There’s no question that cannabis has made an exceptional impact on the medical world. It’s already being used to treat a variety of ailments and diseases including arthritis and plantar fasciitis. Many of its chemical compounds have a strong impact on our endocannabinoid system, which means it can be a powerful anti-inflammatory and pain reliever. Because of these qualities, many people in the scientific community believe it could be used as a preventative measure against liver disease.
Our liver is one of the most important organs in the body, it performs over 500 functions throughout the body and is one of the largest, weighing in at 1.5kg. Some of its most important roles are:
- Creating bile, which aids in the digestion of food and proteins in the stomach.
- Filters toxins from the blood including, hormones and external compounds such as alcohol.
- It regulates blood sugar and cholesterol levels in the body.
- It’s a part of the mononuclear phagocyte, which contains Kupffer cells; these help protect your immune system and make it harder for infection and disease to affect the body.
What is Liver Disease?
Liver disease happens when the liver is damaged and unable to perform its regular functions. It’s more common than many people realise and kills more people annually than diabetes and road deaths combined. Unfortunately, this problem is only increasing – twice as many people now die from liver disease than they did in 1991. The combination of our culture of excessive drinking and poor dietary habits has led our society to become the most susceptible it ever has been to liver disease.
Liver disease can develop into a variety of different types depending on the cause. Here are some of the most common:
- Alcohol-related fatty liver disease
- Non-alcoholic fatty liver disease
- Primary biliary cirrhosis
There are three main stages in the development of ARLD. The first is called Alcohol-related liver disease (confusingly), the second is alcohol hepatitis, and the third is cirrhosis. We are going to explore each of these stages and find out what effect cannabis can have on prevention and treatment.
What is Alcohol-related Liver Disease?
Alcohol-related liver disease (ARLD) normally results from excessive alcohol intake, which causes a build-up of fatty acids in the liver. This can damage and kill important cells in the liver. However, your liver can reproduce new cells to replace the ones lost, if drinking is kept at bay.
Because of this ability to recover cells, many people don’t recognize when they suffer from this stage of ARLD. This has become a real worry not only in the US but the world, as we continuously become more dependent on drinking. But how can cannabis protect against this?
How Could Cannabis Help?
One study, led by hepatologist Terence Bukong, was published in the Liver International Journal in January 2018. They conducted an experiment to try and establish what kind of relationship alcohol and smoking cannabis have when consumed synonymously.
They analysed the discharge records of patients aged 18 years and older, all whom have had an abusive relationship with alcohol, both past and present. They organized this data into 3 groups; non-cannabis users (90.39%), non-dependent cannabis users (8.26%), and dependent cannabis users (1.36%). They used this information in partnership with their knowledge of the four distinct stages of ARLD.
The results showed lower odds in both the non-dependent cannabis users and the dependent cannabis users for developing ARLD during all of its stages. More interestingly, these odds were significantly lower for the dependent cannabis users.
The study felt confident that cannabis had a positive impact on heavy drinkers. Studies like these show just the tip of the iceberg for medicinal cannabis use, so much more research needs to be done in this area.
What is Hepatitis?
Hepatitis is typically the result of excessive drinking or a viral infection, and can cause serious inflammation to the liver. Alcohol Hepatitis is the second stage of ARLD and occurs when drinking is extended over a longer period of time. It often happens in degrees, for instance mild alcohol hepatitis is normally reversible. However, in cases of severe hepatitis, the consequences can be severe and even life-threatening.
Many viral infections such as Hepatitis A, C and E can also cause substantial impact. Their short-term symptoms can be:
- Muscle and joint pain
- Loss of appetite
- Abdominal pain
- Itchy skin
- Feeling and being sick
How Could Cannabis Help?
We know how helpful cannabis can be for the first stage of ARLD, but it can also be a great treatment for the symptoms of viral hepatitis. When our liver becomes inflamed, it is essentially activating immune cells in response to foreign substances. We use this as a defence mechanism to keep our body as healthy as possible.
Cannabis also affects important aspects of our body. It works in our endocannabinoid system and can use our CB1 and CB2 receptors as docks for its two most predominant chemicals, THC and CBD. CBD has very strong anti-inflammatory properties which could potentially help our body fight off viral infections by aiding the liver.
THC is antispasmodic, which also means it can be used as a muscle relaxer for those suffer with symptoms of joint and muscle pain. It has very exciting potential to not only affect the liver directly, but many of the occurring symptoms and side effects of hepatitis.
What is Cirrhosis?
Cirrhosis is the last stage in ARLD, and by far the most serious. It’s caused by an extensive length of alcohol abuse, poor diet, and being infected with hepatitis for an extended amount of time. It can take years to progress and happens when the liver has become too damaged to perform its regular functions, becoming significantly scarred. At this stage, it is unable to repair itself.
A person who has been diagnosed with alcohol-related cirrhosis and doesn’t stop drinking has a less than 50% chance of living for at least 5 more years. It also causes symptoms such as:
- Swollen legs
- Vomiting blood
- Loss of appetite
How Could Cannabis Help?
While cannabis isn’t able to cure this stage of ARLD, it can be used both as preventative measure and a way to control some of the difficult side effects. There has been a lot of excitement among scientists who believe that the cannabinoid CBD may be able to halt the development of scar tissue.
A study conducted in the journal Cell Death and Disease, published in 2011, examined that very claim. They conducted an 8-month experiment where they injected mice with a variety of cannabinoids, including CBD. They found out that HCS, or hepatic stellate cells, were the main culprits in producing scar tissue in the liver, and the mice who were injected with CBD had significantly less of these than their counterparts.
CBD, through the process of apoptosis, helped kill off the HCS which are incredibly harmful in liver disease. Although the study was only conducted on mice, it’s an exciting development in the medicinal potentials of CBD.
What is Non-alcoholic Fatty Liver Disease (NAFLD)?
Obesity is one of the most detrimental health issues of our time with currently 1 in 3 people in America suffering from this. A poor diet of highly fatty foods and little exercise can result in this unhealthy lifestyle. Not only is this a health concern in itself, but it can progress into life threatening illness such as; diabetes, kidney diseases, and liver disease.
A healthy liver should have little or no fat, but people who are either overweight or obese cause liver disease through a buildup of fatty substances on the liver. NAFLD doesn’t happen overnight, it develops in four stages:
- Non-alcohol related fatty liver or steatosis
- Non-alcohol related steatohepatitis (NASH)
- NASH with fibrosis
While cirrhosis can cause permanent damage to the cells in the liver, stages 1-3 can typically be reversed. But obesity can be as much a psychological issue as a physical one, and although the solutions may sound simple, many people struggle to lose weight.
How Could Cannabis Help?
During the NASH stage, people are more susceptible to other health concerns, especially type 2 diabetes. This is why prevention in the NASH stage is considered so important and why many scientists have focused their research on establishing a preventative measure.
A study conducted in PLOS One journal in 2017 explored the impact cannabis use has on NAFLD. In their experiment, they used 14,080 participants; 50% male and 50% female, with a mean age of 39.6 years. These participants were suspected to have developed NAFLD.
They found that in the heavy cannabis use participants, the suspected NAFLD presence was 28%; the light users had 30.5%, the past users had 38%, and those who had never used cannabis had 40.7%. They also found there was no significant gender or age differences. That’s a 22.7% difference in heavy cannabis users compared to non-cannabis users.
This shows that cannabis may have a very important medicinal benefit to NAFLD and have the power to slow down the development of other health concerns.
It’s clear that cannabis has an interesting relationship with liver disease in many different stages of development. Now that in many states cannabis is being legalized, we hope more research will be conducted on its potentials. It’s also important to note that much of this information is just research; if you are suffering from liver disease, make sure to visit your doctor and follow their advice.