The Best Offense: Preventive Medicine Gains an Ally in Cannabis
Cannabis could play a role in preventing serious diseases.
Plant cannabinoids are well-known to be quite safe and to have anti-inflammatory, antioxidant and neuroprotective properties. (Nicholas Belton/iStockphoto) Preventive medicine is a hot topic these days – everyone is looking for ways to stay healthy and avoid illness. Until recently, the mainstream medical community would hardly even consider the idea that cannabis could have a role to play in preventing serious diseases. That is slowly changing, as researchers are uncovering some of the plant's lesser known, but potentially quite powerful, preventive medical applications. One of the most crucial roles of preventive medicine is to help us maintain our internal balance, called homeostasis. Our bodies consist of many unique physiologic systems whose sole purpose is to maintain homeostasis – the pancreas releases insulin to balance glucose levels between the bloodstream and cells, and the thyroid gland releases thyroid hormones, which regulate vital bodily functions related to metabolism, body temperature and much more. Simply put, our bodies are working constantly to stay balanced in response to our external environment. Understanding the Endocannabinoid System One of these physiologic systems, the endocannabinoid system, was discovered by scientists while they were attempting to understand how THC, or the chemical in cannabis responsible for creating a high, causes its well-known intoxicating effects. The role of the endocannabinoid system, or ECS, is to maintain homeostasis of the messages sent between our cells. Further research has shown that sickness, inflammation and injury will trigger the ECS to take action, working to reset our internal environment back to homeostasis. This system has been described as being protective and necessary for life. What if we could target this system to prevent illness and maintain better health? The ECS is the most widespread receptor system in the human body. It's made up of three main parts: cannabinoid receptors; compounds called endocannabinoids; and the enzymes that make and break down the endocannabinoids. Endocannabinoids, often referred to as our "inner cannabis," are synthesized on demand from healthy sources of dietary fat. Cannabinoid receptors sit on the membranes of cells in certain parts of the brain and body. In the brain, these cells are in areas that control pain, memory, emotion, motor control, nausea and appetite, as well as the gut, immune system and peripheral nervous system. When there's a trigger that causes an imbalance, such as an injury or illness, endocannabinoids are released, acting as "keys" that bind to the receptors, which act as "locks" on our cells. Once the receptor is activated, a chemical reaction takes place in the cell, telling the cell to change its message. ECS functioning depends on many factors, including genetics, age, stress levels, diet and overall level of health. There can also be variants in the genes that code for the ECS, and these variants can lead to propensities for certain conditions like ADHD or PTSD. Additionally, chronic illness, chronic stress and/or chronic sleep deprivation may lead to depletion of the endocannabinoids. These disruptions in the normal functioning of the ECS interfere with its ability to regulate cellular imbalances and achieve homeostasis. Breakthroughs in ECS Research While researchers have long understood how gene variation in the ECS can be related to certain conditions and illnesses, researchers were not as clear on how disruptions in ECS functioning affected one's propensity for disease. Some answers were found in 2004 when Ethan Russo, a neurologist and research scientist, published "Clinical endocannabinoid deficiency (CECD): Can this concept explain therapeutic benefits of cannabis in migraine, fibromyalgia, irritable bowel syndrome and other treatment-resistant conditions" in the journal Neuroendocrinology Letters. Russo theorized that certain individuals with the listed conditions responded to cannabis-based treatments because they had endocannabinoid deficiencies that allowed the condition to manifest in the first place. Subsequent research has demonstrated that endocannabinoid deficiency plays a role in autoimmune diseases, epilepsy, complex regional pain syndrome, cardiovascular disease, depression, anxiety, schizophrenia, multiple sclerosis, nausea, Huntington's disease, Parkinson's disease, menstrual symptoms, failure to thrive in newborns and other difficult-to-treat conditions. The cannabis plant produces more than 100 phytocannabinoids, including tetrahydrocannabinol and cannabidiol. These compounds mimic our body's endocannabinoids by interacting with the ECS and restoring homeostasis. Proactive ECS Care While these treatments are effective in combating illnesses that are already present, you don't have to wait until you're ill to begin taking care of your ECS. There are many things you can do to help your ECS function properly, avoid deficiencies and maintain homeostasis. It's common knowledge that a healthy, balanced diet is necessary for emotional and physical well-being. Our bodies rely on our diet to produce the right amount of endocannabinoids to function at optimal capacity. Endocannabinoids are synthesized from the fatty acids in our diets and require a specific balance of omega-6 and omega-3 in order to be produced in the right quantities. A 2016 study examined the relationship between these two fatty acids and their relationship with the endocannabinoid system. For maximum bioavailability, the optimal ratio of omega-6 to omega-3 fatty acids from food is between 5:1 and 1:1 (the lower the better for those with chronic illness). Western diets routinely consist of ratios of 20:1, mainly due to the overconsumption of omega-6 fatty acids which come from vegetable oils in many packaged foods. Western diets with higher ratios of omega-6 to omega-3 fatty acids result in a reduction of endocannabinoids, leading to the inability to maintain homeostasis. Another factor that promotes well-being of the ECS is aerobic exercise. Animal studies report that voluntary wheel running increases cannabinoid receptors in the brain and increases the sensitivity of the receptors to endocannabinoids. Human studies have shown that exercise such as running, biking and hiking enhance endocannabinoid levels in the bloodstream. In fact, endocannabinoids are likely responsible for the phenomenon described as the "runner's high." Probiotics may also benefit the ECS. Lactobacillus acidophilus, a probiotic bacteria found in fermented foods such as yogurt and sauerkraut, was shown to induce the expression of cannabinoid receptors in the gut, promoting intestinal homeostasis. Both acupuncture and osteopathic manipulative treatment enhance the ECS. Yoga and meditation elicit the "relaxation response," a physiological phenomenon whereby one can consciously engage in behavior that promotes mental and physical wellness; although no studies have been done to date, researchers have hypothesized that these stress management modalities enhance the ECS, thereby promoting homeostasis. Lastly, what about the ability of cannabis to prevent illness? Plant cannabinoids are well-known to be quite safe and to have anti-inflammatory, antioxidant and neuroprotective properties. In cases of endocannabinoid deficiency, cannabis use may be the correcting compound, eliminating the symptoms of the condition. Regular cannabis use can decrease chronic inflammation and buildup of free radicals, both of which are thought to be the root causes of many conditions, including autoimmune and neurodegenerative disorders. Cannabis is associated with lower fasting insulin levels and lower insulin resistance, suggesting protection against the development of diabetes. Early this year, German scientists found that chronic low doses of THC reversed the age-related decline in cognitive performance in old mice. Additionally, research published in 2015 documented the significant reduction of the use of prescription medications in states with medical cannabis laws, resulting in almost 25 percent fewer deaths from opiates. Many patients report that cannabis use enhances their overall health by promoting quality sleep, reducing anxiety and depression, and lessening pain and inflammation so that they can continue to be active participants in their lives. Although exact doses and cannabinoid combinations for preventive indications have not been researched, it is likely that low intermittent doses that include both THC and CBD will augment the ECS without causing adverse effects. A healthy diet (including fatty acids in the correct balance), aerobic exercise and stress management will also help your ECS to maintain homeostasis. Take care of your endocannabinoid system, and it will take care of you. Bonni Goldstein, M.D. is a Los Angeles-based physician and medical advisor for Weedmaps, the world's first and largest cannabis technology company, where users can search for medicinal cannabis products. Dr. Goldstein has successfully treated thousands of adult and pediatric patients with cannabis and has recently been recognized as the 2017 Medical Professional of the Year by Americans for Safe Access. Originally published here: https://health.usnews.com/health-care/for-better/articles/2017-12-29/the-best-offense-preventive-medicine-gains-an-ally-in-cannabis