|Marijuana and the liver
May 25, 2013
What does marijuana do to the liver? I have a liver disease, either crigler najjar or severe Gilbert syndrome and want to know if it is safe for me to use marijuana?
| Response from Dr. Taylor
There is controversy about the impact of marijuana on liver disease progression in hepatitis C. I am concerned about daily marijuana use based on a report such as the one below. I am concerned about daily marijuana use as it MAY impact scarring of the liver, as well as not harmful to the lungs and brain when used daily. In my view not using marijuana at all or using once in a while is safer than daily use. Less is known about the impact of marijuana when the liver disease is crigler najjar or severe Gilbert syndrome, but it will be safer to use less and not to use daily.
Clin Gastroenterol Hepatol. 2008 Jan;6(1):69-75. doi: 10.1016/j.cgh.2007.10.021. Influence of cannabis use on severity of hepatitis C disease. Ishida JH, Peters MG, Jin C, Louie K, Tan V, Bacchetti P, Terrault NA. Department of Medicine, University of California at San Francisco, San Francisco, California, USA. Abstract Complications of HCV infection are primarily related to the development of advanced fibrosis and whether cannabis use is a risk factor for more severe fibrosis is controversial. METHODS: Baseline data from a prospective cohort study of 204 persons with chronic HCV infection were used for analysis. The outcome was fibrosis score on biopsy, and the primary predictor evaluated was daily cannabis use. RESULTS: The median age of the cohort was 46.8 years, 69.1% were male, 49.0% were white, and the presumed route of infection was injection drug use in 70.1%. The median lifetime duration and average daily use of alcohol were 29.1 years and 1.94 drink equivalents per day, respectively. Cannabis use frequency (within prior 12 months) was daily in 13.7%, occasional in 45.1%, and never in 41.2%. Fibrosis stage, assessed by the Ishak method, was F0, F1-2, and F3-6 in 27.5%, 55.4%, and 17.2% of subjects, respectively. Daily compared with non-daily cannabis use was significantly associated with moderate to severe fibrosis (F3-6 vs F1-2) in univariate (odds ratio [OR], 3.21; 95% confidence interval [CI], 1.20-8.56, P = .020) and multivariate analyses (OR, 6.78; 95% CI, 1.89-24.31, P = .003). Other independent predictors of F3-6 were >or=11 portal tracts (compared with <5, OR, 6.92; 95% CI, 1.34-35.7, P = .021) and lifetime duration of moderate to heavy alcohol use (OR per decade, 1.72; 95% CI, 1.02-2.90, P = .044). CONCLUSIONS: Daily cannabis use is strongly associated with moderate to severe fibrosis, and HCV-infected individuals should be counseled to reduce or abstain from cannabis use.
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