But, can it KILL you? Runners and NSAIDs

I used to be one of those people, you know, the kind who pops an aspirin or a pain reliever at the slightest hint of pain. My life is busy, busy, busy, and I refuse to let pain interfere. A few aspirin every now and then can’t hurt me right? You know how it is, you’re just about to head out for a long run and your knee is nagging you or you feel a little stiffness in your ankle so you pop a couple of ibuprofen, no big deal, right?

NSAIDs

Wrong.

My Mother has a friend who had a family member in her early 30’s. This woman had 3 children and as far as I know she was in good health. The only medicine she took was acetaminophen, (Tylenol) and she took it regularly. Unfortunately, it killed her. When my Mother told me about this woman it scared me. It could’ve easily been me. I had been a frequent user of Ibuprofen and even though I had stopped taking them regularly, I wondered how dangerous NSAIDs actually were. I researched it and I asked a few doctors and I found out that NSAIDs can cause serious health problems, and I also found out that as a runner, the risk may be even greater.

If you’ve never heard about runners who became seriously ill or died after taking ibuprofen, you can read about an incidence that happened here, or another one that happened here.

I’m obviously not a doctor but I wanted to share with you the info that I found. If you use any type of NSAIDs on a regular basis and you are also a runner or you work out regularly, you may want to check with your doctor to make sure it’s safe to continue taking them.

NSAIDs, (Non-Steroidal Anti-Inflammatory Drugs) such as Ibuprofen, Acetaminophen and Aspirin work by inhibiting the enzyme cyclooxygenase which helps to reduce pain, fever and inflammation. NSAIDs serve a purpose and can be helpful in a lot of situations but they are generally bad for runners, especially long distance runners. In some cases, they can be deadly.

NSAIDs inhibit Prostaglandins. Prostaglandins help protect the lining of the stomach and intestines by inhibiting the secretion of acid. NSAIDs can alter that balance resulting in some pretty bad stomach cramps or worse. Repeated use of NSAIDs has been known to cause stomach ulcers. Acetaminophen does not have the same risk for ulcers but it comes with a set of other problems as it’s been linked to liver damage.

Prostaglandins also help to normalize blood flow to the kidneys. Impaired blood flow caused by NSAIDs and paired with dehydration could cause serious kidney issues.

NSAIDs can also raise your blood pressure. Blood Pressure naturally rises with strenuous exercise so if you add NSAIDs into the mix and if you already have high blood pressure, you increase the risk of a mini stroke or even a heart attack.

And if that isn’t enough to make you want to avoid them, some studies suggest that NSAID’s boost the risk of hyponatremia. Hyponatremia is an electrolyte imbalance that causes the brain to swell and can result in death.

So, what if after you run, you take 2 ibuprofen, that should help right? Won’t it help the inflammation and pain and speed your recovery? Maybe not.

Recent studies have shown that taking ibuprofen may actually impair your recovery. Believe it or not, inflammation is part of the healing process and is crucial to recovery. Without inflammation the recovery process is much slower.

This recent study has shown that the use of NSAID’s may negatively impact the healing process. And another study found the use of NSAIDs was associated with elevated indicators of inflammation and cell damage.

Again, I am not a doctor, but I can tell you that I’m not prepared to risk my health with the use of NSAIDs while running. If I’m sore, I’ll probably listen to my body and take a rest day and as for after running use, I think I’ll trust my body to heal itself with the help of my foam roller, my stick or a bag of frozen peas. I’ll save the NSAIDs for the next time I have a fever, which fortunately is almost never.

What do you think? Do you use NSAIDs before or after running?

Have you ever used them?

Do you use them at other times?

Have you ever had any side effects from using NSAIDs?

14 thoughts on “But, can it KILL you? Runners and NSAIDs

  1. So just a few things, but acetaminophen is NOT actually an NSAID, it has a different mechanism of action than ibuprofen and aspirin. Neither is it an anti-inflammatory. It is GREAT to use Ibuprofen for bone pain and inflammation within the proper dosages listed on the bottle or recommended by your doctor. Yes, there are side effects to just about everything, but as far as pain caused from inflammatory processes (like most running injuries, I know I often get an inflamed knee), ibuprofen is fantastic and not addictive. Ibuprofen is recommended in many cases in order for the inflamed running injury to heal the fastest and most effective way. I am not a doctor, but I would strongly recommend listening to your trained professional. Also, Tyelnol (acetaminophen) is the #1 drug adolescents overdose on, as it’s side effects include liver failure, and I would consider it much more dangerous than ibuprofen unless you have pre-existing bleeding ulcers.

    • Thank you for your comment Loren, you are correct. Tylenol is not an Nsaid. Tylenol is processed by the liver and it is FAR more dangerous, in my opinion. Unfortunately though, in over 25 years of running, I’ve seen many people abuse both regularly.

  2. This is such a great post for spreading awareness. I definitely used to take advantage of them before I became more informed of their side effects a few years ago. I figured if the physicians for a D1 school were telling me to take them then I was fine, but what started to worry me was that that’s all they would do whenever I had an injury, which I knew was only masking the pain. I ended up doing some research for myself on runners and NSAIDs specifically, and came across similar articles like you did and realized I needed to stop listening to the physicians to a point. I know I’m not an expert either, but it’s pretty concerning that people of authority like that aren’t really thinking twice before giving out medication that can be pretty dangerous like that. Same thing when happened when I went to my gynecologist appointment, she told me to start taking NSAIDs before I thought was going to start having cramps, which I didn’t even mention in the first place, umm so what do I do start taking pills a week, two weeks, before I think it’s going to happen? haha sorry if thats tmi, but I think it’s just completely crazy!! 🙂

    • This is exactly why I wrote the post. I think most runnners who have been running for a while know the dangers but a lot of them dont and it’s really bad when doctors suggest that its okay to take these drugs when clearly there are documented cases of injury and even death. We really do have to be our own advocates when it comes to our health and I’m glad you took the initiative to research. I only hope that more people will do the same. 🙂

  3. Wow, very interesting! My neurologist told me I can take a couple ibuprofen before a run to help reduce the pain if I get an exertion migraine. Thankfully after physical therapy I haven’t had one of those beasts, but I also have cut back on my running lately. But, I’ve always tried to stay away from getting dependant on pain meds. I totally agree with you on letting my body heal itself the natural way. I find ice packs and heating pads work wonders for pain.

    • Ice packs and heating pads are great and I’m not sure how bad your migraines are but I’ve been getting pretty severe ones for years. Several years ago the doctor prescribed imtitrex but it caused me to have a seizure so I can’t take it. Ibuprofen and Tylenol do nothing once the headache is in full swing so, I had someone suggest to me dramamine. Dramamine also helps alleviate the nausea that frequently accompany my migraines and I swear to you, I will never go another day without having some in my medicine cabinet, ever. It is my only go to for migraine headaches now and it works like a charm every single time.

      • Thanks for the advice! I’ll keep that in mind. I think the exertion migraines had to do with dehydration and something to do with spinal fluid and pressure in my head..I’m actually in the process of figuring out what exactly is going on since I seem to have tension type headaches daily now along with eye pain. Thanks again, I think I just went way off topic Haha

  4. Yes I do. I’m guilty of a Tylenol PM a few nights a week. They make me a little grouchy and hazy in the morning.

    I have found the more I run and research the aches and pains that come along with running the more alternative ways I find of dealing with them. A lot of time relax, ice, elevate and stretching do the trick. It’s so easy to just pop a pill it’s the quick thing to do.

    Great example is recently I was convinced I had knee issues. It turn out I needed to use a foam roller on my ITbands. It made all the difference in the world. I’m just going to need to do that 2 or 3 minutes a day a few days a week.

    • Good for you Rich. That was the hardest thing for me was realizing I don’t have to pop a pill everytime and now I am terrified of all NSAIDs but especially tylenol.

  5. There is a really interesting This American Life episode all about the dangers of Tylenol, which everyone thinks is a safe drug. Scared me half to death because during college as a double-major, college athlete and working journalists, I took Tylenol daily. I stopped once the craziness stopped and I rarely ever take anything these days, but it could have easily been me in the hospital or dead from Tylenol just a few years ago.

    Here’s the episode: http://www.thisamericanlife.org/radio-archives/episode/505/use-only-as-directed

    • Thank you for sharing that, I will definitely watch it. I always thought Tylenol and Ibuprofen were safe too but I learned that they aren’t and thankfully I learned before anything happened.

  6. Im not an expert…but I remember when I went to run the MCM I had to quite at mile eleven…I had just gotten back from running the SF Nike M and was experiencing a bad cold. The morning before the race…I took cold medicine..that may have had nsaids in it…needless to say I did not finish the race…but maybe if I would have tried I would have died?

    • It’s probably a good thing you didn’t finish. Cold medicine can have harmful things, including nsaids. Sounds like your body told you that you had enough and good for you for listening. We don’t always listen to our bodies when we should. 🙂

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