The downside(s) of NSAID use.
According to the National Institutes of Health, nearly 50 million American adults have chronic pain or severe pain.
The conventional medical model teaches us to reach first for medication to relieve pain, with ibuprofen and other NSAIDs (nonsteroidal anti-inflammatory drugs) at the top of the list. It is after all a pretty realistic expectation.
Have Pain. Get rid of Pain. Done.
However, with research mounting to show NSAIDs have a notable list of dangers, it makes sense instead to look for the root causes of pain and not just cover up the end result of whatever imbalance is causing your pain.
Many people turn to NSAIDs for relief from pain and inflammation. Common NSAIDs are ibuprofen (Motrin, Advil) and naproxen (Aleve). Celecoxib (Celebrex), diclofenac (Cataflam, Voltaren) are prescription NSAIDs.
Aspirin is an NSAID, but it does not pose the same risks for stroke and heart attack.
Ibuprofen is metabolized by the liver, and can cause lesions, liver failure, or jaundice over time. The FDA has even warned against NSAIDs because they increase the risk of heart attack and stroke.
NSAIDs promote leaky gut
Another reason to avoid NSAIDs is their tendency to promote leaky gut, as I’ve mentioned before in some of my other blogs.
In leaky gut, the lining of the small intestine becomes damaged and overly porous, allowing undigested food, bacteria, yeast, and other pathogens into the bloodstream. This triggers inflammation and pain throughout the body — the same thing people use NSAIDs to relieve, creating a vicious cycle that can be very difficult to get off.
So, if the typical go-to medications for pain aren't an option any more, where do we turn?
Functional medicine offers solutions.
Address inflammation to root out pain
When pain is treated with NSAIDs, it typically comes back when the medication runs out. However, in functional medicine the goal is to identify and address the cause of the inflammation and pain instead of simply putting a temporary Band-Aid on it.
It’s understandable to want relief so you can feel and function better. The good news is many people find their chronic pain diminishes substantially or disappears completely when they adopt functional medicine strategies.
So let me be clear on this. I’m NOT saying that functional medicine will fix all your pain problems. BUT, what I am saying is that the entire body is connected. If you have some sort of chronic pain it often becomes a vicious cycle of pain = inflammation = pain = and on and on. By addressing where that additional or extra inflammation is coming from we can often relieve or at least significantly reduce the amount of chronic pain you are in. It eve applies to acute injuries as well. If you body is balanced and has little inflammation prior to an injury, when you do get injured you will heal much faster.
Following are a few ways functional medicine can relieve pain and inflammation:
Anti-inflammatory diet. Remove foods that trigger inflammation, such as gluten, dairy, grains, legumes, eggs, sugar, and nightshades. This is typically done as an elimination and reintroduction protocol where you follow the diet strictly for a period of time and then customize it depending on your food sensitivities. This customization is generally done with Food allergy (IGE antibodies) and food sensitivity/intolerance (IGG antibodies) testing.
Note: not all tests are created equally. Don’t just pick the cheapest or quickest test. Otherwise your results may not mean too much. Check out the Cyrex Array 10 on our Functional Medicine testing page. I will also put some links in the description below. Check em out!
Avoid nightshades. Vegetables in the nightshade family can cause pain and inflammation in the joints. These include eggplant, potatoes (but not sweet potatoes or yams), peppers, tomatoes, tomatillos, hot pepper products and pepper-based spices. Simply removing nightshades from the diet has brought relief from joint pain for many, especially those with rheumatoid arthritis. But keep in mind this doesn’t mean everyone will benefit from this. It’s on a case by case basis. Results may vary. Yada, yada yada.
Turmeric and resveratrol (Pricey but worth it) Each is a powerful anti-inflammatory alone, but research shows that taking them together is much more effective, making them potent tools for quenching the inflammation and damage associated chronic inflammatory disorders. Side note, there is some controversy on the whole with black pepper or without. I say…It depends.
Improve your posture. Chronic pain can develop due to spinal misalignment. Rarely do patients with chronic pain have even pressure on both feet or eyes that move in synchrony. Many patients experience significant or total relief of chronic pain by addressing these imbalances. Go see your Chiropractor.
Nutrients that fight inflammation and pain. These include vitamin D, vitamins A, E, and K, and plenty of omega 3 fatty acids.
White willow bark is an herb traditionally used for pain relief. The same active ingredient in Aspirin, but at much lower and safer doses.
Moderate to high intensity exercise can help reduce inflammation. It also improves insulin sensitivity, a bonus for diabetes prevention. Just make sure to choose exercises that do not exacerbate joint pain; there are lots of options.
Balance your blood sugar. Many people have blood sugar dysregulation issues that contribute to systemic inflammation and pain. In addition, imbalanced blood sugar is one of the risk factors for Alzheimer's and Parkinson's. A good starting point on regulating blood sugar balance is a book by one of my instructors Dr. Mark Hyman. It is call “The blood sugar Solution” and will give you a tone of great information on why glucose regulation is so important and some things you can start dong to help yourself.
Support production of SCFA. Short chain fatty acids (SCFA) produced by your "good" gut bacteria are helpful in dampening inflammation. Eat abundant and varied fresh vegetables daily, eat probiotic-rich fermented foods, and take SCFA-supporting supplements such as butyrate (as in N-butyrate), Saccharomyces boulardii, Lactobacillus sporogenes, and DDS-1 Lactobacilli acidophilus.
Support glutathione. The most important antioxidant in your body, glutathione aids in detoxification, helps maximize immune system function, and shields cells from damage caused by oxidation and inflammation.
A healthy body makes enough glutathione, but faced with chronic stressors such as toxins, poor diet, sleep deprivation, smoking, and excess sugar, glutathione becomes depleted and your body and mind starts to suffer.
Some Glutathione supplements are not effective taken orally. Instead, boost glutathione levels through a liposomal cream, suppository, nebulizer, or IV drip. And make sure it the “S” glutathione and not the “L”.
One must also support glutathione recycling to balance the immune system, protect body tissue from damage caused by inflammation, and help repair damage.
To enhance glutathione recycling, remove stressors depleting glutathione levels such as lack of sleep, smoking, food intolerances, diets high in sugars and processed foods, and excess alcohol intake.
The following nutritional and botanical compounds have been shown to support glutathione recycling. Any I often recommend certain combinations or combined supplements to reduce your vitamin supplement load. Otherwise you may eventually suffer from “pill fatigue”.
These are just a few ways to use functional medicine to address the root causes of inflammation and pain so that you can stop taking NSAIDs.
As always, I recommend checking out my guide on how to order the best quality vitamins. Check out the link.
I’m Dr. Craig Mortensen
Be healthy, be happy!
Nitric oxide for autoimmune and chronic disorders
When it comes to autoimmune disease and other chronic health conditions, taming inflammation is the name of the game. This can be difficult because the body creates vicious cycles where inflammation keeps feeding more inflammation. This makes halting the progression of autoimmune disease and chronic health issues difficult…but not impossible.
However, we now know about nutritional ingredients that can boost anti-inflammatory efforts. These ingredients act on two inflammatory immune messengers called “nitrous oxide” and Interluekin 17 or “IL-17.”
IL-17 is a pro-inflammatory immune cell that damages body tissue, such as the thyroid gland in autoimmune Hashimoto’s, the joints in rheumatoid arthritis, or the nerve sheaths in multiple sclerosis.
IL-17 isn’t completely bad—it’s necessary to fight infection. But when the immune system becomes hyper zealous, IL-17 goes out of control and attacks the body it’s designed to protect.
IL-17 destroys tissue by activating a “inducible nitric oxide,” one of three forms of nitric oxide, a gas, involved in various processes in the body. Two other two forms of nitric oxide are beneficial and actually fight inflammation: endothelial nitric oxide and neuronal nitric oxide.
However, inducible nitric oxide is pro-inflammatory and damages body tissue under the orders of IL-17.
Therefore, one way we can stop the vicious cycle of inflammation is to dampen IL-17 and inducible nitric oxide. Luckily, there are nutritional compounds that help the body do this.
But first — perhaps you’ve heard of arginine to boost nitric oxide. Although arginine boosts the anti-inflammatory endothelial and neuronal nitric oxides, it also boosts inducible nitric oxide. So if you are fighting chronic inflammation, taking arginine may work against you.
Arginine is also touted as being good for boosting growth hormone. But, this can have down sides. Check out my previous post on Arginine and cold sores.
It’s safer instead to take nutritional compounds that studies show support endothelial nitric oxide (one of the anti-inflammatory nitric oxides). These include:
Xanthinol niacinate - a form of niacin
These compounds work synergistically taken together in an emulsified liquid form (very hard to find and generally only found in functional medicine offices). But not everybody can or should take a liquid form.
Not only does boosting endothelial nitric oxide tame inflammation, it also helps repair and regenerate body tissue, promote blood flow, dissolve plaques, and dilate blood vessels. Start with small doses to gauge effects and tolerance.
These compounds also support neuronal nitric oxide (the other anti-inflammatory nitric oxide) and thus the health of your brain and nervous system.
Exercise is another excellent way to boost beneficial nitric oxides. In fact, take these endothelial nitric oxide boosting compounds before getting your heart rate to maximum capacity for a few minutes first thing in the morning. This will optimize anti-inflammatory effects and support brain health. Nitric oxide is helpful for those of use that like to lift weights and enjoy that “pumped feeling during and after the workout.
Also, nitric oxide is what is stimulated with certain medications such viagra and heart medications for angina. Taking these supplements can also help men with issues in the bedroom. “Make you strong like oak”
You don’t have to exercise long — just a few minutes of raising your heart rate as high as you can has profound anti-inflammatory and brain supporting effects. Just be sure not to over train as that produces more inflammation. Also, how you get your heart rate up depends on your fitness level and abilities, so keep it safe and doable.
Other tools to tame inflammation include therapeutic doses of vitamin D3, omega 3 fatty acids, absorbable forms of glutathione, and therapeutic doses of emulsified resveratrol and curcumin. These compounds have been shown to dampen the the inflammatory vicious cycles associated with autoimmune and chronic disorders.
Of course, lifestyle and diet changes are vital too. This includes eliminating pro-inflammatory foods with the autoimmune diet and designing an inflammation-quenching lifestyle.
For help taming your chronic inflammation and autoimmune disorder, ask my office for advice.
Until Next time,
I’m Dr. Craig Mortensen
Be healthy, Be happy.