Benjamin H. Natelson, M.D.
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 A new class of nsaids called Cox-2 inhibitors was developed to reduce this side effect. However, a number of large studies have found that these newer drugs have a higher rate of potentially lethal side effects, such as heart attack or stroke, than the old fashioned nsaids. Two of them—Vioxx and Bextra—have been taken off the market. Although Celebrex is still available, I think its risk for people taking it chronically outweighs any potential benefit over ibuprofen. Whether these toxicities extend to the older class of nsaids is currently not known but is a question undergoing research. |
Jonny Bowden, Ph.D., C.N.S.
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 While nsaids don't "cause" ulcers, it has been reported that 50 percent of patients who regularly take nsaids have some level of gastric erosion and as many as 15 to 30 percent have ulcers.
In early 2007, researchers at the Queen Mary's School of Medicine and Dentistry conducted a series of studies to determine whether zinc carnosine would help protect against the gut-eroding effects of the NSMD drug indomethacin. They treated volunteers with 150 mg of indomethacin every day for five days. But along with their NSMD, half the volunteers also received 75 mg of zinc carnosine a day. |
| Wobenzym N gives you the same effects as aspirin, ibuprofen, and nsaids without any of the side effects," Gordon says. "When you take nsaids [nonsteroidal anti-inflammatory drugs such as Advil], you're suppressing key parts of your body that could have helped you heal. With Wobenzym N you're getting at causes, not merely the suppression of the pain. The differences are dramatic."
Enzymes allow you to work with your body to suppress inflammation without allowing the damage and joint destruction to proceed. |
| He adds that in the majority of cases, "drug prescriptions for nsaids and muscle relaxants were virtually eliminated." (NSAIDs are over-the-counter nonsteroidal anti-inflammatory drugs like aspirin and ibuprofen.)
In addition to fibromyalgia, magnesium has been shown to affect kidney stones. In animal studies, you can induce kidney stones by reducing the amount of magnesium in the diet. Conversely, supplementing with magnesium— and ideally vitamin B6 at the same time—will prevent the recurrence of kidney stones. |
Tori Hudson, N.D.
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 Nonsteroidal anti-inflammatory drugs (NSAIDs) are also used to reduce blood loss, especially in women who have DUB but still have normal ovulation. When nsaids are taken during the episode of menorrhagia, the effect is a 20 to 50 percent reduction in blood loss. The following anti-inflammatories are usually given for the first three days of menses, or throughout the menstrual flow, and seem to have similar effects:
1. Ibuprofen: 600 mg every 6—8 hours
2. Naproxen sodium: 550 mg every 6—8 hours
3. Mefenamic acid: 500 mg first dose, then 250 mg every 8 hours
4. |
| Another category of nsaids includes meclofe-namate (Meclomen) and mefenamic acid (Ponstel). They have been available for more than 20 years and have been highly effective. They are used when cramps begin. COX-II inhibitors such as Celebrex have been very effective in the treatment of dysmenorrhea. However, some head-to-head trials with the other nsaids have not shown them to be more effective, and they are significantly more expensive and possibly have an increase in side effects. |
| Usually, when the oral contraceptives or the nsaids work, the practitioner will consider that the patient has primary dysmenorrhea, which is not associated with another pelvic disease. If the patient has a negative laparoscopy and oral contraceptives or nsaids do not help the dysmenorrhea, she may be carefully watched and administered intermittent narcotic medications under the ongoing supervision of a physician. Narcotic medications should be avoided when possible because of the potential for tolerance and abuse. They should be used only when other options and diseases have been excluded. |
Jonny Bowden, Ph.D., C.N.S.
See book keywords and concepts |
| While nsaids don't "cause" ulcers, it has been reported that 50 percent of patients who regularly take nsaids have some level of gastric erosion and as many as 15 to 30 percent have ulcers.
In early 2007, researchers at the Queen Mary's School of Medicine and Dentistry conducted a series of studies to determine whether zinc carnosine would help protect against the gut-eroding effects of the NSMD drug indomethacin. They treated volunteers with 150 mg of indomethacin every day for five days. But along with their NSMD, half the volunteers also received 75 mg of zinc carnosine a day. |
Benjamin H. Natelson, M.D.
See book keywords and concepts |
| However, a number of large studies have found that these newer drugs have a higher rate of potentially lethal side effects, such as heart attack or stroke, than the old fashioned nsaids. Two of them—Vioxx and Bextra—have been taken off the market. Although Celebrex is still available, I think its risk for people taking it chronically outweighs any potential benefit over ibuprofen. Whether these toxicities extend to the older class of nsaids is currently not known but is a question undergoing research. |
Thomson Healthcare, Inc.
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 One patient taking OEP reported side effects, in contrast to none with topical nsaids. Acceptability rates for OEP and nsaids were 68% and 96%, respectively (Qureshi & Sultan, 2005).
More favorable results for Evening Primrose were obtained in a retrospective study covering seven years, in which 556 women with cyclical breast pain (mastalgia) were tracked. Most women were initially treated with Vitamin B-6 (pyri-doxine HCL) 100 mg daily for a 3-month period. Those who did not respond were given 3 g of Evening Primrose Oil daily for 1 month followed by 2 g daily for an additional 2 months. |
| After three months of treatment, patients were asked to decrease their use of nsaids but to maintain their level from 12 to 15 months. There was a significant reduction in the dose of nsaids used by both the Evening Primrose oil group (p<0.003) and the Evening Primrose oil plus fish oil group (p<0.002). No significant changes were seen in clinical or laboratory measurements in the study. The subjective improvement was also higher in the two treatment groups compared to placebo (Belch et al, 1988).
Cancer
Thirty-eight females with locally advanced or metastatic breast cancer receiving 2. |
Mike Adams, the Health Ranger
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 After all, nsaids are still legal, and they kill five times as many people each year as all the terrorist-related deaths ever recorded on American soil. If nsaids were, say, a Chinese herb, they would have been banned long ago, and armed FDA agents would have raided all the stores carrying inventory in order to "protect Americans." But nsaids remain legal for one reason only: they're profitable.
As I've said before, if all the people who died from over-the-counter drugs in America were to rise from their graves and march on Washington, the demand for change would be unstoppable. |
Andreas Moritz
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 Aspirin and other nsaids can affect the ability of blood vessels to expand, and may also cause sodium retention—two factors that can both raise blood pressure.
In the same context, COX-2 inhibitors—prescription arthritis drugs designed to be safer than NSAIDS— have been found to actually raise heart attack risk and cause strokes.
Based on the results from these studies, the treatment of heart failure should not involve the use of drug-based blood thinners, such as aspirin. |
Bill Sardi
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 NSAIDs include aspirin, ibuprofen and naproxen. More recently, because nsaids can cause stomach irritation potentially leading to bleeding ulcers, a newer class of prescription non-steroidal anti-inflammatory drugs called COX-2 inhibitors (Celebrex, Vioxx) were approved which were widely touted to reduce these risks.
However, upon further examination, the benefits of COX-2 inhibitors with regard to stomach symptoms appear quite small. While there is a reduction in small ulcers compared to standard non-steroidal drugs, these small ulcers are not clinically important. |
Hyla Cass, M.D.
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 THE HEALTHY JOINT SUPPLEMENT PROGRAM
To replace depletions from nsaids, as well as addressing the underlying deficiencies and inflammation, you can take the following supplements as needed. |
Bill Sardi
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| More recently, because nsaids can cause stomach irritation potentially leading to bleeding ulcers, a newer class of prescription non-steroidal anti-inflammatory drugs called COX-2 inhibitors (Celebrex, Vioxx) were approved which were widely touted to reduce these risks.
However, upon further examination, the benefits of COX-2 inhibitors with regard to stomach symptoms appear quite small. While there is a reduction in small ulcers compared to standard non-steroidal drugs, these small ulcers are not clinically important. |
Marshall Editions
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 Narcotic analgesics can be used in appropriate individuals for 48 hours prior to using nsaids. Skeletal muscle relaxants such as cyclobenzaprine (Flexeril®) may be helpful for severe spasm. Local and epidural injections sometimes alleviate chronic back pain.
TRADITIONAL CHINESE MEDICINE
Herbs: In general, you do not have to take herbal medicine for a backache. |
| Returning to normal activity is encouraged, generally while taking nsaids to reduce inflammation and encourage healing.
Neck support: A soft cervical collar can provide an injured neck with good support. However, patients are encouraged to restore the neck's range of motion, and collars should not be used for more than two weeks.
TRADITIONAL CHINESE MEDICINE
Herbs: Consult a doctor of Chinese medicine for advice on whether herbal medicine is appropriate, and to determine the best formula for your individual condition. |
Andreas Moritz
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| A recent study published in the Annals of Internal Medicine showed that use of nsaids such as aspirin and ibuprofen increased the risk of high blood pressure (HPP) by nearly 40 percent. Similar use of acetaminophen was found to increase HBP risk by 34 percent.
The following list provides you with alternative solutions to pain management, without interfering with the body's own efforts to heal itself:
• Boswellia (Boswellia serrata) is an Ayurvedic herb. It alleviates pain and improves mobility in people with arthritis. |
Hyla Cass, M.D.
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| This is why blocking it with nsaids can cause ulcers and bleeding. Selective COX-2 inhibitors like Vioxx and Celebrex block only COX-2.
Despite drug companies' highest hopes, it turns out that blocking only COX-2 doesn't eliminate the risk of GI bleeding. And, blocking only COX-2 affects the clotting of blood and flexibility of blood vessels in ways that bring about an increased risk of heart disease.
In a nutshell, we know now that the newer COX-2 inhibitors are all likely to increase cardiovascular risk. |
Andreas Moritz
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| NSAIDS. In the U.S., the fatality figure is up to five times as high as it is in the U.K. Each year, hundreds of thousands of people are hospitalized due to gastric bleeding caused directly by taking NSAID's. Other side effects include perforation of the colon, colitis, Crohn's disease, blurred vision, Parkinson's disease, liver and kidney damage, hepatitis and hypertension. |
Hyla Cass, M.D.
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| Since this discovery, many of the older nsaids have been implicated in raising heart disease risk as well. This means tough choices for people who need help with arthritis pain or other kinds of muscle or joint pain.
WHAT IS ARTHRITIS?
The word arthritis means "inflammation of the joints" and can include several types. Osteoarthritis (OA) is the most common—the kind of arthritis that often afflicts people in the knees, fingers, hips, or back as they age or because of wear and tear. |
| The NSAID Catch-22
Another adverse effect of NSAIDs: they inhibit the action of enzymes that are needed to create healthy cartilage. Essentially, this means that the drugs used to relieve arthritis-related discomfort accelerate the progression of the disease.
One study of people with knee arthritis found that 47 percent of those taking the NSAID indomethacin got worse, as opposed to only 22 percent of those on placebo. |
Marshall Editions
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| NSAIDs should not be taken by anyone with a peptic ulcer, as they may cause gastric irritation or bleeding. Acetaminophen is another treatment option, but do not take this drug if you have liver disease or if you drink alcohol regularly. Aspirin can also lower a fever, but again, the potential for gastric irritation is high in susceptible individuals. Aspirin should not be given to anyone under 16 years of age.
Keep cool: Drink cool beverages to relieve any symptoms of dehydration that may occur with a fever. Dehydration may be the cause of the fever, and rehydrating may resolve it. |
Hyla Cass, M.D.
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| Be consistent; if you use nsaids on an ongoing basis, your body needs daily replenishment to ensure that levels remain in an optimal range.
There have been warnings about vitamin C causing kidney stones, but further research has shown this to be untrue. For more information on vitamin C, see my User's Guide to Vitamin C (Basic Health Publications, 2003).
OTHER NUTRIENTS AND HERBS FOR PEOPLE WITH OSTEOARTHRITIS
Nutrition can play quite a helpful role in managing your arthritis. |
Bottom Line Health
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| Aspirin and other nsaids may trigger an attack.
If you have liver disease or drink more than three alcoholic beverages a day: Take aspirin or another NSAID. Acetaminophen can harm the liver in some people.
Important: Don't give aspirin to anyone younger than age 15—it can cause Reye's syndrome, a potentially life-threatening condition that causes swelling of the brain and degeneration of the liver.
Myth 5: A fever means you're contagious. Not so. A person who has an upper respiratory tract infection may be contagious early on, when he/she has a runny nose but no fever. |
Ray D. Strand
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 Unlike nsaids and aspirin, glucosamine does not simply cover up the pain but rather helps to rebuild the damaged cartilage. Early studies showed short-term benefits of the use of glucosamine sulfate; however, most physicians remained unimpressed.5
In 1999 a three-year, large, randomized-sample, placebo-controlled, double-blind clinical trial (the sort of studies doctors really like) was reported at the Annual Meeting of the American College of Rheumatology. |
| It is exciting to discover my patients who decide to take glucosamine eventually hardly ever need to take their nsaids. When they are willing to add the antioxidants, minerals, essential fats, and grape-seed extract, they do even better.
I'm not alone in my convictions. Many of my orthopedic friends support the use of glucosamine too, since they realize that being able to delay a joint replacement is ultimately in the patient's best interest.
Chondroitin Sulfate
Chondroitin sulfate is often combined with glucosamine sulfate to create a one-two punch. |
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