Doctors Prescribing Antioxidants for Arthritis

August 1, 2006:-  Are doctors finally "getting it" -- the concept that food provides nutritional and health-building value? The lights may be coming on in the world of arthritis treatment with a new prescription product for osteoarthritis that has the curious distinction of being not a drug but a "medical food." Flavocoxid (Limbrel) contains a blend of natural ingredients featuring flavonoids -- anti-inflammatory compounds that are more commonly found in foods such as green, leafy vegetables, brightly colored fruits, soy, peanuts, cocoa and green tea. The idea is that since dietary deficiencies contribute to inflammation and osteoarthritis, taking a souped-up antioxidant cocktail can help reverse them.

AN ALTERNATIVE TO Non-steroidal anti-inflammatory drugs?

To learn more about this new treatment, I spoke with Roland W. Moskowitz, MD, professor of medicine and codirector of the Arthritis Translational Research Program at University Hospitals of Cleveland/Case Western Reserve University School of Medicine in Cleveland. He told me that in clinical studies and prescription usage so far, Limbrel has improved patients' arthritis symptoms including discomfort, stiffness and loss of mobility.

If over time it continues to demonstrate safety and effectiveness, consumers may want to consider taking Limbrel to replace or cut back on nonsteroidal anti-inflammatory drugs (NSAIDs). This class of drugs includes popular pain and inflammation relievers such as ibuprofen (Advil, Motrin, etc.) and naproxen (Aleve, Naprosyn, etc.), which ease arthritis symptoms but are associated with possible side effects such as gastrointestinal bleeding and liver damage.

CORRECTING NUTRITIONAL DEFICIENCIES

The link between osteoarthritis and nutritional deficiencies is nothing new. While wear and tear and trauma contribute to the breakdown of cells and cartilage in joints as we age, these degenerative changes are hastened by abnormally low levels of key chemical compounds such as flavonoids and antioxidants. The result is chronic inflammation -- which is not just a symptom, but an active contributing factor to arthritis progression through the elevated production of inflammatory metabolites in the body.

According to Dr. Moskowitz, Limbrel is designed to correct nutritional deficiencies, delivering disease-fighting antioxidants in a more concentrated form than is usually possible with diet alone. This product is packed with the anti-inflammatory flavonoids baicalin and catechin, derived from the natural botanical sources Scutellaria baicalensis, Baikal scullcap and Acacia catechu. These have potent antioxidant action that may prevent the oxidation of free radicals that leads to some forms of inflammation. Taking Limbrel may help to restore and maintain the balance of fatty acids in osteoarthritis, which in turn has the potential of reducing inflammation in two different pathways associated with arthritis. In contrast to the double-trouble action of Limbrel, NSAIDs target only one of the arthritis pathways.

SAFETY CONSIDERATIONS

According to Primus Pharmaceuticals, the ingredients in Limbrel are "GRAS" or "Generally Recognized as Safe," meaning that they meet FDA standards for safe use in humans. Other GRAS ingredients include well-known nutrients such as folic acid, vitamin C and calcium, which likewise have therapeutic benefits. In clinical studies, Limbrel's side effects were comparable to a placebo.

Long-term risks of Limbrel are unknown at this point since, as a medical food, it can go to market much more quickly and escape the challenge of looking for any long-term side effects. Given that the ingredient list consists of traditionally used botanicals, Daily Health News contributing editor Andrew L. Rubman ND, does not foresee any significant risk factors with Limbrel.

Dr. Moskowitz cautions that you should not take Limbrel in combination with the arthritis pain and inflammation drug celecoxib (Celebrex) or other so-called "COX-2 inhibitors." Although they are a different class of product, COX-2 inhibitors work on the same COX pathways in the body.

Limbrel can be taken with or without food, although some research suggests that taking it one hour before or after meals may increase absorption. If you are allergic to flavonoid-containing foods such as fruits, vegetables, nuts, cocoa, red wine or tea, tell your doctor before taking Limbrel.

DON'T NEGLECT NATURAL STRATEGIES

If Limbrel is simply a powerful extract of traditional botanicals, then why is a prescription required? That question opens a can of potentially political worms (having to do with marketing, sales and profits) that I won't go into here. However, according to Dr. Rubman, a naturopath who is well versed in the use of botanicals should be able to provide comparable results with OTC preparations of the ingredients at a fraction of the cost. As for Limbrel, only time will tell whether or not it lives up to its promise. In the meantime, however, keep in mind that no pill -- whether it's a drug or a "medical food" -- can take the place of natural strategies.

To discourage inflammation, eat plenty of antioxidant-packed foods such as blueberries, strawberries, blackberries, apples, carrots, peppers, flaxseed, wheat germ, walnuts, pecans and cold-water fish (wild salmon, mackerel, halibut, etc.). Likewise, go light on pro-inflammatory foods such as meat (which contains arachidonic acid), sugar, white flour and fried and fast foods. And last but not least, don't forget to keep joints supple and strong with regular stretching and other exercise. (Read more about natural strategies to beat arthritis in Daily Health News, December 30, 2004.)

Be well,
Carole Jackson
Bottom Line's Daily Health News

Sources:

Doctors Prescribing Antioxidants for Arthritis

Roland W. Moskowitz, MD, professor of medicine and codirector of the Arthritis Transitional Research Program at University Hospitals of Cleveland/Case Western Reserve University School of Medicine, Cleveland, Ohio.
The Tangled Web of Stress

Tom McGuire, DDS, a leading authority on dental wellness based in Sebastopol, California. Dr. McGuire is president of the Dental Wellness Institute, founder of the International Association of Mercury Free Dentists (IAMFD) and author of Tooth Fitness: Your Guide to Healthy Teeth (Diane Books). Visit his Web sites at
www.dentalwellness4u.com and www.mercuryfreenow.com.
American Academy of Periodontology, www.perio.org

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