For the love of your gut, stop using NSAIDS!

Headache? Achy joints? Menstrual Cramps?

Most of us might pop a few Advil in response to an everyday nagging pain without much thought. And why not? These are over-the-counter (OTC) medications after all, so what could be the harm?

NSAIDS (aka Non-Steroidal Anti-Inflammatory Drugs) are a class of over-the-counter painkiller. Examples of NSAIDS include Ibuprofen (like Advil), Naproxen, and Aspirin. Although NSAIDS are very effective in managing a nagging pain, there are a number of consequences these can have on your gut health.

Now, I’m not saying you should NEVER take an NSAID. There are certainly times when these come in handy. The problem lies in chronic use of these medications (say, once a week or more) without much thought for how this can be affecting your gut health.

Below, I outline a few reasons why NSAIDS can be so harmful to your gut and some alternative gut-healthy solutions you can use to to manage pain (including addressing the root cause of why you’re having pain in the first place!).

Ulcers

NSAIDS work by reducing prostaglandins in the body. Prostaglandins are a particular family of molecules in our body important for: promoting inflammation necessary for healing, supporting blood clotting, and protecting the stomach’s lining from the damaging effects of acid (1).

When you take an NSAID you are reducing the protective mucus in your stomach. This can lead to inflammation in the stomach lining, eventually causing a rupture in your capillary, then ultimately causing a bleeding stomach ulcer.

If you ever read a label on an NSAID, you’ll find side effects listed such as: stomach problems including bleeding, stomach upset, and ulcer. Insane, isn’t it?

No need to worry though, ulcers occur with high doses used over a long period of time (hopefully this isn’t you, and if it is then it’s time to re-assess!).

Increased Gut Permeability

One of the first studies showing how destructive NSAIDS were to the gut, found that 71% of those who were exposed to NSAIDs for more than 90 days had some damage to their small intestines (2). The damage to the small intestines manifested as small intestinal permeability (aka “leaky gut”).

Further more, another study showed that even one dose of 600mg of aspirin can increase intestinal permeability! (3)

Why is this important? Our gut lining protects our body from potentially harmful particles being released into our blood stream.

There is a certain level of permeability that’s needed in order for nutrients to get into our body. However, when the permeability of our lining is increased, then harmful particles can access our immune system and set off an inflammatory or autoimmune response (4).

Imbalanced Gut Microbiome

People who regularly take NSAIDS can have significant changes in their gut micro-biome compared to non-users according to a study done in 2015 (5).

Particular species of bacteria were depleted depending on the type of NSAID used and if the NSAID was used in combination with another drug (for example, an anti-depressant).

Poly-pharmacy (the use of multiple prescription and over the counter drugs) could theoretically also play a role in the balance your gut-biome as well.

Another study that was done on mice who were given indomethacin (a first generation NSAID) had damage in the lining of their small intestine but also had altered micro-biome diversity.

Scientists suggest that by altering the gut micro-biome with NSAID use, the integrity of the gut lining decreases leading to leaky gut.

More research is needed to determine what these changes in the biome may indicate. However, it has been noted that overall these anti-inflammatory drugs lead to more pro-inflammatory bacteria in the gut.

WHAT CAN YOU DO?

Before you head for the advil, try some of these tips instead.

1.) Get to the root of your inflammation using a functional medicine approach.

Inflammation happens as a result of a disrupted immune response. Common root causes for pain include:

• Stress
• Poor Sleep
• Structural problems from a past injury–>> a physical therapist and massage therapist are great for this!
• Food Sensitivities
• Hypothyroid
• Low vitamin or mineral status
• Chronic viral infections (lyme disease or EBV)
• Hormonal Imbalances
• An autoimmune condition—these can often be related to gut imbalances or food sensitivities
• Emotional trauma or depression–>> counseling is a huge help here!

2.) Wean slowly off the NSAIDs as these actually lead to worsening of pain.

First, start by lowering your dose and then space out doses further apart and only using pain medication when absolutely necessary. Use alternatives, below, until you can get to the root cause of your pain.

3.) Try using nutrients and herbs to reduce your pain.

***Always consult with your physician first before adding any supplements or herbs. Especially if you’re on other medications!***

For general pain:

• Bromelain: used to reduce chronic inflammation, especially after an injury to your body. The enzyme comes from a pineapple and can help reduce swelling from injury. Typical dosage is 200-300mg twice a day. This not meant to be taken long term.
• Ginger: can be as effective as NSAIDs for relieving pain and inflammation. A typical dose is 500-1,000mg one to two times daily.
• Curcumin: the component of turmeric that is anti-inflammatory. Typical dose is 1200-2400mg per day.
• Bosweilla: this herb is otherwise known as Indian frankincense and it’s great for reducing pain and inflammation. A typical dose is 350mg three times per day.
• Devil’s Claw: typically used for low back pain. You’ll want to use a product that contains 50-100mg harpagoside (the active component of the herb), used once per day.
• Capsaicin: can be used topically (on your skin) to relieve painful joints and headaches. Apply 3 times per day.

For headaches:

• Consider the potential food sensitivities (MSG and tyramine are common triggers for migraine sufferers).
• Do you have a blood sugar imbalance? Be sure to eat frequent small meals and snacks containing fat and protein to avoid a blood sugar crash.
• Have you had too much caffeine? Limit caffeine to 200 mg /day and no caffeinated beverages in the afternoon.
• Are you dehydrated? Drink more water. A good sign of proper hydration is the color of your urine–if it’s straw colored, you’re A-o.k.
• Rub lavender, ginger, or peppermint essential oil or salve on your temples or on the back of your neck.
• Try sipping on chamomile tea (note: not recommended for those with a rag weed allergy).
• Practice deep breathing exercises, a depletion of oxygen to the brain can cause a headache.
• Apply a cold compress to where the pain is radiating. You can use a damp wash cloth placed in the freezer for 10 minutes.
• Use a heating pad to relax the neck and should muscles as this can cause tension headaches when these muscles are tight. Better yet, set up a massage appointment to address tense muscles.

4.) Manage your stress.

Often stress levels and sleep cycles go hand in hand. Getting adequate and restful sleep is so important in managing your perception of pain. When we lack in sleep we can feel more pain than when we are fully rested. Optimally, you should aim for 7-8 hours of uninterrupted sleep each night. Practice good sleep hygiene by limiting your blue light exposure from cell phones, computers, and TVs for at least one hour before your bedtime. Research has found that exposure to blue light suppresses the production of melatonin, a hormone that influences your sleep. Instead, have a pre-bedtime practice that helps you to wind down your brain–take a hot bath with epsom salt and lavender essential oils, meditate, do yoga, converse with your loved one. You’ll also want to make sure your bedroom is completely dark. Turn off all light emitting electronics and shade windows that have street lamps shining into your bedroom (blackout curtains are a great investment).

5.) Get body work.

Pain can be due to old injuries or emotional traumas that have caused you to hold pain and tension in particular areas of your body. Massage, acupuncture, yoga, chiropractic, and physical therapy can all be so very helpful in managing pain and increasing your mobility.

In conclusion

Now you know there’s a lot more you can do for pain before heading immediately for the advil or tylenol. Consider the potential impact long term use of NSAIDs could have on your digestive tract, especially if you’re a woman struggling with IBS.

If you’re a woman looking for help in navigating your digestive issues, then I’ve got you covered! To learn more about my 12 week IBS Rehab program, schedule a free call with me here to learn how I can help!