Endocannabinoid Levels May Be Disrupted Early in Multiple Sclerosis | Research

The takeaway

In a small study of 30 participants, newly diagnosed MS patients showed a trend toward lower anandamide levels compared to healthy controls, with teriflunomide treatment associated with a stronger relationship between the two main endocannabinoids.

MS patients interested in the endocannabinoid system, neurologists, researchers studying cannabinoid-based therapies for MS

Trend toward lower anandamide in newly diagnosed MS (p=0.098)

What the researchers found

Newly diagnosed MS patients in acute relapse showed a non-significant trend toward lower plasma anandamide (AEA) compared to healthy controls (mean difference -5.95 ng/ml, p=0.098). In teriflunomide-treated patients, AEA and 2-AG were strongly positively correlated (r=0.882), a pattern not seen in other groups. Quality of life was significantly lower in newly diagnosed patients.

Why it matters

The endocannabinoid system is thought to play a role in MS through its involvement in immune regulation and neuroprotection. This small study provides early evidence that endocannabinoid levels may be disrupted in MS, potentially offering a biomarker or therapeutic target.

The numbers in context

N=30 (10 per group). AEA trend: -5.95 ng/ml lower in newly diagnosed vs controls (p=0.098). Teriflunomide group AEA-2-AG correlation: r=0.882 (p<0.001). SF-36 scores significantly lower in newly diagnosed vs controls (p=0.044). No significant group differences in 2-AG overall.

How the study worked

Cross-sectional study comparing plasma endocannabinoid levels (AEA and 2-AG) in 10 healthy controls, 10 newly diagnosed relapsing-remitting MS patients in acute relapse, and 10 teriflunomide-treated RRMS patients in remission. Clinical assessments included MMSE and SF-36.

What this study cannot tell us

Very small sample (10 per group) with wide variability. The AEA difference did not reach statistical significance. Cross-sectional design at a single time point. Plasma endocannabinoid levels may not reflect central nervous system levels. No control for lifestyle factors that affect endocannabinoid levels.

How to read the evidence

Preliminary evidence from a very small cross-sectional study where the primary finding did not reach statistical significance.

When this study was published

2025 study exploring endocannabinoid system changes in MS.

The bigger picture

Interest in cannabinoid-based therapies for MS has grown, driven partly by patient self-medication with cannabis for spasticity and pain. Understanding how the endocannabinoid system changes during MS could inform whether and how cannabinoid therapies might complement existing treatments.

Questions still open

Would a larger study confirm the AEA reduction in early MS? Does teriflunomide specifically restore endocannabinoid balance, or is this an effect of disease remission? Could plasma endocannabinoid levels serve as a biomarker for MS disease activity?

Common questions

What is the endocannabinoid system's role in MS?

The endocannabinoid system helps regulate immune responses and protects nerve cells. In MS, an autoimmune disease that attacks nerve insulation, disruption of this system could contribute to disease progression. This study found early hints that anandamide, a key endocannabinoid, may be reduced in newly diagnosed MS.

Does this mean cannabis could treat MS?

This study examined the body's own endocannabinoid system, not cannabis use. While the findings suggest endocannabinoid disruption may be relevant to MS, this small study cannot support clinical recommendations about cannabis use for MS.

Read the original research

Dysregulation of the endocannabinoid system - a key factor in the progression of multiple sclerosis?

Journal of medicine and life, 18(9), 863-868

View on PubMed ↗Publisher’s paper ↗

Citation

Paraschiv, Andreea-Cristina; Văcăraș, Cristiana; Marge, Cristian; Văcăraș, Vitalie. (2025). Dysregulation of the endocannabinoid system - a key factor in the progression of multiple sclerosis?. Journal of medicine and life, 18(9), 863-868. https://doi.org/10.25122/jml-2025-0146