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The endocannabinoid system (ECS) is a broad system of receptors, enzymes, and chemicals that interact with the receptors (agonists). It is present in most of the body’s tissues, and the more researchers look, the more processes it seems to be involved in.
What is cannabis? Cannabis contains more than 60 cannabinoids, which are agonists for the endocannabinoid system. Many people use cannabis to treat some of the symptoms of a migraine, including nausea and pain. However, there is not much data to support this being genuinely useful or to establish the mechanism by which it works.
Pain perception is an important part of pain relief. Many painkillers target the sensory neurons that generate the pain signals. The ECS is a part of the system that receives those signals and decides what to do with it. It regulates the transmission and modulation of pain signaling.
Activating the cannabinoid type 1 receptor (CB1R) causes a release of neurotransmitters that control nociceptive (pain-related) inputs. The mechanism for this is still not fully understood.
Migraines cause a lot of pain via the trigeminal nerve, the one that extends from the face into the brain. The nerve itself is not the problem, it is caused to malfunction by the process of a migraine. Inputs from this nerve are misinterpreted (or so the theory goes), changing the amount of blood flow to parts of the brain, and the brain perceives a huge amount of pain.
Interestingly, the ECS is a big part of both the signals getting to the brain and then the processing of the pain signals when they get there. Some patients report that cannabis can help reduce the pain and duration of a migraine, but the science has yet to catch up. We know that the ECS is heavily involved but we do not know yet how to manipulate it to help migraine sufferers.
This study was published in 2010 and there has been research since that has shown that anandamide, an important CB1R agonist, is reduced significantly in the cerebrospinal fluid during a migraine. Normally, an enzyme called FAAH degrades anandamide at a certain rate. During a migraine, it seems to be working in overdrive. By inhibiting this enzyme, it might be possible to return the levels of anandamide to normal and prevent or alleviate a migraine.
Cannabinoids can theoretically be used to reduce the physical pain, nausea, Alzheimer’s disease and inflammation that people suffer from during a migraine. Anecdotal evidence suggests that it might work.
Unfortunately, there isn’t much evidence yet for clinical uses of cannabis or cannabinoids for a migraine. The ECS is hellishly complex and not well understood. The causes of a migraine are becoming clearer but it is still a long way from being effectively treatable.
Click here to download the research paper.
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