Health, Wellness and Fitness

Proofin’ ibuprofen:  How to use it safely

 By Michael Roizen, M.D., and Mehmet Oz, M.D.

More than 20 million Americans and Canadians take ibuprofen every day, often popping the nonsteroidal anti-inflammatory drug (NSAID) before they exercise or do heavy-duty chores – to prevent muscle aches and pains. But a recent report says ibuprofen plus strenuous activity may be bad news for your intestines; it seems to trigger what docs call “leaky gut.”

Long periods of very strenuous activity reduce blood flow to your digestive system (your body needs that blood elsewhere!). This makes the lining of your intestines vulnerable to injury. Ibuprofen further reduces your body’s ability to protect and repair that lining. Combine these two effects, and the lining of the intestines becomes compromised, which can allow digestive enzymes and even bacteria to migrate from your intestines into your bloodstream.

That’s what Dutch scientists recently concluded when they found that endurance athletes who take ibuprofen before they exercise had elevated levels of a protein that signaled intestinal leakage into the bloodstream. But they also found that the elevated protein levels disappeared about an hour after exercising stopped. So, no one is positive if this phenomenon does lasting damage. There’s even some thought that a short blast of unexpected visitors in the bloodstream could help prime your immune system to better fight off invaders. But considering that up to 90 percent of endurance athletes take ibuprofen before most work-outs and that so many other folks rely on it from time to time or daily, we recommend a new approach to managing exercise-related discomfort or pain. Here’s our advice:

Ease into heavy-duty activity. Weekend warriors, listen up. Instead of going from zero (you on the couch) to 100 mph (you doing a two-hour boot-camp exercise class or all-day yard work), make sure you get some exercise every day. Do a little bit (30 additional minutes of walking a day); then add a little bit more (each week, increase by 10 to 15 minutes per day); and then do even a little more (you’re aiming for a total of 10,000 steps a day). When you build strength and endurance gradually, your muscles will sustain less microtrauma – microscopic tears and swellings – which translates into major aches the day after. It’s the best way to minimize delayed muscle soreness.

Reserve NSAIDs for swelling and pain. Over-the-counter NSAIDs are effective pain relievers, but they are intended for only short-term use. Never use an over-the-counter NSAID for more than 10 days, and make sure you take the dose as outlined on the label. Don’t take extra (more than 25 percent of you do). And don’t take these medications more frequently than recommended. Almost two-thirds of you do that!

Already achy? Chill out. Use indirect cold on tired muscles as soon as you can after exercising. Applying an ice pack wrapped in a towel for 20 minutes or less discourages excess inflammation and reduces pain dramatically. Save heat for later on; using a heating pad set on low for a short time will increase circulation and encourage healing. Heat is also a good soother for aching joints.

What if you’re taking aspirin daily? Many folks take aspirin for its benefits against cancer, heart attack and stroke; if that’s you, by all means, stay with it. (We take aspirin with a half-glass of warm water before and after; it helps the aspirin dissolve faster, reducing the risk of stomach and intestinal bleeding and your risk of distress.) Just make sure to take the aspirin more than two hours before or one hour after you exercise.

We haven’t pointed it out recently, but aspirin really is a miracle pill, and so is ibuprofen. But taking the two together seems to cancel out their anticancer and anti-heart attack benefits, so stay with aspirin if your doc approves (since there are potential side effects, always check with your doc). If you must take ibuprofen also, do it 30 minutes before you take aspirin or eight hours afterward.

Mehmet Oz, M.D. is host of “The Dr. Oz Show,” and Mike Roizen, M.D. is Chief Medical Officer at the Cleveland Clinic Wellness Institute. For more information go to (c) 2013 Michael Roizen, M.D. and Mehmet Oz, M.D. Distributed by King Features Syndicate, Inc.

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