I have usually avoid looking at items that are advocated on ideological wishfulness. A reader forwarded me a link to “The Endocannabinoid System’s Intriguing Role in Gut Health” in the Townsend Letter, October 2018, so it’s time to check current reality.

• Endocannabinoids in the treatment of gastrointestinal inflammation and symptoms[2018].
  • ” Results from clinical trials have to be carefully interpreted owing to possible reporting-biases related to cannabinoids psychotropic effects. Moreover, discriminating between symptomatic improvement and the real gain on the underlying inflammatory process is often challenging.”
• Cellular localization and regulation of receptors and enzymes of the endocannabinoid system in intestinal and systemic inflammation[2018].
  • ” In summary, our study reveals changes in gene expression of members of the endocannabinoid system in situ attesting particularly GPR55 and MGL a distinct cellular role in the regulation of the immune response to intestinal and systemic inflammation.”
• The Use of Cannabinoids in Colitis: A Systematic Review and Meta-Analysis.[2018]
  • “There is abundant preclinical literature demonstrating the anti-inflammatory effects of cannabinoid drugs in inflammation of the gut. Larger randomised controlled-trials are warranted.”
• Endocannabinoid-related compounds in gastrointestinal diseases [2018].
  • “the identification of several EC-like compounds able to modulate ECS function without the typical central side effects of cannabino-mimetics has paved the way for emerging peripherally acting drugs. This review summarizes the possible mechanisms linking the ECS to GI disorders and describes the most recent advances in the manipulation of the ECS in the treatment of GI diseases.”
  • Chart below is from this 2018 article

Microbiome Aspect

The few available studies on mice found no impact on lean mice but significant impact on overweight mice [2015]

•  increased Akkermansia muciniphila
• decreased Roseburia
• decreased Bacteroides/Prevotella
• decreased Clostridium coccoides
• decreased Clostridium leptum

And from [2017]

• increased relative abundance of Akkermansia muciniphila
• decreased Lanchnospiraceae and Erysipelotrichaceae

Bottom Line

The use of Endocannabinoids is not a simple use or do not use question. There can be negative effects reported with some studies for some conditions as shown in the table above.

It probable vector of benefit is Akkermansia muciniphila. There is active work in both Europe and the US on creating a Akkermansia muciniphila probiotic. Alternative ways of increasing Akkermansia muciniphila are covered in this earlier post.