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Re: Holy Basil Sarah T.

Posted by Larry Hoover on February 15, 2005, at 8:59:04

In reply to Re: Holy Basil Larry Hoover, posted by Sarah T. on February 15, 2005, at 0:35:27

> Larry, thank you for your help. I am interested in Holy Basil for both the cortisol lowering and anti-inflammatory properties. My concern is that it is a COX-2 inhibitor. A few months ago, that wouldn't have worried me so much. Now that several COX-2 inhibitors (Vioxx, Bextra, Celebrex) have been withdrawn from the market due to an increased incidence of strokes and heart attacks, I am not too eager to take a COX-2 inhibitor, even if it is in the form of an alternative medicine.

Two thoughts re: COX inhibition.

1. Not all COX inhibitors are created equal. The Vioxx data, for example, only apply to people taking more than the recommended dose (exceeding the maximum approved by the FDA). The Celebrex findings appear only in contrast to another COX drug, naproxen sodium.

2. The increased risk was exaggerated. Not literally exaggerated, but exaggerated by a failure to account for the context of the calculated value. Let's say that the background rate of some severe adverse event is 1 in 100,000 in normal populations (or controls), whereas it is 2 in 100,000 in the drug group. That could be reported as a "doubling in severe adverse effect rate", which takes on an aura of dread not relevant to the absolute rate, which is quite low indeed.

These drug withdrawals were political acts, in response to the current social climate. The FDA and drug companies are under attack, and they're acting with exaggerated prudence.

If tylenol and aspirin were subject to similar scrutiny, they would be withdrawn from the market in an instant.

COX inhibition has been with us for as long as people have sought to control pain. Willow bark (Salix species) is the original source of salicylic acid. Herr Bayer developed a stable synthetic form of salicylic acid, (acetylsalicylic acid) and called it Aspirin. It kills thousands of people in the US every year, and with doctors' full knowledge. It probably saves many, many times more.

As for the COX powers of Holy Basil, or of turmeric (my personal favourite), cross-national comparisons of e.g. rates of heart attack or occlusive stroke or Alzheimer's show that different cultures experience these at dramatically different rates. The world's lowest rates are on the Indian subcontinent, and dietary analysis leads to turmeric as a major influence. Curcumin, the active COX agent in turmeric, is a very powerful COX-2 inhibitor, but nobody has found any adverse effects of that. Quite to the contrary. If you went to Pubmed right now and searched on "curcumin" as a keyword, I bet you'd get close to a thousand hits in the last couple of years alone.

I think that failing to modulate pain is a bigger long-term health risk than is any of the treatments we typically employ, so long as we take note of the individual agents' adverse effect potential. I don't think that COX inhibition is *generally* a bad thing, though it may have *specific* relevance.





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