# Cannabinoid CYP450 and ECS Flowchart

> **Author:** Benjamin Caplan, MD (ABFM Board Certified, MA Lic. #240562, NPI: 1962722637)
> **Publisher:** CED Clinic (https://cedclinic.com)
> **Canonical URL:** https://cedclinic.com/d63-the-biochemical-pathways-of-thc-and-cbd-png/
> **Published:** 2026-09-04T23:01:16-04:00 | **Last Modified / Clinically Audited:** 2026-09-13T14:38:02-04:00
> **Clinical Summary:** How THC and CBD are metabolized in the liver and act on the endocannabinoid system, with an extensive comparison table of their pathways.

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[← Back to the Risks Summary Hub](https://cedclinic.com/topic-risks-diagrams/)Diagram & referenceA visual reference. The evidence, sources and clinical interpretation are in the linked article.About this diagramA five box flowchart. THC and CBD sit at the top and feed into metabolism in the human body, which then splits into two arms: CYP450 enzymes on one side and interaction with ECS receptors on the other. The receptor arm continues to possible effects on immune response and inflammation. Read the split as the point of the graphic, with one arm covering how the body breaks the molecules down and the other covering where they act.The evidence behind it[Read the evidence: how the body handles THC and CBD by two different routes](https://cedclinic.com/thc-and-cbd-metabolism-pathways-compared/)That article carries the cited studies, the limits of the evidence, and the clinical interpretation.

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### Verification & Medical Governance

- **Lead Clinical Author:** Benjamin Caplan, MD
- **Credentials:** Board Certified in Family Medicine (ABFM), Former CMO Canna Care Docs (250,000+ patients supervised), Founder & CMO CED Clinic & CED Foundation, Author of *The Doctor-Approved Cannabis Handbook* (Penguin Random House).
- **Clinical Scale:** 350,000+ lifetime evaluations overseen; 81,008-patient Real-World Evidence Registry (`~/.ced_rwe_vault.db`); 125,000+ peer-reviewed study literature observatory (`http://localhost:8768/api/explorer/terminal`).
- **License Verification:** Commonwealth of Massachusetts License #240562 (https://checkahealthlicense.mass.gov/).
- **NPI Registry:** 1962722637 (https://npiregistry.cms.hhs.gov/provider-view/1962722637).
- **Ethics & Data Privacy:** Clinical registry observations adhere strictly to HIPAA Safe Harbor de-identification (45 CFR § 164.514(b)) and criteria for secondary research exemption under 45 CFR § 46.104(d)(4).