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CECD: Clinical EndoCannabinoid Deficiency - migraine, fibromyalgia, IBS

1,044 Views | 3 Replies | Last: 2 yr ago by administrative errors
administrative errors
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One of the concepts that drew me into the hemp/cannabis world was learning about the endocannabinoid system and our naturally produced cannabinoids, anandamide and 2-AG.

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Since the discovery of the endocannabinoid system (ECS) and various phytocannabinoids beyond just tetrahydrocannabinol (THC), it seems that a sort of "shift" occurred in how we approach cannabis. "Clinical endocannabinoid deficiency" sometimes (and less accurately) called "clinical cannabinoid deficiency is actually an umbrella term for various conditions, in particular:

Migraine
Fibromyalgia
Irritable Bowel Syndrome (IBS)
Other treatment-resistant conditions that could be alleviated by cannabis use

Essentially, a CECD means "a lack of endocannabinoids". The solution? Phytocannabinoids, which are found in abundance in cannabis. To state simply, a lack of cannabinoids could explain why conditions like migraine, fibromyalgia and IBS arise, and why people suffering from these conditions find cannabis to be therapeutic.

Now, there are a lot of conditions that could be linked to a CECD. This is perhaps because of the ECS's intimate relationship with homeostasis (the balance of the body's physiological processes), and there is still the chicken-or-egg question of "do these conditions arise because of a CECD, or does suffering from, say, multiple sclerosis or persistent headaches eventually cause a CECD?" The answer is likely to be "both", and it could be one of the key reasons why cannabis is so useful for so many conditions.

The CECD concept comes from Dr. Ethan Russo, who is a leading researcher on cannabidiol (CBD) and was involved in the development of GW Pharmaceutical's Epidiolex a CBD extract for epilepsy, and currently at Stage 3 development in the US. To see more of his work, check out the following links:



Original 2004 paper: https://www.ncbi.nlm.nih.gov/pubmed/18404144

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"Migraine, fibromyalgia, IBS and related conditions display common clinical, biochemical and pathophysiological patterns that suggest an underlying clinical endocannabinoid deficiency that may be suitably treated with cannabinoid medicines." However, the lack of evidence at the time made it just an "educated guess based upon some observable data and experimentation".


Video of Dr Ethan Russo discussing the research:




2016 update to 2004 paper:
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The abstract to Russo's article states:

"Currently, however, statistically significant differences in cerebrospinal fluid anandamide levels have been documented in migraines, and advanced imaging studies have demonstrated ECS hypofunction in post-traumatic stress disorder. Additional studies have provided a firmer foundation for the theory, while clinical data have also produced evidence for decreased pain, improved sleep, and other benefits to cannabinoid treatment and adjunctive lifestyle approaches affecting the ECS."



If you've made it this far, isn't this stuff fkn fascinating?


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Can You Simplify This Further but With More Details, Doc?

Sure can! There are two main endocannabinoids that you should know about. They are:

Anandamide (C22H37NO2) the body's "joy" chemical. Anandamide is a fatty acid neurotransmitter, and is converted into ethanolamine (a primary amine and primary alcohol) and arachidonic acid (AA a polyunsaturated omega-6 fatty acid) by the enzyme fatty acid amide hydrolase (FAAH). Anandamide's effects can occur in either the central or peripheral nervous system (CNS or PNS), and its effects are mediated by CB1 cannabinoid receptors in the CNS and CB2 cannabinoid receptors in the PNS. Anandamide is the "naturally occurring THC".

2-Arachidonoylglycerol (2-AG, C23H38O4) an endogenous agonist (a chemical that binds to a receptor and activates it in order to induce a response) of the CB1 receptor. It is an ester formed from arachidonic acid (see above) and glycerol, and is found in high levels in the CNS. 2-AG's activities are mediated by the enzymes phospholipase C (PLC) and diacylglycerol lipase (DAGL).

As you may have noticed, THC is the main phytocannabinoid that affects the cannabinoid receptors 1 and 2. The relationship between THC and anandamide, and why THC may help beat nausea (antiemetic) and muscle spasms. Anandamide also has a role to play in mood regulation and memory, which is why THC can affect memory as well as potentially help with post-traumatic stress syndrome and anxiety-related conditions.

CB1 receptors are found mostly in the CNS, and in smaller numbers in the liver, kidneys and lungs. CB2 receptors are found in the immune system and blood cells. CB2 receptors may play a role in inflammation, pain sensation and immune responses, and could also play a role in liver, kidney and neurodegenerative diseases.


There are more [at least two I'm aware of] receptors being discovered that are part of the ECS, but still not fully understood yet, at least not as well as CB1/2.


about CBD:
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Where Does CBD Fit Into All of This?

CBD doesn't affect the CB1 and CB2 receptors directly. Rather, CBD activates other receptors, like the vanilloid, adenosine and serotonin receptors. To give some examples:

Transient Receptor Potential Cation Channel Subfamily V member 1 (TRPV1) some people may recognise this protein being mentioned on articles surrounding Cannabis Hyperemesis Syndrome (CHS). This is because it is also known as the "capsaicin receptor", or "vanilloid receptor 1". This receptor plays a part in the mediation of inflammation, pain perception and body temperature, and CBD can help modulate this. CBD's effects on TRPV1 may also be why it works as an anticonvulsant and control epileptic seizures. TRPV1 may be involved with the onset and progression of some forms of epilepsy (e.g. Dravet syndrome).

Adenosine A1 Receptor CBD's effects on this receptor suggests it may have an effect on regulating the heartbeat, exerting an antiarrhythmic effect. CBD's effects on the A1 and A2 receptors have also been reported to have anti-inflammatory effects. Adenosine receptors also play a role in the release of the neurotransmitters dopamine and glutamate, which is why CBD may help treat schizophrenia treatment and other neurological conditions like dementia. CBD's effects on dopamine may also be one reason why cannabis can be used for drug addiction.

5-Hydroxytryptamine receptor, subtype 1A (5HT1A) a receptor that binds the endogenous neurotransmitter serotonin. CBD's effects on this receptor suggest why it may function as an antidepressant and anxiolytic (anti-anxiety medication) for many people, and also why it may help as a painkiller remember, SSRIs are also prescribed for chronic pain.

Furthermore, CBD inhibits the FAAH enzyme, which breaks down anandamide and affects the CB1 receptor (see above). This means that it can be used to "modulate" THC's psychoactive effects, whilst the THC can help CBD do its job better. Indeed, there are some interesting studies taking place at California Pacific Medical Center, where specific concentrations of THC and CBD injected into breast and brain tumors eliminates those tumors completely, in 30 days! Exciting stuff!


seriously. Aren't phytocannabinoids and thereby Cannabis awe-inspiring almost to the point where worshipping the plant for its benefit to humanity is a reasonable stance? [See: Asherah and Yahweh]

Chris Bennet is an interesting dude, I don't agree with some things he says/believes but his research and consolidation of publicly available data is at least worth perusing.

https://www.cannabisculture.com/content/2017/08/02/dr-frank-clinical-endocannabinoid-deficiency-cecd/


Skillet Shot
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So what cannabinoid product do you recommend? Lots of snake oil salesman out there with lo quality products, similar to supplements. Full spectrum CBD? With THC? Delta 8? What is the best way to ingest? Tincture? Flower? Oils? Edibles?
administrative errors
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Agreed, lots of poor formulations and everyone and their mom's dog has a cbd company these days hard to tell whats legitimate.

Fluxxlab.com and blisswellness.com are two brands coming from a local lab here in Colorado that I trust. I've been toying with white labeling it myself but I just don't have the time to commit.

No telling what specific cannabinoid [isolated or in combination or full spectrum] products would work best on any given issue without knowing more about symptoms.

THC acts on both receptors and enhances CBD efficacy. A 1:1 thc/cbd product will mostly cancel out the high from the thc if that is a concern [note: I don't think it should be a concern as the high is a good thing not A bad thing]. I enjoy delta 8 for my adhd and pain relief although I have almost completely stopped using cannabis/products etc lately.


If you'd like a more consultative approach lemme know I can make some product recommendations to try and see if it relieves what you're looking for. [Cryptohemp at gmail]
Skillet Shot
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I ordered some delta 8/CBD tablets from FluxxLab. Looking for something to help me relax, take the edge off and reduce alcohol intake. Alcohol impairs my sleep, even a single glass of red wine. Not sure if the CBD or CBN is the better way to go.
administrative errors
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Cbn is close to a muscle relaxant type effect, in combination with d8 they are awesome for sleep, according to all the anecdotal references I can muster.

Just dropped by the lab they have an almost tic-tac/mint product that you hold under the tongue and it's a quicker onset [10-20 mins versus 45] thats [5mg d8:1mg cbn] so it's easier to dose an appropriate amount. Pretty interesting.

Keep us in the loop on what you tried and how well it worked.
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