Finding perfect balance: How cannabis affects homeostasisAlana ArmstrongJanuary 27, 2020
We humans function best when all of our systems are performing at a consistent baseline level.
Our bodies prefer a core temperature of about 98.6F (37.0C), and blood pressure within a manageable range of 90-120 (systolic) over 60-80 (diastolic), according to the American Heart Association.
Like clockwork, various physiological systems coordinate and cooperate to keep the body and its interconnected systems in balance.
This steady state is known as homeostasis. And it turns out that cannabis can play a significant role in maintaining it.
When something’s out of whack
The body’s homeostasis is typically thrown off one operation at a time. When something gets thrown out of whack, that’s when our feedback systems—negative and positive feedback loops—come into play.
When our internal temperature increases or decreases, the body creates heat by burning calories or releases it through perspiration. That’s a process of homeostasis. When our blood sugar spikes, we feel thirsty—another aspect of the homeostatic system—and by quenching it we dilute the concentration of sugar in extracellular fluid. Again: homeostasis.
Returning things to an even keel
Many inputs contribute to each person’s state of homeostasis—including genetics, nutrition, physical fitness, mental health and environmental factors.
A disorder of the endocrine system, the nervous system, or a traumatic event like a stroke can throw a wrench into one’s homeostatic state. When that happens, the body will work to return to an even keel, drawing specific organs or tissues into play to return balance to the system.
Defined in the 1930s
Walter Bradford Cannon, the American physiologist who first described the body’s “fight-or-flight” response in scientific terms, also gave us the fundamental concept of homeostasis.
When Cannon’s first work on homeostasis was published in the 1932 book The Wisdom of the Body, science had no knowledge of the body’s endocannabinoid system. But today we do—and we know it plays a critical role in the maintenance of homeostasis.
The role of endocannabinoids
The endocannabinoid system (ECS) is a complex of enzymes, signalling lipids, and the CB1 and CB2 receptors.
The ECS is integral to the functioning of the hypothalamus, a critically important gland located within the brain. The hypothalamus maintains a balance between the endocrine and nervous systems—another instance of homeostasis.
The ECS helps keep things steady and functioning well on a day-to-day basis. When we experience things like pain or nausea, the system kicks in to bring us back to a steady state.
Endocannabinoids are cannabinoids produced by the human body. They’re manufactured within cell membranes and synthesized on-demand.
The primary endocannabinoids, anandamide and 2-AG, act as lipid messenger molecules. By binding to receptors present on various cells, they can modulate the molecular mechanisms of the cell, restoring balance and optimizing activity.
Cannabis contains phytocannabinoids, which are cannabinoids derived from a plant. These also act as agonists of the body’s CB1 and CB2 receptors. (An agonist is a substance that initiates a response when coupled with a receptor.)
Do some have ‘endocannabinoid deficiency’?
Dr. Ethan Russo, one of the world’s leading cannabinoid researchers, has argued that there is such a thing as a “clinical endocannabinoid deficiency.”
Russo came to that conclusion after analysing research done on migraine, fibromyalgia, and irritable bowel syndrome (IBS) patients treated with cannabinoid-based medicines.
All three conditions can be considered disorders of homeostasis. They also lack “objective symptoms” and remain treatment-resistant.
Russo identified a collection of compelling studies that indicate a deficiency in endocannabinoids, made apparent either through treatment with cannabinoid-based medicine or by measuring the cannabinoid tone of the study’s subject using advanced imaging technology like functional MRIs or PET scans.
In the cases Russo outlines, cannabis showed promise in patient outcomes when an endocannabinoid deficiency was implicated in a patient’s condition.
Cannabis isn’t a ‘targeted’ drug
When it comes to finding acceptance among physicians in clinical practice, though, using an exogenous cannabinoid source like the cannabis plant can be controversial because cannabis can’t yet be specifically targeted at the system that’s out of whack.
Some physicians characterize cannabis as a “dirty drug” because it doesn’t reach just one receptor, or one organ, or one symptom. It goes to all receptors throughout the body.
Roger Pertwee is a medical professor at the University of Aberdeen and the editor of Handbook of Cannabis (Oxford University Press, 2014), one of the field’s definitive textbooks. He prefers to call cannabis a “treasure chest” of medicine.
Each cannabis strain contains a unique concoction of cannabinoids and terpenes that when consumed together, as a whole plant medicine, can deliver a wide range of effects. A patient may experience symptom relief from one or more of their symptoms, but they may also feel sleepy, high, or get the munchies.
Cannabis can provide significant relief for those whose conditions have a constellation of symptoms, as may be the case with migraines, fibromyalgia, and irritable bowel syndrome (IBS), but the protocol doesn’t fit seamlessly with current Western medical practice.
Physicians are typically trained to prescribe one drug per symptom. This can result in a layering of prescriptions, starting with drugs to manage specific symptoms followed by others to mitigate adverse effects of the first drug. This, too, might be thought of as an artificially managed form of homeostasis.