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Endocannabinoid Deficiency

Updated: Jun 11, 2021

As modern medicine evolves, a better understanding of our endocannabinoid system (ECS) is proving to be crucial in promoting a healthier population. The ECS plays a vital role in our moment-to-moment health, so understanding what happens when it’s not functioning properly is important in addressing the root cause of some diseases.

Clinical Endocannabinoid Deficiency (CED) is a theory developed by Dr. Ethan Russo in 2001. Essentially, Dr Russo pointed out that sputtering ECS will fail to produce a sufficient amount of compounds the body needs. Those compounds (anandamide and 2-AG) are key players of the ECS and contribute to our inflammatory response, pain threshold, sleep, anxiety, mood, and appetite. Both of these compounds are referred to as endogenous cannabinoids. Per Dr. Russo, if we don’t make enough of these endo-cannabinoids, multiple processes within the body can be disturbed, thus leaving the window open for chronic illness.

The concept of being deficient in important chemicals doesn’t come without precedent. Our body can be low in vitamin C, something we can’t create more of, but can to be remedied with over-the-counter doses of the vitamin. Parkinson’s disease is linked to low levels of dopamine, a compound our bodies create on their own, but a prescription drug called L-Dopa is commonly used in treatment. While we can synthesize our own cannabinoids, we can’t do so on demand. Being behind in cannabinoid production is what CED is rooted in and is attached to three common conditions: chronic migraines, fibromyalgia, and Irritable Bowel Syndrome (IBS).

We’ve grown accustomed to medical conditions being easy to measure. Taking one’s temperature, monitoring high blood pressure, and measuring blood sugar are simple enough to keep track of, but the three main conditions attached to CED aren’t so straightforward. In an interview with Project CBD, Dr. Russo explained these maladies are “hyper-algesic syndromes", meaning that there seems to be pain out of proportion to the observed body conditions. In other words, the tissue appears healthy, but biochemically something else must be driving the pain.

That something may be low levels of anandamide, the endo-cannabinoid that binds to CB1 receptors in the central nervous system. A 2009 study from Italy confirmed that individuals with low anandamide levels in their cerebrospinal fluid were experiencing significantly higher levels of migraines than those with normal anandamide levels. Even more, there is growing evidence that suggests comorbidity between migraines, fibromyalgia, and IBS. If you have one of these conditions, you are more likely to have another, suggesting shared root causes. Sometimes an endocannainoid deficiency is a result of something missing from one's diet. Sometimes the cause is genetic. The connection between these low-cannabinoid diseases can also be triggered by environmental factors that fall under the umbrella of general stress — and a properly functioning ECS is the body’s first line of defense against life’s daily challenges.


While treating low-cannabinoid conditions acutely with prescription drugs is standard, these treatments often don't do much in terms of prevention. However, per Dr. Russo, if we can support our ECS, then it can support us.

So how do we make sure our ECS is taken care of? Perhaps the most direct way to do this is through the consumption of cannabinoids. Plant-based cannabinoids like THC and CBD interact with our ECS like anandamide and 2-AG do. These phyto-cannabinoids can also slow the reuptake of our naturally occurring cannabinoids. For example, CBD inhibits the enzyme called Fatty Acid Amide Hyrdolase (FAAH), which breaks down the anandamide in our brains. In turn, ingesting more CBD indirectly results in elevated levels of anandamide.


While major cannabinoids (like THC and CBD) are all found in the cannabis plant, trace amounts of minor cannabinoids can also be found in dark chocolate, pepper, clove, rosemary, and several cruciferous vegetables. Adding these to an already healthy diet can help ensure your ECS is getting proper support. Even more, certain activities like exercise, social interaction, yoga, meditation, and acupuncture can all contribute to a healthy ECS. This is by no means a call to scrap traditional medicine. However, the concept of CED sheds light on common causes of migraines, fibromyalgia, and IBS while simultaneously underlining the potential of medicinal cannabis.

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