What is the Endocannabinoid System?

Is the endocannabinoid system (ECS) a real thing? Absolutely. Though cannabidiol (CBD) and cannabis are relative newcomers as a means to support the ECS, humans are born with an ECS biological system. And, despite its newly found status, the ECS is and has always been an essential factor in multiple biological functions in health and disease.

Why haven’t you heard about it until now? Because of limitations placed on the study of cannabis, research was also limited on the ECS. That is all changing.

Let’s first look at the ECS’s role in homeostasis, which is the body’s innate ability to self-regulate pathways and processes like blood oxygen, blood glucose, arterial blood pressure, arterial blood pressure, water volume and sodium concentration. As you might imagine all of these processes are essential for life. And, without the ECS, many of our essential physiological functions and signaling pathways that support homeostasis would not function. The ECS is involved in appetite, memories, moods, pain, fertility and reproduction.

3d rendered illustration of the male skeleton

What makes the ECS unique is that it is multi-dimensional. Though we still don’t understand everything there is to know about it, the ECS is a master regulator in the body, meaning that its lipids (fats) are essential to certain vital neurotransmission processes. Without the ECS, our cells energy source, the mitochondria, would not work properly. The ECS is the mitochondria’s regulator of “energy homeostasis,” says Michelle Sexton ND, Assistant Adjunct Professor in the Department of Anesthesia at the University of California in San Diego, who researches the role of cannabinoids in clinical medicine.

What are Cannabinoids?

Cannabinoids are beneficial compounds found in the cannabis and the hemp plant. But that is not all, they are also other plants like black pepper, black truffles, broccoli, cacao, carrots, clove, echinacea and ginseng. Scientists are only just beginning to explore cannabinoids, but they have evidence showing that hemp, black pepper and clove may induce relaxing properties without the psychoactive effects of tetrahydrocannabinol (THC) in cannabis (marijuana).

Plant or CompoundDefinitionLegal Status
Hemp“The plant Cannabis sativa L. and any part of such plant, whether growing or not, with a delta-9 tetrahydrocannabinol concentration of not more than 0.3 percent on a dry weight basis”Hemp is legal to sell as a dietary supplement in all states as long as hemp material is below .03 percent THC. The purchase of hemp grown outside the US was previously legal prior to 2018 Farm bill which made it legal to grow Hemp in the US if grower is licensed.
Marijuana“The plant Cannabis sativa L., whether growing or not; the seeds thereof; the resin extracted from any part of such plant; and every compound, manufacture, salt, derivative, mixture, or preparation of such plant, its seeds or resin.”  Legal status varies from state to state for recreational and medicinal use.
Cannabidiol (CBD) Phytocannabinoids derived from Cannabis species”“The FDA has approved only one CBD product, a prescription drug product to treat two rare, severe forms of epilepsy. It is currently illegal to market CBD by adding it to a food or labeling it as a dietary supplement.”

Source: Defining Hemp: A Fact Sheet, Congressional Research Service

The body is teeming with cannabinoid receptors, endocannabinoids and enzymes for cannabinoid metabolism, which all support the ECS. They have a wide scope of influence and are located anywhere from immune cells to neurons.

  • Endocannabinoids, also called endogenous cannabinoids, are molecules made by your body. They’re similar to cannabinoids in foods, but they’re produced by your body. The body produces two key endocannabinoids, anandamide (AEA) and 2-arachidonoylglyerol (2-AG) and each has a role within the central nervous system (CNS). They assist in neuromodulation, neuroprotection, tempering anxiety, and enhancing memory and learning.Endocannabinoids also have functions beyond the CNS, including the immune system where they interact with the cannabinoid receptors.
  • Cannabinoid receptors include cannabinoid receptor 1 (CB1) and cannabinoid receptor 2 (CB2), which are located throughout the body.CB1 is known to be a psychoactive, neuromodulator and a pain receptor found in the brain, fat, liver, skeletal, and muscular tissues. CB2 is responsible for the anti-inflammatory functions located in cells that are responsible for immune function and may also be found in the CNS. “CB2 also plays a strong role in immune function. But interestingly CB1 is also expressed on immune cells, so they’re both important but delineated in specific roles,” says Dr. Sexton.

Enzymes are also important to endocannabinoids when they finalize their functions. When they are finished, they need to be “broken down.” This is done by two main enzymes: fatty acid amide hydrolase (FAAH) that breaks down AEA and monoacylglycerol acid lipase (MGL) that breaks down 2-AG.10

Supporting the Endocannabinoid System

Can you have an endocannabinoid deficiency? Emerging literature shows that the etiology of migraines, fibromyalgia, irritable bowel syndrome, mood disorders among other conditions may be connected to a dysfunctional ECS. However, this does not mean that a person can self-diagnose themselves, nor should they self-medicate with cannabis or hemp.

Studies in genetics show that not everyone responds the same way to cannabis with THC or hemp-derived CBD products. Each person is unique. You may be incredibly sleepy and unable to function throughout the day, while another person may have a completely different reaction to cannabis-THC products.

Dr. Sexton evaluates the person on many levels including measuring inflammation, immunity, stress hormones and other systemic processes since there is currently no clinical ECS testing.  When Dr. Sexton evaluates a person’s ECS, she uses the guiding hallmarks as defined by Dr. Vincenzo Di Marzo, Research Director at the Institute of Biomolecular Chemistry of the National Research Council (ICB-CNR) in Pozzuoli, Naples. They include assessing the person to see how well the endocannabinoid system is helping the body to eat, sleep, relax, sleep, protect and even forget. The latter is a surprising new finding, as the endocannabinoid system is involved in memory processing, including memory updating and forgetting.

She recommends healthy lifestyle choices that support the ECS, such as engaging in regular exercise, consuming a balanced diet, including Omega-3 fatty acids and other healthy vegetable fats. She warns that cannabis can be incorporated into this approach but that it isn’t a magic bullet. A healthy lifestyle is vital and should come first. In short, we all have an ECS. Whether you use cannabis or CBD products, your ECS needs the right nutrients, exercise and rest to function properly.


Sara Le Brun-Blashka, MS is the Director of Clinical Nutrition and Education at Standard Process, where she led the team to launch the educational website, WholisticMatters.com. She has led many innovative product launches throughout her career in functional nutrition, including hemp products, medical foods, probiotics, and resolvins. Sara is a nutritionist with a Master’s in Nutrition Education at American University and a bachelor of science in dietetics and food science. She is passionate about community-supported agriculture, local Milwaukee Charities, and her family.


This article is sponsored by the Institute for Natural Medicine, a non-profit 501(c)(3) organization, partnered with the American Association of Naturopathic Physicians. INM’s mission is to transform healthcare in America by increasing both public awareness of naturopathic medicine and access to naturopathic doctors for patients. INM believes that naturopathic medicine, with its unique principles and practices, has the potential to reverse the tide of chronic illness that overwhelms existing health care systems and to empower people to achieve and maintain their optimal lifelong health. INM strives to achieve this mission through the following  initiatives:

  • Education – Reveal the unique benefits and outcomes of naturopathic medicine
  • Access – Connect patients to licensed naturopathic doctors
  • Research – Expand quality research of this complex and comprehensive system of medicine

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Deb Hubers

Debra Hubers is a serial entrepreneur and has started seven businesses; ranging from an advanced genomics to an employer health care purchasing cooperative. Deb has over 35 years of experience in healthcare finance, education, technology, and pharmacogenomics.

Ms. Hubers has dedicated her career to measuring and improving healthcare outcomes. Her expertise is leveraging technology to deliver personalized, preventative medicine. Ms. Hubers co-founded La Vita Compounding Pharmacy in 2007. Collaborating with her business partner, physicians and strategic partners, Deb has grown La Vita to be one of the most respected and sought-after personalized medicine providers on the west coast. She is also Co-Founder of EpigeneticsRx, a leading provider of precise, personalized, prevention which positively impacts genetic expression.

Alex Keller, ND

Dr. Alex Keller, ND, AFMCP is a graduate of the University of Ottawa with an Honours Bachelor in Health Sciences and Psychology. Although originally intending to attend conventional medical school, following a three-month volunteer internship at a rural Kenyan hospital where he observed how doctors used local food to treat patients, he shifted his career goals and pursued a degree in naturopathic medicine at the Canadian College of Naturopathic Medicine in Toronto.

After one year of practicing with the esteemed Dr. Chris Pickrell, ND, RH in a community acupuncture setting, in 2015 he and his wife Dr. Jenn Keller, ND moved to rural Ottawa, Canada where they started an organic farm and retreat center. In the same year, Alex and his athletic therapist sister Jess Keller combined their practices to form Keller Active Health, an integrative physical therapy clinic.

Ever curious and passionate about the education of evidence-based natural medicine, in 2017, Dr. Keller joined a fledgling Ottawa-based health tech startup named Fullscript. He serves as its Medical Director and oversees the development of medical education content for practitioners across North America.

Prior to medicine, Alex worked in the renewable energy sector, where he developed a deep passion for sustainable agriculture and environmental stewardship. This connection between medicine and agriculture now drives Alex to focus much of his energy on bringing awareness to the quality and sourcing standards in the supplement and organic agriculture supply chains.

Today, he splits his professional time practicing as a clinician, working for Fullscript, and expanding the farming operation while chasing his kids with Jenn and occasionally running ultra-marathon trail races. He is also currently completing an Executive MBA through the Quantic School of Business & Technology with a focus on supply chain innovation.

Pamela Snider, ND

Pamela Snider, ND, is Executive and Senior Editor for the Foundations of Naturopathic Medicine Project, producing a first of its kind international textbook of Naturopathic medicine through a series of international retreats and symposia. A nationally recognized integrative health and policy leader, she is active in both national and regional integrative health initiatives. Dr. Snider serves on the Board of Directors, was founding Executive Director and co-founder of the Academic Consortium for Integrative Health (ACIH/ACCAHCa consortium of the councils of schools, accrediting agencies and certifying bodies of the licensed, traditional and emerging integrative health professions, and is currently Vice Chair and co-founder of the Integrative Health Policy Consortium (IHPC).  Dr. Snider served as a founding Board Member of the Academy of Integrative Health & Medicine from 2014-2016. Her public policy work includes completing a two year appointment to the DHHS Center For Medicaid and Medicare Services (CMS) Medicare Coverage Advisory Committee (MCAC); serving as a Steering Committee Member for  the HRSA funded American College of Preventive Medicine NCCIM Integrative Medicine in Preventive Medicine Residency program, co-directing in USPHS Region X the Building Bridges Between Provider Communities Group, an exploration of interdisciplinary collaboration and common ground between public health and CAM; serving for 22 years on Washington State’s Health Professional Loan Repayment and Scholarship Program Advisory Committee (HPLRSP); providing technical assistance to and developing key language for the enabling legislation for NIH Center for Complementary and Alternative Medicine (NCCIH/NCCAM); and staffing Joseph Pizzorno ND during his appointment as Commissioner on the White House Commission on CAM Policy.

From 1994-2003, Dr. Snider served as Associate Dean for Public and Professional Affairs and Naturopathic Medicine at Bastyr University, dividing her work between academic and public affairs activities, including chairing the Naturopathic Medicine Program Curriculum Review Committee.  Dr. Snider has been teaching, publishing and lecturing widely on Naturopathic philosophy, theory integrative health, public policy, and other topics for over 30 years. Currently, an Associate Professor at National University of Natural Medicine (NUNM) in Portland, OR, Dr. Snider also continues at Bastyr University in her 22nd year as a faculty member teaching naturopathic medicine history, clinical theory, and global context. Among her Naturopathic medicine professional roles she serves on the Institute for Natural Medicine’s Leadership Council.  In 1989, she co-led the naturopathic profession with Dr. Jared Zeff, in developing a unifying definition of naturopathic medicine and its principles of practice adopted unanimously by the American Association of Naturopathic Physicians (AANP) House of Delegates. She was a co-investigator in the 2004 NIH NCCAM research study, the North American Naturopathic Medical Research Agenda and CAM Advisor in NIHCCAM’s Financing Integrative Health Care (University of Washington).  Her areas of experience include healthcare education; naturopathic and interdisciplinary clinical theory, curriculum development; clinical practice; government and legislative affairs, public policy, interdisciplinary collaboration, and community organizing.  Dr. Snider has received the Ontario Naturopathic Physician of the Year Award, the Physician of the Year Award from the AANP, the President’s Outstanding Vision Award and Distinguished Alumnus Award at Bastyr University, AANP’s President’s Award, an honorary Doctorate of Naturopathic Philosophy from the Canadian College of Naturopathic Medicine (CCNM), the William A Mitchell Vis Award from the AANP and The Gathering – NMSA’s Beacon Award. She received her ND degree in 1982 from Bastyr University of Natural Health Sciences and is a licensed naturopathic physician in the State of Washington. She lives with her husband and children at their homestead in North Bend Washington, in the beautiful mountain to sea landscape and home of The Revival – Restore the Vis, an annual student-led community gathering.

Susan Haeger

Susan Haeger is Founder/Principal of Transformative Health Solutions Inc. She has applied her twenty plus years in executive leadership to help shape and drive adoption of progressive health policy for whole person healthcare. She was a section contributor to the 2021 INM/AANP published professional white paper, Naturopathic Physicians as Whole Health Specialists: The Future is Whole Person Health Care that provides supporting evidence for the profession’s significant and unique contributions to preventive, whole person care and models of integrative clinical practice.

Bruce Barlean

Bruce Barlean is an owner and founder of Barlean’s, a global dietary supplement manufacturer located in the Pacific Northwest in Ferndale, WA. Bruce has been actively involved in the Natural Products industry since 1989 and is passionate about making a difference in the world and positively impacting the lives of others.

Bruce believes that people can make a difference in the world through ordinary purchases. He is committed to improving the quality of life for every person on the planet by making the best products and by using the profits to support outreach programs. Bruce summarizes it simply, “We make good stuff to do good stuff”.

In the late 1980’s Bruce became passionate about how health could be dramatically improved with Flax Oil Supplementation. Bruce along with his entrepreneurial parents saw the potential to improve the lives of many people and in 1989 they began selling Flax Oil under the Barlean’s name. From 1989 – 2000 the business grew an average of 40% year over year. While most companies saw a decline in business in the 2001 recession, Barlean’s continued to grow and soon became America’s #1 selling flaxseed oil and continues to be to the present. The brand has since expanded to include additional oils, green food concentrates and other premium supplements. Bruce continues to drive innovation and over the years his products and company have won countless awards including: Eight consecutive Vity Awards for #1 EFA, Six consecutive Vity Awards for #1 Greens Food Supplement, Natural Choice Award for Best Specialty Supplement, Best Product of the Year, Best New Product, Gold Medal Taster’s Choice Award, Gold Medal American Masters of Taste Award, #1 Health Food Store Brand for Consumer Satisfaction by Consumer Lab, and Manufacturer of the Year.

In 2013 as the company was on the eve of celebrating the 25th year in business Bruce and his parents decided to take their desire to help people to a new level that they call Pathway to a Better Life – which is now seen in the Barlean’s logo. Bruce and his parents had always been generous in their giving and support of charities, but as part of the Pathway to a Better Life they decided to increased partnership with charitable organizations such as: Vitamin Angels, Compassion International, KidsTown International, Autism Hope Alliance, Engedi Refuge, Project 92, and others. And because so many people are unable to meet basic nutritional needs, Bruce created a comprehensive Omega-3 and multivitamin formula that he distributes free-of-charge to local food banks. In addition, Bruce decided the company would supply food banks with organic coconut oil to provide people with a health alternative to standard cooking oils.

Always generous with his time Bruce has served as a youth leader for his local church for several years and continues to mentor youth. He has been on several not for profit boards including; Whatcom County Pregnancy Center (2003-2006), Natural Products Association (dates?), and the Institute for Natural Medicine Leadership Council (presently).

The Barlean family have been avid supporters of Bastyr University since the 1990’s and in 2013 were given Bastyr’s most prestigious honor, the Mission Award, which recognizes their leadership over time in improving the health and well-being of the human community.

Bruce currently resides in Ferndale, WA with his wife Lisa and their two dogs: Heinz & Shadow. When he’s not helping others he can be found fishing (catch & release).

Get Involved!

Michelle Simon, PHD, ND

President & CEO

As president and CEO of INM, Dr. Simon brings her passion for working with organizations dedicated to improving the quality and delivery of healthcare. This desire stems from her years of practice as a licensed naturopathic physician. In addition to holding a Naturopathic Doctorate from Bastyr University she also holds a PhD in Biomedical Engineering from the University of North Carolina at Chapel Hill.

She has served on boards for the American Association of Naturopathic Physicians (AANP), the Naturopathic Physicians Research Institute (NPRI), and several advisory boards. Dr. Simon served nine years on the Washington State Health Technology Clinical Committee, as Ambassador to the Academy of Integrative Health and Medicine (AIHM) and was recognized as 2018 AANP Physician of the Year. Dr. Simon shares with her husband a passion for adventure travel, preferably by boat or motorcycle. She also enjoys teaching a women’s off-road motorcycling class.