The Best Chiropractic Care in Mesa, Arizona
by James Bogash
SSRI and Risk of Upper Gastrointestinal Tract Bleeding
I must admit that this is the first time I have heard of this association, but the numbers are a tiny bit concerning….3.6 times the risk alone and a whopping 12.2 times the risk with concomitant NSAID use. Considering that counseling has gone the way of the sabre tooth tiger (remember when you used to associate psychiatrists with lying on the couch??) the use of meds has skyrocketed and this is a very, very real concern.
by James Bogash
A Cyclooxygenase-2 Inhibitor Impairs Ligament Healing in the Rat
Just in case you thought you’d skip the old fashioned NSAIDs and go for the fancy new selective COX-2 inhibitors, better hope there’s no soft tissue damage. Use of anti-inflammatories for virtually all injuries is just short of legendary, and yet we never give a second’s thought to whether they might actually inhibit the healing process. Well…evidence does seem to lean towards weakening of healed ligaments with NSAID use. My advice…ice it down and see your local chiropractic who uses soft-tissue therapies…
AJSM — Abstracts: Elder et al. 29 (6): 801
by James Bogash
Frequency of Analgesic Use & Risk of Hypertension in Younger Women
There are two things that strike me about this study. First, of the 80,000 or so women in this study, use of aspirin 1 day/month was 51%, NSAIDs was 77% and acetaminophen was 72%. My gosh!! Are we that addicted to OTC pain relief? No wonder this class of drugs (NSAIDs) are responsible for 16,000+ deaths per year. We are taking them like candy, never considering the litany of adverse reactions and long term damage these things can cause. Secondly, in this study NSAID users (22 days/month) had 1.86 times the risk and acetaminophen had twice the risk of high blood pressure. While this use (as 22 days/month) seems incredibly excessive to me, it is a well known fact that these drugs damage the kidneys and this may be one of the mechanisms by which hypertension in affected.
by James Bogash
Indomethacin inactivates gastric peroxidase to induce reactive-oxygen-mediated gastric mucosal injury and curcumin protects it by preventing peroxidase inactivation and scavenging reactive oxygen
I guess this is “long title” week.. It is well known that the NSAID class of drugs is responsible for as many as 21,000 deaths per year. Most of these occur due to fatal GI bleeds. Misoprostol is a drug given along with certain NSAIDs to try to lower the damage done to the lining of the GI tract. Which, of course, has its own set of side effects.
This study finds a powerful ability of curcumin, one of the spices found in turmeric (used in mustard), to protect the GI tract from damage caused by indomethicin.
by James Bogash
Comparing Rates of Dyspepsia with Coxibs vs NSAID+PPI: A Meta-Analysis
Man, this gets confusing. Several years back, we saw the appearance of “public service” ads talking about the dangers of NSAIDs on bleeding ulcer risk and death. Noting that some 22,000 people a year die from this complication, the “public service” ad was directing the general public, who had no idea their ibuprofen could kill them, the find more information.
Little did the general public know that this “educational process” was designed to introduce callers to a new class of drugs called the COX-2 inhibitors like Vioxx, Celebrex and Bextra, that were safer on the stomach. The cost of these drugs was exceedingly expensive, and nearly bankrupted the healthcare system in Australia and led to phenomenal profits for the drug companies. The rest of the story most are familiar with–Merck is fighting off lawsuits because Vioxx had the unintended consequence of increasing risk of heart attacks.
So now, come full circle, we have this study that finds that, giving standard NSAIDs along with another drug to protect the stomach is actually much better on the stomach than the COX-2 inhibitors. Geezz!! How ’bout finding a good chiropractor to reduced the arthritis pain instead???
by James Bogash
Maternal Nutrition, Low Nephron Number, and Hypertension in Later Life: Pathways of Nutritional Programming
This is yet another pathway by which forcing women into pregnancy artificially, whose bodies are not ready for pregnancy because of physiological imbalances, is upsetting the balance of our health. The evidence is piling up that the decisions made in pregnancy can haunt that unborn child’s health for decades into the future.
In this article, the idea is put forth that, when mom is not eating properly, the fetus will develop a lower number of filtration units (nephrons) in the developing kidneys. Later in life, as that child becomes overweight (because they will be at increased in risk for obesity because of the unhealthy mom), this will place excess burden on the kidneys, resulting in kidney failure. Add to this mix a society that doesn’t realize the dangers of NSAIDs on the kidneys and you’ve got a nasty increase in dialysis centers.
by James Bogash
NSAID Use and Progression of Chronic Kidney Disease
Our society has unquestionably come to view NSAIDs like OTC ibuprofen and it’s prescriptive equivalents as relatively harmless ways to cope with “everyday” pain. The commercials make it sounds like these should be used with no more or less concern than a glass of water.
The reality is that this class of drugs is notoriously suspect in a variety of chronic diseases. We know that as little as 400 mg of ibuprofen can disrupt the integrity of the GI tract. Use has been linked to PROGRESSION of arthritis by inhibiting the ability of the joint surface to heal itself (and, in my clinical opinion, many chronic pain sufferers continue to accumulate new areas of complaints that never seem to heal, which I directly related to NSAID use). Liver damage is known. Here’s the real rub. Cumulative use adds up.
This is not a matter of taking this class of drugs a couple times per month. The likelihood of someone in today’s drug accepting society to hit high cumulative doses is great. And while kidney effects have been known as well for over a decade, the authors use some strong language in this study. “Chronic exposure to NSAIDs should be avoided.”
by James Bogash
It comes as a surprise to every patient I bring this up to that non-steroidal anti-inflammatory drugs (NSAIDs) cause anywhere from 16,000-22,000 deaths per year from bleeding ulcers alone.
I usually give this statistic when someone may be nervous about chiropractic care or the safety of chiropractic care. It’s basically the same equivalent as being nervous about flying on a commercial jet under the eyes of the FAA but being OK with bungee jumping off a water tower in Alabama.
These numbers also do not include the monstrous numbers of death caused by NSAIDs’ increased risks of heart attacks, strokes, liver failure and kidney failure. I’m pretty sure most would be absolutely shocked to learn just how dangerous popping a simple over the counter ibuprofen actually is. While these less popular dangerous side effects of NSAIDs are by far more common, the fact remains that most doctors think about the gastrointestinal side effects of NSAIDs more than the other effects.
This is the reason for the creation of the blockbuster class of drugs called the selective COX-2 inhibitors (Vioxx, Celebrex, Bextra). They were supposed to protect the stomach but still achieve the anti-inflammatory effect. So long as you still have your long-term memory intact, you should remember just how well THAT turned out. For those of you showing early signs of lifestyle-related dementia, Vioxx made headlines and was taken to task by the FDA when it was discovered that they knew that Vioxx was causing heart attacks but downplayed the data given to doctors, ultimately leading to Vioxx being pulled off the market.
The ironic part is that, this “GI-protective class” of anti-inflammatories doesn’t even do that very well. Regardless, NSAIDs have known gastrointestinal toxicity. This particular study plants the ultimately irony on this sometimes fatal scenario.
Researchers looked at what might be causing the damage to the lining of the stomach and leading to bleeding ulcers. Their finding? Inflammation.
Yes, the anti-inflammatories are creating their most notorious side effect by the very same mechanism that they are supposed to be stopping. The inflammation in this study came from a compound called TNF-alpha, which is a major driver of inflammation in the body (and the main target of high powered drugs for autoimmune conditions like rheumatoid arthritis and Crohn’s disease).
While this is an animal study, the authors suggest that blocking TNF-alpha with more powerful anti-inflammatories may help protect against the GI related toxicity of the NSAID class of drugs. Brilliant. No wonder our healthcare system is so screwed up.
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