Anything You Need to Know About the “Entourage Effect”

• The entourage effect occurs when multiple cannabis compounds (cannabinoids, terpenes, and flavonoids) interact with your endocannabinoid system at the same time.
• While the entourage effect still isn’t widely understood, patients can experiment with different products to see the effect in action.

Can doctors prescribe CBD for anxiety? In some states, yes. But is that the only cannabis compound that can help you reach your wellness goals?

According to the “entourage effect,” the answer is no. Many experts believe that all of the compounds found in the cannabis plant work together to enhance the effects of marijuana treatment—in other words, an entourage of compounds interact to produce unique results.

For patients using medical marijuana for anxiety, sleep support, or any other health outcomes, the entourage effect should play a role in both your treatment plan and your product selections. In this guide, we’re going to teach you everything you need to know about it: what it is, what it can do, how to leverage it, and how to choose products with the entourage effect in mind.

What Is the Entourage Effect?

In short, the entourage effect is a theory positing that:

• Cannabinoid compounds interact with each other to produce unique effects
• The effects of these combinations are distinct from the effects of isolated products

To really understand this, we need to dive into the science of cannabis.

Cannabis Compounds

The Cannabis sativa plant naturally produces numerous compounds:

• Cannabinoids – These are the compounds you’re likely most familiar with. Cannabinoids (like THC and CBD, the major cannabinoids) interact directly with the body’s endocannabinoid receptors—more on these receptors later.
• Terpenes – Terpenes are only recently being widely studied by cannabis scientists. These naturally occurring compounds impact the aroma of marijuana, but they can also produce unique physiological effects for cannabis patients.
• Flavonoids – Flavonoids are found in a variety of plants and give cannabis strains their unique color profiles. However, they may also interact with the other cannabis compounds on this list to alter the effects of a marijuana product.

It’s important to note that not every cannabis product contains all of the compounds above. Cannabis isolates (like pure CBD oil) only contain the cannabinoid listed on the packaging. CBD isolate oils, for instance, only contain CBD and a fat base (like coconut oil).

Three types of products contain cannabinoids, terpenes, and flavonoids:

• Raw cannabis flower – Whole, smokable cannabis buds contain everything that naturally occurs in the marijuana plant—all three compounds listed above and more.
• Broad-spectrum cannabis products – Broad-spectrum products contain a main cannabinoid isolate (like CBD), flavonoids, and terpenes. Broad-spectrum products do not contain any THC.
• Full-spectrum cannabis products – The only element that sets broad- and full-spectrum products apart is THC content. Since full-spectrum formulas contain all of the compounds found in a specific strain of the cannabis plant, this can include THC (even in trace amounts).

The Endocannabinoid System

Everyone (whether or not they’ve used marijuana before) has an endocannabinoid system (ECS)—a network of receptors that interact with both:

• Endogenous cannabinoids – Cannabinoids made inside your body
• External cannabinoids – Compounds found in marijuana products

The ECS contains two receptors that bind to cannabinoids: CB1 and CB2. Each of these receptors plays a role in a variety of physiological functions, from pain sensitivity to inflammation.

While the ECS was first identified by researchers in the 1980s, experts still don’t have the full picture of CB1 and CB2 (and their respective, complete functions). However, experts do know that cannabinoids directly bind to CB1 and CB2 receptors.

What about terpenes and flavonoids? 

Well, there’s early evidence to suggest that:

• Terpenes could interact with CB1 and CB2 to exert specific actions (even if they don’t actually bind to these receptors).
• Flavonoids may not bind to receptors, but they still have the potential to produce therapeutic effects.

Impactful Combinations

Because all three of the major compounds found in the cannabis plant—cannabinoids, terpenes, and flavonoids—have the potential to either interact with the ECS or produce other physiological effects, this raises the question: do these compounds interact with each other?

There are two things to note about the combination conversation:

• Cannabis compounds impact each other – Experts believe that, when they’re combined, cannabinoid compounds interact with and impact each other. For example, CBD can play a role in the body’s response to THC.
• Combinations produce unique effects – Specific combinations of cannabis compounds, therefore, produce unique effects for users. For example, your body will respond differently to THC in combination with CBD than it would to CBD alone.

While the literature on specific combinations is limited, these two theories open up a world of opportunity for medical cannabis patients. By diving deeper into the cannabinoid, terpene, and flavonoid profiles of specific formulas, patients can individualize their medical marijuana treatment to achieve the results they’re looking for.

What Can the Entourage Effect Do For You?

Let’s expand on the last point above—what results can the entourage effect actually produce? Here are a few documented combinations:

• THC and CBD – The combination of THC and CBD can smooth some of the rough edges of THC—like overstimulation or hunger. This specific combination also offers powerful relief for people living with anxiety, seizures, and chronic pain.
• CBD and Limonene – Limonene is a common terpene found in both cannabis and citrus plants. In combination with CBD, it can offer a mood boost.
• THC and Linalool – Linalool is a terpene found in cannabis and lavender; in combination with indica strains of THC, linalool can offer immense stress relief.

It’s important to note that these combinations have been documented in patient anecdotes—but you might discover your own powerful combinations when you experiment with cannabis products during your treatment journey.

Unlocking the Entourage Effect: Products to Try

If you’re looking to dive into the entourage effect to supplement your cannabis treatment, set your sights on some specific products:

• Flower – Whole, raw marijuana buds contain all of the cannabis compounds in their natural state. You can grind up flowers to roll a joint, pack a glass pipe, or create your own oil extractions for baking or direct administration.
• Vape liquids – While many vape cartridges available at dispensaries feature isolate formulas (i.e., THC-only oils), there are broad- and full-spectrum formulas available. Read labels closely or ask your budtender to direct you toward entourage-friendly vape products.
• Oils and tinctures – Broad- and full-spectrum tinctures offer an exceptional administration method for patients looking to harness the entourage effect. Again, keep your eye out for isolate-only products; while these are excellent products for some patients, they won’t create an entourage effect.
• Edibles – While they’re not as prolific as isolate-based edible products, full- and broad-spectrum edibles are made from extracts containing cannabinoids, terpenes, and flavonoids.

Not sure where to start your entourage experimentation? Ask your budtender for tips and product recommendations.

Finding the Right Product

Between flavonoids, terpenes, and cannabinoids, there are nearly countless possible combinations of cannabis compounds—so it might take time to find your ideal formula.

Experimentation is the name of the game for cannabis patients looking to harness the entourage effect for healing.

Here’s the process we recommend for finding your perfect entourage:

• Start with a familiar product type – If you typically vape, for example, consider switching to a full- or broad-spectrum vape cartridge first. Using a product you’re already comfortable with will help you focus on your observations.
• Try to switch up one compound at a time – If you try a product with THC, CBD, and linalool, and you’re not getting the results you’re looking for, try to change as few compounds at a time between sessions: opt for a product with THC, CBD, and limonene next, for instance.
• Document everything – Medical cannabis treatment is highly intentional. Writing down everything (product type, formula, dosage, timing, and effects) will help you assess your results over time and suss out which ingredients you like most.

It can take time to find your ideal cannabis product, but optimal healing is worth the wait.

TeleLeaf: Your Connection to Cannabis-Informed Providers

If you’re looking into cannabis for insomnia or another chronic condition and want to harness the therapeutic power of the entourage effect, you’ll need access to a marijuana dispensaries or pharmacy. A recommendation for medical cannabis is your ticket to entry.

TeleLeaf helps patients like you get their medical cards and unlock the all-natural, plant-based relief they need. Our providers are cannabis-informed, open-minded, and empathetic; we’ll get to know you and help you craft a cannabis treatment plan that works for you.

Ready to get started? Schedule an appointment with TeleLeaf now.

Sources: 

Healthline. What Is the Interaction Between THC and CBD?
https://www.healthline.com/health/the-entourage-effect

Molecules. The Cannabis Terpenes.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7763918/

RISE Dispensaries. What Are Flavonoids and What Do They Do?
https://risecannabis.com/cannabis-101/what-are-flavonoids

Charlotte’s Web. What Is Broad-Spectrum CBD?
https://www.charlottesweb.com

Biomedicines. Decoding the Postulated Entourage Effect of Medicinal Cannabis: What It Is and What It Isn’t.
https://www.ncbi.nlm.nih.gov/

Neural Regeneration Research. A closer look at cannabimimetic terpenes, polyphenols, and flavonoids: a promising road forward.
https://pmc.ncbi.nlm.nih.gov/

American Chemical Society. Flavonoids in Cannabis sativa: Biosynthesis, Bioactivities, and Biotechnology.
https://pubs.acs.org/doi/10.1021/acsomega.1c00318

FOCL. CBD and THC Together: A Winning Combination for Well-Being.
https://focl.com/blogs/learn/effects-of-cbd-and-thc-together/

Healthline. Cannabis 101: What’s the Deal with Terpenes?
https://www.healthline.com/health/cannabis-terpenes#list-of-terpenes