Rick: Welcome to the Tuesday webinar series Chiropractic Economics Webinars for Doctors of Chiropractic. I’m Rick Vach, editor in chief of Chiropractic Economics. Today’s webinar supporting stress management, brain performance, mood and adrenals, and clinical practice is sponsored by TruGen3 and as always our program’s being recorded and will be archived at CE’s website, chiroeco.com/webinar for one year. Our expert is on board today to speak with you and when his presentation is complete, we’ll follow with the Q and A period. You can submit questions throughout the presentation by clicking on the appropriate icon on the right side of your screen. Our presenter today is Chris Meletis, whose personal mission is changing world’s health one person at a time. He is an expert on CBD and believes that when people become educated about their body, that is the moment when change begins.

And thank you for taking the time to participate in our webinar and for sharing your expertise. Before we get started, can you please give us a brief background of your work with TruGen3?

Dr. Meletis: Certainly. Well, thank you very much. I’ve been a naturopathic physician here in Oregon for 30 years, and I’ve been working with TruGen3 because the science shows that not all CBD is created equal. So I’ve done lots of education, lots of presentations, and you’ll be available to get my book, as well as several of my articles, which are available on TruGen3’s website. Plus, they’ll be sent to you as well. I believe that becoming educated and keeping the awe that we all had became docs is important. So as we see on the first slide, we see the brain, we see the cerebellum and most of us of course think cerebellum, we think balance. But of course, what we now know is 70% of our brain’s neuron densities is within the cerebellum. And so, we start learning more and more about what the cerebellum actually has to do with concentration and focus and all these other aspects.

And today we’ll talk about the hypothalamus, the pituitary, the adrenal, but we’re also gonna just talk about things that we were generally never taught while we were in school. And once again, keeping ourselves in awe is important because as we’ve practiced in clinic, we realize that, “Wow, I didn’t know that.” Or, “I just observed something I wonder if anybody else has observed that.” And that’s called pioneering work. So the objective today, to learn about the HPA axis, hypothalamic-pituitary-adrenal axis and how the endocannabinoid system works. I remember giving a lecture down at A4M, one of the large integrative conferences that trains medical doctors, about five, six years ago. And people would come by and I’d say, “Well, of course, you know about the endocannabinoid system.” And he says, “No.”

And our answer, unless we’ve gone into the weeds is we were never taught about the endocannabinoid system, let alone to the level that we’re gonna talk about today. And so, once again to think we know, and then I like to always look at the logic like, “Wow, this is really exciting.” So the endocannabinoid system in short is the regulatory process of an anandamide, which your body makes every day and 2-AG. There’s also other cannabinoids that your body makes including palmitoylethanolamide great for neurological pain. So once again, this is being made on a daily basis, just like nitric oxide is in our body, just like ATP is in our body, and just like NAD is in our body. But all of these are diminishing with time and age and stress. Likewise, we get an endocannabinoid dysfunction occurring within our body.

So we want you to also appreciate that there’s a play between the microbiome, so our friendly probiotics and our endocannabinoid system, and there’s a peer reviewed journal article on PubMed that I wrote on just that topic that’s also available to attendees today. And it’s great to see hundreds of providers today. Clinical implications of endocannabinoid deficiency. Well, we know adrenal fatigue, we know adrenal insufficiency or deficiency. Well, what about endocannabinoid deficiency? Can we have as healthcare providers and our patients ran so hard for so long? So we went from high school to college, to graduate school. We started our practices and we’re, go, go, go, and can our endocannabinoid system become insufficient to deal with the helter-skelter of our lives? The answer is yes. Impact our adrenals in our immune system, and likewise, whether it be the COVID era.

And I think for us that were around during 9/11, I remember exactly where I was. I remember the meetings that day and the day after of 9/11. I think we’re all gonna know what we were doing during the last couple of years during the COVID era. And it’ll be certain we tell our kids and our grandkids and onwards, but it had impact on our endocannabinoid tone. So just like we have adrenal tone, we have muscle tone, we have other tones in our body. Well, our endocannabinoid system also can get thrown off. So the endocannabinoid system is critical for a happy hypothalamic-pituitary axis. So it’s like, okay, but I was never taught that. Again, likely you weren’t either. So what are we doing to take care of our endocannabinoid system? We can be meditative; we can be prayerful. We can make sure we get our sleep, we eat well, we don’t sweat the small things, but also using things like CBD, which we’ll chat about a lot today and how not all CBD is created equal will be vitally important.

The research is very clear. The endocannabinoid system, remember the anandamide, that’s AEA, and 2-AG are working in our bodies continuously. They’re just ongoing make it, make and make it. Well, we make the same assumption about brain chemistry. We make the same assumption about adrenal output in cortisol. And then the question is, is that really something that’s true to the aspect of does the endocannabinoid system get worn out? Yeah. And so what we’re trying to do is we’re trying to go ahead and prevent an overactive system or an underactive system. And once again, taking care of our endocannabinoid systems is vitally important. A balanced endocannabinoid system interacts with the HPA axis. So once again, modulates lots of docs, and clinicians and scientists don’t like the word modulate. Thinking about back in the day when we had an FM dial, we would tune it in just right to get rid of the static.

We’re looking to balance the body much like we use adaptogens, but now imagine an adrenal cell and the adrenal cell’s tired, it’s worn out. So we’re thinking, we’re giving a maca, Ashwagandha, Rhodiola, Siberian ginseng or a regular ginseng. It’s okay, great. But is there a proper hypothalamic-pituitary-adrenal mechanism going in place so that it could optimally take those nutrients in? And so, the CBD interacts with the dopamine receptors as well. We know dopamine is for contentment and happiness. If you think of Winnie-the-Pooh, we’ve got Eeyore, not really high on dopamine, we got Tigger, pretty jacked up on dopamine. We got Pooh, he’s happy with his pot of honey. So we have that spectrum of dopamine levels and we want to support that. And that also comes to play with the endocannabinoid system as we’ll learn endocannabinoid system and nurturing it critical for how we deal with stress and contemplation in worry and basically being afraid of our shadow, which these days we’ve been conditioned to do so. So it promotes a happier, more kumbaya mood.

So an abstract from the pure view literature, 2014, it actually speaks to knowing the endocannabinoid system as a widespread intracellular signaling system. Well, if I told you about any other intracellular signaling system, you’re like, “Ooh, I better do something about that. That’s gonna have a ripple effect.” Indeed, it does. The endocannabinoid system plays an important regulatory role in the hypothalamus, the master gland that controls all things good when it comes to hormones and potentially bad. And it also helps with endocannabinoid tone and the review that they did way back in 2014, we’re talking about eight years ago now. And they’re saying the review provides new perspective into endocannabinoid control over neurochemical causes and consequences of energy homeostasis imbalance, and even potentially a play on obesity, which we know is a comorbid factor for so many things.

It’s like, “Hmm, why haven’t we learned about this before?” And obviously, the more current literature is even more compelling and more elucidating. So for those of you that are less familiar with the endocannabinoid system, here’s a very brief review. It’s a natural system in our body, exists no different than the HPA axis. There’s receptors on our cells, just like there’s a vitamin D receptor on your cells and or at the nuclear level of a cell. And so, it helps regulates mood and sleep and appetite and memory. And as we now have seen even adrenal function. So you got a person, they’re tired and they’re worn out and we’re giving them adaptogenic herbs, you’re doing great adjustments. You’re giving them all that great advice. But if they have an endocannabinoid insufficiency, will be the term I use, might we want to nudge that? And so, our body makes endocannabinoids every day.

And of course, there’s also Phytocannabinoids, this is where CBD and some of the other cannabinoids come into play and you can get it from, of course, marijuana, cannabis sativa, or hemp, cannabis sativa. But remember hemp is not marijuana in the truest sense because it does not have the THC level. So when you’re giving a good quality CBD, it does not have a measurable amount of THC. So it is good and safe and non-psychoactive. That’s one of the biggest questions I get from the novices that are just entering a place of, “Well, I don’t want a person or I don’t…” And I remember a six foot five, international world-famous martial artist in the Philippine, fighting arts. And he has worked for law enforcement. He said, “Oh, no, lots of PTSD.” He was in Vietnam and so forth. And I said, “Well, CBD’s been…There’s some literature on PTSD.”

And he said, “No, I’m not gonna touch that stuff.” Because of course, the police officer training part of him says I’m not gonna do that. So I had to explain same plant name, but once again, less than 0.3% THC, or not even measurable often. So many CBD’s benefits is it regulates the body. It modulates the body. And so, once again, nudging and nurturing, very, very important. So the endocannabinoid system is known to play an important role in regulating immunity, and it’s considered a gatekeeper to immunity. And you can see the graphic here from 2014, hepatology, speaking about how a CB2 deficiency versus CB2 activation relative to fibrotic and sclerotic changes to the liver. And when I came across that article, first thing I thought about is one of my patients with autoimmune hepatitis. I’m like, “Hmm. So she’s on a list of drugs. So I’m gonna have you look at drug interactions.”

He was like, “Wow, wouldn’t that be cool. We can actually get her to feel better.” And down-regulates auto-attack. So once again, it’s a gatekeeper and the research shows that we have CB1 and CB2 receptors. And for those of you that are deeper into the trenches of CBD, we know we have TRPV1 and 5a1 pathways and other pathways as well. So it’s actually even more pervasive, but just keeping it simple on the CB1 and CB2 receptors, we know that the anandamide we make every day and the 2-AG are at play. Also, what’s interesting is for those of you that are familiar with SSRI selective serotonin reuptake inhibitors, well, they basically help serotonin stay longer in a receptor. Well, we’re now knowing that CBD actually seems to confer a mechanism on FAAH, fatty acid amide hydrolase for those that like the deeper weeds here, and actually allows anandamide to stay more active for a longer period of time.

So it’s like, wow, all these things we didn’t even know until Mechoulam and his work out of Israel. So there’s significant evidence that cells of the immune system except for CB1 and CB2 receptors. Okay, well, let’s go back to, well, doesn’t our cells also have vitamin D receptors? Don’t we do things for our vitamin D levels to keep immune competence? And like, okay, well this is once again, something within our body. And once again, we want to nurture it. So, the endocannabinoid system is critical for just feeling at peace. Once again, Winnie-the-Pooh, not Piglet, not the worrier. We want to actually go ahead and look at how do we support the body and it’s a gatekeeper, and it helps us not be overactive or underactive at the adrenal levels.

And that’s vitally important, and if you look at some of the red highlighted notes of the titles which I highlighted on purpose in red, integration of the endocannabinoid signaling into the neural network, rightly stress-induced activation of the hypothalamic-pituitary-adrenal access, that speaks volumes to where the researchers were going or functional interaction between stress endocannabinoid system from synaptic signaling to behavioral output. So, thinking about how that might apply to one or more of your patients on a daily basis. So what about allostatic load? Some of you are very, very familiar with allostatic load and some of you are not familiar with allostatic load, but allostatic load’s total burden is disruptive or potentially disruptive for homeostasis. And so the endocannabinoid deficiency that was proposed by Russo in his paper way back in 2003, said, “Well, what about irritable bowel? What about migraines? What about other functional conditions? What about?”

And could we get to a point where our endocannabinoid system, the natural mechanisms within our body are so worn out. We have breakthrough issues. Well, we know that when it comes to our adrenal glands, we can get so low on our cortisol levels. On a daily basis we make about 20 milligrams of hydrocortisone on a mellow day. But if we’re making 10 milligrams, you’re gonna have breakthrough inflammation, you’re gonna have aches and pains, you’re gonna have itises, inflammatory processes of your body. And then you use either a steroid or you do something from a natural perspective to support adrenal function, to hopefully make some more hydrocortisone. Well, the same concept here is how can we support our endocannabinoid system so that we can mitigate some of the things that he’s proposing with endocannabinoid deficiency?

And if we weren’t stressed out before 2020 and the whole COVID rollout and all the consequences, I think we’ve just officially put the cream on top of the sundae, so to speak. So think of adrenal insufficiency and think of endocannabinoid insufficiency or deficiency in concert, can you really treat the adrenal glands if you’re not treating the HPA axis? And so, I’d like to do that with all my adrenal patients. And I would say probably 70% of my patients have some symptoms of adrenal-related conditions in clinical practice. There’s a lot of articles available on TrueGen3 that I’ve written for the Townsend Letter, for PubMed onwards, but CBD potential role for attention deficit and autism, and endocannabinoids, Phytocannabinoids, and Palmitoylethanolamide not something offered by TrueGen3, but Palmitoylethanolamide has 600 milligrams BID interesting for neuropathic pain.

So I will use Palmitoylethanolamide and CBD in concert to have an additive effect. So using TruEase along with Palmitoylethanolamide to help with those aches and pains and particularly the neuropathic ones for the Palmitoylethanolamide. And once again, all of these articles are available with lots of references and also the evidence of the clinical use of cannabinoid-rich oils in pain, inflammation, and stress. And I think we’re all stressed out and, or potentially stressed out, even though one of the biggest places that I find when I’m chatting with my patients is that I think stress is one of your problems. And I remember having this conversation with a VP, a large foot apparel company, and she says, “I’m not stressed out.” I insist, “Well, how many weeks a month do you sleep in your bed?” “Two.” “And where do you sleep the rest of the time?” “Hotels.” “And how do you get to those hotels?”

“Airplanes.” “And how many time zones are you in?” And so, she was in full denial of having stress in her life, and I’m going like, “Hmm. And you’re coming in with neck pain, you’re tired, you’re worn out, inflammation. I think you got some stress and I think your little adrenal glands might be telling you that.” And so, once again, finding those fighting words and saying, “Oh, I think you’re stressed out.” Well, that’ll be like telling somebody to calm down and expect them to calm down. Right? And so, we also see the gut-brain axis also critical here and also muscular and visceral issues, including endometriosis was shown in the research. And once again, nicely referenced all these articles available at TrueGen3. So, we need to modulate our zen. Well, we wanna do that by supporting our endocannabinoid gatekeeper and the HPA axis. And as I did on another slide, I’ve also put in red, highlight the titles.

Effects of short-term CBD treatment on the response of social stress. Okay. Next one, effects of acute cannabinoid administration on anxiety and tremors. Okay. And kinedol reduces anxiety induced by simulated speaking. So once again, stress, stress, stress. And once again, can we mitigate that? But remember that saying, “A penny saved is a penny earned.” So if you don’t have to feel it, experience it, you’re conserving it. So it’s a health savings account. You’re saving and adding to your wellness by merely not expending on the other side. So if you don’t spend the dollar, you got the dollar still on the positive side of your bank account or your health savings account. And so, once again, I use a lot of CBD for that mechanism alone, just daily maintenance to allow the endocannabinoid system not to get to that insufficiency or deficiency perspective, my personal clinical experience.

So, CBD also promotes a restful night’s sleep. So the concept of restoration or restore, and important for athletes, but also for us desk jockeys and warriors that live in cubicles. Also important, it makes sense that we don’t wanna have an overactive cortisol pathway because we’re not gonna of course, sleep at night as well. So what about stress? Well, we know the physiological aspect of stress, if we’re stressed, we’re distressed, and if we’re distressed, we’re not in a state of ease. So we’re in a state of disease. And so, CBD can be very beneficial in those regards and also controlling the glucocorticosteroids. Way back, 20 years ago, what did they do before they had biologic drugs? They would give large doses of prednisone to people with autoimmune disease. Well, why? Because steroids are immunosuppressive. We also know that we get stressed out, are we more likely to get ill, a cold or an illness?

Yes, but if our adrenals are lower, our cortisol levels and hydrocortisone are lower, and we’re more likely to have breakthrough inflammation and breakthrough autoimmunity over-reactivity. So very important to take care of the endocannabinoid system for our immune function and also helping as part of the equation, along with vitamin D and so many other things, food sensitivities for autoimmune patients, too in my clinical experience. Once again, lots of references available on these topics as well. So we wanna buffer that feedback loop, and we also wanna help deal with chronic stress. So acute stress, it comes it goes, but so many of us now are just constantly barrage. So my first prescription for my patients is turn off the news, turn off talk radio, because it’s not gonna be edifying.

It’s just talking heads out there trying to stir the pot. And we need to be, of course, the agents of the change we want to see for peacefulness. They all say, “Rest in peace.” How about we all live in peace? What a concept. And so chronic stress can lead to depression-like symptoms. How’s that called for us, healthcare providers? Burnout. And burnout leads to suicide, drinking, addictions, and or self-destructive behaviors. Might wanna get on ATV and jump the largest mud hill that you’ve ever seen, just because you need to feel alive because you’re so worn out at the level of giving every day to so many patients and as chiropractors, you’re very blessed to interact with lots of people, but you hear their stories, you take on their energy. So also buffering it for you, your CA is vitally important as well. Because otherwise we get worn out and worn out people don’t perform as well.

Nor can we sustain it long-term, the rabbit versus the tortoise in the race. We have to keep mellow and methodical throughout the process. So the investigators have looked at the role of endocannabinoid system, which is abbreviated ECB and allostatic load. And they looked at recovery processes and they found that treating a chronic stress-related aspects of being a human being in modern life is vitally important. So interesting, the integration of the endocannabinoid system and the brain. So once again, we think hormones, HPA axis. Why would we ever think of an endocannabinoid, anything relative to the brain? Well, the evidence has been gathering that the strong argument of it of an inventory role of the endocannabinoid system and the HPA axis, and also under acute stress, there appears to be a constraint of activation. So it’s like, “Hey, we’re not gonna burn out here. We’re not gonna freak out here.”

And it’s actually a very rapid response, which we’ll talk about in another slide. It’s like, so we know about adrenaline and adrenaline dump, but you mean the endocannabinoid system can come into play at that level? And once again, all of these slides will be available for you, so I’m not reading the slides to you because you’re plenty capable of doing that. But these are just talking points for us to ponder as clinician to clinician here. And we also see that the endocannabinoid system’s neurotransmission modulation of stress, the gatekeeper effect. Whenever we have a gatekeeper effect, we need to make sure that there is, once again, an active, conscious gatekeeping and that we’re not allowing things to go by just like leaky brain leaky gut immune issues. We need to have a great competent gatekeeper system. So ultimately these data points demonstrate the endocannabinoid system is likely to be integral and neuronal response and plasticity to stress.

For those of our patients that have PTSD, we know that they can run a rut in the road, so to speak. It’s a default position of fear and trepidation and distress. And there’s quite a bit of evidence on PTSD and CBD as well. So once again, looking at that critical because once again, a penny saved is a penny earned. Now, if we look at the research in the hypothalamus and we looked at control groups, we looked at acute stress, we looked at chronic stress and you see here in the synapsis, the endocannabinoids at play. Oh, we know cortisol’s at play for sure, welcome to midriff weight or that breakthrough immunity inflammation. But now we go ahead and look at the fact that there is an overwhelming evidence of, basically you can’t take the endocannabinoid system at the HPA axis and the HPA system cannot work without the endocannabinoid system.

So stress and glucocorticosteroids trigger the synthesis of the endocannabinoids. So it went, remember and anandamide and 2-AG, but they’re also having effects on the brain, the 5HA1 pathway along with multiple other pathways. So this under acute stressors are chronic repeat. It’s like wash rewash, rinse, re rinse. And as a result, there can be a fast feedback inhibition. So this is not necessarily where we want to be. So a fast feedback inhibition, you can see in yellow of the HPA axis via the glucocorticoid-induced ECB release in the hypothalamus. So, okay. But Chris, if you think about that, we’re just talking out loud here. If I have enough adrenal function to dump hydrocortisone and cortisol and cortisone into the system, I’ll have a fast feedback inhibition. If I’m adrenal worn out, and this is just me pontificating here. So maybe instead of that 20 milligrams on a mellow day that a healthy person makes of hydrocortisone, you’re making 12, how fast is that feedback loop?

And are you more likely to, once again, be chasing your tail, worrying about things, crossing bridges that aren’t yours to have? So taking care of the adrenals along with the CBD endocannabinoid pathway in concert is the approach that I like to use. And remember CBD also helps with inflammation often as well. So when we look here at ongoing stress and that little intricate balance, and then we see on figure three, that response to acute stress, there is little to no change to 2-AG, but once again, we’re seeing changes in the plasticity and thank goodness for neuroplasticity and receptor plasticity, because that’s how we have redundancy, but ongoing stress and stress and stress, we’re causing a different stress response and we’re wearing our body out. So we’re not just wearing out our adrenal glands. Our patients are wearing out their endocannabinoid system or at least putting it at risk.

And so, once again, very important to ponder. So, if we were all to sit on a beach, be given fresh fruit and smoothies, watch small little waves and a nice little breeze and get a massage on a daily basis and have no technology around us, we would start finding the traditional balance that many of our ancestors 500 to a thousand plus years ago had. They didn’t have this onslaught. And when we have a better psychological stress, we have generally better immunity, but when we’re stressed out, we have a decline in immunity. And my undergraduate thesis at Reed College was Psychosocial Stress and Immunosuppression in 1988. So once again, there’s 110,000 articles in 1988 when I was writing that thesis that I was like, “Hmm, stressed-out people have messed up immune systems. Summary.” So CBD is involved in a healthy stress response and the 5-HT1A receptors it’s critical for happiness and contentment and also GI function because we know serotonin and serotonin receptors are critical for proper peristalsis.

So now you start thinking about what about my irritable bowel symptoms and my patients with those issues, whether it be IBS-C, so irritable bowel with constipation or IBS-D is we’re doing our ICD-10 coding, but it’s like, okay, well what about those receptors? And that’s where the article I have on PubMed on the endocannabinoid system and GI health offers a lot of great little pearls, but once again, have we been doing that along with our glutamine or our probiotics for our patients? Probably not. So once again, a missing link that we never knew until today, possibly, that can be actually beneficial. And also seeing that cerebral blood flow in various aspects of the brain involving anxiety in the amygdala, hippocampus, hypothalamus, and cingulate cortex, there seems to be ability for CBD to help maybe with some of that as well. And cerebral blood flow is critical.

20% of my oxygen as I’m sitting here is going to my brain, 20% of my ATP is being used by my brain. And so, once again, 20% also of my glucose is being used by my brain. So what did Thomas Edison say? “The prime function of the body is the care around the mind.” So we need to tend to our mind that remembering our mind is a guest of our body as well. So we wanna control the chatter, the little devil angel cartoon, and we need to avoid fear triggering and emotional pain that can be as painful as physical pain. And so if you think about one of the commercials on television for antidepressant, and it says, “Depression can hurt.” As part of that commercial. And once again, helping modulate the brain is vitally important. And once again, you can see in the red titles at the bottom, endocannabinoid and stress, endocannabinoid and consolidation of explicit fear extinction in humans, and also a potential new alternative for the treatment of anxiety, depression, and psychotic disorders.

So interesting. And am I suggesting CBD for psychosis? No, I’m not. I might suggest gluten-free and there’s actually, if you type in gluten-free onto PubMed, first thing that pops up is gluten and psychosis, by the way. If you stress out all the time, what happens? You’re gonna spend a lot of brain chemistry being stressed and whether you’re happy, you’ve been on vacation, you come back and you have that emotional letdown. Or you’re distressed all the time, if you use up all your serotonin, dopamine, epi, norepi being wired, it’s gonna come with a consequence and we want to use our HPA axis to mitigate that and have, once again, a more kumbaya, more relaxed, no worries. And so, CBD is not gonna take away all your magical things. There was a commercial back in the ’70s, Calgon, Take Me Away. Was a bath salt.

Well, but it is gonna support your natural pathways, which you are created with, designed with, and if we don’t tend to them, it’s no different than any other issue that we don’t tend to. Of course, it’s going just sit there and have consequences. So we want to support our dopamine. Our dopamine, of course, is our happiness, contentment. We know dopamine also is often low or on the lower side or it’s not interacting with oxytocin for individuals experiencing autism. And I’m not saying CBD is a cure for anything, but if we have happier dopamine levels, we’re gonna be able to fuel oxytocin and you’re gonna be less antisocial. You’re gonna be more engaged and your patients will less likely be anticipatory about interacting with the front desk or interacting with people in the aisles, in the stores that are in bad moods as they walk around looking at empty shelves.

And so what we wanted to do is we wanted to support the body because we’re no longer in Kansas. So if I was Dorothy, I would say, “Toto, I don’t think we’re in Kansas any longer.” And the reality is lots of extra stress. We had stress before, we have more stress now and who knows what the next few years will hold, but we need to protect ourselves, our patients, and our families in order to take charge, but also remembering our adrenal medulla. What I’ve lectured for the Institute of Functional Medicine, I often speak to male hormones, thyroid, but adrenal cortex. Okay, well, that’s the cortisol cortisone but what about the adrenal medulla? That’s fight or flight in the truest sense. That’s an adrenaline dump and you can only have so many adrenaline dumps, anxiety attacks, panic attacks before you start getting once again, a rut in the road and that’s that fear extinction, and CBD may be helpful for that as well.

And so, we want to realize that dopamine is made into norepinephrine and epinephrine. So if your dopamine’s contentment, norepinephrine and epinephrine are robbing your contentment, and that makes sense. If you’re stressed out, are you content? No. And so once again, that sustainability is critical. So if you’ve lost your contentment, you’re not enjoying work as much, your patients are complaining more, not about you, but about their own lives, which we know is very consistent these days. Well, it’s okay. Well, we need to tend to this and CBD has been shown to be helpful with overall modulation of mood. So what about brain chemistry? No worries. Be happy. Well, if it was only so easy, right? So by taking care of what we have in our body, remember nitric oxide, 50% of the levels by the age of 50 of what we had when we were younger. NAD levels, 50% of where we were when we were in our 40s. ATP, 10% less per decade from the age of 30 onwards.

So nitric oxide levels drop, NAD levels, drop ATP levels drop. Well, once again, endocannabinoid deficiency, adrenal insufficiency, all come with the passage of time. As we want to look at how do we support a healthier mood, and as you see on the title here, the CBD is a partial agonist, in contrast to antagonist, add the dopamine receptor. And so that’s interesting to say the least. So we want to look at how do we support happiness and contentment. And we also wanna minimize pain. What drives our patients into, “I’m tired.”? Well, in my practice, there’s a lot of, “I’m tired.” In your practice there might be, “I’m tired of having pain.” Or, “Doc, it hurts here, here, here, here.” And once again, if you put them on lots of steroids, which I’m not proposing, nor would you, well, a lot of the pain would go away superficially. We’re not addressing the cause. You folks address the cause on a daily basis at a biomechanical level, a nerve innovation level.

Well, what about going ahead and supporting it also at the hypothalamic-pituitary-adrenal, cortisol cortisone, as well as brain receptor perception level. And so, once again, fairly compelling to say the least and ongoing stress leads to inflammation and ongoing inflammation leads to stress. It’s stressful to be in pain. And you’ve seen that with your patients all day long. Since cortisol’s anti-inflammatory, CBD’s effects on HPA axis can help the body have healthier levels of cortisol, all things being equal, supporting all the other pathways as well, rest and sleep and diet and lifestyle and all of that. But once again, why haven’t we including me been using that? 10 years ago was not part of my repertoire, now it is. And so, CBD 101, we got CB1, CB2 receptors. Okay. We also have the TRPV1 receptor, which actually has to do with pain and transient pain. We used to think that capsaicin cayenne worked merely on substance P.

So we rubbed some cayenne ointment on some capsaicin and we had, let’s say a neuralgia or herpes, zoster, chickenpox-like virus activity. It would help minimize. Well, we now know the endocannabinoid system also works on this pathway and it actually so does capsaicin as well. It’s like, hmm, CBD and capsaicin, two Cs for maybe helping control the discomfort. CBD also activates and influences the trends into your peak channels and helping with immunity as well. So the article I was referencing on PubMed that I authored was The Important Role of the Endocannabinoid System and the Endocannabinoid Ome in Gut Health. So endocannabinoids, okay, well, we’ve been talking about this, ome, so yeah. Microbiome and how your friendly probiotics interact with the endocannabinoid receptor the CB1 and CB2. And as you’ll see here in great detail, also other receptors.

So once again, you don’t need to know all of what’s happening unless you want to. And this article will help delineate that with the TRPV1, the PPAR-alpha, the GPR55, and the 5-HT1A showing all these other mechanisms, but our probiotics are interacting with these receptors? That’s how important they are? Wow. So once again, just a brief summary, 2019 PubMed article. So a large portion of the immune system is in our GI tract. We know that. In fact, I just wrote the forward, an endorsement for a colleague of mine’s book on the truth about leaky gut syndrome. In fact, I just submitted it this morning. And he talks about skin and immunity, and how all the microbiome… In fact, one of the concepts came up with over the years. Once again, you folks are creators too, and that’s how we create a future for our future generations of providers. But I came up with the pajama therapy. So, people that have eczema very bad so as your children, well, often their medical doctor will tell them, “Take a bleach bath.”

Well, why would you tell a person to get a bleach bath? Well, because chlorine kills bacteria. So, you’ve been scratching away and it’s all red and inflamed and infected, take bleach baths. Okay. Well, that’s like new kit with the broadest antibiotic possible if you’re doing something internally. So, I’ve actually came with a PJ theory, which is a healthy person in the family wears pajamas for two or three nights, and then they hand the pajamas to the person that’s been given the bleach bath prescription, and they re-inoculate the friendly microbiome of the skin because there is a skin microbiome as well. Go figure that. And I would argue probably endocannabinoid pathway there too. And so it’s interesting, to say the least how we can advance in work on things. And at the very end, I’m gonna share with you my email. So, if you want to write something, publish something, let me know because we’re all here together to make a difference.

The gut microbiota collection of good, bad, and indifferent bacteria, we know there’s also things like Proteus Mirabilis, which is pro-autoimmune in the right circumstance. So, measuring that’s important. We wanna control the inflammation and the zonulin leaky gut side of things. So, once again, endocannabinoid system. As you can see, a lots of references. So, we want to look at how do we support it and realize it in our immune systems in our gut, it’s the filter of the outside world, the inside world. I this morning, welcome the outside world in helter-skelter chaos. To my inside world, I opened my mouth, I swallowed, had maybe more than one cup of coffee. You might be able to tell that and say, “Hmm, but what happens if I have a leaky gut?” Well, things that are not friendly get through those gates. Once again, back to the gatekeeper’s answers. Yes. And so I give the example to young people in my family about self-medication.

And if you have a delicate little cyanamide, you just gently touch it. Not proposing you touch wildlife. But if you gently touch it, it will start closing. You poke it, it totally closes. Well, that’s of course, how it captures its prey. But think of that as a receptor, you want to be gentle to it. And that’s why the concept to start low, go slow on CBD, and most supplements, and most medications. The little bit does the trick and keeps your receptor that your little cyanamide happy for a right-hand upper corner, you’re like, “Okay. Interesting.” So, they looked at 57 healthy participants performing simulated speaking tests and a double-blind study, and they give them massive doses. I mean, 150, 360 milligrams, absolutely astronomical levels not being very nice to our cyanamide or receptors. But they’re trying to see whether they can move the dial. But they went super physiological. The right product at the right milligram dose with good absorption, you need 25 milligrams, you don’t need 150, you don’t need 300, you don’t need 600.

And eventually, just like if you do anything in excess, like too much coffee, then you start losing effect. You want to nudge and not shove all the way through our own chemistry. So, once again, we don’t wanna go super physiological. And those kinds of doses are super physiological. It’s rare exception, or maybe an epileptic issue or something like that. So, susceptibility to the immune system, we know that the cannabinoids act as part of the system and function at the T and B cell levels and natural killer cell and macrophage levels. And we also know that they help regulate the cytokines and Th1 and Th2. So, once again, there’s ability for our endocannabinoid system to regulate our immune system.

And is one of the things when we see people that end up with a catastrophic health challenge, have they worn themselves at multiple levels, have they been undernourished at multiple levels, and potentially also at the endocannabinoid level, which once again, most of us have never even known that we should be addressing for these worn out, stressed out, and chronically broken individuals. So, what is a host? And what about the individual susceptibility? They looked at that, and they looked at 11 attributes, and they looked at inoculum temperature environment age, chance, randomness, history, immunity, nutrition, and genetics. And they said, “Well, what are the issues here? And how can we mitigate the likelihood that we are susceptible to whatever might be occurring?” And the reality is, it’s our microbiome in part but it’s also the how well fortified and nourish are we if we were the three little pigs or built out of straw, sticks, or bricks.

So, once again, this is what we all do on a daily basis in our clinical practice. So, if you want the free CBD book, you’ll need to visit truegen3.com that I’ve written, and you can also find a lot of my national articles there as well. So, you can also learn if you wanna go deeper into the receptors, a lot of information there. And I also have a wealth of literature that I could share as well. So, I’m not gonna go into this slide a whole lot because it’s just knowing that these things are also occurring within your body. Every single moment from the moment you are born and prior to the moment you die, the endocannabinoid systems modulate those biochemical pathways. But what have we done for our endocannabinoid system lately? So, the endocannabinoid system is, of course, a lot of receptors, as I just mentioned, and they did a study of cosmonauts. So, those are Russian astronauts, as you probably remember. We haven’t heard that term in a long time after the Cold War and all that, the cosmonauts.

And they put the up in space, and they say, “Well, what happened to their immune system?” Well, it’s interesting that during their flight, there was a spike of their endocannabinoid system. So, somehow the endocannabinoid system perceive distress rather than actually the HPA axis. So, even though their condition they’re just like, once again, military, but space military, they’re very conditioned to keep their cool and calm. But at the same time, spaceflight also altered their immune system, but they did not find the elevation of cortisol. They had regulated the cortisol but the endocannabinoid system came to play to support that. So, if we can only condition ourselves to be like cosmonauts and allow our endocannabinoid system to work for our behalf. So, there was a significant increase in white blood cell counts in the cosmonauts. Immune cells such as neutrophils, monocytes, B cells increased by 50%, while T cells fell by nearly 60% shortly after landing.

Lymphocyte percentages did not change before or after flight but were high in flight. Once again, endocannabinoid system at play in outer space. Go figure. So, researchers have also looked at things relative to CBD and COVID. I’m not gonna make any claims because, of course, we’re not allowed to say anything about that. But go to literature, whenever you want to see truth or fact or fiction, PubMed. Great little place to go. This was titled “The Potential of CBD and COVID Pandemic.” And remembering we have the risk for endocannabinoid deficiency, Dr. Ethan Russo is a pioneer and a leading thought leader in this field of the CBD pathways in our receptors. I hold it a very high regard, so that’s why I have this up here again. And the reality is we’re treating the adrenals, but we’re also treating the endocannabinoid system as well. So, study show that CBD may play a role in supporting various aspects of immunity. That’s the take home. And it’s also critical to maintain immune and deliver the Th17 pathway on that 2014 slide.

And animal studies have shown it helps with overall immune response. And as you can see in mouse studies, it helps with lung fibrosis. The CBD reduces the levels of inflammatory cytokines. And just a moment of awe so we can geek out together for those of you that like to geek out about the science of things. So, if this is one of my human cells, and then within my human cells, I have the little powerhouses, the mitochondria, well, so now let’s call this mitochondria, the tip of my finger. So, teeny little mitochondria. It has on it MAVS. It actually has a receptor for viruses and actual control cytokines like the interleukins you’re seeing here, and also how much inflammation and the regulation of the immune system. Once a cell has been targeted it’s actually been invaded by a virus, there’s a signal from the mitochondria. And I’m certain that there will be more literature about the endocannabinoid system and mitochondria over the course of time.

The MAVS, MAVS is not necessarily CBD-driven, but you have to wonder what will we find out about even at the mitochondrial level since we’re nuclear DNA, half mom, half dad, but we’re also 99% mom individual mitochondrial DNA, which of course, differ. They are a nuclear DNA. So, I’m sure there’s gonna be interplay that we discovered there as well. So, not all CBD and hemp products are created equal bottom line. And there is a very novel way to ensure that what you’re giving to your patient is what you’re giving your patient. It’s called VESIsorb. And VESIsorb has been shown with a single oral dose to lead to 4.4 times higher Cmax levels underneath the curve, single dose. And so that’s what TruEase is it’s based on that research, and it actually is reproducible in that regard. So we’re looking at taking a small dose or smaller dose and having it absorb 4.4 times more opposed to taking a large dose and not having it absorb.

I rather have a more cost-effective and well-delineated mechanism of action. So, all our patients count on us to vet, what would it do for me or mine? I know what I do for me and mine. Of course, I use TruEase and TruEase with procurement, combination of procurement, Trumeric, and CBD, and once again, a strategy based on science. So, how does it work? How does the best user work? Why can it absorb so much better? 4.4 times better? Well, it is a self-assembling colloid droplet delivery mechanism that increases absorption of bioactives and it’s useful for other nutraceuticals as well, but the actual CBD, well, TruGen3 actually has a CBD delivery mechanism called VESIsorb allowing for that better absorption as a peer reviewed literature shows. And that association colloid then makes a physiological mixture of a nutritional lipid. And of course, what is CBD? It is a lipid, soluble substance. And so TruEase and TruEase with curcumin, which is Korea’s plus curcumin are things we use in our family. We use it in our practice, of course.

And what’s interesting is, how do you approach medicine and patient recommendations? Probably the same way I do. What do I do for me or mine? And if I’m doing it for me or mine, and I see the research, why would I recommend anything else? And so when we look at the VESIsorb, it’s a passionate delivery mechanism, it has a European connection in terms of the science and research. And it’s a proprietary extract process, eliminates solvents and impurities and no detectable THC. Once again, that concern about all but it might have no, but THC is a psychoactive. It does not have detectable levels of the psychoactive. And once again, a 4.4 higher level of plasma levels. Once again, it has to be going through a 60,000 miles of blood vessels watering via the irrigation system, our cells. So, this is how it works. It actually has a liposomal shell that is not a liposome by itself, it’s a special delivery mechanism. And the monolayer allows for it to actually cross over the water-soluble side of our cells as well.

So, our takeaways for the day. Endocannabinoid system has been working behind the scenes for humanity for millennia. We just didn’t know it. There is a subclinical deficiency of endocannabinoid system, it’s very real. And the reality is we’re no longer in Kansas. Our ancestors went through all heck a lot for us to be here. We’re on their backs for their survival techniques, their ability to grow through famines and pestilences, and wars, but those came in seasons. So, it seems like we’re on one continuous blitz right now, and we’re on the football field. And immune competence and once again, stress lowers the immune system to support the endocannabinoid systems and will potentially support immune competence. And CBD and other phytochemicals are part of our toolbox. They weren’t previously, we didn’t have them, it’s not our fault, now they are. And now it’s up to us to implement them and support natural pathways which have been going on for millennia and we just need to nurture them.

Just like we would do vitamin C or vitamin D, well, we do some CBD to nurture a pathway, which is going to work or not work within your body, depending on how well we tend to it. And so there seems to be a play between our endocannabinoid ome, the microbiome, and the receptors. And you can read the article that I wrote in great detail. And we need to have a mechanism where we know we have reproducibility. How many of our patients come in? Well, I tried magnesium, and then it worked. Well, what kind of magnesium were you taking? I was taking magnesium oxide. Oh, my muscles are still tight. Well, what about a citrate or a malate or something like that. Once again, just because I tried it, doesn’t mean they’ve really tried it at the cellular level. And once again, if you want access to any of the booklets, education material, they’re all free at trugen3.com. And I was speaking with one of the owners of the company and they said there’s a 10% discount on your next order, and just go ahead and call them.

And I know I’ll be placing an order as well. So, thank you, and I’m gonna open up for questions.

Rick: Thank you, Dr. Meletis. That was extremely informative, and it brought about some really interesting questions. First off, a doctor asked, “How long does it take to heal your adrenals after years of drinking coffee?”

Dr. Meletis: Oh, wow. Well, I’m still a test subject. I haven’t fully recovered yet. But I would say that for the naturopathic rule is, for every year you’ve done something, it takes at least a month to recover from it. But now I’m gonna add to the doctor’s questions. It’s actually probably the best question I’ve heard in a very long time. It’s like, “Okay. Well, I’m no longer drinking coffee and I’m on the beach watching the little waves with my first smoothies and my massage, not nearly as long as compared to still be in practice.” So, I would say probably six months to a year, depending on how old you are and how long you’ve been doing it. For me, I’m old and I’ve been doing it for a long time since we’re taking a little longer.

Rick: Thank you for that. And another question. Does it help dementia? And if so, where’s the best place to purchase these?

Dr. Meletis: Yeah. So, can it help support the mind? And I’ll be more than glad to answer that question individually. You’ll see my email just popped up, but that falls into a regulatory category. And so, I can send you some articles. I’m assuming your healthcare provider assists as a health care provider webinar. I will be more than glad to share peer to peer, so very compelling literature on that. But do I use it to support brain health in my practice? Yes, I do.

Rick: Thank you for that. And another question. Dr. Meletis, how long have you been using CBD in your clinical practice? And what are your deciding factors on dosing and brands?

Dr. Meletis: So, I’ve been actively using it for about six years, and it has to come down to the science. I need to know if it’s absorbed, it’s THC-free or have minimal THC, and that it has reproducible effects and it’s from a reputable company. And so in this case, VESIsorb, it’s on our shelves in our office as all my shelves at my house. And it’s because it has the research, it has absorption, and has reproducibility. I’ve had patients that said, “I tried CBD for a while and it stopped working.” That’s not how the endocannabinoid system works. We’re born with it and we have it for a lifetime. So, what’s good shopping around and getting things randomly is not good. And they just did a study on Amazon, and they actually found a professional company, which does not sell on Amazon, does not allow it to be on Amazon, and they were buying it at a 1/3 the price of wholesale on Amazon, or maybe was eBay. It was eBay or Amazon. And lo and behold, they tested it.

It was not from the company, though the label looked exactly the same, and it actually didn’t have anything other than chalk dust in it. So, once again, buying professionals, which we do, but telling our patients we’re doing the vetting process for you.

Rick: Thank you. And another question. Can you explain how VESIsorb helps increase the assimilation of CBD by 4.4 times?

Dr. Meletis: Well, certainly. So, because it is fat-soluble, and think of anything that’s fat-soluble like our vitamins A, D, E, and K. So, vitamin A, D, E, K are all fat-soluble. Well, they have to get into the cell. So, once again, this is where we use things that are liposomal. And during this whole COVID era, what was one of the most popular fat-soluble, water-soluble vitamins? Vitamin C and liposomal vitamin C. So, the ability to cross over that cell membrane is the magic sauce because it’s been studied to cross over, and therefore, permeate from the GI tract through circulation, that’s a critical aspect of that is ability to assimilate across the membranes into circulation.

Rick: Thank you. And another question. I’ve heard start low and go slow. Is this a philosophical approach or clinically demonstrated?

Dr. Meletis: Yeah. I mentioned it during the talk, and it’s both philosophical and physiological. So, the answer is both. So, if there’s a choice of picking philosophical and physiologic, that would be the correct answer. And it’s philosophical because if I am listing to the left, and as chiropractors are saying, okay, your spine has a 17-degree scoliosis, which mine does. You can really torque on me and you can maybe get me straight for a while, but we know when we argue with the muscles, the muscles will always win. But if you work slowly and retrain my body so it’s part of that nurturing, so there’s a physiological aspect of not shoving a receptor so much that basically takes more in, the example I give is a cup of coffee. When I started coffee way back when… Yes, it’s a habit. No. My name is Chris and I drink coffee. And that’s not meant to be insensitive, but it’s true. At one point in time, it’s up to 64 ounces of coffee a day. So, I feel much better about myself now because I told you that. And I was pounding those receptors.

Now, I’ve backed off that. A lot of my receptors revitalize. So, a cup of coffee now has an impact on me again, but for the longest time, I had just smooshed it. So, when we go high dose on anything, we’re super physiological. Remember, food is our best medicine. And all of these herbs were used and lots of vitamins, minerals, and nutrients were used. And a food as medicine approach, Hippocrates 400 BCE, and we’ve made everything into quasi pharmaceuticals. And so that’s why I like low dose good delivery.

Rick: Thank you, sir. And one final question someone asked is the website address on the screen? Is that how to access your free book and articles?

Dr. Meletis: Yes. trugen3.com. And I believe that Chiropractic Economics will also be setting out maybe a link to the book as well. But yeah. All the resources, the website are available for public consumption.

Rick: All right. Thank you. We will get that link out too. And at this time, we’d like to thank our sponsor TruGen3 and Dr. Chris Meletis for today’s webinar. And thank you all for attending. Remember, this webinar, including our speaker’s PowerPoint presentation has been recorded and we’ll alert you via email when the webinar is available online and also with that special offer. Thank you again for attending, and we look forward to seeing you next time. Have a great day.

Filed Under: Chiropractic Practice Management, Health, Wellness & Nutrition, Webinar Full Version

Get Chiropractic Economics magazine delivered to your home or office. Just fill out our form to request your FREE subscription for 20 issues a year, including two annual Buyers Guides.