- TABLE OF CONTENTS
- The Endocannabinoid System
- Treatment With Cannabis For The Endocannabinoid System
- Physiological Importance
- Other Clinical Conditions
- My Own Clinical Experience
- Irritable Bowel Syndrome And Endocannabinoid System Failure
- Other Illnesses that suggest an Endocannabinoid Failure are
- Answering The Sceptics
- Clinical Endocannabinoid Deficiency. Theory or reality?
What Is Endocannabinoid System Failure
Doctor Raquel Peyraube is a doctor in medicine and a specialist in the problematic use of drugs. She has trained in psychiatry, toxicology, and psychoanalytical psychotherapy and has 28 years of experience in this area. Throughout her career, she has made contributions in training, prevention, treatment, and damage reduction. She is giving advice on reform of the public drug policy and of the Institute of Cannabis Regulation and Control and she is a clinical researcher and a member of research teams for monitoring the law in Uruguay.
The Endocannabinoid System
The endocannabinoid system(ECS) is a complex system that regulates the homeostasis of the human body. Its importance has been established in the findings of scientific research into its functions and the physiological systems with which it is related to health and disease. Many diseases are the result of failures in regulatory systems. The ECS can have excessive or deficient action of the different hormones. Hyper or hypo hormonal functions are also recognized. It is easy to understand that a system as complex as ECS might also present genetic or acquired failures. It is easy to understand that these failures might be expressed in very varied forms.
Treatment With Cannabis For The Endocannabinoid System
Symptoms have been shown to respond positively to treatment with cannabis. It has been said that many conditions treated with cannabis and CBD might be explained as structural failures of the system or functional failures. This means that there might be reductions and or increases in the endocannabinoids and in their receptors and the enzymes they produce or destroy. Another possibility is that the disease in course creates such an intense or prolonged demand that it exceeds the regulatory capacity of the system. There could be genetic failures or as a consequence of the impact of certain conditions on the system. Data from the research thus far has led to the formulation of the theory of Clinical Endocannabinoid Deficiency. E. Russo and other authors have published a number of studies on the subject. In his most recent work, he gives updated evidence for this possibility.
Any failure in this system will decide the variations in the levels of endocannabinoids through failures in production or destruction. The number of receptors that are in the area will decide how bad the issue is for that person. If the systems that regulate pain, mood, digestive and alimentary functions, immunity and sleep show an increase or reduction in endocannabinoid tone, the result will be various issues of poor health.
According to Russo the strongest evidence for the existence of the CECD lies in findings on migraine. Other issues such as fibromyalgia and irritable bowel syndrome also support this. These conditions which, as well as being resistant to treatment, share certain clinical characteristics such as:
- A state of hyperalgesia (abnormal increase in sensitivity to pain)
- A lack of specific pathological signs at the tissue level
- Association with high levels of anxiety and depression
- They have all been labeled as psychosomatic diseases
- They frequently present in the same individual simultaneously or at different points in time.
Other Clinical Conditions
This review of the available studies shows alterations in endocannabinoid levels. In migraine, the serum levels of AEA, or AEA and 2-AG are significantly reduced, which could be due to an increase in their destruction. This would explain the relief that cannabinoids can bring to migraine patients. This effect would not be mediated by CB1 receptors, but by TRPV1, the sites of action of cannabidiol. One of the most categorical studies is by Sarchielli who shows a significant difference in AEA levels between people who do not suffer migraines and those who do. They conclude that this shows strong evidence of ECS failure.
My Own Clinical Experience
I have seen a very good response to treatment with repeated doses of CBD, requiring very low doses of THC, for which reason its adverse effects are almost entirely absent. Following treatment with cannabinoids, the frequency of migraine crises tends to diminish considerably. In some cases, I have even seen it disappear altogether, at least during the period of clinical monitoring. In the case of fibromyalgia, the findings of the research back the idea of a hypofunction of the ECS at the central level.
Irritable Bowel Syndrome And Endocannabinoid System Failure
The most important functions in the digestive apparatus is a reduction in gastric secretion and the regulation of the lower oesophageal sphincter. Also, the reduction in motility of the digestive system in all areas. The reduction in intestinal secretion and control of visceral sensitivity is there too. The symptoms of irritable bowel syndrome, it is easy to see that this might be explained by a failure of the ECS. We can see a reduction in AEA, and as shown by a study in intestinal biopsies from IBS sufferers, an increase in TRPV1 receptor fibers. This might explain the hypersensitivity and pain.
Other Illnesses that suggest an Endocannabinoid Failure are:
- Multiple sclerosis
- Huntington’s disease
- Parkinson’s Disease
- Post-traumatic stress syndrome
- Depression, anorexia nervosa and an autism spectrum disorder which now tend to be thought of as a degenerative disease linked to ECS deficiency.
Answering The Sceptics
In any medical discussion of treatments, the more these treatments impact the process of disease production, the greater the anticipated effectiveness. These are what we call physio-pathological treatments and would be the case of cannabinoids. We can answer the skeptics who question the use of cannabinoids (CBD). We must again insist on the need, as well as scientific consensus, for randomized placebo-controlled clinical trials and analytical and genetic studies.
Clinical Endocannabinoid Deficiency. Theory or reality?
Is CECD theory or reality? All the evidence appears to point to the real existence of CECD. For a clinical practitioner, this hypothesis is almost self-evident. It is rational and, in empirical terms, it matches the praxis almost perfectly. Indisputably, final confirmation requires more scientific evidence.
Based on all the above, I would like to take this opportunity to make an observation and a proposal. The specialty concerned with neurological diseases, for example, is neurology; endocrinology is concerned with endocrines and so on.
And yet, in this field, we talk about cannabis medicine. We stop referring to “cannabis medicine” and we should speak instead of Endocannabinology. This is a specialty that is concerned with the study and treatment of alterations of the ECS.
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Endocannabinoid System Failure is when your body’s ECS has too much or too little of certain hormones. When your body is in a Hypo or Hyper state these failures will result in various illnesses due to the complex and integral function of the ECS system. Your body cannot maintain balance and a breakdown in certain functions occurs.
Just like we could not live without a digestive system we cannot live without our endocannabinoid system. It developed with us in the womb and is responsible for maintaining balance within the body. It keeps our mental and physical health in check