CLINICAL ENDOCANNABINOID DEFICIENCY

According to the National Health Council, an estimated 133 million Americans have one or more chronic illnesses. While the causes of some of these conditions are well-known, like inadequate insulin production leading to diabetes, others are more elusive.

Many chronic conditions are what one would call ‘disorders of unknown origin‘ – meaning no one is certain what causes them or how to manage them. To further complicate treatment, around 50 percent of Americans with chronic illnesses have two or more co-occurring conditions.

Anecdotal accounts and early scientific research show that cannabinoids, such as those found in full-spectrum tinctures, improve the symptoms of many of these conditions. But why do they work? The theory of clinical endocannabinoid deficiency may hold the answer.

WHAT IS CLINICAL ENDOCANNABINOID DEFICIENCY?

In 2003, Dr. Ethan Russo first explored the idea that a clinical endocannabinoid deficiency (CECD) is the root cause of chronic illnesses, such as fibromyalgia. This theory suggests that when the body does not produce enough endocannabinoids, numerous adverse health effects can occur.

This idea comes from the understanding that other chronic illnesses are the result of deficiencies of various chemicals, such as insufficient serotonin levels in depression. If Dr. Russo is correct, ‘disorders of unknown origin’ are also due to a lack of vital compounds, specifically endocannabinoids.

The presence of the cannabinoid receptors throughout the body helps explain how CECD can theoretically cause these seemingly unrelated illnesses. Ample scientific evidence shows that promoting healthy endocannabinoid (EC) system function reduces pain, regulates digestion, and more.

THE ENDOCANNABINOID SYSTEM

The EC system contains endocannabinoids, compounds that are naturally produced by the body, as well as cannabinoid receptors and enzymes that moderate their activity.

Endocannabinoids, like the bliss molecule anandamide (AEA) and 2-arachidonylglycerol (2-AG), bind to cannabinoid receptors (CB1 and CB2) to activate them, causing a variety of beneficial effects. Enzymes like FAAH work to moderate this activity by controlling the release of cannabinoids, as well as breaking them down.

Not having enough endocannabinoids in the body or having too many enzymes reduces cannabinoid receptor activity, causing health to deteriorate. This dysfunction may be the result of injury or disease, but genetics also seem to play a role in maintaining the EC system.

WHAT MEDICAL CONDITIONS DOES CECD CAUSE?

Chronic migraine, fibromyalgia, and irritable bowel syndrome (IBS) show the most extensive amount of evidence for CECD, although many other illnesses may also be the result of endocannabinoid deficiency. These conditions are called clinical endocannabinoid deficiency syndromes, and they all have some things in common:

-All are diagnosed using subjective criteria, such as how much pain a patient is experiencing. There are no easily accessible lab tests to diagnose these illnesses.

-All are diagnosed using a process of exclusion, meaning multiple tests like bloodwork are needed to rule out other conditions that cause the same symptoms.

-People with these ailments experience a higher rate of anxiety and depression, leading to a chicken vs. egg scenario. Does the disease cause anxiety, or is it the other way around?

These conditions also show a high prevalence of comorbidity, with around 30 percent of people with fibromyalgia having IBS, and vice versa. Chronic headaches affect an astronomical 97 percent of fibromyalgia patients, while 35.6 percent with migraines develop the rheumatic disease. 

This comorbidity supports the idea they all have a similar, if not identical, underlying cause.

CHRONIC MIGRAINE

Along with agonizing headaches, chronic migraines also cause nausea, vomiting, photophobia, and phonophobia. In a medical sense, the term phobia does not refer to debilitating fear but rather a sensitivity to light (photo) or sound (phono).

The most substantial evidence that CECD causes any illness comes from a study examining the spinal fluid of chronic migraine sufferers compared to healthy control participants. Researchers found that people with migraines had significantly lower levels of AEA than their healthy counterparts. 

There is also substantial evidence that cannabinoids help to reduce pain, which is invaluable in the treatment of migraines. Using cannabidiol has the additional benefit of restoring healthy EC system function to prevent migraines from occurring.

The ability of CBD to act as a TRPV1 receptor agonist likely causes these effects, as TRPV1 helps to regulate pain. Other cannabinoids, such as CBN and CBG, also bind to these receptors, which makes full-spectrum tinctures especially advantageous for treating chronic migraines.

FIBROMYALGIA

Fibromyalgia is a rheumatic disease characterized by soft tissue pain that wanders throughout the body and painful lumps known as lipomas. Lipomas are soft bumps beneath the skin that are essentially non-cancerous tumors made of fat.

This disorder is commonly comorbid with anxiety and depression, making it controversial among some doctors who believe it is psychosomatic. Despite the doubt in its validity, fibromyalgia is still one of the most commonly diagnosed illness by American rheumatologists.

Many studies examine the effectiveness of using cannabinoids to treat rheumatic diseases like arthritis, but not many of them focus specifically on fibromyalgia. However, one study found that fibromyalgia patients that used cannabis had significant reductions in pain and stiffness when compared to nonusers.

Another study examining the fascia (the connective tissue that surrounds muscles, bones, nerves, and blood vessels) found that the samples contained both CB1 and CB2 receptor agonists. Because the pain of fibromyalgia develops in the fascia, this finding helps to cement the link between the condition and endocannabinoid deficiency.

IRRITABLE BOWEL SYNDROME

IBS, also known as spastic colon, causes symptoms that include gastrointestinal pain, spasms, discomfort, and altered bowel movements. Many of the symptoms of IBS are regulated by the endocannabinoid system, making it a logical target for treatment and CECD a likely cause.

Cannabis was one of the first effective clinical interventions for diarrhea during the early 19th century when it was used to handle the symptom in patients with cholera. Despite over two centuries of anecdotal evidence that cannabinoids work, anticholinergics, antidepressants, and even opiates are standard treatments for IBS. 

Treatments that regulate the EC system, such as cannabidiol, may boost AEA levels and desensitize TRPV1 receptors, which are known to experience complications due to IBS, contributing to pain. However, more research is needed to be sure which cannabinoids help and at what dose.

While TRPV1 agonists like CBD, CBG, CBN, and CBC are clear treatment options, THC has also been shown to be effective.

OTHER TREATMENT-RESISTANT ILLNESSES

Other diseases that show a link to poor EC system function include obesity, which appears to be caused by overactivation of CB1 receptors. Using a CB1 antagonist, like cannabidiol, can reduce receptor activity to help control compulsive eating.

Additional illnesses that may be CECD syndromes include multiple sclerosis, schizophrenia, anorexia, Huntington’s, Parkinson’s, chronic motion sickness, cystic fibrosis, phantom limb pain, glaucoma, unexplained fetal wastage (repetitive miscarriages), post-traumatic stress disorder (PTSD), bipolar disorders, and many others.

All of these conditions are characterized by pathophysiological features, meaning there are both psychological and physical symptoms, that are difficult to explain. They usually respond poorly to treatment, which implies traditional medications are not addressing the underlying cause.

WHAT ARE THE TREATMENT METHODS FOR CECD SYNDROMES?

Because clinical endocannabinoid deficiency is still a theory, there is no universal treatment as of yet to improve the many syndromes associated with it. The current approach to these illnesses is to treat the symptoms, as the underlying cause is still not completely understood.

For example, patients with fibromyalgia and chronic migraines may take opioid-based medications to control their pain. Doctors often prescribe antidepressants or anti-anxiety medications to treat irritable bowel syndrome. 

All of these treatments are generally ineffective and have the potential to cause more harm than good, which is partially why most of these conditions are treatment-resistant. The other reason is the unwillingness of some physicians to take these chronic illnesses seriously.

Sometimes clinicians are skeptical of how valid these diseases are because of their mysterious origins, leading some to label them as psychosomatic, meaning they are psychological in origin and have no physiological cause. Further research into clinical endocannabinoid deficiency may help dispel this idea, akin to how understanding neurotransmitters changed the treatment of mental illness.

HOW TRADITIONAL METHODS ARE HARMFUL

Not only does the lack of understanding make managing these conditions difficult, but it can also make them worse. Long-term use of an agonist, which directly acts on CB1 and CB2 receptors, can desensitize receptors and decrease their ability to function. It also can cause a tolerance to develop, not only to the pharmaceutical agonist a person is using but to all of them, including endocannabinoids.

Although drugs like SSRIs, antipsychotics, and anxiolytics exhibit potential in preclinical studies, chronic use is likely harmful. Even a partial agonist like THC has been shown to increase CB1 density in rodents, which decreases cannabinoid-induced receptor activity throughout the brain. 

A post-mortem study of humans shows the same results, with long-term cannabis smokers showing a decreased ability for endocannabinoids to bind to CB1. Living subjects also illustrate a direct correlation between the number of years using cannabis and the density of CB1 receptors. 

However, consuming smaller amounts of appears to improve CB1 receptor function and the ability for other cannabinoids to bind to it. This small amount of a partial agonist works to kick-start the endocannabinoid system, helping to improve and regulate function.

USING FULL SPECTRUM TINCTURES TO TREAT CECD

The cannabinoids found in hemp and marijuana could prove to be an effective treatment for the many conditions associated with CECD. Full-spectrum CBD is an excellent candidate, as it contains enough THC to kick-start the EC system but not enough to cause a tolerance to natural CB1 agonists.

THC is also nearly identical in molecular structure to AEA, allowing it to bind to the same receptors to replicate the effects of anandamide. 

CBD, on the other hand, does not bind to these receptors but does enhance the effects of THC by inhibiting FAAH activity, one of the enzymes that breakdown AEA and 2-AG.

Cannabichromene (CBC) and cannabigerol (CBG) are also potent inhibitors of anandamide uptake, which further helps increase levels of the vital endocannabinoid. The additional cannabinoids, terpenes, and flavonoids in full-spectrum tinctures all work together to improve EC system function, restoring a natural balance to alleviate the many syndromes CECD is thought to cause.

IS USING FULL-SPECTRUM TINCTURES SAFE?

Everything on the planet comes with unintended side effects, but the ones associated with full-spectrum CBD are far from dangerous and much less severe than other medications used to treat the conditions linked to CECD. While it is possible to experience drowsiness, appetite changes, and other mild discomforts, they usually resolve on their own within a few days. 

While real, hemp-derived cannabidiol is not dangerous, there are products falsely labeled as CBD that are. Because the FDA does not regulate the production of tinctures, reports of adverse reactions to products containing synthetic cannabinoids abound.

HOW TO FIND A GOOD FULL-SPECTRUM TINCTURE

The lack of regulation means that it is up to consumers to ensure they are purchasing a high-quality, safe product. When choosing a full-spectrum tincture, either to improve a condition associated with clinical endocannabinoid deficiency or to promote overall health, take the time to learn about the product.

Iconic Remedies Full-Spectrum CBD Tincture is made using hemp organically grown in Colorado. The high-quality hemp oil extracted from these plants is mixed with coconut MCT oil to create a fast-acting tincture. Cannabinoids are fat-soluble, so a healthy fatty acid like MCT is invaluable in ensuring the maximum amount of relief in the minimum amount of time.

Independent testing is a hallmark of quality cannabidiol products, and it is the only way to be sure they contain what the manufacturer claims on the label. Iconic Remedies provides independent lab test results for all their products; more information is available by emailing iconicremedies@gmail.com.

THE FUTURE OF CECD & CHRONIC ILLNESS

If the theory of clinical endocannabinoid deficiency proves to be correct, it opens up a realm of treatment possibilities for the millions of Americans with treatment-resistant chronic illnesses. 

Thus far, traditional medications have done a poor job of alleviating these conditions, but the future of using cannabinoids to find relief is bright. Full-spectrum tinctures already show the potential to treat many chronic diseases, as they provide both agonists and antagonists to restore a healthy balance.

Regardless of whether or not clinical endocannabinoid deficiency is the underlying cause, cannabidiol undoubtedly improves symptoms of many of these diseases. That alone makes it an invaluable tool for anyone living with a chronic condition.