Let’s Talk About the Woman Who Feels No Pain
A 66-year-old Caucasian female presented for an orthopedic surgery, more specifically a trapeziectomy, to repair years of damage from osteoarthritis. Despite this typically being a very painful condition she reported no pain before the operation. The operation went well and post operation she again reported her pain as 0/10. Even after her analgesics had worn off, she reported no pain during recovery or during IV manipulation. Additionally, she was diagnosed with severe osteoarthritis of the hip, which she reported as painless. After the painless trapeziectomy surgery and a history of ‘painless operations’, she was referred to and further investigated by pain genetics teams from University College London and the University of Oxford at age 67 years (Habib 2019).
Genetic analysis revealed the she had inherited a microdeletion and FAAH hypomorphic SNP allele. This caused her to lose the normal function of FAAH, which an enzyme that degrades anandamide (AEA), palmitoylethanolamide (PEA), oleoylethanolamine (OEA), and 2-arachnidonoylglycerol (2-AG). More on these endocannabinoids to come. This was further investigated with blood samples which showed, circulating concentrations of AEA were increased by 70% and of OEA and PEA approximately tripled compared to normal.
So, lets review what we have so far. FAAH is an enzyme in our bodies that breaks down endocannabinoids in our body, this is a normal process. These endocannabinoids are AEA, PEA, and OEA. Endocannabinoids are molecules inside our body that look like molecules found in cannabis. Plant based cannabinoids were discovered before the cannabinoids found in our body, hence why molecules in our body are named after cannabis. Anandamide (AEA) has roles in nociception, fear-extinction memory, anxiety, and depression (Habib 2019). Nociception is the scientific word for feeling pain.
Now you are probably thinking I need to get this FAAH enzyme out of my body and I can be living pain free, anxiety free, and depression free. Well science is just gaining the ability to edit your genes, however there is an easier way. CBD will also increase endocannabinoids in your body. Simply by incorporating CBD in your daily routine you can be happier, feel less pain, and have less anxiety.
Habib, A. M., Okorokov, A. L., Hill, M. N., Bras, J. T., Lee, M.-C., Li, S., … Cox, J. J. (2019). Microdeletion in a FAAH pseudogene identified in a patient with high anandamide concentrations and pain insensitivity. British Journal of Anaesthesia, 123(2). doi: 10.1016/j.bja.2019.02.019