Are NSAIDs Safe for Regular Use?

June 24, 2019

"Keep in mind that even though these are available over the counter, there are serious side effects associated with them."

Today, we’re talking about an extremely common pain remedy that’s sold over the counter, namely nonsteroidal anti-inflammatory drugs (NSAIDs). The question we’re asking today is, “Are NSAIDs safe”? Dr. Keller will discuss what these medications are, as well as some of the uses for NSAIDs, associated risks, and the questions we should be asking ourselves before we take them, especially if we are taking them frequently. Dr. Keller will also suggest some alternative solutions for folks who decide they’d like to cut back on NSAID use.

Video Highlights.

  • 01:01: Types of NSAIDs Brands
  • 01:45: What are NSAIDs?
  • 02:47: Side Effects of Steroids
  • 03:05: Why are these considered inflammatory?
  • 04:53: What happens when you take NSAIDs?
  • 05:44: Gastritis
  • 05:54: Symptoms of Gastritis
  • 07:17: Effects of NSAIDs
  • 09:12: Alternatives to NSAID
  • 13:56: Wrap Up

Types of NSAID Brands.

You may not have heard the term “NSAID”, but you’re probably familiar with some of the NSAID brands that you can buy over the counter, including Advil, Motrin, Aleve, and Naproxen. These are common painkillers that people take to relieve headaches, menstrual cramps, muscle aches, and more.

What are NSAIDs?

Essentially, NSAIDs have been created as alternatives to steroids. There are multiple categories of Steroids. Anabolic steroids, for example, are synthetic versions of hormones like testosterone, and are used in gyms to improve performance. However, NSAIDs are classified as corticosteroids. These include things like cortisone, hydrocortisone, and prednisone. These are powerful anti-inflammatories and they have been around for a long time. 

Side Effects of Steroids

Unfortunately steroids often come with a lot of side effects, which is why people have begun looking for alternatives. Some of these side effects include:

  • They can lead to weight gain
  • They’re terrible for your bones
  • They wreak havoc on your adrenal access

So they came up with these classes of non-steroidal drugs to help with the inflammation issue and pain relief. Most of the time, people are taking them as anti-inflammatory drugs. 

Why are these considered inflammatory?

There is an enzymatic process in your body that is called the Cox process. These anti-inflammatories are called Cox inhibitors. They can block this portion of the inflammatory cascade, so they can keep the white blood cells from releasing all their cytokines and leading to the swelling, redness, and pain that’s associated with an injury. 

The problem is that Cox as an enzymatic process has a couple arms to it; there is Cox 1, and there is Cox 2. Cox 2, which is what we’re targeting, is the part of the inflammatory cascade that leads to swelling and pain and all the issues — the things that we want to control so that we feel better.

Cox 1 is a viable process that really has a lot of positives associated with it. It helps heal, and it produces special chemicals that are important for your body; one of them predominantly being the substance that helps protect the lining of the stomach. So if you take something like Advil, that will block Cox 1 as well as Cox 2, and then we’re blocking not only the bad inflammatory stuff but some of that good stuff that we wanted. 

What happens when you take NSAIDs?

You may have heard that if you take a lot of ibuprofen, it can irritate your stomach. Well, this is true. What’s actually happening is that it is blocking the production of some of the natural chemicals that are meant to protect your stomach. If you do that too much, you can actually irritate the stomach, and in worse conditions you can actually get an ulcer. This can lead to a very serious condition where you could actually bleed from that stomach ulcer. Your stomach is a very acidic environment, so it’s churning out hydrochloric acid, which is that really acidic substance that we use to digest food. 

Gastritis

Our stomachs are good at protecting themselves. But if we block the natural protectant, then the acid can start eating away at the stomach and that’s when you end up with something called gastritis. This is just a fancy name for inflammation of the stomach that can be actually quite serious. 

Symptoms of Gastritis

Some of the symptoms of gastritis include:

  • A dull ache, or what is called substernal ache
  • The pain sometimes can increase to a burn
  • It can get really bad and feel like it’s gnawing right through you
  • You might feel like you want to eat something to calm it down, but then you do and it feels worse or just feels better just for a little bit of time
  • You might feel like you’re getting a gassy feeling, bloating, or burping a lot

All these can be symptoms of gastritis. Sometimes it can get more serious and you can start developing an ulcer. Some of the more serious symptoms could be nausea, vomiting (especially vomiting blood) or you might notice your stool has become dark and tarry. This means that there is blood that has come out of your stomach and then been digested along the way, creating an almost molasses-like consistency. If you ever feel those or ever see those, you need to seek medical attention right away because a bleeding stomach ulcer can actually be really dangerous — even life threatening. 

Effects of NSAIDs

There are other things that taking an NSAID can affect. For example:

Heart health

There are studies that show that people who are prone to heart issues can get congestive heart failure from NSAIDs. This means your heart gets weakened and can’t keep up with the blood and you start to basically build up fluid in your body. You can notice it in your legs, and in your lungs if you become short of breath. There has actually been a 20% increase in patients being susceptible to Congestive Heart Failure (CHF) just from taking NSAIDs. 

NSAIDs can also lead to heart attack. It has been shown that your risk of a heart attack skyrockets for a while after taking ibuprofen. The increased risk is not just that day, but for a full week after taking it. The protective mechanisms in this Cox reaction that we’re blocking, are really necessary for our bodies and if we stop them we’re putting ourselves at risk.

Kidney Health

You can actually damage your kidneys if you take too much of something like an NSAID or if you take it too frequently.

Alternatives to NSAIDs

In medicine, it’s always about weighing risks and benefits. There may come a time where you really do need to take something like a steroid, or ibuprofen, because nothing else is going to work. However, you need to weigh those risks and benefits, and look into alternative options whenever possible.

Since really this is all about reducing inflammation, try to find other ways to reduce inflammation. One amazing way to do that is through dietary efforts. Try and follow a diet that is low in inflammatory foods. This could mean cutting out dairy or gluten. You can also do antibody tests that can show you certain foods that might be bad for your body and your system in particular. That could also mean avoiding alcohol, which can cause a lot of inflammation in the body. Keep those things in mind and try to eat a healthy diet. Opt for organic foods and avoid the pesticides and some of the hormones and other chemicals that can also be very inflammatory to your body. 

If you do have to take something like an NSAID, try to protect your stomach. This can mean basically avoiding other things that irritate the stomach like caffeine, nicotine, cigarettes and alcohol.

You can also try some of the natural anti-inflammatory things. A good example of this is curcumin, which is a naturally occurring compound found in turmeric, which is a natural spice. Curcumin has been shown to be a powerful natural anti-inflammatory. You can also incorporate other similar foods like ginger. Ginger is an anti-inflammatory and you can add it to tea, or food. Garlic is also a very powerful anti-inflammatory, and delicious to cook with. 

You can also take MSM, which is a nice anti-inflammatory, or find Cox inhibitors at health food and vitamin shops. These is a natural compilation of things that handle that enzymatic process that we talked about. It has a similar target to NSAIDs, blocking Cox-2, but it gives you good blockage, without blocking the things you want to salvage that help protect you. 

A lot of the other options might have to do with what you do to treat the underlying issue. If it’s a headache for example, and you’re taking ibuprofen all the time, talk to your doctor about other alternatives for headaches. It could be that you’ve got tension headaches that are being caused by posture, or poor eyesight, or it could be that you’re getting migraines that could be easily treated with a migraine treatment. 

If it’s a musculoskeletal problem, talk to your doctor and find out if there’s another treatment you could do for that, like physical therapy to really work on a particular joint, or other injection therapies for that joint. That could include prolotherapy or platelet rich plasma or some of the biological injections that are out there that could help.

Put some thought into what the particular issue is, and instead of just reaching reflexively for Aleve or ibuprofen, just keep in mind that even though these are available over the counter, there are serious side effects associated with them. When you’re informed you make better decisions for both short-term relief and long-term health. 

Wrap Up

We talked about Nonsteroidal anti-inflammatory drugs (NSAIDs) like Aleve, Advil, and ibuprofen. A lot of people take these drugs for a lot of reasons. Just keep in mind, they not only block the inflammatory cascade, they also block a lot of things that don’t really need and blocking, and that can lead to issues with your stomach, kidneys, and heart, or even create life-threatening situations. 

So just really think about possible alternatives like curcumin, ginger, garlic, MSM, or other therapies depending on your condition, that might help handle the issue and not put you at risk for some of those serious side effects.

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