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Is this ancient system the secret to the modern health crisis?

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Dr Ranna is chief medical officer at cannabis education company Endoverse

Thirty years after its discovery, a UK company seeks to drive awareness of the endocannabinoid system and train medical professionals in the newly found field of ‘Endocannabinology’.

Research has linked the endocannabinoid system to sleep, fertility, stress, nerve function, digestion, appetite, metabolism, mood and inflammation. But most people have never heard of it.

Former vascular specialist, Dr Ranna is Chief Medical Officer at Endoverse, a company on a mission to educate the general public and inform medical professionals about the benefits of endocannabinology – the study of the endocannabinoid system (ECS).

The endocannabinoid system is a lipid signalling system which takes care of the body’s homeostasis, or its ability to maintain a stable internal state. The ECS achieves this through the activation of receptors; the most well-known being CB1, which is found in various organs in the body, and CB2, which is primarily affects the body’s immune system.

As the UK’s first organisation dedicated to balancing the endocannabinoid system, the company hopes to recruit medical professionals in the UK to take part in training programmes and gain a certification in the emerging field of ‘endocannabinology’.

Speaking to Cannabis Health, Dr Ranna explains: “ECS is involved with every function in our body and the balance of it is directly related to our health status.”

As the ECS was only discovered 30 years ago, academic understanding of it remains incomplete and there is still very little public understanding of how it affects the body and the mind.

Although the ECS was discovered as a result of research into THC, cannabis is just one of many ways to affect the function of the ECS.

In fact, Dr Ranna says that amongst the medical community, one of the main reasons it is misunderstood is because of its association with the controversial plant. But she asserts that it has “nothing to do with cannabis except in name”.

Dr Ranna says: “The complexity [of ECS] means that searching for evidence is complicated and the knowledge base surrounding the system is expanding every day.

“ECS is not only CB1, CB2 receptors and endocannabinoids. There is a growing family of other receptors and active molecules, including gut and microbiome, involved.”

Existing data suggests that the ECS is linked with a number of chronic health conditions. For example, there is strong evidence that the ECS is connected with epilepsy and metabolic syndrome.

For a short time, a medicine called Rimonabant was used for the treatment of metabolic syndrome. The substance blocked CB1 receptors which are primarily found in the brain as well as other parts of the body such as the liver.

Although the treatment successfully reduced appetite, cravings and fat, it had adverse side effects which increased anxiety and depression. It was quickly withdrawn for these reasons, however it proved that the CB1 receptors are involved in the regulation of metabolism.

Dr Ranna highlights a number of theories that suggest some illnesses are connected to the under-activation and over-activation of the ECS.

Modern western lifestyles are commonly associated with high levels of stress, unhealthy diets and a relatively sedentary day-to-day life. This is thought to result in the over-activation of the body’s ECS.

Looking back circa 500 million years ago, when scientists believe the ECS first began to develop, humans lived very different lives, with an inconsistent source of food and challenging environmental conditions.

Dr Ranna explains: “For the majority, the endocannabinoid system’s existence helped us to survive.

“In the environment of unstable food intake, the energy conserving role of CB1 receptors developed. Activation of CB1 receptors increase hunger, attractiveness of fat and sweet food, fat accumulation and insulin secretion.

“It encourages reward seeking behaviour – we feel good after eating the food and I am sure ancient people felt great after hunting a mammoth.

“The up-activation, when there was enough food, was needed to store fat for tougher times. Episodes of up and down activation were changing according to access to food through the year.”

Flashforward to 2020 and we are in a completely different world, where for most people, real hunger is rarely experienced.

Dr Ranna says the continuous offer of food chronically over-activated our ECS, leaving humans in a “pitfall” of over-activation.

Thankfully, rebalancing the endocannabinoid system is simple. Regular exercise and adopting techniques for controlling stress helps the body achieve homeostasis and improve overall health.

Scientists believe the most important factor for balancing the ECS, however, is diet. A change in eating habits to incorporate more nutritious foods with low processed fat and sugar levels has been shown to help treat metabolic syndrome, anxiety, depression, autoimmune diseases and many more conditions.

Dr Ranna explains: “The ECS is a lipid system. It means that our own endocannabinoids are produced from fatty acids, such as omega 6 and omega 3. Some of these are essential, meaning out body is not able to produce them, and so we have to eat them.

“Western diet contains a large amount of saturated and trans fatty acids, but there is a lack of polyunsaturated acids (PUFAs). Generally, we need to eat PUFAs in a ratio of between 3:1 and 5:1.”

For Dr Ranna, key to improving public health and reducing cases of obesity is taking more responsibility as individuals and educating children from a younger age.

“As individuals we all have a part to play and must take more responsibility for our own health,” Dr Ranna adds.

“There are many people who already do, but we all have a chance to live healthier lives.

“We need to teach our children how to cook and eat properly, deal with stress and take care of themselves. Once they learn ways to balance their ECS in their childhood, they will not have to face an over activation in the future.”

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NFL to explore effects of CBD in players with chronic pain

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The NFL-NFLPA Pain Management Committee wants to find alternative treatments to manage player's chronic pain

America’s National Football League (NFL) is looking into how cannabis and CBD can help in managing player’s chronic pain.

The league and player’s association (NFLPA) made a formal request for information to researchers on “pain management alternatives to opioids” earlier this month.

In an official statement, the NFL-NFLPA Pain Management Committee (PMC) said it is working to “improve player health through evidence-based treatment of acute and chronic pain” and to “facilitate research to better understand and improve potential alternative treatments.”

The NFL is seeking out qualified researchers who could lead studies into pain management and athletic performance in its players.

Areas of investigation include the potential therapeutic role of medications and “non-pharmacological interventions” that are considered to be alternatives to opioids in routine pain management of NFL players, including, but not limited to, cannabinoids such as CBD.

The committee also wants to explore the cannabis or cannabinoids on athletic performance in NFL players.

The PMC was formed in 2019 as part of the NFL-NFLPA Collective Bargaining Agreement with the goal of benefitting the health and safety of NFL players through education and research.

Last year it conducted two informational forums on CBD to learn about the current state of CBD science and manufacturing in the US, as part of its aim to find alternatives to opioids in the pain management of players.

Respondents to the request are expected to have experience conducting controlled, experimental studies in the relevant areas and should be affiliated with institutions or companies that meet state, federal, and IRB requirements.

However the NFL is not committing to funding any specific studies at this stage, and instead wants to seek out qualified scientists who can assist with future research projects.

CBD is not currently listed on the World Anti-Doping Agency’s Prohibited List and, as a result, is permitted for use in sport.

However, all other cannabinoids such as cannabis, marijuana and THC are prohibited in competition due to the receptors activated in the brain which cause a ‘high’.

A 2018 review assessed the impact CBD has on relieving chronic pain. The review examined a number of studies, concluding that CBD was effective in overall pain management and didn’t cause any other negative side effects.

In addition, it has been suggested that CBD can speed recovery and fight fatigue – welcome news for athletes suffering from long-term or recurring injuries.

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How can CBD help arthritis?

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In a Canadian study, nine out of 10 patients said CBD was effective in managing their pain

In the UK, more than 10 million people have arthritis or other, similar conditions that affect the joints – and many are turning to CBD products to ease their pain and discomfort.

With an ever-expanding range of drinks, gummies and edibles on thee market CBD could be seen as something aimed at the younger generation.

However, there is a growing body of research that suggests CBD can also be of great use for the older members of the population – and one condition in particular.

Arthritis is a common condition that causes pain and inflammation in a joint, and while it can affect people of all ages, it is more likely to begin when people are in their 40s and 50s, worsening with age.

A Canadian study from 2020 found that up to one in five patients who consulted an orthopedic surgeon for chronic musculoskeletal pain were using a cannabis product to treat them, with the express aim of reducing pain.

The researchers also found that interest in the compound was high, with two thirds of non-users curious to try a cannabis product to treat their muscle and joint pain.

Furthermore, those patients already using CBD had generally positive experiences using the products. Nine out of 10 said it was effective in managing their pain, and four in 10 said it decreased their reliance on other pain medications. Nearly 6 in 10 said cannabis products were more effective than other drugs.

Such findings corroborate what we already know about CBD; thanks to its anti-inflammatory and analgesic properties, early research into its use as a treatment for acute and chronic pain is promising.

A 2016 study found that transdermal cannabidiol has potential for reducing pain and inflammation associated with arthritis without any noticeable side effects.

Cannabis-based medicines can help manage the pain of arthritis by rebalancing the body’s natural endocannabinoid pain-processing system and soothing inflamed body tissues.

There are two primary ways of taking a CBD supplement; topically or orally.

In the case of arthritis, a cream or ointment containing CBD would be rubbed into the affected area. Topical products may also include common over-the-counter ingredients such as menthol, capsaicin or camphor, which could make it difficult to determine if any positive effect is due to the CBD or another ingredient.

There are a number of ways to take CBD orally, from gummies, snacks and drinks to tinctures and capsules – although gummies are discouraged in households with children, due to their similarity with sweets.

However, all work in largely the same way, being absorbed through the digestive tract. However, it is worth noting that absorption can be slow and dosing is tricky due to the delayed onset of effect (one to two hours), unknown effects of stomach acids, recent meals and other factors.

Whichever method you choose, it is always a good idea to check with your medical practitioner first, as CBD, although it is natural, may interact with other treatments, such as prescription medications.

However, for those looking for an alternative to prescribed drugs, with fewer side effects, CBD could well prove to be the answer.

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9 out of 10 readers have self-medicated with cannabis

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Nine out of 10 Cannabis Health readers have consumed cannabis for medical purposes without a prescription – and almost all said they found it to be more effective than conventional medicines.

 

Over the last few weeks, we’ve been asking for your views on social media to delve deeper into how people are consuming cannabis.

As expected, the proportion of our readers who self-medicate with cannabis was high, but the results also demonstrate the perceived effectiveness of cannabis in comparison with traditional medication, highlighting a need for wider access to safe cannabis based medicines.

Self-medicating

Despite the law around medical cannabis changing over two years ago, gaining a prescription can still be challenging, particularly on the NHS.

This has forced a lot of patients to take matters into their own hands.

According to research, as many as 1.4 million Brits are self-medicating with cannabis, equivalent to just over two percent of the country’s population.

Studies from the US have backed this up, with one suggesting that as many as a third of teenagers with a chronic health condition have taken it upon themselves to manage their symptoms with cannabis.

We asked our readers if they were self-medicating to treat a health condition, with the results confirming that almost 94 percent of people said they were.

On top of this, a further five percent said they were not currently, but were open to the idea.

Just over one percent said they weren’t self-medicating due to the stigma attached, however no one responded that the law was a factor in this. 

Effectiveness of self-medicating 

 

Anecdotal evidence and some early studies suggest that cannabis can ease symptoms of some chronic pain conditions, such as fibromyalgia, where other, more conventional medicines have failed.

There is also promise in the potential of cannabis to relieve some mental health conditions, with some saying it has provided huge relief for disorders such as PTSD.

Ninety five percent of Cannabis Health readers polled said they found cannabis extremely effective at relieving symptoms. 

In addition no one said they had found it ineffective when it comes to treating their condition.

The remaining five percent said they found it to have a similar effect as their conventional treatments. 

Route to administration 

How patients consume cannabis can have an impact on its effectiveness, as well as how quickly it kicks in.

With such high numbers both self-medicating and reporting positive effects, we wanted to discover the common consumption methods.

Smoking the flower is the traditional method of consuming cannabis and often viewed as the one which can provide the most relief.

However, even though it has been seen to be less harmful than tobacco, smoking can still lead to a number of other health issues and is note recommended by health professionals.

Despite this, it remained the most popular choice among Cannabis Health readers, with just over a third saying this is how they consume cannabis.

The modern alternative to this is vaping, which was the second most common route to administration among Cannabis Health readers.

Around a third of readers said this was their preferred consumption method.

Some professionals argue this is the healthiest way for consumption, with clinics recommending vaping cannabis flower, but more research is needed in this area.

One method which has few negative effects is the use of oils or tinctures.

This is typically how CBD is consumed, with 21 percent of readers saying this was their preferred method.

Self-medicating alongside conventional medicines

The NHS says it is unlikely that many people in the UK will be able to gain access to a medical cannabis prescription.

Despite this, many patients have chosen to self-medicate with cannabis either alongside or often in the place of conventional therapies. 

The majority of readers agreed with this, with 55 percent saying they no longer use conventional medicines in favour of cannabis.

A further 22 percent said they would only use their conventional medicines if they did not have access to cannabis and the remainder said that they still consume cannabis alongside conventional medication.

Want to get involved? Cannabis Health will be running a number of polls over on our social media pages, to find out more about your views on CBD and cannabis for medical and wellbeing purposes.

Follow @CannabisHnews on Twitter and @Cannabishealthmag on Instagram and keep an eye out.

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