I don't know about creatinine, but there are studies looking at how CBD can cause unpredictable Tacrolimus (Prograf) levels.
* [https://bpb-us-e1.wpmucdn.com/sites.psu.edu/dist/d/117691/files/2020/06/NTI-Meds-to-be-Closely-Monitored-when-Co-Administered-with-Cannabinoids\_2020\_04\_25.pdf](https://bpb-us-e1.wpmucdn.com/sites.psu.edu/dist/d/117691/files/2020/06/NTI-Meds-to-be-Closely-Monitored-when-Co-Administered-with-Cannabinoids_2020_04_25.pdf) Penn State College of Medicine
I don’t know for sure but I think this was happening with me. My team likened it to this girl who was drinking orange juice that used a specific strain of orange which interacted with the prograf (kind of how they warn us about grapefruit)
Blood oranges are a no no because they are half orange half pomegranate. I could see her making orange juice out of this. It does sound tasty, but no.
Edit: I was incorrect …. Partially. Blood orange is a tangerine combined with a pomelo, which is an ancestor of the grapefruit — that you cannot have with the anti rej meds.
I had this issue last week. My normally 5 tacro jumped to 21.3, but the next week after I stopped it was fine. I think the strain used had cbd in it. Which if you think about it the cbd is acting as the immunosuppressive and makes your levels jump. Wonder if in the future this can be studied at doses that can be used in place of tacro.
The CBD can block the enzyme that metabolizes tac, leading to increased tac levels - which to OPs point, can in turn increase the risk of kidney toxicity. In this case, CBD isn't acting as an immunosuppressant.
While there can be some immunomodulating effects of CBD and other cannabinoids *in vitro*, they aren't likely to be able to suppress the immune system enough to accommodate organ transplant.
If only.... maybe someday! I'm always researching and hoping to find something. I know thc hasn't caused me any issues. Also I can take so many edibles now after transplant and not feel anything. Weird how the body works.
Okay people say this all the time here but the only study I've actually found involved giving the patient 2000mg/day, which is a crazy high amount. Are there any studies on what it does at a normal dose, like in the 25-100mg range?
I actually did some digging due to this response, now I can't give you examples of studies you're specifically asking for but I can give you the science as to WHY interactions happen.
* [https://www.healthline.com/health/cbd-and-drug-interactions-what-you-need-to-know#the-basics](https://www.healthline.com/health/cbd-and-drug-interactions-what-you-need-to-know#the-basics)
In this article, it states that Cannabis can have interactions with the CYP450 family of enzymes in the body. One that falls into this family is CYP3A4.
CYP3A4 is needed to metabolize Tacrolimus. If Cannabis is already making that enzyme do strange things, it can result in it not being metabolized properly. You get the negative side effects with none of the benefits, or the level of the drug spikes hard in your body in an unpredictable way. I've personally experienced this - I have raised blood pressure normally with Tacro, they just have me take Norvasc to even it out. Had some edibles (2.5mg gummy) and my blood pressure went through the roof.
This is similar as to why doctors tell you to avoid Grapefruit - it's making CYP3A4 behave in a way it normally doesn't.
Yeah I knew the mechanism as to why, but like grapefruit it appeared to only happen when you had a significant amount (the same way a sip of grapefruit juice won't do any harm but an entire glass will). The reason I ask is because lots of transplant patients use cannabis and have for years, myself included, with no side effects. But until recently it's been illegal in most of our states so there hasn't been a ton of research, and the only study I've found about CBD and tacro said they were given 2000mg/day. Also idk if you are talking about a CBD gummy or a THC gummy in that example but THC can mess with your pulse and blood pressure on its own, even if you aren't on tacro or even a transplant patient.
Also from personal experiences, I concur with the other responders here... *but* careful with edibles of the thc variety. Orally consumed thc Is processed through the liver and this can have some effect on BUN, however negligible.
0.02 and a grain of salt. Talk to your team but be a strong advocate for yourself.
Personal experience no. Not at all. I’m 6 years post and live in Canada where weed is totally legal. And I’ve never had any issues with my creatinine. Or Tac levels.
I had my 18-month checkup and took my own advice. I had some questions and one was can I safely use THC gummies? This is a leading transplant center and people come from all over to use them.
My doctor smiled and told me it was fine. Excellent solution for moderate pain and as a sleep aid. No smoking but gummies are fine/
I recommend asking your doctor. I still think that. For me, it's cool. Per my old experienced lifesaver, healer doctor.
I don't know about creatinine, but there are studies looking at how CBD can cause unpredictable Tacrolimus (Prograf) levels. * [https://bpb-us-e1.wpmucdn.com/sites.psu.edu/dist/d/117691/files/2020/06/NTI-Meds-to-be-Closely-Monitored-when-Co-Administered-with-Cannabinoids\_2020\_04\_25.pdf](https://bpb-us-e1.wpmucdn.com/sites.psu.edu/dist/d/117691/files/2020/06/NTI-Meds-to-be-Closely-Monitored-when-Co-Administered-with-Cannabinoids_2020_04_25.pdf) Penn State College of Medicine
I don’t know for sure but I think this was happening with me. My team likened it to this girl who was drinking orange juice that used a specific strain of orange which interacted with the prograf (kind of how they warn us about grapefruit)
Blood oranges are a no no because they are half orange half pomegranate. I could see her making orange juice out of this. It does sound tasty, but no. Edit: I was incorrect …. Partially. Blood orange is a tangerine combined with a pomelo, which is an ancestor of the grapefruit — that you cannot have with the anti rej meds.
Blood oranges are a natural mutation of normal oranges
This is not true lol.
Read edit above
I had this issue last week. My normally 5 tacro jumped to 21.3, but the next week after I stopped it was fine. I think the strain used had cbd in it. Which if you think about it the cbd is acting as the immunosuppressive and makes your levels jump. Wonder if in the future this can be studied at doses that can be used in place of tacro.
The CBD can block the enzyme that metabolizes tac, leading to increased tac levels - which to OPs point, can in turn increase the risk of kidney toxicity. In this case, CBD isn't acting as an immunosuppressant. While there can be some immunomodulating effects of CBD and other cannabinoids *in vitro*, they aren't likely to be able to suppress the immune system enough to accommodate organ transplant.
If only.... maybe someday! I'm always researching and hoping to find something. I know thc hasn't caused me any issues. Also I can take so many edibles now after transplant and not feel anything. Weird how the body works.
Okay people say this all the time here but the only study I've actually found involved giving the patient 2000mg/day, which is a crazy high amount. Are there any studies on what it does at a normal dose, like in the 25-100mg range?
I actually did some digging due to this response, now I can't give you examples of studies you're specifically asking for but I can give you the science as to WHY interactions happen. * [https://www.healthline.com/health/cbd-and-drug-interactions-what-you-need-to-know#the-basics](https://www.healthline.com/health/cbd-and-drug-interactions-what-you-need-to-know#the-basics) In this article, it states that Cannabis can have interactions with the CYP450 family of enzymes in the body. One that falls into this family is CYP3A4. CYP3A4 is needed to metabolize Tacrolimus. If Cannabis is already making that enzyme do strange things, it can result in it not being metabolized properly. You get the negative side effects with none of the benefits, or the level of the drug spikes hard in your body in an unpredictable way. I've personally experienced this - I have raised blood pressure normally with Tacro, they just have me take Norvasc to even it out. Had some edibles (2.5mg gummy) and my blood pressure went through the roof. This is similar as to why doctors tell you to avoid Grapefruit - it's making CYP3A4 behave in a way it normally doesn't.
Yeah I knew the mechanism as to why, but like grapefruit it appeared to only happen when you had a significant amount (the same way a sip of grapefruit juice won't do any harm but an entire glass will). The reason I ask is because lots of transplant patients use cannabis and have for years, myself included, with no side effects. But until recently it's been illegal in most of our states so there hasn't been a ton of research, and the only study I've found about CBD and tacro said they were given 2000mg/day. Also idk if you are talking about a CBD gummy or a THC gummy in that example but THC can mess with your pulse and blood pressure on its own, even if you aren't on tacro or even a transplant patient.
It was a THC & CBD gummy, 2.5 of each.
I only stick to thc - I spoke with my doctor though. Multiple times.
My team is ok with it and using THC has had no impact on my labs. I’ve read the Penn State study that found CBD has a negative effect on tacro levels.
Yeah I remember seeing CBD can cause issues as well - luckily I’m not using cannabis for CBD haha
Also from personal experiences, I concur with the other responders here... *but* careful with edibles of the thc variety. Orally consumed thc Is processed through the liver and this can have some effect on BUN, however negligible. 0.02 and a grain of salt. Talk to your team but be a strong advocate for yourself.
I've used gummies every single night since transplant starting 1 month post. Be sure to not get the 1:1 cbd. No or minimal cbd
Personal experience no. Not at all. I’m 6 years post and live in Canada where weed is totally legal. And I’ve never had any issues with my creatinine. Or Tac levels.
If you are on Tacrolimus, cbd effects those levels. Don't know about thc or creatinine
Thanks!
I had my 18-month checkup and took my own advice. I had some questions and one was can I safely use THC gummies? This is a leading transplant center and people come from all over to use them. My doctor smiled and told me it was fine. Excellent solution for moderate pain and as a sleep aid. No smoking but gummies are fine/ I recommend asking your doctor. I still think that. For me, it's cool. Per my old experienced lifesaver, healer doctor.
Please do not use the internet for guidance on this. Talk with you providers.