Medical marijuana advocates’ quest for stronger medication in Iowa was set back Friday, as the board overseeing Iowa’s new program recommended sticking with a limit on how much THC medicinal products may contain.

State law says the new medical marijuana products may contain no more than 3 percent of THC, the chemical that makes users high.

Proponents of medical marijuana say more THC is needed to effectively treat some conditions, including pain. But critics say raising the limit could encourage abuse.

The eight-member Iowa Medical Cannabidiol Board, mainly made up of physicians, voted unanimously Friday against recommending legislators lift the THC limit.

“I’d like to get another year or two under our belts and see how people respond with the current THC cap,” said board member Lonny Miller, a family physician from Creston.

The 2017 law that allowed limited manufacturing and sale of medications made from marijuana plants established the advisory board. The medications are to go on sale Dec. 1 in five new dispensaries across the state.

Board member Robert Shreck, a Des Moines oncologist, told his colleagues the 3 percent THC limit is imperfect but should stay in place for the time being.

“I think it’s a fair compromise the state made. It allows a variety of products to be distributed. People can try them … and see what it does for them,” Shreck said.

The board voted to recommend the state add severe pediatric autism to the list of ailments for which Iowans may legally purchase medical marijuana products. But the board declined patients’ requests to also add attention deficit hyperactivity disorder, post-traumatic stress disorder, bipolar disorder and ganglioglioma, which is a type of brain tumor.

Board members said their main reason for declining to expand the list of approved ailments is there isn’t enough research to show medical marijuana products would help. For bipolar disorder and PTSD, some of the doctors said marijuana could make symptoms worse for some patients.

The board's decisions disappointed patient advocates and medical marijuana business leaders who attended Friday’s meeting in Ankeny.

Lucas Nelson, general manager of MedPharm, said the 3 percent THC limit makes no sense. Patients who want to get more THC could just buy more of his company’s oils, creams or capsules, he said in an interview after the board’s vote. Buying extra medication would be expensive but legal, he said.

If the Legislature wants to limit how much THC Iowans could buy under the new medical marijuana program, it could change the law to say patients could only buy a specified number of milligrams of the chemical in a given period, such as a month or 90 days, Nelson said. His company could make stronger medication under such a rule, but sell smaller quantities of it.

Nelson, whose company has invested more than $10 million in a production facility and two dispensaries, reiterated his fears that the 3 percent THC limit would discourage patients from buying the new medications for treatment of conditions such as pain or multiple sclerosis. “If there aren’t any patients, there really isn’t an industry,” he said.

He said his company and other advocates will continue to lobby legislators to expand the program.

Erin Bollman of Dallas Center spoke to the board Friday on behalf of her 6-year-old son, Abram Miller, who has a rare disorder that causes autism and seizures. She said his symptoms, which include self-injury, have eased since she started giving him an oil from Colorado that has THC and cannabidiol, or CBD.

Bollman hopes Iowa will lift the THC limit on its new program, so she can legally buy products that will help her son. The only way she could do that under current rules would be to buy large amounts of the low-THC oil, she said. “I don’t know how patients are going to be able to afford that,” she said after the meeting.

Friday’s board meeting came a day after MedPharm, the state’s first legal medical marijuana manufacturer, held an open house at its growing and processing facility in Des Moines.

The audience on Thursday included several parents who lobbied the Legislature relentlessly on behalf of children with disabilities. The parents toured MedPharm’s sparkling facility, where hundreds of marijuana plants were growing under tightly controlled conditions in sealed-off rooms. Statehouse leaders from both parties were on hand to thank the parents for pushing them into legalizing a limited medical marijuana program.

“It’s surreal,” said Kim Novy of Altoona, who pushed for the program on behalf of her two teenage daughters with severe epilepsy. At first, many legislators predicted the proposal had no chance of passage, Novy recalled. “Five years ago, we had the door slammed in our face. I mean, we were laughed at.”

The five new dispensaries soon will be selling capsules, oils and creams, which will retail for $30 to $130 for a 30-day supply, MedPharm said. Smokeable forms of marijuana will not be allowed. A second licensed manufacturer, Iowa Relief, is building a production facility in Cedar Rapids.

Although the state board declined Friday to lift the THC cap, it made a recommendation that could help patients get approved for the program. The board voted unanimously to recommend the state let nurse practitioners and physician assistants certify that patients have conditions qualifying them to purchase medical marijuana products.

Under the current law, only physicians may make such certifications. But doctors on the board said nurse practitioners and physician assistants have the knowledge and authority to prescribe other medications.

So far, fewer than 900 patients or caregivers have been approved for cards to purchase medical marijuana products for conditions such as severe pain, epilepsy, cancer, Crohn’s disease, multiple sclerosis, AIDS, Parkinson’s disease or Lou Gehrig’s disease. Supporters hope that number will grow after the medications go on sale.

The board’s recommendation to add severe autism to that list now goes to the Iowa Board of Medicine, which regulates health care.