(Nhia Moua/Unsplash)

Why our endocannabinoid system has to work harder when we wear face masks

The digestive system is one big hole, from the mouth to the other end. Yet, it is a gas in your blood that connects face masks and your butt. We breathe out inflammatory gasses produced in our lungs. So, in theory, a covered face means a bigger workload for our bowels, kidneys, and endocannabinoid systems.

nitric oxide connects face masks and your butt

A partially-covered face means less reactive nitrogen and oxygen species can be properly exhaled and more will be pushed out the other end. Photo (1).

Beyond CO2 poisoning

Contrary to the direction of at least one study (2) with zero adequate controls (3), CO2 hardly passes from the lungs into the bloodstream. So, analyzing CO2 levels in blood does not give an adequate result and contradicts several other studies (3-16) including research by the CDC (14.) Eventually, the build-up of reactive oxygen and nitrogen species that we normally exhale might pose a concern as well, though (15.) After all, if those gasses become trapped in our masks, as another study suggests, (16) we will be forced to rebreathe viral particles, cytokines (17), and free radicals. And they have to go somewhere since these particles do circulate back into our bloodstream. If we don’t breathe, spit, or sweat them out then that only leaves two options.

It connects to an increased risk for gastrointestinal damage if face masks do increase a load of free radicals up the butt, in the endocrine system, and in the bowels (18). This often presents itself as any of the following – celiac or wheat sensitivity, IBD, IBS, or cancers of the kidney, bladder, and colon.

Photo courtesy of @CaseyhouseTO

Princess Diana touched an AIDS patient

Science sometimes takes time to catch up with reality. HIV became a mysterious and heavily misunderstood virus shortly after 1981 (19-22). Sadly, the populous feared each other since everyone thought simple touch could spread the disease, not just unprotected sex. (23)

That was before Princess Diana made an appearance in front of a global audience on BBC and shook the hand of a man dying from HIV. (24) She dawned no PPE which shocked the world. And again, she wore no PPE while hugging a seven-year boy in 1989, according to the LA Times. (25) AIDS was strictly referred to as a gay disease with a homophobic focus on butt sex, (26) despite being connected to an engrossed fear of touch without face masks and gloves. (27) Gay men found themselves banished into quarantine without reason.

The Princess (28) changed the stigma; a welcoming advent to those who were dying needlessly alone despite their need for compassion. It is stark how much science and social nuances have both changed and repeated themselves in less than half-a-century. True, the transmission of SARS-COV2 and HIV cannot be compared in any light. (29) But, each global response (30) was initially wrought with fear (31) and ignorance (32) that simply perpetrated greater levels of harm. (33)

Photo courtesy of BC Human Rights Commissioner.

Crying for oxygen without a solution

For many people, masks provide a harmless form of collective protection from coronaviruses for their shoulder neighbor. (34, 35.) Other men and women, however, should instead rely on social distancing. Some nurses will understand this since they must plea with patients suffering from Congestive Heart Failure. (36) These patients must watch their bedside neighbor receive supplemental oxygen (37) while they suffer from constant breathlessness. This is because the disease fills the lungs with fluid and disrupts the heart’s ability to transfer blood-gasses. Sadly, however, oxygen therapy will not stop the feeling of suffocation (38) in patients with this heart condition. This is due to the difference between dyspnea (breathlessness) (39) and hypoxia (40) (low blood-oxygen- levels).

COPD has multiple phenotypes. Blue bloaters struggle to exhale and become insensitive to harmful CO2 levels (41).

My medical exemption? Not enough cannabinoids

Thankfully, the feeling of suffocation stands as a legal cause for a medical exemption and refusal to wear a mask, at least in Canada. Individuals who are exempt due to cerebrovascular or sensory conditions such as migraines, fibromyalgia, and IBD deal with greater levels of oxidative stress due to a theoretical endocannabinoid system deficiency. 

Our bodies rest in a mystical pendulum between cellular destruction and cancerous mutation. The ECS, in its mysterious entirety, acts as a pivotal counterweight in many biological systems. For this reason, the cannabinoids naturally produced by our bodies will protect the intestines, heart, and even the lungs. So, we can all thank the ECS for working hard to keep everything in balance if a greater level of free radicals in our butts from using face masks does not connect to damage or harm.

CBD stops the damage that connects face masks and your butt

CBD and Reactive Oxygen Species

Financial exemptions from social distancing vs. mask mandates

True, face masks might not be a gastric risk to your healthy butt, despite being connected to an increase in free radicals. Keep in mind though, airlines (and bus companies) sent petitions to Government leaders (42, 43). They begged them to be allowed to operate without social distancing to avoid further financial loss (44, 45). So, is it fair if individuals medically exempt from masks are unable to freely rely on social distancing to ensure their viability of life (Canadian Charter, Section 7 and 15?) If your answer to that question is no, then it may be best to butt out of their business and keep your distance if you see a patron without a mask.

Let us know what you think when you see maskless patrons in the comments. And for any healthcare workers, do you cut your mask before throwing them in the trash to prevent sterilization and reuse (46-48)?

Counterfeit Mask. Photo Courtesy of CDC (49).

Aknowledgments

Some information presented was graciously offered by various nurses, including this writing author’s mother, a senior Certified Registered Nurse whose own mom was a TB nurse in Tranquille Sanatorium’s tuberculosis hospital before her.

Sources

  1. Kelm M. (1999). Nitric oxide metabolism and breakdown. Biochimica et biophysica acta1411(2-3), 273–289.
  2. Samannan, R., Holt, G., Calderon-Candelario, R., Mirsaeidi, M., & Campos, M. (2020). Effect of Face Masks on Gas Exchange in Healthy Persons and Patients with COPD. Annals of the American Thoracic Society, 10.1513/AnnalsATS.202007-812RL. Advance online publication. doi:10.1513/AnnalsATS.202007-812RL
  3. Tong PS, Kale AS, Ng K, et al. Respiratory consequences of N95-type Mask usage in pregnant healthcare workers-a controlled clinical study [published correction appears in Antimicrob Resist Infect Control. 2016;5:26]. Antimicrob Resist Infect Control. 2015;4:48. Published 2015 Nov 16. doi:10.1186/s13756-015-0086-z
  4. Rosner E (2020) Adverse Effects of Prolonged Mask Use among Healthcare Professionals during COVID-19. J Infect Dis Epidemiol 6:130. doi:10.23937/2474-3658/1510130
  5. Fikenzer, S., Uhe, T., Lavall, D., Rudolph, U., Falz, R., Busse, M., Hepp, P., & Laufs, U. (2020). Effects of surgical and FFP2/N95 face masks on cardiopulmonary exercise capacity. Clinical research in cardiology : official journal of the German Cardiac Society109(12), 1522–1530. doi:10.1007/s00392-020-01704-y
  6. Rebmann, T., Carrico, R., & Wang, J. (2013). Physiologic and other effects and compliance with long-term respirator use among medical intensive care unit nurses. American journal of infection control41(12), 1218–1223. doi:10.1016/j.ajic.2013.02.017
  7. Johnson AT. Respirator masks protect health but impact performance: a review. J Biol Eng. 2016 Feb 9;10:4. doi: 10.1186/s13036-016-0025-4. PMID: 26865858; PMCID: PMC4748517.
  8. Özdemir L, AzizoÄŸlu M, Yapıcı D. Respirators used by healthcare workers due to the COVID-19 outbreak increase end-tidal carbon dioxide and fractional inspired carbon dioxide pressure. J Clin Anesth. 2020;66:109901. doi:10.1016/j.jclinane.2020.109901
  9. Roberge, R. J., Coca, A., Williams, W. J., Powell, J. B., & Palmiero, A. J. (2010). Physiological impact of the N95 filtering facepiece respirator on healthcare workers. Respiratory care55(5), 569–577.
  10. Kyung, S. Y., Kim, Y., Hwang, H., Park, J. W., & Jeong, S. H. (2020). Risks of N95 Face Mask Use in Subjects With COPD. Respiratory care65(5), 658–664. doi:10.4187/respcare.06713
  11. Li, Y., Tokura, H., Guo, Y. P., Wong, A. S., Wong, T., Chung, J., & Newton, E. (2005). Effects of wearing N95 and surgical facemasks on heart rate, thermal stress and subjective sensations. International archives of occupational and environmental health78(6), 501–509. doi:10.1007/s00420-004-0584-4
  12. Kao, T. W., Huang, K. C., Huang, Y. L., Tsai, T. J., Hsieh, B. S., & Wu, M. S. (2004). The physiological impact of wearing an N95 mask during hemodialysis as a precaution against SARS in patients with end-stage renal disease. Journal of the Formosan Medical Association = Taiwan yi zhi103(8), 624–628.
  13. Smith, C. L., Whitelaw, J. L., & Davies, B. (2013). Carbon dioxide rebreathing in respiratory protective devices: influence of speech and work rate in full-face masks. Ergonomics56(5), 781–790. doi:10.1080/00140139.2013.777128
  14. Williams, WJ [2010] Physiological response to alterations in [O2] and [CO2]: relevance to respiratory protective devices. J Intl Soc Resp Protect. 27(1):27-51.
  15. Beder A, Büyükkoçak U, Sabuncuoğlu H, Keskil ZA, Keskil S. Preliminary report on surgical mask induced deoxygenation during major surgery. Neurocirugia (Astur). 2008 Apr;19(2):121-6. doi: 10.1016/s1130-1473(08)70235-5. PMID: 18500410.
  16. Fletcher SJ, Clark M, Stanley PJ. Carbon dioxide re-breathing with close fitting face respirator masks. Anaesthesia. 2006 Sep;61(9):910. doi: 10.1111/j.1365-2044.2006.04767.x. PMID: 16922771
  17. Guan T, Hu S, Han Y, et al. The effects of facemasks on airway inflammation and endothelial dysfunction in healthy young adults: a double-blind, randomized, controlled crossover study. Part Fibre Toxicol. 2018;15(1):30. Published 2018 Jul 4. doi:10.1186/s12989-018-0266-0
  18. Brown K. et al. (2014) Free Radicals and Gastrointestinal Disorders. In: Laher I. (eds) Systems Biology of Free Radicals and Antioxidants. Springer, Berlin, Heidelberg. doi/10.1007/978-3-642-30018-9_137
  19. Goodson P. Questioning the HIV-AIDS Hypothesis: 30 Years of Dissent [retracted in: Front Public Health. 2019 Oct 29;7:334]. Front Public Health. 2014;2:154. Published 2014 Sep 23. doi:10.3389/fpubh.2014.00154
  20. Kary Mullis (2021, January 16). Wikipedia contributors. In Wikipedia, The Free Encyclopedia. Retrieved 00:58, January 22, 2021
  21. Heller J. (2015). Rumors and Realities: Making Sense of HIV/AIDS Conspiracy Narratives and Contemporary Legends. American journal of public health105(1), e43–e50. doi/10.2105/AJPH.2014.302284
  22. New York Times, (1981) Protracted War on Cancer, opinion, NY
  23. How Do You Get or Transmit HIV?. Updated June 24, 2019. HIV Gov.
  24. BBC, 2017 (1987), How Princess Diana changed attitudes to Aids, LDN ENG.
  25. Golman J, (1989), 7-Year-Old AIDS Patient Shares Hug With Princess, LA Times, NY
  26. Kern, P., Müller, G., Schmitz, H., Rácz, P., Meigel, W., Riethmüller, G., & Dietrich, M. (1985). Detection of coronavirus-like particles in homosexual men with acquired immunodeficiency and related lymphadenopathy syndrome. Klinische Wochenschrift63(2), 68–72. doi/10.1007/BF01733070
  27. CDC. Diagnoses of HIV infection in the United States and dependent areas, 2018 (updated). HIV Surveillance Report 2020;31.
  28. Diana, Princess of Wales. (2021, January 18). Wikipedia contributors. In Wikipedia, The Free Encyclopedia. Retrieved 01:25, January 22, 2021
  29. CDC. Scientific Brief: SARS-CoV-2 and Potential Airborne Transmission, 2020 (updated).
  30. Denmark to Ease Restrictions next Week after Coronavirus Lockdown. (April 6, 2020). Reuters.
  31. ‘Shoot them dead’ – Philippine leader says won’t tolerate lockdown violators (April 1, 2020). Reuters.
  32. Coronavirus: Outcry after Trump suggests injecting disinfectant as treatment (April 24, 2020). BBC
  33. Tom Odula. 13-year-old shot dead; Kenyan police enforcing curfew blamed. (March 31, 2020.) ABC News. AP.
  34. Jacobs, J. L., Ohde, S., Takahashi, O., Tokuda, Y., Omata, F., & Fukui, T. (2009). Use of surgical face masks to reduce the incidence of the common cold among health care workers in Japan: a randomized controlled trial. American journal of infection control37(5), 417–419. doi:10.1016/j.ajic.2008.11.002
  35. MacIntyre CR, Seale H, Dung TC, et alA cluster randomised trial of cloth masks compared with medical masks in healthcare workersBMJ Open 2015;5:e006577. doi: 10.1136/bmjopen-2014-006577
  36. Nariman Sepehrvand, Justin A. Ezekowitz. Oxygen Therapy in Patients With Acute Heart Failure: Friend or Foe?, JACC: Heart Failure, Volume 4, Issue 10, 2016, Pages 783-790, ISSN 2213-1779, doi/10.1016/j.jchf.2016.03.026.
  37. Oxygen Therapy (2020, December 31). Wikipedia contributors. In Wikipedia, The Free Encyclopedia
  38. Pulmonary edema. (2020, December 11). Wikipedia contributors. In Wikipedia, The Free Encyclopedia.
  39. Kobayashi, S., Nishimura, M., Yamomoto, M., Akiyama, Y., Miyamoto, K., & Kawamaki, Y. (1996). Relationship between breathlessness and hypoxic and hypercapnic ventilatory response in patients with COPD. The European respiratory journal9(11), 2340–2345. https://doi.org/10.1183/09031936.96.09112340
  40. Hypoxemia. (2021, January 14). Wikipedia contributors. (2021, January 14). In Wikipedia, The Free Encyclopedia.
  41. Corlateanu, A., Mendez, Y., Wang, Y., Garnica, R., Botnaru, V., & Siafakas, N. (2020). “Chronic obstructive pulmonary disease and phenotypes: a state-of-the-art.”. Pulmonology26(2), 95–100. doi/10.1016/j.pulmoe.2019.10.006
  42. Support the British aviation industry during the COVID-19 outbreak. June 25, 2020. Petitions. UK Goverment and Parliament.
  43. IATA Calls for Passenger Face Covering and Crew Masks. May 5, 2020. IATA. PR.
  44. Bundgaard H, Bundgaard JS, Raaschou-Pedersen DET, et al. Effectiveness of adding a mask recommendation to other public health measures to prevent SARS-CoV-2 infection in Danish mask wearers: a randomized controlled trial. Ann Intern Med. 2020 Nov 18. doi: 10.7326/M20-6817.
  45. Rob Shaw. Health concerns raised as Canadian airlines abandon social distancing. July 03, 2020. Vancouver Sun. Van BC.
  46. Major win to prohibit use of carcinogen for PPE sterilization. April 29, 2020. WSNA. W.S.
  47. Adam Chang. Camosun College developing portable mask decontamination device. July 21 , 2020. CTV News. V.I. BC.
  48. Zhiqing L, Yongyun C, Wenxiang C, et al. Surgical masks as source of bacterial contamination during operative procedures. J Orthop Translat. 2018;14:57-62. Published 2018 Jun 27. doi:10.1016/j.jot.2018.06.002
  49. Counterfeit Reapirators/ Misrepresentation of NIOSH-approval. Updated January 5, 2021. CDC.
  50. Barnes PJ. Oxidative stress-based therapeutics in COPD. Redox Biol. 2020 Jun;33:101544. doi: 10.1016/j.redox.2020.101544. Epub 2020 Apr 20. PMID: 32336666; PMCID: PMC7251237.
  51. Barnes, P., Burney, P., Silverman, E. et al. Chronic obstructive pulmonary disease. Nat Rev Dis Primers1, 15076 (2015). doi/10.1038/nrdp.2015.76
  52. Pahal P, Hashmi MF, Sharma S. Chronic Obstructive Pulmonary Disease Compensatory Measure. [Updated 2020 May 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-.
  53. Russo EB. Clinical Endocannabinoid Deficiency Reconsidered: Current Research Supports the Theory in Migraine, Fibromyalgia, Irritable Bowel, and Other Treatment-Resistant Syndromes. Cannabis Cannabinoid Res. 2016;1(1):154-165. Published 2016 Jul 1. doi:10.1089/can.2016.0009

Footnote(s)

https://doi.org/10.1016/s0005-2728(99)00020-1

https://www.atsjournals.org/doi/abs/10.1513/AnnalsATS.202007-812RL

https://aricjournal.biomedcentral.com/articles/10.1186/s13756-015-0086-z

https://www.clinmedjournals.org/articles/jide/journal-of-infectious-diseases-and-epidemiology-jide-6-130.php?jid=jide

https://www.pubmed.ncbi.nlm.nih.gov/32632523/

https://www.pubmed.ncbi.nlm.nih.gov/23768438/

https://www.pubmed.ncbi.nlm.nih.gov/26865858/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7242931/

https://www.pubmed.ncbi.nlm.nih.gov/20420727/

https://www pubmed.ncbi.nlm.nih.gov/31992666/

https://www.pubmed.ncbi.nlm.nih.gov/15340662/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7087880/?report=reader#__ffn_sectitle

https://www.cdc.gov/niosh/nioshtic-2/20037275.html

https://www.pubmed.ncbi.nlm.nih.gov/18500410/

https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2044.2006.04767.x

https://oem.bmj.com/content/75/6/446

https://link.springer.com/referenceworkentry/10.1007%2F978-3-642-30018-9_137

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172096/

https://www.wikipedia.org/wiki/Kary_Mullis

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4265931/

https://www.nytimes.com/1981/06/12/opinion/protracted-war-on-cancer.html

https://www.hiv.gov/hiv-basics/overview/about-hiv-and-aids/how-is-hiv-transmitted

https://www.bbc.com/news/av/magazine-39490507

https://www.latimes.com/archives/la-xpm-1989-02-04-mn-1517-story.html

https://www.pubmed.ncbi.nlm.nih.gov/2984454/

https://www.cdc.gov/hiv/group/msm/index.html

https://www.wikipedia.org/wiki/Diana,_Princess_of_Wales

https://www.nursesunions.ca/cfnu-research-summary-on-covid-19/

https://www.reuters.com/article/us-health-coronavirus-denmark/denmark-to-ease-restrictions-next-week-after-coronavirus-lockdown-idUSKBN21O2LH

https://www.reuters.com/article/us-health-coronavirus-philippines-dutert/shoot-them-dead-philippine-leader-says-wont-tolerate-lockdown-violators-idUSKBN21K0AY

https://www.bbc.com/news/world-us-canada-52407177

https://www.abcnews.go.com/International/wireStory/13-year-shot-dead-kenyan-police-enforcing-curfew-69895736

https://www.pubmed.ncbi.nlm.nih.gov/19216002/

https://www.sciencedaily.com/releases/2015/04/150422121724.htm

https://www.sciencedirect.com/science/article/pii/S2213177916301597#:~:text=Supplemental%20oxygen%2C%20a%20therapy%20that,use%20in%20normoxemic%20patients%20is

https://en.wikipedia.org/wiki/Oxygen_therapy#:~:text=Oxygen%20therapy%2C%20also%20known%20as,while%20inhaled%20anesthetics%20are%20given.

https://www.mayoclinic.org/diseases-conditions/pulmonary-edema/symptoms-causes/syc-20377009

https://pubmed.ncbi.nlm.nih.gov/8947082/

https://en.wikipedia.org/wiki/Hypoxemia#:~:text=Hypoxemia%20refers%20to%20the%20low,other%20mechanisms%2C%20such%20as%20anemia.

https://www.sciencedirect.com/science/article/pii/S2531043719302089

https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/prevention-risks/about-non-medical-masks-face-coverings.html

https://petition.parliament.uk/petitions/303081

https://www.vancouversun.com/news/health-concerns-raised-as-canadian-airlines-abandon-social-distancing

https://www.iata.org/en/pressroom/pr/2020-05-05-01/

https://en.wikipedia.org/wiki/Section_7_of_the_Canadian_Charter_of_Rights_and_Freedoms

https://www.canada.ca/en/canadian-heritage/services/rights-people-disabilities.html

https://www.wsna.org/news/2020/major-win-to-prohibit-use-of-carcinogen-for-ppe-sterilization

https://www.vancouverisland.ctvnews.ca/mobile/camosun-college-developing-portable-mask-decontamination-device-1.5033412?cache=yes%3Fclipid%3D373266%3FautoPlay%3Dtrue

https://www.wikipedia.org/wiki/Tranquille_Sanatorium

https://emcrit.org/pulmcrit/respiratory-drive/?hcb=1

https://doi.org/10.1038/nrdp.2015.76

https://www.sciencedirect.com/science/article/pii/S0005272899000201

https://mobile.twitter.com/primevideo/status/1311505160598745088