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We are all familiar with the spice turmeric - the yellow coloured spice in curry - but it does a lot more than taste good. In fact, it is being intensively studied for its role as a powerful pain reliever - and even an anti-ageing nutrient.

The yellow colour of turmeric is due to pigments called curcuminoids. Turmeric belongs to the Zingiberaceae or the ginger family. Curcuminoids have a long history of use in Ayurvedic medicine in the treatment of painful conditions from sore throats to arthritis.

Processing turmeric as an extract provides three different curcuminoids - all with potent antioxidant, anti-inflammatory, antiviral, and anti-carcinogenic properties. And, it appears, the ability to lower cholesterol.

However it is the ability of curcuminoids to act as an anti-inflammatory agent - and replace the pain relieving Non Steroidal Anti Inflammatory Drugs or NSAIDs - that is the hot news in medicine.

A safe alternative in arthritis treatment

NSAIDs are among the world's most widely prescribed drugs, and the most frequently purchased over the counter (OTC) medicines. But NSAIDs can irritate the stomach lining and cause internal bleeding. Moreover, they can produce gastric ulceration, estimated to affect 20% of long-term NSAID users.

This risk led to the introduction of a new form of pain-relieving NSAID called the COX-2 Inhibitors under brand names like Vioxx and Celebra. The early success of the COX-2 drugs was cut short in 2004 when David Graham, then the Associate Director for Science and Medicine at the US FDA's Office of Drug Safety, described them as "maybe the single greatest drug-safety catastrophe in the history of the world".

Graham believes, on the evidence made available to him, that the COX-2 inhibitor Vioxx may have caused as many as 139,000 heart attacks, strokes and deaths. Soon after Vioxx had been taken off the market, Celebrex, Bextra and other COX-2 Inhibitors came to be linked to the same problems.

The tragedy was that the COX-2 Inhibitors proved little more effective than the products they replaced. But there is another lesson. Synthetic drugs too often risk harmful, sometimes fatal, side-effects.

In contrast, where nutritional alternatives to drugs exist - products derived from fruit and vegetable food ingredients - they are logically to be preferred, as their side effect is normally only positive - a generally healthier body. This is certainly true of the curcuminoids in turmeric.

Safe pain relief - with multiple, positive side-effects

The curcuminoids reduce pain and inflammation by inhibiting COX-1 and COX-2, plus another inflammatory enzyme known as lipooxygenase or LIPOX. In other words curcuminoids act like the COX-2 drugs - but without the negative side-effects.

Unlike the COX-2 Inhibitors, curcuminoids are demonstrably not cardio-toxic. They are powerful anti-oxidants - lowering LDL (the "bad") cholesterol, and protecting it against oxidisation. They reduce blood pressure by damping inflammation in the blood vessel walls.

Curcuminoids also prevent the over-growth of smooth muscle cells in the artery walls. This is important as arteries are narrowed when smooth muscle cells grow thick. This in turn leads to high blood pressure and potentially a blockage of the artery.

The curcuminoids make the blood less likely to form clots. They also improve the ratio of HDL (the good form of cholesterol) to LDL (the bad form).

All these actions constitute a very powerful cardio-protective combination of effects. Thus, in direct contrast to the outcome of the COX-2 scandal, the curcuminoids actively protect against the risk of heart disease. For good measure, there is convincing evidence that they protect against cancer and Alzheimer's also.

The safety of turmeric has been proven at the highest level. In the US, the National Toxicology Program of the National Institute of Environmental and Health Sciences, at the request of the National Cancer Institute and the FDA, evaluated the safety of turmeric curcuminoids. They concluded that turmeric extracts were non-toxic with a wide range of potentially therapeutic properties.

Curcuminoids just one of the favourable "flavonoids"

The curcuminoids are just one example of a wider category of phyto-nutrients called flavonoids, a family of compounds which occur in many plant foods such as berry fruits and which are associated with better health prospects. In contrast to the highly targeted drugs developed by 'Big Pharma', the flavonoids act at many different sites in the body, modifying and improving many of our physiological systems in a coordinated manner.

Thus curcuminoids also block a group of enzymes called Matrix Metallo-Proteases or MMPs, which are actively involved in the process of ulceration. Inhibiting the MMPs is considered not only to protect against ulceration, but also against some of the key steps in tumour growth and cancer metastasis.

When used for arthritis pain relief, curcuminoids can usefully be combined with glucosamine hydrochloride, pomegranate extract, beta sitosterol, vitamin D and vitamin K as an ideal way to first reduce pain, and then start the process of cartilage reconstruction.