Monthly Archives: March 2006

The Endocannabinoid System I: What We all Need to Know

The Endocannabinoid System I:  What We all Need to Know

Competency # 1 RISK

Reference: Clin Cornerstone. 2006; 8 Suppl 4:S24-35

The Endocannabinoid System: This is huge and sort of fun.  Herein is your first introduction to this system.  I thought I was going to scoop the market and get to you first, but Time Magazine got out there this week and has a short little paragraph on the first drugs coming to market this summer that targets the ECS or “Endocannabinoid” system.  So, consider me scooped, but you can still be miles ahead of anyone else.  The drugs aren’t out there yet, but they will be and they may be blockbusters.    Because…you can take a pill, lose weight, not feel hungry and sustain your weight loss.  Your cholesterol gets better; your inflammatory markers go down.  And it’s not a form of speed or amphetamine.  This will be huge.  Every drug company in town has one and they will all be huge.

What is the ECS?   It’s the set of signals, markers, and “hormones” that define your feelings of hunger, your appetite, and most interestingly of all, the components of the metabolic syndrome.  The metabolic syndrome is what we get when we find our waist size a little big, our blood pressure a little high, our lipids a little high, our sugar a little high and our insulin a little ineffective.  And when you look under the surface, we find our C-reactive protein, a marker of inflammation, is elevated, along with a bunch of other inflammatory markers.  As mentioned in this column a month or so back, the ECS starts in childhood.  Twelve-year old overweight kids in France have it.

The name, the ECS system, was invented by following the trail of curiosity around why people get the munchies when they smoked marijuana: cannabis.  The cannabinoid receptors in the brain were discovered in the early 90s, and the ECS was born.  Bit by bit, researchers have teased out the fact that our “visceral” fat is dangerous for us.  That’s why our Nutritional Competency # 1 is “Know Thyself and Thy Waist to Hip Ratio”, or just plain, “Know Thy Waist Size”.  (Waist to hip ratio > .9 for men and .85 for women is a problem.   Coming from a .91, a very difficult to solve problem)

We have found that those with big waists, fat around the tummy, have a much higher risk for the metabolic syndrome.  And those with the metabolic syndrome have insulin resistance, high C-reactive protein, and down the road, much high rates of coronary artery disease, stroke, peripheral artery disease etc.  50% of us die from these illnesses.

So, the ECS is the key to understanding the cause of the metabolic syndrome.

Next week:  How.  Just like we all learned about ibuprofen and how it works through prostaglandin and anti-inflammatory pathways, we are now going to learn how the ECS works.  Promise.