our bodies and cannabis graphic

The endocannabinoid system is one of the great frontiers of medicine today
– a game-changer for what we know about modern health. Image from ukcbd.com.

Clinical Endocannabinoid Deficiency (CECD) is a speculative disorder that causes permanently-low endocannabinoid levels in the affected individual. Although we still have much to learn about this disorder, researchers believe that it might explain multiple illnesses that up to now have had no established cause.

What is Clinical Endocannabinoid Deficiency (CECD)?

CEDC is the term given to a phenomenon reported in a number of patients suffering from certain chronic illnesses where endocannabinoid (EC) levels are found to be persistently lower than in healthy controls. In other words, low EC levels could be the cause of the chronic illnesses, rather than a symptom.

In this article, we will:

  • explain the endocannabinoid system and basic principles of CECD
  • list the primary disorders associated with CECD
  • discuss the potential causes of CECD, which may be congenital or acquired
  • provide simple advice on strain selection and delivery method

What is the EC system, and how is it affected?

endocannabinoid system graphic

This graphic illustrates how the EC system joins with cannabinoids like a lock and key – a perfect fit.

The endocannabinoid (EC) system is a complex system that includes protein receptors known as cannabinoid (CB) receptors – which are situated in various body tissues – and a set of endogenous (produced within the body) fatty acids known as cannabinoids.

Two main cannabinoid receptors have been identified thus far (dubbed the CB1-receptor and CB2-receptor), along with two primary endogenous cannabinoids, known as anandamide and 2-AG.

Of the known endogenous cannabinoids (endocannabinoids), anandamide appears to be the key to understanding CECD. Anandamide is an agonist, which means that it has the ability to bind to a receptor and cause biological activity to occur.

The idea is that as anandamide circulates within the blood, it encounters and binds to the CB-receptors. This important bond – which medical science is only just now beginning to understand – controls or assists in the regulation of multiple bodily systems including sleep, appetite, motor control, perception of pain, and immune response.

In CECD, anandamide levels remain permanently low, and as a result, these various metabolic and regulatory processes may be impaired or halted entirely.

The remedy, as researchers are coming to understand, lies within the cannabis plant. Because THC is also an agonist, it too stimulates the CB-receptors, while substances such as CBD, which are antagonists, block the receptors and cause them to become inactive. This would explain how CBD can mitigate the effects of THC, reducing some of the more intense side effects.

To learn more about how CBD and THC work together, check out this video:

The EC system was only discovered in the early 1990s, although its existence had been postulated for several decades by then. Twenty or so years later, we are still only beginning to understand the basic principles of this vastly complex system. Thus, it may be decades more before we are able to understand the potential effect on individual health for those suffering from CECD.

Disorders that have been linked to CECD

The following conditions have been repeatedly linked to inherently low endocannabinoid levels. This commonality has led researchers to propose that a single common disorder, CECD, is the underlying cause.

  • Fibromyalgia

Fibromyalgia is characterized by hyperalgesia (the subjective experience of pain in response to non-painful stimuli) and pain in certain key points of the body. Fibromyalgia sufferers anecdotally report experiencing relief from symptoms after using medical cannabis. Studies have shown that antagonists/inverse agonists cause hyperalgesia in animal models, suggesting that agonists should prevent or reduce it.

  • Migraine

Chronic headaches are caused by a complex biological mechanism that has been repeatedly shown to involve both the serotonergic and endocannabinoid systems. Cannabinoid agonists including THC have been shown to inhibit serotonin release, which relieves symptoms in many migraine sufferers.

  • Irritable bowel syndrome (IBS)

This digestive disorder is often present alongside migraine and/or fibromyalgia, and is also thought to be associated with both serotonergic and endocannabinoid signalling. Currently, drugs that target the serotonin receptors are often used to treat IBS, with limited efficacy, and research suggests that the CB-receptors would make a superior target.

  • Autism spectrum disorder (ASD)

Several studies demonstrate that ASD is fundamentally linked to dysfunctional endocannabinoid signalling. There are various studies demonstrating that children with ASD exhibit altered endocannabinoid expression, and there are multiple anecdotal reports from parents who have had success with administering THC.

  • Cystic fibrosis (CF)

This study argues that the chronic congenital lung disease cystic fibrosis is a result of imbalanced endocannabinoid levels, and that THC and other agonists are good candidates for further research. It is also possible that other respiratory/immunological disorders such as asthma are linked to the phenomenon.

Causes of CECD: Congenital & Acquired

The speculative disorder known as CECD may be either congenital or acquired. A congenital disorder is one that is either hereditary (genetic in origin and inherited from a parent) or acquired during the fetal development stage.

With CECD, it is likely that some cases have a genetic element, as various mutations of the genes encoding for expression of endocannabinoids and CB-receptors have been associated with specific diseases. For example, a study involving 17 children with ASD showed that the subjects exhibited increased levels of the gene encoding for CB2-receptors, but no difference in that encoding for CB1-receptors.

Multiple studies have shown EC system activity to be high at several key points during fetal development, and it is also possible that some cases of CECD are caused by abnormalities in this activity. As well as this, there is the possibility that CECD could be acquired in the course of an individual’s lifetime, either due to injury or infection.

Will medical cannabis help you?

medical cannabis doctor.

As with any medication there is no guarantee, but enough people have found successful healing with cannabis that it might very well be worth a shot.

A lot of people have successfully treated their CECD-related ailments with whole-plant cannabis. But at present it is difficult to apply any standard to cannabis-based treatments simply because people react so differently to both cannabis and CECD.

In the future, as testing procedures become more effective and accessible, it should be possible to develop treatments targeted to the individual.

However, if you feel your condition is caused by an underlying endocannabinoid deficiency, at this stage it’s more about finding a strain or strains that relieve your symptoms. From the current state of research, it seems that high-THC and low-CBD strains are ideal for conditions related to CECD.

While sticking to high-THC strains seems to be the way forward, you may wish to experiment with slightly lower or higher CBD levels, as some patients report better results when using the two compounds in combination.

Should you decide to experiment with strains, dosage levels, and various methods of delivery – remember that it often takes a bit of trial and error before medical cannabis patients find their optimal regimen.

Have you had success treating CECD-related ailments with cannabis? If yes, we’d love to hear from you in the comment section below.

You can also SIGN UP with Green Flower for all the latest in cannabis education and our upcoming courses.


Clinical endocannabinoid deficiency (CECD)
E Russo 2003


Clinical endocannabinoid deficiency (CECD) revisited
Smith SC, Wagner MS 2014