Chronic Use of Advil/NSAIDs

There was a time where I was grabbing for an advil every month for my cramps but grabbing for the “relief” without looking at the underlying cause just keeps it in an endless dependent loop. 

We’ve all taken aspirin or advil. I do think there are emergency situations where its warranted but its the constant usage that can be causing more harm than good. Chronic use of drugs in the NSAID/ non steroidal anti inflammatory family has been shown time and time again to break down and cause damage to the gastric mucosa - an essential layer to our gut lining. Damage to this essential part of our body can contribute to a number of other issues.

Leaky gut can cause food particles, toxins, antigens, bacterias to leak into the blood. Leaky gut allows entry of antigens from the gut into the host/blood which can promote local and systemic inflammation. These foreign particles detected in the blood by the immune system will enable release of lymphocytes, triggering systemic inflammation.

With leaky gut, the body is in a constant state of immune system stimulation - this is great for survival but not day to day living. Chronic systemic inflammation is a breeding ground for illness and imbalance. It has been linked to Alzheimer's/dementia, inability to lose weight/obesity and joint pain.

Its interesting because NSAIDs are taken to help relieve discomfort and paid that are inflammation based but yet they also contribute to the cycle by damaging the gut lining and enhancing systemic inflammation.

I don't remember the last time I had to take advil for period cramps. What led to this was addressing the root of my cramps and pain (INFLAMMATION!). I had to take a step back and look at lifestyle factors that were enabling the pain. I also started to assess which other interventions could work to provide me with relief for the months that I do experience higher levels of pain. Eventually what I found worked for me were turmeric + magnesium (in combination with other lifestyle factor changes, and some patience as they don't provide relief as quickly as a pharmaceutical).

Again, its not the end of the world to take an NSAID once in a while if you feel the need, its the chronic constant usage that can be detrimental to our gut. If you do take them often try to look at the underlying reason for the pain (which leads to the need for relief). Whether its for period cramps or a headache, try asses whats at the root of this. Do you notice a pattern when your headaches arise? Could it be from dehydration, lack of minerals, a spike in blood sugar or low blood sugar? Could a change in those areas minimize or eliminate the pain and therefore eliminate the need to grab an NSAID for relief?

NSAID - non steroidal anti inflammatory drugs:

Are one of the most frequently used drugs in the world, taken daily by millions of people. They are widely used to reduce inflammation, pain relief and cardiovascular health. People often take them to combat headaches, period pains, colds and arthritis.
Drugs under the class of NSAIDs include: advil/ibuprofen, aspirin, diclofenac/voltaren.

NSAIDs work by inhibiting COX enzymes which synthesize prostaglandins which are mediators of inflammation.

Prostaglandins also influence platelet activation (blood clotting) which is why taking aspirin can thin the blood as it's blocking the activation of blood clotting.

Prostaglandins are unique compounds because they act like hormones influencing different processes in the body like inflammation, blood flow, blood clot formation and inducing labour. Prostaglandins also modulate virtually every aspect of mucosal defense. With chronic ingestion of NSAIDs development of ulcers in the stomach is a significant clinical concern  (PMID: 18923189).

Mitochondria - NSAIDs can inhibit or uncouple oxidative phosphorylation which can lead to cellular lipid peroxidation (break down on cell membrane) and result in cellular apoptosis (programmed cell death) PMID: 21373261. Uncoupling of mitochondria has also caused a decrease in intracellular concentration of ATP, leakage of calcium out of the cell and loss of control over intercellular junctions - resulting in increased permeability.

Chronic NSAID use can damage the gastric intestinal mucosa. In as many as 80% of NSAID users, mucosal erosions are detected. Long term users suffer from diminished absorption capacity and increased intestinal permeability. Loss of intestinal barrier can lead to an activated immune signaling and intestinal inflammation. Disruptions to the intestinal barrier can lead to dysbiosis.

NSAIDs can cause damage to gastric mucosa through several mechanisms:
-topical irritant effect of these drugs on the epithelium

-impairment of mucosa barrier properties

-suppress gastric prostaglandin synthesis

-reduce gastric mucosal blood flow

-interfere with repair of superficial injury