Ibuprofen is a type of non-steroidal anti-inflammatory drug (NSAID) that is used to treat such conditions as fever, arthritic pain and inflammation. The drug has been on the market since the 1970s and has a generally favorable reputation because of its ability to be tolerated and have mild, short-lived effects. When used on occasion in the proper dose for severe inflammation, ibuprofen can be an effective regimen. Unfortunately, endurance athletes and weight lifters have been using the drug like candy, popping pills before their workouts to minimize pain, inflammation and soreness. This has caused some of the drug’s harmful side effects to surface and has put into question the safety and efficacy of ibuprofen use before workouts.
The Emergence of Ibuprofen Among Athletes
For athletes and regular gym-goers, finding ways to recover faster is the key to competing longer and harder. Athletes often believe that they don’t have the time to let their bodies recover on their own, which is why they turn to over-the-counter solutions such as ibuprofen. More athletes have been using ibuprofen and other NSAIDs before and after their competitions so that they can compete at the highest intensity. NSAIDs include naproxen sodium, aspirin and ketoprofen in addition to ibuprofen.
Even though workout fanatics may believe that ibuprofen allows them to work harder, work faster and heal quicker, ibuprofen has many dangers that can harm the body and end up causing more damage than good. New reports have studied the relationship between athletes and ibuprofen to determine whether or not ibuprofen minimizes soreness during and after workouts. What medical experts fear is that athletes are becoming too dependent on ibuprofen, self-medicating themselves before competitions and suffering unforeseen consequences.
It seems to be that recent studies are consistent with this theory. The best, most comprehensive real-life study was carried out by researcher David Nieman several years ago, as he studied runners who were competing in the 100-mile Western State Endurance Run. Nieman assessed 25 runners who didn’t take ibuprofen before the race and 25 runners who took ibuprofen in 600mg and 1200mg doses.
What Nieman found was startling. Those athletes who took the drug showed signs of kidney impairment and bacterial toxins in the bloodstream. What’s even more interesting is that the ibuprofen didn’t help with performance or recovery. The pain was the same as those who didn’t take the drug, and those who took the ibuprofen had 50 percent more inflammation in their bodies. 
If ibuprofen does more harm than good, then why are athletes so quick to take the pill? For many athletes, it’s simply misinformation and the good old placebo effect that keeps them taking ibuprofen. But to truly understand why ibuprofen has been so heavily relied on by athletes, we must delve deeper into the history of the drug.
The History of Ibuprofen
Ibuprofen was made by the Boots Group during the 1960s and was created from propionic acid. In 1961, the drug was patented and used to treat rheumatoid arthritis in the United Kingdom in 1969. It soon followed after in the United States in the mid-1970s. The drug went on to receive recognition, with its creators winning numerous awards for its discovery and ability to reduce hangover symptoms.
But ibuprofen didn’t stop there. In the 1960s, it was available with a prescription, but the drug continued to show that it had a good tolerability profile and was able to be used in a large percentage of the population. The safety and effectiveness of the drug led it to being offered as an OTC medication in pharmacies and supermarkets across the globe. Today, ibuprofen can be purchased over-the-counter in up to 200mg as recommended by the FDA. Patients can easily receive higher dosages with a written prescription, however.
Ibuprofen is generally used to treat pain and inflammation, but it can also be used to treat acne, severe low blood pressure when standing up and is associated with a lowered risk for Parkinson’s disease. However, more information is needed on the latter two because there are still many risks that could cause other problems in Parkinson and Alzheimer patients.
Nevertheless, ibuprofen has emerged successfully onto the market, and is often considered a low-risk drug that is safe to use for pain and inflammation. For these reasons, people have no problem reaching for ibuprofen to treat these symptoms. Unfortunately, medical professionals are starting to see problems from long-term ibuprofen use that we haven’t seen in the past, mainly because the drug has only been on the market since the 1970s.
How Ibuprofen Works
So how exactly does ibuprofen work in the first place? How did this drug gain such a popular reputation for itself over the past several decades?
Ibuprofen works on a group of chemical compounds called prostaglandins, which are also referred to as hormones. Prostaglandins have a wide range of effects, one of them being inflammation. For example, if you injure your muscles, your body creates protective mechanisms to repair the body. White blood cells build up at the site of the injury, and this is what will cause your muscles to be sore. What’s happening underneath the skin is that the white blood cells create swelling, heat, redness, fever and pain, all of which emerge as inflammation.
When you take ibuprofen, the drug has the ability to stop the production of prostaglandins that are responsible for controlling the inflammation response. Ibuprofen interferes with a compound called cyclo-oxygenase, thus slowing the production of prostaglandins. Therefore, when you take ibuprofen, the drug prevents the inflammation response from taking place, reducing the side effects of pain and soreness.
For athletes, the effects of ibuprofen are welcoming. When athletes need to compete, they want to feel better faster and be able to compete to their maximum potential. For years, athletes have believed that ibuprofen was their answer. They don’t just take the drug to treat pain and inflammation but also to prevent them. To these individuals, they may be minimizing soreness, but in reality, they’re preventing prostaglandins from doing their job in the body and creating a host of other side effects.
The Side Effects of Ibuprofen
Like any oral medication, there is a wide array of side effects than can be experienced from taking ibuprofen. These include dizziness, nausea, heartburn, stomach cramps and a rash. There are also less common side effects that include itching, ringing in the ears, bloating, indigestion, vomiting, gas, nervousness, head pain and problems with vision. Most side effects are mild if they do occur.
But it’s not the immediate side effects that medical professionals are concerned about. If you do suffer one of these side effects, you will most likely stop taking the drug and not use it again. What medical experts are worried about are the athletes that continue taking the drug and suffer the much more severe, long-term implications of NSAID use.
Consider that ibuprofen stops the production of prostaglandins, the hormones responsible for inflammation. Yet prostaglandins have many more effects on the body than just inflammation. They also help protect the lining of the gut and are imperative in the proper functioning of blood clotting. This is why NSAIDs are so highly linked to gut problems and reduced blood clotting, making bleeding more likely. Studies have also shown that those who take regular doses of ibuprofen have elevated levels of endotoxemia, which is the presence of endotoxins in the blood that can cause shock.
And while ibuprofen has gained a popular reputation for being well-tolerated and having low-risks, keep in mind that it sends 107,000 patients to the hospital each year for gastrointestinal problems, and at least 16,500 deaths occur that are related to taking NSAIDs, according to The American Journal of Medicine . What’s even more concerning is that the New England Journal of Medicine reported similar findings as the AJM and wrote that if there are 16,500 deaths among patients who take ibuprofen, this would be the same as all the deaths for asthma, multiple myeloma, cervical cancer and Hodgkin’s disease combined . Furthermore, if the deaths from gastrointestinal complications were counted separately, these effects would be the 15th most common cause of death in the U.S. However, mortality statistics do not include deaths that have been the result of OTC NSAIDs.
Other journals have published equally disturbing statistics. The Journal of Rheumatology reported that between 10,000 and 20,000 deaths occur from NSAIDs that are all centered on GI bleeding and complications. To much surprise, these journal articles have not been published in the last ten years. They were published in the early to late 1990s, and the numbers have gone unchanged. As long as people continue to rely on ibuprofen as a daily pill for pain and inflammation, the effects of GI bleeding, abdominal pain and even death will remain. Still, the problem goes under-appreciated. Doctors keep prescribing the drug and people keep taking it, despite the widespread problem that some call a “silent epidemic.”
Why Pain and Inflammation are Not the Enemies
For athletes, they often treat pain and inflammation as the enemies, when really, these are the body’s ways of telling you to rest and allow the body to repair itself. All ibuprofen does is pass over these effects so that they can be ignored.
Interestingly, it’s not always the big injuries that cause inflammation. Every week while you work out, your body triggers responses in the body that create inflammation, you just don’t know it because there are no outward signs. Yet the more you work out, the more your muscles adjust and get stronger, being able to adjust to inflammation. Small amounts of inflammation allow your tissues to be more resilient and your cells to handle oxidation and inflammation. Bottom line: inflammation fights infection and speeds up recovery. While not all inflammation is good for the body, it shouldn’t be looked at as the enemy.
Consider that as an athlete, when your body experiences pain and inflammation, it’s trying to tell you something. This pain is a warning sign that tells you to take it easy on the body and the muscles so that they can repair themselves. You’re supposed to stop working out and competing during this time, and by doing so, you’re actually making your body stronger and aiding in skeletal muscle proteins that are required for growth and repair. 
Furthermore, NSAIDs have been shown to have a slower effect on injured muscles, tendons and ligaments, which means you can heal faster without the use of medications. Fewer prostaglandins also mean less collagen, and collagen is needed to heal tissue and bone injuries that occur after workouts or competitions.  The bigger picture goes beyond taking ibuprofen for pain. Athletes should listen to their body and take the necessary steps to protect their bodies naturally when pain and inflammation do occur.
When Should Ibuprofen be Used?
Armed with this information, is ibuprofen ever safe to take? NSAIDs should be reserved for excessive inflammation – never as a daily pill. It should also never be taken before a workout to minimize pain and inflammation. We now have more information to show us that taking ibuprofen does not affect performance, and instead causes elevated levels of inflammation and cell damage. Instead, athletes should focus on proper warm-up routines, good sports nutrition and adequate hydration before, during and after workouts. These steps will keep you safer during competitions and reduce soreness in the muscle tissues.
Although ibuprofen is acceptable to take with extreme inflammation, always remember the side effects and the drug’s effects on prostaglandins. If you can deal with the pain in a natural manner, such as by applying ice and heat, you are better off treating the pain naturally. Athletes need to stop looking at ibuprofen and NSAIDs as a source of pain prevention. This ritual is one that leaves people damaged and living with long-term side effects such as chronic GI tract complications.