Endocannabinoid System 101: The Cannabis Receptors In Your Body

 You’ve heard of the nervous system, the digestive system, and the adrenal system . . . but have you heard of the endocannabinoid system? 

That’s right. Your body actually has a physiological system in place designed to receive cannabinoids — the organic compounds in cannabis. “The endocannabinoid system is a transmitter system that exists in our brain and throughout our bodies,” said Dr. Jordan Tishler, MD, a physician and cannabis specialist at InhaleMD. “It’s important for maintaining healthy balance (called homeostasis) and function of our bodies.”

What Is It?

Unlike the digestive system and the cardiovascular system, there aren’t large organs to identify this system of the body. “The ECS [endocannabinoid system] is different from most systems that we’re aware of because it functions to maintain balance between the other systems,” said Dr. Tishler. “It’s kind of a control system, rather than doing something particular like mood, or movement. This is why it’s a relatively new discovery,” he explained. “It’s kind of ‘hidden’ behind the main systems that do various things that we notice, like thinking and moving and feeling. Yet it controls all of that.”

There are two main physical components of the ECS you should know: CB1 and CB2 receptors (also referred to as receptor cells). These receptors are found in various parts of the body — CB1s are mostly found in the nervous system/brain (as far as we know) and CB2s are in peripheral organs and immune cells. 

Aside from these cells, the endocannabinoid system comprises enzymes and endocannabinoids (phytocannabinoids come from plants, endocannabinoids come from the body). The two most important endocannabinoids are 2-AG and anandamide.

What Does It Do? 

Think of the ECS as a government of sorts for the other organ and hormone systems. “The basis of the endocannabinoid system is to check and balance the biologic and physiologic and chemical makeup of what goes on to keep homeostasis,” said Dr. Perry Solomon, MD, board-certified anesthesiologist and cannabis expert. 

That homeostasis is key, according to Dr. Solomon. If something’s off in your body or brain, it may be due to an imbalance within the ECS. “The ECS’s job is to maintain us,” said Dr. Tishler. “Normally we don’t affect it. However, we’re learning now that some illness may be the result of being ‘off balance’ because our ECS is not functioning properly,” he explained. “Illnesses as diverse as depression, anxiety, pain perception, and immune dysfunction all seem to be related through the ECS.”

You can think of this system (somewhat) like the pancreas and its role with blood sugar. When blood sugar is too low, the pancreas releases glucagon; when blood sugar is too high, the pancreas increases insulin — all with the goal of checking balancing blood sugar levels. However, this is merely a one-dimension example to highlight how the multidimensional ECS works with many systems within the human body.

And of course, the ECS receives cannabinoids when they’re ingested or inhaled. These cannabinoids bind to the receptors, signaling the body to do different things. This is how you feel the effects of cannabis medicine. The receptor cells — CB1 and CB2 — will manage this. “Different types of chemicals in your body hook up to [CB1 or CB2] and then release certain chemicals,” said Dr. Solomon.

Dr. Tishler elucidated further, saying that “THC, in particular, binds to the receptors we already have that interact with our own internal cannabinoids. In this way, we can use these plant chemicals as medicine to influence our ECS.” He posited that the plant’s chemicals work best synergistically. “THC is the main medicine [in cannabis] as it is the only one that directly stimulates the main internal receptors. CBD is important, along with a range of other, less well studied chemicals, to modulate the effect of THC. It turns out that unlike most conventional medications, that cannabis works because of the mixture of chemicals and the way they work together.  None in isolation seems to be very effective.”

But... What Does That Do For Me?

OK so you’re like “Cool, there’s a system that does stuff in my body, why do I care?” Well sister, the ECS can potentially impact things like your mood and emotions (hello, that’s why we take CBD for anxiety), immune system, pain levels, appetite and metabolism, sleep, digestion, inflammation, and more.

For example, if your endocannabinoid system is out of whack, it could be a contributing factor with insomnia. “It could be that 2-AG is not being produced adequately enough,” said Dr. Solomon. “The imbalance may be that the endocannabinoid system isn’t giving enough relaxing chemicals.”

The solution, in that case, would be to take CBD or cannabis in lieu of something like “ambien, which they could get hooked on.” Dr. Solomon emphasized the power of using cannabis medicine instead of something potentially addictive.

How Do You Balance Your ECS?

So how do you keep it in check… or know when it’s off? Fun answer time: there’s no one way to do either. “You can’t just draw blood and see if [a patient’s] 2-AG isn’t high enough when they have insomnia,” said Dr. Solomon. He said that “using cannabis instead of addictive medications,” is just one part of the puzzle when it comes to keeping your ECS healthy.

“Exercise and eating a healthy diet are the foundation — you can’t expect to not take care of yourself, and then take cannabis and fix everything,” said Dr. Solomon. “Pay attention to your total body and your activities, and don’t assume that cannabis is going to fix everything. It’s not like an antibiotic where you have a disease and you take an antibiotic and in 10 days you’re completely cured. Cannabis is a medicine that can help in fixing metabolic or emotional problems.”

There are no studies about improving your ECS — yet. However, one theory (emphasis on theory) Dr. Solomon shared was “Starting with a lower dose of CBD or THC helps your own ECS rev itself up.” So, you can always start there if you suspect something is off.

Why Are We Just Now Hearing About All of This? 

That’s a complicated question, because there are a lot of factors. “It used to be, up until last year or the year before, that only 13-percent of med schools were teaching the endocannabinoid system,” said Dr. Solomon. It wasn’t even really discussed in the medical world until 1990.

“When you have an imbalance in the endocannabinoid system, how can you rectify it?” Dr. Solomon posed. “If a patient has low synthroid [thyroid hormone], you give them synthroid and increase their hormone. If a patient has low insulin, you can take an insulin to supplement. But if you have a low endocannabinoid level or a deficiency, a medical student will ask their processor, ‘What am I supposed to do? Give THC or CBD?’” Until recently, this wasn’t an option.

And even now, when doctors can prescribe CBD — and even THC in some areas and under circumstances — there are no definitive products or methods of dosing, Dr. Solomon says. So though medical schools are beginning to teach about this system more and more, it’s still not familiar to many doctors. 

That is beginning to change, and the results of said shift, so far, have been powerful and impactful. “Doctors are now talking to patients in the VA about cannabis for anxiety and PTSD,” said Dr. Solomon. A huge win, honestly. “Physicians are able to discuss cannabis with vets who come in. Before, they weren’t able to discuss it at all — the landscape is changing with the discussion that goes on between patients and doctors, and physicians are interested in learning more about it.”