One of the nation’s first licensed medical doctors to treat patients with cannabis spoke to a packed house at the Laytonville Garden Club on June 15 about the remarkable results he’s had treating inflammatory bowel disease (IBD), Alzheimer’s disease, and many other conditions with cannabis.
Dr. Jeffrey Hergenrather, a Sebastopol physician and president of the California Cannabis Research Medical Group, said the reason cannabis is effective in treating many diseases is because all animals, with the exception of insects, produce their own cannabinoids, called endocannabinoids that work to protect the body from cancers and other injury. Animals have cannabinoid receptors in their brains, hearts, livers and gastrointestinal systems that can respond to externally supplied cannabis products.
“Pain signals go down when endocannabinoids are released,” said Hergenrather, a former Sonoma County emergency room physician. “When we’re injured, endocannabinoids go to help. . .They are doing things in very primary, elemental ways in keeping our bodies healthy. It’s homeostasis.”
The Laytonville Garden Club invited Hergenrather to speak as a part of its Cannabis Renaissance series.
On July 13 at 4 p.m. the group will present “Water Regulation, Cannabis and What We Can Learn from the Wine Industry.” Panelists will be John Nagle, a Sonoma environmental compliance consultant who works with small vineyards, and Hezekiah Allen, a Humboldt environmental consultant and lobbyist for cannabis farmers.
Hergenrather earned his medical degree from Brown University in 1975. For some years he was house doctor for the legendary alternative community called The Farm, in Tennessee, where he treated more than 1,000 residents, according to a report in O’Shaughnessy’s magazine. Many folks at The Farm reported that smoking pot regularly helped relieve everything from menstrual cramps to migraines, with “no significant adverse effects.” Ever since then, Hergenrather has incorporated cannabis into his private medical practice —first secretly, now openly.
Treating inflammatory bowel disease
Although Hergenrather’s study of inflammatory bowel disease in 38 patients was small and did not include an evaluating institutional review board required by major scientific journals, he presented his research in “Cannabis in Primary Care,” a 2013 continuing medical education course he created that was accredited by the University of California at San Francisco.
He believes his study of IBD patients provides a model on which physicians and patients can measure the effectiveness of cannabis in treating many disorders.
Hergenrather explained to the garden club audience that the human body has two types of cannabinoid receptors— CB1 and CB2 receptors. In inflammatory bowel disease, cannabis can activate both kinds of receptors in the lower esophagus, stomach, small intestine, colon and rectum. The cannabis “down-regulates” or slows intestinal motility and secretions, decreases pain and inflammation and lowers the risk of tumors. Patients’ appetites, moods, mobility and overall quality of life also improved.
Most of Hergenrather’s bowel patients smoked or inhaled cannabis with vaporizers; half stopped using their prescription medications, except during flare ups.
The downsides of the treatment for his IBD patients, according to Hergenrather, were the fear of discovery by employers, feeling too sleepy or spacey, and the costs.
Another potential risks of cannabis smoking that he cited was bronchitis. He also said megadoses of concentrated cannabis oils may affect the liver by competing for breakdown pathways with other medications.
Success with Alzheimer’s symptoms
Hergenrather showed slides and graphs measuring amazing results with a number of his patients at Primrose, a Santa Rosa assisted living facility for adults with Alzheimer’s and related forms of dementia. Most of the patients have symptoms such as moderate to severe memory loss, mood swings, aggressive behavior, agitation, severe depression, and mobility and other neurological problems.
At Primrose— beautiful, fenced and gated, according to Hergenrather — patients are often difficult to control. Those who tend to be aggressive, for example, can forget who their roommate is and may physically attack their roommate, whom they mistake for an intruder.
Traditionally, the only way to keep Alzheimer’s patients under control and out of danger to themselves, staff and other patients, is by prescribing what Hergenrather called “black box warning” drugs, including major sedatives, anti-psychotics and anti-depressants, some of which state on the box: “Warning: Increased mortality in elderly patients with dementia-related psychosis.” In other words, the drugs used to treat many Alzheimer’s patients are also killing them.
Working with the nursing staff and the approval — often the encouragement of —patients’ families. Physicians are putting participating patients on high-THC cannabis, including edibles and tinctures, that he says can impact the evolution of the disease by inhibiting amyloid aggregation — nerve tangles in the brain that cause many Alzheimer’s-related problems.
Hergenrather described an array of Alzheimer’s patients, all of whose symptoms had improved after using cannabis. They included an “alpha” male with aggression; a person who obsessively picked their skin, and a “5150” mental patient with extreme agitation and aggression. Like Hergenrather’s IBD patients, many of his Alzheimer’s patients refused to go back on their old medications after their course of cannabis.
High THC or high CBD cannabis?
“I don’t know if the results are same with high CBD cannabis,” Hergenrather said. “THC helps agitation, anxiety, psychosis and restlessness.”
The doctor emphasized that every patient is different and responds differently to cannabis depending on the strain, ratio of THC to CBD, amount, and delivery system used. Edibles, for example, are slow to take effect but last much longer and may be stronger-acting than smoked or vaporized cannabis.
By ingesting the raw green plant instead of smoking the dried plant, he said patients can increase their cannabis dose without the risk of getting stoned. That’s because heating cannabis “decarboxylates” THC, making it psychoactive.
Patients can increase their cannabis dose significantly without getting high by ingesting the plant’s raw green flowers. For example, a bud that would take a week to smoke, he said, could be put it into a smoothie and ingested two or three times a day without producing a high. Eventually, he said, a plant’s terpenes, which are aromatic hydrocarbons that have a protective function for the plant, can make people high if they are ingesting large amounts of raw cannabis.
“One dose is life changing for some patients,” he said. Some of the “toughest” tumors, including gliomas in children, respond well to cannabinoids.
One remark the physician made surprised some Laytonville herbalists in the audience who have switched out many of their high THC strains of cannabis for non-psychoactive high-CBD strains. Hergenrather said that for political not therapeutic reasons many researchers are using high-CBD cannabis in their studies. “It doesn’t have the stigmas of feeling good and getting high,” he said.
He said he regrets that Kaiser Permanente “won’t allow patients to use cannabis” despite the request of many patients and their families. “They think of it as a drug of abuse without medicinal value. They don’t believe it does anything.”
Teens and cannabis
Throughout his presentation Hergenrather fielded questions from the audience, including one from a woman who asked his opinion of a recent Laytonville presentation by educator Ralph Cantor on cannabis and the teenage brain. In his Healthy Start Coalition talk, Cantor presented data suggesting that regular use of marijuana by children between the ages of 13 and 17 could impair brain development and character formation.
Hergenrather dismissed that possibility and said he could as easily argue that “playing video games” could have a significant effect on a teenager’s brain.
“I don’t see it as a problem,” he said. “I recognize a lot of youth are using cannabis. Some kids stay right on track and pursue career paths. . . I’m not seeing dysfunction.”
Treating cancer
Hergenrather said he’s had good results removing skin lesions, from keratosis to carcinomas, by placing concentrated cannabis oil on them.
“For keratosis, try a Band-Aid with cannabis oil for a month. The more concentrated the better.”
Not all tumors are sensitive to cannabinoids. Hergenrather said common lung cancer, and some thyroid and breast carcinomas do not appear to respond well to cannabis treatment.
Cancers that have responded, he said, are: neuroblastomas; certain types of breast cancer; hepatic, renal, pancreatic cancer; colorectal, cervical and prostate cancers; Hodgkins, Non-Hodgkins, and Mantle cell lymphomas,; some leukemias; skin cancers, and sarcomas.
Cannabis alone, he said, without some positive lifestyle changes, cannot guarantee good health. “We’re kind of lulled into this sense that a bad diet is okay.”
(Jane Futcher, author of Women Gone Wild, has been writing regularly on local marijuana issues.)
As a molecular pharmacologist who has studied receptors homologous to the CB1/2 I am aware of the few molecular-clinical studies of CB receptors. I agree with Dr Hergenrather that the effects of CB are truly systemic (many and varied tissues/organs) and beneficial. Further, the time has come for us to press the establishment to fund studies so that new important uses of the structurally varied cannabinoids and misinformation can be clarified. I am not yet convinced that chronic use by adolescents is a good idea and may alter development, but again controlled studies are desperately needed to sort this out.
Richard Clark, PhD.