@: First, explain briefly what the endocannabinoid system (ECS) is in the human body and why that’s important to understand. At In the late 80s, scientists discovered that we have cannabinoid receptors (CB] and CB2) in every organ system of the human body, and soon after in the early 90s, they found that we make our own cannabislike compounds, endocannabinoids (ECs), and enzymes to produce and degrade them. Put ll those elements, together, and you have the ECS ~ a ‘new’ system in the body, just es important as our nervous system or our digestive system. Ithelps us respond to stress by modulating endocrine function, regulating “fight or fight”, and supporting o healthy inflammation/immune response. W's essential to understand the ECS if you want to understand how CBD works. CBD works by balancing and supporting the ECS through its subtle effects on CBI and CB2 receptors, as well as ther receptors that modulate serotonin, GABA, dopamine, and many that impact behavior and inflammation. That is why CBD has so many potential applications. @: How can CBD help the gut? [A The ECS is an avid participant in normal gut function. The exact mechanisms of action are sill being defined, but some areas of particular interest to me clinically are the ECS’ effects on gastrointestinal motility disorders, inflammatory bowel disease (IBD), and gut permectility. CBD is an immune modulator and potent antiinflammatory agent. In addition, it helps to balance the ECS, cand therefore has tremendous potential to positively impact « variety of digestive complaints I's interesting to note that deficiencies in the ECS are associated with pathological states including irritable bowel syndrome (IBS), colorectal cancer, and celiac disease. Clinical endocannabinoid deficiency syndromes (CEDS) may be improved with CBD becouse it prevents the breakdown of our ECs, prolonging their action. In fact, this is one of the main mechanisms of action of CBD. Ler’s not forget the role of siress and anxiety when it comes to digestion! Most of us know that stress exacerbates our gut, and monaging stress is crucial to keeping symptoms at bay. CBD has been shown to promote stress resilience and decrease anxiety, adding to its powerful role in gut function @ Can you say more about gut motility issues and CBD? ‘A: Gut moility is the term given to the stretching and contractions of the muscles in the Gl tract. When nerves or muscles in any potion of the GI tract don't function with their normal strength and coordination, « person develops symptoms like diarthea, constipation (or both), cramping, bloating, etc. IBS is a motility issue, as is SIBO (smell intestine bacterial overgrowth], and to ¢ certain extent IBD (inflammatory bowel disease). The ECS plays on important role in modulating intestinal contractility. CBD may be able to support healthy motility through its ability to dampen overstimulation at the CB1 receptors and its indirect effects on the CB2 receptors, creating beter endocannabinoid tone. In eddition, CBD impacts the enteric nervous system ‘the brain below’) Vie serotonin receptors that are key mediators of motility, secretion, ond pein sensation. Also, studies have shown thot CBD con reduce chemicalinduced hypermotility in mice @: More specifically, what does CBD do for gut inflammation, like IBD (Crohn’s and ulcerative colitis)? [As The ECS is involved in s0 many areas of gut health, from motility to visceral sensation to inflammation, no surprise thet there has already been some early success in mouse models of IBD by treating with substances thot inhibit endocannabinoid breakdown. The good news is that CBD does this, i's safe, and readily available! ©: Can CBD help leaky gut? ‘A: Cannobinoid recepiors along the small iniestine have been shown io modulate the expression of tight junctions that are in part responsible for maintaining gut integrity. Moreover, we now knew that there is crosstalk between the ECS and the gut microbiota which impacts leaky gut. As a matter of fact, it eppears that treatment with certain probiotic strains have been shown to increase the expression of CB2 receptors clong the small intestine, which can support function! Additionally, CBD and other phytocannabinoids have been shown to support « healthy inflammatory response that is essential to heal leaky gut. ‘@: What amount of CBD is most often used for treating inflammation in the gut? ‘A: We sill need more human date in order to determine exact dosing. In my practice, | start with 15-25mg of CBD in 6 full spectrum hemp extract at bedtime. Assuming they tolerate that, I begin to see if we ean add an ‘equal dose in the morning without any sedation. Dose will vary based on individual tolerance and symptoms. For some patients, one dose at night works well. For others, twice @ day dosing does the rick. Others may need 50mg I-2x/day, expecially with severe illness. Safety data is excellent with CBD, 20 there's lots of room to find the ‘magic dose’. You con't go wrong if you start low and go slow.