Medical Treatments

Athletes: Don't Take Dangerous NSAIDs

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Your knee hurts.

Your back aches.

Your muscles are soooo sore the day after trying that new exercise.

I get this; I race bikes.

Yet I urge you to avoid seeking relief in the form of the pain-relievers called Non-Steroidal-Anti-Inflammatory Drugs, or NSAIDs. You have heard the names before: ibuprofen (Advil), naprosyn (Aleve), diclofenac (Voltaren), celecoxib (Celebrex.) There are others.

An occasional reader of this site can attest that inflammation lies at the root of most disease. The irony here is that pills purported to be anti-inflammatory may be even worse–a classic example of how treatment can be worse than the disease.

It’s also ironic that it takes a prescription to get one of the safest medicines on planet Earth, any beta-blocker, but with only a couple of dollars, you can buy a bottle of NSAIDs. And, in doing so, greatly increase your risk of heart attack, internal bleeding and kidney failure.

I urge you not to swallow these pills.

I urge my enlightened orthopedic and primary care colleagues to more vigorously spread the word about the dangers of these drugs. I’m sick of fighting with patients, and surprisingly, with other doctors, about stopping them.

And to you endurance athletes who run around in a chronically dehydrated inflamed state as a matter of routine, you are especially at risk from NSAIDs.

Sure, I have another study: As published ahead-of-print, in the high-impact journal Circulation, researchers from Denmark showed that patients with a history of prior heart attack that took NSAIDs—even in the short term—had a greater risk of death, or another heart attack.

Though you may think this study does not apply to you because it looked at patients with prior heart attacks, I suggest its importance for three reasons:

  • Like the legions of prior studies, they too report that NSAIDs increased the risk of death and heart attack.
  • Contrary to prior consensus statements, which state that short-term use of NSAIDs are less risky, this study showed that taking NSAIDs of any duration was dangerous.
  • Specific NSAIDs may differ in their risks. The prescription-strength diclofenac (Voltaren) increased the risk of problems immediately, and its risk persisted throughout the follow-up period. Strikingly, diclofenac conferred a higher risk than Vioxx—which was pulled from the market because it caused heart attacks. Ibuprofen looked bad as well. Naprosyn (Aleve), however, looked to be the best of the worst, which is also consistent with prior reports.

I cannot stress it enough. These pain relievers are dangerous.

Be careful.

Be informed.

Be mobile.