What Is Clinical Endocannabinoid Deficiency?

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Our understanding of the endocannabinoid system (ECS) has grown significantly in recent years. Despite ongoing research into its regulatory role and possible interactions with cannabinoids, there is one phenomenon that remains unanswered. Keep reading to find out how a deficiency in endocannabinoids is believed to be an underlying factor in several debilitating diseases.

The role of the endocannabinoid system

The endocannabinoid system is a series of receptors, chemical compounds, and metabolic enzymes that help keep our biological systems in balance. This state of homeostasis occurs when the body and all its functions operate at their optimal level. However, the endocannabinoid system is not capable of improving our body's optimal state past its natural limits—to do that, it needs supplemental input. This is where cannabinoids come in.

The cannabinoids found in the Cannabis sativa species (and a handful of other plants) are capable of binding to receptors linked to the ECS. When they do, a wide range of biological effects are possible. Together, the endocannabinoids we produce internally and the cannabinoids we consume externally can be used synergistically to boost the capabilities of our ECS.

Studies have shown that adequate levels of endocannabinoids are necessary to maintain the ECS’s regulatory abilities, so what happens if these levels take a dip? That is the same question that Dr. Ethan Russo, a leading researcher of the ECS, aimed to find out.

What is clinical endocannabinoid deficiency?

In 2004, Dr. Russo outlined a phenomenon that he believed could be a contributing factor to migraines, fibromyalgia, irritable bowel syndrome, and other treatment-resistant conditions. Clinical endocannabinoid deficiency (CECD) is believed to occur when endocannabinoids dip below their normal levels, causing us to suffer from disease as a result—diseases that would normally be kept at bay by the regulatory power of the ECS.

Dr. Russo proposed that in several of the conditions mentioned above, there were similarities in the mechanisms that caused their onset. One observed similarity was a deficiency in anandamide, a crucial endocannabinoid that plays a role in pain management, pleasure, and appetite regulation. At the time, the study was met with a significant degree of scepticism because our understanding of the endocannabinoid system was still in its infancy.

The potential implications of CBD and clinical endocannabinoid deficiency

If Dr. Russo’s theories were conclusively proven to be accurate, then the importance of supplementation with cannabinoids becomes paramount in treating the conditions linked to CECD. CBD would inevitably be a frontrunner for those diagnosed with clinical endocannabinoid deficiency because of its interactions with the endocannabinoid system.

In a 2012 study, CBD was found to inhibit the production of the FAAH enzyme. This interaction is important due to the effect FAAH has on anandamide. Fatty acid amide hydrolase is responsible for breaking down anandamide and preventing the endocannabinoid from sustaining its effect. If we think back to one of the underlying mechanisms associated with CECD, anandamide was a key player. Therefore, CBD’s ability to inhibit FAAH production and encourage higher levels of anandamide could prove essential to improving CECD.

Support for CECD is growing

The only problem with the potential interactions between CBD and CECD is just that: they are only “potential”. The phenomenon of clinical endocannabinoid deficiency has yet to be conclusively proven, and any relationships between cannabinoids and treatments are only suspected at this point. Since the initial exploration of the concept, Dr. Russo has released a second paper with further studies to support his claims.

The review highlights, again, similarities between the mechanisms behind migraines, fibromyalgia, and IBS. However, outside of comparing studies, which all have different variables, there is no single study that has set out to identify CECD. Even though the impact of clinical endocannabinoid deficiency is only suspected at this point, the implications, if proven, are significant. It is for this reason that Dr. Russo continues to explore the concept and solidify his theories.

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