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What you don't know about Advil...

Thought you might find this article on hyponatremia interesting

www.xtri.com/features_display.aspx

Note, this is a Nephrologist from the Mayo Clinic advising us not to use NSAIDS (Advil, Motrin, Aleve, etc) during endurance events. 

Folks who know me have seen this theme in some of my posts from the past, but I think that this is one of the least well publicized pieces of info in the endurance world. 

OK, I'm off my soapbox...

Mike

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    I find it surprising whenever I hear anyone talk about taking NSAID's during races. I hear it a lot. Thought it was generally accepted as a no no. Tylenol used to hand out tons of free stuff at marathons a few years back making the point that it was a much better alternative if you needed pain killers while racing. I have never been one to take anything while racing, figure that it would not make the real pain go away and I would not want to mask anything minor.

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    There are a variety of very interesting studies looking at Advil (and other NSAIDS such as Celebrex, Naprosyn, etc) and its effects relative to exercise and as a long term therapy. A few thoughts from a doctor by day and triathlete by night.

    1) Advil is tough on your kidneys, no doubt about it. Probably not a good idea during a race. While most will get away with it without any problems, the long term possible consequences are devastating. Even if risk is only 1%, you don't really care that the other 99 people got away with it if you get bitten.

    2) Advil may have the same long term cardiac side effects (albeit to a lesser extent) that caused the withdrawal of Vioxx from the market (and Celebrex almost certainly does). I would be very hesitant to pop an Advil after every workout and make that a habit extending over many years.

    3) Use of NSAIDS does not improve recovery from or reduce pain from Delayed Onset Muscle Soreness in several clinical studies, yet I suspect many take it for that purpose.

    4) Use of NSAIDS does appear to blunt the body's adaptive period following a workout.  Turns out that inflammation you are inhibiting may also be part of the trigger necessary for improving long term performance. Work like a dog for a hard 2-hour run and then toss your hard work in the garbage by tossing back 2-Advil?

    In summary, I only use Advil sparingly and generally only when really sick (flu, etc). Tylenol is definitely safer and is not an NSAID. Major tylenol risk is liver damage associated with overdose, but as long as you stick with no more than 2 tabs every 6 hours you are safe.

     

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    well that settles it, pain killers are limited to helping with hangovers only from now on.
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     I gotta say that Ibuprofin has been the Magic Bullet in a few IM races, at least for me. 

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    Posted By Bill Russell on 01 Dec 2009 07:45 PM

     I gotta say that Ibuprofin has been the Magic Bullet in a few IM races, at least for me. 



    Amen, brotha!! ;-)

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    Since Tylenol and hangovers were mentiond... Never take Tylenol with alcohol.  The Tylenol breaks down and combines with the alcohol to form a liver toxin.  So, for hangovers, Advil is safer.

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    Ibuprohen + glucosimine tabs are my post run cocktail, sometimes pre-run.

    I've taken vit-I during races and long rides, can't say it's really helped me. Not much is gonna help after mile 18. I seem to get more good mojo from cafeine.

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    One of the very first things I learned about in medical school was the inflammatory reponse: rubor, calor, dolor. Redness, swelling, pain. The swelling is the primary thing here - pressure on various body parts like nerves and cell membranes is what gives the pain sensation. And the redness signifies increased blood flow to bring repairative cells and substances to the affected area. In other words, inflammation is your friend. Don't inhibit it with Non Steroidal Anti Inflammatory Drugs. Your body knows how to heal itself. Give it the tools it needs, and get out of its way.

    I daily prescribe  pain meds for people who are really hurting. What we experience as a result of our workouts/training sessions is not the same; it's really no different than breathing heavy or sweating - it's part of the package. Slowing down the body's response with NSAIDs slows down the recovery process. If you think you need to deal with that soreness after a two hour run, put ice on your thighs, soak your legs in a cold tub, put on some compression stockings.

    I admit to using Alleve for a day or two after an all out Ironman. Like anyone else, I'd like to be able to walk downstairs without grimicing. And until about two years ago, I took one Alleve tab a day for arthritis pain in my hands. Funny thing - when I stopped, my hands felt better. That experience, along with on-going medical studies showing the effects of long term NSAID use on kidneys and heart, plus the counter-productive effect on recovery, have convinced me to drop that "supplement".

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