NSAIDS in the News–2015       

Michael and I get quite a few magazines, journals and literature every month and it seems this month’s biggest splash in the news is about Non-Steroidal Anti Inflammatory agents (NSAIDS for short).

It seems that the FDA approved canadian pharmacy is requiring more stringent words of caution for both prescribed and over the counter NSAIDS. Tylenol PM, which is not an NSAID but is a pain reliever, was in the news last month as a common cause for the acceleration of dementia.

In the United States 29-60 million people per year (there were conflicting numbers from a couple of sources here) use NSAIDS and 100,000 people are hospitalized every year for side effects contributing from taking NSAIDs—15,000 of those people die as a result.

NSAIDS include: Ibuprofen (Advil, Motrin), Diclofenac (Voltaren), Celebrex (Celecoxib), Naprosyn (naproxen, Aleve), and Aspirin (acetylsalicylic acid). Rofecoxib (VIOXX) was pulled from the market in 2004 after killing more than 60,000 people and causing about 100,000 heart attacks.

Side effects of NSAIDS include: Cardiovascular disease (stroke, heart attack, heart failure), gastrointestinal complications (bleeding, abdominal pain, ulcers, nausea/vomiting), hearing loss (tinnitus occurred in 27% of 27,000 men in one study), allergic reactions such as asthma, and did you know there is an 80% greater risk of miscarriage associated with NSAID use? That is outrageous!

NSAIDS in pregnant women suppress production of prostaglandins needed for successful implantation of the embryo. NSAIDS have also been linked to heart problems in the offspring, low amniotic fluid and prolonged labor.

Those with a history of heart disease are at highest risk but studies are finding that even low dose and long term use of NSAIDs are causing problems.

Taking low-dose aspirin as a daily blood thinner: An article in Bottom Line/Health, Oct. 2015 revealed that many people are experiencing more harm than good from taking aspirin as a preventative. Of the 16,000 deaths each year attributed to bleeding associated with NSAID use, about one-third of these deaths occur in those who were taking low-dose (81mg) aspirin.

It’s very dangerous to take more than one blood-thinning agent at once. Those people on the drugs Plavix (clopidogrel), Coumadin (warfarin), Pradaxa, heparin, Lovenoxl (enoxaparin sodium), Normiflo (ardeparin sodium), and Orgaran (danaparoid sodium) are toying with danger, but even over-the-counter herbs can cause too much thinning of the blood when combined with NSAIDs.

Some herbs and foods that thin the blood include: Bromelain, Cayenne pepper, Chamomile, CoQ-10, Dong quai, Feverfew, Fish Oil (Omega-3-Fatty Acids), Garlic, Ginger, Ginkgo biloba, Nattokinase, Nettles, St. John’s Wort and Vitamin E (mixed tocopherols).

NSAIDS and Antidepressants don’t mix: In a study of over 4 million people it was found there is a 30% more likelihood of suffering internal brain hemorrhaging when taking NSAIDS in combination with antidepressants. (Bottom Line/Health Nov. 2015 Byung-Joo Park,MD, PhD.)

NSAIDS and Memory Challenges: When NSAIDS are mixed with anticholinergic drugs such as those used for insomnia, colds, allergies, depression, bladder control and motion sickness the combination can cause cognitive impairment. These drugs include benzodiazepines, tricyclic antidepressants, opiates and anticonvulsants. Some common names include Benadryl, Dramamine, Excedrin PM, Nytol, Sominex, Tylenol PM, Unisom, Paxil, Detrol, Demerol and Elavil. Older people taking these drugs are 46% more likely to have mental function decline. (Reference: Nutrition News and Views for health professionals July/Aug. 2015 vol 19, No. 4 Sustain the Brain by Judith a DeCava, CNC, LNC.)

Drugs that reduce stomach acid (Prilosec, Nexium, Zantac, Tagamet) can also reduce cognition by diminishing the absorption of essential nutrients (Vitamins B-12 and C) needed for brain cell function. Statins (cholesterol-lowering drugs) are also linked to memory loss.

So what does one do when they are in pain from arthritis, headaches and muscle injury?

The recommendations seem to be to use heat, aspirin or acetaminophen and use NSAIDS only when the pain is substantial, to use the lowest effective dose and only for short periods of time. If you are using NSAIDS for crippling pain, talk to your doctor for more options and to discuss trade-offs in benefits and risks. Naproxen is the least likely to increase the risk of stroke or heart problems but is it also more likely to cause stomach bleeding.

In the meantime, some herbs/foods/treatment modalities used in place of NSAIDS include:

Dr. Moffat’s note: Just eat the fish for best results instead of using fish oil and omega fatty acid capsules. Use sardines, salmon, krill or other fatty fishes—it’s rare that my clients test strong on fish oil in capsule form for some reason—maybe it’s the processing and maybe it’s the gel caps. Who knows at this point.

Helpful Links and References for NSAIDS:

NSAIDS and dementia: https://www.peoplespharmacy.com/2015/01/27/are-your-drugs-raising-your-risk-for-dementia/