While I am a fully licensed physician in Kansas, this communication does not constitute personal medical advice or establish a physician-patient relationship. See your own physician to discuss your particular diagnosis and treatment
Endocannabinoids
Stress is a common condition in our society. Stress can promote (i) inflammatory diseases such as asthma, eczema or urticaria, rheumatoid arthritis, ulcerative colitis, and sickness syndrome; (ii) pain disorders such as headaches and abdominal, pelvic, and lower back pain; (iii) gastrointestinal dysfunction such as diarrhea, constipation, and peptic ulcers; (iv) mental illnesses such as anxiety, depression, psychosis, cognitive dysfunction, and insomnia; (v) metabolic diseases such as diabetes mellitus, hypercholesterolemia, visceral obesity, and sarcopenia; (vi) ischemic heart disease; (vii) neurodegenerative diseases; and (viii) osteopenia and osteoporosis. This is not an exhaustive list, but gives insight into the widespread manifestations of stress. When I discuss the pillars of health with my patients, stress comes up. Leveraging the endocannabinoid system can help reduce stress.
The endocannabinoid system is a widespread neuro modulatory system that plays important roles in central nervous system development, synaptic plasticity, and response to endogenous and environmental insults. The endocannabinoid system is a retrograde system, functioning post to pre-nerve synapse, allowing it to be a master regulator in the body. At the synapse, endocannabinoids inhibit the release of many excitatory and inhibitory neurotransmitters. Therefore, endocannabinoid's post-synaptic target cells can influence their own incoming synaptic signals. The endocannabinoid system functions through the regulation of neurotransmitter function, apoptosis (programmed cell death), mitochondrial function, and ion-gated channels. The endocannabinoid system runs through adipose tissue, important in adipogenesis, lipogenesis, and glucose uptake, all stimulated by the CB 1 receptor. Dopamine activity is tied to endocannabinoid activity. CB 1 receptors are located across the striatal regions of the brain that mediate reward function.
Endogenous cannabinoids are endogenous lipids that engage with cannabinoid receptors. These are synthesized from omega-3 and omega 6 fatty acids. Examples include Anandamide or N-arachionyolyethanolamine (AEA), (first endocannabinoid discovered) and 2-arachidonolyl glycerol (2-AG). AEA may be very important for pain control. AEA also has ability to make or break short-term connections and nerve cells that affect memory. Utility may be to decrease PTSD. 2 AG is the most prevalent endocannabinoid in the body. It seems to play a role in inflammation through immune suppression. Also, 2-AG has psychoactive properties when bound to CB1 receptors. Cannabinoids are rapidly synthesized and degraded, therefore, do not stay in the body for a long time, possibly a safer alternative to opioids and benzodiazepines. Endocannabinoid's have antiproliferative, anti-inflammatory, and anti-metastatic effects.
Cannabinoid receptors are present throughout the body and in the brain. There are CB1 and CB2 receptors. CB1 receptors are in the brain and CNS. They control the level and activity of most of the other neurotransmitters. In the process, they also help to regulate hunger, temperature, sleep, memory, fertility, bone remodeling, motor control, liver function, stress, and alertness. The drug rimonabant blocked the CB1 receptor. It was developed as an anti-obesity drug due to the effect of the endocannabinoid system on hunger. It was successful in promoting weight loss through decreased hunger, however, it caused significant effects on mood. Blocking CB1 receptors can result in suicidal ideation. CB2 receptors are mostly present in the peripheral nervous system and immune cells and help control inflammation. When these receptors are stimulated, patients do not experience "a high". When 2-AG is activated, it increases the effects of the GABA system, results in CNS “relaxation”. Endocannabinoids have a calming effect. They may be responsible for the “runners high” experience and seem to be more likely than endorphins. Endocannabinoid's can easily pass the blood-brain barrier promoting short-term psychoactive effects.
Mental health disorders such as schizophrenia have been linked to a malfunctioning endocannabinoid system. THC can bind to both CB1 and CB2 receptors. Increased use of THC cannabis is associated with increased incidence of schizophrenia and psychosis.
CBD does not bind to CB1 or CB2 receptors in the same fashion that THC does. It is possible that CBD prevents other Endocannabinoids from being broken down.
Foods that function as Endocannabinoids: Truffles, dark chocolate, coffee, oregano, curcumin, cinnamon, Chia seeds, hemp, walnuts, sardines, anchovies, eggs.
Medium and high intensity exercise also stimulates the endocannabinoid system. Moderate intensity exercise dramatically increased concentrations of anadamide in blood plasma levels.
Stress lowering activities such as meditation will also stimulate the endocannabinoid system. A 4 day yoga-meditation retreat reveals blood level changes and survey reported improved depressive and anxiety symptoms.
Supplements: Omega-3 fatty acids, vitamin C
CBD oil: CBD appears to act on opioid, serotonergic, and cannabinoid receptor systems. CBD also activates PPAR gamma, reducing neuroinflammation and excitotoxicity associated with stress. Binds to CB2 receptors to help with immune support, but do not feel euphoria. CBD is used by up 10% of the population to relieve stress and over 90% of people that tried it reported feeling less stressed based on subjective report. The FDA has issued a caution about safety. CBD is only approved for seizure treatment for Lennox Gastaut, Dravet syndrome, or tuberous sclerosis complex seizures. Reported risks/concerns with CBD oil: Dry mouth, diarrhea, decreased appetite, drowsiness, fatigue, liver injury and interaction with blood thinner medications.
I hope this information helps you and your loved ones!
Jason Williams, D.O.