I have a question related to the use of Advil, in many of races mentioned in the book Becoming an Ironman I read about the use of advil. Now I am wondering since I am unfamiliar with IM-dtances (I only do Olympic Distances this year and have the goal doing 1/2 IM next year) why they are using it so much?
I also have a question about eating: I currently in the habbit of eating a powerbar every 40 minutes when I am on the bike, is that sufficient or not? Does anybody have some advice on timing of food?
There has been much discussion on this board advising against the use of Ibuprofen. The reason is when your body is devoting much effort to forward motion, as in Tri, there isn’t much left over for much else. Ibuprofen (Vitamin I) is processed out of your system by your kidneys and combining the two, high effort/increased load on the kidneys, can set you up for kidney damage or even failure. THIS IS REAL AND IT IS A POSSIBILITY. Oh yeah, if I recall correctly, Tylenol (Acetominophen) is processed out by the liver and use of that during high effort sets you up for liver damage.
Having said that, there’s a reason Ibuprofen has become known to many as “Vitamin I”. I’m sure many use it in their training. If you make this choice, make it an informed choice, use it sparingly and I wouldn’t recommend it when you are really taxing your system.
( Aside: I once met a guy hiking the pacific crest trail from San Diego to it’s endpoint ‘a far piece’ up north as a means of coping with his divorce. He was popping Ibuprofen like M&M’s )
Regarding eating, there’s a great article here on Slowtwitch about setting up your nutrition plan.
Ibuprofen belongs to the general class of medications called NSAIDs, non-steroidal anti-inflammatory drugs. This class of drugs inhibits an enzyme named cyclo-oxygenase, COX. COX has two different enzymes COX1 and COX2. COX2 is responsible for everything bad in life. It causes inflammation and sets in motion enzyme cascades and reactions that cause pain, swelling and the type of stuff that promotes overuse injuries. COX1 is beneficial in that it protects the lining of your stomach from ulcers. NSAIDs, including aspirin, inhibit both enzymes and so much is said about how bad they are and how many ulcers they cause, especially if you take them under stress such as sickness or an endurance event. Pfizer and Merckk have both developed drugs that selectively inhibit COX2 and thus are reported safer because they do not cause so many ulcers. The problem with either of these medications is that both classes can decrease blood flow to the kidneys and lead to renal failure especially in the case of dehydration. Personally, I take an anti-inflammatory, either Vioxx, Celebrex or ibuprofen whenever I have some type of overuse injury and I think this is generally recommended. I am not sure how it is recommended in the book you speak of. Obviously, any medication we take has side effects and we must weigh there benefit vs. their risk.
you’re talking about using drugs to race. I know it’s a harmless one (maybe) but it’s still a drug.
You should train hard, plan your race smart and give it all you have. Don’t waste your time by planing on cheating, which this in my opinion clearly is.
Don’t cheat! Do the best you can with the time and abilities you posses!
First of all thanks for all the replies I got, 2nd I stay away from any medicine unless I really need it and even then it needs to be on a doctors prescription (I used Advil the 1st time in my life this year after pulling a muscle in my shoulder!!! and can not recall using any other medicines ever or it must have been ages ago).
I was just wondering reading through the book why it was mentioned so often in the diaries of the participants and since I eventually want to do an IM I read as much as I can in order to learn and reflect some of my thoughts on this forum.
…I know it’s a harmless one (maybe) but it’s still a drug.
Ibuprofin during racing is definitely not harmless. The stress that NSAID’s place on the kidneys during racing can throw off the body’s sodium balance. You can develop hyponatremia even if you have been drinking electrolyte drinks and taking salt tabs. A death due to hyponatremia in an IM race last year was directly attributed to the use of NSAID’s during the race by the victim. It’s recommended that you do not take any NSAID’s for 48 hours beforehand, and during the race.
It’s not a question of …not… using NSAIDs. It’s an issue regarding using NSAID’s properly. To use NSAID’s for performance enhancement (before or during a race or training) is not only wrong but is potentially dangerous. On the other hand, using NSAID’s for recovery enhancement to reduce inflamation (AFTER an endurance event) is proper use of drugs.
The bottom line is … needing to be dependent on a dialysis machine the rest of your life takes a lot the fun out of being a triathlete.
The difference between COX2 inhibitors and Non specific COXinhibitors does not change the safety of these drugs in the use in stuations of extreme stress.
COX2 I are safer to use if they are used chronically, or if you are susecptible to begin with.
The problem with these drugs is their effects on your kidneys. The inhibiton of the COX2 pathway is that it will block the production of a chemical called prostoglandin which is necessary for the regulation of blood flow through the kidneys which is very very very necessary to be regulated especially in ultra endurance athletes.
Further these drugs are known to be acute and chronic intertitial nephritis, nephrotic syndrome, and acute renal failure. Treanslated these can cuase your kidneys to stop working instantly. If this happens you will may end up on dialysis waiting for a kidney transplant…
These drugs are pretty safe under normal circumstances. However through the stress of an ironman, you can become dehydrated, overhydrated, etc. etc. which means that your body is having to be functioning very well to keep you from dying.
Further the COX enzymes are very important in the hemostasis cascade adn platelet functioning. This means that if the concentrations get to high because you are dehydrated and your kidneys can’t filter it out you can develop a temporary bleeding disorder which is bad news…
Asprin and tylenol are the same story. These two have additional problems of Asprin is a much more potent blocker of platelet COX and can lead to some serious bleeding problems in such a situation and Tylenol is hepatotoxic (kills your liver) as some one mentioned before…
These drugs should all be generally avoided during as much of your training as possible. ESPECIALLY if you have ever been told that you have a problem with your kidneys.