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6 Reasons NSAIDs Are Harmful To Your Gut

January 30th, 2020

Headache, fever, muscle aches, back pain, and joint pain. Many people immediately reach for over-the-counter Advil or Motrin, or pharmaceutical Celebrex or Feldene and other non-steroidal anti-inflammatory drugs (NSAIDs) to get fast relief from the discomfort of these symptoms. However, these over-the-counter medications are not the miracle cures they are often touted to be. In fact, they have some serious side effects that could wreak havoc on your gut. They can actually lead to conditions that cause inflammation! Before you opt for an NSAID, let’s uncover the details pharmaceutical companies may prefer you don’t know and talk about natural solutions for a healthy inflammatory response such as liposomal curcumin and Omega-3s.

What Are NSAIDs?

Non-steroidal anti-inflammatory drugs are used in conventional medicine to treat inflammation, reduce pain — especially in the joints — and decrease fever. Unfortunately, many people will never even realize their troubles may be just beginning when they reach for these little pills. As I’ve often stated, inflammation is at the root of nearly every modern, chronic illness. And while these medications may reduce the symptoms of inflammation temporarily, they do not get to the root cause of what’s causing the inflammation in the first place. As you’ll see, they can even make it worse. 

However, NSAIDs are among the most widely used medications in the world. You may not even be aware that aspirin is on the NSAID list. Many of these are purchased at convenience stores, pharmacies, and grocers, however, prescription-strength varieties are responsible for about 5-10% of all medications prescribed each year.1 Millions of people are merely masking their symptoms while their inflammatory system is under ever-greater stress.

In fact, the dangers extend far beyond simply masking symptoms. The New England Journal of Medicine estimates that there are 16,500 NSAID-related deaths among patients with rheumatoid arthritis or osteoarthritis alone every year in the United States.2 That’s a sobering number. Let’s take a closer look at these common medications, how they can negatively impact your health, and the effective natural solutions you can opt for instead.

How Do They Work?

NSAIDs work by stopping the production of chemicals in your body called prostaglandins which promote inflammation, pain, and fever.3 They do this by blocking cyclooxygenases (COX) enzymes. These enzymes produce prostaglandins, yet they also protect your stomach and intestinal lining.4 This is why NSAIDs can damage your gut. The analgesic effect of NSAIDS isn’t fully understood, and there are various theories regarding how they reduce pain apart from blocking COX enzymes.5

Here are some common NSAIDs:

Prescription:
Oxaprozin (Daypro)
Celecoxib (Celebrex)
Diclofenac (Zorvolex)
Diflunisal (Dolobid)
Indomethacin (Indocin)
Ketoprofen (Orudis, Ketoprofen ER, Oruvail)
Ketorolac (Toradol)
Nabumetone (Relafen)
Piroxicam (Feldene)
Salsalate (Disalcid)
Sulindac (Clinoril)
Tolmetin (Tolectin)

Over-the-Counter:
Aspirin (Bayer, St. Joseph’s)
Ibuprofen (Advil, Motrin)
Naproxen (Aleve)

Each NSAID comes with a range of negative side effects, including damaging your gut. Those with kidney disease or kidney stones, heart disease, high blood pressure or liver disease, and those over age 65 or who take diuretic medications should be especially cautious about them. This is because they may cause an increased risk of sudden kidney failure and even progressive kidney damage.6

6 Ways NSAIDS Impact Gut Health

1. Bacterial Imbalance

It’s long been known that NSAIDS can cause bleeding, inflammation, and ulcers in the stomach and small intestine. However, recent research suggest that this is the result of dysbiosis, or changes in the gut microbiome balance brought on by these medications. Studies show that the combination of medications you ingest are reflected in the types of bacteria that populate your gut. In one study, celecoxib and ibuprofen users were discovered to have more enterobacteriaceae, which is a family of bacteria that includes E. coli, shigella and salmonella, as well as other disease-causing bacteria.7 Scientists believe that each type of NSAID can affect different bacteria in the gut, causing a different imbalance depending on which one you take. Because each person’s gut microbiome is unique, the effects may vary significantly from one person to another.

2. Digestive Discomfort

The most commonly reported side effects of NSAID use are gastrointestinal symptoms, including gas, feeling bloated, stomach pain, constipation and diarrhea because they disrupt the enzymes that protect your gut lining. One study showed that diarrhea due to NSAID use could last for up to six days after their use.8,9

3. Heartburn/GERD

GERD is short for gastroesophageal reflux disease. It’s a condition that develops when the contents of the stomach returns to the esophagus. The most common symptom is heartburn, one of the many risks of NSAIDS.4,10 GERD symptoms are significantly more common among NSAID users than non-users.11 Both these effects are caused by the fact that NSAIDs irritate the lining of your esophagus, as well as the intestinal lining.12 The symptoms may be so severe and acute that they feel like a heart attack.13

4. Gastrointestinal Ulcers and Bleeding

NSAIDs can cause ulcers and bleeding in the stomach because they block the Cox-1 enzyme and disrupt the production of prostaglandins, which protect your stomach from mucosal damage.14 These are some of the most common side effects of NSAID use. In fact, approximately 15% of patients who take NSAIDs long-term develop a peptic ulcer, which is a sore in the lining of the stomach, lower esophagus, or small intestine.15 The risk of bleeding ulcers doubles if you take aspirin with other NSAIDs.

5. Leaky Gut

NSAIDS not only cause leaky gut, they can be one of the greatest barriers to recovering from it because they increase your intestinal permeability, which means they make leaky gut worse.16 This means they widen the tight junctions in your gut cell wall that allow food particles and other toxins to enter your bloodstream. One study showed that even one 600 mg dose of aspirin was enough to increase intestinal permeability.17 Research on animals also shows that NSAIDs not only compromise your gut lining structurally, they also may cause gluten sensitivity.18

6. Acute Colitis and Autoimmune Disease

NSAIDs may also set off a chain reaction that leads to conditions such as ulcerative colitis and Crohn’s disease.19,20 NSAIDs are associated with hospitalizations for severe colitis in patients with inflammatory bowel disease (IBD), and relapses of IBD.21 This is due to the inflammation that they cause, as well as the leaky gut, which can let through food particles that are so similar to your body’s own cells that your immune system attacks your body.

The Functional Medicine Approach to Fighting Inflammation

It’s clear that NSAIDs should be avoided whenever possible for all those reasons. Here’s what I propose instead: reduce your inflammation by getting to the root cause and repairing your leaky gut, rather than simply masking the symptoms. I took this approach with thousands of patients in my functional medicine clinic and helped them return to optimal health, without relying on harsh medications. The four pillars of The Myers Way® will help you address the root cause of your inflammation.

Pillar One: Heal Your Gut
  1. Remove the bad including toxic and inflammatory foods and gut infections such as Candida overgrowth and SIBO.
  2. Replace what’s missing including digestive enzymes and stomach acid.
  3. Reinoculate your gut with high potency probiotics. Certain probiotics, including Lactobacillus casei,22 have been seen to support a healthy stomach lining.
  4. Repair your gut with healing foods such as bone broth or supplements like my Leaky Gut Revive®.
Pillar II: Get rid of gluten, grains, and legumes

I recommend that all of my patients remove gluten from their diets because it’s so inflammatory. I highly recommend removing all grains and legumes from your diet as well. Instead, enjoy a diet rich in grass-fed meats and wild-caught fish, as well as fresh, organic fruits and vegetables to support your gut and optimal health.

Pillar III: Tame the toxins

Reduce your exposure to other toxins. You may know to avoid pesticides, heavy metals, and toxic mold but you may not be aware that body care and cleaning products can also be dangerous. I cover this topic in much greater detail in The Autoimmune Solution.

Pillar IV: Heal your infections and relieve your stress

It’s very likely that you’ve been exposed at some point to the Epstein-Barr or herpes simplex viruses, which remain in your system and can cause problems many years down the road. I’ve found the most effective strategy is to support your immune system with The Myers Way® and prioritize stress reduction.

Take Natural Supplements, not NSAIDs

While you are addressing the root cause of your inflammation with The Myers Way® or any time your inflammatory system needs additional support, you can turn to natural substances that will support, rather than harm, your gut.

Liposomal Curcumin

Curcumin is the active compound in turmeric. Research suggests that curcumin can help promote a healthy inflammatory response. It can be useful in supporting your body in a wide range of oxidative and inflammatory conditions, including metabolic syndrome, arthritis, anxiety, and hyperlipidemia, which is an abnormally high concentration of fats in your blood.23 

My Liposomal curcumin is my #1 supplement recommendation to help modulate a healthy inflammatory response, and supports normal immune function, intestinal health, and liver function. The liposomal form solves the problem of poor absorption and bioavailability of typical  curcumin supplements by surrounding the curcumin molecule with a thin layer of fat from medium-chain-triglyceride (MTC) oil. This micelle “pocket” creates a liposome that is at least 5.6x more absorbable than most typical curcumin supplements available on the market today.

Omega-3s

Omega-3 fatty acids are essential nutrients. The three most important types are alpha-linolenic acid (ALA), docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). They can be found in fish, fish oils, flax seeds, chia seeds, flaxseed oil, and walnuts. Fish oil supports everything from luxurious hair, a healthy mood & cognitive function, to joint comfort, glowing skin, and a healthy heart, and is especially important in supporting your body’s inflammatory response.24 

Supercritical extraction, the method I use, is the very best way to extract fish oil because it ensures that heat, solvents and oxygen are not able to harm the oil. Fish oil is the world’s best and most bioavailable source of Omega-3 fatty acids EPA and DHA, which positively promote the production of inflammation-mediating proteins for a healthy inflammation response. 

My Complete Omega-3 Softgels contain 67% more DHA than my previous Omega-3 formula, and far exceeds international standards of purity. It supports healthy vision, mood and cognitive function, and is 170% more bioavailable than leading fish oil supplements.

To recap, NSAIDs have a wide range of side-effects that can harm your gut, particularly over the long term. They don’t even address the root cause of your inflammation, and can promote leaky gut, peptic ulcers and bleeding, digestive discomfort, heartburn and GERD, and autoimmune disease, as well as damage your microbiome. There are many natural ways to address inflammation, including healing your gut and introducing nutrients that support a healthy inflammation response, such as my Omega-3 softgels and liposomal curcumin.

Article Sources

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5772852/
  2. http://americannutritionassociation.org/newsletter/deadly-nsaids
  3. https://www.rxlist.com/nsaids_nonsteroidal_antiinflammatory_drugs/drugs-condition.htm
  4. http://americannutritionassociation.org/newsletter/deadly-nsaids
  5. https://www.ncbi.nlm.nih.gov/pubmed/8922554
  6. https://www.kidney.org/atoz/content/painmeds_analgesics#targetText=Nonsteroidal%20anti%2Dinflammatory%20drugs%20(NSAIDs,specific%20group%20of%20pain%20relievers.&targetText=NSAIDs%20may%20cause%20an%20increased,and%20even%20progressive%20kidney%20damage.
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4754147/
  8. https://my.clevelandclinic.org/health/drugs/11086-non-steroidal-anti-inflammatory-medicines-nsaids
  9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1774951/
  10. https://www.ncbi.nlm.nih.gov/pubmed/12190159
  11. https://www.ncbi.nlm.nih.gov/pubmed/18671778
  12. https://howtotreatheartburn.com/nsaids-heartburn-gerd/
  13. https://www.health.harvard.edu/diseases-and-conditions/does-heartburn-feel-like-a-heart-attack
  14. https://www.medicinenet.com/nonsteroidal_anti-inflammatory_drugs_and_ulcers/article.htm
  15. https://www.medicinenet.com/nonsteroidal_anti-inflammatory_drugs_and_ulcers/article.htm
  16. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5473116/
  17. https://www.ncbi.nlm.nih.gov/pubmed/22757650
  18. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0006472
  19. https://www.ncbi.nlm.nih.gov/pubmed/8739836
  20. https://www.ncbi.nlm.nih.gov/pubmed/26485106
  21. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4034022/
  22. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3422810/
  23. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5664031/
  24. https://www.ncbi.nlm.nih.gov/pubmed/28900017
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