Clinical Endocannabinoid Deficiency: Fibromyalgia, Migraines, & More?

Clinical Endocannabinoid Deficiency (CECD) is a condition where an individual produces a lower amount of cannabinoids than experts consider to be essential in the promotion of health, vitality, and well-being.

Scientists now believe CECD may play a role in the following conditions:

  • Fibromyalgia
  • Pain
  • Anorexia
  • Depression
  • Irritable Bowel Syndrome (IBS)
  • Migraines
  • Multiple Sclerosis (MS)
  • Post-Traumatic Stress Disorder (PTSD)
  • Neuropathy
  • Huntington’s
  • Parkinson’s
  • Motion Sickness
  • Autism

Researchers believe that the underlying cause of many ailments, particularly those related to the immune system and inflammation, could be a disorder referred to as clinical endocannabinoid deficiency.

Endocannabinoid deficiency is a theory for the symptoms and conditions that develop when the body’s endocannabinoid system isn’t functioning properly. We’ve previously discussed the endocannabinoid system and its role in regulating a wide array of body processes to maintain our health. The body naturally produces neuromodulatory lipids called endocannabinoids, which interact cannabinoid receptors throughout the body to elicit chemical responses that keep the body in balance.

The theory of clinical endocannabinoid deficiency suggests that in some cases the body doesn’t produce enough endocannabinoids or enough receptors for the endocannabinoid system to function properly. As a result, the many functions aren’t regulated properly and the body becomes unbalanced, allowing diseases to arise.

Renowned cannabinoid researcher Dr. Ethan Russo first proposed the theory of clinical endocannabinoid deficiency in 2004. In a study, published in Neuro Endocrinology Letters, Russo suggested that deficient cannabinoid levels might explain why some conditions develop.

Russo had examined the available literature and found evidence that people diagnosed with certain conditions had lower levels of endocannabinoids. He suggested that a person being deficient in endocannabinoids and/or cannabinoid receptors could explain why supplementing with cannabinoids found in plants like hemp were proving effective at alleviating some conditions.

“Migraine, fibromyalgia, [irritable bowel syndrome] and related conditions display common clinical, biochemical and pathophysiological patterns that suggests an underlying clinical endocannabinoid deficiency that may be suitably treated with cannabinoid medicines,” Russo concluded in his research review.

Cannabinoids found in plants like hemp, including cannabidiol (CBD), are analogous to the endocannabinoids naturally produced by the body. Research shows that they interact with the cannabinoid receptors of the endocannabinoid system to elicit chemical responses that help bring about homeostasis.

A deficiency in endocannabinoids has been linked to several other disorders besides migraine, fibromyalgia and irritable bowel syndrome. The endocannabinoid system is responsible for regulating the release of neurotransmitter, so diseases that are attributed to their dysfunction, such as Alzheimer’s disease and Parkinson’s disease, may be related to clinical endocannabinoid deficiency.

While more research needs to be done before endocannabinoid deficiency can be proven, the theory could open the door for methods to prevent and manage certain conditions. Russo believes cannabinoids from cannabis plants like hemp are essential nutrients that can minimize certain diseases by assisting the endocannabinoid system and ensuring that it functions properly.

Anandamide and arachidonoylglycerol (2-AG) are neurotransmitters that carry messages throughout the endocannabinoid system (ECS). They are modulators, serving to maintain homeostasis throughout the body. When systems get out of balance, these neurotransmitters go to work to bring us back to a state of health.

The ECS has CB1 receptors in the brain with a greater density than most of the other neurotransmitter systems, and CB2 receptors are found throughout the GI tract, liver, spleen, immune system and peripheral nervous system.

With this prevalence of the ECS, if anandamide and 2-AG are deficient in their activities, we would expect to see health problems like lowered pain thresholds, problems with digestion, problems with sleep, and an increase in mood disorders.  Research on the proper functioning of the ECS could give us new opportunities to address some health problems that have, so far, been difficult to both diagnose and treat.

The three most studied conditions linked to Clinical Endocannabinoid Deficiency (CED) are migraines, fibromyalgia, and Irritable Bowel Syndrome. These three have much in common. All of them cause an increased sensitivity to pain and all must be diagnosed subjectively by a process of exclusion, there being no objective tissue or lab findings for any one of them.  All are associated with a higher incidence of anxiety and/or depression. And they often overlap, with patients presenting with some combination of the three quite often.

Anyone with fibromyalgia knows the frustration of diagnosing and treating this disabling condition. Fibromyalgia is the most common diagnosis in American rheumatology practices. Patients with fibromyalgia have painful trigger points that are severe enough to limit lifestyle and quality of life. Over time, these painful areas intensify pain perception in the brain leading to disturbances in sleep, dysfunction of the nervous system, and depression. Unfortunately, the depression of fibromyalgia does not respond well to commonly used anti-depressant medication.

The connection between hyperalgesia (increased sensitivity to pain) and the endocannabinoid system is supported by studies that injected cannabinoid antagonists into mice. When the CB1 receptors were blocked this way, the mice experienced significant pain, which was relieved by the injection of synthetic cannabinoids. This and other studies support the use and study of cannabinoid agonists for chronic pain conditions like fibromyalgia and migraines. Presumably, if the endocannabinoid system was working as it should, chronic pain and hyperalgesia would not develop. Supplementing a deficient endocannabinoid system with phytocannabinoids could help patients with fibromyalgia regain some quality of life.


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