The endocannabinoid system across the lifespan: a new review consolidates 20 years of data
How CB1 expression changes from childhood through old age, and what that means for dosing.
A review paper out of UCSF this month synthesizes two decades of work on how the endocannabinoid system changes across the human lifespan. The headline finding is that CB1 receptor density peaks in the early twenties, plateaus through middle adulthood, and declines sharply after about 65 — with implications for dosing that the medical cannabis world has only loosely accounted for.
The clinical reading, according to the authors, is that older patients likely need lower doses of THC than the standard adult titration would suggest. The current dose-finding protocols in most state medical programs do not account for age-related receptor decline.
The review also notes a significant data gap on the pediatric endocannabinoid system. Most of what is known comes from animal studies and a handful of small clinical cohorts in pediatric epilepsy.