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01/Jun/2022

Each individual has a unique endocannabinoid system (ECS) tonus that reflects the level of ECS constituents. Both, too low and too high ECS tonus levels can lead to health problems and appear to be involved in the development and chronicity of diseases. Unfortunately, the connections are largely unknown in the medical community.   

We asked Robert Uhlenbrock, a Kalapa Clinic physician and expert in the use of medical cannabis, about the importance of ECS tonus.   

CanPharma: Mr. Uhlenbrock, what happens in the human body when the ECS tonus deviates from the norm (the average values)? 

 Currently, science assumes that, for example, a clinically relevant endocannabinoid deficiency leads to an imbalance in the body’s system. This imbalance seems to be involved in a number of chronic diseases. Several studies suggest a link between low ECS tonus and irritable bowel syndrome, migraine as well as fibromyalgia complaints [1]. Especially in the development of migraine, there is increasing evidence for an involvement of the endogenous endocannabinoid system [2].    

 What are the causes for a deficiency of endogenous cannabinoids and how can this knowledge be used therapeutically? 

 Low ECS tone can have both genetic causes and be influenced by a person’s individual health behavior. For example, if the human body produces too many enzymes that break down the body’s own endocannabinoids, the tone will be too low. Since endocannabinoids play a crucial role in human physiology, deficient ECS tone can be associated with individual complaints or manifest diseases. 

 This knowledge has therapeutic relevance: If, for example, the anandamide* level in the blood were examined at regular intervals, we would notice a clinically relevant imbalance at an early stage and be able to react. I am thinking here of the intake of exogenous – i.e. plant-based – cannabinoids, but also regulation via sport, stress reduction and a healthy diet. For the so-called lifestyle factors in particular, there are now promising studies that demonstrate a health-promoting effect [3].   

 CanPharma: Why is the ECS tonus hardly considered among physicians? 

 Knowledge of the body’s endocannabinoid system is not a topic of university teaching and is therefore hardly anchored in the professional world. Whoever asks treating physicians for a determination of the anandamide level will most likely encounter little knowledge. Furthermore, as far as I know, there is no laboratory that measures this parameter as part of a blood count. The therapeutic importance of ECS the tonus is significantly underestimated. This must change urgently!  

 * Anandamide, is the best known and scientifically first described endocannabinoid. It is one of the most important endocannabinoids for controlling the balance in our body, called homeostasis. 

sources  

[1] Russo, Ethan B. “Clinical Endocannabinoid Deficiency Reconsidered: Current Research Supports the Theory in Migraine, Fibromyalgia, Irritable Bowel, and Other Treatment-Resistant Syndromes.” Cannabis and Cannabinoid Research, vol. 1, no. 1, Dec. 2016, pp. 154–165, ncbi.nlm.nih.gov/pmc/articles/PMC5576607/, 10.1089/can.2016.0009. 

[2] Greco, Rosaria, et al. “Endocannabinoid System and Migraine Pain: An Update.” Frontiers in Neuroscience, vol. 12, 19 Mar. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC5867306/, 10.3389/fnins.2018.00172. Accessed 23 Nov. 2020. 

[3] “Beeinflusst Sport Endocannabinoide Im Blut Und Migräne? • DGP.” DeutschesGesundheitsPortal,  25 Nov. 2021, www.deutschesgesundheitsportal.de/2021/11/25/beeinflusst-sport-endocannabinoide-im-blut-und-migraene/. Accessed 17 May 2022. 


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05/May/2022

Elderly (geriatric) patients often suffer from chronic pain and are sensitive to opiates and other centrally acting substances. A retrospective evaluation from a medical practice shows: Medical cannabis – in this case dronabinol – can alleviate the symptoms of those affected.   

Study participants included all geriatric patients aged 80 and older who were treated in a pain medicine practice in Potsdam, Germany from the time the cannabis law came into effect in March 2017 until mid-July 2018. Group A consisted of geriatric, non-palliative pain patients, group B included geriatric palliative pain patients.   

Questionnaire with information on dosages and pain intensity  

 The basis for the retrospective monocentric cohort study was a questionnaire with information on pain intensity, dosage, effects and side effects of dronabinol therapy. The results are encouraging: 21 out of 40 patients whose data were analyzed achieved a pain reduction of more than 30 percent. Another ten percent even reported an improvement of more than half. According to the respondents, about four symptoms or side effects of the previous therapy were positively influenced.  

 The authors of the study conclude from the results that cannabis-based medicines represent an effective and low-risk therapy option for the treatment of geriatric pain and palliative patients. At the same time, they call for further clinical studies – especially on the indication spectrum of the substances.   

 

Source:  

Wendelmuth C, Wirz S, Torontali M, Gastmeier A, Gastmeier K. Dronabinol bei geriatrischen Schmerz- und Palliativpatienten : Eine retrospektive Auswertung der ambulanten kassenärztlichen Therapie [Dronabinol in geriatric pain and palliative care patients : A retrospective evaluation of statutory-health-insurance-covered outpatient medical treatment]. Schmerz. 2019 Oct;33(5):384-391. German. doi: 10.1007/s00482-019-00408-1. Erratum in: Schmerz. 2019 Dec;33(6):562. PMID: 31473816. 


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20/Apr/2022

Disturbed thinking, delusions and sometimes even hallucinations are all typical symptoms of a psychosis. That CBD can have an influence on the brains of people suffering from psychotic episodes has now been discovered by British researchers at King’s College using imaging techniques.  

A 19-member control group and 13 psychosis patients were participants in the double-blind study in England. Symptomatic subjects received their regular antipsychotic medication. Brain activity of all participants was monitored using magnetic resonance imaging (MRI) technology.  

 Normalization of activities in prefrontal and medio temporal brain areas  

 The symptomatic subjects received a placebo on individual days, and the researchers were able to determine deviating activities in the prefrontal and medio temporal brain areas compared to the control group. In addition, the hippocampus and striatum of the non-psychotic participants interacted less strongly. A brain activity similar to the healthy control group could be shown in the symptomatic group after the administration of 600mg CBD.  

Based on these findings, the authors of the study conclude that CBD is effective in treating psychotic symptoms. However, final conclusions cannot yet be drawn due to the small number of participants. There is also a lack of studies on the long-term effects of CBD consumption. Therefore, the researchers call for more extensive studies in connection with CBD and psychoses and other neuropsychiatric diseases.  

 

Source:  

O’Neill A, Wilson R, Blest-Hopley G, Annibale L, Colizzi M, Brammer M, Giampietro V, Bhattacharyya S. Normalization of mediotemporal and prefrontal activity, and mediotemporal-striatal connectivity, may underlie antipsychotic effects of cannabidiol in psychosis. Psychol Med. 2021 Mar;51(4):596-606. doi: 10.101 


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05/Apr/2022

Inhaling cannabidiol e-liquid has positive effects on the verbal episodic memory of young healthy people. This was recently found by a group of Swiss researchers in a placebo-controlled study. Thirty-four people with an average age of 22 and no previous illnesses were asked to memorize 15 unrelated nouns. They were then given a single dose of CBD (12.5 mg cannabidiol e-liquid) once and once a placebo to vaporize. After about 20 minutes, they were assessed on their verbal episodic memory.

CBD outperforms placebo

The result is clear: compared to the placebo, CBD improved the short-term memory performance. The Basel research group concludes that not only does CBD have no negative effect on basic cognitive functions, they also see further evidence of the interaction of the central endocannabinoid system with vaporized CBD. In conclusion, CBD may be able to positively influence memory processes and may have further therapeutic potential if appropriate.

To investigate optimal dose-response relationships, the neuroscientists from Switzerland recommend further extensive studies.

 

Source: 

Hotz J, Fehlmann B, Papassotiropoulos A, de Quervain DJ, Schicktanz NS. Cannabidiol enhances verbal episodic memory in healthy young participants: A randomized clinical trial. J Psychiatr Res. 2021 Nov;143:327-333. doi: 10.1016/j.jpsychires.2021.09.007. Epub 2021 Sep 7. PMID: 34536664. 


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