Pain is difficult to control.
tacofleur / Pixabay – Pain is difficult to control.

COX-2 and 5-LOX are two inflammatory processes in your body. Each requires a different type of anti-inflammatory to be fully effective. What options are available to counter each process?

AKBA (3-O-acetyl-11-keto-b-boswellic acid) binds directly to and selectively inhibits the 5-LOX (5-lipoygenase). AKBA, in double-blind placebo-controlled tests, decreased swelling and pain in arthritic knee patients. Glucosamine sulfate and boron with AKBA made it more effective.

My research has found that there are only two compounds that can effectively inhibit the enzyme COX-2 (cyclooxygenase-2) and not affect COX-1 (cyclooxygenase-1). This is a major deal in pain control. COX-1 is an enzyme that produces prostaglandins. These prostaglandins protect your stomach and intestinal linings and activate your platelets when needed.

The COX-1 enzyme is always active in your body. The COX-2 enzyme is present but left inactivated until inflammatory factors cause it to activate. Once activated, COX-2 is responsible for the pain, redness, heat, and soreness associated with swelling and inflamed joints.

I have found only two compounds in my research which effectively inhibit COX-2 and do not affect the COX-1 enzyme. They are gamma mangostin and curcumin. Gamma mangostin is a xanthone contained in the mangosteen fruit. Curcumin is found in turmeric, a spice in the ginger family. Curcumin is more bioavailable when used with piperine (black pepper extract). All the other compounds that I’ve researched have some level of impact on COX-1.

Pharmaceutical companies developed NSAIDs (non-steroid anti-inflammatory drugs) to fight pain and inflammation (swelling). They found that NSAIDs inhibited the COX-2 enzyme, which is great, but they also inhibit the COX-1 enzyme, which is detrimental to your health – think bleeding ulcers in your stomach and gastrointestinal lining, not to mention other side effects.

COX-2 selective drugs were developed which were ‘selective’ in fighting the COX-2 enzyme and had minimal effect on the COX-1 enzyme. However, the side effects became life-threatening, and the minimal effects were still stronger than desired. Celebrex is the only COX-2 selective drug available in the United States. Vioxx and Bextra were removed due to death, heart attacks and strokes associated with long-term use.

Nutritional supplements which minimize symptoms associated with arthritic pain are glucosamine sulfate, chondroitin, hyaluronic acid, (MSM) methylsulfonylmethane, (SAMe) s-adenosyl-methionine, omega-3 fatty acids, ginger, Bromelain, Vitamin D3, Astaxanthin, Vitamin C, (EGCG) epigallocatechin gallate in green tea, niacinamide, resveratrol, coenzyme Q-10, (PQQ) pyrroloquinoline quinone, (NAC) n-acetylcysteine and (GLA) gamma linolenic acid.

Many of these nutritional supplements don’t have side effects. However, in the presence of prescription drugs and/or other health problems, there may be serious consequences. As such, talk to your physician before starting a nutritional supplement to support your current arthritis managed care regimen.

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