Medical cannabis expert Dr Julie Moltke, discusses how by making changes to our lifestyle, we could modulate the endocannabinoid system to make us more resilient to stress.
Danish medical cannabis prescriber, Dr Julie Moltke is a specialist in pain, anxiety and stress, as well as a yoga teacher and mindfulness instructor.
Through her recent investigations into stress and the endocannabinoid system, she found that making several relatively small lifestyle changes could help people cope better with stress and anxiety.
How the endocannabinoid system works
The endocannabinoid system (ECS) was discovered in 1992 when researchers were trying to uncover the receptor mediating the effects of THC, the psychotropic cannabinoid from cannabis, responsible for many of the behavioural, emotional and physiological actions of recreational cannabis in humans.
Since then, the ECS has emerged as one of the most important regulators of general human homeostasis (a stable internal environment). It regulates reward, appetite, mood, memory, immune function, fertility, pain, and neuroprotection, among others. The endocannabinoid receptors (primarily CB1R or CB2R) have been found almost in every organ system in the body.
The density of these receptors is particularly high in parts of the brain involved with fear, memory, and emotional processing – namely the amygdala, hippocampus, prefrontal cortex, and hypothalamus. These brain areas are not only interconnected in the brain, but they are also involved in regulating the physiological stress response and the release of cortisol and adrenaline.
The body of evidence suggesting that the ECS is involved in the regulation of the behavioural aspects of the stress response, such as anxiety, learned fear and stress-coping, is growing and the field of cannabinoid-based medicine is attempting to use this understanding to use medicinal cannabis to treat many mental health issues.
It is well documented that people with higher levels of anandamide (the endogenous molecule of the endocannabinoid receptor CB1R) are more resilient to stress whereas lower levels are associated with several psychopathologies including depression, PTSD and suicide.
How does lifestyle affect the endocannabinoid system?
It has been shown that running can increase circulating levels of anandamide, as well as endorphins. This seems to be partly responsible for the so-called runners high, a feeling of wellbeing and elevated mood, often following moderate-intensity running.
Activation of the endocannabinoid system is also hypothesized to be involved with the reduction of pain perception which tends to accompany running. Further studies into this interesting field have shown that the above applies only for moderate intensity exercise, whereas low and high-intensity workouts do not seem to have the same effects.
Moderate intensity cycling seemed to raise anandamide levels in a study conducted on healthy male athletes. Researchers found the same association and concluded that the endocannabinoid system might be responsible for the anti-depressant effects that exercise seems to have.
A similar study was conducted by O’Sullivan and colleagues with nine female volunteers from a local choir. This study did not show elevated levels of anandamide after cycling which indicates there might be some gender differences.
This generally seems to increase anandamide levels, but it is worth noting that research suggests that you will get the best effect in improving mood and decreasing anxiety when undertaking a type of exercise that you enjoy]. This might also explain why O’Sullivan and colleagues did not find an increase in anandamide and improved mood (the women were choir singers and not athletes).
The study mentioned above involving nine females also showed that singing increased circulating levels of anandamide and increased positive mood and emotions. The authors also found that the participants felt less hungry with higher levels of anandamide. This indicates that increasing levels of anandamide by either of the above methods will not only be able to improve mood but might also help decrease hunger and thereby maintain a stable body weight.
The study by O’Sullivan and colleagues also investigated the effects of dancing, though they did not find an increase in levels of anandamide. They suggest that singing when perceived as enjoyable, can help decrease anxiety and improve mood.
Some certain foods and ingredients are shown to be able to interact with the ECS and thereby potentially improve our resilience to stress, as well as improving inflammation and help balance our mental health. These have been named cannabimimetic molecules and can be found in certain vegetables like carrots and fava beans, turmeric, and coffee. Omega-3 and omega-6 fatty acids are precursors of endocannabinoids and a sufficient intake is important to help balance the ECS. They can be obtained either from food-sources or as supplements.
In an animal study, Wei and colleagues found that oxytocin (the social bonding hormone) increases levels of anandamide, which is involved in the regulation of social reward. The researchers suggest this oxytocin-driven anandamide signalling might be defective in autism spectrum disorders.
Read the full report and bibliography here
Find out more about Dr Julie Moltke and her work at www.drjuliemoltke.com/
Daniel Gauci – the crowdgrowing pioneer aiming to revolutionise the cannabis industry
The ‘Gentleman Smoker’ is a stylish, family man – and cannabis influencer. His mission is to break down stigmas by promoting responsible use of cannabis among its many benefits.
Under this public figure we find Daniel Gauci, CBDO at JuicyFields, a medicinal cannabis crowdgrowing platform that is revolutionising the fast-growing industry.
Today he is with us to talk about his relationship within the cannabis industry and the medicinal resources that offer the world’s most famous green plant.
What is it like to be The Gentleman Smoker? Tell us about the positive and negative aspects.
The Gentleman Smoker came about from the want of promoting the positive aspects of medicinal marijuana from a realistic albeit different perspective.
To break the stereotypes of what a typical cannabis user is and to show that a modern day cannabis user is a professional, responsible person.
I have a vast history with cannabis and most if not all is positive, from positive, personal points of view regarding introspection, mental health and productivity matters to the medicinal benefits within many diseases including ones my children suffer from.
The negative aspects, if I have to view it that way, would be that my private and professional life are now as one, and that my thoughts and motives are there for all to see, but that also has positives.
Many people still deny the health benefits that cannabis has to offer, what do you think about that?
The evidence is there. I am still surprised to hear the claim that there is not enough research, data or studies regarding medicinal marijuana and the benefits that it offers.
There are more than fifteen thousand peer reviewed studies and trials freely available for review and many more recently that focus on the endocannabinoid system that is clearly recognised throughout the medical world, with many clinicians prescribing cannabis for a multitude of treatments.
It does pain me that people can deny something when the information is freely available, however, it is understandable due to the many years of negative propaganda campaigns.
More and more countries are changing their legislation and perception of medical cannabis. Will we ever see a world in which medical cannabis is legislated and socially accepted?
I hope so. However, let us not forget there are places in the world where it is still a crime to be gay or to favor one religion over another.
There are many challenges that marijuana legislation faces but I see them being overcome one by one.
Let us take Europe as an example, the shift for positive legislation has come quick with governments and medicine authorities realising the potential that medicinal marijuana offers not only as medicine for patients but as an industry for the nation.
If we look at the current predicted figures the industry is expected to boom in the coming years, this will only speed up favourable legislation ultimately benefiting the consumer.
If we look back 10 or even 5 years, progress is gaining insatiable momentum that was not predicted by many so soon.
You have a background experience in the pharmaceutical field. Could you list some new medical benefits that can be found in cannabis if research continues?
Everyday I wonder where the research will take us. I read almost weekly of new applications and possible uses that medicinal marijuana can offer.
Not just in relation to cannabinoids but also in relation to terpenes and also the entourage effect, the innovation is truly outstanding.
When I studied pharmacology we touched upon cannabis in relation to the psychoactive elements in relation to the body and mind but since then microbiology and the understanding of chemical relationships has advanced so much I believe that we will keep learning more about this wonderful plant and what she has to offer for many years to come.
The most curious aspect for me is the relationship between the creation of amino acids and the importance of synapse connection in relation to speech. I am very much looking forward to the progress in this particular field of research.
On a personal level, what influence has medical cannabis had on your life?
Cannabis has held a different influence over me at various stages during my life. From one off theory and research to that of actively keeping members of my family alive.
The gap is profound and stretches so far but to narrow in on the practical medical applications in a personal scenario, it would be that of helping to save our baby daughters life.
It showed me how persecution from ignorance was prevalent in many avenues in life, not just in the medical marijuna world. In reflection it influenced me to be a better person, father, husband and member of society.
Having seen with your own eyes the benefits of medical cannabis, what would you say to those who want to try but are not sure about it?
Go and do it and do not waste time. Seek medical expertise prior but do not wait for any condition to worsen. Cannabis, while not 100% safe in all methods and for all people, has very little side effects with very, very high quantities needed for any type of overdosing classification.
Medicinal marijunana can have an immediate effect in certain conditions such as epilepsy and Parkinson’s disease with other conditions and symptoms being alleviated within minutes.
There are numerous resources available that can guide and help you to make an informed decision. Currently we are treating our severely autistic, non verbal son with CBD oil.
The results are proving positive, the studies and trials undergoing currently, particularly in Spain, are very encouraging.
My daughter was treated with high strength (and dosage) of full spectrum THC oil when undergoing chemotherapy for a tumor on her kidney, not only did it help with managing negative side effects of the harsher treatments, we believe also stopped the tumor from growing. (However, we have no medical evidence to present for this claim).
What is the role of JuicyFields regarding the medical cannabis industry?
JuicyFields enables people to support the medicinal cannabis industry by keeping the supply chain within grassroots and community cultivation level operations.
JuicyFields is adamant that the people working within this industry for years, fighting for legislation and research should be the ones to benefit now that legislation is positive and the industry being legalised.
We operate so that the money generated in this industry goes back to the community farmers and cultivators and processors so that they can continue to support themselves and grow, rather than having to sell their lands or businesses to multinational corporations eager to monopolise the industry for profit.
Is crowdgrowing going to change the course of the cannabis industry? How?
I believe so, yes. The other role of JuicyFields is to provide easy access to those wanting to support and invest in the medical cannabis industry.
For those who have looked, it is very expensive and prohibitive to enter. High costs, many licenses, industry knowledge and a highly skilled workforce is required if one were to venture in the industry as a normal business might.
That is where crowdgrowing comes into play. JuicyFields provides a platform that these budding entrepreneurs and investors can not only support the grass roots level cultivators but to also make a profit for themselves without the heavy time and financial commitment usually required.
The cultivation partners on the platform are all vetted to the highest of standards and comply with every regulation required where they operate and beyond.
All with full compliance and cultivation licenses from the relevant authorities and are also insured. This means that crowdgrowers are fully legal and compliant to enter into what is traditionally an exclusive yet very profitable and fast growing industry.
Fibromyalgia and cannabis: What does the latest research say?
Cannabis Health rounds up the latest research into the impact of cannabis on fibromyalgia.
There are thought to be around 1.5-2 million people in the UK currently living with fibromyalgia, a condition which causes chronic pain around the body, muscle stiffness and fatigue.
With no cure for the illness and symptoms severely affecting day-to-day life, research is focusing on therapeutic treatments – including medical cannabis.
In 2019, research published by Sagy, Schleider, Abu-Shackra and Novak showed that cannabis can help reduce fibromyalgia pain. The study of 367 patients found that pain intensity decreased when treated with medical marijuana, leading the team to state that “cannabis therapy should be considered to ease the symptom burden among those fibromyalgia patients who are not responding to standard care”.
Chaves, Bittencourt and Pelegrini further supported these findings in October 2020, concluding that phytocannabinoids can serve as an affordable yet well-tolerated therapy for fibromyalgia symptom relief and quality of life improvements.
After the randomised controlled trial, the researchers went as far as to suggest that the cannabinoid therapy “could become an herbal or holistic choice of medicine for treating fibromyalgia as part of Brazil’s public healthcare system”.
A study in Italy, published in February 2020, also demonstrated that medical cannabis improves the efficacy of standard analgesic fibromyalgia treatments.
Researchers concluded: “This observational study shows that medical cannabis treatment offers a possible clinical advantage in fibromyalgia patients, especially in those with sleep dysfunctions.”
Published in the Clinical and Experimental Rheumatology journal, the study followed 102 fibromyalgia patients who had not responded well to conventional treatments. These participants were given two forms of medical cannabis oil extracts and researchers then collected data over a six-month period from patients, who self-reported fibromyalgia symptoms, how well they slept, and feelings of fatigue, as well as depression and anxiety levels.
While only a third of fibromyalgia patients reported reduced symptoms of the disease overall, cannabis did improve overall quality of life for some. Fewer symptoms of depression and anxiety were found in around half of patients, too.
Despite fibromyalgia being more common amongst women – up to 90 per cent of sufferers are female – one study has found that cannabis may provide better pain relief for men.
The preclinical studies, conducted in 2016, compared the analgesic, subjective and physiological effects of active cannabis and inactive cannabis in male and female cannabis smokers under double-blind, placebo-controlled conditions, and measured pain response through the Cold-Pressor Test.
Among men, active cannabis significantly decreased pain sensitivity relative to inactive cannabis. However, in women, active cannabis failed to decrease pain sensitivity relative to inactive, indicating that in cannabis smokers, men exhibit greater analgesia compared to women.
Researchers concluded: “Sex-dependent differences in cannabis’ analgesic effects are an important consideration that warrants further investigation when considering the potential therapeutic effects of cannabinoids for pain relief.”
While further research is necessary, it is clear to see that medical cannabis can make a huge difference to treatment and relief of pain caused by fibromyalgia.
The best ways to take CBD for pain relief
CBD is becoming a popular tool for pain management, but with so many options out there, how do you know where to start?
With research constantly emerging to support the health benefits of CBD, more and more people are turning to the remedy – especially when it comes to alleviating pain and discomfort.
But how does it actually work? There are several ways to take CBD, each offering various pros and cons – we’ve rounded up some of the best methods.
In terms of pain relief, one of the most common methods is on the skin. Topical products like lotions and balms can be applied to skin over painful joints or bones and are particularly effective when used to relieve symptoms of arthritis.
However, research is still ongoing to determine whether these products deliver CBD below the skin. It is also difficult to pinpoint the exact effect CBD delivers – with many including common over-the-counter ingredients such as menthol, capsaicin and camphor, it’s uncertain whether the positive relief is solely due to CBD, or if these other ingredients play a significant role.
Several studies have hailed CBD oil as one of the most helpful methods when it comes to relieving pain symptoms, especially when combined with other forms such as topicals.
Medical nutritionist and health author Dr Sarah Brewer said: “Cannabidiol oil has direct effects on the endocannabinoid system in the brain. This enhances the effects of other brain chemicals, such as serotonin and anandamide, to reduce pain perception. It is also a powerful antioxidant which suppresses inflammation.”
Something to digest
Another well-known method for using CBD is by mouth. Whether in capsules, food or liquid, CBD that is swallowed is absorbed through the digestive tract.
Despite its popularity, this method does have its downfalls. Absorption is slow and dosing can be tricky due to the delayed onset of effect (it can take one to two hours to fully have an impact), plus many believe there isn’t enough research into how recent meals and other factors affect consumption.
But it has been widely reported that after a safe and effective dose has been established, capsules can work for daily use.
While it may not taste particularly pleasant, CBD can also be effectively absorbed directly into the bloodstream by holding liquid from a spray or dropper under the tongue. Research shows effects can the be felt in as little as a few minutes.
Give the vapors
CBD can also be inhaled via a vaporising, ‘vape’ pen. However, it’s possible that inhalation can carry unknown risks, particularly in those with respiratory issues and ailments such as inflammatory arthritis, and so isn’t widely recommended as a method for use.
With all methods, the common downfall is wavering dosage guidelines. Measures can change depending on a number of factors including age, weight and reason for use, however resounding guidance from experts is to ‘go low and slow’. Start with just a few milligrams twice a day, and if relief is inadequate after one week, increase the dose by the same amount, in small increments over several weeks if needed.
It’s clear that more research is needed to determine exact details into these methods, but this is only set to increase as the number of people turning to CBD for pain relief continues to grow.
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