The things you didn’t know about your pain medication that could hurt you.

After winning a 24-hour track run in record time, Stephanie Ehret should have been celebrating. Instead she was in the hospital being treated for rhabdomyolosis[i]. This is a dangerous breakdown of muscle that can damage your kidneys. Turns out she wasn’t following the recommended guidelines for Ibuprofen usage and took one too many during her race. This in conjunction with the athletic overload was too much for her kidneys to handle. Yes, this is an extreme case of overuse of pain medication, but is it? There is no doubt that this class of medication works and works well. However, in the face of situations like Stephanie’s, we can all use this as a reminder to check in on our usage and proper dosages.

I get it. You are busy. You have goals. You have meetings, deadlines, work and life demands and you need to be on your game. You don’t have time to deal with a headache or an injury, so you reach into your purse for an Advil. You think, just let me get through this meeting, finish this race, just one more day and then I will deal with it. But that day rarely comes.

Let’s review some of the common side effects of this medication and what you need to know.

What are NSAIDs?

Nonsteroidal anti-inflammatory drugs (NSAID) are medications that relieve or reduce pain. The most popular examples of this group of drugs are aspirin and ibuprofen[ii]. Inflammation is the immune system’s response to infection and injury. Heat, redness, swelling, and pain are noticeable signs of inflammation. This class of drug helps to stop or reduce these inflammatory signals.

NSAIDs are widely used and often used in a manner that increases the risk of serious side effects[iii]. Studies show that NSAID use could be hurting you more than you realize.

If overused, NSAIDs can cause great harm to patients. In fact, these drugs are one of the leading causes of hospitalization among patients admitted for adverse or side effects of medications.[iv] For some, continuing to put your symptoms aside may lead to a more serious condition that forces you to stop and deal with the problem.

Heads Up Runners:

Ever see that commercial where the person has an injury, pops an over the counter pain reliever and then goes for a run? Unless you are an Olympic Athlete, running through the pain, isn’t always the best plan of action.

Anti-inflammatories can delay the healing process. If you have an injury that is taking a long time to heal it might be time to investigate other options.

Almost half of all runners take NSAID medication. Like Stephanie, they don’t realize the risks involved or understand that excessive or inappropriate NSAID use during such events could pose considerable potential risks to runners’ health.[v] Especially those with already elevated blood pressure or other pre-existing conditions.

What Are NSAIDs Commonly Used For?

Cramps, aches, pains, musculoskeletal injuries, arthritis, headaches, swelling and fevers.

Potential Interactions and Side Effects to Watch For:

Mood

NSAIDs have the potential to interact with another commonly prescribed class of anti-depressant drugs called SSRI’s (Selective Serotonin Reuptake Inhibitor’s such as Paxil, Celexa and Prozac.) One study discovered that the combination of NSAID and SSRI greatly increased the chance of gastrointestinal adverse effects; this is particularly worrisome, as SSRIs are usually prescribed for daily use, and people commonly take over the counter NSAID medication daily, or even several times a day, as well[vi].

Fertility

New research suggests NSAIDs have been shown to inhibit ovulation and reduce progesterone levels in young women, which could seriously undermine fertility[vii]. This is especially important for females choosing to conceive in their 30’s and 40’s.

Tummy

If you already have a peptic ulcer, NSAID use may not be your choice of pain management. Long-term or high-dose use of NSAIDs could lead to ulcer development in the gut. NSAIDs reduce the actions of prostaglandins, which reduces inflammation. This is good when looking to manage pain and inflammation; however, prostaglandins also protect the stomach lining by helping it to produce mucus. In this way, NSAIDs leave the stomach open to the effects of acid[viii].

Cardiovascular Health

A 2017 study shocked researchers with its results indicating that all NSAIDs can statistically increase your risk for a myocardial infarction, or heart attack. This is most serious for people who have experienced a heart attack, have other heart problems or have risk factors for cardiovascular events. This correlation may be most significant with higher doses of medication[ix].

What is the Answer?

It is important to have this discussion with your doctor to determine if usage is safe, what a safe dosage might be and what alternatives might exist. Keep in mind:

• Stopping NSAID use suddenly can also pose a risk. The body’s reaction to such a cut off could make blood clots more likely, adding to the risk of heart attack or stroke. Instead, a person who is regularly using NSAIDs should talk with his or her doctor about the best way to taper off[x].
• Stay within the recommended dosages.

YOU are the answer. There comes a point that you simply have to “make time” to deal with our symptoms before you land yourself in the hospital like Stephanie.

Naturopathic Medicine provides an opportunity to dig a little deeper, find out why you are suffering and treat the root cause. Acupuncture, Clinical Nutrition and Supplemental support are just a few of the treatment options you have for pain and injury management.

The information relayed in this article is not intended to create fear. It is important to have an awareness of your symptoms and what you are putting into your body. If you are concerned about your NSAID intake, this is an important discussion to have with your Medical and Naturopathic Doctor.

The information provided is for informative purposes and is not intended to substitute professional medical advice, diagnosis or treatment.

References

[i] http://www.nbcnews.com/id/37341523/ns/health-pain_center/t/common-pain-meds-can-put-you-world-hurt/#.WyPTLYpKjIU

[ii] https://www.medicalnewstoday.com/articles/179211.php

[iii] https://www.ncbi.nlm.nih.gov/pubmed/27865294

[iv] https://www.physiciansweekly.com/the-overuse-of-nsaids/

[v] https://www.g2gultra.com/images/SAJSM%20495.pdf

[vi] https://www.physiciansweekly.com/the-overuse-of-nsaids/

[vii] https://www.medscape.com/viewarticle/846552

[viii] https://www.medicalnewstoday.com/articles/179211.php

[ix] https://www.spine-health.com/treatment/pain-medication/potential-risks-and-complications-nsaids

[x] https://www.spine-health.com/treatment/pain-medication/potential-risks-and-complications-nsaids

Dr. Jennifer Tanner, has a broad, evidence based practice with a focus on sports and performance based medicine. Being a marathon runner and having been a competitive equestrian, an active lifestyle is important. Dr. Tanner uses a variety of tools including Acupuncture and Clinical Nutrition, putting an emphasis on “food as medicine” and addressing the root causes of inflammation . In conjunction with the Integrative Health team, Dr. Tanner is thrilled to help people achieve an optimal state of health and pursue their performance based health goals!