Endocannabinoid Deficiency - What Is It?

‍The Endocannabinoid System

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‍Our physical wellbeing relies on an ever-shifting balance, a physiological juggling act performed by our bodies called homeostasis. This process ensures that enzymes, the catalysts for the biochemical reactions constantly occurring within us, can function properly without disruption. When this balance is lost, the systems that keep us healthy can begin to collapse, like a trapeze artist wobbling precariously on a high-wire.

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In order to maintain homeostasis, the body utilizes a complex cell-signaling process known as the endocannabinoid system (ECS). Our bodies naturally create endocannabinoid molecules, neurotransmitters which bind to receptors in our central and peripheral nervous systems when homeostasis is disrupted by illness, injury or emotional distress. The ECS – comprised of 1) endocannabinoids, 2) the receptors in the body they bond with, and 3) the enzymes that break these cannabinoids down – is like a safety net under the balancing act, giving our bodies the security needed to regain its balance and resume optimal activity.

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Endocannabinoid Deficiency

Clinical endocannabinoid deficiency syndrome (CECD) is a scientific theory, first proposed by Dr Ethan Russo in 2001, that seeks to explain the causes of chronic incurable complaints such as migraines, fibromyalgia, cystic fibrosis, and irritable bowel syndrome. The theory posits that a deficiency in endocannabinoids in the body may result not only in a disruption to our homeostatic processes, but also in the lowering of our pain threshold, and thus an increased sensitivity to and awareness of the resulting discomfort.

In his 2016 paper Clinical Endocannabinoid Deficiency Reconsidered, Russo maintained his theory had further bolstered its scientific integrity. “Medicine continues to struggle in its approaches to numerous common subjective pain syndromes that lack objective signs and remain treatment resistant,” he writes. “Additional studies have provided a firmer foundation for the [ECS] 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.”

How to Improve ECS Function

Under normal circumstances, exercise, a healthy diet (high in polyunsaturated fats low in carbs, and rich in fresh vegetables and spices), restful sleep, and effective stress management are all already essential to our homeostatic balance, and ensuring our endocannabinoid systems are not overtaxed. But for people who feel they may also be suffering from endocannabinoid deficiency system, it is worth looking into one’s family health history for clues about a possible genetic disposition to CECD. These debilitating health issues, which may also include a spectrum of other conditions such as glaucoma and bipolar disorder, can become easier to manage once their underlying pathological history is more fully understood. As Russo asserts in the conclusion to his 2016 report: “Multimodality approaches are most likely to be fruitful in treatment of these common yet difficult clinical challenges.”

How Cannabis May Help

The cannabis plant Cannabis sativa L. contains more than 100 cannabinoids. The two most studied are tetrahydrocannabinol (THC), the compound that creates the ‘high’, and cannabidiol (CBD), which triggers positive responses in the body without the high (or the other potential side effects of THC such as paranoia or anxiety).

Conditions such as migraine and fibromyalgia seem to be linked to an excess or deficiency respectively of the mood-modulation hormone serotonin in the blood, and sufferers of these conditions often report significant improvement in their systems after cannabis use. As THC would appear to both trigger and inhibit the release of serotonin at different doses, it is unclear exactly how it interacts with the ERCS to alleviate CECD-related conditions.  

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CBD is understood to inhibit the enzyme fatty acid amide hydrolase (FAAH), which  is involved in the breakdown and degradation of the endocannabinoid anandamide (by contrast, FAAH cannot break down CBD or THC, which is why these compounds linger for far longer in the body). Known to play a role in our sensation of pleasure (it is present in small quantities in chocolate), anandamide - from the Sanskrit word ananda, or ‘bliss’ - can also mitigate feelings of fear and anxiety. The fact that CBD may increase its half-life in our bloodstream would suggest that both THC and CBD may have important therapeutic impacts on ECS function, particularly in people who suffer from an endocannabinoid deficiency. 

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An Interview with Dr Ethan Russo

You can listen to an interview with Dr Ethan Russo in one of our LabAroma podcast episodes here.