Powered by Smartsupp

What is the entourage effect?

Cannabis contains many bioactive substances such as cannabinoids and terpenes that have a potential therapeutic effect. The entourage effect is the theory that cannabis compounds work better together than separately. This means that the interaction of phytocannabinoids, terpenes and other compounds can enhance or complement the effects. 

Synergistic interactions can be found between different cannabinoids ('intra-entourage') and between cannabinoids and terpenes ('inter-entourage'). 

The theory of the entourage effect was first proposed in 1998 by Professors Raphael Mechoulam and Shimon Ben-Shabat. They observed that a number of apparently 'inactive' metabolites and related molecules significantly increase the activity of the endogenous cannabinoids, anandamide and 2-arachidonoylglycerol, which are part of the endocannabinoid system (ECS). 

Importance of terpenes and terpenoids

The work of Mechoulam and Ben-Shabat was followed by the American physician and scientist Ethan Russo, who published dozens of studies on the entourage effect and extended his observations to terpenes and terpenoids. These essential oil constituents of cannabis not only mediate the fragrance of the flowers, but also have some therapeutic abilities either on their own or as coactivating agents that enhance the beneficial activity of phytocannabinoids on humans. An example is alpha-pinene - if there is a sufficient amount of this terpene in cannabis, it can block one of the adverse effects of THC - impairment of short-term memory. The cognitive and memory deficits induced by THC can also be eliminated by the cannabinoid CBD. 

Not only cannabinoids but also other secondary metabolites of cannabis, such as terpenes, alkaloids, flavonoids, phenolic acids, lignans and saponins, have been shown to have anxiolytic properties. For example, the terpenes limonene, pinene and linalool have pharmacological effects that improve mood. Caryophyllene, linalool and myrcene can help with the symptoms of certain ailments, such as pain or anxiety, and help to improve sleep.

 

Studies that support the effect of accompaniment

And what has research found about the entourage effect? In a randomised controlled trial of oromucosal cannabis extracts in patients with intractable pain, the THC-dominant extract did not make much difference to placebo, while the whole plant extract containing both THC and CBD proved statistically significantly better than both placebo and the THC-dominant extract.

A study of several human breast cancer cell cultures showed that a cannabis extract containing THC and small amounts of cannabigerol (CBG) and tetrahydrocannabinol acid (THCA) was more effective than pure THC.

The results of a meta-analysis of 11 studies on a sample of 670 patients with severe forms of epilepsy, such as Dravet and Lennox-Gastaut syndromes, showed that 71% of patients improved when taking cannabis extracts with a predominance of CBD (and other plant compounds) compared with 36% taking pure (purified) CBD. In terms of the rate of reduction in seizure frequency, this was statistically the same in both cases (50%), but the average daily doses of the extracts differed considerably - while the daily dose of purified CBD was 27.1 mg/kg, for CBD-rich extracts only 6.1 mg/kg was sufficient. Apparently, the lower dose was sufficient precisely because of the synergistic benefit of the other conjugates in the extract. In addition, the incidence of mild and severe adverse events was higher in patients taking purified CBD than in those taking the CBD-rich plant extract. 

These observations support the hypothesis of greater efficacy of cannabis extracts combining multiple anticonvulsant constituents such as CBD, THC, THCA, THCV, CBDV, linalool, and caryophyllene.

What is the link between CBD and the entourage effect?

Based on the information mentioned above, it seems that the ideal product contains the full spectrum of compounds from cannabis, which are terpenes, flavonoids and other phytocompounds in addition to cannabinoids. In the case of CBD, these are full-spectrum oils and drops that contain all the active substances, including the cannabinoid THC, in the legally permitted amounts (up to 0.3% in the EU, up to 1% in the Czech Republic).

If for some reason you want to avoid THC altogether and still benefit from the synergistic effects, choose a broad-spectrum CBD oil that contains a range of minor cannabinoids and terpenes but not a trace of THC.

In contrast, don't expect an entourage effect with CBD isolate. CBD isolate is the purest form of CBD, containing no terpenes or other phytocompounds. Isolate has a longer shelf life and is cheaper to produce, but does not have the same effects as full-spectrum or broad-spectrum products.

 

Conclusion

The entourage effect has been studied in the context of the treatment of various diseases and disorders, including chronic pain, inflammation, epilepsy, anxiety and depression. Studies suggest that combinations of different cannabinoids and terpenes may lead to better outcomes compared to isolated compounds. However, this is still only a theory supported by a few studies. 

Far from all studies have produced conclusive results, which is why some question the effect of the accompaniment. While the benefits of full-spectrum CBD products have been confirmed by users themselves, further research will be needed to fully understand the entourage effect.

 
Sources:

 

Photo: Shutterstock

„All information contained on this website, as well as information provided through this website, is for educational purposes only. None of the information contained herein is intended as a substitute for medical diagnosis and such information is not to be considered medical advice or recommended treatment. This website does not promote, endorse or advocate the legal or illegal use of narcotic drugs or psychotropic substances or the commission of any other illegal activity. Please see our Disclaimer for further information.“