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The cannabis plant is complex. It produces over 100 cannabinoids, or compounds, and over 150 different terpenes. Some of these terpenes include limonene, myrcene, and linalool. And two of the cannabinoids that you’ll see often in medical cannabis are cannabidiol (CBD) and tetrahydrocannabinol (THC). CBD is non-psychoactive, meaning it doesn’t make you feel ‘high’. THC is psychoactive, so can be behind that ‘high’ feeling recreational cannabis use is sometimes associated with. But what happens when the terpenes in cannabis, CBD, THC and all the other elements come together? We’ll be exploring that below.
Since 2018, medical cannabis has been legally available on prescription through licensed clinics like Alternaleaf for 50+ conditions. You can find out if you’re eligible by completing the quick eligibility checker on our website.
What Is the Entourage Effect in Cannabis?
The entourage effect is a phenomenon where cannabinoids, like THC and CBD, terpenes (the part of any plant that produces the smell), and other compounds like flavonoids may work together to enhance the therapeutic effects of cannabis. It’s thought that this THC and CBD interaction, as well as all the other compounds working together, compared to when each compound is used in isolation, makes the effects of medical cannabis potentially better.
How the Entourage Effect Works in the Body
THC and CBD work by interacting with the central nervous system, the immune system, and your endocannabinoid system (ECS). The ECS is a messenger and receptor system that is integral to homeostasis (the management of balance) within the human body. Research suggests that the ECS influences and modulates mood, appetite, sleep, pain, and much more.
One of the core components of the ECS are the cannabinoid receptors, which includes CB1 and CB2. They’re one of the main reasons behind why medical cannabis might work so positively on so many different conditions. Many experts believe that, by consuming cannabinoids, it’s possible to interact with these receptors.
THC is chemically similar to your body’s endocannabinoids which is why it can interact with your cannabinoid receptors. It binds with the cannabinoid 1 (CB1) receptors and releases neurotransmitters in your brain. This is what can produce a ‘high’, but it depends on the dosage level, individual and symptoms being treated, as well as other compounds that may potentially counteract these effects.
When prescribed medical cannabis with Alternaleaf, one of our expert clinicians will work with you to decide on the best dosage or form for you. Following their advice will reduce risk and unwanted effects. If you’re ever unsure or worried, have a conversation with them.
The CB1 receptors are primarily found in the central nervous system (CNS). When THC binds to the CB1 receptors in the CNS, it can affect appetite and pain. And when we experience less pain, it can affect our overall mood and quality of life.
CBD can interact with the serotonin (5-HT) receptor, and due to this interaction, has the potential to have anti-anxiety effects. CBD may also potentially interact with TRPV1 and GABA receptors which further modulates mood and stress.
And as we said above, when these compounds work together, effects can potentially be enhanced due to the entourage effect in medical cannabis.
Cannabis Compounds Involved in the Entourage Effect
To recap, here’s a list of some of the different compounds in cannabis that are thought to play a role in the entourage effect:
- THC
- CBD
- CBG
- Myrcene
- Linalool
- Pinene
- Limonene
- Caryophyllene
- Flavonoids
Each of the above plays a unique role in the effects and potential benefits of medical cannabis, and based on research on the entourage effect, we know that they’re stronger together.
Entourage Effect vs Isolated Cannabinoids
As we’ve established, the entourage effect is when lots of cannabis compounds work together. And when a product features a range of compounds extracted from a cannabis plant – like cannabinoids, terpenes, essential oils and flavonoids – it’s classed as full spectrum cannabis.
Isolated cannabinoids are purified forms of individual compounds. For example 99% pure CBD or THC. This means they may only contain trace amounts of other cannabis components, and often none at all.
Due to the precise control of isolates, they’re often used in research, clinical trials and drug development. However, there are some limits:
- You may need a higher dose for the same effect.
- They can potentially increase the risk of side effects. For example, THC isolate is more likely to cause anxiety. Whereas in this trial both THC and CBD-dominant cannabis helped reduce people’s anxiety
- And of course it’s thought to be less versatile because it may not have the same potential benefits of full-spectrum cannabis. There’s no entourage effect to potentially enhance anything.
CBD vs full-spectrum
Like full spectrum, broad spectrum can contain a wide range of cannabis plant compounds and terpenes, but it contains no THC. In some instances, this may be the preference for people who are new to medical cannabis. But again - a combination of THC and CBD may potentially be better.
Medical Conditions that Entourage Effect May Impact
So, now that you know a little bit more about the entourage effect, we thought we’d share some conditions that medical cannabis may potentially ease the symptoms of.
- Chronic pain
- Anxiety
- Depression
- Parkinson’s Disease
- Endometriosis
- Epilepsy
- Insomnia
- Multiple sclerosis
- Inflammatory disorders, like Crohn's disease for example
We’ve linked some of our other articles that explore the above in a bit more detail, and include some research. But, keep in mind that clinical evidence is evolving, and results may vary.
Best Cannabis Formats to Experience the Entourage Effect
You’ll often see full-spectrum oils, balanced flower strains, and certain vaporised extracts that contain multiple different compounds working together to offer the most potential benefit. But, the best way to consume medical cannabis can vary from person to person. It really is about the individual: their needs and personal preference.
- Dry herb vaporiser: This method of consumption provides rapid onset of effects, typically within minutes, making it suitable for immediate relief.
- Vape cartridges: Vape carts come pre-filled with liquid cannabis concentrate – no grinding required. As a ‘full spectrum’ product, vape carts can offer high THC, CBD or both, depending on the patient’s needs. Each cart contains around 200 inhales, and is powered by a battery.
- Edibles: From gummies to lozenges, edibles can take longer to kick in, but offer relief that’s both longer and more pronounced.
- Oils: A popular choice for patients who want discretion. Oil can be THC-dominant, CBD-focused, or balanced, and provide a slow-acting yet long-lasting effect (up to 24 hours, in some cases).
Remember, everyone is different, and it may take some trial and error to find what works best for you and your condition. Guidance from an expert, like our friendly clinicians at Alternaleaf, will mean you’ve got someone by your side every step of the way, with advice and knowledge readily available.
Is the Entourage Effect Safe for All Patients?
Your clinician will work with you and advise the best dose based on your condition. Medical cannabis is generally well tolerated, but remember, you may not get your dosage right the first time. It’s important to find a strain that’s suitable for your body and individual needs, so that you can get the most effective results and reduce the chance of side effects. We always recommend you start low and go slow, and follow your clinicians guidance.
Some factors that may influence your ideal dosage include:
- Weight and body size
- Metabolism
- Your medical condition or symptoms
- The strength or ‘potency’ of the medical cannabis
- Whether you’re new to medical cannabis, or have built up some tolerance over time
- Your chosen/recommended method of consumption
Summary
Whether you were curious about isolate vs broad vs full-spectrum, or wanted to know a little bit more about the science behind medical cannabis, we hope this article helped.
The best thing to do is speak to your clinician, or seek the help of a licensed medical cannabis clinic like Alternaleaf if you’re considering medical cannabis treatment. Find out if you’re eligible by heading to our website and completing our 30 second eligibility checker.