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ibuprofen side effects

Ibuprofen Side Effects: Add a New Life-Threatening One to the List

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Unfortunately, when most of us think about the side effects of NSAIDs like ibuprofen, we think ulcers.

That’s not to say some 20,000 bleeding ulcers annually leading to death is something to be taken lightly, but it’s merely the tip of the iceberg.  The cardiovascular risks of NSAIDs began to appear in the medical literature some 5+ years ago, with the cardiovascular societies ultimately putting out the recommendation that anyone with a pre-existing cardiovascular condition should NOT take a NSAID.

That’s a pretty strong statement.  And one that has largely gone unnoticed by both the rest of the medical community and the general public.

Overall, the number of patients who die prematurely every year as a result of taking something as “benign” as an ibuprofen or diclofenac, is likely uncountable because the use of this class of drugs is so massively high.

Closer to home, pretty much every single week I hear something about a patient who was told by his or her doctor NOT to see a chiropractor, or has a friend or coworker who would NEVER see a chiropractor or heard a news report that chiropractors are killing people on a daily basis with cervical manipulation (I personally just throw our practices’ dead bodies in the dumpster at the end of my parking lot).

And yet, these same doctors, these same friends and coworkers will prescribe and pop anti-inflammatories like they are candy with no knowledge of the numbers of deaths they cause annually.

This disparity in the perceived danger and the actual dangers is about to get a little wider.

In this particular study, we can add yet another side effect of NSAIDs to the already long list.

Atrial fibrillation (irregular heartbeat).

Researchers looked across 5 studies to see whether NSAID use was associated with an irregular heartbeat.  Here’s what they found:

  • NSAID use was associated with a 12% increased risk for AFib.
  • The risk was worse among new users, rising up to 53%.

The authors concluded that the risk of new onset AFib should be included in the list of known side effects of ibuprofen as well as other drugs in the NSAID class.

I can’t help but point out that, at the time of the writing of this article, no such additional life-threatening warnings have been applied to chiropractic care…

 

Ibuprofen Side Effects: Osteopororis Now on the List

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Ok. I’ll admit it—I’m no fan of anti-inflammatories. The list of side effects is far longer than most doctors realize.

Despite how long the list already is, there is always room for more negative effects when it comes to drugs that interfere with the way your body functions. (In case you’re not familiar with the long list already, feel free to check out my eBook on the dangers of NSAIDs)

This particular article adds bone density problems to the potential list of side effects of ibuprofen and its ilk. The author is looking at the physiological pathways by which NSAIDs could contribute to bone density problems and not summarizing an actual study linking anti-inflammatory drugs with low bone density. Because of this, we can’t say with certainty that ibuprofen side effects will include low bone density, but it certainly makes sense.

Here’s how it works:

Inflammation is needed for both new bone formation and old bone breakdown. Bone is essentially really tough soft tissue, and in a previous blog article I look at evidence linking NSAIDs and poor soft tissue healing after surgery. So it would make sense that NSAIDs would also effect bone healing.

The problem is that we are always breaking down bone and repairing it. Exercise causes microfractures in bone that the body then has to go in and repair. This is one way that exercise improves bone density.

In addition, chronic use of NSAIDs will, ironically, lead to inflammation in the gut. Inflammation in the gut will lead to more serotonin, which, in turn, has been linked to lower numbers of osteoblasts (the cells that build bone).

Pretty crazy web, huh?

Overall, you need to really understand that the use, acute OR chronic, of anti-inflammatoy medications comes with a price, and this price is likely to be far greater than what you took it for in the first place.

 

Could Your Anti-Inflammatory Destroy Your Brain?

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I was teaching a class to doctors this weekend and, on a break, heard one of the doctors on the phone talking about a patient with costochondritis and telling the person on the other end to take an anti-inflammatory to fix the inflammation.

This is THE response in society and in medicine today.  Sure, most physicians and patients are aware of the risk of ulcers with anti-inflammatories but rarely understand the risks beyond this.  As the author of an ebook that covers the vast array of side effects from anti-inflammatories (click here to view the book on Amazon.com), I am always happy to add new, unexpected side effects to this dangerous class of drugs that we take so blissfully.

Diabetes and prediabetes is very bad for the brain.  This is one of the reasons we are seeing an increase in the rates of cognitive decline, dementia, Alzheimer’s dementia and Parkinsons disease.  These conditions are very strongly related to the diabetic spectrum.  Given the rate of prediabetes in this country, that means that well over half of us are already at risk.

This increased risk is likely due to some combination of blod flow to the brain (the diabetic spectrum is very bad for the health of your blood vessels) and a disruption in the way brain cells are able to use energy (brain cells require lots and lots of energy made from glucose in their mitochondria).  So, you can envision that anything that is going to negatively effect blood flow in the brain will be a bad thing ON TOP OF being diabetic.

Enter anti-inflammatories, specifically a particularly nasty one called indomethacin (Indocin).  This particular study looked at what happened to blood flow in the brain of a small group of diabetics in response to the administration of indomethacin.

Here’s what they found:

  1. Mean flow velocity (a good thing, higher = more blood flow to the brain) was reduced after indomethacin use.
  2. The researchers, however, seemed happy that, when indomethacin was taken, the blood flow in the brain was improved when the patients held their breath multiple times in a row.

Certainly I can see where the researchers may view the improvement in the brain blood flow with breath holding as a good thing.  However, given that most diabetics (or prediabetics, for that matter) don’t go around holding their breath multiple times in a row, I’m not entirely sure this overshadows the negative side of indomethacin’s effects on overall blood flow.

The bottom line is that, while indomethacin may show a benefit in those holding their breath, this is not a commonly done behavior in diabetics or prediabetics that I am aware of.  However, merely taking indomethacin slowed the flow of blood into the brain–a clearly damaging action that will do long term harm to the brain cells.

While I’ve said it before, let me re-iterate that you need to view taking ANY pill, although in this case we are looking at indomethacin, as a risk benefit scenario.  Is the reason you are taking this drug going to outweigh the long list of side effects that will inevitably come as a result of taking the drug?  Better yet, is there another route you could take (such as, maybe…chiropractic?) that does not have the associated side effects?

On the other hand, if your brain is not that important to you, than pop away.

 

Could Anti-Inflammatories Be THE Enemy? 3 Steps to Take

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This is certainly not the first time I’ve written about the hazards of using anti-inflammatories at the first sign of a twinge.  But this one is going to take it from a different viewpoint.

I think we could all agree that the process of inflammation is a natural one.  After all, why would the human physiology have a process in place that is useless?  It wouldn’t.  Inflammation serves several purposes.  One key purpose would be the prevention and management of infections.  Your immune system (the system responsible for the inflammatory response) gears up to fight off an invader, and, should that invader break through, it will gear up an attack on that invader, be it a virus, bacteria, yeast or even a tumor cell.  Another key purpose is the clearing out of damaged tissue and subsequent repair of the damaged region.

Each of these actions of the immune system needs balance and control:

  1. Too much protection against an invader and you get allergies and asthma.
  2. Too strong of a reaction against an invader and you could go into shock.
  3. Too strong of a response to an injury and undamaged tissue gets taken out in the process.

But these are all on the upswing of the inflammatory response and controlling this side of things is a good thing.  But can our society’s obsession with anti-inflammatories be affecting the natural history of this process?  You bet!

Consider inflammation as pushing a boulder uphill.  Once you get it over the top, the going’s easy from there.  Anti-inflammatories may, in the initial stages, make the hill smaller.  But the initial stages of inflammation are supposed to end–after a few days with an infection (hopefully) and within 24 hours with an injury (depending on severity of the injury).  We used to think that inflammation, once started, would resolve all on its own.  We now know this is not true.

The resolution of inflammation is not a passive process.  The body has to actively end inflammation.  And there are some critical factors needed for this process.

Namely, our old friends, DHA and EPA from fish oils.

Specifically, DHA and EPA are required to make a class of compounds referred to as Resolvins and Protectins (I know, but I didn’t come up with the creative names…).  If you’re a biochemistry nerd, you can read more about them in this particular review.

This begins to explain the many benefits we see from essential fatty acid supplementation on a long list of chronic disease.  More importantly, you can begin to lay out some “to do” things on your journey to control and resolve inflammation in your own body.  These include:

  1. Increasing your intake of healthy fats found in such foods as wild caught fish, olive oils, raw nuts, seeds and avocados.
  2. Decreasing your intake of less healthy fats found in hydrogenated oils and vegetable oils.
  3. Avoiding anti-inflammatories.  With the exception of aspirin, which may help the process, other anti-inflammatories actually slowed or stopped the ability of EPA and DHA to halt inflammation.
  4. If inflammation from an autioimmune disorder or chronic pain is a concern, consider supplementing UP TO 3 full grams of omega-3 / day (this does NOT mean 3 capsules per day).

So, next time you think about curbing inflammation with drugs, shift your thinking.  Think about how you are going to RESOLVE your inflammation instead.

 

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?