The Endocannabinoid System (Part One)
By Michael Moskowitz, MD
The endocannabinoid system is critical to the existence of all living animals. It is present throughout species and is largely used to stabilize critical underlying systems, such as the immune system (inflammation, anti-inflammation, protection), the endorphin system (pain and pleasure continuum), the catecholamine/serotonin system (mood, anxiety, energy and rewards), the GABA/Glutamate system (stimulation and soothing), the Hypothalamic/Pituitary/Adrenal axis (hormones), the PPAR system (anti-
microbial, neuroprotection, neuroregeneration) and the TRP system (neuroprotection, bone health, temperature perception).
This incomplete list gives a good overview of how important this system is, despite only being understood since 1996. It has a simple core of 2 pure receptors of CB-1 and CB-2 (Cannabinoid-1 and Cannabinoid-2), 2 neurotransmitters and immune signaling agents (ANA and 2-AG) and five enzymes, including three that synthesize ANA and 2-AG (NAPE and DAGL-α and DAGL-δ and two that break them down (FAAH and MAGL). Beyond these basic substances there are many other substances in the body that enhance these substances and are considered part of the extended endocannabinoid system.
This is the system that is activated by plant based cannabinoids from cannabis plants, known as phytocannabinoids. There would be no recreational cannabis without the endocannabinoid system, which is what allows THC to activate the CB-1. It is the medical cannabis system that not only affects receptors, but also imitates the molecules within the endocannabinoid system, stimulates this system and then works directly and indirectly on all of these other systems. This is why medical effects from cannabis can be profound. When the activity of the endocannabinoid system is understood then we can more precisely guide treatment with phytocannabinoids for over 30 medical symptoms and conditions.