Using NSAIDs during an IM
What are the EN thoughts and prevailing wisdom when it comes to using NSAIDs (your aspirin/naproxen/ibuprofen products) during an IM? I'm aware of some of the potential side effects (slowed down absorption, kidney issues, masking of pain which can lead to injury) - however slight and miniscule those chances may be.
I'm not talking about chewing 'em like candy for 12 hours. I'm talking about taking two at the halfway point of the run out of my run special needs bag.
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There's an EN thread about NSAIDs here.
I know what the prevailing wisdom is about over-use of these meds are and I understand and agree.
Your question is specifically about taking during an IM event, not over using. I have consulted a few docs and what I hear is that you should not take during an event if you are dehydrated. Something about being able to flush through the kidneys. So if I need something for pain while racing (not sure I would take preemptively) I make sure I can pee first. If so, I will take two Advil. And then make sure I continue to drink.
Haven't done it very often, but nice to have onboard if/when needed.
John
NSAID use alone could theoretically cause hyponatremia, renal failure, or kidney disorders in an endurance athlete, but these conditions would far more likely be due to other causes and exacerbated by NSAID use.
Healthy 20 year old woman with normal kidney function goes to the OR for a minor procedure, gets plenty of i.v. fluids (therefore not dehydrated), received ONE dose of NSAIDs and has renal failure requiring dialysis.
WOW! I understand the theory for certain people and that extreme cases happen. And I also have a friend who had stomach surgery because she was eating Advil daily for a few years because of headaches. So over use is definitely (with almost anything) an issue. But it leads me to ask the question: If the risk is that high/extreme, why isn't it completely banned from the market? I and many, many of my friends use this occasionally without issue.
With that said, is there an alternative one can use to help with pain for someone who only uses a pain reliever on occasion (maybe once or twice a month)?
Thanks.
I will let the experts chime in. I have had 3 episodes of internal bleeding in training while using Ibuprofen. You be the judge. My wife is a pharmacist and if you want more expert based opinion, I can ask her to write a response to your question, obviously with a permission if I have to secure one from the forum admin or EN........
It all hardly seems worth the potential downside.
As far as alternatives, it depends on hey you're taking them. Different recommendations for headaches vs. Muscle aches vs. Joint aches, etc. There are alternatives. Most docs I know seem to think that the most benign of the pain relievers is Tylenol.
Mike
Army sick call generally prescribes ibuprofen for everything (referred to by many as Vitamin I). I've been given bottles and bottles of 800mg ibuprofen in the few years I've been in. The practice has become so common that there are plenty of people in my current unit who average over 800mg of ibuprofen a day. I like to think of my business as a relatively athletic one, and I'm pretty concerned about the long term effects of NSAIDs on the military community.
Coolio. Thanks for all the feedback.
@Bob: Sorry to hijack your post. I think you got your answer.
So did I. 
But on top of that, the potential *benefit* (for your personal risk-benefit calculation) just isn't much during a race! Ibuprofen is great for relieving moderate muscle pain, but that's just an entirely different universe than any mid-race pain...it's just a mis-use of the stuff.
The other benefit of ibuprofen is as an anti-inflammatory, which also sounds attractive...until you realize it's only good at higher doses and after having been in your system for a while (days?). Again, just not relevant to mid-race discomfort!