Unveiling the science behind cannabinoid therapeutics
Many of us have heard of some of the transmitter systems within our bodies, such as the sympathetic nervous system, which gives us our fight-or-flight response. Fewer have heard of the more recently discovered endocannabinoid system (ECS), which is amazing when you consider Harvard Medical School states, “The ECS is critical for almost every aspect of our moment-to-moment functioning.”1
The ECS regulates and controls many of our most critical bodily functions, such as learning and memory, emotional processing, sleep, temperature control, pain control, inflammatory and immune responses and eating. The ECS is currently at the center of renewed international research and drug development.1
The use of cannabinoids (CBD and low-dose THC) for chiropractic care has gained significant attention in recent years, with increasing recognition of the therapeutic potential of cannabinoids. Central to this understanding is the endocannabinoid system (ECS), a complex regulatory network within the human body that plays a crucial role in maintaining homeostasis. Educating patients on the ECS is essential for empowering them with knowledge about how cannabinoids interact with their bodies and how this interaction can impact health and wellness.
The basics of the endocannabinoid system
In 1992, researchers Raphael Mechoulam and Shimon Ben-Shabat, along with NIMH researchers William Devane and Lumír Hanuš, identified the first endocannabinoid, anandamide. Anandamide was named after the Sanskrit word “ananda,” which means bliss, highlighting its role in mood regulation.
Every mammal has an ECS, which interestingly was named after the main compounds in the cannabis plant, cannabinoids. Researchers saw the striking similarities between cannabinoids found in the cannabis plant and the molecules found in your ECS, so they named the system after cannabinoids.
The ECS is a biological system composed of endocannabinoids, receptors and enzymes. Endocannabinoids, such as anandamide and 2-arachidonoylglycerol (2-AG), are naturally occurring compounds within the body. Receptors, known as CB1 and CB2, are primarily found in the central nervous system and peripheral tissues, respectively. Enzymes, like fatty acid amide hydrolase (FAAH) and monoacylglycerol lipase (MAGL), break down endocannabinoids once their signaling tasks are complete.
The ECS is the only system which works retrograde
The ECS is the key system in your body that allows organs and cells to “talk” to each other. According to Harvard, “They act like traffic cops to control the levels and activity of most of the other neurotransmitters. This is how they regulate things: by immediate feedback, turning up or down the activity of whichever system needs to be adjusted, whether that is hunger, temperature or alertness.”1
Some examples of the ECS at work:
- Stomach cells communicating retrograde to your parietal cells that they have enough acid
- Overstimulated neurons communicating to other neurons to stop firing
- Joints and muscles telling your immune system to stop producing histamine and prostaglandins
What are the functions of the endocannabinoid system?
Homeostasis maintenance: According to the National Institutes of Health, the ECS “is primarily responsible for maintaining homeostasis, a balance in internal environment (temperature, mood and immune system) and energy input and output in living, biological systems. In addition to regulating physiological processes, the ECS directly influences anxiety, feeding behavior/appetite, emotional behavior, depression, nervous functions, neurogenesis, neuroprotection, reward, cognition, learning, memory, pain sensation, fertility, pregnancy and pre-and post-natal development.”2
Neuroprotection: In the central nervous system, the ECS acts as a protective mechanism, influencing the modulation of neurotransmitter release and preventing excessive neuronal activity. According to Nobel Laureate Julius Axelrod, “Cannabinoids have been found to have antioxidant properties, unrelated to NMDA receptor antagonism. This newfound property makes cannabinoids useful in the treatment and prophylaxis of a wide variety of oxidation-associated diseases, such as ischemic, age-related, inflammatory and autoimmune diseases.”3
Immune system regulation: CB2 receptors, primarily found in immune cells, help regulate the immune response. Modulating the ECS can potentially impact inflammation and immune system function.
Cannabinoids and the endocannabinoid system
Cannabinoids derived from the cannabis plant, such as tetrahydrocannabinol (THC) and cannabidiol (CBD), interact with the ECS. THC binds directly to CB1 receptors, leading to the psychoactive effects associated with cannabis use. On the other hand, CBD has a more complex interaction, influencing receptor activity indirectly and interacting with other receptors outside the ECS.
What do CBD and other cannabinoids have to do with the endocannabinoid system?
Good question. The simple answer: The average American does not make enough endocannabinoids of their own and Americans are not supplementing this deficiency through diet. Due to the prohibition of cannabis in 1937 and for the first time in human history, our bodies are incapable of closing the 360° feedback loop needed. We simply do not have enough endocannabinoids for the signal, so no signal goes through. The feedback loop is broken.
The neurons keep firing and firing. With no feedback loop, the neurons continue to signal your cells to continue producing the compounds they have enough of. DCs know this as inflammation and overstimulation — they see this every day.
Consumption of natural cannabinoids can close that deficiency by closing the “open-loop” and shutting down the overproduction signals neurotransmitters are sending to excite the cells. Your body needs cannabinoids as much as it needs iron, vitamin C or B12.
The NIH goes into more detail in the article, “Clinical endocannabinoid deficiency (ECD) reconsidered.4 Current research supports the theory in migraine, fibromyalgia, irritable bowel and other treatment-resistant syndromes.5
What are the benefits of supplementing the ECS with cannabinoids?
Pain management: The ECS is implicated in the modulation of pain perception. Cannabinoids, especially CBD, have shown promise in alleviating chronic pain conditions. According to the National Institutes of Health (NIH), “CBD was found to demonstrate therapeutic potential for the relief of arthritic pain-related behavior and to exert an anti-inflammation effect without any evident high-brain-center psychoactive effects.”6
Mental health: The ECS plays a role in mood regulation, and cannabinoids may offer therapeutic benefits for conditions, such as anxiety and depression.
Sleep: Getting a good night sleep is critical to patients’ health, and it is clear Americans are not getting enough sleep. Twenty-seven percent of Americans say they are not well-rested, with more than 1.2 million workdays and $14.3 billion in annual economic losses due to lack of sleep.7 The answer to a lack of sleep is not Ambien. According to the NIH, when using cannabinoids, “Sleep scores improved within the first month in 48 patients (66.7%) but fluctuated over time.”8
Cannabinoids work in conjunction with your ECS to help your body and mind wind down after a long day.
Educational strategies for healthcare providers
Clear communication: DCs should convey information about the ECS in a clear and accessible manner, avoiding unnecessary scientific jargon.
Customized information: Tailoring discussions based on individual patient needs and medical conditions ensures a more personalized and effective education strategy.
Evidence-based resources: Providing patients with reputable sources of information, backed by scientific evidence, helps build trust and confidence in the therapeutic potential of cannabinoids.
JOE KRYSZAK, MBA, is president of Stirling Professional CBD. He can be contacted at pro@stirlingoils.com. For more information about Stirling Professional CBD, visit stirlingprofessional.com.
References
- Grinspoon P. The endocannabinoid system: Essential and mysterious. August 2021. Harvard Health Publishing. [Blog]. https://www.health.harvard.edu/blog/the-endocannabinoid-system-essential-and-mysterious-202108112569. Accessed Dec. 1, 2023.
- Lowe H, et al. The Endocannabinoid System: A Potential Target for the Treatment of Various Diseases. Int J Mol Sci. 2021;22(17):9472. Pub Med. https://pubmed.ncbi.nlm.nih.gov/34502379/. Accessed Dec. 1, 2023.
- Hampson AJ, et al. Cannabinoids as antioxidants and neuroprotectants. U.S. Patent. https://patents.google.com/patent/US6630507B1/en. Accessed Dec. 1, 2023.
- 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. Pub Med. https://pubmed.ncbi.nlm.nih.gov/28861491/. Accessed Dec. 1, 2023.
- Pertwee RG. Cannabinoid pharmacology: the first 66 years. Br J Pharmacol. 2006;147(Suppl 1):S163–S171. NCBI website. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1760722/. Accessed Dec. 1, 2023.
- Hammell DC, et al. Transdermal cannabidiol reduces inflammation and pain-related behaviours in a rat model of arthritis. Eur J Pain. 2016;20(6):936–948. NCBI website. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4851925/. Accessed Dec. 1, 2023.
- Cvetkovska L. The Most Sleep Deprived Countries in the World (Map). October 2019. [Blog]. https://disturbmenot.co/most-sleep-deprived-countries/. Accessed Dec. 1, 2023.
- Shannon S, et al. Cannabidiol in Anxiety and Sleep: A Large Case Series. Perm J. 2019;23:18-041.NCBI website. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6326553/. Accessed Dec. 1, 2023.