Medical Marijuana for Hepatitis C

The hepatitis viruses are very common in the United States. The virus can come in one of several distinct forms including A, B, C, D, and E.  Hepatitis C in particular is the most common bloodborne infection in the country. In this post, we will cover what hepatitis is and how medical marijuana can help those who have been diagnosed.

If you or someone you know have any questions regarding Florida medical marijuana, our team of medical professionals are eager to help! To start the process of becoming a legal Florida medical marijuana patient, click ‘Get Started’ at the top of our web page to complete our online eligibility survey. In just 5 minutes or less you can find out if you pre-qualify for a Florida MMJ recommendation. 

What is Hepatitis?

Hepatitis is an inflammation of the liver. The liver is a vital organ responsible for many functions including filtering out toxins, breaking down carbs and fats, synthesizing proteins, etc. When the liver becomes inflamed, symptoms such as fatigue, dark urine, weight loss, and jaundice can manifest. Physicians will often diagnose hepatitis with physical exams, blood tests, ultrasound, or biopsy. 

Hepatitis can be caused by several different things. Autoimmune diseases and toxic substances, such as drugs or alcohol, may cause hepatitis, but the most common causes are the hepatitis viruses. There are five main forms of the virus (A, B, C, D, and E) and each are different. 

• Hepatitis A: Most commonly spread through consumption of contaminated water or food. Generally mild, with most cases making full recoveries, but can be deadly.
• Hepatitis B:  transmitted through exposure to infective blood, semen, and other body fluids. HBV can be transmitted from infected mothers to infants at the time of birth or from family member to infant in early childhood.
• Hepatitis C: Transmitted through exposure to infected blood. There is currently no vaccine to prevent HCV.
• Hepatitis D: Can only occur in those already infected with hepatitis B, resulting in a stronger disease.
• Hepatitis E: Transmitted through contaminated food or water. 

In our case we will focus on hepatitis C (HCV). About eighty percent of people exposed to the virus end up with a chronic infection. Generally, though, most people with a chronic infection experience no symptoms until much later. As time goes on, those infected may develop cirrhosis (a condition where normal tissue in the liver is replaced by scar tissue) or liver cancer. 

HCV may also cause problems outside the liver. Some examples include autoimmune disorders, insulin resistance, diabetes, and low platelet count. More information on hepatitis C and help for those living with HCV can be found on the American Liver Foundation’s website.

Can Medical Marijuana Help Those with Hepatitis C?

We’ve seen marijuana used to fight both chronic and acute diseases, but few cases where marijuana is paired against a virus. Researchers, however, have begun to look into possible links between marijuana and HCV outcomes.

Of course, a large player within this research is the endocannabinoid system. The endocannabinoid system is composed of both the natural endocannabinoids your body produces and the cannabinoid receptors that can be found across the body. More information on the system can be found on the DocMJ blog!

Some research has found that cannabinoid receptors are upregulated in cirrhotic liver samples [1] and high levels of certain endocannabinoids in these same tissues [2]. This has led to CB1 receptors being identified as strong enhancers of fibrosis in the liver (eventually leading to cirrhosis). This was found by introducing CB1 antagonists (or outright inactivating CB1 receptors) and measuring fibrosis levels. It was found that inactivating CB1 or adding CB1 antagonists lowered the density of fibrogenic cells and inhibited fibrosis progression [3].

Several studies have also been done on the direct effects of marijuana on chronic HCV infections. One such study followed 270 patients and measured the effect of smoking marijuana on the progression of liver fibrosis. The study concluded that those who smoked cannabis daily were more likely to experience progression of fibrosis [4]. A similar study was published in 2008. 204 patients with HCV were monitored and the effect of marijuana use on fibrosis measured. The study also found that daily marijuana use was associated with later stages of fibrosis [5].

Other studies, though, paint a different picture. One study in 2018 showed that marijuana users with HCV induced chronic liver disease had lower incidents of liver cirrhosis, unfavorable discharge disposition, and lower total healthcare costs [6]. A separate study from four years earlier had yet another different outcome. In these cases, marijuana use did not affect biopsy histology or predict fibrosis stage [7].

Outside fighting the virus itself, marijuana may have other uses. Some patients have been using marijuana to combat the side effects of other drugs. This is extremely common and is generally the case in HIV/AIDS and cancer patients who are looking to regain their appetites or fight CINV or nausea. 

In these cases, marijuana has shown to be effective many times both in research and anecdotally. However, it is important to speak with a physician concerning any and all medication and conditions you may have before taking marijuana in any form. 

Summary

The research concerning marijuana and HCV shows no clear indication that it helps fight the virus or hepatitis itself but may be of use when medications for the infection have harmful side effects. Mechanisms linking the endocannabinoid system and hepatitis are being researched and may lead to exciting developments in the future but need further testing for now. If marijuana is taken alongside other medication, it is vital to speak with a doctor concerning any possible interactions.

Resources

[1] https://www.gastrojournal.org/article/S0016-5085(04)02353-4/fulltext

[2] https://www.ncbi.nlm.nih.gov/pubmed/15482346?dopt=Abstract

[3] https://www.journal-of-hepatology.eu/article/S0168-8278(08)00049-4/fulltext#section0045

[4] https://aasldpubs.onlinelibrary.wiley.com/doi/full/10.1002/hep.20733

[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3184401/

[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6174743/

[7] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4144456/