Most of us are familiar with the idea of boosting the immune system to maintain optimum health and think nothing of taking vitamins and minerals to give it a helping hand when defenses are low.
But what if there were another physiological system that when depleted could cause a whole host of health issues.
Discovery of Endocannabinoid System sheds new light on our health
Well, many scientists believe there is – and it’s called the endocannabinoid system (ECS) – the body’s vast network of chemical compounds and receptors that act to maintain homeostasis or balance in the body.
Discovered in the 1980s when scientists were trying to find where the psychoactive compound in cannabis THC binds, they noticed the body produces its own natural compounds eliciting a similar effect to cannabis. So much so, they named one Anandamide, taken from the sanskrit word for bliss, Ananda, because of the feeling of relaxation and well being it promotes. It was called an endocannabinoid because it’s a cannabinoid created within the body, and along with the other endocannabinoid 2-AG, binds to the receptors CB1 and CB2.
CB1 receptors are predominantly found in the brain and the central nervous system, functioning as neuromodulators and are the main targets for Anandamide and its plant mimetic THC. 2-AG binds to both the CB1 and CB2 receptor, the latter being found mostly in the immune system with responsibility for amongst other things, pain management.
The basic functions of the ECS were described by Italian scientist Vincenzo di Marzo as ‘relax, sleep, eat and protect’. A system doesn’t get more comprehensive than that.
In a recent interview Dr Ethan Russo a pioneering scientist in the endocannabinoid field, describes the ECS as a buffer ‘something that will work both ways as need be. So, for example, in the endocannabinoid system one of its main roles in the brain is to regulate neurotransmitter function and again, if there’s too much of one kind of neurotransmitter it will bring it down, if there’s too little it will bring it up’.
Another example of how the ECS restores balance is with neuropathic pain – a condition associated with MS, HIV and diabetes, but notoriously difficult to treat with pharmaceutical drugs. High levels of glutamate, one of the primary stimulatory neurotransmitters can prolong neuropathy, however when endocannabinoids are excreted, they inhibit glutamate production, thus alleviating the symptoms.
So the ECS acts as a dimmer switch, upregulating or downregulating when necessary, a principle that can be applied to all systems of the body.
Studies suggest many patients could have a Clinical Endocannabinoid Deficiency
But what happens if the Endocannabinoid System isn’t functioning correctly. According to Dr Russo, ‘If you don’t have enough endocannabinoids you have pain where there shouldn’t be pain. You would be sick, meaning nauseated. You would have a lowered seizure threshold. And just a whole litany of other problems’. Russo sees a pattern between these symptoms and a number of conditions that until now modern medicine has found difficult to treat, namely migraine, irritable bowel syndrome (IBS) and fibromyalgia.
He believes these conditions, as well as potentially many more, share a lack of what has become known as ‘endocannabinoid tone’ – i.e. how well the ECS performs its core role of keeping balance in the body. In the case of all three conditions, there is a hyperalgesia, an abnormally high sensitivity to pain, often accompanied by anxiety or depression, plus a comorbidity between the three syndromes i.e. if you have one, there’s a fair chance that at some point you will start with one or more of the others.
Sceptics might believe this to be pure coincidence, but studies have already shown how the production of the endocannabinoid anandamide might have some bearing on the situation. Russo states ‘available data confirm that the target organs (brain, gut, musculoskeletal system) seem to express lower than normal levels of anandamide, thus providing credence for the concept that they would benefit from treatments that would upregulate the ECS back to normal levels’.
Russo’s named it ‘Clinical Endocannabinoid Deficiency’ (CED) and is based on the concept ‘that many brain disorders are associated with neurotransmitter deﬁciencies, affecting acetylcholine in Alzheimer’s disease, dopamine in parkinsonian syndromes, serotonin and norepinephrine in depression, and that a comparable deﬁciency in endocannabinoid levels might be manifest similarly in certain disorders that display predictable clinical features’ as a result of this deﬁciency.
He believes that supplementing an impaired ECS with plant cannabinoids will bring it back to optimum function, thus provoking an improvement in any associated conditions.
In the case of IBS, gastrointestinal propulsion, secretion and inflammation are all modulated by the ECS, indeed in the 19th Century cannabis was used for the intense diarrhea experienced by cholera patients. Today many IBS patients self-medicate with cannabis, with some reporting improvements in their symptoms.
Could an improvement in fibromyalgia patients’ symptoms after taking Cannabis give validity to CED?
Fibromyalgia, much maligned as a psychosomatic disorder, is the most common diagnosis in American rheumatology practices. The high levels of pain experienced by patients is due to secondary hyperalgesia (over sensitivity to pain) and according to Russo, ‘is observed in association with central endocannabinoid hypofunction in the spinal cord’, which is in turn eased by taking cannabis.
In a small study 28 ﬁbromyalgia patients took cannabis and were compared with a control group of patients who did not. Two hours after cannabis use, there was a reported ‘reduction of pain and stiffness, enhancement of relaxation and an increase in somnolence and feeling of well-being’. Another recent survey comparing the efficacy of cannabis with pharmaceutical drugs generally used for fibromyalgia found that cannabis came out best compared to the prescription alternatives.
Is it possible to measure Clinical Endocannabinoid Deficiency?
However, one reason why Clinical Endocannabinoid Deficiency remains just a theory is because until now it has been both difficult and expensive to measure. Migraine sufferers are one of the few cases in which endocannabinoid levels have been studied. Lumbar punctures were taken to examine the cerebrospinal fluid from a group of 15 chronic migraine sufferers versus a control group of 20. The tests showed that the migraine sufferers had significantly lower levels of anandamide, which according to Russo is the clearest evidence to date of the presence of CED.
THC, the psychoactive cannabinoid which along with anandamide locks onto the CB1 receptor, has been reported to have a beneficial impact on migraine sufferers. One observational trial carried out at a cannabis-oriented clinic in the state of Colorado found that among 120 adults with migraine for whom cannabis prophylaxis was recommended, the frequency of headache diminished from 10.4 to 4.6 attacks per month.
CBD improves Endocannabinoid function
Unlike THC, Cannabidiol does not attach directly to any of the receptors, but instead indirectly activates endocannabinoid signalling by suppressing the enzyme fatty acid amide hydroxylase (FAAH).
FAAH breaks down anandamide, so the more FAAH you have, the less anandamide there is in the body. Turns out CBD suppresses the production of FAAH, therefore allowing more anandamide to be present and strengthening endocannabinoid tone. The theory being that if you have a condition associated with low levels of anandamide, taking CBD would return it to optimum levels, which in turn could improve the symptoms.
Russo doesn’t just limit Clinical Endocannabinoid Deficiency to IBS, migraines and Fibromyalgia. He believes it could be at the root of may other conditions such as MS, Parkinson’s, Huntington’s disease, depression, neonatal failure to thrive, cystic ﬁbrosis, causalgia, brachial plexopathy, phantom limb pain, infantile colic, glaucoma, dysmenorrhea, hyperemesis gravidarum, unexplained fetal wastage (repetitive miscarriages), post-traumatic stress disorder (PTSD) and bipolar disease.
ECS testing in the future
So imagine if you will, a time when it’s as easy to get our Endocannabinoid levels measured as it is to do a cholesterol test. It’s not beyond the realms of possibility that someone lacking in anandamide or 2-AG might be prescribed cannabis or CBD, just as someone is currently given iron tablets for anemia.
Indeed, you could go so far to say that regularly taking cannabinoids could be a proactive way of looking after our health as even the American government has taken out a patent on CBD as an antioxidant and neuroprotectant.
However realistically, until there have been sufficient clinical trials proving the efficacy of cannabis for certain conditions, it is unlikely that funds will be made available to develop a testing mechanism for imbalances in the Endocannabinoid system. And this requires a shift in attitude by governments, the medical profession and pharmaceutical companies alike.
Knowledge is power
But here’s where you can help. Right now the Endocannabinoid System is barely taught in medical school and certainly hasn’t made it into the public domain. So it’s your chance to get educating and share this information. The more the Endocannabinoid System becomes ingrained in the public consciousness, the more likely it is that people will get access to the most appropriate treatment for their condition. Why not share this article with your doctor too.
References: Clinical Endocannabinoid Deficiency Reconsidered: Current Research Supports the Theory in Migraine, Fibromyalgia, Irritable Bowel, and Other Treatment-Resistant Syndromes by Dr Ethan Russo