Ibuprofen can damage your liver and kidneys. It's even worse if you're using it after alcohol to help with a hangover. Aspirin is better but it can cause stomach issues for some people, so that leaves Tylenol as the best choice. So says my doc, who is a marathon runner.

Aspirin is no safer and the same class of drug as ibuprofen (neither metabolized by the liver like Tylenol).

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Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD

ibuprofen has been linked to kidney failure in endurance athletes:

http://www.trailrunnermag.com/...amp;start=&cat=3

Me + ibuprofin + 56 mile ultra = hyponatremia (hard to put into words how bad this could be & was) I will NEVER take ibuprofin before or during a long distance event again. That's learning the hard way...

http://www.bmj.com/content/342/bmj.c7086

Hogwash. Don't exceed the dosage recommended on the bottle and I guarantee you'll be fine.

Since you posted that paper I'll ask for your assistance interpreting the information.

Ibuprofen was the worst in this class of drugs for strokes with a rate of 3.36 events (per 100,000 patient years?). Is that compared to a placebo = 1.0 events?

In real world terms, does this mean the chance of stroke on ibuprofen compared to placebo moves from infinitesimally small to <slightly greater> than infinitesimally small?

This was a review article, so it did not address dosage, nor a specific patient population.

I take ibuprofen occasionally and in races with no adverse effects to date. My personal experience would tend to side with ductus, keep your dose within the normal range and the chance of problems are very small (and worth the risk).

Some good info here...

http://www.sciencebasedmedicine.org/?p=11264

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"The will to win means nothing without the will to prepare" - Juma Ikangaa

http://www.litespeed.com

More Information:
http://www.endurancecorner.com/Larry_Creswell/NSAIDs

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"Good genes are not a requirement, just the obsession to beat ones brains out daily"...the Griz

There are potentially serious health issues that can occur with ibuprofen even following the recommended doses. In addition to the aforementioned kidney/fluid and electrolyte issues there is the potential for gastrointestinal bleeding. I could probably buy a whole fleet of Shivs on what I've made cauterizing bleeding ulcers from ibuprofen over the years. I'm amazed at how the thought of Cipro strikes terror into the heart of the average ST'er but NSAIDs, not so much.
Forewarned is forearmed. Use at your own risk. And remember, NO ONE CAN GUARANTEE YOU WON'T HAVE A PROBLEM!

There's potential side effects from everything, posting on ST about what will work for you is about the least most helpful thing you can do. Everyone is different. You've seen the side effect warnings on TV from drugs, they list everything under the sun as a "possibility". NSAIDs are no different - there's potential risks with everything. Aspirin may be better for one person, ibuprofen for another. You need to talk to your doctor who has access to your personal health history and get their input before you decide.

I had a fairly significant GI bleed training for my first IM using naproxen. Took one pill on an empty stomach before a 12 mile run. Result was taking my crit down to 30. Won't touch NSAIDs anymore...

Jodi

try Hammer's Nutrition - Tissue Rejuvenator... MUCH better then Ibuprofen

My question is why some of you are taking NSAIDS before and/or during the training session or race, especially on an empty stomach? If you want to take something prophylactically, take fish oil instead and save the NSAIDS and ice for after and during recovery.

True, my post, as any advice or opinion, does come with some clarification or conditions, but in the whole I stand by it 100%. I think most are aware that they should avoid ibuprofen and the like if they've had problems with ulcers or other GI issues, kidney problems or any allergic reactions to the class of drugs. But as implied in my post, that information is available on the bottle. If you cauterize ulcers for a living then you realize that a lack of causality is impossible to "prove," so some level of suspicion of everything we're exposed to will always exist. The article referenced in Trail Runner is a good example of the classic "Sunscreen use causes drownings" argument.

My health (and yours) is more endangered by riding a bike on streets with traffic than taking ibuprofen within the recommended range of dosage.

At the end of the day, one may still hedge their bets by taking no more than is absolutely necessary.

For sore muscles I think Badger's Sore Muscle Balm is the best thing I've every used. I tend to get a touch of tendonitis and serious muscle fatigue every time I ramp up training and the Badger Balm does an amazing job keeping me going and feeling fairly fresh. I'd recommend it over popping a pill any day...

I had three pretty serious episodes of internal bleeding while running and using Ibuprofen as prescribed. No longer do that. Sure, there are issues with taking NSAIDs on regular basis and training. If you have to do that, better don't train or suck it up. I know you will not like my response, but that is an honest brutal truth. Wife is a pharmacist, she gave many reasons why not do that.

Thanks. I don't have any GI, ulcer or any of the other conditions. I think I will give Tylenol a try. Might also try the other recommendations. But ultimately if they do not help I might use Ibuprofen sparingly.

May I ask your background pertinent to this issue?

As an occasional ibuprofen user after workouts, and several times during races, all I seem to read about this comes from "the "don't do it" camp based on either 1) personal experience, 2) popular articles from RW, etc.,or 3) parroting studies without any real understanding of the methods/demographic.

I've taken it regularly, with no acute side effects. I would like to keep doing so, it has helped me get through some pain in a marathon and a HIM. My doctor said there is a small risk but since my experience has been positive (it worked as advertised with no ill effects) I'm fine to stick with my routine and use the product in moderation.

Your opinion seems informed. I'm sure there are plenty out there using NSAIDs like I do, but any time the subjest comes up the chorus of "DON'T" is all I hear.

Thanks, Kevin

I agree that background plays a huge role. I took ibprofen regularly for a while. It took away the pain but made me feel lightheaded and just a little "off". Once I got off of it I went back to normal. I will take it occassionally now but only when the pain is really bad. Maybe because I am still transitioning from the young and dumb to experienced crowd. If you can take it and it causes no side effects, I see no problem just like the post above.

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I'm an anesthesiologist, FWIW. First, let me say the best advice in this thread comes from Azr431 who suggested asking your personal doc about it, and I'm impressed you've already done so. If your doc thinks that the potential benefits outweigh the possible complications in your case, then that's the bottom line.

There are different issues all being discussed here, and just about about everything that's been posted is true, but I think it's a matter of perspective. The main complications of ibuprofen use are the things like GI bleeding, kidney problems, allergic reactions or, in some cases, worsening of asthma. Obviously, some people here have experienced those complications, however we really know very little about those cases, for instance, what other medications (including over-the-counter or herbal!) they may have been taking that could increase their risk.

Others have expressed concern about the potential electrolyte/hydration problems associated with ibuprofen use. I have yet to see anything other than occasional case reports or individual experiences which warrant significant concern. The point I was trying to make earlier was that some cases of hyponatremia or kidney failure probably had more to do with the exertion, fluid management and breakdown of muscles than it did with NSAID use. Could NSAID use complicate those situations? Absolutely. Were they the primary cause? Doubtful.

Yet a third issue discussed is that of possible increased cardiovascular risk of NSAIDs. Every reference on this thread leads back to a single article published in BMJ, and your comments above hit the nail on the head...the risk of stroke increases from infinitesimal to slightly greater than infinitesimal. Go back to that reference provided by Lime Crush and check out the editorial associated with it.

What's curious is that, as we all know, aspirin too is an NSAID, yet years of studying and review have determined that, in small daily doses, the risk of stroke is actually decreased as we age. Just a couple more observations: acetaminophen is a great drug too, but it is a pain-relieving and fever-reducing drug only...no anti inflammatory effect. Also, acetaminophen in toxic doses will kill you more certainly than any of the other drugs discussed. Also, in another article referenced above, Dr. Creswell, who I'm sure is a bright guy, advises using acetaminophen and opioid (narcotic) pain relievers in preference to NSAIDs. Uh...no, thanks...and I'm not holding my breath for any kind of consensus in favor of that.

In addition, any NSAID should be considered as only one component of a complete plan. I think Bart (the original question) might benefit from a knowledgable bike fitter. He should also apply ice after long runs, as everyone agrees. [It's the "R" of RICE we all hate] He may even benefit from PT or orthotics down the road (I've been there too). I think it's great that non-pharmaceutical measures work for fasterisbetter, kattarddx and others, and I may try some of their suggestions.

The point of my first post was: In the great scheme of things, there are more important things to worry about than ibuprofen-associated electrolyte disturbances, which I assume is what the race director of the original post was referring to. Again, if in doubt, follow Azr431's advice: ask your own doctor. As for me, I am not planning to curtail my frequent, though not daily, use of ibuprofen or naproxen.

Thanks for taking time to put some balance to this discussion.

ibuprofen + dehadration= lever failure

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Formely stef32

I will carefully monitor my lever when I take NSAIDS. Thanks for participating.