Black pepper contains the alkaloid guineesine, which is an anandamide reuptake inhibitor. It may therefore increase anandamide's physiological effects.
Low-dose anandamide has an anxiolytic effect, while in one study, high doses injected directly into the cerebral fluid of the brain of mice shows evident cell apoptosis (programmed cell death) in vitro as opposed to necrosis. That being said, another study conducted under similar conditions demonstrated neuronal growth both in vitro and in vivo.
Endocannabinoids may disturb homeostasis in several ways: by enhancing  hunger sensations, encouraging increased food intake, and shifting energy balance towards energy storage. A resultant decrease in energy expenditure is observed.
Another study with rats found that reductions in AEA signaling through FAAH overexpression within the basolateral complex of amygdala (BLA) appeared to reliably reduce measurements of anxiety and overall levels of corticosterone, a primary glucocorticoid in animals like birds, rodents, reptiles and amphibians responsible for energy regulation,  immune and stress responses. This is similar to the main glucocorticoid cortisol in humans. Reduction of AEA in the BLA has been shown to suppress fear behavior and promote fear extinction. This suggests possible involvement of AEA intervention in the future for the treatment of psychological disorders. However, further work in this area of study is needed, as reduced anandamide signaling is believed at this moment to involve CB1 receptors as well as GABAergic and glutamatergic interactions.
Cortical glutamatergic transmission may be modulated by endocannabinoids during stress and fear habituation. Glutamatergic interaction in the BLA believed to be responsible for changes in anxiety, appears to normalize stress-induced anxiety-like behavior. A study indicated that infusion of the GluK1 receptor agonist ATPA into the BLA enhanced GABAergic neurotransmission, which is currently believed to have a large role in the reduction of anxiety symptoms.
Additionally, the ECs, along with AEA, have been highlighted for their potential involvement in obesity development and harmful effects on lipid and glucose metabolism, which may contribute to insulin resistance and deficiency, both of which are major risk factors for developing type 2 diabetes mellitus. Blockade of CB1 receptors was found significantly to improve lipid resistance and lipid profile in obese subjects, but also has potential to increase fat accumulation through increased food intake, favored lipogenesis and reduced energy expenditure. This may affect downstream systems like the pancreas, liver, adipose tissue, and skeletal muscle, with inflammation and apoptosis in the case of the pancreas. CB1R inhibition with peripherally restricted antagonists and inverse agonists may aid in the treatment of diabetic neuropathy and neuropathy. CB2R agonists may show promise for the treatment of inflammation, which contributes to renal injury.
AEA was associated with nonalcoholic fatty liver disease, nonalcoholic steatohepatitis (NASH), and liver fibrosis. Data suggests AEA as a marker for cardiometabolic disease and NAFLD severity. NAFLD can progress to more severe diseases, like NASH, cirrhosis, and hepatocellular carcinoma.
A Scottish woman with a rare mutation in her FAAH gene that resulted in elevated anandamide levels was reported to be immune to anxiety, unable to experience fear, and insensitive to pain. The frequent burns and cuts she suffered due to her hypoalgesia healed more rapidly than was expected.
Topical Anandamide was found to reduce peripheral neuropathic pain by interaction with peripheral cannabinoid receptors.
The American Academy of Dermatology has named topical Anandamide a promising therapy for cutaneous lupus erythematosus.