Ibuprofen: do you know your limits?

published in Reader's Digest,
02 March 2018

link to Reader's Digest article

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What do sunlight, alcohol and ibuprofen have in common? In small doses, they can be helpful, though some can take none at all; in large doses or taken for too long, they can be lethal.

The importance of ibuprofen

Just as sunlight strengthens bones and soothes certain skin conditions, whilst wine may be good for the heart, ibuprofen’s impact on period pain, fever and flu, swelling and stiffness, headache and backache, and bone pain in cancer is often impressive.

Broadly speaking, ibuprofen works to reduce inflammation, fever and pain by lowering levels of hormone-like agents known as prostaglandins. Released by nearly every tissue in the body, prostaglandins have potent positive effects, helping in healing, safeguarding the stomach from acid attack and causing contractions in labour. They can be pesky though: fever results when they reset your body’s thermostat; their ability to sensitise nerves and widen blood vessels triggers pain and inflammation.

When ibuprofen is inadvisable

Some people are allergic to sunlight, breaking out in blisters when exposed; others are alcohol intolerant, as a result of a genetic condition. For them, abstinence is advised.

One man’s meat is another man’s poison when it comes to ibuprofen too. Ibuprofen is inappropriate for those who are allergic to aspirin (since it belongs to the same family of drugs). It should also be avoided if you’ve got liver, kidney or heart problems, are pregnant or have had a stomach ulcer or stroke.

For those who do take ibuprofen, it’s safest to take the smallest possible dose for the shortest possible time to avoid unwanted side effects such as stomach ulcers and bleeds, nausea and constipation.

It’s safest to take the smallest possible dose for the shortest possible time.

The law of diminishing returns

Used in economics when talking about investments, this law refers to the point when further investment would not be wise, and may actually reduce your return from the investment.

It’s the same with sunshine, alcohol – and ibuprofen. Benefits bestowed by some rays of sun, a small glass of wine or a few ibuprofen pills can turn to sunburn and skin cancer, liver damage or, in the case of ibuprofen, a small increase in the risk of heart attack, heart failure and stroke (if it is taken at a high dose over a long period of time). Knowing when to stop is key: risk can soon outweigh the benefit.

Reasons for the heart and stroke risk with ibuprofen remain unclear, but it’s possible that the drug causes the kidneys to retain more salt and water, raising your blood pressure.

Falling fertility is another fear with ibuprofen: very recent research speculates that testosterone levels may drop in men after ibuprofen exposure. When taken during pregnancy, the future fertility of a developing daughter may be at risk as the ovaries are attacked.

Alternatives to ibuprofen

One alternative is still ibuprofen, but in gel form. This way, you receive pain relief, but less will be absorbed into the blood to cause side effects.

For some types of pain, it may be that you don’t need ibuprofen at all. Back pain, for example, may be better treated by gentle exercise, physiotherapy, stress reduction, a daily dose of vitamin D (made in the skin in response to sunlight) – and even a little alcohol? Scientists recently showed that alcohol may increase pain threshold and reduce pain intensity.

Sunlight, alcohol and ibuprofen may then be swappable when it comes to treating some pain – but it’s safest always to keep the dosage short and sweet.