I have been using Zyflamend for joint pain for a couple of years because it contains naturally occurring ingredients, albeit in higher concentrations than can be found in their original sources. My question concerns the advisability of COX-2 inhibition in general (in light of the heart problems linked to Vioxx). Is there a risk in continuing to take Zyflamend?
-- Anonymous

Answer (Published 05/20/2005)

Since the arthritis drug Vioxx was found to endanger the heart and was removed from the market in the fall of 2004, I?ve often been asked whether Zyflamend, a natural anti-inflammatory product I frequently recommend for joint pain and stiffness, presents a similar threat. Zyflamend, from New Chapter Inc., contains ginger, turmeric, green tea and other herbs that moderate the inflammation associated with arthritis. One of its components, by the way, is resveratrol, a component of red wine believed responsible for its heart protective effects.

It is true that Zyflamend has some of the same effects as Vioxx in that it inhibits an enzyme (called COX-2) responsible for the joint inflammation that causes arthritis pain. Vioxx and similar prescription drugs described as ?selective? COX-2 inhibitors were formulated to target the COX-2 enzyme alone. I believe the herbs in Zyflamend deliver a balanced and proportionally safe effect on related enzymes that were unaffected by pharmaceutical COX-2 inhibitors. Vioxx may have led to an imbalance in enzymes that might have contributed to adverse effects among users.

Zyflamend also contains two other components that advertisement may protect rather than endanger the heart. One, holy basil (Ocimum sanctum), contains compounds that have antioxidant effects and may combat high cholesterol and plaque formation. A University of Chicago study concluded that another Zyflamend component, the Chinese herb Scutellaria baicalensis, may also have heart-protective effects.

All told, I see no reason for concern that taking Zyflamend would expose you to the same risks as Vioxx and other pharmaceutical COX-2 inhibitors. The herbs it contains have been used safely for thousands of years by many millions of people. Zyflamend is a supercritical extract of botanicals - meaning the extracts were made with liquid carbon dioxide rather than a solvent such as hexane. Despite the use of a better, safer solvent, keep in mind that extracts of plants are still not as safe as the plants themselves. Use caution whenever you take any herbal product, especially a concentrated one. As with any product, report any unusual symptoms to your health professional and get checked after a month or two of use to make sure you are getting the desired effect.

Andrew Weil, M.D.