Chronic Marijuana Use As A Potential Cause Of Hypopituitarism

Chronic Marijuana Use As A Potential Cause Of Hypopituitarism

This case report possibly raises as many (or more) questions as it claims maybe to answer!

Abstract #825


Richard Pinsker, MD, Hineshkumar Upadhyay, MD, Narindar Kukar, MD, Prakashkumar Patel, MD, David Lee, BS, Kelly Cervellione, MPhil Jamaica Hospital Medical Center


Hypopituitarism is most often caused by a mass lesion and less commonly by inflammatory, infiltrative, or vascular disease. Tetrahydrocannabinol (THC), the psychoactive ingredient of marijuana, has ability to alter various neural transmitters in the hypothalamus or neural transmitters in the CNS which affect the hypothalamus. We report a case of hypopituitarism seemingly secondary to chronic marijuana use.

Case Presentation

A 37-year-old male presented to the Emergency Department with symptoms of dyspnea on exertion, increasing fatigue, and loss of libido. The patient reported daily use of marijuana for 15 years. There was no history of radiation exposure or head trauma. On physical exam, significant findings of bibasilar rales, gynecomastia, and bilateral atrophied testis were noted. Considering the possibility of hemochromatosis, iron studies and echocardiography were completed, which were normal. Hormonal evaluation revealed low LH (0.2 mIU/mL), FSH (1.8 mIU/mL) and testosterone (22 ng/dL) along with high prolactin (53.3 ng/mL). Further endocrine chemistry revealed ACTH of 6 pg/mL, and cortisol at 0 and 60 minutes following administration of cosyntropin of 6.4 ug/dL, and 9.3 ug/dL respectively. Additional lab studies revealed low total T3 (30 ng/dL), high T3 resin reuptake (49%), low total T4 (3.94 ug/dL), normal free T4 (0.97 ng/dL) and low TSH (0.22 uIU/ml). In addition, growth hormone was within normal limits (5.0 ng/mL) and IGF-1 was low (75 ng/mL; Z-score of -1.3). MRI of head showed a protuberant pituitary gland that was slightly larger than expected size, but there was no identified mass lesion. The patient was started on cortisone 25 mg in the morning and 12.5 mg at bedtime and levothyroxine 25 mcg daily. Subsequent to this his fatigue and edema improved dramatically.


THC impairs GnRH release resulting in lowered LH and FSH, which is responsible for reduced testosterone production by the Leydig cells of the testis. Several studies have also shown impaired cortisol response to stress resulting from cannabis exposure. Similarly, animal models have shown that exogenous cannabinoids suppresses multiple hypothalamic-pituitary pathways, including growth hormone, and thyroid hormone. Given these findings, we postulate that chronic cannabis use, by modulating the hypothalamic-pituitary axis, is a potential cause of hypopituitarism.


Given the climate of increasing legalization of cannabis in the United States, the relationship between chronic marijuana use and its potential effects on the endocrine system warrants further study.

Also, written up in a more journalistic style and with video here:


Image is an old Grays Anatomy drawing of pituitary.

10 Replies

  • Boy, I wonder if they would pay you to take part in further studies. ;) PR

  • On a more serious note. PR

    Cannabis Use in Teens Linked to Irreparable Drop in IQ

  • Boy, maybe you felt a bit naughty there PR, s' OK I was going to offer for the trial too ;)

    but hesitated as I'm on other sites with Chronic pain and see the real world, well either that or LDN - folks will try alternative stuff to help - and who can blame them?

    Personally I see no difference in this to long-term treatment with ADs or similar, most just gather yet more problems. Just my humble opinion, and no darn expert! J (or MJ) x

  • I know it has and is making a difference to my son. He was fine untill uni. now adicted. 25yrs old. cant live without it. His mood changes radically.

  • Oh, FFS! ADDICTED…?! To CANNABIS…?! Pull the other one! Do some fecking research (I suggest you begin with NORML UK's facts page, then move on to the UK Cannabis Social Clubs site). Learn the difference between 'addictive' and 'habit-forming', cannabis may be the latter, but it's certainly NOT the former, it's probably the LEAST ADDICTIVE plant on Earth, there's simply NOTHING in it to which one could POSSIBLY become addicted; the only way that could be possible is if it was being cut with tobacco and, in that case, it's the nicotine in the tobacco to which he's addicted, NOT the cannabis - it is IMPOSSIBLE to become addicted. You're as likely to become addicted to hops, they're the same family (you ever drunk a soporific tea blend…? Most of those contain hops. If you have, are you now addicted…? What's that - you're not…? I rest my case).

    You also claim it's altered his mood, I assume you mean negatively; this also tells me that whatever-it-is he's smoking is NOT cannabis - or it's not cannabis alone - because THC (the cannabinol responsible for the 'high') is probably the best antidepressant on Earth.

    I STRONGLY suspect that your son is cutting his weed with baccy to make it go further; this is a pretty stupid thing to do because a) tobacco IS addictive (why do you think it's legal, and weed isn't…? Precisely that reason; it's addictive, it's harmful, and billions can be made from creating drugs to treat the diseases it causes, and products to help people quit. I know of many folk who've successfully quit ciggies by smoking MJ instead - why would they swap one addictive substance for another…?).

    The Misuse of Drugs Act 1971 is the biggest piece of BS legislation in British legal history; Sativex, licensed cannabis oil used to treat MS, is available on private prescription, yet the plant itself - and all other forms - are classified Schedule 1 (no medical use/significant harm).

    The MoDA is spurious, arbitrary and COMPLETELY unscientific; Professor Dr. David Nutt, formerly the chairman of the Advisory Council for the Misuse of Drugs - and the government's most senior scientific adviser, was sacked by Gordon Brown in 2009 over cannabis being reclassified as a Class B substance (Nutt is in favour of legalisation for medical use, and possible legalisation for recreational use - certainly it ought to be decriminalised).

    Before he was sacked, Dr. Nutt proposed a new 9-point system to judge a substance's harm-potential (you can find this by searching Wikipedia for 'drug classification: making a hash of it?'). Apply each point to alcohol and tobacco - then come and tell me WHY they're not Class A. Cannabis would score 9 'Nos', alcohol 9 'Yeses' and tobacco 2 'Nos' and 7 'Yeses'.

    LSD, MDMA (ecstasy) and psilocybin 'magic' mushrooms, are Class A, alongside heroin, cocaine, methamphetamine and crack, yet their harm/risk potential is FAR LOWER than that or either alcohol or tobacco.

    Class C includes ALL benzodiazepines, sleeping pills, GHB (aka GBH) and anabolic steroids.

    I'm highlighting these classes because they illustrate just how nonsensical the Act is; a lethal dose of most benzodiazepines is around 5-7g, and ALL are addictive. In fact, all drugs classified as C are highly addictive, whereas LSD, MDMA, mushrooms and cannabis are not. Cannabis has the lowest potential for misuse of ANY substance - illegal or otherwise; it's non-toxic, non-lethal, and has ZERO potential for overdose. In order to receive a potentially fatal dose of THC, you'd need to consume around a TONNE in a single sitting - that's approximately between 500k and 1m joints (depending on how much is used) and you'd need to consume them within 15 minutes (approximately 556-1,111 joints per second) - all these stories floating around claiming "cannabis poisoning" or "cannabis overdose" are pure, unadulterated BS; any coroner, or pathologist, who declares cannabis OD/poisoning as cause-of-death, should consider his/her position VERY SERIOUSLY.

    As a member of NORML UK, it is my duty to stamp out spurious, unfounded, nonsense, as it harms our work campaigning for FULL LEGALISATION of the most harmless - and most beneficial - plant on Earth. In India, it's known as ganja, from 2 Sanskrit words meaning 'the herb which makes one wise'. It should be praised and revered, NOT condemned and demonised.

    True democracy and freedom cannot exist whilst Mother Nature lies in shackles. Please, for the sake of the 100s of 100s of people who rely on it as a side-effect-free natural cure (it is NOT a 'drug'; drugs are artificially manufactured, Mother Earth doesn't create drugs, it's a holistic, healing herb), as I do, do some research before you post again! No other substance - natural, nor artificial - can truly be claimed to be a panacea.

  • I had over 30 years of daily use! Only occasionally now! I Have hypothyroidism and sometimes wonder if there is a connection! However I think life is a lottery, Some tobacco smokers get cancer, some don't! I stopped smoking tobacco 11 months ago and am relieved not to be addicted anymore.

  • Umm, I tried it once and promptly collapsed, is the chronic use they are suggesting?

  • It's a topic where people's values (including those that purport to know best) tend to get projected into the mix.

    My own upbringing was far too sheltered to have much experience :) , but it does seem fairly clear from observation that individuals who have smoked it regularly for extended periods do seem to develop a characteristic sort of 'fuzzy' and unfocused sort of vibe. Almost the cliched 'h-i-i-i-i-i-i maa-a-a-a-an' mode of relating.

    Who knows whether or not this a good thing - one thing that's for sure is that continuous striving isn't a recipe for happiness either. It's also possible that other 'substances' and not marijuana use might in those cases be to blame for any observed effect....


  • Stay well clear of the stuff. I personally know of two people who were sectioned into a psychiatric ward because smoking the strong stuff over a long period of time caused them to be extremely depressed and very suicidal. One of them has a mother who has hypothyroidism and is also depressed. Neither mother or son have been tested for Hashimoto's!!

    Although sounding dramatic I have heard how marijuana can help some people suffering with MS (I think). I also remember seeing a program once about how they can do a blood test to see if you're pre-disposed to getting psychiatric problems from using marijuana. Interesting and scary.

  • Please read my response above; WTF your pals were smoking it WAS NOT CANNABIS! THC is an ANTIDEPRESSANT - there is NOTHING in weed to cause any kind of psychosis. Any - and ALL - links between MJ use and mental health issues have been thoroughly debunked and discredited.

    Please do some research before responding. Thank you.

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