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Re: How Much Ibuprofen in a Day is too Much? [Crank] [ In reply to ]
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Maybe figure out why you are having so much pain? There may be a better alternative than taking so much ibuprofen.

I think the manufacturer recommends no more than 2grams per day or 2,000mg. It might be possible to take a bit more, but with increasing dosages for increasing durations, there is also increased risk of stroke, GI bleeding and kidney damage.

If 400 mg of ibuprofen isn’t taking your pain where it needs to be, you can also mix it with acetaminophen (Tylenol) (assuming you have no liver issues). So maybe try 400mg of ibuprofen, and if in 2 hours you are not seeing any relief, then try 650mg of acetaminophen. This would typically be safer and more effective than high dose ibuprofen alone. But again, this is just a band aid- you really need to addess the underlying cause of the pain to begin with- and for many kinds of pain, non-paharmacolocigal methods are effective add ons to medication (physical therapy, hot and cold applications).
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Re: How Much Ibuprofen in a Day is too Much? [Running mom] [ In reply to ]
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2400mg a day. There was an incident while I was a young Corpsman at 1st Marine Division where the idiot platoon Corpsman told his Marines prior to their 24 mile hump to take an 800 every time they stopped. The next morning their BAS was secured so six of their guys came to our BAS six were vomiting blood and two of them were moments away from Renal Failure.

I had a patient that had some significant pain I offered him 500mg of Naproxen twice a day for seven days, he said it does not work on him only Aleve works...

All I Wanted Was A Pepsi, Just One Pepsi

Team Zoot, Team Zoot Mid-Atlantic

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Re: How Much Ibuprofen in a Day is too Much? [trail] [ In reply to ]
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trail wrote:
windschatten wrote:


I like to keep my weapons sharp.

.


Yeah, that's legit. I use it in ultra events because it's fucking magic when needed. I discovered it accidentally while hobbling along at like 3AM in the cold dark woods of Oregon, hypothermic, injured in several places.. I was in a dark place, only hadn't quit because you can't quit when you're in the middle of the wilderness with no one to pick you up. I scrounged through my supplies, and found 4 little ibuprofen pills.

It had the effect of what I imagine cocaine would do. 20 minutes later I was bounding through the woods, full of optimism and energy. Let me push through to dawn, and the finish line.

So I save it for times like that.

Playing with fire if you're using ibuprofen in ultras.

Go to the Western States website and look at the medical page and you'll find it one of the first things listed. Fine recipe for rhabdo.

I've seen two runners hospitalised in ultras due to serious complications from racing on ibuprofen. One has never raced at a high standard again with that performance being her last of significance, the other was considered by the treated doctor fortunate to escape permanent kidney damage.
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Re: How Much Ibuprofen in a Day is too Much? [satanellus] [ In reply to ]
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satanellus wrote:

Playing with fire if you're using ibuprofen in ultras.


Oh yeah, you have to careful. You don't want to take it dehydrated, and you don't want to take it "chronic," and you don't want to take it to mask an injury.

It's still useful, though.

And everyone gets rhabdo. It's just a question of how much you get. If you don't get some rhabdo, you didn't finish. Ultras are a fine recipe for rhabdo, to paraphrase you. Ibuprofen can maybe help get you a little bit more rhabdo. And that site is pretty speculative. I don't think anyone's done any actual statistics to correlate use of ibuprofen with higher incidence of renal failure.
Last edited by: trail: Oct 19, 18 21:50
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Re: How Much Ibuprofen in a Day is too Much? [trail] [ In reply to ]
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trail wrote:
satanellus wrote:

Playing with fire if you're using ibuprofen in ultras.


Oh yeah, you have to careful. You don't want to take it dehydrated, and you don't want to take it "chronic," and you don't want to take it to mask an injury.

It's still useful, though.

And everyone gets rhabdo. It's just a question of how much you get. If you don't get some rhabdo, you didn't finish. Ultras are a fine recipe for rhabdo, to paraphrase you. Ibuprofen can maybe help get you a little bit more rhabdo. And that site is pretty speculative. I don't think anyone's done any actual statistics to correlate use of ibuprofen with higher incidence of renal failure.

As speculative as you may wish to convince yourself that may be, I am yet to meet anyone among medical staff of any ultra who advocate the use of NSAIDS while racing. Conversely, all that I have spoken with on the subject strongly discourage their use.

For many years, it has been stressed at every pre-race medical briefing I have attended. It is there in the WS medical advice to competitors which is based on several years of analysis of medical admissions at the race, which has been published elsewhere.

It is a consistent message I have encountered whether it be delivered by race medical teams (including the highly experienced team behind the ultra which I organise), advice given to competitors on national teams, or from those with a medical background within the sport, (such as fellow competitors and fellow race directors).

Your opinion appears to drawn from your own personal experience of rolling the dice in a handful of races.

When responsible for the health and well being of a whole field of runners (and the logistics of supplying medical care to ill or injured athletes), the odds of rolling the dice are multiplied by the number of competitors in a race, and the broader (and more accurate) picture is taken into account.

When athletes are taking ill-advised options against explicit and specific medical recommendation, that potentially draw the availability medical support from their fellow competitors,.............OK, while wearing my Race Director hat, I'll go softly with finishing this sentence and just say "irresponsible".
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Re: How Much Ibuprofen in a Day is too Much? [satanellus] [ In reply to ]
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satanellus wrote:

When athletes are taking ill-advised options against explicit and specific medical recommendation, that potentially draw the availability medical support from their fellow competitors,.............OK, while wearing my Race Director hat, I'll go softly with finishing this sentence and just say "irresponsible".


Interesting. I've just never alarmist language like that used before . There is this Stanford study which recommends acetaminophen instead. That's probably what your medical support is using as evidence. They found that an 18% higher rate of acute kidney injury. But study is also interesting in that that's dwarfed by the high rate of acute kidney injury. Basically half of all finishers had signs of acute injury. (I think I may have read this study before, hence my post above). So of course the responsible action here would be for me to stop running ultras and you to stop putting people at risk by putting on races. Because the health risks from just running far, far exceed any additional risk from ibuprofen. :)

But of course neither of us are going to do that. And my research seems to corroborate your anecdotal evidence, and siding on the conservative side is always best, so I will look at Tylenol vs. ibuprofen. Though every kidney test I've ever had has come back golden. Even pretty shortly after races.

Cheers.
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Re: How Much Ibuprofen in a Day is too Much? [trail] [ In reply to ]
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trail wrote:
satanellus wrote:


When athletes are taking ill-advised options against explicit and specific medical recommendation, that potentially draw the availability medical support from their fellow competitors,.............OK, while wearing my Race Director hat, I'll go softly with finishing this sentence and just say "irresponsible".



Interesting. I've just never alarmist language like that used before . There is this Stanford study which recommends acetaminophen instead. That's probably what your medical support is using as evidence. They found that an 18% higher rate of acute kidney injury. But study is also interesting in that that's dwarfed by the high rate of acute kidney injury. Basically half of all finishers had signs of acute injury. (I think I may have read this study before, hence my post above). So of course the responsible action here would be for me to stop running ultras and you to stop putting people at risk by putting on races. Because the health risks from just running far, far exceed any additional risk from ibuprofen. :)

But of course neither of us are going to do that. And my research seems to corroborate your anecdotal evidence, and siding on the conservative side is always best, so I will look at Tylenol vs. ibuprofen. Though every kidney test I've ever had has come back golden. Even pretty shortly after races.

Cheers.

Thanks for posting. Well worth reading the Stanford study. It is one that I haven't seen previously and I really do appreciate it.

And no, if any of my medical team has read it, it's not among the articles or studies they have shared with me, nor is it by any means the sole source of information that they draw upon in making their recommendations which were formulated years before this study was conducted.

It's interesting that the study revealed runners were already showing significantly increased rates of acute kidney injury in an event as short as a 50 miles, where runners would have been likely to be running on Ibuprofen for a relatively brief period. Running a further 50 miles (or indeed an additional 100 or 150) while taking ibuprofen would quite likely exacerbate the proportionate risks.

And the severity of those risks extends beyond the acute kidney injury as per the following from the study:

"And while most cases of acute kidney injury appear to resolve spontaneously, the condition has the potential to progress to renal failure"


And that is the issue and it's not what the increased odds of 18% to which you referred to is addressing.

Sure, we all knock ourselves around in ultras, that is part of the game. We all accept that. But the longer one spends in this sport and the wider one's experience extends beyond our "experiment-of-one", the clearer it becomes that mixing ibuprofen and ultras is not a good idea.

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Re: How Much Ibuprofen in a Day is too Much? [satanellus] [ In reply to ]
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I had a kidney disorder that developed before I became a serious endurance athlete. Oddly enough it hit in the that period of life between being a serious college rower and getting into triathlons. The first thing the nephrologist said was no NSAIDs. They kidney issue resolved over a year or two, but I still get annual checks and the nephrologist says to just use acetominophen for the rest of my life.

I have always wanted to try an ultra, but I don't think the risk is worth it given my history.
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Re: How Much Ibuprofen in a Day is too Much? [Duffy] [ In reply to ]
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Duffy wrote:
schroeder wrote:
Tylenol is the drug that can be very bad for the liver if you exceed the recommended dosage. It only took the medical/pharmaceutical profession about 40 years after the liver problem was discovered before they were forced to add a new label warning. Government is slow to react to science when money is involved.


https://livertox.nlm.nih.gov/Ibuprofen.htm

Thanks for providing a link that shows that ibuprofen is pretty safe, contrary to your "poison" belief:

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Ibuprofen is considered to be among the safest NSAIDs and is generally well tolerated but can, nevertheless, rarely cause clinically apparent and serious acute liver injury.

Of course, there are individuals who are susceptible to these effects with just about everything. That says nothing about the general safety of said substance.

----------------------------------
"Go yell at an M&M"
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