Clinical endocannabinoid deficiency (CECD): can this concept explain therapeutic benefits of cannabis in migraine, fibromyalgia, irritable bowel syndrome and other treatment-resistant conditions?

E. Russo, Neuro Endocrinol Lett Feb-Apr 2004;25(1-2):31-9.

Clinical Endocannabinoid Deficiency Reconsidered
Current Research Supports the Theory in Migraine, Fibromyalgia, Irritable Bowel, and Other Treatment-Resistant Syndromes Author: E. Russo. Cannabis Cannabinoid Research, 2016 Jul 1;1(1):154-165.

What is Clinical Endocannabinoid Deficiency?
In 2004, the concept of a Clinical Endocannabinoid Deficiency (CECD) that underlies several common diseases was proposed by Dr. Ethan Russo. In 2016, Dr. Russo published a second article that provided supportive research that validates CECD.

Dr. Russo describes that CECD conditions are characterized by several common features. The three most common CECD diseases are migraine, fibromyalgia, and irritable bowel syndrome. All are characterized by hyperalgesia or extreme sensitivity to pain, which is subjective and lacks characteristic tissue pathology or easily accessible objective laboratory findings. All are diagnoses of exclusion that often generate extensive negative diagnostic work-ups. They display elevated incidence of anxiety and depression and have been labeled psychosomatic in origin or even wastebasket diagnosis. Comorbidity often occurs between CECD diseases. While some patients suffer from only one of these syndromes, lifetime risk to develop another or all three is quite common. These conditions are also responsive to treatment with cannabinoid medications, either prescription or from plants, and they can be congenital or acquired.

Although the original 2004 article specifically proposed three conditions as being related to CECD, Dr. Russo thinks that there are many more. He writes, “An extensive list of other disorders previously cited that may fall under the CED rubric included. All display as yet unfathomed pathophysiological features and remain treatment resistant. Might their underlying nature have been missed?”

Fringe Commentary:
In this study a single dose of CBD improved performance and decreased biomarkers of muscle damage 72 hours after an intense strength training session. There was also a trend for decreased One of the clues that Dr. Russo observed when generating the CECD hypothesis was that these conditions respond to treatment with cannabis. Cannabidiol (CBD), is one of the major cannabinoids in cannabis. As we’ll explore in the next several newsletters, CBD has been found to provide benefits to people suffering from these CECD conditions.


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