Oct
19
2019

How Marijuana Affects Your Reproductive Health

The latest edition of the British Columbia Medical Journal contains an article on how marijuana affects your reproductive health.

Dr. Dunne is an assistant professor in the Department of Obstetrics and Gynecology at the University of British Columbia. She is the author of the linked review above.

Products of the Cannabis sativa plant like marijuana and hashish are most popular in North America. Since October 2018 smoking recreational marijuana is legal in Canada.

The medical community has some concerns, as we do not fully know the long-term effects of smoking marijuana. In the following I will summarize the effects on the male and female reproduction based on Dr. Caitlin Dunne’s report.

Consumption of marijuana

Marijuana contains over 500 compounds, of which 100 are cannabinoids. The ingredient that produces the high a user gets is due to tetrahydrocannibinol (THC). Cannabis is available in different forms. It can be smoked (raw leaves or extract), but it can also be converted into edibles. Ingestion of cannabis creates a longer-lasting experience. The reason for this is that the liver metabolizes cannabis into more psychoactive forms by the liver enzyme, cytochrome P-450. Smoking marijuana can irritate the airways; oral consumption of cannabis products can lead to vomiting, nausea and disorientation.

Contaminants in cannabis such as pesticides, microbial toxins and metals can also be harmful to recreational marijuana users.

Endocannabinoid system

Researchers found endogenous cannabinoids in the brain that function as messenger molecules. They need to activate their targets, the cannabinoid receptors, called CB1 and CB2. CB1 receptors are found mainly in the central nervous system. CB2 receptors are located mainly in the immune system. Reproductive organs have their own cannabinoid receptors. The lining of the uterus contains only CB1 receptors. Ovaries and testicles both use CB1 and CB2 receptors. THC from smoking or ingesting marijuana can stimulate these cannabinoid receptors also. But compared to the body’s own cannabinoids THC is much stronger. This leads to more pronounced effects that concern many physicians.

How marijuana affects your reproductive health: female fertility

The normal functioning of the body requires that the hypothalamus send gonadotropin-releasing hormone (GnRH) to the pituitary to release follicle stimulating hormone (FSH) and luteinizing hormone (LH). The FSH release happens mainly in the first two weeks of the menstrual cycle. LH is released in the 3rd and 4th week of the menstrual cycle. Only when the female hormone rhythm works can a follicle in the ovary mature and ovulate normally. After ovulation the corpus luteum needs further LH stimulation to start prednisone production, which helps with embryo implantation and with sustaining the pregnancy.

THC from cannabis consumption interferes at all the levels of these hormone actions. Cannabinoids suppress GnRH, FSH and LH release.

This is the reason why moderate to heavy users of marijuana have infertility problems. If a woman is a moderate to heavy consumer of marijuana she cannot ovulate normally, and hence she has difficulties getting pregnant.

How marijuana affects your reproductive health: pregnancy

THC from cannabis use can cross the placental barrier. Levels in cord blood are three to six times lower than the mother’ blood level, as the placenta attempts to detoxify THC.

Prenatal exposure to cannabis can interfere with fetal growth and alter neurodevelopment. These children can have permanent effects regarding academic achievement and intellectual capacity. Other risks are hyperactivity, attention-deficit disorder, and impulsivity, but also future substance abuse.

CB1 receptors seem to regulate mitochondria, the energy packages of cells and cellular adenyl cyclase.

The end results are mitochondrial dysfunction and oxidative stress.

Clinical studies regarding cannabis use in pregnancy

Recently a BC study followed 243,140 pregnant women. Over an 8-year period cannabis use rose from 2.2% to 3.3%. Closer analysis of the pregnant cannabis group showed an increased risk of poor perinatal outcomes. 47% had smaller babies than expected (“small for gestational age” is the medical term). 27% were born prematurely, there was a risk of 2.4-fold that the baby died in the womb (“intrapartum stillbirth”). Women who used cannabis often used other illicit drugs as well. They also often had a history of mental illness. The authors relied on self-reporting, which means the cannabis use likely was underreported.

An American study

An American study from 2016 identified 7,851 pregnant patients who used cannabis. Like the BC study they showed a low-birth weight and preterm deliveries. But when the authors controlled for confounding factors, namely mainly tobacco use, statistical significance disappeared.

Often marijuana users are also tobacco users. Tobacco has long been proven to lead to prematurely born babies and babies that are too small for their age. The BC study had controlled for tobacco use and thee results were only due to smoking or consuming marijuana.

How marijuana affects your reproductive health: male fertility

Males on cannabis also contribute to infertility of the couple. The hypothalamic/pituitary/testicle hormone axis needs to also be intact for proper sperm cell maturation to take place. In medical language sperm cells are spermatozoa. The hypothalamus generated gonadotropin-releasing hormone (GnRH), which stimulates the pituitary to release FSH and LH. LH stimulates testosterone production in the Leydig cells of the testicles. FSH stimulates spermatogenesis (production of sperm cells) from the so-called Sertoli cells. Testosterone, along with FSH provides a stimulatory effect on spermatogenesis. Whenever a system is that complicated, much can go wrong. Sperm cells contain both CB1 and CB2 receptors. When the man uses marijuana regularly, THC exposure can significantly interfere with CB1 and CB2 receptors.

Effects of THC on sperm motility, sperm concentrations and DNA

This leads to sperm cell mobility reduction. In an experiment where THC was added to sperm from 78 men in vitro (Petri dishes) researchers simulated high marijuana users and moderate marijuana users.

They found that lower THC concentrations caused 28% sperm motility reduction, high TCH caused 56% sperm motility reduction. Many other publications exist that documented similar results and correlated these findings with infertility of couples.

Studies on sperm cell motility and marijuana use are inconsistent. In 2019 a study came out from the Chan Scholl of Public Health where researchers analyzed 1143 semen samples and 317 blood samples.

They found no difference in terms of findings among men who smoked marijuana versus men who never smoked Marijuana. They looked at sperm concentrations, DNA aberrations of sperm cells.

This leaves many questions open regarding marijuana toxicity.

How Marijuana Affects Your Reproductive Health

How Marijuana Affects Your Reproductive Health

Conclusion

Marijuana affects the reproductive organs, but it is easier to document in women than in men. In women marijuana has an effect on fertility and on pregnancy, which is measurable. However, in men the results of investigations have been conflicting. Here is a statement of the Society of Obstetricians and Gynecologists of Canada. They believe “there is sufficient evidence of harm to advise women to avoid cannabis when pregnant”. Use of marijuana is also not advisable for women who are breastfeeding. At this point a similar clear suggestion regarding reproductive health cannot be made to men, but the in vitro study with TCH suggests that it is wise to refrain from marijuana when a man tries to father a child. Further studies will likely clarify these outlines.

Sep
10
2016

Crazy Food Trends

CNN wrote about strange, crazy food trends that seem to receive a following. I thought it would be interesting to analyze them medically and point out to the reader what’s right and what’s wrong.

Crazy food trend one: Ashwagandha

In India this herb, also known as Indian ginseng has been used as part of the Ayurvedic medicine for centuries.

At the 22nd Annual Anti-Aging (A4M) Las Vegas Conference in mid December 2014 Pamela Smith gave a presentation entitled ”How To Maintain Memory At Any Age”. She gave a comprehensive overview of what you can do to prevent Alzheimer’s disease.

Dr. Smith recommended many other supplements, which I will not explain in detail here: B vitamins, vitamin E and C, carnosine, acetyl-L-carnitine, boron, ginger, coenzyme Q-10 (or CoQ-10), curcumin, vinpocetine, zinc, grape seed extract, blueberry extract, Ashwagandha, glyceryl-phosphoryl-choline, SAMe, huperzine A and DMAE and others. She specifically pointed out that she felt Ashwagandha was very powerful. It helps people preserve their memory, more so than regular drugs that doctors prescribe.

When the benefits of taking CoQ-10 were discussed, Dr. Smith reminded the audience “whatever is good for the heart, is good for the brain”. She recommended reading Dr. Perlmutter’s book from which this phrase was borrowed (Ref. 1).

Ashwagandha is an herb with multifaceted effects. Here is a review by a doctor about the various effects of Ashwagandha.

It does not belong into foods; it should only be in use as a supplement, if your doctor agrees with it.

Crazy food trend two: astrologically farmed eggs

Picture biodynamic farming of eggs with the guidance of the moon. Now you are producing astrologically farmed eggs. The Hemsley sisters insist you should eat these astrologically farmed eggs for breakfast. I don’t buy into this. This is hokey! It smells like somebody is trying to lure money out of your pocket by trying to convince you that there is health benefit to “astrologically farmed eggs”. There isn’t.

What does make sense is to buy eggs that do not have antibiotic residue in them and that came from free-range hens. Yes, I buy organic eggs that are somewhat more expensive. If you like to buy organic omega-3 eggs, this would also be scientifically superior to ordinary hen eggs. There is also the difference of “free run” and “free range” hens. “Free run” does not give you any guarantee for a healthy product, as the birds live in crowded barns and are likely receiving medications to combat diseases. “Free range” birds are hens that have access to the outdoors, and there is less of the overcrowding that is common in a barn.

Crazy food trend three: Cordyceps

There are about 400 subspecies to these sac fungi. Cordyceps has been used in Chinese medicines to help as an aphrodisiac, help improve kidney function in the elderly and also with regard to some anticancer activity. There are very few clinical review papers to substantiate any of these claims; yet traditional medicine insists on using Cordyceps for these purposes. If you want to see a traditional Chinese doctor, do so on your own. But don’t consume food that is prepared with Cordyceps.

Gwyneth Paltrow’s morning smoothie cost more than 200$, so if anything, I would be more concerned about bankruptcy than real nutrition with this type of breakfast drink.

I have my doubts that Cordyceps that kill ants to sprout their spores in their corpses (see Wiki link above) could be of any objective benefit to humans.

Crazy food trend four: blue majik

Blue Majik is just another name for a common antioxidant, phycocyanin. It derives from algae, Arthrospira platensis.It has some similarity with the green spirulina. But just because it seems fashionable right now, does not mean that it is superior to vitamin C as a cheap antioxidant or vitamin E. The creators of blue majik are cashing in on color effects and selling false hopes of better health. You can live very well without it.

Crazy food trend five: cannabis

When I heard that people are starting to mix cannabis into foods, it reminded me about a story I heard from one of my patients in the mid 1980’s who worked in the shipyards of North Vancouver. One day he saw some cookies on a tray in the lunchroom. A co-worker offered some to him and he ate it. After 5 minutes his head started pounding with an excruciating headache and he became nauseous. Shortly after he vomited and started getting a rapid heartbeat. His co-workers laughed and told him that these were very special cookies that they treated with marijuana.

I suspect that whoever baked these cookies used a higher dose of marijuana and my patient experienced a marijuana overdose.

This example illustrates that cannabis has special properties that affect the body.

In the brain it binds to cannabinoid receptors. These are not only present in brain tissue, but also in lungs, liver and kidneys. Even the immune cells have cannabinoid receptors.

There may be a place for chronic pain patients under the guidance of a physician to get medical marijuana. But keep cannabis away from your food. Don’t consume it! You have no idea what you are doing to your body that is full of receptors for cannabis. Cannabis requires treatment like a drug. This means a doctor should prescribe marijuana and the patient s should take it according to doctor’s orders. Like with any drug there will be effects and also side effects.

Crazy Food Trends

Crazy Food Trends

Conclusion

Out of five crazy foods reviewed there are only 2 that merit consideration, but not mixed into food. These are Ashwagandha as a supplement (part of memory loss prevention and others) and cannabis for chronic pain. A physician should supervise both. The remainders are fashion crazes. Unfortunately many people will fall for these fashion trends and lose a lot of money. This will make someone who peddles these items very rich. Is this what you want to do: throw your money out and toss it right into the pocket a huckster? Rethink what you want to do. You may just want to buy organic eggs from chickens that happily scratch away in a farmyard. This is very much down to earth, and nothing “astronomically farmed” is needed.

References

Ref 1: David Perlmutter, MD: “Grain Brain. The Surprising Truth About Wheat, Carbs, And Sugar-Your Brain’s Silent Killers.” Little, Brown and Company, New York, 2013.

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Mar
01
2008

The Culprits For Periodontal Disease

When people think of hazards to dental health, the first thought will be about tooth decay, lack of brushing and flossing and eating candies and other sugar-laden foods. Periodontal disease is often neglected, and yet it is just as threatening to teeth and gums. Destructive periodontal disease will lead to loss of the supporting tissues of the teeth and as a result, there will be loose or shifting teeth and ultimately tooth loss. Generally these findings were seen in older population groups. It was thought that the disease would rarely occur in patients younger than 35 years of age and the theory was that dental plaque was the likely cause. Lifestyle choices were not thought to play a large role. Recent findings told a different story. A cohort study consisting of 903 participants examined self-reported tobacco and marijuana smoking and dental examinations were also done. The authors of the study found that tobacco smoking as well as cannabis (marijuana) smoking was linked with a higher incidence of destructive periodontal disease before the age of 32 years.

The Culprits For Periodontal Disease

The Culprits For Periodontal Disease

In comparison to this dental plaque was not contributing to a higher incidence of periodontal disease in this younger age group. Another risk for destructive periodontal disease in the youngest age group (as young as 12 to 18 years of age) was impaired glucose intolerance (a condition leading to diabetes). Due to those findings it is obvious that brushing and flossing are not the only weapons against periodontal disease. Healthy eating habits and cessation of smoking are equally important for dental health. This is particularly important as heart disease, which is also an inflammatory condition is closely linked to inflammatory disease of the gums and you likely have heard that heart attacks can be prevented by brushing and flossing teeth.

More information about periodontal disease: http://nethealthbook.com/dentistry/periodontitis/

Reference: Journal of American Medical Association 2008; 299(5): pages 574-575

Last edited November 3, 2014