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Pros and Cons of Medical Marijuana with Hepatitis C

Nicole Cutler L.Ac. June 20, 2007

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A 2006 report demonstrated the benefits of marijuana for people undergoing interferon and/or ribavirin treatment for Hepatitis C. On the other hand, recent studies have shown the use of marijuana may increase the acceleration of the disease process and possibly cause decreased immune function. The information presented in this article is not intended to encourage or discourage illegal activity, but rather to provide the reader with proven facts about marijuana’s impact on the liver.

Despite its illegality in most cases, Cannabis Sativa, commonly known as marijuana, remains a popular recreational drug throughout the world. Now, an increasing amount of proposed legislation is seeking to maintain the legality of medical marijuana, allowing for people with certain medical ailments to legally continue using this illicit drug. As of May 2007, 11 U.S. states host medical marijuana programs that allow for the chronically ill and their caregivers to possess and use marijuana for pain relief or other therapeutic purposes.


The basis of any argument in favor of medical marijuana claims that it can relieve pain, reduce nausea, and increase appetite in those with chronic disease. While illnesses such as cancer and HIV are approved for some medical marijuana legislation, Hepatitis C has been largely ignored. However, a 2006 report demonstrated a positive use of marijuana for people with HCV.

While therapy for chronic Hepatitis C is most often based on interferon medication, its value is limited due to the uncomfortable side effects it can induce, such as flu-like symptoms, fatigue, insomnia, loss of appetite, nausea, muscle and joint pain, and depression. These symptoms often lead to interferon therapy’s poor adherence, which manifests either in a dose reduction or discontinuation of treatment—both of which hinder interferon’s potential effectiveness against HCV.

Published in the October 2006 European Journal of Gastroenterology and Hepatology, a Northern California study involving 71 participants demonstrated that moderate marijuana use may relieve interferon’s side effects, helping people with Hepatitis C stick with the full treatment regimen.

Without any evidence of killing the virus, researchers assume that marijuana’s influence on Hepatitis C is due to side effect management, rather than an antiviral effect. Lead researcher, Diana Sylvestre, MD, of the University of California at San Francisco emphasized that the benefit of marijuana was primarily due to improved ability to stay on adequate doses of interferon and/or ribavirin. Sylvestre told that the researchers could not judge whether marijuana had a direct antiviral effect.

Unfortunately for heavy users, this study did not examine a direct dose-response relationship between the amount of marijuana consumed and the likelihood of successful interferon therapy. In fact, participants who used the largest amounts of marijuana had less success with Hepatitis C interferon therapy. Because the researchers did not perform pre and post-treatment histological assessments using paired liver biopsies, and did not measure immune parameters, the claim of marijuana’s value in Hepatitis C therapy remains limited.


Ever since the results of the 2006 California study were published, experts have been expressing concern about the health implications of Hepatitis C patients using marijuana. A French study of untreated individuals with Hepatitis C (those not taking interferon therapies) showed that, compared with occasional or non-users of the drug, people who used marijuana daily were:

  • more likely to have severe liver fibrosis
  • at a higher risk for rapid fibrosis progression.

At the 2007 42nd Annual Meeting of the European Association for the Study of the Liver in Barcelona, Spain, the same French research team reported on a study linking marijuana use and liver steatosis. These researchers noted that marijuana binds to two receptors, CB1 and CB2. Recent experimental data suggests that activation of CB1 receptors increases steatogenesis (liver fat accumulation). Stimulation of the CB1 receptor is assumed to be the reason daily marijuana smoking is associated with the development of significant hepatic fibrosis.

In addition to the discovery that smoking marijuana accelerates liver fibrosis, concerns remain about its impact on the immune system. Experts explain that the use of marijuana may suppress immune function. Cannabinoid receptors are confirmed to be present on the surface of immune cells, and when the cannabinoid molecules from marijuana bind to these receptors, the person’s resistance to disease is compromised. Therefore, various studies have concluded that using marijuana can enhance the disease process.

To Use or Not to Use

While the decision to use marijuana with Hepatitis C is highly personal, taking these facts into consideration can help clarify its proven impact on those living with this disease. In particular, advocates suggest that medical marijuana laws and programs who specify its use for patients with specific conditions such as AIDS and cancer should also include people with Hepatitis C. Additionally, if you have Hepatitis C and are currently struggling with side effects of interferon therapy, it may be worth your while to investigate medical marijuana use in your area. Whether it’s breaking the law or not, any person with Hepatitis C considering smoking this drug should be aware that marijuana has been linked with increased liver fibrosis and possibly with decreased immune function. Whatever you choose to do, make your decisions based on what you believe will enhance your odds at fighting the infectious virus, not on what will hamper them.


Cabral GA, et al., Effects on the Immune System, Handbook of Experimental Pharmacology, 2005.

Klein, TW, et al., Marijuana, immunity and infection, Journal of Neuroimmunology, March 1998., Senate votes to allow medical marijuana permanently, Ray Henry, The New York Times Company, May 2007., Cannabis Use Predicts Severe Liver Steatosis in Patients with Chronic Hepatitis C, Liz Highleyman,, 2007., Moderate Cannabis Use Associated with Improved Treatment Response in Hepatitis C Patients on Methadone, Liz Highleyman,, 2007., Hepatitis C — Current State of the Art and Future Directions, David Bernstein, MD, Medscape, 2007., Daily Cannabis Smoking as a Risk Factor for Fibrosis Progression in Chronic Hepatitis C,, 2007., Marijuana Aids Therapy, Rick Weiss,, September 2006.

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  • Jtoohey1

    I used cannabis sativa most all my life,since 8th grade,I am now 51.When  I gave free blood in 1993,(absurd what hospitals charge us for blood)I was told I have Hep C. In 2011 I was told my Gall Bladder was bad & had to be removed immediately! The Doc looked at my Liver during surgery & say’s my Liver was pink & cotton candy colored! I have had Hep C since I was 33,& because of Hep C I never would drink much alcohol.If sativa hurts the Liver & I used it most of my life why don”t I have Fibrosis yet? It”s a darn shame what the cost of treatment is for Hep C. My Uncle was treated for Hep C  &  had to pay $1000 bucks each dose for more than a year after Insurance paid their part.(1 a month). J. 2-E………………..

    • Jenn_BLS_DoomCrewInc

      Dear Jtoohey, your story inspires me. As I posted earlier, my nephew was just diagnosed-and I’m desperate looking for information to help him. I don’t know when he got it, or how-But he’s been sick with these symptoms for YEARS and NO DOCTOR EVER checked him for Hep C up until this past week. He’s always in such pain and depressed. I know for a fact depression causes pain as well. Physical & mental pain. He quit taking his pain meds (they make him very nauseous) and quit smoking marijuana as well, he never eats or sleeps anymore. I’m so worried about him. Thank you for your post. I’m going with him to talk to his doctor tomorrow when we go back to see what meds they’re going to put him on, about using this alternative also. Thank you again~ x :)

  • Jenn_BLS_DoomCrewInc

    If it does cause decreased immune functions, can’t an increase in protein (Which helps fight infections, heal damaged liver cells) work to counteract that? In “Nutrition Therapy & Pathophysiology,” authors advise that HCV patients maintain a protein level of approximately .45 g to .55 g per pound of body weight. A 143 lb. person would require 65 g to 78 g of protein daily. Unless they’re at the end stage of liver disease. Which intake would be decreased. I don’t know, but I think that Marijuana for medicinal purposes including HCV is a PRO. Plus there are different strains of it being made every day. Look at “Treat Yourself Magazine”, which does clinical & trial studies and gives facts about all the new strains and the benefits they offer. My nephew just turned 20 and was diagnosed today with HCV. He has NEVER been a drinker, needle junkie and has only had ONE sex partner his entire life, (with his fiancee). My heart is breaking for this child who is more like my son. My mom keeps trying to blame the fact that he used to smoke weed as the reason he has HCV. I HATE that. I have smoked since I was 14, I am 33 and I have severe asthma. Sometimes marijuana is my ONLY help. I live in NM and we are a legal state. I have an inhaler that costs me $198.00 and pills that cost $350.00 PER MONTH, when Medical marijuana works just fine to open up my bronchials-and is so much cheaper. I think a new study must be performed before we say it’s a CON for HCV. The ONLY thing MMJ is guilty of in my opinion, is giving you the munchies. If you keep ONLY healthy foods in your house, as I do; You’ll have no choice but to eat what you have, staying healthy. Blessed Be. Please don’t hate, it’s just my own honest opinion.

    • carrie

      i use cannabis for my hep c no problems with immune at all in fact it keeps my weight up before i started cannabis i was sick all the time was malnourished i still have problems but they r minor and i spend a lot less time in the drs office n the hospital but as far as making my liver worse its actually helped it cause i dont have to take any pills the only pills i take now are my med for menopause one pill a day

    • Kenyetta Brown

      I have read, (in more than one book), that natural remedies,(such as marijuana), cannot be patented. That is why it is probably such a big deal. If people don’t get sick, the medical field won’t make money. The sicker people are, the more money the doctors & hospitals make off of them. The meds that doctors perscribe are super expensive & so is the hospital visit. Nothing is wrong with marijuana. I have never heard of anyone over-dosing on marijuana or having side effects except for hungary, sleepy, & happy. Marijuana is good for pain, insomina, & to increase appetite. It’s calming & much more safer than alcohol or any other drug. I think people just like to talk badly about marijuana because they don’t understand it, probably because they never tried it. Plus they put out such bogus lies about marijuana such as Reffer Madness, (what a load of nonsense, thank Randolph Hertz for that with his smear campagin against marijuana). Hemp & Marijuana were supposed to help save trees & the environment, but the big wigs back in the day were making money in the timber business, so they got the cops, government, (President Nixon), & other big wigs to be against marijuana for his own personal gain. Eating marijuana is good for you. Smoking anything, (even marijuana), & putting toxins into your lungs is bad. In my honest opinion, there is nothing wrong with Marijuana, I just think some people are mis-educated. And Marijuana does help with asthma. I perfer Marijuana instead of those inhalers.

  • Joe

    Marijuana smoking does not appear to cause progression of liver fibrosis in the Canadian HIV/HCV Co-infection Cohortstudy
    APRIL 2012

  • Greg G.

    thank you for sharing that link Joe :)

  • SG

    yes thanks. i was able to bring this in to my hepatologist and she was unaware of the study. thanks again :)

  • Kenyetta Brown

    Have you tried Tincture oil? It is medical marijuana thc oil. It comes with a dropper so you can measure the dosage. The ingredients are thc, honey, vegetable oil, glycerin, & vitamin C. It is natural & organic. The side effects are hungary, sleepy, & happy. It will definately increase his appetite. He can just drop the tincture oil on his tongue & let it absorb since he doesn’t want to eat. It is also a pain reliever. Check it out. I hope it helps. Goodluck & God Bless! :-)

  • Kenyetta Brown

    AWESOMENESS! I don’t take pills either, only medical marijuana, thc oil, & other edibles. I found out that things like tylonal can cause liver damage. What a horrible side effect! Marijuana doesn’t have side effects except hungary, sleepy, & happy! :-)

  • Kenyetta Brown

    My Father-In-Law has cancer of the mouth from smoking ciggeretts all of his life, & to top it off he has liver failure from drinking all of his life. Because of his liver failure, he can’t process certain foods or sugar. Edibles have lots of sugar. So my question is: Is it ok to give him medical marijuana tincture oil? It has honey in it, so I don’t know if it’s good to give it to him. I can also get cannabutter, (which is marijuana made into butter), to cook his food with. If I did cook his food in cannabutter, would it help him with his pain & nausea? I don’t want to give him the wrong thing & it harms him. I did talk to a doctor, & she said that it would be good for him to vaporize marijuana & inhale it. Vaporizing marijuana takes out all of the tar & other carcinogins you may inhale into your lungs while smoking marijuana in a joint, blunt, bong, or pipe. I’m not sure he should be smoking/vaporizing anything, because he already has cancer of the mouth. Does anyone have any positive info that I can use to help him?

    • mecurt

      I just started hep c treatment last night. had my first dose of interferon last night at 8 and now 15 hours later I still feel fine!! I have smoked marijuana the entire time though, I also lost my gall bladder from the damages from hep c but my liver is still full functional, no complications other than gall bladder. I do believe I’ve had it for about 7 years known for only 2 years and none of my children have it which is a blessing as well! to jtoohey1…I also can’t afford the treatment either. it’s asinine, but I contacted the drug company( Pegasus) and they worked it out within about 5 days for my entire treatment to be paid for and a pharmacy called me that day and over nighted by UPS my meds. check into!! it’s so amazing how much they are willing to help. now I get to spend 6 months being treated and be free of this virus! I’m so happy and I’ll likely depend on my main lady MaryJane to help me the entire way! :))

      • oscar meza

        Ms Brown I liked your story & I wish you all the luck in the world. I would really like to follow your progress if you dont mind I have been living with hep c for around 15 to 20 years now I think I got it from contaminated tatoo needles. Well Im 49 dont take care of myself much I have severe fatige & knee joint pain Im thinking of starting treatment.I would love to hear how things go for you.My name is Oscar my e-mail address is Thank you.

      • kathy

        Mrs brown, do u live in an area where u can get tincture oil easily? must be nice. I’ve had hep c for 18 years, my ast and alt’s are super low, but cause i don’t drink, and i’m knotty w/mj, there is no help for me!

  • dj

    Cotton growers were the big culprit in making marijuana illegal.

  • RevealHim

    Milk Thistle, Milk Thistle, Milk Thistle. I use VegLife 175mg and take 1 every morning. I’m 5’10, 165 lbs. 300mg per day is recommended. The active compound in milk thistle will insulate the liver cells and protect them from damage by the virus. Because the liver can regrow, cell production is prompt. The AFP Alpha-fetoprotein will increase as the liver is repairing. It does not stop the virus but increases liver health and function. AFP is present in the blood when a baby is developing in the womb (Growing its liver) and with the use of milk thistle slowing cell death, more cells increase and rebuild. Its important to have ultrasounds, MRI’s or CT’s annually to insure no tumor growth. I’m 55, Hep-C for over 35 years, and I still have my factory liver. Research MilkThistle, I did and is recommended quietly by my hepatologist.

  • MindFury

    That study they did in France had no control group that didnt drink alcohol. I’m getting denied treatment because the doctor says it does cause fibrosis,because of that outdated study. Also says she has seen it first hand. It’s the one thing that kept me able to function through the side effects of the disease. Don’t ever come to New Mexico if you have Hep c and need treatment if you use Marijuana to fight the symptoms. It’s been my death warrant.

  • Cyndi Phillips

    The irony of worrying about using pot while having us use interferon is not lost on me. I tried treatment once and the Intefereon screwed up my head so bad I can’t use a checking account or remember appointments even years later. I’m still positive for hep c but I’m waiting for the Interferon free treatments which will hopefully be out in the next 6 months or so. I advise anyone considering treatment to wait if at all possible. They don’t tell you what Interferon can do to you when you sign up for treatment. Liars that don’t care if we come out the other end whole or not. I had to test clean for drugs including pot before I was allowed to start treatment but I did smoke it once I was on it, mostly because the doctors ignored my pleas for help with side effects like nausea and pain. I was given the treatment drugs and then ignored. No help from the doctors with my treatment, I was on my own. It was horrible and worse yet I’m still infected. Turns out I have two types of hep c at the same time. Just found that out recently. That means it was probably the blood transfusions I got years ago when I lost my baby, tubal pregnancy. Doctors gave me this disease, doctors failed me during treatment. I’m hoping to find an honest one when the time comes, so that I can have my life back.

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  • Geese

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