Cannabis interacts directly with our body through an extensive network of receptors called the endocannabinoid system (ECS). The human body itself produces neurotransmitters which are identical to tetrahydrocannabinol (THC), a compound found in cannabis, and these endogenous cannabinoids bind to receptors in our brain and other areas in our body. The ECS was only discovered in the early 1990s and cannabinoid research was limited until recently because of prohibition. The ECS is thought to be one of the most important physiological systems in our body as there are receptors in almost every organ and there are more endocannabinoid receptors in our brain than all the other neurotransmitter receptors combined. As we slowly learn more about the importance of the ECS and its involvement in certain illnesses, schools are now slowly including this information in their curricula and countries are changing their laws to recognize cannabis as a medicine.
There are two main types of cannabinoid receptors, the CB1 receptors, which are most abundant in the brain and central nervous system, and the CB2 receptors which are located outside the nervous system, mainly in the immune system.
The CB1 receptors are involved in regulating learning and memory, reducing pain and addictive tendencies, reducing nerve inflammation and degeneration, regulating metabolism, appetite, bone mass and heart function.
The CB2 receptors are implicated in allergic and autoimmune conditions, inflammatory and neurodegenerative diseases, osteoporosis (loss of bone mass), chronic pain and stress responses.
The function of the ECS is to maintain a state of balance in the body known as homeostasis. When there are abnormalities in neurotransmitter levels, inflammatory processes or metabolic disorders, the ECS steps in to restore the chemicals that are unbalanced, restoring normal functioning. Through this system, the human body regulates pain, mood, sleep, appetite, the immune system and many other bodily functions. In short, the ECS serves to “sleep, eat, relax, forget and protect”.
The body produces two types of endogenous cannabinoids, anandamide (AEA) and 2-arachidonoylglycerol (2-AG). These endocannabinoids interact with our CB1 and CB2 receptors on demand to exert their effect. Since these receptors are present throughout the body, they are responsible for controlling many of the body’s essential functions. Endocannabinoids are broken down by metabolic enzymes, making their effect short-lived.
When there is an abnormality in the ECS, several systems can be affected. Most cases of fibromyalgia, irritable bowel syndrome (IBS) and migraines are manifested through endocannabinoid deficiency (Dr Ethan Russo, 2016). Symptoms of endocannabinoid dysfunction may include hypersensitivity to pain, mood abnormalities, anxiety, gastrointestinal disturbances and insomnia. In severe cases, the body becomes hypersensitive to everything and affected patients suffer from allergies, food intolerances, chronic pain and are very often unable to tolerate most medications.
Patients with endocannabinoid dysfunction or endocannabinoid deficiency are advised to follow a healthy diet based on fresh green vegetables, fruit, fish, chicken and rice. Refined sugars and processed foods should be avoided as they may cause hypersensitivity and may even increase pain levels. Gluten and lactose intolerance are also very common in such patients.
Regular exercise within the patient’s fitness levels is advisable. During exercise, the body produces neurotransmitters which can help to boost the ECS. High impact exercise such as boxing and jumping (as in high-intensity interval training) is the most effective can sometimes be used to treat mild cases of endocannabinoid deficiency.
A sufficient intake of Magnesium, Omega 3, Vitamin B, C, D and E is essential for proper endocannabinoid functioning. While a lot of these vitamins and minerals can be obtained from a diet high in fish and green vegetables, it is often hard to achieve the necessary recommended daily levels without adding a supplement. Probiotics are also considered to be an essential requirement for a healthy ECS. These can be consumed through certain foods but supplementation through capsules is very often recommended. When choosing a probiotic, one should go for a preparation with different strains of bacteria and ideally containing 20-30 billion bacteria per capsule.
Stress directly affects the endocannabinoid system. When the body is exposed to long periods of stress, the endocannabinoid system is overworked and eventually “burns out”. When there is an established endocannabinoid deficiency, such as in fibromyalgia, stress aggravates symptoms and prevent healing. Chronic stress may also contribute to weight gain, diabetes, high blood pressure, heart disease, stroke, auto-immune disorders and cancer. Stress is very often the root cause of many inflammatory conditions and stress reduction is of utmost importance in the management of all chronic conditions, especially where the ECS is involved.
Mindfulness-based stress reduction (MBSR) and mindfulness meditation are very effective, evidence-based ways for reducing stress. Mindfulness is recommended as an adjunct in the management of all cases of chronic pain. This therapy also helps with acceptance and coping with a chronic condition. Complementary therapies such as aromatherapy may also help to boost well-being and enhance healing.
Cannabis-based medicines are powerful tools that can help patients with abnormalities in the ECS. These may be in the form of a natural plant extracts or synthetic cannabinoids. The medicines interact with the CB1 and CB2 receptors in our body thus producing a therapeutic effect. You can read more about cannabis as medicine here.