Limbrel and arthritis



by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit




The process of inflammation begins with arachidonic acid which is an ingredient found in cell walls. Arachidonic acid is produced when cells are subjected to stress from aging, trauma, or wear and tear. Arachidonic acid is converted into prostaglandins which are the primary mediators of inflammation. The process of arachidonic acid conversion to prostaglandins is through two enzyme pathways- cyclooxygenase (COX) or lipoxygenase (LOX).

Cyclooxygenase is an enzyme pathway that has two components. The first is COX 1 and the second is COX-2. COX-1 is responsible for the inflammatory response but also plays a role in helping to protect the stomach from ulcers and promoting normal kidney function.

COX-2 also has a large role in the inflammatory response. Traditional anti-inflammatory medicines block both COX-1 and COX-2. Examples include ibuprofen, naproxen, sulindac, indomethicin, nabumatone, etodolac, piroxicam, meloxicam, etc.

They inhibit inflammation but also make the body vulnerable to certain conditions such as stomach ulcers, high blood pressure, and kidney problems.

Drugs that block COX-2 alone also block inflammation. There has been concern that blockade of COX-2 may also have deleterious effects such as elevated blood pressure, reduced kidney function, and possibly an increased tendency for heart attack and stroke. Vioxx was removed from the market after concerns regarding the possibility of an increase in cardiovascular problems related to this drug. Bextra also was taken off the market because of similar concerns.

Celebrex is the only COX-2 drug that remains on the market. It is currently undergoing extensive trials to further evaluate its safety profile. Interestingly, it appears now that all anti-inflammatory drugs share a similar risk for causing cardiovascular events to occur.

Another important cause of inflammation are reactive oxygen species. These are also known as “oxygen free radicals.” These oxygen free radicals lead to the production of pro-inflammatory proteins. ROS cause the formation of fatty metabolites that lead to cartilage damage and damage to joint lining cells.

A novel drug is a plant-derived anti-inflammatory product called flavocoxid. The trade name is Limbrel. This medication apparently has blockade effects on COX-1, COX-2, as well as a third pathway called lipoxygenase (LOX.) By blocking LOX, flavocoxid also prevents the formation of leukotrienes which are instrumental in the inflammatory response. The extent of blockade is not excessive so that theoretically, flavocoxid may avoid the problems associated with traditional NSAIDS.

Clinical data so far has shown that the side-effect profile is generally lower than that for other anti-inflammatory drugs. Flavocoxid is a blend of phytochemical compounds derived from fruits and vegetables. It carries the GRAS (Generally recognized as safe) designation by the FDA which is mandatory for all medical food products.

Flavenoid compounds found in flavocoxid include baicalin and catechin. Both of these have been recognized for their anti-inflammatory and antioxidant properties.

One word of caution is that despite its "natural" appeal, Limbrel has been associated with significant liver damage leading to death. Close monitoring is advised.


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