.
Dr. Sanjay Gupta
00:06:09
Do you find that there are certain people who are just going to be better candidates for this type of medication?
Dr. Staci Gruber
00:06:16
You know the old adage, we're all created equal. No, we're not. It's not true. From a biologic perspective, we are not all equal. We're just not. I may be a very slow metabolizer of something that you're a very rapid metabolizer of, and our experiences then will be very different, especially as it turns out to be the case with cannabis. A very slow metabolizer of THC will literally have that experience for significantly longer than someone who's a rapid metabolizer. Genetic profile actually plays a role. What else is on board? Medication. We know that there are some drug interactions we have to be mindful of, so there are people who are more likely to be better candidates for this type of treatment. So, what we need are large scale studies where we can actually do machine learning and predictive modeling in terms of who's more likely to benefit clinically.
Dr. Sanjay Gupta
00:07:02
'Since we first spoke and this has been, you know, almost a decade and a half ago now, there's a lot that has happened in this world. Obviously, we've seen it from a cultural and a legal standpoint. But just with the science and what's happening in the medical world. You recently did this interview, I guess it was a few years ago now, where you talked about post-traumatic stress. GBM, meaning glioblastoma, a type of brain tumor and pain caused by inflammation could all be things that could be addressed in part with cannabis. I remember reading and thinking, it's pretty extraordinary. I mean, just GBM alone, glioblastoma, neurosurgeons. These are really challenging patients to care for. How best to contextualize this, Dr. Gruber?
Dr. Staci Gruber
00:07:48
'So I think it's really helpful again to take a step back and to acknowledge that the plant is this miraculously complex structure with, you know, again, over 500 compounds. And it does appear in pre-clinical work and some of the basic experiments have been done that certain cannabinoids, in combination with other cannabinoids and other compounds, appear to allow things like tumor progression to either slow. Halt or even perhaps be reversed. That's extraordinary. You know, full stop. Mic drop. That's amazing. And to your point, this is an extraordinary population of individuals who have very little to be hopeful about.
Dr. Sanjay Gupta
00:08:28
Can you just for the audience, just sort of describe from your perspective as a researcher, what are the barriers that you face when trying to do this sort of research on cannabis? I mean, so something's not, quote unquote, legal on a federal level. What does that mean on a practical level for you?
Dr. Staci Gruber
00:08:44
I think that it's very easy for people to read headlines and be bombarded with news feeds, which happens every day. Cannabis is terrible for this and wonderful for that. And they tend to lose sight of the fact that at the federal level, cannabis remains an illegal substance. Schedule one again most restrictive of the Controlled Substance Act, which means you can't write a prescription for it. By definition, it means there's no accepted medical value. It has a high liability for abuse and no accepted safety profile.
Dr. Sanjay Gupta
00:09:11
Now, I do want to take a second to talk about the different schedules here and what they mean. So the United States government puts drugs into one of five categories otherwise known as schedules. They are based on that drug's accepted medical use and the drugs abuse or dependency potential. The most restrictive is schedule one, which includes cannabis, but also includes drugs like ecstasy, heroin, LSD.
Dr. Sanjay Gupta
00:09:35
Drugs like cocaine, methamphetamine, fentanyl, for example, are considered schedule two drugs and so forth, all the way down to schedule five, which includes drugs like cough syrup. Now, keep in mind, all of that is at the federal level.
Dr. Staci Gruber
00:09:51
But at the state level, states get to set their own rules. So the state and federal regulations are at odds with each other. And I've had a lot of people say, listen, my state says I can do this, this and this, so it's fine. Right. And I think, okay, it may be fine in your state, but you're still violating federal law. The only way to do certain types of experiments and be within the federal law is to make sure that you're following all of the restrictions, the guidelines, which are significant for schedule one. There are more restrictions with regard to different types of products and or compounds that can be used where those compounds come from, the storage and surveillance, and let's just say administration and bookkeeping related to these types of substances is extraordinary in terms of security. You know, I used to joke that I had to buy a safe that was as big as a small car to hold something that would never, ever have any diversion potential. It would never get anybody high. They'd be very disappointed if they grabbed it. Things that are classified in this country as hemp, which is the variety of cannabis with anything equal to or less than 0.3% THC by weight. Those are actually legal, and I have a lot more latitude using those products and getting approval from the FDA to do those kinds of studies. So it's been a little bit easier.
Dr. Sanjay Gupta
00:11:02
Wonder if you can take us just on a little bit of a history trip here and I'll set the stage. Cannabis has been a schedule one drug in the past. These are drugs that are deemed to have no medicinal value. They have high potential for abuse. For reference, other schedule one drugs. Just so the audience understand heroin, LSD, ecstasy. So, you know, I think what people really think of as serious drugs. But to give some context, why was cannabis originally scheduled this way? And what is sort of happened over the last, you know, I guess 150 years or so?
Dr. Staci Gruber
00:11:41
Again, it was legal. When we talk about things and states passing laws to legalize cannabis. I always make the comment, you mean re legalize cannabis because it was legal. You know, again, in 1850, it was part of our pharmacopeia. It fell out of favor for a number of reasons, most of them sociopolitical. And there's a lot of discord about that, exactly what was happening. But it seems that there were an awful lot of stakeholders that were not exactly fans. And the Marijuana Tax Act in 1937 made it illegal. It gets pulled from the pharmacopeia in 42 and placed in this very newly created Controlled Substance Act in 1970, in the most restrictive class schedule and where it remains today. It did not receive Schedule one status because of any data suggesting there was no medical value. We didn't have any scientific data at that time necessarily to put it in schedule one. It was really much more, again, sociopolitical shift as opposed to a scientific initiative.
Dr. Sanjay Gupta
00:12:37
We're going to take a short break here. But when we come back, what Dr. Gruber thinks about how this rescheduling might change things for researchers and for patients. We'll be right back.
Dr. Sanjay Gupta
00:12:57
You have heard about what's going on, the DOJ proposing to reschedule cannabis as a Schedule three drug. That would mean that it has moderate to low potential for physical and psychological dependance, and it has some evidence of medical use. What do you think of that schedule for cannabis?
Dr. Staci Gruber
00:13:16
Yeah. So I think the first and maybe the biggest thing about the potential rescheduling of cannabis from schedule 1 to 3 is the acknowledgment that there is some medical value. And I think that's as much a psychological shift in this country as anything else. You have a lot of people who basically saying, hold on. Absolutely. It could never be medicine. People who are using this medicine, they'll give me the air quotes. They're just looking for a legal way to get high. And I say, well, interesting. But they're not using products that get them high. So what's you know, I you know, I'm not sure I believe that. Okay. Well, that's why we have data. But I think it does make an impact in terms of people and their perception of what we're talking about, which is the first really big step for many. For some, they don't understand that there is a huge difference in one letter, Right? Reschedule is not deschedule. I've had a lot of people say, this is great. I can get it anywhere. Nope, not what that means. You know, people who say, I can get this at my gas station. Fun fact. Maybe that's not a great place. I'm not sure I would buy anything that I would call medicine at the gas station. I don't know. But I think there's a lot of misconception about what the rescheduling means and what it changes for consumers and patients, as well as people like me versus industry stakeholders.
Dr. Sanjay Gupta
00:14:32
Yeah, you know, it is interesting this point that you're raising that, hey, you guys are just doing this to try and make recreational the thing. You're just using this as a ladder towards broader recreational legalization.
Dr. Staci Gruber
00:14:45
Yeah.
Dr. Sanjay Gupta
00:14:46
'And you know what I have found and this is my own humble sort of assessment of things, is that, yeah, anything is possible. Sure, There are people, there's lots of stakeholders and there are people who may want to to sort of say, let's use this as a bridge to broader legalization. Sure. That may be the case. But I think what the flip side is, what you're talking about, Dr. Gruber, is this idea that for some people, it does appear to be a a medicine. And not only does it appear to be a medicine for them, it has worked for certain people when nothing else has. So not only is it a medicine, it is a necessary medicine. For some people, they don't have any other options. You and I both know the story of Charlotte Figi, who sadly passed away, and we talk about her a lot, But she was emblematic of so many more people for whom nothing else had worked. And I try not to sound preachy here or create sort of unfair cognitive dissonance in people's mind, but for some people, this is as much a moral argument as it is a medical argument. Like that, you would acknowledge the fact that, sure, some stakeholders may come in here and try and co-opt what is happening with legalization to bolster a different industry. But that doesn't take away from the fact that it has worked as a medicine for some people. And then when they travel from one state to another, they can't take their medicine with them legally. That still boggles my mind that I mean, people had to move because of these laws, right?
Dr. Staci Gruber
00:16:11
These marijuana refugees. Right. I mean, that's the thing. This is it. They're clearly not doing it to get high people who would give up their jobs, their families, their everything. And so, as you know, for their kids to move across the country to a place where they're no longer violating law, so that if that doesn't tell you everything you need to know, I don't know what does. And these children aren't altered or intoxicated. And I also hear people on the other side say, but, you know, you don't know what else could be happening. Well, I've had an awful lot of parents say, you know, I live a life where I can watch my child have their seventh birthday now, as opposed to the alternative, which is, you know, never getting there.
Dr. Sanjay Gupta
00:16:45
'And it gives me it gives me goosebumps. Sometimes I just think about, you know, these parents who had hold their children, who had intractable seizures. And it's just so visceral because you they have a disease that is so visual. And for them, they see it, you know, these seizures And and then, by the way, they're often told to use medications on those seizures that can be very cardio toxic. So it's not like the medications they are being recommended for their children are perfectly safe by any means. But, you know, look - you and I could probably talk about that all day long. I am curious why now do you think when it comes to this proposed rescheduling, what do you think's going on?
Dr. Staci Gruber
00:17:24
So, you know, I think there's a number of possibilities as to why now. And I always thank goodness, and I'm not a legislator or a politician, I try to help and do my best to educate both sides on really what the good, the bad and really the truth, the science of what we know and what we don't know so that people can make better decisions and move forward again with science actually, you know, leading the way. I think that it's been a long time coming. I think there's been an awful lot of work. I think that having the very first plant derived than this cannabis plant derived, single extracted purified form of cannabidiol or CBD as epidiolex for these pediatric onset intractible seizure disorders was a big shift. I'm sure you hear this a lot, but you raised the nation's consciousness with regard to things like cannabis as medicine, especially for children. And it did raise an awful lot of concern among some how could you do it? How would you do it? And then you just watch for five minutes and you'll never ask the question again.
Dr. Sanjay Gupta
00:18:16
Right.
Dr. Staci Gruber
00:18:17
And when you look at the potential downside of, again, as you appropriately point out, other conventional medications that are either not working and or introduce tremendous adverse effects, why not try it? When people demand access to certain products and they express their extraordinary frustration and concern about being in the wrong place with regard to legalization. This is a very important, I think, first step. You know, in terms of all practical changes, what it really changes is, again, for industry investors and stakeholders, it's very different from patients and consumers, very different for researchers.
Dr. Staci Gruber
00:18:55
For researchers. What it really does is it changes the security requirements for things like securing the supply. It changes the requirements for monitoring and surveillance, things like that. There's a fair number of administrative hurdles that we all have to deal with, including getting federal and state schedule one licenses and maintaining them. And again, these are not without a fair number of requirements themselves. But regardless of whether or not you have a schedule one license, as I do, you may not I repeat, you may not do a clinical trial in this country of a product that is currently on the marketplace for sale. You have to use something that is either supplied to you by the National Institute on Drug Abuse and or another DEA approved license. So it's not that you can study anything that you can get in a dispensary. For patients and consumers, it doesn't really change anything. People are under the impression that they can then just go and get it anywhere. No it's just like any other schedule three. Right. So think about testosterone. Where are you going to go to get that? You can't just go to your drugstore on the shelf and get it right. It's a scheduled substance. You have to have a prescription for it.
Dr. Sanjay Gupta
00:20:00
So, again, the important point is, if you were thinking that once cannabis gets rescheduled, you're going to be able to legally get it everywhere, Dr. Gruber says that's not really going to be the case. And even if cannabis were readily available. Well, I'll tell you, there's still actually a lot to consider before trying it out, even for medical reasons.
Dr. Sanjay Gupta
00:20:20
My mom, who's 82 years old and she, you know, she's a very tough woman, you know, just an engineer her whole life, really a very science based person. And she told me she was maybe interested in trying it. She had had some pain and she thought about trying it, but had no idea, frankly, what to do when she got to a dispensary. It was very confusing. And she's like, Well, I'll call my son, who's made seven documentaries on this. And then she realized I was pretty useless as well when it came to this. But but what like, what do you tell people who may say, okay, I want to be really thoughtful here. I have a chance to hear from Dr. Stacey Gruber. What do you tell people who are thinking about doing this in this demographic of people who are now the fastest growing demographic of users?
Dr. Staci Gruber
00:21:01
Absolutely. And I think it's such a great question because people assume, you know, again, we're all created equally. I always start with an end with the same line, which is age matters. Age matters. When we look at preclinical data and basic science outcomes, we see a real difference in very young versus older animals, for example, and how they respond to these types of things. We actually see improvements in older animals and or adult humans in our studies. And so I think first and foremost, the first thing is buyer be aware. We have to ask our individuals, our older adults, who are thoughtful and deliberate and generally quite invested in their own health care, because they generally are balancing a number of things that are happening at once.
Dr. Staci Gruber
00:21:43
Biology is cruel. We tend not to get better at things as we get older necessarily. The average adult over the age of either 60 or 65 on five conventional medications. So first and foremost, we want to be mindful first that there's no drug drug interaction. That's really important. People don't talk about it because it's not popular. And if you're smoking or vaping, it's not as much a concern. But if you're using anything that becomes consumable and you swallow it, it's an issue. The second thing is to be know before you go, before you go to a dispensary or buy something online, know what you're looking for before you buy a product. You want to know what you need, whether it's for pain, sleep. Maybe it's both. Maybe it's for mood. Top three conditions in this country chronic pain, sleep disruption and mood anxiety or PTSD, maybe depression. So know before you go. And also, of course, start low and go slow. You can always add you can never take away. Once it's in, it's in. You know, people are convinced, I can get it out. You can't get it out. So, again, be mindful a little can go a long way and we are not all the same. What affects you in one way affects somebody else very differently.
Dr. Sanjay Gupta
00:22:48
The start low, go slow I think is really good advice. And then this idea that this idea of stacking, if you are using edibles, you may not think it's doing anything, but it may take a while and then you can get a second response, what they call a biphasic response. So one peak and then, I'm fine, and then a second peak as your body metabolizes it. Stacking can be a real problem.
Dr. Staci Gruber
00:23:15
'Especially for older adults. Again, metabolism is slower, right? So we have slowed metabolism and we have longer rise time anyway, time to get an effect. Then your liver takes Delta nine THC and converts it into something more intoxicating. What's fun that is - 11 hydroxy. So you've waited an hour. You don't feel much. You have more. Oh, after an hour and a half that first doses kicked in and now you're going to get that second dose.
Dr. Staci Gruber
00:23:37
'People very often know how they're going to respond after 1 or 2 gin and tonics. They get it right because they've had experience. Alcohol, straightforward single molecule. You can go from feeling pretty terrific with a little bit of cannabis on board to feeling absolutely terrible in very short order. So I think it's also from the older adults, COA, certificate of analysis. Wherever you buy a product, ask for COA - an outside lab has analyzed that product and tells you for your batch of that product in your hand, how much of each of those cannabinoids is present. That helps you determine how much you should be taking. You don't want to start with something that's a what we would call a large dose. What's a large dose? Depends on the person. But in this country we tend to think the National Institute on Drug Abuse have suggested that fo r THC, Delta, nine THC, five milligrams as a standard serving five milligrams. So when you see products that are 20 or 30 per serving, you know.
Dr. Staci Gruber
00:24:31
That's different.
Dr. Sanjay Gupta
00:24:32
Yeah. I mean, you've got to be careful. I mean, you can get really good guidance, but you have to be careful and you have to do a lot of research here yourself. As you say, know before you go, that involves doing little bit of homework.
Dr. Staci Gruber
00:24:43
'Right. And not everybody is willing to do that. And they are often, you know, met by these very enthusiastic, well-intended people behind the counter. Patient care advocates or budtenders mean no harm, but they don't necessarily take into account a patient's medical history, their psychiatric history, their own personal limits of other things. They happen to be a slow metabolizer of other things. All of these things make a difference.
Dr. Sanjay Gupta
00:25:07
You know, when we talk about rescheduling, we're talking about it, you know, sort of broadly for the consumers out there. If this does help facilitate your research, what are some of the big questions you're still hoping to answer?
Dr. Staci Gruber
00:25:20
Well, we have no shortage of questions. You know, we have lots of things that we're looking at. We're spending a lot of time these days, to your point on getting older. You know, as we age a biological process, aging, right. We are all aging every day. And how we might be able to harness some of these combinations of cannabinoids to address things like health and wellness as we age, not just addressing conditions and indications when they arise, how can we prevent certain things from happening in the first place? I think there's a lot of work to be done for folks who are experiencing mild cognitive impairment and different neurodegenerative disorders. A number of things like Alzheimer's, dementia, other dementia related disorders. There's a lot of room potentially if you get in early enough to potentially slow the process. Individuals with gynecologic pain. We're spending a lot of time these days thinking about women who are largely understudied, ignored. It's unbelievable what people endure. And there may be ways to harness different types of products novel, let's just say routes of administration or modes of use. So there's an awful lot of ground to cover.
Dr. Sanjay Gupta
00:26:21
'Do you think that there's something larger going on, like the rescheduling of cannabis? Do you think that that might influence the rescheduling of other drugs with potential therapeutic benefits, MDMA for severe post-traumatic stress? What do you think?
Dr. Staci Gruber
00:26:35
Yeah, I think there's a lot of discussion about that and there's a lot of people extremely interested in this. I think that people are incredibly invested and very, very hopeful for the therapeutic potential. And if you are have ever been I would tell this to everyone if you have ever had a friend, a family member, a colleague who has been affected negatively by anything, and you finally see some glimmer of change in them, there's no way you wouldn't be invested in trying to figure out how that might help other people. Everyone is someone's nephew or brother or partner. Everybody, right. So when you see it up close and personal, as some of us do every day, you want to be able to figure out mechanisms for other people. You start with the few and hope for the many.
Dr. Sanjay Gupta
00:27:15
I hope today's conversation really helped you understand what we can reasonably expect from this anticipated rescheduling and why it's considered such a big deal that cannabis would finally be recognized for having medicinal value as a Schedule three drug. I think what you probably have heard is that this shift is not going to change everything immediately for researchers and patients out there, but that it's a promising start. For me, again, as someone who's been following the story for over a decade, I'm pretty hopeful that rescheduling cannabis could open new doors for scientists like Dr. Gruber to continue and even expand critical research. Because as we know, research isn't just about understanding. It's taking that understanding and then hopefully using it to change lives in a positive way.
Dr. Sanjay Gupta
00:28:04
Up next, I'm going to answer a listener question for this week's Paging Dr. Gupta. We'll be right back.
Dr. Sanjay Gupta
00:28:21
And now it's time for our segment On Call. We got a question from one of you, our listeners.
Audience Listener Voicemail
00:28:27
Hi, this is Clara. I just listened to your latest episode with Dr. Basu on the impact of extreme heat on our health, which was really insightful. And I was wondering if you could discuss how this might relate to the practice of hot yoga, which is very common here in the US. Given the concerns about heat exposure, how does hot temperatures affect our health while practicing yoga. Thank you.
Dr. Sanjay Gupta
00:28:55
Okay, Clara, thanks for calling in with this intriguing question, something that really made me think. Now, after listening to Dr. Basu explain about the dangers of excessive heat on the human body, it might seem paradoxical then, that hot yoga sometimes practice more specifically as Bikram yoga could even be considered safe. At first glance, of course, living in extreme heat like Dr. Basu was talking about and practicing yoga in extreme heat would appear to be the same.
Dr. Sanjay Gupta
00:29:24
But there are a few notable differences between them. The first is that the heat and humidity in hot yoga are high, but they're also controlled and they're limited, usually between 90 and 105°F and 40% humidity. The second thing is that classes are usually not longer than around 90 minutes. And the third is that a hot yoga class is usually not that vigorous, even though it might feel like it at the time.
Dr. Sanjay Gupta
00:29:53
Look, the truth is that working out in the heat, no matter how controlled the environment, can be dangerous. Proponents of hot yoga say there are many benefits increased flexibility because the heat helps quickly warm up muscles and tendons. They also claim that hot yoga can be detoxifying, can help with weight loss and muscle strengthening. Detractors say that it can lead to overstretching dehydration, dizziness, even trouble breathing, especially for people who are new to the practice and not yet acclimated. Their contention is that you can reap all the proven benefits of yoga in just a regular class. So we looked into this a little bit.
Dr. Sanjay Gupta
00:30:31
The American Council on Exercise did published two small studies on hot yoga in 2013 and 2015. There were not any definitive red flags. The 2015 study did raise some concerns about high core body temperatures that were measured in some participants.
Dr. Sanjay Gupta
00:30:47
So is it dangerous? For most people inclined to do hot yoga? It's probably fine. But pregnant women, people with diabetes, people with cardiovascular disease, including high blood pressure, which incidentally is something that you should just check before you do any kind of activity. A lot of people have high blood pressure and they don't realize it. The point is that if you're exerting yourself and you're combining that with the heat, you're making your heart work harder. So you want to make sure to have that checked out ahead of time. Also, you know, people with preexisting health conditions, they should talk to their doctor before signing up for a class like this.
Dr. Sanjay Gupta
00:31:23
Now, if you're going to the class, you should probably ease into the practice no matter what kind of shape you think you're in. Maybe start at a warm, not super hot temperature and maybe start with a shorter class. A really important recommendation. You got to stay hydrated. You know this. But it's especially important with hot yoga. And that might mean drinking more than the sanctioned water breaks in a class that can help your body better regulate its core temperature. And if you feel lightheaded or dizzy, lie down until you feel better or step outside the room. If you can safely do so, seek medical help if the bad feeling persists. Don't let that one get away from you.
Dr. Sanjay Gupta
00:32:04
'Clara, I hope this clarifies the issue for you. Thanks for calling in. And if any of you have a question for me, I really want to know. Record a voice memo. Email it to ask Sanjay at CNN Kcom or give us a call. (470) 396-0832 and leave a message. That's all for this week. Thanks for listening. Thanks for Chasing Life. We'll see you next Friday.
00:32:32
Chasing Life is a production of CNN Audio. Our podcast is produced by Eryn Matheson, Jennifer Lai, Grace Walker and Jesse Remedios. Andrea Kane is our medical writer. Our senior producer is Dan Bloom. Amanda Sealey is our showrunner. Dan Dzula is our technical director and the executive producer of CNN Audio is Steve Lickteig. With support from Jamus Andrest Jon Dianora, Haley Thomas, Alex Manasseri, Robert Mathers, Leni Steinhardt, Nichole Pesaru, and Lisa Namerow. Special thanks to Ben Tinker and Nadia Kounang of CNN Health and Katie Hinman.
