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Everybody knows that cannabis is "supposed" to be harmless. However, for people who have MTHFR mutations, marijuana smoking poses serious, sometimes even deadly cardiovascular complications. Here's how to know if you could be part of that group.

Marijuana is a "soft" drug that fewer and fewer people give a second thought. There are valid medicinal uses for different strains of marijuana (although no single strain of pot helps for every disease in every user). More and more countries and localities all over the world are lifting legal restrictions on smoking, vaping, and eating marijuana. Some people who have something called an MTHFR mutation, however, are at risk of serious complications from smoking pot unless they take some sensible, easy precautions.

What Is MTHFR? What Is an MTHFR Mutation?

Everybody knows that vitamins are vital. The form vitamins take in our food, however, is not always the form in which our bodies use them. This is particularly true for vitamin B9, also known as folate (in the form in which it appears in food) and folic acid (the artificial vitamin used in fortified foods and nutritional supplements). 

Our bodies don't use folate or folic acid. These food or supplement substances have to be transformed into a compound called methylfolate to enter the cells that use them. The body uses an enzyme called methylenetetrahydrofolate reductase, also known as MTHFR, to make the metabolically active form of the vitamin. About 40 percent of the population,however, has one or more mutations in the DNA that codes the RNA that codes the sequence of amino acids that make up the enzyme. [1

These mutations aren't so severe that the enzyme doesn't work at all. It just doesn't work very well. Usually these MTHFR mutations just involve one or two amino acids in a sequence of over 1300 amino acids strung together in a precise sequence [2]. The defective enzyme can still do about 10 percent of the conversion the body needs it do do [3].

But that's not enough to prevent two serious problems. Folate from food and folic acid from supplements don't go inside the cells where they are needed, and they even interfere with the absorption of the small amount of methylfolate that actually gets made by the defective enzyme. As a result, cells don't replace themselves fast enough. This is a huge problem for a growing embryo, of course [4]. And the body at any age isn't able to regulate the production of an inflammatory substance called homocysteine [5].

MTHFR and Homocysteine Can Cause Problems in Cannabis Users

High homocysteine is associated with cardiovascular problems. It's an inflammatory compound. It keeps blood vessels from responding to the chemicals that relax them and ease the flow of blood. Making matters worse, it also is associated with the formation of more blood clots. The blood vessels tighten up when they need to relax [6], and this makes them more likely to catch clots.

This problem is made worse with the use of inhaled (smoked or vaped) cannabis. There have been cases of young, otherwise healthy people who developed blood clots in the lungs after:

  • heavy use of cannabis and
  • high homocysteine levels [7].

It isn't just smoking pot that does this. It's a combination of smoking pot and having an MTHFR mutation that causes high homocysteine (and high homocysteine isn't entirely about folic acid levels, either). 

If you don't have an MTHFR mutation, the effects of smoking pot are added to the effects of smoking tobacco in determining your lifetime risk of cardiovascular disease [8]. Smoking pot doesn't cause a huge increase in your risk of pulmonary embolism, heart attack, or stroke, only 10 percent or so. But if you do have an MTHFR mutation, you have real risk of those diseases even if you are not yet 40 years old [9]. The problem is common enough that between 15 and 37 percent of all trips to the ER for cardiac emergencies involve the use of cannabis [10].

What Do You Do If You Have an MTHFR Mutation and You Use Cannabis?

You probably think I'm going to tell you to give up cannabis, don't you? I'm not. I'm going to tell you that if you use cannabis regularly, you should get MTHFR testing. Then if you are part of the 40 percent of the population who carries one or more mutations of the MTHFR genes, you need to be taking a supplement called methylfolate. This simple step can protect your from the metabolic errors that cause the accumulation of homocysteine in your body that can become the prelude to cardiovascular catastrophe.

Even if you don't use cannabis, if you carry a MTHFR mutation, you will benefit from methylfolate. It's inexpensive. It's non-toxic. It can save your life.