Challenge Iceland, 23. 7. 2016

On Saturday, 23.7. 2016, we were a part of an amazing, inaugural Challenge Iceland, half Iron distance triathlon. The name says it all and all three of us agree that this was the most fascinating, adventurous triathlon we have ever done. An unforgettable experience in the land of the Vikings.

Swim start (source; Challenge Iceland)
Swim start (source; Challenge Iceland)

The swim start took place on Saturday morning in a 10.000 years old glacier lake situated 40 km from Reykjavik. It was a rainy morning with outside temperatures approximately 12°C. The water in the lake was said to have 15°C but in fact this was only true for the shallow part on the entry into the lake… as you went further, the water became colder and colder. We dressed up our swim suits in a nearby tent because the rain was pouring from the sky. The tent was already crowded with athletes and it seemed like we all knew that going into that lake will take some craziness. The scenery behind the lake was a picturesque mountain and hills covered with snowy patches and we also noticed a waterfall which was probably providing all this cold water into our lake. It was time to get in. We did not think much; we got wet as fast as possible and once you swam a few metres the water temperature seemed bearable. We were laughing and shaking, waiting for the start signal.

Swim start (source: Challenge Iceland)
Swim start (source: Challenge Iceland)

Swimming started and the first few hundred meters were actually OK, like swimming in a »normal« lake. The water was crystally clear and the first problem we have encountered was its unequal depth. Therefore, we had to walk for a few meters in the middle of the lake until we could swim again. The time went by, I could feel my finger tips freezing and after swimming for 40 minutes the coordination of limbs was awfully bad…I got the feeling that I came into the coldest part of the lake. It took another 5 minutes to swim to the exit on the shore and a few minutes to get out into the transition zone. The conditions really prolonged our swimming times.

Bike ride (source: Challenge Iceland)
Bike ride (source: Challenge Iceland)

Iztok and Dušan were already starting the bike ride, when I entered the transition zone and dressed up my bike gear in a whole-body-shaking condition. As a doctor, I would of course totally disencourage anyone to perform swimming in a cold, glacier lake… I was thinking of our kidneys, our heart pumps and all the organs who had to perform their functions despite our morning glacier bathing. But on the other hand, we will never walk this road again and I knew we were well prepared and fit enough to do this without consequences. The cold water took its toll, some of the athletes had to finish their race during or after the swim…medical professionals had much work to do; from mild hypothermia to cramps. Luckily, nothing serious.

Bike ride-Dušan (source: Challenge Iceland)
Bike ride-Dušan (source: Challenge Iceland)

I took my bike and ran to the bike start area. I almost dropped it as I was getting on it. In the second attempt I managed to start biking, rain was still pouring from the sky. »Nice and easy« said someone from the surrounding crowd… and we took his advice, we did the 90 km bike ride considering all the safety precautions; careful use of brakes, slow turning. I was afraid to speed up since the road was slippery and I do not have a lot of experience with racing in the rain. All the events so far were in tropical conditions in comparison to this event. I was happy with the scenery I was able to see during the bike course. Astonishing. The road was actually traffic-free and as you were riding in the middle of the road with cliffs and shore on one side, mighty hills on another side it felt like living on another planet. The hills seemed like being there forever, long before the human invasion of this planet and they were the silent witness of our bike ride on that vintage day. From Vikings to Challenge Iceland, those hills can manage all as long as you leave nothing but footprints and take nothing but memories.

Bike ride (source: Challenge Iceland)
Bike ride (source: Challenge Iceland)

The bike course was going up and down with app. 1000 m of ascent. This warmed my fingertips, the rain stopped pouring and after 90 km it was time to do the 21 km run-a half marathon. The run took its place around the lake, two 10,5 km laps. I was so hungry when getting off the bike, I could not wait for that chocolate bar in the transition zone. I must have underestimated the conditions on the bike and took only one small bar with me on the bike… obviously not enough. I changed my clothes and started running. The run was sitauted in a lovely scenery beside the lake, there were some aid stations with chocolate and bananas. The sun was already shinning and it was time to get to the finish line. Passing the line I stopped and took a few deep breaths.

Bike ride (source: Challenge Iceland)
Bike ride (source: Challenge Iceland)

There was a hot, spicy pumpkin soup in the finish area. We ate several cups of it, and a lot of fruit, it was delicious! And all the volunteers with cool, big Icelandic hearts were there to help us through the day. We did well in competition and our highest rankings in our age groups brought us entry slots for the Challenge World Championship 2017 in Šamorin. For all the rest, I will let the pictures do the talking…

Moraviaman,18.6. 2016

It was a sunny Thursday afernoon when we packed our things and hit the road to Czech Republic, more accurately to Otrokovice town. Moraviaman triathlon is a part of Czech national triathlon championship but it is also open for foreign athletes. We arrived in the late evening and of course all the restaurants were closed. So we took a look into the nearest restaurant with lights on (later we foud out that it was actually a Texas country style bar) which served us heated deep-frozen pizzas and, of course, Staropramen beer. It looked like we were the most complex guests in the last few years since they had to brush the dust from the menu. Well, we were satisfied anyway.

The following day was dedicated to “carbo-loading”…it is that sweet part of the preparations when you have to do “all you can eat” thing. Boiled potatoes, lots of bread, pizza (from the night before), pasta (in the days before) and some muffins. I must say that the last year I was actually tired of eating so much, but this year I ate smarter: less, but with more complex carbohydrates. I was really satisfied with how I felt: strong and full of OH. In another words, ready to make a lot of ATP molecules on the Ironman day.

Dušan and I went to do the registration on Friday. Iztok was our indispensable companion since he had to skip this Ironman because of some unpredictable health issues. Luckily, he shall be ready for Challenge Iceland since it was not easy for him to skip this emotional, amazing racing day.

Transition zone
Transition zone

Saturday. The swim start was at 7 AM, so we set our clocks at 5 AM. It was a sunny, promising morning. The sun was already up and we had to prepare our things and check in the bikes. I had prepared all the accessories on the desk the night before: swimming googles, swim suit, clothes, helmet, cycling shoes, running shoes, … For breakfast we had some croissants with no filling: this always works for the first  hours.

Swim start in the morning
Swim start in the morning

And there it was…a swim start in the nearby lake. Dušan was already dressed up in his swimming suit, I had to dress up too. My thoughts were already in the evening, I had that weird dumpling in my stomach, I was trying to look calm but inside I was really tense …it was that exciting fear of the unknown, that feeling you get when you are coping with a challenge far greater that yourself. I was trying to visualize the finish line, the adrenaline that will flush me in the last kilometres of running and that deep pride inside.

As they say, the swim start in the Ironman can not be felt, it can only be lived. When the gun goes off, it is a war. A 3,8 km swim started violently, people were trying to swim over each other. I managed to make my way through the crowds. There were approximately 400 athletes and it was hard to swim for the first few minutes. The water was dark but it somehow did not bother me too much… I fell into my swimming speed and the time was flying by. We had to do three laps and in between I could see the dark clouds gathering above the lake… After approximately 1h 20 min I was getting out of the lake, the sun was shinning again and I was encouraged for the next distance: 180 km cycling.

Cycling hours - Dušan
Cycling hours – Dušan

I changed my clothes in the transition zone, that took me approximately 3 minutes. I put a banana in my pocket, took my bike and ran to the start of a long, challenging bike ride. We had to do 4 laps, each lap 45 km long. The first part of a lap was somehow boring, heading up the main road, but the second part was abundant with green scenery, with ascents and descents… altogether 800m of ascent. The winds were not helpful and so I can say that the bike course was challenging. I was cycling in a steady pace and I let my mind wander off… in the future, in the past, in imaginary worlds and then back to reality. One moment I felt so happy and fulfilled… indescribable thing. I was doing good until a weird cramp in my gastrocnemicus muscle spoiled that mental harmony… I poured some cold water on it from the bottle on the bike. It was ok then and I ignored the pain since I knew that some salt from the iso drink in the transition zone after the bike ride will save this problem. I was such a relief to get off the bike after more than six hours…

Getting off the bike
Getting off the bike

I was really relieved when the run started. 42,2 km, a marathon under the hot sun. We really tried to wash off all the salt that was left on the skin. During the run I reset my watch because I was somehow interested in the distance… and it is mentally encouraging to count down the kilometres. The runnig course was really beautiful, but not flat. There were many ups and downs and in that steep parts my running pace was slower. I tried to drink as much as I could… iso every 20 minutes. After three hours of running the tiredness was coming to the surface. The sun was already going down, loosing its power and when I took my last 10 km lap it was all so full of nostalgie, running in the middle of the wheat fields swaying in the evening breeze. I could easily cry of happiness and relief because the finish line was in the reach.

A marathon
A marathon

And there was the finish line in the evening after 13h and 12 min….  A gift for all evenings in the last months spent in preparations for this day.  I took a glass of champaign in the finisher arena. It was again an amazing day, like in the last year”s Ironman. There are many priceless moments in life, those are one of them… We achieved two third places and this was a memorable award for all of us.

Ocean Lava Race Celje-Logarska Valley, Slovenia

On 28. 5. 2016 we were racing the only half iron distance (1,9-90-21) triathlon in Slovenia. This year it was included into the Ocean Lava Series but it has already existed since 2013.

Swim start
Swim start

The weather this year and general conditions were excellent.  The swim start was in Šmartinsko lake near Celje. The water was surprisingly not cold, but this lake is known for its large inhabitants (catfish 2 metres long etc.). Therefore we had an additional motivation to swim fast and near the group of other swimmers. It is not a lovely feeling to stay behind knowing that you might be a tempting stranger for those creatures below.  Luckily, I did not see a thing.

A beautiful forest run (Iztok and co-runner)
A beautiful forest run (Iztok and co-runner)

Bike course was 90 km long, with the last 30 km ascent to the valley. Winds were upfront, so all this together made it a quite difficult ride to T2 location. But it went fast since the nature was so astonishing you could easily forget the conditions you were in.

Mountain scenery
Mountain scenery (Dušan on the go)

The run was actually one of the most beautiful ones. There were two 10, 5 km laps and the course was going up and down in the forest. The last part, and the most memorable part, was headed to the meadow and then turning onto the soft grass with the mountain scenery in the back. Since the sun was really strong, we all got sunburned (in up-to-the knee-fashion).  Anyway, it was a nice saturday and a really beautiful triathlon in the nature.

Award ceremony (2nd place)
Award ceremony (2nd place)

Austrian 1/2 Iron Triathlon Mureck

It was a 1,9k/90k/21k half Iron distance triathlon in Mureck, Austria on 7.5. 2016. In the morning it looked like it was going to be a beautiful day, not like a week before when we had snow in the last days of April. Therefore we had a reason to expect that the water in the Rocksee lake is about to be cold. The start for the women was at 9.15 AM  and at 10 AM for the men and the sun had just began to warmen the atmosphere. When I first put my soles into the lake, I was positively surprised… it was not so cold afterall. The water had 18°C but I was ok with it for that 40 min swim.

Rocksee, 7.5. 2016
Rocksee, 7.5. 2016

There was one slight problem in transition 1, getting out of the water and on the bike, because I had some problems with taking off my swim suit. It just did not want to go off! And it took me more than three minutes to get out out T1 zone with my bike. I was already on the bike for 15 minutes when Iztok and Dušan started their race in the second wave-men start.

Rocksee, 7.5. 2016
Rocksee, 7.5. 2016

There were two 45km bike laps and it took me 2h and 53 min for both laps, taking into account the two hilly passages in the middle of the lap. The bike course was windy most of the time and it took a lot of effort to cycle against it. Transition 2, from bike to the run, was much faster, taking a little bit more than one minute.

Rocksee, 7.5.2016
Rocksee, 7.5.2016

The run was very beautiful, two laps around the lake and into the forest. On the run the sun was already hot and many of us took some seconds to drink cola in between running. It really felt good. Rushing against the 21st kilometer of running I was already seeing the finish line and passed it after 5h 16 minutes and 51 seconds. And that is my recors for this distance. Not to mention, I achieved the firts place and a voucher for shopping in Giga Sport. It was worth sweating for. 🙂 After the race, there was an award ceremony and we took the chance to meet and make a photo with Marino Wanhoenacker,  a Belgian triathlete who broke the world record for the full Ironman triathlon at Klagenfurt in Austria, finishing after 7 hours, 45 minutes and 58 seconds.

Rocksee, 7.5. 2016
Rocksee, 7.5. 2016

At the end of the day, we went for a tasty dinner and this was the best possible ending of that perfect day.  Anyway, the trainings contiune, there is 5 weeks until the full Ironman distance.

Ehinokokoza

Zgodba iz vsakdanjika. Nekaj, kar se pri nas diagnosticira vsakih nekaj let.

Moški v srednjih let sprejet zaradi enostranske pljučnice in pnevmotoraksa. Vse skupaj se je začelo z epizodo kašlja, ob katerem je za kratek čas izgubil zavest. Na CT-ju prsnega koša pa presenečenje… slika, identična spodnji.

Vir: www.radiopedia.org
Vir: www.radiopedia.org

Torej, na prvi pogled izgleda kot klobčič parazitov v levem pljučnem krilu…in tako je tudi v resnici. Kasneje je bilo z analizo dreniranega materiala iz ciste ugotovljeno, da gre za ehinokoka. Bolezen, katero povzroča, pa se imenuje hidatidoza ali ehinokokoza. Pogosto se bolezen začne popolnoma brez simptomov in traja leta in leta.  Najpogostejša je alveolarna oblika bolezni, kakor zgornja, ki se najprej začne v jetrih (in v resnici je bila na ct-ju vidna tudi zgostitev v jetrih) in se nato širi v možgane ter pljuča. Ko bolezen prizadene pljuča, pride do zgoraj opisanih simptomov.

In kje v naravi se lahko okužimo s trdovratnimi jajčeci tega parazita? Najpogosteje so s paraziti okuženi psi, lisice, volkovi. Jajčeca se nato v naravo izločajo z njihovim blatom, človek pa se okuži preko tesnega stika z okuženo živaljo ali njenim blatom. Psi, lisice, volkovi pa parazita dobijo s prehranjevanjem s surovimi organi recimo ovc ali glodalcev.  Seveda se lahko tudi mi okužimo s tem, ko jemo recimo premalo pečeno ovčetino ali drugo meso.

Zdravilo, ki se uporablja za zdravljenje je albendazol – širokospektralni antihelmintik. Včasih ga je potrebno jemati tudi več let. Seveda pa je ob formirani cisti indicirana kirurška odstranitev le-te.

It all starts with a plan

And it is good to have one, I agree. In a sport field we have a few self-challeging goals for this season. If you set up a goal, it is of course easier to commit to it, not looking right or left but going straightforward to the finish line. The best part of this journey is the journey itself. And all the time you have invested enriches your album of experience, your personality. Therefore, never regret the time invested in reaching your goals… the fact is that the time will pass anyway. And it is not about the results, it is about getting to the finish line feeling satisfied with your race against yourself. It is an art to combine your full-time working responsibilities and training and therefore I really respect the older athletes, being successful in their career, having two or three happy kids (who can not wait to pass the finish line with their parents) and a family and doing the Ironman. And not to mention that those were the one of the most positive, inspiring people we have ever met.

Vir: www.pinterest.com
Vir: www.pinterest.com

In April we are running an Ultramarathon in Istria, in May the first half-iron distance triathlon this year. Then comes June and an a fulfilling full Iron distance triathlon in Czech Republic. I know all the excitement will be as rich as the first time last year… leaving the comfort zone and looking forward to it. Then in August again one half-Iron distance in Slovakia. For autumn we do not have a plan yet, but working/professional responsibilities always come first so sport will  have to step aside in autumn in order to commit fully to other projects.

Now, I have it written!

I will probably often return to this post when searcing for motivation, inspiration for another afternoon training sesson (the problem is that before the Iron day the long endurance bike rides all become the same). But the passion for life felt on a racing day will pay off all the efforts and I will forever know I did not miss an opportunity to feel it and that I gave great memmories, created with my loved-one, a chance to happen. And that is the spirit of the Ironman triathlon.

Zgodnja obravnava menopavzalnih težav

Iz letošnje Menopavzne šole v Ljubljani sem želela izluščiti predvsem napotke, ki bi mi bili kot družinskemu zdravniku v pomoč pri obravnavi pacientk z menopavzalnimi simptomi, seveda temelječ na znanstveno potrjenih dejstvih. Veliko je bilo govora tudi o hormonskem nadomestnem zdravljenju, katerega pa prepuščamo ginekologom. Izven hormonskega nadomestnega zdravljenja namreč obstaja kar nekaj pristopov, s katerimi se je vredno seznaniti. Poleg tega se mi je tudi razjasnil pogled na t.i. bioidentične hormone, ki so predvsem v Ameriki zelo “opevani”, a je resnica povsem drugačna. Priznam, da je tudi mene mikal študij (na daljavo) tovrstnega zdravljenja v Belgiji, a se mi zdi pametno glede na dosedanje znanstvene izsledke s tem še malo počakati.

Kot vemo, je menopavza zadnja menstruacija v življenju ženske. Določamo jo retrogradno, pri  nas se pojavlja okoli 50.  leta starosti, v stari grščini pa klimax predstavlja zadnjo najvišjo prečno letev ali zaključek stopnišča. Sicer so longitudinalne študije pokazale, da se postopno izčrpavanje in upad plodnosti pojavi že vsaj 10 let pred foliklov v jajčniku pade pod 25.000.

V zgodnji pomenopavzi prevladujejo spremenjeni fiziološki procesi prilagajanja na spremenjeno hormonsko ravnotežje v telesu in na pomanjkanje estrogenov. Pomenopavzno obdobje je povezano z naravnim izgubljanjem mišične mase (sarkopenija) in mineralne kostne gostote (osteoporoza). Upad mišične funkcije je predvsem v stilu izgube hitrih mišičnih vlaken, zato verjetno po petdesetem letu ženske ne bomo prekosile svojega hitrostnega rekorda na 42,2 km pri 25ih.  Kostna gostota se začne spreminjati zaradi povečane razgradnje kosti in njene zmanjšane izgradnje.

Lajšanje klimakteričnih težav je sicer v domeni ginekologov, ki lahko ženskam predpisujejo različne oblike hormonskega nadomestnega zdravljenja, A vendar nekatere ženske tega zdravljenja ne smejo uporabljati, ga odklanjajo ali pa jih zanima naraven način zdravljenja, fitoterapija. Učinkovitost slednjega potrjuje veliko število kliničnih dokazov in kot samozdravljenje jih lahko svetujemo v ambulanti. Poznamo dve veliki skupini naravnih snovi, ki se na tržišču pojavljajo kot snovi za lajšanje klimakteričnih težav.

a) Fitoestrogeni (v prehrani ali koncentrirano v obliki prehranskih dopolnil)

b) Zdravilo naravnega izvora: grozdnata svetilka (Cimicifuga racemosa)

Fitoestrogen je vsaka snov rastlinskega izvora, ki je strukturno in/ali funkcionalno podobna estrogenu in njegovim aktivnim metabolitom. Po domače: lajša menopavzalne težave, saj deluje kot estrogen. Poznamo več kot 20 različnih fitoestrogenov, ki se nahajajo v več kot 300 rastlinah. Fitoestrogene razdelimo v dve veliki skupini: lignani in izoflavoni. Med pomembnejšimi viri izoflavonov sta soja in črna detelja, lignane pa najdemo v lanu, žitaricah, sadju in zelenjavi. Na primer: Azijke le redko poročajo o menopavzalnih teđavah in kot možno razlago za to lahko jemljemo dejstvo, da je njihova prehrana bogata s sojo, kajti njihov dnevni vnos sojinih izoflavonov znaša do 100 mg dnevno. Pri nas v Evropi pa so vnosi do 2 mg maksimalno. Svetujemo lahko torej večjo vključenost omenjenih hranil v prehrano, a lažje je zadosten vnos zagotoviti z rastlinskimi pripravki, ki se na tržišču pojavljajo kot prehranska dopolnila  (npr. Menosoy in drugi).

Vir: www.nutragreenbio.com
Vir: www.nutragreenbio.com

Drugo naravno zdravilo za lajšanje klimakteričnih težav je ekstrakt korenike rastline grozdnate svetilke. Gre za severno ameriško in kanadsko rastlino, poznano kot kanadsko zdravilo. Naravno registrirano zdravilo iz grozdnate svetilke je Remifemin. Izsledki predkliničnih in kliničnih raziskav pa so potrdili, da lahko pacientke to naravno zdravilo varno uporabljajo in naj bi bila celo primerljiva s hormonskim nadomestnim zdravljenjem. Bolj kot estrogenska aktivnost naj bi bil učinek grozdnate svetilke vezan na spremembe na ravni nevrotransmiterjev v osrednjem živčnem sistemu. Raziskava Liskeja in sod. je potrdila odsotnost estrogenskega učinka rastline, ugotovili pa spremembe v prenosu preko dopaminergičnih in serotoninskih receptorjev.

Tudi pri nas bi lahko torej ženskam z blagimi klimakteričnimi simptomi najprej priporočali spremembo življenjskega stila in sočasno uporabo naravnega zdravila grozdnate svetilke ali prehranskih dopolnil s sojinimi izoflavoni, predpisovanje hormonske nadomestne terapije pa naj ostane standard za zdravljenje zmernih in hudih klimakteričnih težav.

Treviso Marathon, 6.3.2016

On March 6th, Sunday, we took part in Treviso Marathon; 42,2 km run. Well, for the beginning I made three classical pre-marathon mistakes: new shoes worn only for a 5km run a few days before, too much clothes, no chocolate bars in the pocket (the first crackers were available on 21st km). Therefore, I enjoyed running the first 32km, but the last 10 km were a bit painful (or very painful) and I had to slow down the pace.

Treviso Marathon Finisher Medals
Treviso Marathon Finisher Medals

There is an interesting phenomenon, which I always observe in long distance running.  It is the group effect. Though I have I feeling  that I am running at a training pace, when I look at my Garmin, I am surprisingly 1 minute faster as it seems to my “internal pace detector”. I tried to explain it with relativity. I could say that I seem faster because some other runners I pass are a bit slower. But this theory falls since Garmin gives an exact pace per kilometer.  Well, the other theory is, of course, the group. It is very simple.  When you decide to follow a fast group, you somehow become faster too. Up to 40 % faster.

But as I mentioned in the introduction, this was not the case here. 🙂 At least not for the last 12 km…

Konoplja v medicini II

Tokrat pa nekaj več o medicinskih učinkih konoplje oziroma možnostih njene uporabe v medicini. Iz 11. stoletja izvirajo prvi znani zapisi o uporabi konoplje kot zdravila. Takrat jo je arabski učenjak al-Majusi uporabil za preprečevanje epileptičnih napadov. Poznejše in tudi sodobne klinične študije potrjujejo učinkovitost THC-ja kot antiepileptičnega zdravila. Kot vemo ima THC psihoaktivne učinke, zato večjo potencialno vrednost pri preprečevanju epileptičnih napadov pripisujejo drugima dvema fitokanabinoidoma: kanabidolu (CBD) in tetrahidrokanabivarin (THCV).

Na področju zdravljenja nevrodegenerativnih bolezni je bilo ugotovljeno, da THC kompetitivno zavira acetilholienesterazo, CBD pa zmanjša tvorbo reaktivnih kisikovih spojin, katere izvirajo iz beta amiloida – tako in vivo kot in vitro. Oboje je seveda pomembno s stališča Paarkinsonove kot tudi Alzheimerjeve bolezni. Na področju zdravljenja multiple skleroze, ki je kronična, progresivna bolezen z demienilizacijskimi poškodbami, so klinično preizkušali THC, CBD in dronabinol in dokazali manj spastičnosti in oksidativnega stresa. To je pripeljajo tudi do pridobitve dovoljenja za promet za prvo zdravilo, ki vsebuje kanabinoide rastlinskega izvora: Sativex. Tudi v Sloveniji bi ga lahko predpisali pacientom z multiplo sklerozo, kateri bi nato hodili v lekarno po svoje doze konoplje, a je proces menda tako zapleten (utemeljena indikacija, naročilo lekarne za uvoz točno določene količine zdravila, papirologija), poleg tega pa tudi zdravniki premalo (nič) ne vemo o njenem predpisovanju, da to preprosto ni stalna praksa.

Source: www.everydayhealth.com
Source: www.everydayhealth.com

Kanabinoidi so posebej pomembni tudi na področju zdravljenja kronične bolečine. Kanabinoidi namreč preko receptorjev CB1  preprečujejo sproščanje vnetnih mediatorjev iz mastocitov, preko receptorjev CB2 pa posredno stimulirajo opioidne reeptorje, prav tako pa povečujejo tudi analgetični učinek NSAR (nesteroidni antirevmatiki). Lahko rečemo, da imajo kanabinoidi protibolečinski učinek v perifernem živčevju, hrbtenjači in možganih in bi lahko postali ustrezna alternativa danes široko uporabljanim (še posebej v ZDA) in odvisniškim opioidom. Kar četrtina kliničnih študij, ki trenutno poteka, preučuje vpliv kanabinoidov pri bolečini.

Kanabinoidi tudi stimulirajo apetit in povzročijo povečan vnos hrane, kar je še posebej pomembno pri rakavih in kahektičnih bolikih.Na področju zdravljenja raka so  ugotovili protitumorsko aktivnost na in-vitro in živalskih modelih, žal pa primanjkuje tovrstnih kliničnih študij na ljudeh. Na Zdravniški zbornici naj bi kmalu potekalo izobraževanje o medicinski konoplji in možnostih njenega predpisovanja, vsekakor pa bo potrebno v eni izmed naslednjih objav spregovoriti tudi o toksikologiji in nekaterih nevarnostih konoplje.