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Dr. Jason Winkelmann

CBD for Chronic Pain: How To Activate Your Body's Natural Pain Reliever


CBD for pain

Cannabinoids, like cannabidiol (CBD) have been gaining a lot of attention as a therapy for a lot of different conditions from insomnia to anxiety.  But no condition has drawn more attention from the benefits of CBD than chronic pain. Learn how you can stimulate your endocannabinoid system, a truly forgotten system, to ease pain and promote overall health!


What is the endocannabinoid system?

The endocannabinoid system (ECS) is a bodily system similar to your hormonal system.  It is composed of compounds called cannabinoids and their receptors.  These receptors are found throughout the body: in the brain, organs, connective tissues, glands, and immune cells to name a few.  The main goal of the ECS is to maintain homeostasis.  Which, if you remember from school science class, is the maintenance of a stable internal environment despite fluctuations in our external environment.  A classic example of how your body maintains homeostasis is the regulation of body temperature.  Your thermoreceptors sense an increase in temperature on a hot sunny day.  To prevent your internal temperature from raising too much, your blood vessels dilate to move blood to your periphery and away from your core.  Your sweat glands open to initiate perspiration and your thirst response may even heighten.


chronic pain and cbd
https://www.geeksforgeeks.org/homeostasis/


Homesostasis is always explained with the seesaw analogy.  When one side goes up, the other goes down.  When an outside force influences you, your body responds by balancing your internal environment.  Your body does this constantly throughout the day in ways you don’t even realize.  It does so with the help of your ECS, and an efficient ECS keeps your seesaw from swaying to much in either direction.  It helps keep it as balanced as possible with little micro fluctuations.


Endogenous Cannabinoids

The first half of the ECS equation are cannabinoids.  These are molecules that your body makes itself (endogenous) and can be found in nature.  There are two that your body makes naturally: anadamide (AEA), and 2-arachidonylglycerol (2-AG).  They are synthesized on-demand from your cell membranes and have a local effect.  This is a good and bad thing.  Good in that these cannabinoids can be fast acting, but bad in that they don’t travel far in your body.  So if you have a hard time making them where you need them, you may be out of luck. The fact that your body makes its own cannabinoids is the strongest argument for the use and legalization of phytocannabinoids.


cbd and chronic pain
https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2021.636228/full

Phytocannabinoids

Most don’t realize that their body makes cannabinoids since all the attention is on phytocannabinoids.  Phytocannabinoids are plant substances that stimulate your endocannabinoid system.  The most common and potent come from the cannabis sativa plant.  They are delta-9-tetrahydrocannabinol (THC), and cannabidiol (CBD).  But this is not their only source.  They can also be found in:

  • Spices: Cinnamon, Clove, Oregano and Black Pepper

  • Herbs: Echinacea & Rue

  • Plants: Helichrysum & Liverworts

  • Veggies: Broccoli, Kale & Sprouts

  • Dark chocolate


cbd and chronic pain
https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2021.636228/full

Minus THC having psychoactive properties (“getting high”) it is virtually the same as CBD.  THC stimulates your ECS the same way that CBD does.  So in regards to their therapeutic actions they are essentially the same.  THC is just a little more potent than CBD in accomplishing this task.


Receptors

The second half of the ECS is receptors.  There are two different receptors in your body that cannabinoids can bind to.  They are CB1 and CB2.  CB1 receptors are found in your nervous system, connective tissues, gonads, glands, and organs.  CB2 receptors are found in your immune system and its associated structures.  Any cannabinoid can stimulate any receptor, so the overall message is that receptors are found all throughout your body, on almost every cell.  This is the other argument for the legalization and use of phytocannabinoids.  Even if your body didn’t make its own cannabinoids, it makes receptors that are stimulated by the cannabinoids found in nature. They have proven to be a valuable nutrient throughout human evolution.


cod and chronic pain
https://physicianslab.com/cbd-and-the-endocannabinoid-system/

The receptor is where all the magic happens.  Think of cannabinoids as a key and receptors as a lock.  A key has a unique shape that fits perfectly in one oppositely shaped lock.  But a key is useless without a lock just as a cannabinoid is useless without a receptor.  Once the key turns the lock the door can open.  Once a cannabinoid binds to a receptor, a message is sent throughout the rest of the cell telling it what to do.


What The ECS Affects

Pain sensation, inflammation, thermoregulation, memory, mood, appetite, stress, sleep, metabolism, immune function, reproduction, earning and memory motor control, cardiovascular system function, muscle formation, bone remodeling and growth, liver function, reproductive system function, skin and nerve function, and more!


Pretty much every bodily function because every bodily function can become imbalanced.


How The ECS Affects Pain and Inflammation

The most common reason people consume cannabinoids, especially CBD is to stimulate the ECS to help modulate pain and inflammation.  It does so in a plethora of ways too!  Pain is a compiled process.  Your body can create pain in many different ways.  The most common is the stimulation of pain receptors by pain causing chemicals.  Most pain relievers work by blocking pain receptors.  These pain relievers contain molecules that look like the pain causing chemicals, they bind to the pain receptors, but do not activate the receptor to transmit a pain signal to your brain.  A brilliant system for managing pain symptoms but it is inherently flawed. Pain relievers are designed to only block one type of pain receptor.  If your body is stimulating a different pain receptor, that drug won’t work.  If a drug worked initially, then stopped working, it’s because your body started utilizing a different receptor.  Your ECS helps modulate many different pain receptors.


Inhibition of PGE-2 synthesis

Prostaglandins are one way that your body creates pain and inflammation after injury or infection.  NSAIDs, like ibuprofen, and Tylenol work by blocking the synthesis of prostaglandins but they also block the synthesis of other molecules that are beneficial to your body.  The reason that NSAIDs and Tylenol, for example, are dangerous is that they may provoke gastrointestinal ulceration and bleeding, can cause heart attacks, strokes, and liver damage because they interfere with the good and not just the bad.  Your ECS only shuts down the bad!


cod and chronic pain
https://twitter.com/medbullets/status/1697635679231152283


Inhibits glutamate release

Glutamate is an excitatory neurotransmitter.  It amplifies the pain signals going to your brain so that you experience pain more intensely than you should.  Your ECS helps make sure this doesn’t happen!


Reduce NMDA response

Your NMDA receptor is a potent pain receptor that is targeted by pharmaceutical interventions, mainly ketamine, when other treatments, such as opioids stop working.  Stimulating your ECS can help you to not need such narcotics!


Inhibition of calcitonin gene-related peptide

This is another pain causing molecule that your ECS helps mitigate.


Stimulates beta-endorphin production

Your body makes its own opioids in the form of endorphins.  This molecule helps dampen the pain response traveling to your brain.  Sometimes your body doesn’t make an appropriate amount.  With the help of your ECS you can make more to more appropriately experience pain.


Prevents development of tolerance to and withdrawal from opiates

Most people require increasing doses of opioids because they lose their effectiveness over time.  An increased dose increases the chances and dangers of side effects.  Stimulating your ECS helps to keep opioid prescriptions more effective at lower doses and helps prevent withdrawals from opioids!


Rekindles opiate analgesia after a prior dosage has worn off

This helps keep a lower dose effective for longer


Displays antioxidant activity greater than ascorbic acid (vitamin C) or tocopherol (vitamin E)

The free radical damage done by chronic pain prevents damaged tissues from fully healing.


Inhibit tumor necrosis factor-alpha (TNF-α)

This is a very potent inflammatory pathway that is targeted by biologics which are usually prescribed if you have an autoimmune condition.


Imagine a plant outperforming prescriptions medications like that!



The Emergence of CBG

Cannabigerol (CBG) is another phytocannabinoid that has been getting a lot of attention lately.  It has the same properties as CBD, it just binds rather poorly to CB1 and CB2 receptors.  Probably why it hasn’t gotten the attention it deserves.  However, when it does bind to receptors, it can stimulate the the ECS even more than CBD and THC do!  CBG stimulates the ECS to inhibit GABA uptake to a greater extent than THC or CBD do.  This keeps the calming neurotransmitter around longer so you can experience more muscle relaxation and anxiety reduction.  CBG also stimulates the ECS more than CBD and THC to provide more pain relieving benefits!  Keep a lookout for CBG products from your local CBD shop!


Cannabinoids In Pharmacology

The therapeutic potential of stimulating your ECS is well documented.  So much so that conventional medicine wants their piece of the pie now.  Since you cannot patent a plant the pharmaceutical industry has been synthesizing synthetic THC in the form of the prescription drugs Dronabinol (Marinol), and Nabilone (Cesamet).  These are FDA approved drugs for the treatment of severe nausea and wasting syndrome. However, some clinicians have found them helpful in the off-label treatment of chronic pain and migraines


Clinical Endocannabinoid Deficiency

Researchers have determined that some people have a more difficult time making endogenous cannabinoids.  This has led to a condition referred to as clinical endocannabinoid deficiency.  Not being able to properly stimulate your ECS can lead to any number of issues since we’ve determined how many bodily function the ECS is involved in.  Some researchers suspect that clinical endocannabinoid deficiency, whether genetic or caused by injury or disease, can lead to a variety of medical conditions, including migraines, fibromyalgia, or irritable bowel Syndrome (IBS).


This is an incredibly powerful bodily system that has been virtually ignored up until this point and likely has not been addressed by any of your doctors!


Why Supplement?

If we make our own cannabinoids, why even supplement?  Well we don’t always make enough when we need them.  Humans make their own vitamin D yet most of us are deficient and require supplementation.  We make our own hormones and neurotransmitters, but sometimes need a little extra help.  The same goes for cannabinoids.


There are other perks to supplementation though.  Small doses of CBD can help signal your body to make more endogenous cannabinoids and build more receptors!  The reason why many first time cannabinoid users don’t feel an effect is because they don’t have enough receptors in their body for the supplemental cannabinoids to bind to!  The more receptors you have to more sensitive you become to cannabinoids.  This means that smaller doses have larger effects and you’ll have a enhanced baseline of endocannabinoid system activity!


 

Is CBD going to be the miracle that will get you out of chronic pain? Probably not. But is stimulating your ECS a good idea? Always! You wouldn't ignore your hormone system or your nervous system so don't ignore your Endocannabinoid System! No one thing is keeping you in pain and no one thing is going to get you out of pain. You have to do a lot of things right if you want to end your suffering. Hopefully you know understand the importance of stimulating your ECS in route to this goal!

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