Epistomology
Epistemology of cannabis
As physicians, where do we get our knowledge from? For many of us, cannabis receptor pharmacology was not understood when we went through medical school, and even now, cannabis education in medical schools is scant and usually directed at abuse.
This article which appears on Time online, makes it clear that there is a scientific consensus that smoking cannabis is causative of gynecomastia, despite the opinion of cannabis advocates.
So just how strong is that link? This news article does not link to any scientific studies, only the personal opinion of a plastic surgeon. The burst of activity on this topic apparently comes from a different article, written by a plastic surgeon, Anthony Youn from Detroit. In this article, Dr. Youn mentions two articles, one supporting his hypothesis and one negating it.
So can smoking pot really give you man boobs?
"Probably. Although the association between marijuana and gynecomastia hasn't been conclusively proven, it appears very plausible."
Dr Youn appears to be overconfident in his very limited supporting evidence. The studies he is quoting are remote and conflicting, with little followup in the intervening years. Given the ubiquity of both cannabis and gynecomastia in North America, it should be easy to establish this link in a scientific manner, but the evidence does not yet exist.
Most physicians and most people in general do not possess the knowledge or ability to do this kind of fact checking, to separate the opinions of a surgeon who benefits from performing surgery on patients with this condition, from an accurate representation of the medical literature, which would unfortunately be a more boring article.
So can smoking pot really give you man boobs?
While questions about that association have been raised, there is no evidence to support that causative claim. The Mayo Clinic has this to say: "Gynecomastia caused by hormone changes during puberty is relatively common. In most cases, the swollen breast tissue will go away without treatment within six months to two years."