Medical Marijuana for Hepatitis C in Ohio

The viral causes of hepatitis are common in the United states. These viruses can come in several different forms (A, B, C, D, and E) and cause a range of problems. Hepatitis C (HCV) in particular is actually the most common blood-borne infection in the US. In this blog post, we will go over what hepatitis is and the research behind medical marijuana and the virus.

If you or someone you know have any questions regarding medical marijuana, our team of professionals are happy to help! To start the process of becoming a legal Ohio medical marijuana patient, click ‘Get Started’ on our homepage and complete our easy online eligibility survey.

What is Hepatitis?

Hepatitis itself means inflammation of the liver. The liver is a very important organ responsible for a variety of functions including filtering out toxins, breaking down carbs and fats, and synthesizing proteins. When hepatitis occurs, the person may become fatigued, pass dark urine, lose weight unexpectedly, or become jaundiced. Hepatitis may be diagnosed via physical examinations, biopsy, and ultrasound.

There are many causes of hepatitis, including autoimmune diseases, drugs, and alcohol. The most common causes, though, 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.

For our purposes we will focus on HCV. Nearly eighty percent of those infected with HCV end up chronically infected. In general, most people infected do not even know it, as symptoms may not manifest for decades. However, 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 MMJ Help Those with HCV?

We have seen cases where marijuana is used to fight autoimmune diseases, cancers, and injuries, but not many where marijuana is used to fight a virus. This may seem strange, but researchers have begun looking into linking marijuana and HCV outcomes. 

As usual, the endocannabinoid system has been shown to play a role. The endocannabinoid system is made up of both the endocannabinoids produced in the body and the cannabinoid receptors found throughout it. More information of the endocannabinoid system and its effects can be found on the DocMJ blog!

Past research has found that certain cannabinoid receptors are upregulated in cirrhotic liver samples [1]. Other studies have found higher levels of endocannabinoids in the samples as well [2]. This has led to the identification of CB1 receptors as enhancers of fibrosis in the liver, which may lead to cirrhosis. This was shown by blocking or inactivating CB1 receptors and measuring the resulting fibrosis levels. In both cases, fibrosis levels and density were decreased, and progression was inhibited [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].

Other than fighting the virus and its consequences, marijuana may be able to help. Patients have begun to use marijuana to ease the side effects of commonly prescribed HCV drugs. This use case is very common, and many people seem to find success. 

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/

Dr. Jack Rothman

Dr. Rothman is a diplomate of the American Board of Obstetrics and Gynecology.  He has received multiple special awards and recognitions, including Physician of the Year, from the Pinellas County Medical Association (2014 – 2015) and the President’s Service Award from the Pinellas County Medical Society.

He attended medical school at State University of New York Upstate Medical Center in Syracuse, New York, where he also completed his Obstetrics and Gynecology residency. In addition to practicing medicine, Dr. Rothman’s professional career includes being an Assistant Professor at the University of South Florida and Clinical Instructor at the University of Tampa’s College of Nursing.

Dr. Rothman received his Florida Medical Marijuana Physicians Certification in 2016 and was one of the first recommending physicians through DocMJ in the state and is loved by many of those early patients today.