Healio Interview

Disclosures: Vijay reports no relevant financial disclosures.
December 07, 2021
2 min read

Q&A: Exercise increases endocannabinoid levels, decreases inflammation


Healio Interview

Disclosures: Vijay reports no relevant financial disclosures.
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Adults with osteoarthritis who exercised daily reduced their pain, produced anti-inflammatory cytokines and increased their levels of endocannabinoids, according to findings published in Gut Microbes.

“Our study clearly shows that exercise increases the body’s own cannabis-type substances, which can have a positive impact on many conditions,” Amrita Vijay, MS, PhD, a research fellow in the school of medicine at the University of Nottingham in the United Kingdom, said in a press release.

Knee Pain
Knee pain. Source: Adobe Stock.

Vijay and colleagues conducted a small longitudinal cohort study in which 38 patients with engaged in 15 minutes of muscle strengthening exercises daily for 6 weeks. Their progress was compared with another 40 40 patients with knee osteoarthritis “who did nothing.” The patients in these two groups were all aged 45 years and younger. The researchers analyzed changes in participants’ gut microbes by collecting their blood samples and fecal matter at baseline and during each visit.

Amrita Vijay

Vijay and colleagues wrote that the participants in the intervention group produced more , lower levels of cytokines and higher levels of endocannabinoids than participants who did not exercise. Moreover, a third of the anti-inflammatory effects experienced by participants was the result of increases in endocannabinoids that their bodies produced. The cross-sectional links between endocannabinoids and bacterial abundances were validated in an independent cohort of healthy individuals aged 18 years and older, according to the researchers.

Healio Primary Care asked Vijay to provided more details about the association between exercise and endocannabinoids.

Healio Primary Care: What prompted this research?

Vijay: We carried out this research to see if exercise had an effect on the levels of anti-inflammatory substances produced by gut microbes and on endocannabinoids produced by our bodies.

Healio Primary Care: What is the key takeaway of the study for physicians?

Vijay: The findings from the current study highlight that simple lifestyle interventions such as exercise can modulate endocannabinoids. This is a timely discovery especially since there is increasing interest around the use of cannabidiol and other related supplements in reducing levels of inflammation.

Healio Primary Care: Were you surprised by the findings?

Vijay: Yes. The findings are novel as we may have found a key link between how substances produced by gut microbes interact with the substances produced by our own bodies which tells us how physical exercise reduces inflammation.

Healio Primary Care: How should this impact clinical practice? What are the implications for this research for reducing pain in patients?

Vijay: The current study highlights a simple but effective practical approach which can alleviate symptoms of pain. Simple yet effective exercise regimens can be easily adopted in clinical practice using a structured approach such as the one we have used in the current study.

One of our next steps would be to broaden our study cohort to include those with other conditions and see if we find similar effects.

Healio Primary Care: At what level and duration should physicians be recommending exercise for patients with arthritis? Does cardio or other forms of exercise yield the same anti-inflammatory benefits?

Vijay: We saw significant effects with just 15 to 20 minutes of exercise daily. This could provide a good starting point for patients with osteoarthritis. We know cardio and other forms of exercise do elicit anti-inflammatory benefits. However, we are unsure if this is via the endocannabinoid-gut microbiome pathway. This is yet to be tested.

Healio Primary Care: What other steps can reduce cytokines and increase endocannabinoids?

Vijay: Diet has a significant effect on reducing cytokines and we have recently found that it also increases endocannabinoids. A paper on this is currently under review.


Exercise increases the body’s own ‘cannabis’ which reduces chronic inflammation, says new study. Published Nov. 17, 2021. Accessed Dec. 2, 2021.

Gohir SA, et al. JAMA Netw Open. 2021;doi:1001/jamanetworkopen.2021.0012.

Vijay A, et al. Gut Microbes. 2021;doi: 10.1080/19490976.2021.1997559.