NSAIDs and exercise article

[John VN]

http://fitness.mercola.com/sites/fitness/archive/2012/12/21/ibuprofen-use.aspx

I thought an interesting read.

 

[cewait]

Actually, this article does not emphasize the fact that one's organs may be in harm's way if they consume NSAIDs in and around endurance activities. It was an interesting read on the GI issues but the critical issue is cooking the kidneys to failure. The primary method that a NSAID works to to prevent the vessels from dilating - i.e. shunting blood flow thus minimizing the inflammation process. Endurance activities by their nature will also shunt blood flows to organs such as the stomach that are not mission critical to the flight effort. The probability exists that the kidneys may suffer as a result of the use of NSAIDs while running long periods of time.

There is a side effect that is thought to also be exasperated through the use of NSAIDs. That is hyponatremia or low blood sodium. This occurs when the sodium levels in the blood stream fall to a certain point. Cells will swell essentially drown in water if sodium levels go too low. The mechanisms are through two possible methods in an endurance event. First, over-hydration is thought to be a primary method. But the other is a loss of kidney function during the endurance activity. Couple that with NSAID use and it may occur more rapidly.

The big issue with hyponatremia is that it presents itself with the same symptoms as dehydration. So an inexperienced tech in a first aide tent would look at the person and start pushing IV fluids.... exactly the wrong thing to do.

Long story short....

Do not take NSAIDs on race morning or until renal functions resume post run (i.e. I can urinate again). Tylenol is a safe alternative on race day, though please review the new maximum recommended daily doses issued recently.

 

[KippWade]

Wow... the one quote that got me was:

"The idea is just entrenched in the athletic community that ibuprofen will help you to train better and harder..."

In the 2 years that I've been reading up on running while training for my Half marathons, I've read EVERYWHERE to avoid taking NSAIDS. The suggestions that I have been following are to not take any for 24 hours before a long run or the race and wait until your pee returns to normal before taking any afterwards.

For those of us that are taking medications for cholesterol and/or blood sugars (I'm sure this goes for many other meds also) this is even more important advice to take, as our medications are already taxing vital organs.

 

[PRmamiDEdos]

This may have nothing to do with exercise, but with kidney failure. My mother's twin has stage 4 kidney failure. My mom was going through a battery of tests to see if she could donate. During testing, the doctors determined my mother also had failing kidneys and told her to see a specialist back home. Turns out the many, many years that my mom popped Aleves like candy had an effect on her kidneys. Thank God it turned out not to be kidney failure, but the NSAIDs mimicked the disease and stopping seemed to reverse it. My poor mom has to find another way to deal with her pain (chronic bursitis and arthritis), but she vowed never to take Aleves again.

 

[Buckalew11]

Oh this is upsetting to read. Suffering from shin splints in my right leg before the race...

 

[dragitoff]

Has anyone ever heard anything about stomach issue medication like Pepto? I always take 2 Pepto-to-go before a long run after a few REALLY close calls. It definitely works, but I don't want to be doing anything that could risk something far worse than an unexpected bathroom break.

 

[cewait]

Has anyone ever heard anything about stomach issue medication like Pepto? I always take 2 Pepto-to-go before a long run after a few REALLY close calls. It definitely works, but I don't want to be doing anything that could risk something far worse than an unexpected bathroom break.

I dunno. Pepto's main ingredient is a derivative of aspirin, (a NSAID). There are warnings about kiddos taking Pepto who have Reyes Syndrome, just like on aspirin. The fact it is a derivative would may me think twice, but not too hard. The derivative seems to work on bacteria and not necessarily through the same mechanism as an NSAID. Wondering if A half strength dose of Imodium would work... other than it's dehydrating affect.

Disclaimer - not a doc

 

[indygirl99]

I dunno. Pepto's main ingredient is a derivative of aspirin, (a NSAID). There are warnings about kiddos taking Pepto who have Reyes Syndrome, just like on aspirin. The fact it is a derivative would may me think twice, but not too hard. The derivative seems to work on bacteria and not necessarily through the same mechanism as an NSAID. Wondering if A half strength dose of Imodium would work... other than it's dehydrating affect.

Disclaimer - not a doc

I'm not a doc either I'm a nurse that works in pediatrics. Both Pepto and Immodium would be dehydrating during a half/full marathon. We see a big dehydrating effect in the kiddos.

I did ask one of our docs who is a runner and he said he would not take either one before an endurance run for the same reason NSAIDS are not recommended. "Our kidneys are very important"

Of course remember we take care of small fry kiddos and their bodies react different to meds.

 

[cewait]

I'm not a doc either I'm a nurse that works in pediatrics. Both Pepto and Immodium would be dehydrating during a half/full marathon. We see a big dehydrating effect in the kiddos.

I did ask one of our docs who is a runner and he said he would not take either one before an endurance run for the same reason NSAIDS are not recommended. "Our kidneys are very important"

Of course remember we take care of small fry kiddos and their bodies react different to meds.

Thanks... did not know about the pink. Also great to know they are considered a NSAID.

 

[mickeysgal]

Thanks... did not know about the pink. Also great to know they are considered a NSAID.

Me either. Good to know.

 

[John VN]

Acetaminophen does not sit well with me so this morning I popped two calcium carbonate 500mg tablets then two 500mg acetaminophen tablets before an aggressive 60 mile bike ride. I consumed 3 Gu gels, some dark chocolate nibs along with raisins and a sugar free dark chocolate Russell Stover Pecan Delight. Normally my stomach would bother me a little but today I had no problems at all. Will try the same tomorrow when I go out for my Dopey training. I need something to minimize pain from arthritis and other problems.

 

[MouseDogMom]

I dunno. Pepto's main ingredient is a derivative of aspirin, (a NSAID). There are warnings about kiddos taking Pepto who have Reyes Syndrome, just like on aspirin. The fact it is a derivative would may me think twice, but not too hard. The derivative seems to work on bacteria and not necessarily through the same mechanism as an NSAID. Wondering if A half strength dose of Imodium would work... other than it's dehydrating affect.

Disclaimer - not a doc

I asked my doc, and she seemed fine with my taking a regular dose of Imodium before a race. I take a full strength dose before any half or full marathon now, and it hasn't had any apparent negative effect. And the best part is - it works!

 

[Terapin]

My main symptom of hyponatremia is swelling in my hands. For me, I lose a lot of sodium in my sweat, not because of over hydration. The swelling is caused by my body shunting fluid from my blood into the third space (ie tissues) to try to achieve homeostasis of sodium-water in the bloodstream. I need to take salt tablets when out for a long run and keep taking them. I also get muscle cramps when becoming hyponatremic as muscle cells need sodium to contract.

It is also interesting to note that folks that take the maximum amount of Tylenol dosage for as little as one week will show evidence of enzymes associated with kidney damage. It is reversible with cessation of Tylenol but still gives me pause for thought.

Actually, this article does not emphasize the fact that one's organs may be in harm's way if they consume NSAIDs in and around endurance activities. It was an interesting read on the GI issues but the critical issue is cooking the kidneys to failure. The primary method that a NSAID works to to prevent the vessels from dilating - i.e. shunting blood flow thus minimizing the inflammation process. Endurance activities by their nature will also shunt blood flows to organs such as the stomach that are not mission critical to the flight effort. The probability exists that the kidneys may suffer as a result of the use of NSAIDs while running long periods of time.

There is a side effect that is thought to also be exasperated through the use of NSAIDs. That is hyponatremia or low blood sodium. This occurs when the sodium levels in the blood stream fall to a certain point. Cells will swell essentially drown in water if sodium levels go too low. The mechanisms are through two possible methods in an endurance event. First, over-hydration is thought to be a primary method. But the other is a loss of kidney function during the endurance activity. Couple that with NSAID use and it may occur more rapidly.

The big issue with hyponatremia is that it presents itself with the same symptoms as dehydration. So an inexperienced tech in a first aide tent would look at the person and start pushing IV fluids.... exactly the wrong thing to do.

Long story short....

Do not take NSAIDs on race morning or until renal functions resume post run (i.e. I can urinate again). Tylenol is a safe alternative on race day, though please review the new maximum recommended daily doses issued recently.