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Dr. Ethan Russo proposed the idea of Clinical Endocannabinoid Deficiency (CECD) in 2004 — outlining conditions that emerge when naturally-produced endocannabinoid levels are too low. Clinical means “based on observing patients” and seeing trends: it is not precisely diagnosable & treatable yet. Mainstream neuroscience is just now starting to focus on studying the endocannabinoid system.

The greatest evidence of CECD is present in migraines, fibromyalgia and irritable bowel syndrome [R]. But not everyone has these particular issues. An extensive list of other disorders may fall under the endocannabinoid deficency category and can vary depending on a person’s endocannabinoid levels, diet, personal history & genetics. The CECD-causing deficiencies can be present at birth, or can be acquired [R]. People with normal endocannabinoid function can suddenly become worse if they undergo chronic stress and trauma.

The archtypical person with a low functioning cannabinoid system is a thin, anxious person. Obese people are more likely to overactive endocannabinoid systems [R]. One of the best weight loss drugs ever made was a powerful endocannanbinoid blocker called Rimonabrant. It was quickly taken off the market due to awful side effects: nausea, insomnia, anxiety, depression and mood disorders. People with low levels of endocannabinoids may experience these type of symptoms naturally.

Commonly Reported Symptoms of Endocannabinoid Deficency

Here are the most common symptoms I observed over several years of interacting with chronically-ill forum users and health coaching clients:

1. Anorexia (thin body) – naturally skinny, small boned “ectomorphic” body type. CB1 activation interacts with the orexin system and contributes to increased appetite and body weight [R,R]

2. Anxiety – the general consensus of many published studies is that eCB signaling constrains anxiety [R]

3. Food allergies & sensitives – the endocannabinoid system is very important for creating tolerance to your environment, especially the food in your gut [R]

4. Bowel inflammation – actions of endocannabinoids in the gut critically determine the course of bowel inflammation [R]

5. Poor appetite – Blocking the cannabinoid receptors leads to decreased appetite and food intake. [R]

6. Brain fog – this symptom of limbic system dysfunction is intertwined with the endocannabinoid system [R]

7. “Chronic cardio” exercise habits – 30+ minutes of intense exercise boosts anadamide levels, especially at high altitudes [R,R]. Some people with eCB deficiencies become avid marathon runners, cyclists, dancers, skiers, etc.

8. Migraines – brain inflammation resulting in painful, debilitating headaches [R]

9. Fibromyalgia – diffuse sensations of neurological pain in joints and muscles & hypersensitivity [R]



10. Depression – Blocking the CB1 receptor causes depression [R]

11. Poor stress tolerance – Disruption of CB1 receptor impairs our ability to handle stress [R]

12. PTSD / cPTSD – The endocannabinoid system controls the extinction of adversive memories [R].

13. Hypervigilance – “the endocannabinoid system acting in synaptic circuits of the extended amygdala can explain the fear response… to unpredictable threats.”[R]

14. History of cannabis use – the “self-medication hypothesis” is used to explain high rates of cannabis use in patients with trauma-related disorders [R]

15. History of anti-depressant use – “antidepressant drugs… likely result in CB 1 upregulation, at least in some brain regions”[R].

16. History of alcoholism or hard drug use – acute benzodiazepine & opiate use boosts the endocananbinoid system [R]. People may turn to alcohol to self-medicate from the miserble effects of eCB deficency.

17. Panic attacks – a common misdiagnosis for PTSD / cPTSD flashbacks. CBD shows promise in treating panic disorder [R]

18. Neuroinflammation – in mice, short-term CBD treatment helped avoid cognitive & emotional impairment and reduced neuroinflammation [R]

19. Attention Deficient Disorder (ADD) – Sometimes misdiagnosed “dissociation” from PTSD [R].

20. Autism – increasing anandamide activity improves autistic social impairment [R]

21. Insomnia – CBD, an anadamide booster, may have therapeutic potential for the treatment of insomnia [R]

22. Physical Tension – chronic tightness in neck, shoulders, back caused by constant sympathetic nervous system (SNS) activation.

23. Muscle spasms — episodes of severe stress causing physical agony or immobility. Cannabinoid therapy can reduce spasms [R]

24. TMJ Joint Dysfunction – popping and clenching in the jaw joint, probably from tension in face muscles. Can be reduced by taking cannabinoids & anti-inflammatories [R].

25. Arthritis – “Increasing evidence suggests that the endocannabinoid system, especially cannabinoid receptor 2 (CB2), has an important role in rheumatoid arthritis [R].”



26. Schizophrenia – low anadamide levels correlate with an increase in psychotic symptoms in schizophrenics [R]



27. OCD – Hypervigilance, drasticizing and catastrophizing from c/PTSD are sometimes misdiagnosed as “OCD.” Low doses of anandamide inhibited compulsive behavior in mice [R]



28. Bipolar – there might be an association between cannabinoids and bipolar [R]

29. Epilepsy – “thirsty” available CB1 receptors in the seizure onset zone may contribute to the development of epilepsy [R]

30. Adrenal Fatigue – according to one theory it is caused by limbic system dysregulation and altered cannabinoid function [R]

31. Chronic fatigue (ME/CFS) – Neuroinflammation was found to be widespread in the brain areas of the patients with ME/CFS [R]. Data suggests the endocannabinoid system has a role in neuroinflammation [R]

32. Aches and pains – more susceptible to being bothered by minor strains, pains & injures. Blocking the breakdown of anandamide reduced hypersensitivity to pain [R].

33. Acid reflux / GERD – Activation of CB1 by endogenous or plant effectively reduces both gastric acid secretion [R]

34. Hoarse & raspy voice – probably caused by muscle tension in throat & acid reflux. Vagus nerve provides parasympathetic stimulation to the GI tract [R]

35. Ahedonia – feeling “blah,” nothing is rewarding, not enjoying socializing or activities enough to make much effort [R]

36. Agoraphobia – the feeling of not wanting to travel far from the home. More common among women with cannabis use disorder [R]

37. Suicide thoughts – About 1% of the people who tried endocannabinoid blocking diet drug Rimonabant thought of killing themselves [R]

38. Social alienation – can’t socially relate to normal, cheerful, well-adjusted people at work or school. Hangs out with freaks, losers & weirdos.

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Image credits: Dr. Russo , WayTru, Guilherme Yagui .

About the Author:

Brett Borders is a natural health coach specializing in stress-related issues such as anxiety, fatigue & PTSD. Please don't hesitate to contact me if you could use help getting your life and health back! You can call me for a free 15-minute consultation.