by Diana on 26/09/2013 | Medicinal

Cirrhosis and cannabis

Cirrhosis Like any other medicinal plant, cannabis has intrinsic properties that allow it to produce both beneficial effects and undesired side effects. Some of these side effects are cognitive, such as the impairment of the short-term memory or the potential to trigger psychotic episodes in susceptible individuals. The negative physical side effects of cannabis include an increase in oxygen consumption by the heart tissues and, as we shall see in this article, the capacity to accelerate the progression of fibrosis in individuals suffering chronic Hepatitis C, if cannabis is consumed regularly and not just on a sporadic basis.


A note from Sensi Seeds:

This article was originally published in Cáñamo magazine in 2012. Since its publication both there and on this blog, a new study has been performed which contradicts some of the findings of this post. The study can be found here, and we will be publishing a new post which takes into account these new findings at a future date. Thanks to Winston Matthews for the link and to everyone else who drew our attention to this. 

The original article follows.

Cirrhosis and cannabis

 

Like any other medicinal plant, cannabis has intrinsic properties that allow it to produce both beneficial effects and undesired side effects.

Some of these side effects are cognitive, such as the impairment of the short-term memory or the potential to trigger psychotic episodes in susceptible individuals. (Sensi Seeds published an interesting article on Cannabis and Episodic Memory. To read it click here, ed)

The negative physical side effects of cannabis include an increase in oxygen consumption by the heart tissues and, as we shall see in this article, the capacity to accelerate the progression of fibrosis in individuals suffering chronic Hepatitis C, if cannabis is consumed regularly and not just on a sporadic basis.

In cirrhotic human livers, there is a higher number of CB1 Cannabinoid receptors, which indicates that the Endocannabinoid system is involved in the physiopathology of this clinical picture. (You can read more about the Cannabinoid Science and the Endocannabinoid System here, ed)

Anandamide and the Endocannabinoid System

It was initially thought that the endocannabinoid anandamide produced vasodilation in cirrhosis. However, a study carried out by Spanish researchers in 2004 proved that the increase in anandamide levels in hepatic cirrhosis was not related to the intensity of the hepatic damage or the extent of the vasodilation.

On the other hand, the cannabinoid receptor CB2 plays an important anti-fibrogenic role in cirrhosis. This indicates that in the future it may be possible to use the agonist cannabinoids of this receptor in the treatment of hepatic fibrosis in cirrhosis.

The effects of cannabis
The effects of cannabis

It is interesting to observe how these CB2 receptors are located in the liver cells of patients with active cirrhosis, but not in the liver cells of people not suffering from cirrhosis. This observation appears to indicate that the endocannabinoid system plays a protective role in this illness. The mechanism that the endocannabinoid system uses to reduce the fibrosis process is similar to the one it uses to control cancer cells. This process consists of the inhibition of cell growth and the induction of apoptosis, or programmed cell death.

 Fibrosis and CB2 receptors

The activation of the CB2 receptors not only leads to a significant decreases in the signs of fibrosis such as inflammation, but also improves arterial pressure. This was proven in a study carried out on rats with cirrhosis, during which a selective agonist of these receptors was used for nine days.

In another similar study, an antagonist of the Cannabinoid receptors delayed ascites formation in rats with hepatic cirrhosis.

If we focus on the CB1 receptor, we find that its antagonism decreases the progression of fibrosis, as is shown in a French study using three models of chronic liver lesions in mice, in which severe liver damage was provoked.

Therefore, it appears that both CB2 and CB1 agonists can be used as pharmacological tools with the potential to help treat this disease.

Many questions still need to be answered with regard to cannabis and hepatic cirrhosis, such as the fact that the levels of the endocannabinoids anandamide and, to a greater extent, oleoylethanolamide (OEA) or palmitoylethanolamide (PEA), are significantly higher in the blood of patients with hepatic cirrhosis than in that of healthy subjects. In addition, PEA and OEA levels are also higher in cirrhotic liver tissue.

Studies in humans

With regard to research carried out with humans, two studies are of particular interest. The first one was carried out in France in 2004. French researchers studied the impact of the use of cannabis on the development of fibrosis in chronic Hepatitis C in 195 patients. In a multivariate analysis, a high fibrosis progression rate was related to daily cannabis use and the daily intake of 30g of alcohol, with the age of exposure being over 25 years and physical activity being involved. However, the moderate use of cannabis had no effect on the development of fibrosis. 51% of the participants did not consume cannabis; 17% were occasional consumers (an average of 7 cannabis cigarettes per month); and 32% were daily consumers (an average of 107 cannabis cigarettes per month).

Cirrhosis and cannabis

 

The effect of cannabis varied among the different subgroups. In individuals aged under 40 and who were consumers of less than 30g/day of alcohol, 20% of those who did not consume cannabis or only consumed it occasionally had cirrhosis, while the figure rose to 37% if they consumed it daily. In individuals aged over 40 and who were consumers of less than 30g/day of alcohol, 35% of those who did not consume cannabis or only consumed it occasionally had cirrhosis, while the figure rose to 71% if they consumed it daily. In individuals aged under 40 and who were consumers of more than 30g/day of alcohol, 38% of those who did not consume cannabis or only consumed it occasionally had cirrhosis, while the figure rose to 50% if they consumed it daily. In individuals aged over 40 and who were consumers of more than 30g/day of alcohol, 76% of those who did not consume cannabis or only consumed it occasionally had cirrhosis, while the figure dropped to 50% if they consumed it daily. The result of the last subgroup was rather surprising. (If you are interested in finding out more about cannabis for medicinal use click here, ed)

In research carried out on animals, the team of scientists had proven that this acceleration in the progression of hepatic fibrosis could be regulated by the cannabinoid receptors, which explains why a notable increase in the number of CB1 receptors in some liver cells of cirrhosis patients was observed. The mice without CB1 receptors with chronic exposure to tetrachloride showed a reduced development of liver fibrosis when compared with normal mice.

Effects of Cannabis on Cirrhosis and the Virus C Hepatitis (HCV)

 The most recent study was carried out at the University of California, San Francisco. In this study of 204 individuals, the daily consumption of cannabis was associated with a moderate increase in the risk of developing severe cirrhosis (or fibrosis) of the liver. Between 2001 and 2004, the participants were interviewed in order to assess different parameters such as demographic data, risk factors for hepatic C virus (HCV), and the consumption of cannabis and alcohol. In addition to carrying out a serologic and virologic test, liver biopsies were performed. The median age of the group was 46.8 years; 69% were male and 49% were white. The cannabis use frequency within the 12 months prior to the study was: daily in 13.7% of the cases; occasional in 45.1%; and never in 41.2%. No cirrhosis was detected in 27.5% of the subjects, mild cirrhosis was found in 55.4% and moderate to severe fibrosis in 17.2%.

The daily consumption of cannabis was associated with a 7 times greater risk of developing moderate to severe cirrhosis. There was no association between current daily consumption and mild cirrhosis. An important limiting factor in this study in the method, since only one test was carried out, which limits the capacity for establishing a temporal relationship between the consumption of cannabis and cirrhosis. However, it confirms the previous French trial of 2004, in which the daily use of cannabis was also associated with a higher risk of suffering cirrhosis of the liver. The authors of both studies conclude by stating that, “We would advise individuals with a chronic HCV infection to seek counselling to reduce or abstain from cannabis use.”

Thus, it would appear prudent to recommend that individuals with chronic HCV should avoid the daily use of cannabis, while occasional consumption appears to be safe.

Author: Javier Pedraza

 

Comment Section

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Winston Matthews

I think you may find this interesting..

http://www.ncbi.nlm.nih.gov/pubmed/23811492

Marijuana Smoking Does Not Accelerate Progression of Liver Disease in HIV-Hepatitis C Coinfection: A Longitudinal Cohort Analysis.

26/09/2013

johnhudson

i smoke and will till i die it helps me to deal with dumasses who look down there nose and think there better cause they dont smoke give them a f ing cookie thank you

19/07/2014

Linda Grsy

Just wanted to say when you get older you will be more concerned for your health. I recommend that you try to Vape when you can. I know you love a joint. Oh man I do too. But I have severe Emphysema and I so wish I could smoke a fatty
I guess I will try on my death bed

28/03/2016

Jamie

If you're going to call someone a dumb-ass then at least spell the word "dumb" correctly ffs

24/10/2016

John

I was diagnosed with Cirrhosis of the liver, the doctor also mentioned liver cancer. I was told that I had 2 weeks to two months to live. That was December of 2012.
"Relevant info" My Mother died Jan 2 2012 I went into a self induced state of drunken decency. I was also percribed by doctors and abused by myself, Oxycontin for pain and Xanax for my depression. I was also a Marine stationed in camp LeJune where I was told that I more than likely digested some toxins from the water.
Cirrhosis: Initially my symptoms were extreme. Swelling, ( Ascites and Edema) they removed 14 jars full of black bile (Looked like Guinness ) I was jaundice. I suffered through Detoxification DT's (Sorry about spelling). To date I haven't seen a Doctor since I left the Hospital in 2012, almost 3 years ago I am 57, I am 6 ft and 245 lbs. I quit drinking and I have been avoiding any prescriptions drugs including Tylenol. I drink a lot of water. I am getting better, however, I have suffered mentally and have some dementia I suffer joint pain I believe Ascites, or could it just be just weight gain? and from Neuropathy. Thats a killer.
To my question: I cant afford Medical care. I'm hoping that the V.A. will help. I have a claim pending. Is there any advice besides "See a Doctor" you can offer. I'm a little frightened.
My best
Sincerely
John Flynn

21/09/2014

Rich gonzalez

Hey John hope everything is going well with you, my father is 60 years old n is suffering from chirossis n stage 2 liver cancer . Any advice ? Should he be on cannaboils? Thanks best to you..

01/06/2016

Shawnalea P Whaley

14 minutes ago
Hello my mom went into a hepatic coma 2 yrs ago..for 10 days..she wasnt expected to survive..shes not a drinker never was ...as she aged she developed. Chronic pain. with arthritis..after antiinflamatories etc. Her liver finally failed without Canadian Dr.s taking notice..apparently shed had this primary liver cirosis since my brothers birth when she was 33...but my dad was rcmp so we were transfered from small town to isolated small town with Dr.s that never even offered for her to be put on a transplant list! Now its too late...we adminerstered high doses of liquids of milk thistle..and it has kept her alive...the issue is this..of course dr.s took her off everything..told her suffer through the pain..or die..nice options right! So she started taking nips of alcohol at night just to ease the pain...this of couse is causing ammonia spikes...I want her to stop the boose and try cannabis for the pain and help her sleep...and Im looking for info on the least damaging method to the liver...I am assuming inhalation would be less likely to cause trouble as its not being digested..but Im not sure? Can anyone help me find information...or tell me thidr exp..I dont want to kill my mom..and I want to help her last bit of time here to be worth being here?

08/06/2016

Shawnalea P Whaley

my mom almost died in the absolute worst way...for months I was taking her to the emerg for severe swelling...they sent us home...then one day coming home from picking up rx's I got an anfry call from my brother asking if Id talked to my mom that morning..I said no..Im actually on my ay there now..why..he had called an ambulance he thought she had had a stroke...Id been with her the eve before...she seemed sleepy..but Id thought she was tired as she thought she had hurt her back..and was in bed...she was rushed to emerg where she got worse..no one was even testing her blood levels..I demanded a test..they didnt preform it for another 8 hours...now my mom was telling me she had just fed the horse over there some hay...and why did my daughter have blood on her neck? ( she didnt) knowone was listening to me...when I arrived the next morning...I spoke to her one last time before she slipped into a coma they expected her to die from....she would never even remember we were there...she was in a coma for 10 days...we did shifts around the clock..I found out they have a new iv drug that can scrub amonia levels from the blood in 12 hrs..its being fast tracked through the usa...any drug like this that has life saving benifits can be brought in with canada forms under these circumstances...it would have saved her yrs of rehab..she still cant walk unassisted...we began milk thistle extract liquid while she was in coma though her feed tube...then gave it to her 4 times daily while we did shifts....she went through a surgury to remove a blood clot from her ankle caused by the coma...then 2 bouts of c diff...we got her out as soon as we could...leaving her in hospital while recovering would have killed her as her imune system was gone..she was in total blood failure...we kept hopefull I kept researching....she went to hawaii last year...her twin grandaughters are now 6..they at least will remember her...my daughter is becoming an actress Im tring to get into production my screenplay...she has alot to see yet..and Im tring to do everything in my power to keep her here with us...I know high doses of lactulose help bind ammonia and remove it from the body...and liquid milk thistle is the only thing known to man to help regenerate liver cells..its a rx in germany..where genevas liver confrence is held where are the top minds are working on new techniques..like the new iv drug..that scrubs ammonia from the blood...she really needs that therapy...and its not available unless shes dieing...define dieing..shes dieing daily! I dont know if this is any help to any of you but Ill gladdly tell you our story..and what has helped us.Iam looking into cannibis as a pain killer that she can take that wont kill her quicker..and give her back quality of life.I did help my friend aunt..she began apparently behaving the same way...but because of knowing my moms symptoms she called me they adminersted lactulose before going to hospital... And fluids and lasic furosimide and got her onto milk thistle..they avoided a coma...and her liver levels continue to improve..which dr.s are saying is impossible.
0 Edit Reply

08/06/2016

Jonathan

John I don't know what state you are in,but you mentioned VA. Yor post is a year old and maybe you know this now. The A took on the task of curing Hep C with Harvoni. Turns out many baby boomer period Veterans, especially those that served in the 3rd ( San Diego command) and 7th Fleet (Yokosuka, Japan command). This has made the VA accept and treat many more cirrhosis patients and have come to give Veterans significantly better attention to liver disease.

Additionally the secretary, of the VA appointed by Trump, has approved an initiative to not deny benefits or take them away from Vets in a state where it is legalized and they and they are a cardholder. He believes Vets have given enough and if something relieves their pain and symptoms then they should not loose their benefits. CAVEATS: You must be enrolled in the state medical m,marijuana registry. The VA Doctors CANNOT prescribe Marijuana, but they can discuss with the Vet alternative treatments even if it Marijuana.
There is no reason to have someone with Non alcoholic Cirrhosis developed from Hep C becoming addicted to anti-anxiety drugs, opiods, etc. if THC or CBD helps them.

05/12/2017

Dlind

I'd like to know if this was a controlled study.

As in they only smoked marijuana and did not drink any alcohol, take prescription drugs, aspirin. Or anything else that can severely damage the liver.

24/01/2015

George Richmond

To John Flynn... Have you been tested for Hepatitis C ?? Ihave had hep c for 30 years before I was even diagnosed , My liver is now 100% useless to the point I had to have a stint straight through it . No cancer , yet . Judging by your age I assume you were in Vietnam , and I have heard from a lot of vets who got Hep C from all of the vacinations , especially the air injected type . It seem that a lot of blood was transfered between individuals . If that is the case with you , the VA should not only be responsible for your treetment but may be liable for a lot of different problems . They are hard to fight but there are a lot of attornys who specialize in VA problems .Most of them will take your case for for no charge .. I hope this may help in some way .Most important of all is to Fight Fight Fight and NEVER GIVE UP

28/02/2015

Miguel Canet

They did not run the tests on human with JUST cannabis? Why did they always have alcohol as part of the equation? This research tells me nothing.

07/04/2015

Theresa

I agree with Miguel. What was the point of doing the study if they threw it off with alcohol? I also do not believe there is enough evidence. My opinion is that it's unlikely to cause the body harm especially when we have marijuana receptors in our body. Marijuana is a natural cure.

16/07/2015

Mary

My brother was diagnosed in the later part of June with having Hepat cellular carcinoma, cirrhosis, and Hepatitis C. He also suffered with 2 hernias. He was hospitalized for 8 days and they sent him on his way with no hope. No surgery, no chemotherapy, no radiation. They gave him a large prescription for Oxycodeine. I immediately jumped into action as a friend of mine suggested to get him on RSO and CBDs. He has been consuming this for 2 months now and looks to be getting better. The medical community refuses to look into the possibilities of this as being the cure yet many people have become cancer free. He will need some new scans to know for sure but they will not perform any until they are damn well ready. They suck. If nothing else, this man will have a much better quality of life with out the Oxycodein they prescribed. That medicine is junk. He was very confused and could not even function. In the beginning, they removed 3 liters of fluid from his abdomen. He has not needed that procedure since using the RSO and CBDs. Fluid collection in the abdomen is common with cirrhosis and continues to come back even after having it removed. So if using this would cause cirrhosis, why isn't my brother worse.

31/08/2016

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