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marijuana and your liver

HelloMD

If you’ve been reading up on cannabis science, you’ve probably seen lots of references to how cannabis is a much healthier alternative to certain pharmaceutical options that can negatively impact your liver.

All kinds of medications can build up in your liver and cause health problems later on, even over-the-counter pills like aspirin. But few people discuss whether cannabis in any form may have an impact on our livers as well.

Are Cannabis Edibles Bad for Your Liver?

Cannabis consumers may be especially interested in how cannabis edibles may affect liver health. Are they OK to consume? Or, because the liver is key to digesting food, do marijuana edibles overwork the liver even more, making edibles a less-than-healthy choice for everyone?

When it comes to the science of cannabis and livers, we unfortunately have very little data to work with. Few studies have addressed liver-related issues and cannabis, and those that have were mostly rodent studies and not direct studies on humans. Still, these studies, while limited, provide valuable insight into the ways cannabis may affect your liver.

To get a better idea of cannabis and its impact on liver health, we spoke with HelloMD’s Chief Medical Officer Dr. Patricia Frye to learn more about how to approach liver health as a cannabis consumer.

When it comes to cannabis edibles, Dr. Frye points out the lack of studies on this specific question. She also notes that she isn’t “aware of any data that suggests that edibles are hepatotoxic,” or in other words, damaging to liver cells.

She also points to the lack of studies on how cannabis—in any form—affects healthy livers. Most of the studies on cannabis and liver health have been designed to look at how cannabis affects folks with liver conditions or health issues that may impact the liver.

So, while we have some data for those with liver issues, for folks with healthy livers, it’s especially challenging to say how cannabis may affect their liver health. There just haven’t been any studies that look at this issue in healthy people.

In some ways, no news is good news. With so many cannabis consumers, it seems likely that medical professionals would have noticed liver issues in folks who take marijuana by now. But it’s always possible that long-term effects have gone unnoticed or have been attributed to other causes. We need more research on human models to really answer the question.

How Marijuana May Benefit Liver Health

While we don’t have much data on cannabis’s effect on healthy livers, we do have some data regarding livers that are already compromised by some type of issue.

And it does seem like there may be benefits to consuming cannabis for certain liver conditions, such as:

  • Chronic hepatitis C
  • HIV
  • Alcoholic and nonalcoholic fatty liver disease
  • Hepatic fibrosis
  • Hepatic encephalopathy
  • Psychosis-related steatosis

When it comes to the research we do have, Dr. Frye says that “CB2 activation and blocking CB1 receptors in the liver may be hepatoprotective—decreasing fibrosis, inflammation and promoting hepatocyte survival and regeneration.” This could mean that cannabinoids which activate the endocannabinoid receptor CB2 but block the CB1 receptor are actually helpful for liver health.

As Dr. Frye explains it, “Hepatic CB1 receptors upregulate hepatic fatty acid production and promote liver fibrosis.” On the other hand, “CB2 receptors can suppress fatty liver disease and protect the liver from damage caused by decreased oxygen delivery.”

With CB2 activation people see decreased:

  • Hepatic inflammation
  • Oxidative stress
  • Fibrogenesis So, activating CB2 receptors in the liver and blocking the liver’s CB1 receptors could be key for helping to address certain liver conditions.

Still, cannabis’s effect on the liver depends greatly on the exact liver condition someone has. For example, Dr. Frye points out that “in patients with hepatitis C, the antiviral effect may be of some benefit. But this does not apply to hepatitis B.” For other conditions, cannabis seems to offer the liver some protection from damage.

Also, among alcohol users, for example, individuals who also consume cannabis showed significantly lower odds of progressing through the stages the alcoholic liver disease and developing:

  • Steatosis
  • Steatohepatitis
  • Fibrosis
  • Cirrhosis
  • Hepatocellular carcinoma

And the data suggests that cannabidiol (CBD) may offer even more protection from nonalcoholic fatty liver disease (NAFLD). According to Dr. Frye, one German study even showed 20% reduced prevalence of NAFLD in patients who took cannabis. These cannabis consumers also saw reduced rates of obesity and diabetes, which are commonly associated with NAFLD.

And a new study on cannabis and liver health demonstrated that cannabis can play yet another a protective role, helping protect the liver in patients suffering from psychosis.

The study looked specifically at liver health for patients suffering from psychosis and found cannabis consumption was associated with a lower risk of liver steatosis in psychosis. Scientists aren’t sure if this protective effect has to do with cannabis’s metabolic effects on weight gain or if marijuana’s positively affecting liver tissue directly, but cannabis certainly seems to be beneficial.

How Cannabis May Be Risky for Liver Health

It’s clear that cannabis can be helpful for certain liver conditions, but it could it also be harmful? As it turns out, there’s some evidence that cannabis may pose risks for your liver as well.

When it comes to taking cannabis for your liver, Dr. Frye warns that “heavy use may exacerbate end-stage cirrhosis.” So if you have this condition, you may want to avoid consuming much cannabis.

Those with chronic hepatitis C may also want to be cautious, despite the beneficial antiviral effects cannabis may have.

A 2008 study showed that daily cannabis consumers had higher incidence of fatty liver associated with chronic hepatitis C. Still, Dr. Frye points out that it’s “not clear if there is cause and effect.” It’s impossible to tell from the study whether those patients were simply more symptomatic, and so consumed more cannabis to address their symptoms or if cannabis was actually causing the fatty liver disease.

There’s also some worry after a study in which high doses of CBD given to mice led to the death of some of the subjects involved. The researchers concluded the mice died from liver issues because they had elevated liver enzymes and increased liver size.

Still, other researchers have noted issues with this research. For one thing, the dose was incredibly high—more than most humans would ever ingest and 100 times higher than the maximum recommended dose for Epidiolex, the only FDA-approved CBD-based medicine.

The CBD administered to the mice was also extracted using hexane—a solvent with known neurotoxic properties. So it’s unclear whether the hexane could have been a factor in the mice death.

In addition, the test was on a very small sample size—only six mice. And the researchers reported that 75% of the subjects died. But as critics have pointed out, this would mean that four and a half mice would have died, a true impossibility. Errors like this should certainly lead people to question the truth of the rest of the data in this study.

Still, testing of Epidiolex also found elevated liver enzymes in human subjects, too. So, we shouldn’t simply ignore this data. But we should take it with a grain of salt and balance it against the data showing CBD can be helpful for the liver in other studies.

If you’re concerned about your own liver health with cannabis, it’s best to talk to a doctor familiar with cannabis who can help you to figure out whether the plant—and in what form—is right for your situation.

Photo credit: VDB Photos/Shutterstock.com

If you’re new to cannabis and want to learn more, take a look at our Cannabis 101 index of articles. And if you have questions about cannabis, ask them and our community will answer.

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Are you harming your liver by eating marijuana edibles? The studies are scarce, but it seems there are pros and cons around cannabis and liver health.

Marijuana May Protect the Liver from Alcohol — But Experts Urge Caution

Share on Pinterest Researchers are actively exploring cannabinoids that could be used to prevent or treat liver disease. Getty Images

The negative health consequences of misusing alcohol are becoming clearer every day.

Regularly exceeding the recommended daily limits of one drink for women and two drinks for men is associated with an increased risk for high blood pressure, stroke, and numerous cancers, including liver cancer.

Recently, researchers sought to understand the effects of regular alcohol and cannabis use on the liver.

While it may not be a good idea to combine intoxicating drugs, recent research finds that using alcohol and cannabis regularly has an unexpected effect on your health.

A 2018 study looked at about 320,000 people with a history of both misusing alcohol and using cannabis to discover what effect, if any, using both drugs had on liver health. What they found out was surprising.

Dr. Terence Bukong of the University of Massachusetts Medical School and the INRS-Institut Armand-Frappier Research Centre told Healthline: “The primary aim of our study was to assess the impact of cannabis use and the development of alcoholic liver disease.”

“Given that no clinical studies had previously evaluated the impact of cannabis use and the development of progressive stages of alcoholic liver disease in humans, we thought that this was an important research area which needed urgent investigation,” he added.

Dr. Hardeep Singh, gastroenterologist at St. Joseph Hospital in Orange, California, told Healthline, “Alcohol increases fibrosis in the liver, it has a direct toxic effect to liver cells and causes them to become inflamed. This causes scarring to the liver — advanced scarring of the liver is cirrhosis.”

He emphasized that the effect was very individual, with some people harmed by much lower alcohol intake than others.

But Bukong and team found that regular users of alcohol and marijuana significantly reduced the risk of alcoholic liver disease (ALD), and the heaviest cannabis consumers benefited the most.

The anti-inflammatory effects of cannabis are well-documented. Previous research had already found that cannabinoid receptors in the liver are potential targets for new ways to treat liver disease.

Activating these receptors with cannabis reduces the inflammation that happens early in ALD, slowing the progression of the disease.

However, Bukong cautioned, “Our studies could not ascertain which cannabis strains were used. So we couldn’t determine the cannabinoid content of what each individual ingested. We also couldn’t ascertain the dosage or modes of use, although it’s most likely through smoking.”

Singh emphasized, “However, some of this scarring goes away as the healthy liver regenerates, so cirrhosis can improve if an individual simply stops drinking. But, some scarring will remain.”

“My research group is currently working to discover which cannabinoids or cannabinoid formulations will provide the best therapeutic benefits for specific liver diseases,” Bukong said.

These anti-inflammatory properties are already being used to relieve pain, colitis (inflammation of the colon), multiple sclerosis, and arthritis.

“Our findings revealed that cannabis users were less likely to develop alcoholic liver disease, and cannabis-dependent individuals were the least likely individuals to develop alcoholic liver disease,” said Bukong.

He’s confident that “specific formulations of cannabinoids might soon be used [to] prevent or treat liver disease. My research group is actively working on important cannabis formulations which we hope will be important drug leads for future testing in the prevention and treatment of liver disease from inflammatory, metabolic, and even viral causes.”

Dr. Singh cautioned that one liver disease, hepatitis, is made worse by cannabis.

“Patients with hepatitis C who used cannabis had way more liver scarring than those who didn’t and more progression of their liver disease. Something in the cannabis could actually be increasing fatty liver disease and fibrosis,” he said.

Singh theorizes that some people have sensitivity to cannabis that influences whether they can benefit from it or not. “You can’t just tell the public marijuana is good for your liver, because there may also be people whose liver is harmed by it.”

He said current treatment, in limited cases, consists of “a short course of a steroid drug called prednisolone, for about eight weeks, which can help combat the effects of alcohol on the liver.”

He added that in some people with fatty liver disease, drinking two to three cups of black coffee per day has helped reverse scarring in the liver, although it’s not known which ingredient in coffee is providing the benefit.

According to National Institute on Alcohol Abuse and Alcoholism (NIAAA), drinking is responsible for roughly 88,000 deaths per year.

Could cannabis help reduce alcohol dependency to prevent liver disease?

A 2017 study looked at a clinical population of people with depression and alcohol use disorder (AUD) to find that marijuana had no beneficial effect, and could have worsened their depression.

The study concluded that — at least in people with depression — marijuana isn’t an effective treatment.

More evidence that cannabis won’t help wean people with AUD off alcohol is demonstrated in research that found that people treated for AUD, who also used marijuana, relapsed sooner than people who didn’t use marijuana.

There is strong evidence that stimulating the natural cannabinoid receptors in the liver can slow or even prevent the development of cancerous liver tumors. The health benefits associated with marijuana and cannabis products in general has created a lot of buzz.

Singh insists that, right now, too little is known about what effects cannabis compounds have on health.

“There are many substances in cannabis and it could be that one is really bad for the liver while another is beneficial. The take-home point is that more research is needed because we need data on both sides, good and bad,” he said.

The fact remains that cannabis is illegal in many parts of the United States and the world. It’s also important to remember that cannabis, like almost all drugs, is not harmless.

However, in a nod to the growing evidence that cannabis has medical benefit, the Food and Drug Administration (FDA) announced it will hold a public hearing May 31 to gather more information on the science, manufacturing, and sale of cannabis compounds.

Recent research finds that marijuana use is associated with a reduced risk of alcohol-related liver damage — including liver cancer.

However, there’s scant evidence that people who drink excessively can use marijuana to overcome a disorder. Research actually shows that it can worsen depression in some people with an alcohol use disorder.

As evidence grows that cannabis and cannabis-derived products can treat or prevent a broad range of health issues, it’s important to remember that marijuana is still illegal in many parts of the world.

Cannabis is a drug, and like any other drugs, has the potential to cause harm if misused.

A recent study shows that certain components in cannabis may help reduce inflammation associated with alcohol use and serious liver health issues. ]]>