[pct-l] Ibuprofen
Ellen Shopes
igellen at comcast.net
Sun Oct 4 20:28:42 CDT 2009
Ibuprofen, Advil, Naproxen, etc are non-steroidal anti-inflammatory drugs
(aka NSAID). Tylenol (or acetaminophen) is also a NSAID, although it's in a
different class.
The Advil group interact with prostaglandins, inhibiting their action.
Prostaglandins come in many different 'flavors' in the body. Unfortunately,
prostaglandin inhibition is generally non-specific. That means that this
class of drugs will effect all prostaglandins in the body, regardless of
their function. Some prostaglandins increase renal blood flow. With
NSAIDs, renal flow is decreased, predisposing one to renal failure. The
drugs do not themselves cause dehydration, but can increase the risk of
kidney damage in dehydrated individuals. In the hospital, we are avoid it
in patients who are dehydrated or have decreased renal function from other
causes.
There has been debate for a long time about delayed bone healing with
NSAIDs, to the extent that some orthopedists avoid it in patients.
I am unaware of any problems with the liver with the Advil class. Tylenol
is metabolized into a substance, that when sufficiently concentrated in the
liver can cause damage, but this does not occur (to my knowledge) with the
other NSAIDS.
Prostaglandins are also involved in blood clotting, and Advil and such can
increase bleeding/bruising with injury.
Use these drugs when you have to, but I would discourage routine use if you
can avoid it!
----- Original Message -----
From: "Thomas Jamrog" <balrog at midcoast.com>
To: "PCT MailingList" <pct-l at backcountry.net>
Sent: Sunday, October 04, 2009 10:41 AM
Subject: Re: [pct-l] Ibuprofen
I have problems with arthritis, and occasionally bursitis and
tendonitis. My 59 year old body is a roadmap of surgeries dealing
with high wear and tear . I was in the habit of dosing with liberal
vitamin when I backpacked -I until I met the best shoulder surgeon in
Maine, who did the best he could to clean out a shoulder two years
ago. He instructed me to cut back on ibuprofen, due to the toxicity
associated with use. He advised me it was better to learn to live
with unmedicated low level pain and save the ibuprofen for the times
when the pain was really invasive, and then stop it when things
returned to baseline discomfort. He instructed me that folks who
practice daily dosage are putting themselves at risk for premature
liver failure.
Uncle Tom
Blogging about the Great Outdoors
on http://tjamrog.wordpress.com ( hotlink)
On Oct 4, 2009, at 7:46 AM, Mountaingoat Fraser wrote:
> Very, very interesting. I was on 12 Vitamin I a day on my first ill-
> fated
> shot at the AT. Breakfast began with four of the buggers... I was
> later
> diagnosed as having stress fractures in both legs, and I'd been
> limping
> bravely on for about 200 miles until I bailed in mid-PA. I read on Ray
> Jardine's blog that on his latest AT thru-hike (this year) his total
> ibuprofin intake for the whole walk was...zero. I'm hoping to avoid
> the
> stuff as well next year, replacing it with an old folk remedy called
> Lightweight Hiking.
>
> On Sun, Oct 4, 2009 at 12:50 PM, Spring <kjssail at yahoo.com> wrote:
>
>> I think this article from the NYT is worthy of being read by all of
>> with
>> aches and pains from long distance hiking. I learned something new
>> (to me)
>> when I was informed that the fellow who won the 100k race at
>> Willamette Pass
>> in August had been in the hospital with renal failure due to due to
>> the use
>> of ibuprofen on top of being dehydrated. This is a bit more news
>> on that
>> front to be aware of.
>> Spring
>>
>>
>> http://well.blogs.nytimes.com/2009/09/01/phys-ed-does-ibuprofen-help-or-hurt-during-exercise/?scp=1&sq=ibuprofen&st=blog
>>
>>
>>
>>
>>
>>
>>
>>
>>
>>
>>
>>
>>
>>
>> September 1, 2009, 11:59 pm
>>
>>
>>
>>
>>
>>
>> Phys Ed: Does Ibuprofen Help or Hurt During Exercise?
>>
>>
>> By Gretchen Reynolds
>>
>>
>> Dan Saelinger/Getty Images
>> Several years ago, David Nieman set out to study racers at the
>> Western States Endurance Run, a 100-mile test of human stamina held
>> annually in the Sierra Nevada Mountains of California. The race
>> directors had asked Nieman, a well-regarded physiologist and director
>> of the Human Performance Laboratory at the North Carolina Research
>> Campus, to look at the stresses that the race places on the bodies of
>> participants.
>> Nieman and the race authorities had anticipated that the rigorous
>> distance and altitude would affect runners’ immune systems and
>> muscles,
>> and they did. But one of Nieman’s other findings surprised everyone.
>>
>> After looking at racers’ blood work, he determined that some of the
>> ultramarathoners were supplying their own physiological stress, in
>> tablet form. Those runners who’d popped over-the-counter ibuprofen
>> pills before and during the race displayed significantly more
>> inflammation and other markers of high immune system response
>> afterward
>> than the runners who hadn’t taken anti-inflammatories. The ibuprofen
>> users also showed signs of mild kidney impairment and, both before
>> and
>> after the race, of low-level endotoxemia, a condition in which
>> bacteria
>> leak from the colon into the bloodstream.
>> These findings were “disturbing,” Nieman says, especially since
>> “this wasn’t a minority of the racers.” Seven out of ten of the
>> runners
>> were using ibuprofen before and, in most cases, at regular intervals
>> throughout the race, he says. “There was widespread use and very
>> little
>> understanding of the consequences.”
>> Athletes at all levels and in a wide variety of sports swear by their
>> painkillers. A study published earlier this month
>> on the website of the British Journal of Sports Medicine found
>> that, at
>> the 2008 Ironman Triathlon in Brazil, almost 60 percent of the racers
>> reported using non-steroidal anti-inflammatory painkillers (or
>> NSAIDs,
>> which include ibuprofen) at some point in the three months before the
>> event, with almost half downing pills during the race itself. In
>> another
>> study, about 13 percent of participants in a 2002 marathon in New
>> Zealand
>> had popped NSAIDs before the race. A study of professional Italian
>> soccer
>> players found that 86 percent used anti-inflammatories during the
>> 2002-2003
>> season.
>> A wider-ranging look
>> at all of the legal substances prescribed to players during the 2002
>> and 2006 Men’s World Cup tournaments worldwide found that more than
>> half of these elite players were taking NSAIDS at least once during
>> the
>> tournament, with more than 10 percent using them before every match.
>> “For a lot of athletes, taking painkillers has become a ritual,”
>> says Stuart Warden, an assistant professor and director of physical
>> therapy research at Indiana University, who has extensively studied
>> the
>> physiological impacts of the drugs. “They put on their uniform” or
>> pull
>> on their running shoes and pop a few Advil. “It’s like candy” or
>> Vitamin I, as some athletes refer to ibuprofen.
>> Why are so many active people swallowing so many painkillers?
>> One of the most common reasons cited by the triathletes in Brazil
>> was “pain prevention.” Similarly, when the Western States runners
>> were
>> polled, most told the researchers that “they thought ibuprofen would
>> get them through the pain and discomfort of the race,” Nieman says,
>> “and would prevent soreness afterward.” But the latest research into
>> the physiological effects of ibuprofen and other NSAIDs suggests that
>> the drugs in fact, have the opposite effect. In a number of studies
>> conducted both in the field and in human performance laboratories in
>> recent years, NSAIDs did not lessen people’s perception of pain
>> during
>> activity or decrease muscle soreness later. “We had researchers at
>> water stops” during the Western States event, Nieman says, asking the
>> racers how the hours of exertion felt to them. “There was no
>> difference
>> between the runners using ibuprofen and those who weren’t. So the
>> painkillers were not useful for reducing pain” during the long
>> race, he
>> says, and afterward, the runners using ibuprofen reported having legs
>> that were just as sore as those who hadn’t used the drugs.
>> Moreover, Warden and other researchers have found that, in
>> laboratory experiments on animal tissues, NSAIDs actually slowed the
>> healing of injured muscles, tendons, ligament, and bones. “NSAIDs
>> work
>> by inhibiting the production of prostaglandins,”substances that are
>> involved in pain and also in the creation of collagen, Warden says.
>> Collagen is the building block of most tissues. So fewer
>> prostaglandins
>> mean less collagen, “which inhibits the healing of tissue and bone
>> injuries,” Warden says, including the micro-tears and other trauma to
>> muscles and tissues that can occur after any strenuous workout or
>> race.
>>
>>
>>
>> The painkillers also blunt the body’s response to exercise at a
>> deeper level. Normally, the stresses of exercise activate a
>> particular
>> molecular pathway that increases collagen, and leads, eventually, to
>> creating denser bones and stronger tissues. If “you’re taking
>> ibuprofen
>> before every workout, you lessen this training response,” Warden
>> says.
>> Your bones don’t thicken and your tissues don’t strengthen as they
>> should. They may be less able to withstand the next workout. In
>> essence, the pills athletes take to reduce the chances that they’ll
>> feel sore may increase the odds that they’ll wind up injured — and
>> sore.
>> All of which has researchers concerned. Warden wrote in an
>> editorial this
>> year
>> on the website of the British Journal of Sports Medicine that
>> “there is
>> no indication or rationale for the current prophylactic use of NSAIDs
>> by athletes, and such ritual use represents misuse.”
>> When, then, are ibuprofen and other anti-inflammatory painkillers
>> justified? “When you have inflammation and pain from an acute
>> injury,”
>> Warden says. “In that situation, NSAIDs are very effective.” But to
>> take them “before every workout or match is a mistake.”
>>
>>
>>
>>
>>
>>
>>
>>
>>
>>
>> if (typeof NYTD.Blogs.user != 'undefined') {
>> if(NYTD.Blogs.user.isLoggedIn()) {
>> var dcsvid=NYTD.Blogs.user.getId();
>> var regstatus="registered";
>> }
>> else {
>> var dcsvid="";
>> var regstatus="non-registered";
>> }
>> }
>>
>>
>>
>>
>>
>>
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