Updated: Jan 28
Endocannabinoid System (ECS).
The Endocannabinoid System
To use CBD effectively, we should understand the role of the endocannabinoid system within the human body (Crippa et al, 2018) (Salaberry & Astern, 2018). The Endocannabinoid System (ECS) is a modern and ever evolving discovery, it was first identified in the 1980’s as “an integral part of the physiology of all vertebrate animals” (Cannabis Access Clinics, 2020).
The Endocannabinoid System (ECS) is explained by Medical Herbalist Karin Mallion in her brilliant little CBD Handbook as 'the one to rule them all' (Mallion, 2021) it is the over-branching system that over rides and incorporates all the other systems within the human body. The nervous system, urinary system, cardiovascular system etc all slot into the ECS because the endocannabinoid system has receptors in every single body system and therefore its effects can be synergistic and manifold. Interestingly everyone's ECS is personal to them and the way it reacts with endocannabinoids is a completely individual selection process of chemical reactions attractions and repulsion. Interestingly being breast fed as a baby primes the endocannabinoid system. At least twelve endocannabinoids have been identified in human breast milk and have shown to play a significant role in neonatal immunity and brain development.
Does this mean that we should all take CBD? Actually the nuance of our ever evolving understanding imparts that cannabis or CBD as with other medicinal plants may simply not work for some people. Other people will benefit tremendously from its use. Sometimes external use in the form of balms and patches may be beneficial when internal oils and teas were troublesome. Some people are better to avoid CBD altogether. Always remember that taking CBD alongside conventional medication should only happen with professional consent and guidance as it may potentiate or interact with prescription meds.
So to recap the endocannabinoid system does not exist essentially ‘because’ of the medicinal plant cannabis sativa. The ECS is a refined network of receptors spread throughout the entire body that controls a wide variety of internal functions. It governs our reaction to both the external and our internal environment: this includes a person’s mood: modulating the process of neurotransmitter release, the regulation of pain perception, memory, sleep patterns alongside controlling appetite and other biological functions. Weigh up the pro's and con's of usage with professional help and ask your local medical herbalist for further information regarding suppliers and dosages.
Disruption of the ECS or endocannabinoid deficiency has been proposed to be responsible for a wealth of chronic disease, found in patients that seek Western Herbal Medicine: IBS, migraine, fibromyalgia, PTSD, MS, Parkinson’s, metabolic syndrome, digestive and sleep disorders: to name but a few. Understanding these two phytochemicals (THC & CBD) has developed our scientific understanding of the Endocannabinoid system as a tightly controlled, responsive, precisely mediating system that modulates an appropriate biological response triggered and controlled on a unique and even mysterious basis.
Endocannabinoid receptors are produced by our body and are located throughout the bodies peripheral and central nervous system. Crucial in all stages of human existence from the fetal development of synaptogenesis and synaptic pruning within neurology, to the two G-coupled cannabinoid receptors that are found systematically throughout the human body. CB1 receptors (discovered in 1988) are primarily famous for their interaction with THC, facilitating the intoxicating effect of the cannabis plant. CB1 receptors are found in the brain and nervous system. Whilst CB2 receptors (identified in 1993) do not modulate a psychoactive effect and are established in the immune and reproductive tissues, offering a mediatory effect, regulating pain perception and inflammation within the enteric nervous system (Brewer, 2020).
The keys that fit these perspective locks (the receptors) are recognized as endocannabinoids, ‘endo’ meaning endogenous, produced by body in deep tissue. The two established endocannabinoids in human physiology are N-arachidonoyl ethanolamine (anandamide, AEA) and 2-arachidonoylglycerol (2 A-G). CBD acts as a non-competitive negative allosteric modulator of the CB1 receptor working synergistically with THC whilst reducing the potency of THC and AEA this is known as the ‘Entourage Effect’ (Reggio, 2010) (Russo, 2011).
CBD essentially binds to TRP V1 receptor, influencing pain perception comparable to Capsaicin found in Capsicum annuum L. (the Chilli pepper). Activating this receptor has shown to be safe, and effective even during long-term use (Maroon, J et al, 2010). In 2020, Nelson et al remained skeptical about the touted 'cure-all' status of CBD and maintained that there was insufficient double-blinded, placebo controlled clinical trials to substantiate ‘anecdotal claims of CBD’s clinical utility’. In the research paper 'the essential medicinal chemistry of cannabidiol' Nelson draws our attention to potential harmful and adverse effects of CBD. Raising the question of its metabolism, absorption, and excretion. Nelson concludes oral administration exhibits low bioavailability with substantial liver clearance. Questioning if the placebo effect responsible? And questions Is the hype around CBD valid and substantiated by science? These are all questions that need to be further explored particularly by clinical medical herbalists.
The body’s reaction to CBD medicine is completely individual and although some patients will experience immediate effect (within 15 minutes of an initial dose). Some people may take up to 2 weeks before significant benefit is established. Other people are better to avoid this health approach and may explore other modalities to find personal health and well being. The recommendations from UK suppliers when CBD is indicated, is to start low and go slow using 1 or 2 drops initially and thinking of reducing rather than building the dose to find each individual persons 'sweet spot'. Remember to always seek the advice of your primary healthcare practitioner before self medication. CBD products should always be recommended by a qualified practitioner. Remember the quality of the product used will have a significant effect on the efficacy of treatment.
Crippa et al. (2018). Translational Investigation of the Therapeutic Potential of Cannabidiol CBD: Towards a New Age. Frontiers in Immunology.
Epilepsy Action [EA]. (2020). Epilepsy and cannabis-based medicine. [online] Available at: https://www.epilepsy.org.uk/involved/campaigns/cannabis [Accessed 15 January 2021].
Great Britain General Medical Council (GBGMC) copyright. (2018). British Pharmacopoeia 1867. London: Forgotten Books.
Mallion, K. (2021). The CBD handbook: using and understanding cbd and medical cannabis. Lewes: Aeon Books.
Maroon, J. et al. (2010). Natural anti-inflammatory agents for pain relief. Surgical Neurology International, 1, pp. 80.
Mechoulam, R. (2012). Cannabis – A Valuable Drug That Deserves Better Treatment. Mayo Clinic Proceedings, 87(2), pp. 107-109.
Nelson, K. et al. (2020). The essential medicinal chemistry of cannabidiol (CBD). Journal of Medicinal Chemistry, 63 pp. 12137-12155.
Reggio, P. (2010). Endocannabinoid Binding to the Cannabinoid Receptors: What Is Known and Unknown. Curr. Med Chem. 17(14), pp.1468-1486.
Russo, E. (2011). Taming THC: Potential Cannabis Synergy and Phyto-cannabinoid – terpenoid entourage effects. Br J Pharmacol 163 (7) pp. 1344-1364.
Russo, E. (2016). Clinical endocannabinoid deficiency reconsidered: current research supports the theory in migraine, fibromyalgia, irritable bowel, and other treatment-resistant syndromes. Cannabis and Cannabinoid Research, 1(1), pp. 154-165.
Sallaberry, C. & Astern, L. (2018). The Endocannabinoid System, our Universal Regulator. Journal of Young Investigators, 34(6) pp. 48-55.