More is being known about the human internal cannabinoid system all the time. For example, according to a review by the US Department of Health endocannabinoid system and its deficiency states are associated with almost all diseases (1). This article looks specifically at endocannabinoid deficiency as a potential cause of migraines, fibromyalgia, and irritable bowel syndrome (IBS).
Purpose of the endocannabinoid system
The purpose of the endocannabinoid system is to monitor, balance and maintain the body’s various functions. This clever system is part of a vast receptor network. Cannabinoid receptors CB1 and CB2 are located everywhere in the body and therefore it affects almost all physiological functions of the body (2).
Substances naturally found in hemp such as cannabinoids ( CBD etc.), terpenes and flavonoids affect the endocannabinoid system in a balancing way all together ( Entourage effect ) and individually (3).
The human internal cannabinoid system was only discovered in the 1990s.
The endocannabinoid system, i.e. the internal cannabinoid system a significant discovery took place in the early 1990s. It was only then, thanks to Lisa Matsuda and her colleagues, that the first cannabinoid receptor CB1 was discovered. Next, the CB2 receptor was discovered, which was found to be part of the immune system and the nervous system. CB2 cannabinoid receptors have been found all over the body. They are found, among other things, in blood vessels, heart, liver, kidneys, intestine, spleen, bones, genitals and lymph cells (4).
Cannabinoid system deficiency states (CECD) can be the cause of e.g. for irritable bowel syndrome (IBS), fibromyalgia and migraine
In a 2004 study, leading endocannabinoid researcher Dr. Ethan Budd Russo was the first to put forward a theory related to the state of internal cannabinoid deficiency (CECD, or Clinical Endocannabinoid Deficiency ). and related health problems. The deficiency state can be caused by a low amount of cannabinoids in the body, or it can also be related to defective or missing cannabinoid receptors in the body. If the body is unable to maintain homeostasis, i.e. a state of balance in its physiological systems, it may contribute to the onset of various diseases. The diseases under study are significantly related to the functioning of the immune system.
Based on new research, several researchers think that deficits in the internal cannabinoid system may be related to migraines and diseases such as fibromyalgia and irritable bowel syndrome, or IBS (5). Although not all medical professionals support this idea yet, new research results support the theory and there are more and more of them all the time.
Migraine refers to a disease that causes headache attacks. Although the exact cause of migraine is still not completely known, it is known that it is usually caused by a disturbance in the brain stem caused by external factors. Genetic predisposition also has a decisive influence on the development of migraine. Migraine with aura in particular seems to be a hereditary type (6).
Migraine occurs to some degree in one in ten people and is three times more common in women than in men. For women, migraine attacks most often occur at the same time as menstruation, when it is possible to talk from menstrual migraines. Migraines also occur in children and young people (6).
Migraine attacks and intensities vary from person to person and are often caused by external factors. A migraine attack can be triggered by, for example, stress, sunlight, alcohol, insomnia and too long meal breaks (6).
Fibromyalgia refers to a chronic disease that causes long-term musculoskeletal pain that is not caused by injury, inflammation or damage. Other common symptoms associated with fibromyalgia include memory problems, fatigue, and sleep problems. Sleep problems usually mean that sleep is not refreshing, i.e. fatigue continues even after a night’s sleep (7).
Fibromyalgia is a fairly common syndrome in Finland and about five percent of Finns suffer from it. The majority of patients are female (7).
According to research conducted by Ethan Russo in 2004, it has been found that the internal cannabinoid system is involved in the perception of pain and the sending of pain signals to the brain. Based on research results, disturbances in signals can contribute to the formation of diseases that produce long-term pain conditions. The study found that cannabinoids can reduce mechanisms in the peripheral nervous system, digestive system and spinal cord that increase pain perception (5).
Irritable Bowel Syndrome (IBS)
Irritable bowel syndrome or IBS (Irritable Bowel Syndrome) is very common in Finland. At least 10% of Finns suffer from this problem. In general, IBS occurs twice as often in women as in men (8).
Despite the fact that IBS is an unpleasant problem, it is not considered dangerous and is not associated with other serious diseases. In the past, this syndrome was called irritable bowel syndrome, but later its name has been changed because the symptoms are essentially also related to the small intestine (8).
Irritable bowel syndrome is a functional problem of the intestines, in which the functioning of the intestines is disturbed and the patient may experience pain in the abdominal area. Usually the symptoms are also accompanied by abdominal swelling and flatulence. The function of the intestine can also change, so that defecation is less frequent or more frequent than average and the stomach is, so to speak, either loose or hard (8).
In most cases, the spectrum of intestinal microbes in an IBS patient is smaller than in a completely healthy person. The reasons for the symptoms are not yet completely known, but researchers estimate that it is related to bowel movements, the permeability of the walls in the intestine, low-grade inflammation, pain perception or nervous system activity. For others, eating may make symptoms more difficult and therefore changes in eating habits may ease symptoms caused by irritable bowel syndrome. Sometimes irritable bowel is associated with another functional symptom. Psychological factors such as anxiety and depression can also be associated with irritable bowel syndrome (8).
In the future, deficiency states could be alleviated with suitable cannabinoid medicines.
Based on Dr. Ethan Russo’s research, a lack of endocannabinoids can be a significant factor in the development of irritable bowel syndrome in the same way as it is with migraines and fibromyalgia. All of these diseases seem to be related to serotonin levels and its function.
It would seem that the treatment of symptoms can be developed especially by affecting the patient’s serotonin levels, and cannabinoids naturally offer essential help in this. Although more research is needed, according to Ethan Russo, endocannabinoid deficiency could be alleviated with appropriate cannabinoid medications. More research is also needed on the subject, so that the whole concept of the endocannabinoid deficiency state can be better understood (5).
1. Pál Pacher & George Kunos. 2014. Modulating the endocannabinoid system in human health and disease: successes and failures. FEBS J . https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3684164/
2. Bradley E. Alger. 2013. Getting High on the Endocannabinoid System. Cerebrum . https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3997295/
3. Ethan Russo & John McPartland. 2001. Cannabis and Cannabis Extracts: Greater Than the Sum of Their Parts. https://www.researchgate.net/publication/228897917_Cannabis_and_Cannabis_Extracts_Greater_Than_the_Sum_of_Their_Parts
4. Sean Munro et al. 1993. Molecular characterization of a peripheral receptor for cannabinoids. Nature. https://www.nature.com/articles/365061a0
5. Russo, EB 2004. Clinical Endocannabinoid Deficiency (CECD): Can this Concept Explain Therapeutic Benefits of Cannabis in Migraine, Fibromyalgia, Irritable Bowel Syndrome and other Treatment-Resistant Conditions? Neuroendocrinology Letters. https://www.nel.edu/userfiles/articlesnew/NEL251204R02.pdf?route=pdf_/25_12/NEL251204R02_Russo_.pdf
6. Sari Atula. 2019. Migraine . Medical book Duodecim. https://www.terveyskirjasto.fi/dlk00047. Referred on 03.01.2022
7. Heikki Julkunen. 2019. Medical book Duodecim. https://www.terveyskirjasto.fi/dlk00016/fibromyalgia?q=fibromyalgia. Referred on 04.01.2022
8. Tiia Reho. 2021. Doctor’s journal Duodecim. https://www.terveyskirjasto.fi/dlk00068/artyvan-suolen-oireyhtyma-ibs?q=%C3%A4rtyv%C3%A4n%20suolen%20oireyhtym%C3%A4. Referenced 04.01.2022