LifeCare Chiropractic

The Best Chiropractic Care in Mesa, Arizona

NSAIDs Dangerous

NSAIDs, First Occurrence of Heart Failure and Relapsing Heart Failure – (02-18-02)

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NSAIDs, First Occurrence of Heart Failure and Relapsing Heart Failure

I was not aware that NSAIDs will increase risk of recurrent attacks of heart failure, but it appears that this risk is quite substantial. This definitely fits the mold of the new selective COX-2 inhibitors increase risk of heart failure. Remember that we do not fully understand the physiology of most processes in the human body, and blocking one pathway artificially will inevitably produce downstream effects (usually harmful) due to the blocked pathway.

Read entire article here

Analgesic use: Predictor of chronic pain, medication overuse headache – (07-21-03)

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Analgesic use: Predictor of chronic pain, medication overuse headache

The results of this study find that in patients with heavy analgesic use, they were more likely to experience chronic pain 11 years later. This is not really a big surprise since it is well known that NSAIDs inhibit proper healing of connective tissue. Consider a patient on long term NSAIDs that sustains an injury. The injury never properly heals because of the block to normal healing. We know have a tissue that is prone to injury, setting up the cycle for further injury and NSAID use.

Neurology — Abstracts: Zwart et al. 61 (2): 160

Read entire article here

Anti inflammatories can damage the heart – (11-16-00)

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NSAIDs, Intestinal Integrity & Bacterial Translocation in Chronic Heart Failure

This is truly a wonderful editorial illustrating how the systems of the body do not work alone, but rather as an intricate web. It demonstrates other side effects that those of us in natural medicine have always warned about with the use of NSAIDs. As little as 800 mg of ibuprofen can begin to destroy the integrity of the barrier in the intestine, thus allowing molecules to leak through that otherwise should not.

Read entire article here

Gastrointestinal bleeding after the introduction of COX 2 inhibitors – (06-18-04)

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Gastrointestinal bleeding after the introduction of COX 2 inhibitors: ecological study

This is a very interesting article. When the COX-2 selective inhibitors were first released, I was seeing many patients come in that were prescribed this class of drugs, most inappropriately (was only supposed to be used in patients at high risk of GI complications). However, the number has dropped off to almost zero. This once blockbuster class of drugs seems to be falling to research that is finally showing that it is not all that effective as a pain med, and it’s side effect profile is really nothing to brag about, either. And all this coupled with the fact that this is a very expensive class of drugs compared to other NSAIDs.

This article notes that, with the 41% increase in NSAID use (due entirely to the increased use of COX-2 inhbitors), a 10% increase in hospitalization rates for upper GI bleeds was seen. Sell your Pharmacia stock.

bmj.com Mamdani et al. 328 (7453): 1415 –

Read entire article here

ANALYSIS OF COMPLICATIONS OF NSAIDS – (05-16-02)

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Metaanalysis of Severe Upper GI Complications of NSAIDs

This huge review of available literature identifies a 3x greater risk of severe GI bleed with NSAID use. This included as little as four days of use. We need to stop thinking of NSAIDs as benign drugs used to treat everything from minor headache to severe pain. It is rare that a chiropractic patient in my office needs to continue use of pain meds. It would be highly likely that an increase in utilization of chiropractic in the general population would drop the estimated 16,000 deaths per year from this class of drugs.

Abstract: –

Read entire article here

Ibuprofen Side Effects Worse Than We Thought

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Most people are aware that all drugs have problems, but few are fully aware about the dangers and risks of ibuprofen side effects and how much they harm the body.

Our society pops Advil and Alieve with nary a thought to the downsides, choosing merely to believe in the ability of these types of over the counter medications to control pain and inflammation. After all, the TV commercials suggest that they work wonders.

The general concern with NSAID side effects is gastrointestinal. GI bleeds account for about 16,000-21,000 deaths per year from the use of these drugs. While these numbers sound pretty significant, I personally think this side effect pales in comparison to the cardiovascular concerns.

Ever since Vioxx was pulled off the market amid safety concerns brought to light by a whistleblower that had been hidden by Merck for at least 3 years, the research into the link between heart attacks and stroke and NSAIDs has been ongoing.

Now, it is clear that NSAIDs should not be used in anyone with a history of cardiovascular disease. I would personally add anyone who is prediabetic as well (which catches over 1/2 the population) since this condition also leads to increased clotting of the blood and an increased risk of heart attack and stroke.

This particular study adds an additional dimension to the scary side effects of use of NSAIDs.

The Sirtuin family of genes has been clearly associated with longevity. Without getting too physiological, they are NAD+ dependent histone deacetylases that help to protect our DNA from damage. This affect is believed to be pronounced in the telomeres of our cells.

Overall, this is a very good thing and is associated with the longevity associated with calorie restriction and resveratrol.

So what if you found out that among NSAID side effects is the blocking of this pathway? I don’t know about you, but I’d be heavily concerned about what this is going to do to me in the long run. That is, of course, if I survive the GI bleed and heart attack and don’t become too depressed from the impotence.

My bottom line is, of course, biased because I am a chiropractor. Not everyone who goes to see a chiropractor is going to get off of their pain medications. But, the number of patients who would never need them in the first place because they got in for treatment right away as well as the patients with chronic pain who could reduce of eliminate the use of NSAIDs and avoid the ibuprofen side effects would be significant.

So often chiropractic care is compared to standard drug treatments for conditions like headaches, neck pain and low back pain. Most often we are at least as effective (although these studies evaluate manipulation only and do not look at typical comprehensive care in a chiropractic office), but none of these studies comment on the overall stark difference in side effects of manipulation vs NSAIDs.

If you use some type of NSAID on a consistent basis, what have you done to try to wean yourself from them?

Arthritis Relief: Is Ginger Good for Joint Relief?

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We want to live life to our fullest; this means no arthritis pain. Many use drugs for arthritis relief, but safety is a concerns. Is ginger good for joint relief?

Mother Nature knew what she was doing.  Us–not so much.

It seems like anytime we try to mess with nature we screw things up.  Anti-inflammatories are certainly on this list.  Here is how things usually work:

  • Nature makes a compound that positively effects some pathway in our body.  This effect is usually subtle and takes time for the effect to show, but has a very good safety profile for long term use.
  • Scientists find said natural compound and modify it so that it has a strong short term effect but thus becomes dangerous in the long run.

Overall, the drug companies try to find compounds that have the greatest effect at the lowest concentrations.  They want compounds with as high of a LD50 as possible (the LD50 is the level at which the compound kills 50% of the study participants).  But they all will kill at high enough dosages (even water can kill if you stuff enough of it in our bloodstream).

While the list of problems associated with anti-inflammatories (specifically the NSAID class of drugs) is quite long and has been addressed in prior posts that can be read here, suffice it to say that I consider this one of the most dangerous classes of drugs, resulting from a combination of the broad spectrum of subtle side effects combined with the near-universal belief in their safety by the general population.

 There are many natural, unadulterated compounds that have been shown to lower inflammation and have solid research behind them.  Curcumin / turmeric, boswellia, cat’s claw and proteolytic enzymes to name a few.  Ginger is also on the list.

This particular study looks at the effectiveness of ginger to both control pain associated with arthritis as well as protect the lining of the stomach (a MAJOR concern with NSAIDs).  It was compared with diclofenac (Voltaren), a common anti-inflammatory used for arthritis pain.

The safety profile of ginger was, as expected, much better on the stomach than the diclofenac.  Surprisingly, the pain relief was equivalent in both groups (as measured by the Visual Analog Scale, or VAS).

If you have tried ginger for arthritis relief, what was your experience?

Vioxx News: Risk of Having Heart Attack was Hidden for Years

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In case you hadn’t heard the Vioxx news, it was pulled off the market in Sept of 2004 when it was confirmed that it increased the risk of having a heart attack.

I’m pretty sure none of us think that the drug companies have the best of intentions when it comes to our health. But outright lies, deceit and death in the name of profit? Sounds like a perfect Hollywood plot.

But it’s not.  It’s far too real.

Given that society has a very short memory, I’ll refresh you on what happened as it relates to the selective COX-2 inhibitor story.

The problem with anti-inflammatories is that they had this nasty side effect called bleeding ulcers that kills about 16-21,000 people per year (depending on the year). Not something you want prominently displayed on the front of the pill bottle. (As a side note–I always find this little tidbit of deaths associated with NSAID use pertinent to a discussion of risks vs benefits as it relates to chiropractic care).

This tiny little problem of bleeding ulcers and death is the result of the blockage of an enzyme called cyclo-oxygenase (COX). Now, COX has several isoforms–consider them close cousins. The COX-1 cousin actually protects the lining of the stomach and gut and keeps bleeding from occuring. Block this and you get your GI bleeds.

The other cousin, COX-2, was the version that played a role in the pain cycle.

So, block COX-2, but not the protective cousin COX-1, and you’ve got a blockbuster drug. Thus was born Bextra, Celebrex and Vioxx. And boy did they take off. The drug company advertising on this class of drugs kept the media people in BMWs and Porsches for several years.

There were some low level grumblings about concerns over heart disease risk, but these were brushed aside by the company line and well-prepared pharmaceutical reps.

It wasn’t until a whistle-blower came forward that the dam broke. Only then was the true carnage of this class of drugs understood.

You see, unbeknownst to all, the enzyme COX-2 also effected the production of a compound called prostacyclin that thins the blood. Block this and you run the risk of strokes and heart attacks. So much so that we believe in excess of 100,000 heart attacks and who knows how many deaths occurred.

Not to mention to fact that these drugs really weren’t all that much more protective to the stomach lining.

In the lawsuit that followed, much information came to light about just how subversive Merck was with their product Vioxx. The two major concerns focused on:

  1. The hiding of known data that there were increased cardiac risks
  2. The promotion of faked studies (called seeding studies) produced by the marketing teams to get doctors used to prescribing the drugs

To look a little closer at item number 1, in this particular study, researchers tore through the data in studies done by Merck. Studies that Merck claimed did not show any early warning signs of the coming storms.

Turns out, they DID know. To the tune of a 357% increase in the risk of cardiac deaths taking place in those taking Vioxx. And they knew this a full 40 months prior to Vioxx being pulled from the market.

Just under 3 1/2 years. The number of deaths may never truly be known.

So, the pertinent question is…

It is very likely that this is not an isolated scenario at an isolated drug company for an isolated class of drugs.

Just how many other bombshells have been quietly suppressed, never to be revealed, or how many are yet to come to light in the future of this “blockbuster drug” society we live in?